Method for increasing effectiveness of endosurgical management of patients suffering acute biliary pancreatitis
SUBSTANCE: thoracic epidural analgesia is conducted by puncturing and catheterisation of an epidural space at ThVIII - ThIX before the expiry of 24 hours from the onset of a disease after a moderate intravenous infusion therapy in the amount of 15-20 mg/kg of crystalloid solutions. 20 minutes before an expected endoscopic papillosphincterotomy, a catheter is moved 4-5 cm in a cranial direction. At ThV-ThX, 0.4% naropin 10-12 ml or 0.2% Marcaine 10-12 ml and clonidine 100 mcg are administered through a catheter. That is followed by a pre-medication by administering 0.1% atropine 0.5-1 ml and 0.5% relanium 1-2 ml. Thereafter, the patient is taken to an X-ray operation room to conduct the endoscopic papillosphincterotomy without an endoscopic retrograde cholangiopancreatography with general pancreatic duct stenting. After the operation has been completed, the patient is taken to an intensive care unit wherein an extended epidural analgesia is conducted by administering 0.2% naropin 10-12 ml or 0.15% marcaine 10-12 ml into the epidural space every 4 hours until the patient is taken to a department of surgery.
EFFECT: early intestinal motility recovery, increased pancreatic secretion, prevented spasm of the gastrointestinal sphincter ensured by a pathological complete blockade of sympathetic impulsing.
The invention relates to medicine, in particular for endosurgery and anesthesiology, and applies tactics of treatment of patients with the syndrome of biliary hypertension, acute biliary pancreatitis.
The proportion of acute biliary pancreatitis in the structure of acute inflammation of the pancreas, according to various authors, 30-40% of cases[1, 2, 3, 4, 5]. Overall mortality in acute pancreatitis, both in our country and in the European countries is 7%-10%, and in severe acute biliary pancreatitis reaches 20%-39% .
There is a conservative treatment for acute biliary pancreatitis, which includes the use of various drugs: drugs that reduce exocrine activity of the pancreas (somatostatin), which improves motor function of the intestine (prokinetic, cholinomimetic agents), non-hormonal anti-inflammatory drugs, heparin, and others.
The disadvantages of this method are the low efficiency and a high risk of developing septic complications, high cost of these drugs, high risk of relapse.
Known endosurgical treatment of acute biliary pancreatitis, which in the early stages perform endoscopic papillosphincterotomy, using as obezbolivaet what I narcotic analgesics, intravenous anesthesia or endotracheal anesthesia (prototype). Some researchers recommend the use of epidural anesthesia with local anesthetics only paresis of the intestine and in the presence of satisfactory evidence of pancreatic necrosis.
The disadvantages of this method are its lack of effectiveness, since, in some cases, swelling of the papillae after endoscopic papillosphincterotomy leads to violation of the outflow of pancreatic juice, which negatively affects the course of the disease. And the use of the above methods of anesthesia does not provide a complete blockade of pathological sympathetic activity and in the immediate postoperative period leads to the inhibition of intestinal peristalsis, increase comproducts pancreas, as well as spasm of the sphincters of the gastrointestinal tract. A delayed application of epidural anesthesia only local anesthetics is not effective.
The technical result of the claimed method is to increase the efficiency of treatment of patients with acute biliary pancreatitis.
The technical result is achieved by the fact that the way to improve efficiency endosurgical treatment of patients with acute biliary pancreatitis, including early, up to 24 hours, for endoscopic papillosphincterotomy without e is roscopically retrograde pancreatography with stenting common pancreatic duct, performing against the backdrop of thoracic epidural analgesia with the purpose for which, after reasonable intravenous infusion therapy in the volume of 15-20 ml/kg crystalloid solutions, the dotted line and kateteriziruyut epidural space at the level of ThVIII - ThIX, the catheter promote 4-5 cm in the cranial direction, 20 minutes before the expected endoscopic papillosphincterotomy to achieve sensory and sympathetic blocks of a ThV-ThX, through the epidural catheter impose naropina solution of 0.4% - 10-12 ml or solution marcaine 0,2% - 10-12 ml and the solution clonidine 100 mcg, after sedation with the use of a solution of atropine 0,1% - 0,5-1 ml of a solution Relanium a 0.5% 1-2 ml of the patient served in the x-ray operation room for endoscopic transpapillary intervention, and after endoscopic transpapillary intervention the patient is transferred to the intensive care unit, where they extended epidural analgesia is injected into the epidural space every 4 hours solution naropin 0,2% - 10-12 ml or solution marcaine 0,15% - 10-12 ml to transfer the patient in the surgical ward.
