Method of predicting exacerbations of chronic viral hepatitis b in teenagers
SUBSTANCE: invention relates to field of medicine, namely to hepathology and pediatrics. In order to predict exacerbations of chronic viral hepatitis B in teenagers, blood test is performed. By means of bioluminescent method determined is activity of lymphocyte enzymes in peripheral blood of patients: glucose-6-phosphate dehydrogenase (G6PDG) and lactate dehydrogenase (NADN-LDG), ratio of activities is calculated. If value of obtained index is equal or is higher than 1.15 exacerbations are predicted, if index value is lower than 1.15, absence of exacerbations is predicted.
EFFECT: method makes it possible to predict exacerbations of chronic viral hepatitis B in teenagers with clinical-biochemical remission with high accuracy.
4 ex, 2 tbl
The invention relates to medicine, namely to Pediatrics and Hepatology, and can be used to predict the clinical course of chronic hepatitis b (CHB) in adolescents.
A known method for predicting acute viral hepatitis by studies of bilirubin in serum and determining the level of serum iron at the peak of bilirubinuria and 7-10 days after it . With increase of level of serum iron in comparison with the initial level predict exacerbation of viral hepatitis. The disadvantage of this method is the prediction of exacerbations only when the protracted course of acute hepatitis. In addition, the method requires repeated blood sampling.
The objective of the invention is the creation of informative method of early prediction of acute exacerbations of HBV in adolescents.
The task carried out due to the fact that using bioluminescent method to determine the enzyme activity of peripheral blood lymphocytes of patients: glucose-6-phosphate dehydrogenase (GPDH) and lactate dehydrogenase (NADH-LDH), calculate the ratio of the activities, and when the value of the resulting measure is equal to or more than 1,15, predict exacerbation, and when the value is less 1,15 predict the absence of attacks.
The value of 1.15 is obtained empirically on the basis of FOSS is the provision of the calculation and the nature of the flow CHB from the surveyed adolescents.
The value of the index, determined by the ratio of activities GFDG and NADH-LDH equal to or more than 1,15 shows a significant outflow of substrates with glycolysis reaction of the pentose-phosphate cycle, which reduces the level of anaerobic processes and reduces the functional activity of lymphocytes.
It is known that lymphocytes that implement basic functions of the specific immune response, are the main cells in the immunological system of supervision and take an active part in the system of anti-infective protection, including viral hepatitis b (HBV) . From the level of functional activity of lymphocytes depends on the outcome of acute infectious diseases and nature of chronic infectious process. At the same time showed that the functional activity of lymphocytes is largely determined by the level of their metabolic processes . Among the indicators, the most objectively reflect the basic parameters of intracellular metabolism, can be attributed dehydrogenase.
Glucose-6-phosphatedehydrogenase (EC 184.108.40.206) is involved in the dehydrogenation of glucose-6-phosphate and coenzyme NADP. Formed during the reaction of 6-phosphogluconic-δ-lactone is unstable and hydrolyzes either spontaneously or with the help of the enzyme 6-phosphogluconolactonase with the education 6-phosphogluconate . GFDG catalyzes the initialization and key reaction in the pentose-phosphate cycle, which is a competitor of glycolysis for the substrate (glucose-6-phosphate). In normal share pentose-phosphate cycle in quantitative conversion of glucose usually small and varies depending on the functional state of the cells.
Lactate dehydrogenase (EC 220.127.116.11) - enzyme of glycolysis, catalyzes the reversible oxidation of lactate to pyruvic acid with participation as a coenzyme NAD+. Lactate dehydrogenase is a key position in the regulation of the cytoplasmic level of NADH/NAD and characterizes the level of the terminal reactions of glycolysis .
The method is as follows.
In children, adolescence, patients with CHB, collect venous blood from the cubital vein free current in heparinized tubes. Isolated lymphocytes. Centrifuged on a density gradient ficoll-urografin by the standard method A.Boyum (1968) . Calculate the concentration of lymphocytes, for example, in the camera Goryaeva. When control of the morphological composition of leukocyte suspensions determine the purity of the output of lymphocytes, which is not less than 97%. 1 million allocated cells are used to determine the activities GFDG and NADH-LDH in lymphocytes of one of the known methods, for example, bioluminescent . For this purpose, 150 ál of incubation is MESI, containing the appropriate substrate and cofactor, make 50 μl of the suspension of the destroyed cells. Specific values of the concentrations of substrates and cofactors, as well as pH-defined enzymes are presented in table 1.
