Diagnostics technique for active opium addiction in patients with chronic viral hepatitis type c

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to gastroenterology. Diagnosing active opium addiction in patients with chronic viral hepatitis type C is ensured by evaluating: basal, stimulated level and stimulation index of tumour necrosis factor α (TNF-α); basal and stimulated level of interferon-γ (IFN-γ); stimulation index of interleukin-2 (IL-2); basal level of interleukin-4 (IL-4) If basal TNF-α is 12 pg/ml to 50 pg/ml, stimulated TNF-α is 15 pg/ml to 80 pg/ml, TNF-α stimulation index is 0.65 to 1.78, basal IFN -γ is 20 pg/ml to 22 pg/ml, stimulated IFN -γ is 20 pg/ml to 22 pg/ml, stimulation index of IL-2 is 1 to 1.45, basal IL-4 is 9.1 pg/ml to 11.8 pg/ml, active opium addiction is diagnosed.

EFFECT: technique provides higher accuracy of diagnosing active opium addiction in patients with chronic viral hepatitis type C.

3 ex, 1 tbl

 

The invention relates to medicine, in particular gastroenterology, and can be used to diagnose the current opium addiction in patients with chronic viral hepatitis C.

Currently, up to 90% of young people infected with chronic viral hepatitis, ill by injecting drug use. Formed the concept of drug addicts epidemiological process in chronic viral hepatitis C[1, 2, 3, 4]. Causing hepatitis viruses identified in patients with drug addiction and often in combination with toxic effects of opiates cause of chronic liver disease [5, 6]. Mainly in the younger age group (15-29 years), usually with markers concomitant viral infection is HCV+HBV [7, 8, 9]. Drugs according to the number of works reinforce biochemical, microcirculation, immunological and morphological violations in viral hepatitis. [1, 6, 2, 9].

Given the immune mechanisms of liver damage in chronic viral hepatitis C, immunosuppressive and toxic effects of opiates, young age of the patients and severe outcomes of chronic viral hepatitis, undoubtedly, extremely pressing problem objective diagnosis of the current opium addiction.

Currently, there is extensive material, indicating g Ubykh changes of immunological reactivity in patients suffering from opium addiction. With the use of opioids is associated with more severe liver disease by reducing blood CD3+, CD4+, CD8+, a decrease in the ratio of CD4+/CD8+ [10], note immunological disorders with predominant disturbance of T-cell immunity, which is accompanied by a significant decrease of CD3+ and CD4+ lymphocytes [11].

In the analysis of the literature found only a few work with performance evaluation of cytokines in chronic viral hepatitis C in the background of opium addiction, which are contradictory [12, 13, 14]. So, Dchkmrmy (2002) a characteristic feature of the immune status of patients, drug abusers with chronic viral hepatitis type b and b+C is an increase in the indicators of humoral immunity and increased concentrations of proinflammatory mediators and indicators of T-cell component differed little from the results obtained in patients who have not used drugs [12]. In the work Vourable (2002), on the contrary, patients with opium addiction serum level of tumor necrosis factor-α were not significantly different from the healthy group, serum levels of interleukin-2 and interleukin-4 was increased in two and four and a half times, respectively, and in the induction of cytokine synthesis by lipopolysaccharide (LPS) of E. coli LPS-induced synthesis of factor necrosis of the tumor-α oppressed by almost 2 times. [13]. According to Nvisual (2002) individual indicators of activity of IFN-γ were equally low in patients with isolated chronic viral hepatitis C, and on the background of opium addiction [14]. However, not every work compared the performance of cytokine metabolism in patients with chronic viral hepatitis C with similar indicators for viral process on the background of opium addiction. The authors of famous works did not think to diagnose the current opium addiction in patients with chronic viral hepatitis C.

Approaches to the treatment of chronic viral hepatitis C for the purpose of antiviral therapy require abstinence, duration of which shall be not less than six months. To address the question about the purpose of the treatment is very important to objectively assess the presence or absence of abstinence, which is dedicated to our diagnostic method.

New technical problem - a method of diagnosis of the current opium addiction in patients with chronic viral hepatitis C.