The essence of the proposed method.
Improving the efficiency of treatment of patients with acute biliary pancreatitis is achieved early endoscopic papillosphincterotomy, without endoscopic [retr] the grapes of pancreatography, with stenting common pancreatic duct, with the use of thoracic epidural analgesia with local anesthetics and α2-agonist Central action.
In conducting retrospective study in state budgetary educational institution of higher professional education "Volgograd state medical University Clinic No. 1 in 2008 - 2012, it is proved that the use of this tactic has significantly reduced the number of deaths (5.8 times), the cost of treatment in these patients and the time of their hospitalization (2.1 times).
When using the inventive method offers the possibility of effective treatment of patients with acute pain and comorbidity.
Methodology the proposed method.
The method is as follows. After ultrasound or MRI to confirm a patient with acute pancreatitis signs of choledocholithiasis or stenosis of the major duodenal papilla, the patient arrives in the ICU, where, after a moderate intravenous infusion therapy in the volume of 15-20 ml of crystalloid solutions, the dotted line and kateteriziruyut epidural space at the level of ThVIII - ThIX, the catheter promote 4-5 cm in the cranial direction, 20 minutes before the expected endoscopic papillosphincterotomy to achieve sensory and sympathetic blocks of a ThV - ThX,through the epidural catheter impose naropina solution of 0.4% - 10-12 ml or solution marcaine 0,2% - 10-12 ml and the solution clonidine 100 mcg, after sedation with the use of a solution of atropine 0.1% to 0.5-1 ml of a solution Relanium a 0.5% 1-2 ml of the patient served in the x-ray operation room to conduct endoscopic papillosphincterotomy without endoscopic retrograde pancreatography, with stenting common pancreatic duct, and after endoscopic transpapillary intervention the patient is transferred to the intensive care unit, where they extended epidural analgesia is injected into the epidural space every 4 hours solution naropin 0,2% - 10-12 ml or solution marcaine 0,15% - 10-12 ml to transfer in surgical branch.
An example of a specific implementation.
Patient N., 41 year history No. 504, was admitted to the surgical Department of the hospital №1 Wagga 09.02.12 at 09.40 hours with a diagnosis of post-cholecystectomy syndrome. Choledocholithiasis. Acute biliary pancreatitis.
Patient transferred to the intensive care unit for preparation for endoscopic papillosphincterotomy.
09.02.12 was made urgent endoscopic papillosphincterotomy, lithoextraction, stenting of the main pancreatic duct.
As the anesthesia was used thoracic epidural analgesia.
The Protocol breast disease the General analgesia.
Infusion therapy: aq NaCl 0,9% - 400ml, aq Glucose 5% - 400ml. Under aseptic conditions, under local anesthesia Sol. Lidocaini 2% - 2ml, level ThVIII - ThIX produced puncture and catheterization of the epidural space, the catheter is pulled to 5 cm in the cranial direction, the suction test is negative, put a test dose of Sol. Lidocaini 2% - 4 ml, 15 min signs of intrathecal injection of anesthetic no. Aseptic dressing, catheter fixed with adhesive tape.
After carrying out the suction of the sample entered the main dose: Sol. Marcaini 0,2% - 12ml, Sol. Klofelini 0.01% by lml. After 15 min: sensory block level ThV - ThXI, sympathetic block ThIV - ThXII.
Breathing independent, adequate, stable hemodynamics, HELL 125/65 mm Hg, PS 67 1 min, rhythmic.
With sedation/entered: Sol. Atropini of 0.1% to 0.6 ml, Sol. Relanii 0,5% - 1 ml. The patient is transported in the x-ray operation room.
Protocol operations No. 28.