|Enzyme||The substrate, mm||Cofactor, mm||The PH of the buffer|
|GFDG||Glucose-6-phosphate - 1,5||NADP - 0,025||9,8|
|NADH-LDH||Pyruvate - 0,25||NADH - 0,005||7,0|
|Note: an environment with a pH of 9.8 prepared in Tris-HCl buffer (ICN Biomedicals Inc., USA); pH 7.0 - K+, PA+phosphate buffer (the buffer is prepared from a2NRA4and NaH2PO4(Reakhim, Russia).|
After incubation of samples tested at 37°C for 30 minutes for GFDG or 5 minutes for NADH-LDH to 200 μl of the incubation mixture are added 50 μl of playmonopolyonline (FMN) in a concentration of 1.5×10-5M, 50 μl of 0.0005% myristic aldehyde and 10 ál of enzyme system NADH: Flexibilityto-Liu is iterate (all reagents bioluminescent system diluted in 0.1 M +Ka+phosphate buffer with pH 7.0). After mixing bioluminescent reagents and incubation of the sample with biochemiluminescence, for example, the brand "BL-8803", measure the luminescence. Given that the cell has a certain number of substrates for the various metabolic reactions, including those catalyzed by the studied enzymes, identify indicators, conventionally called the "substrate background of enzymes". The determination performed in the same conditions as for the above dehydrogenases, but in the incubation mixture instead of the appropriate substrate contribute buffer. In the result of measuring luminescence on bioluminometer get the relative values of activity of the investigated enzymes. To obtain the absolute value of the activity construct graphs of the intensity of bioluminescence on the concentration of NADPH and NADH (calibration). For this, 200 µl of a standard solution of NADPH or NADH in the range of 10-9-10-4M contribute in the cell of bioluminometer containing FMN, maristany aldehyde and NADPH: Flexibilityto-luciferase in the concentrations specified above, then measure the intensity of bioluminescence. Due to the wide range of pH buffers used for determining the dehydrogenase activity and pH-dependence of bioluminescence fermentat the ate system of luminous bacteria, the calibration graphs are built on the basis of the corresponding buffer. The enzyme activity was calculated according to the formula A=Δ[C]×V/T
where A is the activity of dehydrogenase, E 1×104lymphocytes (1E=1 μmol/min );
Δ[C] is the difference of concentrations OVER(f)N in samples of "enzyme" and "background of the enzyme", umol;
V - volume of sample, ml;
T is the incubation time, minutes
Then calculate the ratio of activities GFDG and NADH-LDH (GFDG/NADH-LDH). The value of the derived indicator that is equal to or more than 1,15, shows the development of deterioration, and the value of the parameter is less than 1,15 - about the lack of aggravation.
This method was tested on 34 adolescents, patients with CHB. All patients adolescents at admission to hospital and dynamics through 6 months were examined using conventional laboratory methods of examination. Held: the analysis of peripheral blood, the biochemical analysis of blood to determine the concentration of total bilirubin and its fractions, thymol turbidity tests, alanine transaminase (ALT), aspartic transaminase (ACT) and alkaline phosphatase. Using enzyme immunoassay in serum were determined by specific serological markers HBsAg and anti-HBcIgG. Using the method of polymerase chain reaction in patients was determined by a DNA virus of hepatitis C. the Activity GFDG and NADH-LDH in the blood lymphocytes of adolescents with CHB were determined using biolu inessential method.
According to the results of biochemical blood analysis found that in 22 children and adolescents within 6 months there was no exacerbation of CHB (ALT activity and ACT were within the normal range), 12 - in the range from 3 weeks to 6 months developed exacerbation of CHB (with the re-examination detected increased activity of transaminases in the serum).
All patients found the coincidence of prediction made by the proposed method (table 2).
|The prognosis of acute exacerbations of HBV|
|No.||Will/will not be exacerbations||The ratio of activities GFDG and NADH-LDH|
|7||will exacerbation||to 2.29|
|9||will exacerbation||of 3.77|
Clinical example 1. Patient B., age 9 (no history 128), was on routine examination in children infectious diseases ward of the MUSES GKB №20 of them. Iserson Krasnoyarsk with a diagnosis of chronic viral hepatitis b inactive. The child was in the dispensary for 3 years in a medical office hepatocyte MUSES GKB №20 of Krasnoyarsk. From the anamnesis it is known that the girl's mother is also sick with chronic viral hepatitis C. When entering the children's infectious diseases unit, the girl had no complaints.
The results of biochemical tests: bilirubin total of 14.6 µmol/l, ALT of 0.5 mmolc/l (within normal limits), ACT 0.24 mmol×h/l (within normal limits).
In the study of peripheral blood lymphocytes bioluminescent method and the proposed method found that the ratio of activities GFDG and NADH-LDH amounted to 0.14 (example No. 15 of table 2), indicating that nuutste aggravation.