To solve the problem in the diagnostic method of the current opium addiction in patients with chronic viral hepatitis To determine basal, stimulated level and the stimulation index of tumor necrosis factor-α (TNF-α), basal and stimuleren the config level of interferon-γ (IFN-γ), the stimulation index of interleukin-2 (IL-2) and the basal level of interleukin-4 (IL-4) and at the basal TNF-α from 12 PG/ml to 50 PG/ml, stimulated TNF-α from 15 PG/ml 80 PG/ml, index, stimulation of TNF-α from 0.65 to 1.78, basal IFN-γ from 20 PG/ml to 22 PG/ml, stimulated IFN-γ from 20 PG/ml to 22 PG/ml, stimulation index IL-2 from 1 to 1.45, basal IL-4 from 9.1 PG/ml to 11.8 PG/ml diagnose the current opium addiction.

The method is as follows. When handling patient diagnosed with chronic viral hepatitis C levels were measured at basal, stimulated TNF-α, the index of stimulation of TNF-α, basal and stimulated IFN-γ stimulation index IL-2, the basal level of IL-4.

Determination of the levels of TNF-α, INF-γ, IL-2, IL-4 supernatant cultured mononuclear cells was performed using a solid-phase immunoenzymatic "sandwich" method. The basis of this identification is the conjugation of one epitope of a molecule cytokine mouse monoclonal antibody, adsorbed on the solid phase of the microtiter plate. Procedure perform the immunoassay was performed according to the instructions offered by manufacturers of test systems ("Procon", Russia; "Cytimmune, USA).

To obtain supernatants selected mononuclear cells resuspendable in complete culture medium consisting of 90% RPMI-1640, 1% inactivated (at 56°C for 30 min) fetal calf serum - (ICN Biomedicals Inc., USA), 280 mg/l L-glutamine, 100 mg/l gentamycin and 2 mm/l HEPES ("Flow", UK). Standardized the number of cells in suspension to 2.0×106/ml For stimulation of the secretory ability of lymphocytes in the sample made phytohemagglutinin (PHA) ("Difco, Germany) at a concentration of 0.01 mg/ml of culture. Cell suspension in 2 ml were incubated at 37°C and 5% CO2within 24 hours After incubation, the tubes were shaken, centrifuged 10 min at 1500 rpm, the supernatant was collected and used for the quantitative determination of the concentration of cytokines [15].

To study the ability of mononuclear white blood cells to produce INF-γ in wells pre-washed microplate was made in 200 µl "About dose and standards INF-γ with known concentrations. In the remaining cells were placed in 100 ál of supernatant and phosphate buffer were incubated for 1 h at 37°C. After three times washing cycle in the wells of the microplate was added 200 μl of the second antibody and incubated for 1 h at 37°C. Three times washing the plate with buffer in each cell was made in 200 ál conjugate of horseradish peroxidase with antivirovym polyclonal antibodies and were placed in a thermostat at 1 h After triple rinse cycle in the wells was added 200 μl of the substrate solution with the dye. After 15-20 min of incubation in a dark place at room is based temperature was brought to 50 μl of stop solution (0.5 M sulfuric acid).

To assess levels of TNF-α, IL-2 and IL-4 by using the pipettor was added 100 μl of "0 dose" and standards of these cytokines with known concentrations in the corresponding cells pre-washed with buffer microplate. In the remaining wells were made supernatant in a volume of 100 μl and incubated for 1 h at 37°C. After several washing cycles in each cell was added by 100 (to determine TNF-α and IL-4) and 200 (IL-2) μl of the solution of the second antibody and conducted a one-hour incubation at 37°C. after Washing the plates buffer and distilled water in each well was made by 100 (TNF-α and IL-4) and 200 (IL-2) ál conjugate with streptavidin horseradish peroxidase and incubated for 30 min at 20-25°C (TNF-α and IL-4) and 1 h at 37°C (IL-2). After incubation, washing the microplate, each well was added 100 (TNF-α and IL-4) and 200 (IL-2) μl of the substrate solution with the dye. After 10-15 min the wells were made in 50 µl of stop solution.