In the stomach - the picture is mixed gastritis. The mucosa of the duodenal bulb edematous, hyperemic. Large duodenal papilla significantly pronounced swollen, the mouth up to 4 mm with scalloped edges, covered with fibrin. From the mouth of the choledochus bile is not received. Canulate to 60 mm Retrograde cholangiography was not performed. Endoscopic papillosphincterotomy to 18 mm In instrumental revision and reorganization of the choledochus received calculus di the meter. 11 mm cholesterol "putty". From the mouth of the choledochus actively enters the bile. Through the mouth of the common pancreatic duct held plastic stent diameter 5Fr.
Diagnosis: post-cholecystectomy syndrome. Choledocholithiasis. Acute biliary pancreatitis.
In the postoperative period was held conservative therapy, prolonged epidural analgesia. After 20 hours removed the catheter from the epidural space, the patient was transferred from intensive care to the surgical Department. Within 2 days of normal laboratory values, disappeared clinical signs of acute pancreatitis. When the control ultrasound data for the presence of free fluid in the abdominal cavity is not revealed. After 4 days recorded samochodzie stent of the common pancreatic duct. Discharged on the 6th day in a satisfactory condition.
Advantages, the positive effect of the claimed method:
- The effectiveness of the inventive method more efficient than all known methods of treatment of acute biliary pancreatitis;
- The use of this method reduces the risk of fatal complications (pancreatic shock, multiple organ failure);
- Safe in patients with severe concomitant (particularly cardiovascular) pathology;
- The claimed method can significantly cut the ü the incidence of septic complications;
Compared with other methods do not require significant expenses.
It should be noted that the application of the inventive method leads to a reduction of the average duration of hospitalization with 16.8 days to 7.9 days. This relative reduction in mortality of 82.9%. The reduction in the absolute risk of fatal complications is 6.3%.
1. Kim V.L., Khakimov MS, Karimov FS Retrograde endobiliary intervention in acute biliary pancreatitis // Annals of surgery, 2005; 4: 39-42.
2. Kovachev KG, Abdullayev EG, Chacabuco MS, Abdullayev SUPERVISION Opportunities endoscopic techniques in the treatment of patients with acute biliary pancreatitis // Bulletin of the Ivanovo medical Academy, 2010; 4(15): 24-28.
3. Nazarenko, M., Nazarenko, D.P., Kanishchev J.V., Tarasov O., Loktionov A.L., Alyokhin S.A. Surgical tactics in acute biliary pancreatitis // Annals of surgical Hepatology, 2011; 4(16): 71-76.
4. Pascari ST. Pathogenetic approaches in the treatment of biliary pancreatitis // Herald of the Russian military medical Academy, 2010; 3: 78-83.
5. Shapovalianz YEAR, Myl'nikov, A.G., eagles, HE, Pankov A.G., Budzinskaya S.A., Ardzinov T.B. Diagnosis and treatment of acute biliary pancreatitis // Annals of surgical Hepatology, 2009; 1(14): 29-33.
The way to improve efficiency endoh the surgical treatment of patients with acute biliary pancreatitis, characterized in that for this purpose perform early, up to 24 hours, endoscopic papillosphincterotomy without endoscopic retrograde pancreatography with stenting common pancreatic duct, which perform against the backdrop of thoracic epidural analgesia with the purpose for which, after reasonable intravenous infusion therapy in the volume of 15-20 ml/kg crystalloid solutions, the dotted line and kateteriziruyut epidural space at the level of ThVIII-ThIX, the catheter promote 4-5 cm in the cranial direction, 20 minutes before the expected endoscopic papillosphincterotomy to achieve sensory and sympathetic blocks of a ThV-ThX, through an epidural catheter is injected solution naropin 0,4% - 10-12 ml or solution marcaine 0,2% - 10-12 ml and the solution clonidine 100 mcg, after sedation with the use of a solution of atropine 0.1% to 0.5-1 ml of a solution Relanium a 0.5% 1-2 ml of the patient served in the x-ray operation room for endoscopic transpapillary intervention, and after endoscopic transpapillary intervention the patient is transferred to the intensive care unit, where they extended epidural analgesia is injected into the epidural space every 4 hours solution naropin 0,2% - 10-12 ml or solution marcaine 0,15% - 10-12 ml to transfer the patient to the surgical the e branch.