For outpatient examination of the patient in the clinical study of the EMC Hepatology center after 6 months, the activity of ALT ACT was within normal limits.
Clinical example 2. Patient R., age 16 (no history 539)were on treatment at the children's infectious diseases ward of the MUSES GKB №20 of them. Iserson Krasnoyarsk with a diagnosis of chronic viral hepatitis with moderate activity. From the anamnesis it is known that the child received a transfusion of blood at the age of 5 years in connection with surgery. The child is in the dispensary for 5 years in the medical Cabinet of the MUSES GKB №20 of Krasnoyarsk. An examination in an outpatient office hepatocyte identified hyperferritinemia, and the child was sent to the hospital to clarify the nature of the liver and the decision of a question on tactics of treatment. When admitted to hospital, the patient complained of recurrent pain in the abdomen. During the inspection revealed a modest increase in liver (1/3-2 cm-2 cm).
The results of biochemical tests: bilirubin total 11 µmol/l (normal up to 20 µmol/l), ALT 1,6 mmolc/l (above the norm 2.3 times), ACT 0,99 mmol×h/l (slightly above normal).
In the study of peripheral blood lymphocytes under the proposed method found that the ratio of activities GFDG and NADH-LDH amounted to 1.13 (example No. 14 of the who L.2), that indicates no deterioration.
In the control of biochemical analysis blood was decreased bilirubin concentrations and normalization of indicators ALT ACT. On the 23rd day of hospital stay the patient was discharged.
For outpatient examination of a patient in an outpatient office hepatocyte after 6 months, the activity of ALT ACT was kept at normal parameters.
Clinical example 3. Patient D., age 11 (no history 438), was on routine examination in children infectious diseases ward of the MUSES GKB №20 of Krasnoyarsk with a diagnosis of chronic viral hepatitis In, with a minimal degree of activity. The patient is observed for 2 years in medical office hepatocyte MUSES GKB №20 of Krasnoyarsk with a diagnosis of chronic viral hepatitis C. an examination in an outpatient office hepatocyte identified hyperferritinemia, and the child was sent to the hospital to clarify the nature of the liver and the decision of a question on tactics of treatment.
The results of biochemical tests: bilirubin total of 13.4 µmol/l, ALT 0,76 µm×h/l (above the norm), ACT of 0.39 mmol×h/l (within normal limits).
In the study of peripheral blood lymphocytes under the proposed method found that the ratio of activities GFDG and NADH-LDH was 18,47 (sample No. 2 of table 2), indicating that the development is of ostrinia.
On the 16th day of hospitalization the patient was discharged. However, in outpatient examination in an outpatient office hepatocyte 6 months again marked increase in ALT activity and ACT 1.3 times.
Clinical example 4. Patient B., 15 years old (no history 108), was on the examination and treatment at the children's infectious diseases ward of the MUSES GKB №20, Krasnoyarsk with a diagnosis of chronic viral hepatitis b with a high degree of activity. From the anamnesis it is known that the child is observed since 2008 dispensary Cabinet of the MUSES GKB №20 of Krasnoyarsk with a diagnosis of chronic viral hepatitis B. During routine examination, the child was registered with increased ALT activity, and the boy was sent to the hospital.
The results of biochemical tests: bilirubin total of 19.6 µmol/l, ALT 5.2 mmol×h/l (above the norm 7.7 times), ACT 1.2 mmol×h/l (above normal in 2 times).
In the study of peripheral blood lymphocytes under the proposed method found that the ratio of activities GFDG and NADH-LDH was 44,15 (sample No. 6 in table 2), indicating the development of an exacerbation.
On the 28th day of hospital stay the patient was discharged. However, in ambulatory patient in a clinical study after 6 months again marked increase in ALT activity and ACT in 1.6.
The technical result of the proposed method:
probably the th forecast exacerbations of HBV in adolescents with clinical and biochemical remission;
- single fence venous blood;
- high level of coincidence of the forecast.
The proposed method allows to adjust the plan and tactics of treatment on the stages of the dynamic observation and can be recommended for use in clinical practice.
Sources of information
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2. Savchenko A.A., Suntsova LN. Highly sensitive determination of the activity of dehydrogenases in peripheral blood lymphocytes of human bioluminescent method // Laboratory work. - 1989. No. 11. - P.23-25.
3. Tomica G.S., Mediannikov O.Y a Method for predicting acute viral hepatitis // Patent RF №2188429 C2, G01N 33/68, G01N 33/84, BIPM No. 6, 27.02.2002.