Analysis immunofermentnogo analysis was made by using a microplate photometer for "Multiscan EX ("ThermoLabSystems, Finland) at a wavelength of 450 nm. The concentration of cytokines was calculated based on the calibration curve.

When the value of the basal TNF-α from 12 PG/ml to 50 PG/ml, stimulated TNF-α from 15 PG/ml 80 PG/ml, index, stimulation of TNF-α from 0.65 to 1.78, basal IFN-γ from 20 PG/ml to 22 PG/ml, stimulated IFN-γ from 20 PG/ml to 22 PG/ml, index STI is ulali IL-2 from 1 to 1.45, basal IL-4 from 9.1 PG/ml to 11.8 PG/ml was diagnosed with a valid opium addiction.

Proposed criteria selected on the basis of the analysis of the results of clinical observations of patients suffering from chronic viral hepatitis and chronic viral hepatitis C in the background of opium addiction. A survey of 49 patients with chronic viral hepatitis C, 16 of which came up with the main group and were opium addicts with a maximum duration of abstinence for 2 months. They all had positive PCR for HCV. Age of surveyed ranged from 18 to 48 years (mean age of surveyed to 28.2±5,1 years), men were 40 (81,6%), women - 9 (18.4 per cent). The time of inclusion in the study - verification in the hospital EDO Tomsk chronic viral hepatitis C and the fact that the system of regular intravenous use of opiates according to the anamnesis. Some patients (7 people), used drugs, when the survey was in a state of abstinence (with a maximum duration of 2 months), other (9 persons) studies were conducted in patients receiving opiates that were confirmed positive test for the presence of opiates in urine. In all cases, as the drug was used raw opium. All patients in the group of opium addicts enzyme-linked immunosorbent assay (ELISA) was determined markers of acute VIR is red hepatitis b in the form of isolated HB cor AT(IgG) and active HCV infection. The duration of drug use ranged from 2 to 14 years (average duration of opium addiction 6±3,4 years), duration of infection ranged from 2 to 14 years (mean duration of HCV infection of 7.3±3.6 years). From the study were excluded patients for whom alcohol was isolated toxic factor in the presence of chronic viral hepatitis C patients with antiviral treatment in history, with severe comorbidity that could influence the severity of liver damage, prevent the abuse of drugs.

Two patients with isolated chronic viral hepatitis With in his youth (12 and 10 years ago) had single episodes of injecting drugs, which caused the infection.

All patients were determined basal and stimulated levels of TNF-α, the index of stimulation of TNF-α, basal and stimulated levels of IFN-γ, the stimulation index IL-2 and basal level of IL-4. Healthy adult volunteers (15 men) were evaluated by basal and stimulated levels of TNF-α, basal and stimulated levels of IFN-γ and the basal level of IL-4.

To perform statistical processing of the actual material used statistical package SAS 8.0 (SAS Inc., USA). Tested but malnoti the actual distribution of the data was performed using criterion Shapiro-Fork. The results are presented as median, lower and upper quartiles (Me, Q1-Q3), and the average ± standard deviation (M±SD).

Comparisons of independent samples, when the number of groups = 2 in the case of normal distribution and equal variances in the groups used the t-student test for independent observations or criterion Aspera-Walcha when unequal variances; when the deviation of the distribution from the normal criterion was used Mann-Whitney. Statistically significant were considered differences at p<0,05.

When analyzing the results (see table 1, which presents the data content of immunocytokines in supernatant (PG/ml) in patients with isolated chronic viral hepatitis With and against the background of opium addiction (Me; Q1:Q3)).