SUBSTANCE: group of inventions refers to medicine, and can be used in need of the delivery of therapeutic compositions for local application, including for local analgesic therapy. That is ensured by a system comprising a container having a first chamber with a therapeutic composition for local application with at least one active ingredient, and a second chamber containing a coating composition. The composition for local application and the coating composition is dispensed through a valve and supplied through one nozzle gradually. The delivery can be also gradual by dispensing the composition for local application by pressing a first release button, while the coating composition is dispensed from the system by pressing a second release button.
EFFECT: invention provides the most convenient delivery of the therapeutic compositions ensured by the gradual release of the two compositions having different consistence through the same nozzle.
SUBSTANCE: invention refers to medicine, namely to paediatric anaesthesiology, and may be used for executing the surgical operations of neck and head cancers in children. A pre-operative Kerdo index is determined. If observing an initial sympathicotonia, the anaesthesia is induced by sevoflurane inhalations and potentiated by administration of 1% propofol to be followed by sevoflurane inhalations.
EFFECT: method enables optimising the course of anaesthesia, achieving the normotonic sympathovagal balance and providing the haemodynamic stability by taking into account the individual vegetative response, as well as the separate and sequential administration of propofol and sevoflurane.
2 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely to anaesthesiology, and may be used as an anaesthesia care of a surgical intervention for carotid endaterectomy or internal carotid artery resection after pathological deformation thereof. That is ensured by general anaesthesia in a combination with deep and superficial cervical plexus blockade. Pre-medication is used the day before the operation and on the operative day in the morning. Diazepam is introduced intramuscularly 30 minutes before the operation in a combination with phentanyl; the introduction is followed by ECG monitoring and heart rate count, plethysmography with arterial blood saturation, non-invasive blood pressure measurement and neuromonitring according to a bispectral index or entropy. Catheterisation of patient's peripheral or central vein is followed by an infusion therapy, an ionotropic therapy, a cardiotropic therapy, peripheral resistance maintenance. If heart rate is no more than 80 beats per minute, the anaesthesia is induced to reach an anaesthetic depth according to the bispectral index or entropy within 40-60 units. Analgesia is provided by the intravenous introduction of 0.005% phentanyl; myoplegia is ensured by the intravenous introduction of a myorelaxant. After tracheal intubation, the patient is transferred to forced volumentic artificial pulmonary ventilation with the CO2 level within 35-45 mm Hg according to capnography. The anaesthesia is maintained by supplying an inhalation anaesthetic to the steam level of 0.8-1.0 MAK 0.8-0.9 litre of the air and oxygen flow containing 50% oxygen with controlling the inhalation anaesthetic volume by the level of the anaesthetic depth according to the bispectral index or entropy. That is followed by deep cervical plexus blockade. A tubercle of the VI cervical vertebra (a carotid tubercle) and a mastoid process are localised; thereafter a line connecting the above reference points is drawn on skin. The second line is drawn 1 cm below the first one in parallel. To verify an injection point of a local anaesthetic, the spines of IV, III, II cervical vertebras being at 1.5 cm from each other are palpated, and the reference point is the VI cervical vertebra. The needle is inserted perpendicularly to the skin and slightly in the caudal direction to reach the spines. The anaesthetic is introduced in a dose of 5-7 ml in each point C4, C3, C2. Another 5-7 ml of the anaesthetic is introduced in a point found in an apex of the mastoid process. The superficial cervical plexus blockade requires introducing he fan-shaped introduction of the anaesthetic solution in a dose of 15 ml in a point found in the middle of a lateral crus of the nodding muscle under the above muscle, 4-5 ml in each direction from the same point; the first and following injections are performed at a depth of a usual intramuscular needle perpendicularly to nodding muscle.
EFFECT: method provides the adequate and safe anaesthesia ensured by avoiding linear blood velocity reduction in the medial cerebral artery during the surgical intervention, preventing intracranial pressure increase, reducing cerebral perfusion pressure in a combination with providing adequate protection against surgical invasion with maintaining stroke volume and arterial pressure.
4 cl, 3 ex
SUBSTANCE: invention refers to medicine, namely anaesthesia, and may be used as a postoperative anaesthesia accompanying low- and medium-injury operations. For this purpose, at the stages of anaesthetising and de-anaesthetising, nonsteroidal anti-inflammatory compounds (NSAICs) are introduced intravenously. The NSAIC dose is equivalent to ketorol 0.5-3.0 ml. The introduction is performed 1-3 times.
