Method for prediction of cns pathology in newborns
SUBSTANCE: substance of the method for prediction of a CNS pathology in newborns consists in the fact that that blood of a pregnant woman on her 3rd trimester is examined for a nitrogen oxide. If the blood NO concentration is 6.12 mcmol/l and more, the developing CNS pathology is predicted in a newborn.
EFFECT: use of the declared method enables effective screening assays of the pregnant women for identification of the CNS pathology in newborns.
The invention relates to medicine, namely to Perinatology and pediatric neurology, and can be used to predict the development of perinatal hypoxic lesions of the Central nervous system in newborn infants born to mothers with Feto-placental insufficiency.
One of the main causes of perinatal morbidity and mortality is the Feto-placental insufficiency (NEF), which is accompanied by hypoxia and fetal growth retardation, the frequency of hypoxic-ischemic lesions of the Central nervous system 4.8 times higher than in uncomplicated pregnancies (Nguvauva et al., 1999; Ainstream et al., 2003; Navantia, Anthraco, 2004).
Hypoxia, have been studied for many decades, still remains a challenging issue of obstetrics, Pediatrics and Perinatology. This is because it causes significant and often irreparable damage to the developing organism. Various etiology, duration and severity of hypoxia of the fetus and newborn, but especially varied its consequences: from behavioural disorders and difficulties in teaching to children with cerebral palsy, speech defects and hearing impairment, intellectual disabilities (Duda I., Duda V.I., 1997). In this regard, the obvious need for new prognostic markers for hypoxic-ischemic porage the s CNS, adequate assessment and interpretation of the data.
Screening markers, warning about the subsequent development of those or other complications should be clinically available to identify women requiring clinical follow-up during pregnancy and preventive therapy before clinical manifestation (J.C.Forest et al., 1989; J.R.Hiqqins, 1998; M. Moretti et al., 2004).
In recent years, proposed numerous methods of monitoring the status of the fetus - from the very simple, for example, the calculation of the perturbations of the fetus (actigraphy is a method of registration of motor activity of the fetus) to the more complex, requiring specialized equipment, experience and skills of the researcher, for example, Doppler. Many of the methods used have not passed the test of time and not give those results are expected from them (Enkin m, Keirse M.J.M.C., 2000). Others proved to be very expensive, which does not allow to use them for screening.
"A method for the diagnosis of neurological complications in newborns" (copyright certificate for invention № 1830483, 1993), consisting in the fact that children with perinatal encephalopathy for early prediction determine the content of total phospholipids in plasma in the dynamics of the pathological process and increase their level relative to the initial months of age to judge the formation of neurological complications.
However, the known method has the following disadvantages: possible individual variations quantitative indicators phospholipid spectrum of the body, depending on the characteristics of the course the embryo, pathogenese, presence of concomitant pathology in the newborn;
- neurological disorders are projected on the background of existing perinatal encephalopathy;
- the need to re-research total phospholipids to assess their dynamics;
- end forecasting in relation to neurological complications is possible only to the end of the late neonatal period;
- the need of compromising the integrity of the skin, when to assess phospholipid spectrum have to take venous or capillary blood, which is associated with invasiveness and does not exclude the possibility of infection of a child with hepatitis b or HIV infection.
On placental insufficiency may indicate increased activity in maternal blood and amniotic fluid enzymes: alkaline phosphatase, oxytocinase, lactate dehydrogenase, creatinephosphate, γ-glutamyltranspeptidase, as well as the changing characteristics of lipid peroxidation and antioxidant defense systems.
There is a method of predicting health disorders children with perinatal CNS damage in the first year of life studies is the study of umbilical cord blood, characterized in that to determine the relative content definintely cells in their content of 9% and over predict the preservation of neurological symptoms by the end of the first year of life (patent RF №2121682, 1998.11.10.)
The disadvantages of the method:
1) the Method is not specific: change T-link the immune system does not only take place in the presence of encephalopathy of the newborn, as observed in other pathological conditions (congenital immunodeficiencies, intrauterine viral and bacterial infections).
2) the method Used for determining the state of the T-link the immune system with the use of quantitative registration theophylline-sensitive cells in the blood of the umbilical vein has a number of features that will surely make a significant error in the result is:
a) high-speed centrifugation of blood to obtain lymphocytes at 200 g for 45 minutes without cooling will contribute to the heating of the contents of the test tubes (suspension cells)that causes the destruction of these cells. The presence of a centrifuge with refrigeration unit is possible only in medical institutions at the regional level, and therefore this method may not find wide application;
b) obtaining a suspension of lymphocytes from the tube after centrifugation can be carried out by highly professional specialists, one are also currently only in laboratories, medical centers regional level.