Received that patients with chronic viral hepatitis C, was pronounced immunosuppression in comparison with healthy volunteers, but the opium addicts was significantly lower indicators of immune status in comparison with Zdorovie volunteers, and in comparison with isolated chronic viral hepatitis C. In patients suffering from opium addiction, the resulting combination of extremely low levels of cytokines. The values of basal TNF-α was in the range of from 12 PG/ml to 50 PG/ml, with imporoving TNF-α - from 15 PG/ml 80 PG/ml, index, stimulation of TNF-α from 0.65 to 1.78, basal IFN-γ from 20 PG/ml to 22 PG/ml, stimulated IFN-γ from 20 PG/ml to 22 PG/ml,

16
Table 1
IndicatorsHealthy donorsHug-Drug abuseP porn.
123
NMeNMeNMe
IFN-γ basal15112,5933100,01620,5p1-3<0,001,
level104,8:126,621,5:14520:22p2-3=0,005
IFN-γ stimulus-th15280,233180,01620,0p1-2<0,001,
level257,9:305,222:31020:22p1-3<0,001,
p2-3=0,001
TNF-α basal15113,883338,751620,0p1-2<0,001,
levelan 80.2:137,530:12512:50p1-3<0,001,
the p2-3=0,003
TNF-α stimulus-th15410,2433125,01630,5p1-3<0,001,
level102,6:465,266:27115:80p2-3<0,001
TNF-α, the index of--332,0161,16p2-3=0,001
stimulation1,33:2,870,65:1,78
IL-2, index--331,81,31p2-3=0,001
stimulation1,41:3,671:1,45
IL-4 basal1561,083344,01610,6p1-2<0,001,
level49,18:73,219,9:749,1:11,8p1-3<0,001,
p2-3=0,026

the stimulation index IL-2 from 1 to 1.45, basal IL-4 - from 9.1 PG/ml to 11.8 PG/ml, which allowed to say that they use opiates.

The examples on the implementation of the method

Example 1

In the gastroenterology Department Bureau of Tomsk received the pain is Oh 21 years with complaints of weakness, pain in the right upper quadrant of the pull of nature, recurrent furunculosis. The use of opiates denied, at the age of 19 years diagnosed with chronic viral hepatitis C. Zloupotreblenie alcohol, drugs denied, antiviral treatment is not received. The patient is asked to assign him antiviral therapy. Objective examination revealed a body temperature rise up to 37,3°C, hepato - and splenomegaly. In the biochemical analysis of blood showed increased AST to 53 u/l, increased bilirubin level to 28.3 μmol/L. Diagnosed with kidney damage in the form of mixed forms of glomerulonephritis. In the serum was determined markers of viral hepatitis In and With, with the presence of active HCV infection in combination with serological markers of HBV in the form of "isolated" Hbcor AT (IgG). When examining immunity detected T-cell immunodeficiency (absolute lymphopenia, low content of Mature T-lymphocytes),reducing immunoregulatory index, inhibition of nonspecific link protection (low number of natural killer cells), increase in the number of lymphocytes with increased apoptotic readiness and high activity of humoral immunity (IgM 1.3 g/l), elevated amounts of circulating immune complexes (CIC) to 68 Units.

Indicators of cytokine currency were following and basal level of TNF-α - to 12.0 PG/ml, stimulated the level of TNF-α to 15.0 PG/ml, the stimulation index of TNF-α of 0.65, the basal level of INF-γ to 20.0 PG/ml, stimulated the level of INF-γ to 20.0 PG/ml, the stimulation index IL-2 to 1.0, the basal level of IL-4 and 9.1 PG/ml

According to the proposed method in this patient diagnosed acting opium addiction, which was confirmed by a positive test for the detection of opiates in urine, the data of anamnesis, the subsequently received from relatives. Using our method was diagnosed acting opium addiction that caused the denial of antiviral therapy for this patient. The patient was explained about the need to give up the harmful habit and a possible meeting with the purpose of treatment 6 months after rejection drugs. However, after this period the patient did not return. Relatives say he, unfortunately, continues to opiates.