EFFECT: method provides the complete prevention of developing postoperative pain syndrome ensured by the intravenous introduction of the NSAIC at the specific stages of anaesthesia in certain doses.
1 tbl, 5 ex
SUBSTANCE: presented group of inventions refers to anaesthesiology, and may be used in performing X-ray endovascular heart, aorta and other great vessel surgeries in infants and young children. For this purpose, 10-12 hours before the surgery, a patient is pre-medicated by administering benzodiazepine, antihistamine and blocker H2. The anaesthetic administration is enabled by fast induction of sevoflurane before the first surgical stage. Then, a two-flap laryngeal mask is used, its drainage duct is used to pass a gastric probe a correct placement of which is monitored by X-ray, and the gastric contents is evacuated. The probe is removed, and the same duct is used to insert an echocardiographic probe. The anaesthesia is maintained by infusion of propofol in a dose of 6-8 mg/kg/h and bolus introduction of an opioid analgesic. The artificial pulmonary ventilation is conducted through the laryngeal mask, and the patient is transferred to unassisted respiration with a dose of propofol to be reduced to 4-5 mg/kg/h. The principal stage of the surgery and ultrasonic control, or control with introducing a contrast agent, the echocardiographic probe is removed. Infusion of propofol is terminated after suturing and compression hemostasis. In the period of escaping the anaesthesia with the laryngopharyngeal reflexes recovered, air is evacuated from a cuff of the laryngeal mask, and after adequate respiration recovered, the same mask is removed.
EFFECT: group of inventions ensures the adequate anaesthesia in these patients by means of the developed method of lung ventilation using no myorelaxants, and prevented regurgitation of the gastric contents.
8 cl, 3 ex
SUBSTANCE: invention refers to medicine, in particular to anesthesiology and intensive care, and may be used if preoperative preparation of the patients with chronic pancreatitis and manifested pain syndrome required. For this purpose, back skin of a sitting patient is treated within a puncture at the Th7-Th8 level. Then, an epidural space is punctured, and a puncture catheter needle is introduced therein, and the catheter is pushed forward in the cranial direction to a depth of 3 cm. The needle is removed, and the catheter is placed along the spine and is brought out to the subclavian region while strapped all over. Thereafter, a test dose of 2% lidocaine 3.0 ml is introduced. If observing no effects of spinal block, prolonged permanent introduction of 0.2% ropivacaine at rate 4-5 ml/hour 3 times a day. With underlying it, 30 minutes before a meal, fractional introduction of 0.75% ropivacaine 3.0 ml and 0.005% fentanyl 1.0 ml for 4-5 days is performed.
EFFECT: method provides the adequate preparation of the patients for pancreatic surgery due to pain relief that enables supplying proteins and eliminating hypovolemia, as well as due to improved pancreatic-duodenal microcirculation.
FIELD: medicine, pharmaceutics.
SUBSTANCE: present invention refers to new derivatives of ((phenyl)imidazolyl)methylheteroaryl of formula wherein A represents pyridyl or thienyl having 0 or 1 substitute; B represents phenyl having 0, 1 or 2 substitutes; wherein each substitute independently represents alkyl having 1 to 8 carbon atoms, -F, -Cl, -Br or -CF3. Also, the invention refers to the use of the declared compounds for the purpose of preparing a therapeutic agent, a pharmaceutical composition on the basis of the declared compounds, and to a kit containing the pharmaceutical composition above.
EFFECT: there are prepared new derivatives of ((phenyl)imidazolyl)methylheteroaryl effective in pain management.
10 cl, 1 tbl, 2 ex
SUBSTANCE: invention relates to field of medicine, in particular, to experimental anesthesiology and resuscitation science. Method is realised in experiment by introduction of protamine sulfate in dose 10 mg/kg of animal weight before introduction of narcotic medication such as ether, or ethanol, or droperidol, or aminasin, or sodium oxybutirate.
EFFECT: invention makes it possible with introduction of narcotic medication to ensure short time of falling asleep of operated animal and long sleep during surgery.
