Diagnostic technique for reperfusion syndrome
SUBSTANCE: peripheral blood lactate level is measured. If the postischemic lactate level exceeds 10 mmol/l, reperfusion syndrome is diagnosed.
EFFECT: improved diagnostic accuracy.
5 dwg, 1 ex
The present invention relates to medicine, namely to abdominal surgery, and can be used for the diagnosis of ischemia-reperfusion syndrome.
The prototype of the invention is a method of diagnosis of reperfusion syndrome, based on the determination of the levels of products of lipid peroxidation in tissues during ischemia and reperfusion (Mwinilunga. Ischemic and reperfusion injury of organs. - M.: Medicine. 1989. - 368 C.). The disadvantage of this method is its low accuracy, high variability indicators, the level of products of lipid peroxidation is often little different from their levels in the preceding stage - ischemic period.
As you know, after the restoration of blood flow during ischemia resulting damage is much heavier and is called reperfusion injury. Reperfusion syndrome occurs not always, its manifestation depends on the time and severity of the preceding ischemia (Kashibadze PHD, Nakashidze IM Oxidant-antioxidant processes in tissues in ischemic and reperfusion injury of the small intestine. Pathological physiology and Experimental therapy. 2009. - 32. - p.19-22: Mwinilunga. Ischemic and reperfusion injury of organs. - M.: Medicine. 1989. - 368 C.). In clinical practice, critical diagnostics Vozniknovenie and severity of reperfusion syndrome for extra early to prevent complications and intensive care.
The objective of the invention is to develop a method for early diagnosis of reperfusion syndrome.
The technical result when using the invention - improving the accuracy of diagnosis.
The proposed method for the diagnosis of reperfusion syndrome is as follows. Measure the lactate levels in the peripheral blood before ischemia, at the stage of ischemia and again within 2 hours after removal of ischemia. When the value of lactate more than 10 mmol/l diagnosed syndrome reperfusion. Lactate is a product of anaerobic oxidation of glucose and is the most sensitive to oxygen deficiency.
The invention is illustrated as follows: figure 1 shows the seal kidney cells, the violation of their circulation and destructive changes in nephrons of experimental animals. Paint hematoxylin-eosin. Micrograph 10, Ob; figure 2 is a stagnation of blood in the capillary network of the cortical substance of the kidney of experimental animals. Paint hematoxylin-eosin. Micrograph 10, Ob; figure 3 - the destruction of the Central vein of liver segments and destruction of adjacent hepatocytes in experimental animals. Paint hematoxylin-eosin. Micrograph 10, Ob; figure 4 is compressed area light, visible inflammatory process. Paint hematoxylin-eosin. Micrograph 10, Ob; figure 5 is a dense area formed the CSOs in experimental animals. Paint hematoxylin-eosin. Micrograph 10, Ob.
To confirm the possibility and reliability of the proposed method, we performed experiments on 7 pigs weighing 10-12 kg Model of ischemia of organs of the abdominal cavity created by a busy pneumoperitoneum (>2 hours). To busy pneumoperitoneum by the end of the period of intra-abdominal hypertension (stage ischemia) and before removing busy pneumoperitoneum in the peripheral blood of pigs was determined by the level of lactate (lactic acid), re-lactate was determined during the first 2 hours after removal of ischemia (stress pneumoperitoneum), when you call the reperfusion syndrome. After the death of the animal was performed laparotomy and sampling of internal organs for histological examination. The results are in the normal level of lactate is 2.6+/ - 0.3 mmol/l, during the period of ischemia was 8.8+/and-0.6 mmol/l and in the development of reperfusion syndrome in all cases more than 10 mmol/l and in General was 12.2+/-0,73 mol/l (P<0,05).
Example. The pig weighing 10-12 kg in terms of endotracheal anesthesia was performed puncture of the anterior abdominal wall trocar diameter 10 mm
Measured the level of lactate peripheral blood - 2.5 mmol/L. Trocar connected to insufflator air pressure gauge. Note time and was pumped into the abdominal cavity of the atmospheres of the first air up to 30 mm Hg, so busy creating pneumoperitoneum. Exposure busy pneumoperitoneum was 2 hours. Identified lactate peripheral blood by the end of the period of intra-abdominal hypertension - 8.7 mmol/L. Then performed decompression of the abdominal cavity, eliminating stressful pneumoperitoneum and measured the lactate level after the first 2 hours after removal of ischemia, which amounted to 12.1 mmol/L. Diagnosed syndrome reperfusion.