Example 2

In the gastroenterology Department Bureau of Tomsk received patient 27 years old with complaints of pain in the right upper quadrant of the pull of nature. Drug addiction at the time the appeal was denied, but argued that the cause of his infection, chronic viral hepatitis C at the age of 22 was intravenous use of opiates, clearly the duration of abstinence to call but could not, was insecure, razdrazhitel is h, however, expressed an active desire to receive antiviral therapy. Zloupotreblenie alcohol, drugs denied, antiviral treatment is not received. According to the data of objective examination revealed hepatomegaly. In the biochemical analysis of blood revealed no pathology. Indicators of immunity testified to the presence of T-cell immunodeficiency, reducing immunoregulatory index, nonspecific inhibition of link protection, the increase in the number of lymphocytes with increased apoptotic readiness, povyshenie activity of humoral immunity (IgM 1.6 g/l) and complexation (level CEC 128 Units). Indicators of cytokine exchange were as follows: basal level of TNF-α - 50,0 PG/ml, stimulated the level of TNF-α - 80,0 PG/ml, the stimulation index of TNF-α is 0.9, the basal level of INF-γ to 20.0 PG/ml, stimulatory the level of INF-γ - 21,0 PG/ml, the stimulation index IL-2 - 1,28, the basal level of IL-4 and 11.8 PG/ml

According to the proposed method is diagnosed acting opium addiction, which was confirmed by the information obtained subsequently from relatives that the patient within five years of regular use of opiates, but opium addict himself does not recognize. Given that these indicators cytokines consistent with the current opium addiction, the patient was explained to the heart and soul is the need to abandon the drug and the duration of abstinence at 6 months to apply for the appointment of antiviral therapy. The patient turned 6 months, but, unfortunately, the values of cytokines he had the same, i.e. extremely low. The current opium addiction was also confirmed by a positive test for the presence of opiates in urine. The patient re-explained the need to take drugs. More patient did not return - relatives say he continues to opiates.

Example 3

In the gastroenterology Department Bureau of Tomsk received a 24-year patient with complaints of fatigue, pain in the right upper quadrant of the pull of nature. From history revealed that 16 years intravenous use of opiates, at the age of 17 years diagnosed with chronic viral hepatitis C. Zloupotreblenie alcohol, drugs denied, antiviral treatment is not received. The patient is asked to assign him antiviral therapy. In the last two months of narcotic substances are not used. Objective examination revealed hepatomegaly. In the biochemical analysis of blood revealed a twofold increase in Alat. In the serum was determined markers of viral hepatitis In and With, with the presence of active HCV infection in combination with serological markers of HBV in the form of "isolated" Hbcor AT (IgG). When examining immunity absolute identified lymphopenia, low content of Mature T-lymphocytes, reducing immunoregulatory index, low number of natural killer cells, an increase in the number of lymphocytes with increased apoptotic readiness and high activity of humoral immunity (IgM 2.3 g/l), increasing the level of the CEC to 85 Units. Indicators of cytokine exchange were as follows: basal level of TNF-α - 17,0 PG/ml, stimulated the level of TNF-α - 17,0 PG/ml, the stimulation index of TNF-α - 0,74, the basal level of INF-γ to 20.0 PG/ml, stimulatory the level of INF-γ to 20.0 PG/ml, the stimulation index IL-2 to 1.0, the basal level of IL-4 is 10.4 PG/ml immune status Data with extremely low values of cytokines: the value of the basal TNF-α was in the range of from 12 PG/ml to 50 PG/ml, stimulated TNF-α in the range from 15 PG/ml 80 PG/ml, index, stimulation of TNF-α from 0.65 to 1.78, basal IFN-γ from 20 PG/ml to 22 PG/ml, stimulated IFN-γ from 20 PG/ml to 22 PG/ml, stimulation index IL-2 from 1 to 1.45, basal IL-4 - from 9.1 PG/ml to 11.8 PG/ml was allowed to diagnose a valid opium addiction. The patient explained that for purposes of therapy, duration of abstinence must be at least 6 months. Six months later, the patient is asked again. Values cytokines were as follows: basal level of TNF-α - 64,0 PG/ml, stimulated the level of TNF-α - 150,0 PG/ml, the stimulation index of TN is-α - 2,34, the basal level of INF-γ by 30.0 PG/ml, stimulatory the level of INF-γ - 59,0 PG/ml, the stimulation index IL-2 and 1.8, the basal level of IL-4 is 22.4 PG/ml, the Patient is prescribed antiviral therapy and received positive effect.

Just acting opium addiction was diagnosed in 9 patients and was confirmed in 7 patients, which was confirmed by data from the survey of relatives and in the absence of abstinence - positive tests for the determination of opiates in urine.