2 tbl, 5 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: present invention refers to a new (-)-stereoisomer of formula (I) wherein X is H, or its pharmaceutically acceptable salt which agonise GABA receptor, to a pharmaceutical composition on the basis of the presented compound, to a method for preparing the (-)-stereoisomer of formula (I) or its pharmaceutically acceptable salt, to a method for inducing or maintaining general anaesthesia, to a method for promoting pain management and to a method for promoting pain management and to a method for prototyping antiemetic activity with the use of the presented (-)-stereoisomer or its pharmaceutically acceptable salt, as well as to a new diastereoisomer (-)-2,6-di-fluoro-butylphenyl ester of carbamic acid of formula (II) wherein R1 represents a chiral amino group, and X is H, or to its pharmaceutically acceptable salt.
EFFECT: preparing the pharmaceutically acceptable salt which agonise GABA receptor.
14 cl, 15 ex, 8 tbl, 3 dwg
FIELD: medicine, pharmaceutics.
SUBSTANCE: present invention refers to a new (-)-stereoisomer of formula (I) wherein X is H, or its pharmaceutically acceptable salt which agonise GABA receptor, to a pharmaceutical composition on the basis of the presented compound, to a method for preparing the (-)-stereoisomer of formula (I) or its pharmaceutically acceptable salt, to a method for inducing or maintaining general anaesthesia, to a method for promoting pain management and to a method for promoting pain management and to a method for prototyping antiemetic activity with the use of the presented (-)-stereoisomer or its pharmaceutically acceptable salt, as well as to a new diastereoisomer (-)-2-fluoro-butyl-6-isopropylphenyl ester of carbamic acid of formula (II) wherein R1 represents a chiral amino group, and X is H.
EFFECT: preparing the pharmaceutically acceptable salt which agonise GABA receptor.
16 cl, 12 ex, 6 tbl, 4 dwg
SUBSTANCE: invention refers to medicine, namely hepatology, and may be used for treating patients with hepatic cirrhosis. That is ensured by prescribing Essentiale Forte N as a hepatoprotective agent, detoxification agents, enzymes, diuretics, hemostatic preparations, vitamins B1, B6, C. The probiotic Linex is additionally taken. If observing Child Pugh A and B hepatic cirrhosis, a dosage is 2 capsules 3 times a day. In Child Pugh A disease, the length of the treatment is 6 weeks, while Child Pugh B requires 7 weeks of the treatment. The stage of Child Pugh C hepatic cirrhosis provides taking 3 capsules 3 times a day. The length of the treatment makes 8-9 weeks.
EFFECT: method provides the higher clinical effectiveness ensured by a differentiated approach depending on the stage of hepatic cirrhosis.
2 tbl, 4 ex
SUBSTANCE: invention refers to medicine, namely recreation therapy, and may be used for human health improvement. That is ensured by traditional medical examination of the patient. The findings are used to draw up the rehabilitation program including body cleansing, intestine and liver purification, physical exercises. One week before the beginning of the rehabilitation program, the patient starts separate nutrition with preferential vegetable food and dairy products, limited consumption of salt, alcohol and sugar. One day before the rehabilitation program, a fasting day is kept with taking 1% kephir or fresh apple juice. Further, on the first two days of the three-day program or on the first four days of the seven-day program, the body is cleansed by keeping a juice diet. The juice diet contains fresh vegetable and fruit juices, herbal infusions and mineral water. Water is unlimited. On the first day of the cleansing program, the intestine is purified with the preparation Fortrans. Starting from the first day the liver and gall bladder are cleansed with using herbal and saline choleretics for four days of the 7-day program and for two days of the 3-day program. That is combined with paradoxical respiration by Strelnikova's technique and hydrotherapy. Physical exercises involve physical loads on a cardio-vascular machine, one training as prescribed by the doctor - yoga, pilates, chi gong, water aerobics or hypoxi capsule. Therapeutic massage and lymph drainage massage follow. Then body-detox, ozone therapy, collagenarium procedures are performed. Cold training procedures involve Linear Kneipp, saunas, swimming pool, turpentine bathes. Bathing and cold training procedures are followed by pilling and algae wraps. From the 5th day of the 7-day program, or from the 3rd day of the 3-day program, the diet involves water cereals, vegetable and fruit salads, vegetable fast soups.
EFFECT: method provides effective patient's health recovery, namely weight loss, health improvement, blood value normalisation, formation behavioural model of health preservation over a shortest possible period of time.