A method for diagnosing the progression of the pathological process in the brain in neonates with hypoxic lesions of the Central nervous system (No. 2148262, 27.04.2000), characterized in that the liquor newborn determine on the 2nd and 6th days of his life the content of malondialdehyde and the value of its indicator on the 2nd day over to 0.72 µmol/l and an increase of 6 days in 2 times in comparison with the norm diagnose the progression of the pathological process in the brain.
The disadvantages of this method are:
1. Low accuracy, time-dependent sampling of urine and therapy in the newborn.
2. The necessity of determining the concentration of creatinine in the urine.
A method for predicting perinatal hypoxic-ischemic encephalopathy in newborns (No. 2157534, 10.10.2000) by immunogenetic studies of the status of the body, characterized in that the cord blood to determine the antigen loci A, B, DR HLA system and if one of the antigens A32, B8, B27, DR3 or combinations thereof predict perinatal hypoxic-ischemic encephalopathy in neonates.
This method has a number of imperfections:
1. The method is non-specific (the presence of antigens of different loci of the HLA system, in particular, B27, occurs when Reiter syndrome, B8 - syndrome behceta, the syndrome of the red Volcan and, violations of the functional state of the thyroid gland, autoimmune hepatitis, with this neurological disease, as Myastenia gravis (Clinical immunology and Allergology. M: Medicine. 1990. Vol.2. Edited Ligera).
2. The method is very time-consuming.
3. To perform the method requires a highly skilled specialist immunologist.
The method has other drawbacks:
- investigated the umbilical cord blood, which means later prediction of perinatal hypoxic-ischemic encephalopathy in newborns and does not allow timely preventive measures;
the method requires the determination of four parameters for the prediction of perinatal hypoxic-ischemic encephalopathy in newborns;
- currently, the determination of the antigens of the HLA system is produced in the PCR reaction, which requires expensive equipment and reagents.
There is a method of forecasting encephalopathy in the newborn (2254573, 20.06.2005), including the study of biological material, characterized in that in placental tissue, from which it is prepared, a 10%homogenate, determine the activity of NADPH-oxidase recovery 2,6-dichlorophenolindophenol in the presence of NADPH, the results take into account spectrophotometrically at a wavelength of 600 nm, and when the value of the activity of NADPH-oxidase, 13.5% Opti is eskay density and higher predict the development of encephalopathy in the newborn.
A known method for predicting perinatal pathology in women with chronic inflammatory diseases (2256914, 20.07.2005), including the study of blood, characterized in that in the venous blood to determine the ability of blood leukocytes pregnant to the production of interferon, an antibody to interferon, antibodies to myelin basic protein and S-100 and by reducing the production of interferon - less than 16 IU/ml, autoantibodies to myelin basic protein and S-100 less (-) 40 used for each indicator and the raising of antibodies to interferon than 20 usled predict perinatal pathology.
The method has drawbacks:
- the need to determine the four parameters, each of which requires expensive reagents;
to assess products ELISA necessary stimulation of peripheral blood leukocytes viral macrophages (Ershov FI System of interferon in norm and at a pathology. - Moscow: Medicine. - 1996. - 240 S.);
- no clear mechanism for the development of CNS pathology in newborns with this combination of indicators, because the content of interferon in the blood less than 16 IU/ml, reduced the level of autoantibodies to myelin basic protein and S-100 is uncomplicated pregnancy and normal fetal development, and increased levels of antibodies to interferon may be the result of allergic reactions;
- change the production of interferon in the venous blood may be accompanied by a threat of premature birth;
- do not specify the duration of pregnancy, which conducted the study.
The described method for early diagnosis of perinatal lesions of the Central nervous system in newborns (2289136, 20.07.2006), including a study of indicators of lipid peroxidation in the amniotic fluid, characterized in that a sample of amniotic fluid is taken by vaginal amniotomy in the first stage of labor during the opening of the cervix at 4-5 cm by means of a needle for carrying out spinal puncture, define him as the concentration of malonic dialdehyde and an increase in the concentration of malondialdehyde in the amniotic fluid more 4,50 µmol/l diagnosed with perinatal Central nervous system in the newborn. The disadvantages of this method are:
1. The invasiveness of research associated with a high risk for mother and fetus.
2. The need for expensive equipment.
3. High professional requirements for personnel conducting the sample is amniotic fluid.
4. The inability to compare results with other laboratories because of the bindings used equipment and reagents.
5. Low accuracy issledovaniya contact with blood in a sample of the amniotic fluid.
6. The impossibility of long-term storage of the sample of the amniotic fluid.
A method for predicting perinatal hypoxic lesions of the Central nervous system in newborns (2313095, 20.12.2007) by immunological studies of peripheral venous blood of pregnant, characterized in that with 35 weeks of pregnancy complicated by preeclampsia, determine the content of interleukin-1, and its value is >40 pkg/l predict the development of perinatal hypoxic lesions of the Central nervous system.