Thus, the proposed method allows to diagnose the current opium addiction with a sufficient degree of accuracy that allows you to choose the right medical tactics in the treatment of this category of patients.

Sources of information taken into account when drafting

1. Kozhevnikova G.M. Epidemiological and clinical features of acute viral hepatitis b and C among drug users: author. dis. Dr. med. Sciences / Gemchuginka. - M., 2000.

2. Liver drug addicts / Aselinos, Lyulchenko, Temzelides etc. // Therapeutic archive. - 1999. No. 9. P.39-44.

3. The Semka VA Prevalence, disease variability and clinical-psychological aspects of opium addiction in the Tomsk region / Vasenka, Nahan, Aiginger // Narcology. - 2002. No. 7. - P.20-23.

4. Chuikov SURDS Current epidemiology and prevention of viral is Ipatiev b and C in the Tomsk region / Ciechanow // Siberian journal of medicine. - 2000. No. 3. - P.27-29.

5. Loginov A.S. Gastroenterology yesterday, today, tomorrow / Ascogenous // Therapeutic archive. - 2000. No. 2. - P.5-7.

6. Masevich CG, Ermolaeva, L.G. Clinical, biochemical and morphological features of chronic hepatitis of different etiology / Cgisessid, Lgemoawo // Therapeutic archive. - 2002. No. 2. - P.35-37.

7. Ivashkin V.T. State and prospects of development of gastroenterology / Wtihin, Fearow // Therapeutic archive. - 2002. No. 2. - P.5-8.

8. Bondarenko A.L. Adverse prognostic immunological and immunogenetic factors in the formation of cirrhosis in patients with chronic hepatitis C / Alejandrina, Savarina // Russian journal of gastroenterology, Hepatology, Coloproctology. - 2004. No. 4. - P.54-58.

9. Tomica G.S. Viral hepatitis coinfection etiology of drug abuse: author. dis. Dr. med. Sciences / G.S., Tomika. - Moscow, 2001. - 40 S.

10. The relationship between the activity of hepatitis, liver fibrosis and immune status in children with chronic viral hepatitis b+C / Pentelikon, Nigeriaa, Gayanov, Wasserweg // Journal of Microbiology, epidemiology, immunology. - 2004. No. 2. - P.50-56.

11. Clinical and laboratory features of hepatitis C in drug-addicted patients younger / Eaaooneee, Evitare, Samersova, Oisca, Avilesandres // the Bulletin In which LGA. - 2007. No. 4 - C.

12. The same DH cytokines and the immune status of patients with viral hepatitis C and co-option of hepatitis C+: author. dis. Kida. Biol. Sciences / Dchkmrmy. - Novosibirsk, 2002. - 22 S.

13. Risberg VY Features of the immune status and apoptosis of lymphocytes with opium addiction: author. dis. Kida. the honey. Sciences / Vouring. - Ufa, 2002. - 27 S.

14. Kasyanov NV System of interferon in drug users with chronic HCV infection: author. dis. Kida. the honey. Sciences / Navratalova. - Moscow, 2002. - 19 S.

15. Khaitov R.M R.M. Norm and pathology evaluation of the immune status of the person / Rmitv // Clinical immunology. - 2000. No. 2. - P.5-6.

The way to diagnose the current opium addiction in patients with chronic viral hepatitis C, which determine the basal, stimulated level and the stimulation index of tumor necrosis factor-α (TNF-α), basal and stimulated levels of interferon-γ (IFN-γ), the index of stimulation of interleukin-2 (IL-2) and the basal level of interleukin-4 (IL-4) and at the basal TNF-α from 12 to 50 PG/ml, stimulated TNF-α from 15 to 80 PG/ml, index, stimulation of TNF-α from 0,65 to 1.78, basal IFN-γ from 20 to 22 PG/ml, stimulated IFN-γ from 20 to 22 PG/ml, stimulation index IL-2 from 1 to 1.45, basal IL-4 from 9.1 to 11.8 PG/ml diagnose the current opium addiction.



 

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4 ex, 5 tbl

FIELD: medicine.