SUBSTANCE: invention relates to novel omega-3 lipid compounds of general formula (I) or to their pharmaceutically acceptable salt, where in formula (I): R1 and R2 are similar or different and can be selected from group of substitutes, consisting of hydrogen atom, hydroxy group, C1-C7alkyl group, halogen atom, C1-C7alkoxy group, C1-C7alkylthio group, C1-C7alkoxycarbonyl group, carboxy group, aminogroup and C1-C7alkylamino group; X represents carboxylic acid or its carbonate, selected from ethylcarboxylate, methylcarboxylate, n-propylcarboxylate, isopropylcarboxylate, n-butylcarboxylate, sec-butylcarboxylate or n-hexylcarboxylate, carboxylic acid in form of triglyceride, diglyceride, 1-monoglyceride or 2-monoglyceride, or carboxamide, selected from primary carboxamide, N-methylcarboxamide, N,N-dimethylcarboxamide, N-ethylcarboxamide or N,N-diethylcarboxamide; and Y stands for C16-C22 alkene with two or more double bonds, which have E- and/or Z-configuration.
EFFECT: described are pharmaceutical and lipid compositions, which contain said compounds, for application as medications, in particular, for treatment and/or prevention of peripheral insulin resistance and/or condition of diabetes, for instance, type 2 diabetes, increased levels of triglycerides and/or levels of non-HDL cholesterol, LDL cholesterol and VLDL cholesterol, hyperlipidemic condition, for instance, hypertriglyceridemia (HTG), obesity or condition of excessive body weight, fatty liver disease, for instance, non-alcoholic fatty liver disease (NAFLD) or inflammatory disease or condition.
60 cl, 3 tbl, 65 ex
SUBSTANCE: pharmaceutical composition for treating or preventing hepatic disorders containing herbal docosahexaenoic acid and polydatin in a certain amount per a dose.
EFFECT: composition is effective for treating or preventing the hepatic disorders.
7 cl, 1 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely physiotherapy. A method involves the administration of chophytol, diet therapy, magnetic therapy and exposure to electric current. The magnetic therapy is performed by a low-frequency sinusoidal alternating magnetic field. The exposure covers a collar zone and liver for 10-15 minutes. A continuous mode, frequency 50 Hz, grade I-II magentic induction are specified. The magnetic therapy is immediately followed by the exposure to complex-modulated pulse electric current with a neural-like pulse shape. The exposure is generated at the level ThVII - ThXI, paravertebrally to the right, and cover skin projections within the liver and gallbladder transversally. For this purpose, the electrodes are placed in 6 procedure fields: 1 - paravertebrally to the right at the level of the ThVII spine, 2 - paravertebrally to the right at the level of the ThXI spine, 3 - in a projection of the liver on a front surface of the body, 4 - in a projection of the liver on a back surface of the body, 5 - in a projection of the gallbladder on the front surface of the body, 6 - in a projection of the gallbladder on the back surface of the body. The 1st and 2nd electrodes are connected to the channel IV, while the 3rd and 4th electrodes - to the channel I, and the 5th and 6th electrodes are connected to the channel II. The channels I, II work in a frequency-drift group mode. The channel IV work in a continuous mode at fixed frequency 20 Hz. The current intensity is adjusted to apparent vibration sensation. Duration of a session is 10-15 minutes. The therapeutic course is 10-12 daily procedures.
EFFECT: method improves the motor function of the gall bladder ensured by the improved cholekinesis, hepatic circulation and cholestasis elimination.
2 ex, 3 tbl
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to pharmaceutical industry, particularly to a hepatoprotective herbal tea. The hepatoprotective herbal tea that contains black currant leaves, red raspberry leaves, great willow herb, meadowsweet herb in certain proportions.
EFFECT: herbal tea provides the effective hepatoprotective action.
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to pharmaceutical industry, namely to a microcapsules for preventing or treating hepatic disorders. The microcapsules for preventing or treating hepatic disorders containing a capsule coating, an encapsulating suspension of a therapeutically effective hepatocyte count in a physical contact with a hepatocyte-stimulating amount of erythropoietin. A method for preparing microcapsules involving preparing the suspension of the therapeutically effective hepatocyte count and the hepatocyte-stimulating amount of erythropoietin to bring them in physical contact with each other, and encapsulating the suspension of hepatocytes and erythropoietin in a biologically compatible capsule shell so that to form a microcapsule. A method for preventing or treating a hepatic disorder in an individual in need thereof involving administering the microcapsules in the individual in need thereof. The method for introducing the hepatocytes in the individual involving administering the microcapsules in the individual. A method for hepatocyte culture in a culture medium involving hepatocyte culture in the microcapsules in the appropriate culture medium.