The animal was taken from the experience by injecting lethal doses of muscle relaxants. Made laparotomy, took pieces of organs for histological examination.
The results of histological research.
In the immediate vicinity of the portal histological structure of the kidney are areas significantly altered patterns as kidney cells, and nephron tubules (figure 1). When this calf kidney sealed and the network of blood capillaries is not defined, and the gap space between the inner and outer capsules renal bullock greatly expanded. Along with changes in overall structure of the parenchyma of the kidney, are determined by expressed human renal blood flow in experimental animals. Especially characteristic is the stagnation of blood in the blood capillaries surrounding the renal tubules (figure 2).
Slices of liver with destructive changes in the ons Central vein (figure 3), when the endothelial cells are not detectable in the immediate vicinity of the hepatocytes exposed to destructive processes, while hepatocytes lyse and fragmented. Vnutritrekovye sinusoidal capillaries saved, but they greatly expanded and perisinusoidal edema. In the lumen of the capillaries are defined by the formed elements of blood.
There are small areas of lung tissue with a marked infiltration and compacted fabric structure (Fig.4-5). When the alveoli are not often such changes of the respiratory part of the lung are located in close proximity of the bronchioles and bronchi different caliber.
Method for the diagnosis of reperfusion syndrome in the experiment, including the determination of biochemical indicator during and after ischemia, characterized in that in the peripheral blood as biochemical indicators determine the lactate and when it is in the postischemic period of more than 10 mmol/l diagnosed syndrome reperfusion.
SUBSTANCE: substance of the laboratory diagnostic technique for sepsis consists in a quantitative analysis of blood serum for nonprotein microorganism metabolism products, particularly n-hydroxyphenyllactic (HPLA), phenyllactic (PLA), n-hydroxyphenylacetic (HPAA) and homovanillic (HVA) acids. If the contents of said four acids listed above synchronously excess the a healthy level by 5 times or more, sepsis is diagnosed.
EFFECT: use of said technique allows higher reliability of diagnosing sepsis in the patients with hyperthermia of an uncertain aetiology, in impaired state of the patients in hopital, in the intensive care patients, and in surgical postoperative complications.
4 tbl, 3 ex
SUBSTANCE: invention describes a method of quantitative evaluation of blood acetic, propionic, isobutyric, butyric, valeric, isocapronic and capronic acids by gas chromatography analysis wherein a blood sample is acidified with 1 % sulphuric acid to pH 2-3, evaluated acids are extracted with isobutyl alcohol volume of which is related to the blood sample volume as 1:1. The protein separation is enabled by centrifugation. 2-3 drops of 0.4 % alkali is added, and the extract is evaporated dry, further the solid residue is added consistently with 1 % sulphuric acid and isobutyl alcohol that is followed with gas chromatography separation of the mixed acids in a capillary column with a flame ionisation detector, and the amount of each acid is evaluated by a calibration diagram.
EFFECT: higher sensitivity and accuracy of the method of quantitative evaluation of acetic, propionic, isobutyric, butyric, valeric, isocapronic and capronic acids if found in blood together.
5 cl, 1 ex, 4 tbl
SUBSTANCE: invention relates to field of medicine, namely, to gastroenterology. For non-invasive diagnostics of fibrosis and cirrhosis in case of HBV and HCV infections complex ultrasonic examination of liver and spleen tissue is carried out. Additionally duplex scanning with colour Doppler mapping of porto-hepatic region vessels is performed and quantitative indices of hemodynamics of rate of blood flow in vessels, including splenic vein, are determined. Blood test is analysed and used to determine number of platelets, biochemical blood tests are performed, most significant for determination of disease degree indices of coagulogram are taken. After that, discriminant analysis of obtained characteristics and indices is carried out, and taking into account age and experimentally obtained coefficients, total value of two canonical discriminant functions F1 and F2 for HCV and HBV is calculated. Further, by obtained in empiric way territory map position of point for calculated by patient's concrete indices values F1 and F2 for cases of HCV-infection and HBV-infection is determined. Depending on point location on territory map case of mild fibrosis, severe fibrosis or liver cirrhosis is diagnosed.
EFFECT: method increases reliability of fibrosis and cirrhosis diagnostics in case of HBV and HCV infections.