SUBSTANCE: conjunctival cell sample is collected by pressing a bulbar conjunctiva of an examined eyeball at 2-3 mm above a limb in the meridian 12 hours with a soft contact lens (SCL) placed with its concave side on a tonometre. Then, the SCL is removed from the tonometre and turned out so that the collected sample is at the bottom of the SCL which is fixed in 95% alcohol by single dip. Then, the SCL is washed with distilled water, then coloured with hematoxylin for 10-15 seconds, wash with distilled water and air-dried. Thereafter, the SCL is placed on a slide surface for cytological analysis.

EFFECT: invention allows simplifying the method for conjunctival cell preparation for cytological analysis, reduced analysis time and cost.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to oncology, and can be used for clinical effectiveness control in children with neuroblastomas. That is ensured by neo-adjuvant combination cytostatic therapy with peripheral vein blood sampling prior to and after each course of chemotherapy. Blood is examined for plasminogen and plasmin activity to calculate the relation of the first to the second. If the value increased after chemotherapy, a therapeutic clinical effect is predicted. If the value decreased or remained unchanged throughout two courses of chemotherapy, the absence of effect is predicted that is a basis for changing the cytostatics to provide an adequate treatment.

EFFECT: method provides assessing cancer invasiveness, its invasive and metastatic potential, detecting the patients with an expected therapeutic effect, good prognosis and the patients with no effect who require timely correction of anticancer therapy to provide prolonged and improved quality of life of the patients.

2 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gastroenterology. It involves clinical judgment of a digestive-transport function; the observed clinical manifestations are scored by the Table "Score-Scale System for Assessment of Intestinal Loss Appearing from Gastrectomy" presented in the description, and the derived scores are summed up. Feces are examined for the concentration of short chain fatty acids (SCFA). If total score of the observed clinical manifestations is 1 to 9 points, and the concentration of SCFA is 7 to 10 %, a mild degree of intestinal loss is diagnosed; if total score of the observed clinical manifestations is 10-20 points, and the concentration of SCFA is 4 to 6 %, a moderate degree of intestinal loss is diagnosed; while total score of the observed clinical manifestations exceeds 20 points, and the concentration of SCFA is up to 4 % and less, a severe degree of intestinal loss is diagnosed.

EFFECT: method presents more accurate assessment of intestinal loss following gastrectomy.

1 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention relates to veterinary science. The technique involves blood serum examination in an immunodiffusion reaction. As a diagnosticum, an antigen prepared by mechanical mixing of equal proportions of the O-polysaccharide M-antigen produced of the vaccine strain B melitensis Rev-1, and the O-polysaccharide A-antigen produced of the vaccine strain B abortus 19 is used.

EFFECT: use of the offered technique provides higher diagnostic accuracy and reliability of bovine and sheep brucellosis.

3 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to diagnosing malignant processes in a human body. A diagnostic technique for a malignant process in a human body consisting in sampling a patient's living tissue, grinding, mixing with physiologic saline to a state of suspension, keeping and agitating under certain conditions, then centrifuging, separating supernatant and detecting cancer-specific markers by an immunochemiluminisent assay.

EFFECT: method exhibits a simple and high degree of malignant process detection in the human body, both at the early, and following stages of disease.

1 tbl

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to orthopedics. In order to estimate state of bone tissue in case of immobilisation osteoporosis in a laboratory animal examined are homogenates: bone, muscular, bone marrow of any extremity and peripheral blood. Biochemical and integral parametres are determined. Five factor variables F1-F5 are calculated using values of biochemical and integral parametres, constant values of factor coefficients of biochemical parametres and free coefficients. After that calculated is the value of discriminant function, whose value is used to estimate bone state as normal or conclusion about presence of immobilisation osteoporosis is made.

EFFECT: method increases accuracy and efficiency, has high stability of immobilisation osteoporosis recognition.