A method for predicting CNS pathology in newborns (2317014, 20.02.2008), characterized in that child's cord blood to determine the level of endothelin-1, and on the sixth day spend dopplerometrical the study of the middle cerebral artery and, if the level of endothelin-1 is 8,14 PCG/ml or more, the resistance index is equal to 0.73 and more, predict the development of neurological symptoms in this child in the first 3 months of life.
The prototype of the claimed invention, we have chosen a Method for predicting CNS pathology in newborns (2317014, 20.02.2008).
The disadvantage of this method is:
- the use of expensive test systems;
the inability to compare results with other laboratories due to the binding reagents;
- high professional requirements for personnel conducting the study;
Mark is no mark, what methods of diagnostics and forecasting of the development of perinatal CNS lesions do not claim completeness. There is every reason to believe that our further research in this direction will lead to the discovery of new, original approaches to their diagnosis and prevention.
The invention is based on the results of research to develop an algorithm is available examination of the fetus and newborn to assess the severity of hypoxic lesions of the Central nervous system.
The problem is solved in that a pregnant woman 3 trimeter determine the level of nitric oxide and, if he is 6.12 mmol/l or more, predict the development of CNS pathology in the newborn.
Therefore, the positive effect of the proposed method is achieved by improving the accuracy of prediction of perinatal CNS pathology in newborns. This, in turn, provides the possibility of early and timely forecasting of pathology of the Central nervous system at birth of the child for targeted correction of neurological status.
Using this method will help in the early neonatal period based on changes in indicators of nitric oxide to predict subsequent formation in the first months of life delayed neurological disorders in children, which will allow the pediatrician to assign p EventInfo pathogenetic therapy.
Among the many biologically active substances produced by the endothelium, the most important is nitric oxide.
It is known that the mechanisms of adaptation to hypoxia essential role of nitric oxide (NO) (Berger R., Y. Garnier, 1999).
The nitric oxide, a short-lived molecule. NO - it viagrabillig, reactive free radical, which rapidly undergoes oxidation with the transition into nitrites and nitrates. That is why the biological effects of NO are limited to the place of his education (Boldyrev A.A., 1995). Nitric oxide plays an important role in the life and development of the fetus in a single system mother-placenta-fetus" (Norman G.E., I.T. Cameron, 1996; Purcell T.L., 1999). Affain (2000), Wpeutil (2000), Umezono (2001) reported that nitric oxide is one of the main regulators of the tone of cerebral vessels. The basis of this neurovascular effect is a feature of the innervation of the smooth muscle of cerebral arteries, which is not mediated adrenergic and cholinergic transmitters, and nitric oxide, and therefore the corresponding synapses are called "nitroxidergic".
In the reduction of cerebral blood flow in patients with cerebral vasospasm is a change in nitroxidergic regulation of vascular tone due to violations of endothelium-dependent vasorelaxation. Against this background, the more pronounced is the influence of vasoconstric the Torno substances. NO levels are reduced because of the death of NO-producing cells or deficit of energy for its synthesis.
It should be noted that the foetus during pregnancy is normal, does not experience oxygen starvation, as supplied with oxygen in accordance with his needs. The fetus does not experience oxygen starvation also due to adaptive mechanisms, providing it with a sufficient supply of oxygen: increase breathing capacity of the placenta, increasing the number of red blood cells and the amount of hemoglobin, the presence of fetal hemoglobin has a greater affinity to oxygen, suction effect of respiratory movements of the fetus and stir it, accompanied by a rise in blood pressure and increased velocity of circulation. Last satisfy the needs of the fetus in adequate amounts of oxygen and because the fetus uses in utero 4 times less oxygen than a newborn baby. However, towards the end of pregnancy, especially before birth the fetus is supplied with oxygen, compared with previous periods of pregnancy, to a lesser extent, and providing oxygen his body is straining all compensatory reserves of the organism, both mother and fetus. The degree of oxygen saturation shelter the vein of the umbilical cord of the fetus at 36-37% below saturation of arterial blood, and at 22 weeks, this difference is only 21-22%and 30 weeks 24-25%.