10 dwg, 2 ex
SUBSTANCE: peripheral blood thrombocytes of women suffering gestosis of various severity levels on their 32-38 weeks of pregnancy are analysed for the activity of glutathione reductase (GY), NADF-dependent glutamate dehydrogenase (NADFGDG) and NADF-dependent isocitrate dehydrogenase (NADFICDG). A nicotine amide adenine dinucleotide phosphate transfer coefficient (NTC) represented by the relation of the GY activity to a product of the NADFGDG and NADFICDG activities is calculated. At the NTC value is equal to 1.3 and lower, the newborn's Apgar score is predicted to be equal to 6 and less, and the NTC value exceeding 1.3 provides the Apgar score being 7-10 points.
EFFECT: more accurate prediction of the newborn's state.
2 tbl, 5 ex
SUBSTANCE: areas highly exposed to harmful chemical agents are chosen. A random group of children without clinical signs of living in this territory is tested using chemical laboratory tests of blood to identify the content of chemical compounds, which are priority chemical environmental factors on the selected area of residence and clinical and laboratory studies are conducted to determine a set of laboratory indicators of adaptation system. Then using the results of the study the average values of chemical compounds in the blood are fixed and then they are compared to the background and average values for each of the above laboratory parameters are fixed and compared to the physiological norm; deviation of this value from the normal rate reveals children bodies response to chemical exposure. Next, a causal relationship is established between the level of content of chemical compound in the blood and the response of the child body through deviation of laboratory parametres from the norm using a logistic regression model. Using method based on analysis of odds ratios the maximally inactive level of marker of exposure and corresponding response marker based on the conditions are determined under which the odds ratio that characterises the degree of the connection between exposure to a chemical compound and the body's response will be greater than or equal to one; for this a model of dependence between the level of a marker of exposure and the specified index odds ratio is designed, the parametres of the model are determined and they reflect the change in the probability using which the value of the maximally inactive level of marker of exposure is calculated, i.e. maximum ineffective concentrations of chemical compounds. From the entire spectrum of defined concentrations of certain chemical compounds for each laboratory parametre of adaptation systems choose the smallest value that is accepted as the maximally inactive concentrations on a child adaptation system for a given chemical compound i. In future diagnosis of violation of adaptation of children living in the selected area is performed by comparing the content Ci of certain chemicals in their blood with previously established value of inactive concentration for this chemical compound; and if a ratio is a violation of adaptation is diagnosed.
EFFECT: method allows diagnosing violation of children adaptation under chemical hazards of environmental factors with high precision at an early preclinical stage, with simultaneous simplicity and accessibility for a wide practical application.
5 tbl, 2 dwg
SUBSTANCE: zeolite antioxidant activity test is enabled by introducing a substance being tested into bodies of experimental animals. Biological products of tissues and organs of the experimental animals and control sets are prepared. Metabolic process indicator substances are evaluated. The pulmonary tissue, blood plasma, erythrocytes and thrombocytes are analysed for the content of lipid peroxidation products and natural antioxidants which are scored and summed up. The zeolite antioxidant activity is tested relatively to the normal values of the content of lipid peroxidation products and natural antioxidants which are defined as an arithmetical mean of the relevant values received in the animals of a control set.
EFFECT: enabled reliable zeolite antioxidant activity test at the enabled comparative evaluation of substances by this parametre.
2 tbl, 1 ex
SUBSTANCE: vaginal fluid is analysed. The vaginal secretion is collected by means of a common tampon placed in a vagina for 8-9 hours, further weighted; microbial metabolites are extracted in equiponderate amount of distilled water, and the extract is analysed by gas-liquid chromatography. If the vaginal discharge contain acetic acid more than 0.315 mg/g and total propionic and butyric acids ≤0.200 mg/g in an age group of 17 to 34 years, and acetic acid more than 0.210 mg/g with total propionic and butyric acids ≤0.120 mg/g in an age group of 35 to 48 years, nonspecific aerobic vaginitis is diagnosed.
EFFECT: more accurate diagnosis of nonspecific aerobic vaginitis.
SUBSTANCE: method of evaluating immunogenicity of brucella strains includes enzyme-linked analysis of culture supernatant of peripheral blood cells for content of cytokines - tumour necrosis factor (TNF-α), interleukin-1β (IL-1β) and colony-stimulating factor (CSF), synthesized by mononuclear cells of peripheral blood in vitro without impact (spontaneous production) and under the impact of antigens of evaluated brucella strains (induced production) and determination of their immunogenicity by ratio of spontaneous and induced production of said cytokines, brucella strains are considered immunogenic if their antigens cause enhancing of TNF-α by 1-1.25, IL-1β by 2-2.50 and CSF by 3-3.70.