4. Khaitov R.M P.M., Ignatieva GA, Sidorovich I.G. Immunology. - M.: Medicine, 2000. - 432 S.
5. Boyum A. Isolation of lymphocytes from blood and bone marroow // Scand. J. Clin. Lab. Invest - 1968. - Vol.21 (Suppl. 97). - P.77-80.
6. Jacobs S.R., J.C. Rathmell Lymphocyte selection by starvation: glucose metabolism and cell death // Trends Immunol. - 2006. - Vol.27, No. 1. - P.4-7.
A method for predicting exacerbations of chronic viral hepatitis b in adolescents by examining the blood, characterized in that by using a bioluminescent method to determine the enzyme activity of peripheral blood lymphocytes of patients: glucose-6-phosphate dehydrogenase (GPDH) and lactate dehydrogenase (NADH-LDH), calculate the ratio of activities and p and the value of the derived indicator, equal to or more than 1,15, predict exacerbation, and when the value is less 1,15 predict the absence of exacerbations.
SUBSTANCE: formation of a risk group of neoplastic disorders in a cervical epithelium is carried out by IF staining of a cervical epithelium smear with using a monoclonal antibody reacting with a sialylated conformational glycopeptide antigen determinant as a part of MUC1 followed by with cell finish staining with chromogenic nuclear stain. The sample is examined by alternated fluorescent light and transmission light. Each cell with a depolarised stained surface membrane detected by fluorescent light is examined in transmission light. If the cells with the depolarised stained surface membrane detected by fluorescent light show cytological symptoms of dyscariosis, and/or proliferative parabasal cell complexes with no symptoms of dyscariosis show depolarised stained surface membranes or granular stained cytoplasm, a patient is subsumed to the risk group of the presence of neoplastic disorders in the cervical epithelium.
EFFECT: higher analysis accuracy.
SUBSTANCE: LAKK-02 apparatus is used to evaluate a capillary blood flow reserve in two iontophoresis sampled taken from skin of a left forearm in a point along a median line 4 cm higher than styloid process of ulna and radius. An endothelial function coefficient EFC is calculated by formula: where AC BFR is the capillary blood flow reserve in response to acertylcholine; SN BFR is the capillary blood flow reserve in response to sodium nitroprusside. If the EFC value is lower than 1.0, a disturbed microvascular endothelium vasoregulation is stated.
EFFECT: use of the invention allows simplifying diagnostics of the microvascular endothelium status in patients with bronchial asthma.
SUBSTANCE: biopsy materials of a mucous membrane of a gastric corpus and a duodenum are analysed for mast cell count per 100 cells of infiltrate. At detecting more than 3.5 mast cells per 100 infiltrate cells in the biopsy materials of the mucous membrane of the gastric corpus and more than 4.75 cells per 100 infiltrate cells in the biopsy materials of the mucous membrane of the descending duodenum, immunohistochemistry or PCR diagnostics are required. If detecting Epstein-Barr virus antigens or DNA in the biopsy materials of the gastric and duodenal mucosa, EBV associated gastroduodenitis is diagnosed.
EFFECT: use of the technique allows diagnosing EBV associated gastroduodenitis in children.
SUBSTANCE: invention describes method of noninvasive potentiometric determination of oxidant/antioxidant activity of biological tissues, which includes bringing analysed object in contact with electroconductive medium, which containing mediator system and estimation of oxidant/antioxidant activity by change of potential difference on electrodes, introduced into electroconductive medium, and electroconductive medium represents gel, which contains as mediator system a pair of chemical compounds, containing element in different degrees of oxidation, electrodes through gel contact with the analysed object, and oxidant/antioxidant activity is determined by formulae. For realisation of method claimed is device, which includes apparatus for measuring potential difference and filled with electroconductive medium reservoir with working electrode and electrode of comparison, connected with device for measuring potential difference, where reservoir is made open from one side. As electroconductive medium applied is gel, and working electrode is made in form of plate, placed from the side of open part of reservoir and partially covering it.
EFFECT: increase of reliability and accuracy of obtained results.
4 cl, 5 ex, 6 dwg
SUBSTANCE: light flux power passed though biological tissue specimen is measured in photometric chamber at two different flux reception aperture. Note here that, first, diaphragm is used to limit flow diameter to that equal to diameter d of specimen illuminating beam. Then, said diameter is increased to diameter D 5 to 10 times greater than first diameter d. Dissipation and absorption factors s and a are defined from formulas, respectively: s = p∂+τ∂ and a = 1 - s - τd, where τd is directed transmission factor defined as τd=Fτd/F0, F0 is initial power of illuminating beam, (mW), Fτd is measured power of transmitted flux with diaphragm d, τ∂ is diffusion transmission factor defines as: τ∂ =τ -τd, where τ is total (integral) transmission factor defined as τ=Fτ/F0, where Fτ is measured power of transmitted flux, (mW), with diaphragm D, ρ∂ is back scatter factor defined from for photometric invariant
EFFECT: high accuracy.