1 ex, 3 tbl

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, in particular to dentistry. In order to determine bleeding sickness type clinical manifestations are determined and assigned point marks, by table 2, contained in the description. Obtained points are summed up, and is the sum of points equals 3 and more index Z is calculated by formula: Z=Σ10R, where R is index of the degree, to which it is necessary to raise figure 10 in case if clinical manifestations, given in table 3, contained in the description, are present. If index Z is within the range 10-30, made is conclusion about high probability of inherent haemorrhagic disease with microcirculation type of bleeding sickness; from 50 to 499 - of acquired haemorrhagic disease with microcirculation type of bleeding sickness; from 500 to 3000 - of inherent haemorrhagic disease with mixed type of bleeding sickness; from 10000 to 50000 - of inherent haemorrhagic disease with hematoma type of bleeding sickness; from 100000 to 500000 - of acquired hemophilia; and if Z value is higher than 1000000 - simulation of haemorrhagic disease.

EFFECT: method increases efficiency of detection of patients who may develop bleeding after tooth extraction.

4 dwg, 1 ex, 5 tbl

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to methods of predicting post-operational complications, namely to methods of predicting development of scars after previous acne. In order to predict scar development content of receptor antagonist of interleukin-1 (RAIL) is determined during 15 days after resolution of inflammatory process. Scarless development of process is diagnosed at level RAIL in peripheral blood serum after disease being within physiological norm (300-800 pg/ml). If level of RAIL is lower than said norm prediction of acne complication in form of skin scars is diagnosed. Possibility of development of hypertrophic scars is predicted if RAIL concentration is lower than 200 pg/ml.

EFFECT: method makes it possible to predict type of complications after previous acne, therefore correcting therapy carried out in due time can prevent risk of skin scar formation and improve patient's life quality.

2 cl, 1 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, in particular, to neurosurgery. Minimal diametre of trepanation is calculated by formula: where: D1 is diametre in case if unilateral trepanation is performed; D2 is diametre in case of bilateral trepanation; W is mass-effect of trauma (%), which is calculated for patients with presence or absence of additional intracranial formation: hematoma, hydroma, hygroma, contusion focus, by given mathematical formulae. During calculation of mass-effect taken into account are: volume of additional formation, in cubic cm, and estimation of patient's state by GLASGO scale.

EFFECT: method makes it possible to determine optimal dimensions of trepanation hole for carrying out operations of decompression orientation in treatment of craniocerebral trauma in children.

2 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to infectious disease, and can be used for prediction of antiretroviral therapy efficiency in case of HIV-infection. For this purpose by method of solid-phase immunoenzyme assay level of cytokines is determined. If indices of soluble tumour necrosis factor alpha receptor protein 75 are from 4335.48 to 6001.86 pg/ml, soluble tumour necrosis factor alpha receptor protein 55 - from 768.72 to 1323.87 pg/ml and soluble interleukin-6 receptor from 1770.77 to 3800.31 pg/ml, favourable clinic course of HIV-infection after 1-3 months since beginning of antiretroviral therapy is predicted.

EFFECT: method ensures increase of accuracy of antiretroviral therapy efficiency prediction due to selection of certain immunological criteria.

1 dwg, 7 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, in particular to nephrology. In order to predict progressing of steroid-resistant nephrotic syndrome in case of glomerulonephritis in children clinical-morphologic predictors of progressing and efficiency of the 1-st course of immunosuppressive therapy are estimated. As clinical-morphologic predictors of progressing determined are: "focal-segmental glomerulosclerosis, angiopathy of retinal vessels, increase of creatinine in blood in disease manifestation, stable increase of cholesterol level in blood >6.7 mmol/l, stable increase of fibrinogen in blood >4 g/l, disturbance of day rhythm of arterial pressure by "night-peackers" and "non-dippers" type, left ventricle hypertrophy in echocardiographic examination, increased size of kidneys in ultrasonic examination". If more than four clinical-morphologic predictors are detected and/or there is no effect from the 1-st course of immunosuppressive therapy, progressing of steroid-resistant nephrotic syndrome in case of glomerulonephritis in children is predicted.

EFFECT: method makes it possible to predict progressing course of steroid-resistant nephrotic syndrome in case of glomerulonephritis in children on the basis of early detection of clinical and morphologic predictors.

2 ex, 4 tbl

FIELD: medicine, clinical toxicology.

SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.

EFFECT: higher accuracy of prediction.

2 ex, 3 tbl

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