EFFECT: method improvement.
SUBSTANCE: sampling of patient's lacrimal fluid (LF) is performed, analysed reaction mixture (ARM), consisting of substrate and analysed lacrimal fluid (ALF) is prepared, where as substrate, collagen gel is used. In course of ARM preparation, ALF is mixed with collagen gel in ratio 1-1.5:1 and keep at room temperature until homogeneous mixture (said ARM) is obtained. After that said ARM is applied on a microscope slide, kept until complete drying up of the entire microscope slide surface, measuring the time of complete ARM drying up. Then, quantitative determination of ALF CA is carried out by means of preliminarily built calibration curve of dependence of time of complete drying up of standardised reaction mixture samples, each of which consists of substrate and collalisin solution with specified collagenolytic activity, on collagenolytic activity. Obtained earlier ALF CA value is compared with normal values and if value of collagenolytic activity is lower than 231.8 kU/ml, lower ALF CA is determined, if the value of said activity is 231.8-297.8 kU/ml, normal ALF CA is determined, and if the value of said activity is higher than 297.8 kU/ml, higher ALF CA is determined.
EFFECT: application of the method makes it possible to increase accuracy of LF CA determination, reduce duration of determination procedure, eliminate possibility of infecting people who are carrying out the analysis.
1 dwg, 3 tbl
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, hepatology.
SUBSTANCE: one should detect the level of hepato-specific enzymes (HSE) in blood plasma, such as: urokinase (UK), histidase (HIS), fructose-1-phosphataldolase (F-1-P), serine dehydratase (L-SD), threonine dehydratase (L-TD) and products of lipid peroxidation (LP), such as: dienic conjugates (DC), malonic dialdehyde (MDA). Moreover, one should detect the state of inspecific immunity parameters, such as: immunoregulatory index (IRI) as the ratio of T-helpers and T-suppressors, circulating immune complexes (CIC). Additionally, one should evaluate the state of regional circulation by applying rheohepatography (RHG), the system of microhemocirculation with the help of conjunctival biomicroscopy (CB) to detect intravascular index (II). In case of increased UK, HIS levels up to 0.5 mcM/ml/h, F-1-P, L-SD, L-Td, LP products, CIC by 1.5 times, higher IRI up to 2 at the norm being 1.0-1.5, altered values of regional circulation, increased II up to 2 points at the norm being 1 point, not more one should diagnose light degree of process flow. At increased level of UK, HIS up to 0.75 mcM/ml/h, F-1-P, L-SD, L-TD, LP products, CIC by 1.5-2 times, increased IRI up to 2.5, altered values of regional circulation, increased II up to 3-4 points one should diagnose average degree of process flow. At increased level of UK, HIS being above 0.75 mcM/ml/h, F-1-P, L-SD, L-TD, LP products, CIC by 2 and more times, increased IRI being above 2.5, altered values of regional circulation, increased II up to 5 points and more one should diagnose severe degree of process flow.
EFFECT: higher accuracy of diagnostics.
FIELD: medicine, infectology, hepatology.
SUBSTANCE: in hepatic bioptate one should detect products of lipid peroxidation (LP), such as: dienic conjugates (DC), activity of antioxidant enzymes, such as: catalase (CAT)and superoxide dismutase (SOD). One should calculate by the following formula: C = DC/(SOD x CAT)x100, where DC - the content of dienic conjugates, SOD - activity of superoxide dismutase, CAT - activity of catalase. At coefficient (C) values being above 65 one should predict high possibility for appearance of cirrhosis, at 46-645 - moderate possibility and at 14-45 -low possibility for appearance of cirrhosis.
EFFECT: higher accuracy of prediction.
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
FIELD: medicine, juvenile clinical nephrology.
SUBSTANCE: disease duration in case of obstructive pyelonephritis should be detected by two ways: either by detecting the value of NADPH-diaphorase activity, as the marker of nitroxide synthase activity in different renal department and comparing it to established norm, or by detecting clinico-laboratory values, such as: hemoglobin, leukocytes, eosinophils, urea, beta-lipoproteides, lymphocytes, neutrophils, the level of glomerular filtration, that of canalicular reabsorption, urinary specific weight, daily excretion of oxalates, arterial pressure, and estimating their deviation against average statistical values by taking into account a child's age.