1 ex, 1 dwg
SUBSTANCE: stool consistency and urine acidity are determined. Stool type is estimated by Bristol scale. Diet is administered. When stool type 5 or 6 by Bristol scale and alkaline urine reaction are achieved, conclusion about sufficient content of dietary fibres in diet is made.
EFFECT: method makes it possible to establish individual need in dietary fibres.
SUBSTANCE: invention refers to a diagnostic technique for chronic tonsillitis (CT). A patient is examined for a complex of intestinal mirobiocenosis indicators: the content of bifidus bacterium, lactic acid bacillus, normal coli bacillus, hemolytic coli bacillus, lactose-negative coli bacillus, enterococcus, staphylococcus saprophyticus, staphylococcus aureus, Candida fungus to be compared with the reference values by a score scale. A dysbiosis index is calculated by formula: where DI is the dysbiosis index, I1 I2…In are the evaluated intestinal mirobiocenosis indicators, n is a number of the evaluated indicators. If the dysbiosis index is 0 to 0.73±0.07, a compensated form of the disease is diagnosed in a patient with local signs of CT. If the dysbiosis index is 0.89±0.11 and higher, a decompensated form of CT is stated.
EFFECT: use of the method enables diagnosing the compensated and decompensated forms of CT, specifying a further therapeutic approach, detecting indications and contra-indications to surgical intervention, prescribing an adequate antibacterial therapy and carrying out preventive measures.
2 tbl, 3 ex
SUBSTANCE: blood serum is analysed for a creatinine level, glomerular filtration rate is evaluated by MDRD formula, relative urine density is determined, then a maximum thickness of renal parenchyma, systolic and diastolic blood pressure are measured. Further, the presence of sclerosis is calculated by formula:
, where S is an index of renal glomerule sclerosis, K is glomerular filtration rate calculated by MDRD method (ml/min/1.73 m2), O is a relative morning urine density, T is the greatest thickness of renal parenchyma determined by ultrasound data (mm), C is systolic blood pressure (mm Hg), D is diastolic blood pressure (mm Hg). If S <10, the absence of glomerule sclerosis is diagnosed, and if the values S≥10.1 shows the presence of nephritic tissue sclerosis. The method can be used in initial diagnosing of glomerulosclerosis in the patients with diffuse renal diseases.
EFFECT: use of the method provides noninvasive diagnostics of renal sclerosis in glomerulopathies.
3 ex, 2 tbl
SUBSTANCE: invention can be used: in medicine, in studying the diseases associated with inflammations, cell respiration disturbance, protein decomposition, in pharmacology, for detecting the iatrogenic diseases caused by various fillers, in biophysics (magnetobiology), for interpreting a mechanism of biomedical effect produced by electromagnetic fields in a human body, in mineralogy whereas considerably expanding temperature barometric, time and oxidation-reduction limits of oxide and sulphide mineral formation, in biochemistry, colloidal chemistry etc. The use of an ultrathin tissue section prepared for electron microscopy enables mineral grain analysis by electronic microdiffractometry.
EFFECT: higher reliability of the phase analysis.
2 ex, 6 dwg
SUBSTANCE: invention describes a method of evaluating the heparin concentration in puerperants underwent acute herpes viral infection in the third trimester, characterised by the fact that a piece of placenta is sampled from the puerperants, homogenate is prepared and processed for glycosaminoglycans recovery. Thereafter, the prepared glycosaminoglycans extracts are separated by gel electrophoresis in a polyacrylamide gel, and a heparin percentage is calculated by optical density sensitometry; a herpes viral infective episode is stated by spectrophotometry and shown by increasing titre of herpes virus antibodies.
EFFECT: higher analysis accuracy.
SUBSTANCE: invention relates to medicine, namely to cardiology. In people with newly arising episode of persisting atrial fibrillation with metabolic syndrome, estimated are waist circumference, systolic and diastolic levels of arterial pressure, level of triglycerides, low and high density lipoproteins, glucose in blood plasma. Index of metabolic syndrome (IMS) is determined as sum of points of all used parameters. IMS value is used to predict spontaneous recovery of rhythm, good effect of drug/electric cardioversion; need of additional examination or formation of constant form of atrial fibrillation.
EFFECT: increase of method efficiency.