As mentioned above, complications of pregnancy, resulting in placental insufficiency, cause a reduction of oxygen delivery to the fetus and often lagging behind in its development (Nhlaralumi, OTA, 1985, Whirlow, 1996).
For solving the tasks conducted a screening survey of women with physiological pregnancy and in early neonatal period. Among the patients were women with complicated gynecological, obstetric and medical history. The total sample consisted of 156 people. The sequence and number of studies in each of the pregnant and newborns were identical.
In accordance with the tasks all clinical material was retrospectively divided into 2 clinical groups:
Group I (n-65) - rodorazresheniye through the birth canal.
Each group divided into 3 subgroups, formed when the final diagnosis of neonatologists in newborns at discharge from maternity hospital: healthy "N" (n=34), cerebral ischaemia first degree "QI I (n=16), cerebral ischemia, degree II QI II (n=15).
Group II (n-91) - rodorazresheniye by Caesarean section. Practically healthy "N" (n=52), cerebral ischaemia first degree "And I" (n=24), cerebral ischemia II degree "QI II (n=15).
All pregnant women and newborns were observed in the maternity ward NIIAP.
Placental insufficiency in group I vodorazdelny vaginal delivery subgroup "N" was diagnosed in 11 (32.4%) with women, the subgroup QI I - 2 (12,4%), the subgroup of "QI II - 1 (6,6%). In the group of women, vodorazdelny by Caesarean section, the subgroup "N" in 22 (42,3%), subgroup QI I - 11 (45,8%), the subgroup of "QI II" - 9 (60%).
The extreme degree of placental insufficiency, manifested by fetal growth retardation in group I women vodorazdelny through the birth canal, the subgroup "N" was diagnosed in 5 (14.7%), and in the subgroup of "QI II - 1 (6,6%). In the group of women, vodorazdelny by Caesarean section, the subgroup "N" in 7 (13.5 per cent), in the subgroup of "QI II - 1 (6,6%). In both groups of women surveyed in the subgroup of "QI I" fetal growth retardation was not met.
All newborns immediately after birth were examined by a neonatologist and a neurologist made neurosonogram. In order to conduct neurosonography were used apparatus Aloka 1400, and TOSHIBA (Eccocee) SSA-340A with color Doppler mapping in real time and is equipped with an electronic sensor sector scan with a frequency of 5 MHz and above. Special attention was paid to their neurological status, and dynamics of those Neuve is ideological symptoms which took place at birth and their compliance with data neurosonogram for 1 day and at discharge from the maternity ward on the 5th day of life of a newborn.
Data processing was carried out using the package STATISTICA version 6.0, EXCEL 2003 add-AtteStat, MedCalc and service Deductor Studio Pro version 5.2. The validity of the results was calculated at p = 0.95 and precision of 0.05. The above confirms the prognostic value of the claimed method.
To compare the differences between groups used the method Wilcoxon-Mann-Whitney for independent groups with service AtteStat 6.4. With the help of SPSS was calculated confidence intervals for the median.
Detailed description of the method and examples of its clinical implementation.
Laboratory methods women included those studies that are traditionally used to assess the status of pregnant women: clinical, biochemical blood tests, determination of blood coagulation by Sukharevo, prothrombin time, clinical urine analysis, microscopy discharge from the cervical canal and vagina, as well as special techniques. Our research began with a sampling of venous blood pregnant when admitted to the maternity unit to determine NO.
Determination of the content of the oxide azo is a (NO)
The level of nitric oxide (NO) in the serum of patients was determined by a colorimetric method based on the enzymatic conversion of nitrate to nitrite by nitroreductases that occurs with the participation of nitrogen oxides. The measurement was repeated sets of firm R&D (USA). The solutions of the reagents were prepared according to the instructions to the set.
The serum was pre-diluted with a buffer for dilution in 2 times. The determination was carried out in two stages.
In the first stage determined the concentration of endogenous nitrite. For this purpose, into the appropriate wells of polystyrene plate was made 50 ál of standard solutions with known concentrations of nitrite or of the investigated samples. All wells were made in 50 ál reaction buffer. To each well was made in 50 ál Grissa 1, then all wells were made in 50 ál Grissa 2, and incubated 10 minutes at room temperature. Measured optical density in each well at 540 nm on a spectrophotometer Stat Fax 100 (USA) and counted the concentration of endogenous nitrite in the samples in µmol/L.