EFFECT: higher efficiency of detection.
7 dwg, 1 ex, 6 tbl
FIELD: clinical medicine, pulmonology.
SUBSTANCE: one should carry out complex estimation of interleukin-1β) concentration in blood, saliva, bronchoalveolar liquid. Moreover, one should detect distribution coefficient (DC) for IL-1β as the ratio of IL-1β blood content to IL-1β salivary content. At increased IL-1β blood content by 10 times and more, by 2 times in saliva, unchanged level of bronchoalveolar IL-1β, at DC for IL-1β being above 1.0 one should predict bronchial obstruction. The method enables to conduct diagnostics of the above-mentioned disease at its earlier stages.
EFFECT: higher efficiency of prediction.
FIELD: medicine, diagnostics.
SUBSTANCE: the present innovation deals with genetic trials, with diagnostic field of oncological diseases due to analyzing DNA by altered status of gene methylation that take part in intracellular regulation of division, differentiating, apoptosis and detoxication processes. One should measure the status of methylation in three genes: p16, E-cadherine and GSTP1 in any human biological samples taken out of blood plasma, urine, lymph nodes, tumor tissue, inter-tissue liquid, ascitic liquid, blood cells and buccal epithelium and other; one should analyze DNA in which modified genes of tumor origin or their components are present that contain defective genes, moreover, analysis should be performed due to extracting and purifying DNA out of biological samples followed by bisulfite treatment of this DNA for modifying unprotected cytosine foundations at keeping 5-methyl cytosine being a protected cytosine foundation followed by PCR assay of bisulfite-treated and bisulfite-untreated genes under investigation and at detecting alterations obtained according to electrophoretic result of PCR amplificates, due to detecting the difference in the number and electrophoretic mobility of corresponding fractions at comparing with control methylated and unmethylated samples containing normal and hypermethylated forms of genes one should diagnose oncological diseases. The method provides higher reliability in detecting tumors, detection of remained tumor cells after operation.
EFFECT: higher efficiency of therapy.
1 cl, 3 dwg, 4 ex
FIELD: medicine, gastroenterology.
SUBSTANCE: one should carry out diagnostic studying, moreover, on the 5th -6th d against the onset of exacerbation in case of gastric and duodenal ulcerous disease one should detect the content serotonin, histamine and acetylcholine in blood, then during 2-3 wk one should conduct medicinal therapy to detect serotonin, histamine and acetylcholine level in blood again and at serotonin content being by 2-3 times above the norm, histamine - by 1.15-1.4 times above the norm and acetylcholine - by 20-45% being below the norm one should predict the flow of gastric and duodenal ulcerous disease as a non-scarring ulcer.
EFFECT: higher accuracy of prediction.
SUBSTANCE: method involves taking blood from ulnar vein (systemic blood circulation) and from large vein of the injured extremity proximal with respect to lesion focus (regional blood circulation). Spontaneous NST-test value is determined and difference is calculated in systemic and regional blood circulation as regional-to-systemic difference. The difference value is used for predicting clinical course of pyo-inflammatory disease in extremities.
EFFECT: high accuracy of diagnosis.
4 cl, 2 tbl
FIELD: medicine, gastroenterology.
SUBSTANCE: one should introduce biologically active substance, moreover, in patient's blood serum one should detect the content of acetyl choline and choline esterase activity followed by 2-h-long intragastric pH-metry at loading with biologically active substance as warm 40-45%-honey water solution at 35-40 C, and at increased content of acetyl choline being above 1.0 mM/l, choline esterase being above 0.5 mM/l/30 min and pH level being 6.0-6.9 it is possible to consider apitherapy to be useful for treating ulcerous duodenal disease.
EFFECT: higher efficiency and accuracy of detection.
FIELD: medicine, gastroenterology.
SUBSTANCE: it has been suggested a new method to detect pharmacological sensitivity to preparations as acidosuppressors. After the intake of the preparation a patient should undergo fibrogastroduodenoscopy 3 h later, then, through endoscopic catheter one should introduce 0.3%-Congo red solution intragastrically and the test is considered to be positive at keeping red color that indicates good sensitivity to the given preparation, and in case of dark-blue or black color the test is considered to be negative that indicates resistance to this preparation. The suggested innovation widens the number of diagnostic techniques of mentioned indication.
EFFECT: higher efficiency of diagnostics.