SUBSTANCE: invention relates to medicine, namely to oncology. In order to predict development of metachronous hyperplastic processes in organs of female reproductive system analysis of neoangiogenesis in tissue of malignant tumour of mammary gland ablated during operation is performed. If coefficient of ratio of vessel endothelium growth factor level to epidermal growth factor in malignant tumour tissue equals 2.5+0.2, development of metachronously developing hyperplastic process in uterus body in patients with breast cancer is predicted.
EFFECT: method makes it possible to predict metachronously developing hyperplastic process in uterus body before their clinical manifestation in patients with breast cancer.
1 ex, 1 tbl
SUBSTANCE: invention relates to field of medicine, namely to therapy and cardiology. In order to stratify risk of cardiovascular diseases in young women with estrogen deficiency risk factors are identified: presence of early menopause in mother, presence of arterial hypertension, increase of general blood cholesterol, increase of level of triglycerides in blood, increase of content of low density lipoproteins, reduction of content of high density lipoproteins. Risk factors are estimated and if content of low density lipoproteins in blood is higher than 4.0 mmol/l, 4 points are given; in case of family history of early menopause - 3 points; if content of triglycerides in blood is higher than 2.0 mmol/l - 2 points; in case of arterial hypertension - 1 point; if content of high density lipoproteins is lower than 1.2 mmol/l - 1 point; in case if cholesterol content in blood is higher than 5.5 mmol/l - 1 point. If sum of points is from 1 to 4 points, group of low risk is determined, in case if sum of points is from 5 to 7, group of middle risk is determined, in case of sum is higher than 7 group of high risk of cardiovascular diseases is determined.
EFFECT: method makes it possible to determine risk of cardiovascular diseases in young women with estrogen deficiency.
3 ex, 1 tbl
SUBSTANCE: invention relates to medical equipment and can be used in transplantology. Apparatus perfusion of transplant isolated from body of kidney transplant donor is carried out in hypothermal conditions for 3-6 hours with constant systolic pressure 35-40 mm Hg, quality of transplant being estimated by change of values of resistive index and rate of perfusate flow, if during perfusion resistive index decreases in 2.5-3.5 times with simultaneous more than 80 ml/sec increase of perfusate flow rate, transplant is considered suitable for single transplantation, if resistive index decrease by 25-35% with simultaneous increase of perfusate flow rate by 25-35% with respect to initial values, simultaneous transplantation of both kidneys is recommended, if resistive index and rate of perfusate flow do not change, transplant is not suitable for transplantation.
EFFECT: method makes it possible to objectively estimate state of vascular bed of kidneys from donors with extended criteria for performance of single or double transplantation.
1 cl, 3 ex
SUBSTANCE: invention relates to medicine, namely, to phthisiology and is intended for prediction of development of drug-resistant pulmonary tuberculosis (DR TB). On first 3-5 days after arriving at hospital as risk factors in point estimation determined are: discharge of bacteria, clinical form of tuberculosis; spread of tuberculosis process in lungs; category; contact with patient with tuberculosis, abuse; patient's social status; sex; age; tobacco smoking; terms of fluorographic examination; type structure building of blood serum facies; collection of pathological markers of necrobiosis in blood serum facies. Sum of points is calculated and if it equals 1-7 points, probability of DR TB development is estimated as low, 8-12 - as moderate, 13-19 - as high.
EFFECT: method makes it possible to realise correction of chemical therapy of patients with high risk of DR pulmonary TB development.
SUBSTANCE: invention relates to medicine, obstetrics, gynecology, pediatrics and can be used for early diagnostics of autoimmune oophoritis in teenage girls with abdominal pain. Complex estimation of complaint parameters, anamnesis, objective examination, alboratory and instrumental indices, during which each of parameters is given corresponding number of points: tainted hereditary as to autoimmune diseases - 3 points, tainted hereditary as to thyroid gland diseases - 2 points, pregnancy toxicosis in mother - 3 points, retarded development in period of early childhood and at the moment of examination - 3 points, presence of body weight deficiency at the moment of examination - 3 points, verified diagnosis of celiac disease - 4 points, accompanying celiac disease autoimmune diseases of other organs and systems - 2 points, retardation of puberty - 3 points, late beginning of menarche - 4 points, menstrual cycle disorders - 4 points, inflammatory gynecological diseases - 3 points, painful menstruations - 3 points, presence of heavy menstrual bleeding - 2 points, pain in abdomen during palpation - 4 points, developed pain abdominal syndrome - 1 point, increase of total volume of ovaries according to USE - 4 points, disformity of bile bladder according to USE - 4 points, reduction of estradiol level - 3 points.
EFFECT: method ensures early diagnostics of autoimmune oophritis in teenage girls with pain in abdomen with earlier diagnosed celiac disease, who are on diet.