In the second stage using nitroreductases reaction was determined the concentration of total nitrite. For this purpose, into the appropriate wells of polystyrene plate was made 50 ál of standard solutions with known concentration of nitrates or investigated samples. Contributed by ml NADH solution to all wells. Then all wells were made in 25 μl of a solution of nitrate reductase, was stirred and covered the tablet film. Incubated tablet in thermostat at 37°C, was added 50 ál Grissa 1 to all wells. Made of 50 ál Grissa 2 to each well, incubated 10 minutes at room temperature. Measured optical density in each well at 540 nm on a spectrophotometer Stat Fax 100 (USA) and counted the total concentration of nitrite in the samples in µmol/L.
Nitrate levels were found by difference between total and endogenous nitrite in each sample, multiply the result by the dilution factor (2) and expressed it in µmol/L.
The child from the mother of Seksan OG 24 years, history of births No. 6249903, born 10.10.2008, from 2 pregnancies, 1 term labor, proceeding with symptoms of preeclampsia in the second half of pregnancy with a single tight umbilical cord entanglement around his neck. Diagnosis: Genera I in period. Neurocirculatory dystonia in cardiac type. Once the tight entanglement of the umbilical cord around the fetal neck. Weight at birth 3700, length 54 cm, estimation on Apgar scale 7/8 points, status at birth is satisfactory. During the observation in the hospital pathology in neurological status is not detected.
In the mother's blood at admission to hospital in the period 39-40 weeks determined the concentration of nitric oxide. Got result: NO=5.8 µmol/ml It according to our data evidenced a low percentage of development of neurological symptoms in the newborn. In umbilical cord blood at birth was determined by the level of neurospecific markers: S100β - 560,4 and NSE - 65,77, which corresponds to the standards of this age group.
The child was discharged from the hospital for 5 days with a diagnosis of the health group I (healthy).
Example # 2
The child from the mother Podkin EV 31 year history of births No. 883/152, born 20.02.2008 g 1 pregnancy, 1 term labor, proceeding with symptoms of preeclampsia and Orosi interrupt I and II half of pregnancy, anemia pregnant, Feto-placental insufficiency. Diagnosis: Genera I in period operational. The scar on the uterus. Sosensible on system AVO. Late gestosis YONG. Anemia of I degree. Birth weight 3300, length 50 cm, estimation on Apgar scale 7/8 points, status at birth is satisfactory. During the observation time in the hospital was marked tremor of the limbs. The child was examined by a neurologist diagnosed with cerebral ischemia of I-II degree, the excitation syndrome. Somatic pathology it is not revealed.
In the mother's blood before labor determined the concentration of nitric oxide. Got result: NO=20,34 µmol/l, which exceeded the regulatory requirements and testified to the development of neurological symptoms at birth and the early neonatal period. In umbilical cord blood at birth was determined by the level of neurospecific markers: S100β - 395 and NSE - 167,7 that exceeded the standard indicators for this age group and confirmed neurological disorders. On the advice of a neurologist in the maternity ward took the course of therapy.
The child was discharged from the hospital with a diagnosis of cerebral ischemia II degree, under the supervision of a physician neurologist recommendations.
NO concentration in group I, subgroup "N" was 5,90 (5,0; of 19.72), "QI I" - 6,12 (4,81; 16,58), "QI II - 9,16 (5,5; 15,89), respectively.
NO levels in group II subgroup "N" was 5,62 (4,73; 10,91), the subgroup of "QI I - 5,91 (4,8; 21,73), the subgroup of "QI II - 6,17 (5,55; 16,8), respectively. The concentration of nitric oxide in group I, subgroup QI II" surveyed has increased sharply in contrast to subgroup "N" and "QI I", which indicates the growing fetal hypoxemia, to enhance the vasodilating effect.
Thus, the claimed method is more effective in comparison with the known and has a number of advantages:
1. It has high accuracy. In 86% of cases was predictable pathologies of the Central nervous system.
3. Eliminates the need for multiple research.
4. Clinical application of the method will allow us to choose the time and manner of delivery.
The inventive method is effective in screening pregnant women to identify newborns with perinatal lesion that is allows you to choose the right tactics pregnant women in the third trimester of gestation and mode of delivery.
The timely introduction of measures will contribute to the reduction in the incidence of perinatal CNS lesions in newborns and at the same time will reduce the economic costs of their treatment.
A method for predicting CNS pathology in newborns by examining the blood, characterized in that pregnant 3 trimeter determine the level of nitric oxide and, if he is 6.12 mmol/l or more, predict the development of CNS pathology in the newborn.
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
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
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.