1 tbl, 2 ex
SUBSTANCE: invention relates to medicine, namely to neurosurgery. Values of 20 prognostic signs, which contain 12 anatomo-anthropometric parameters separately for men and women, 8 immunologic and immunogenetic indices, selected by methods of principal components and expert evaluation, are estimated. By Bayesian algorithm in Genkin-Gubler modification found are corresponding prognostic coefficients: for anthropometric parameters in men with body length: less than 168.6 cm equal +3, from 168.6 to 177.2 cm equal - 1, more than 177.2 cm equal 0; with body weight: less than 67.5 kg equal 0, from 67.5 to 85.9 kg equal - 1, more than 85.9 kg equal +4; with fat fold of hip: less than 8.4 mm equal +19, from 8.4 to 18.3 mm equal -6, more than 18.3 mm equal -6; with fat fold of chest: less than 8.0 mm equal +5, from 8.0 to 17.9 mm equal 0, more than 17.9 equal -3; with girth of shoulder: less than 27.9 cm equal +1, from 27.9 to 33.0 cm equal 0, more than 33.0 cm equal -1; with distal diameter of shoulder: less than 6.6 cm equal -9, from 26.6 to 7.4 cm equal +1, more than 7.4 cm equal +1; with transverse diameter of chest: less than 28.4 cm equal +2, from 28.4 to 33.3 cm equal -1, more than 33.3 cm equal +1. When values of Tenner's index are: less than 93.1 equal -7; from 83.7 to 93.1 equal +3, more than 83.7 equal +6; when values of index of relative width of shoulders is: less than 20.6 equal 0, from 20.6 to 23.5 equal -3, equal -3, more than 23.5 equal +6; when values of index of relative width of pelvis are: less or equal 15.9 equal +6, from 16.0 to 17.9 equal -5, more or equal 18.0 equal -2. When values of Ketle's index are: less than 18.5 kg/m2 equal 0, from 18.5 to 30.0 kg/m2 equal -1, from 25.0 to 30.0 kg/m2 equal -1, more than 30.0 kg/m2 equal +7; for anthropometric parameters in women: with body length: less than 156.5 cm equal 0, 156-165 cm equal 0, more than 164.7 cm equal -1; with body weight: less than 63.7 kg equal -1, from 63.7 to 83.8 kg equal - 1, more than 83.8 kg equal +3; with fat fold of shoulder on the front: less than 11.3 mm equal +1, from 11.3 to 20.6 mm equal -1, more than 20.6 mm equal +2; with fat fold of shoulder on the back: less than 19.6 mm equal +2, from 19.6 to 29.9 mm equal -1, more than 29.9 mm equal +1; with fat fold of hip: less than 14.5 mm equal+19, from 14.5 to 25.2 mm equal -2, more than 25.2 mm equal -11; with girth of hip: less than 55.7 equal +1, from 55.7 to 64.3 cm equal -3, more than 64.3 cm equal +14; with distal diameter of ankle: less than 5.8 cm equal -3, from 5.8-6.8 cm equal +1, more than 6.8 cm equal -1. When values of Rees-Eisenck index are: more or equal 107 equal -3, from 106 to 97 equal +2, less or equal 96 equal +4; when values of index of relative width of shoulders is: less than 20.6 equal +16, from 20.6 to 23.5 equal -5, more than 23.5 equal -6; when values of index of relative width of pelvis are: less or equal 15.9 equal+3, from 16.0 to 17.9 equal -2, more or equal 18.0 equal 0; when values of pelvic-shoulder index is: less or equal 69.9 equal 0, from 70.0 to 74.0 equal -1, more or equal 75 equal 0. When values of Ketle's index are: less than 18.5 kg/m2 equal +3, from 18.5 to 25.0 kg/m2 equal -2, from 25.0 to 30.0 kg/m2 equal-1, more than 30.0 kg/m2 equal +2. For immunologic and immunogenic parameters with relative content of CD3+: less than 67% equal 0, from 67 to 76% equal +1, more than 76% equal 0. With relative content of CD8+: less than 28% equal +4, from 28 to 40% equal -1, more than 40% equal -5. When values of immunoregulatory index (CD4+/CD8+) are: less than 1.2 equal -1, from 1.2 to 2.0 equal +2, more than 2.0 equal +3. When level of IgA is: less than 1.4 g/l equal -1, from 1.4 to 4.2 g/l equal 0, more than 4.2 g/l equal +6; when level of IgM is: less than 0.5 g/l equal 0, from 0.5 to 1.3 g/l equal 0, more than 1.3 g/l equal +1; when level of IgG is: less than 8.0 g/l equal -7, from 8.0 to 16.6 g/l equal 0, more than 16.6 g/l equal +6. When level of CIC is: from 0 to 100 c.u. equal 0, more than 100 c.u. equal +7; with HLA B27 phenotype: HLA B27(+) equal +7, HLA B27(-) equal -7, which are summed up, and if obtained value is +13 and higher, high degree of risk of developing fibrosis in epidural space is predicted, if value is 13 and lower - insignificant risk of development, in cases, when total prognostic coefficient is less than +13 and higher than -13 prognosis is estimated as indefinite.
EFFECT: method makes it possible in preoperative period of standard microdisectomies to determine degree of risk of developing fibrosis in epidural space after surgery of hernias of lumbar intervertebral discs and thus increase efficiency of its prevention.
SUBSTANCE: invention relates to field of medicine and can be used for detecting efficiency of carrying out therapeutic or therapeutically-health-improving measures in passage of patient from pathogenesis to sanogenesis under influence of controlling therapeutic impacts. Measured are values of different diagnostic signs xi, which characterise vector of human organism state (VHOS) x=(x1,x2,…xm)T in m-dimensional phase space of states (PSS). For group of patients as a result of said signs xi measurement obtained is set of points in PSS in form of a "cloud", and for an individual patient carried are several repeated measurements, when patient is in approximately similar physiological conditions and obtained totality of measurements of xi (points in PSS) also, but already for an individual person forms a "cloud" in PSS, which occupies definite region of phase space, designated as quasiattractor (QA). Performed is calculation of parameters of obtained quasiattractor in PSS, namely: volume of Vg of m-dimensional parallelepiped, inside which QA is placed by formula: where values Di=(ximax-Ximin) represent dimensions of sides of parallelepiped with volume Vg, and coordinates Ximax represent extreme "right" point from the set in projection on coordinate axis xi and ximin - extreme "left" point from the same set of coordinates; coordinates of vector xc of the centre C of said m-dimensional parallelepiped from formula where xc=(x1c,x2c,…,xmc)T; index r of asymmetry is determined as a distance between coordinates of chaotic centre in PSS and stochastic centre xis. Said parameters QA for group of patients or for one patient - in case of repetition of measurements - are determined before beginning of carrying out therapeutic or therapeutically-health-improving measures and after expiry of certain time τ. By measurement of Vg, xc and r value conclusion about therapeutic impact efficiency is made. If changes ΔVg, Δxc Δr are small - less than 10% from initial value, decision about low efficiency of therapeutic measure is made.
EFFECT: method makes it possible to estimate quantitatively efficiency of carrying out therapeutic, training-health-improving and other measures, selecting as xi various diagnostic signs.
3 tbl, 5 dwg
SUBSTANCE: invention relates to field of medicine, in particular to low-invasive methods in surgical endocrinology. In order to diagnose pathologically changed parathyroid glands carried out are: fine-needle aspiration puncture biopsy under ultrasonic navigation; washing from aspiration needle with reagent; determination of parathyroid hormone are performed. Washing from needle is carried out with specially prepared "draining serum" from healthy donors with preliminarily known level of parathyroid hormone. Determination of parathyroid hormone level is performed by subtraction of mean arithmetic value of parathyroid hormone of "draining serum" from obtained value of parathyroid hormone in mixture of "draining serum" and contents of aspiration needle. Level of parathyroid hormone at which pathologically changed parathyroid gland is diagnosed is 65 pg/ml and higher or value, higher than is contained in blood serum of said patient.
EFFECT: method increases accuracy of diagnostics of pathologically changed parathyroid glands due to determination in obtained material of parathyroid hormone level with small trauma due to targeted aspiration of contents.
SUBSTANCE: invention relates to field of medicine, in particular to toxicology and pharmacology. Reduction of neurologic indices of nervous system functioning: behaviour (B), pharyngeal reflex (PR), tactile-pain sensitivity (PR), flexion reflex of hind limbs (FR), papillary reflex (PR), corneal reflex (CR) is estimated by four-point system. Index of severity of nervous system depression (ISNSD) is calculated by formula: ISNSD= 5*B+4*PR+3*PR+2*FR+2*PR+CR. If ISNSD value is higher than 55 points, state of nervous system functioning is estimated as being within physiological norm, from 46 to 55 points - torpor; from 36 to 45 points - spoor; from 26 to 35 points - moderate coma; from 18 to 25 points - deep coma, 17 points and lower - prohibitive coma.
EFFECT: method makes it possible to increase reliability of determining degree of nervous system depression in case of alcoholic intoxication.
2 tbl, 4 dwg, 4 ex
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