EFFECT: microcapsules are effective for preventing or treating the hepatic disorders.
20 cl, 1 dwg, 1 ex
SUBSTANCE: group of inventions refers to treating fatty liver degeneration. The method of treating a patient suffering fatty liver degeneration involves administering a therapeutically effective amount of cysteamine or cystamine, or a pharmaceutically acceptable salt thereof as a part of a composition. The method of treating the patient suffering non-alcoholic fatty liver degeneration (NAFLD) or non-alcoholic steatohepatitis (HASH) involves administering the therapeutically effective amount of the composition containing cysteamine or cystamine, or the pharmaceutically acceptable salt thereof. In both methods, the composition may be presented by a delayed or controlled release dosage form containing an enteric coating and providing the improved delivery of cysteamine or cystamine, or the pharmaceutically acceptable salt thereof.
EFFECT: improving the method of treating.
24 cl, 3 ex, 7 dwg
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to chemical-pharmaceutical industry, and represents an immunomodulator for treating chronic hepatitis, hepatic cancer, lymphatic sarcoma, chronic leukemia, and for improving the functions of liver and blood-forming organs, for enhancing the immunobiological body characteristics, prepared by mixing 1000 ml of an aqueous infusion of sandy everlasting blossom, pepper mint herb and chicory herb with 50 ml of bovine serum containing leukaemia oncovirus antibodies, 20 ml of wild rosemary infusion, 40 g of ascorbic acid, 2 g of sorbic acid, 0.2 g of folic acid until the ingredients are dissolved completely, with adding 60 g of liver powder, 30 g of lymphatic node powder, 30 g of young bovine spleen powder; the prepared solution is settled at room temperature for 24 hours, then kept at a boiling water bath for 30 minutes and cooled for 6-8 hours at room temperature; the settled solution is filtered, wherein the aqueous herbal solution is prepared by mixing equal proportions of the separately prepared aqueous infusions of 40 g of pepper mint herb in 1000 ml of water, 30 g of sandy everlasting blossom in 1000 ml of water and 30 g of chicory herb in 1000 ml of water, while the wild rosemary infusion is prepared by infusing 60 g of ground wild rosemary blossom in 1000 ml of 70% purified ethanol.
EFFECT: invention provides creating the high-efficacy agent and reducing the length of treatment.
SUBSTANCE: group of inventions refers to medicine, namely to gastroenterology and may be used for treating hepatitis C. For this purpose, an effective amount of glutaryl histamine or a pharmaceutically acceptable salt thereof is introduced into the patient. The above agent may be administered in a combination with pegylated interferon and ribavirin. The group of inventions also refers to a pharmaceutical composition for treating viral hepatitis C. This group of inventions enables disclosing a new drug preparation having a manifested antiviral effect and being effective in treating viral hepatitis C.
EFFECT: what is developed is the effective combination of the drug preparations for treating viral hepatitis C, which allows reducing the rate of side effects of the antiviral therapy substantially.
39 cl, 3 ex
SUBSTANCE: group of inventions refers to medicine, namely otorhinolaryngology and may be used for various ear diseases. That is ensured by presenting the systems for electrophoresis drug delivery to a human or animal ear drum. The system contains an ear tampon having distal and proximal portions with a tube passing in between and having a smaller rigidity as compared to the proximal and distal portions of the ear tampon. One flexible sealing element extending from an external surface of the tube and closer to a distal end than to a proximal one. An electrode consisting of an extended shaft, a tip having a greater diameter as compared to the trunk. The electrode is placed inside of the tube of the ear tampon from the retracted position wherein a fluid can flow in the tube round the electrode into the extended position, wherein the electrode tip is in contact with the internal surface of the tube thereby preventing the fluid flow in the tube. The system can also comprise two flexible sealing members integrated with the extended tube. There are also presented methods for anaesthetising the ear drum by using the given system. There are presented kit for anaesthetising comprising the drug delivery system and controller coupled with the electrode.
EFFECT: inventions provide the drug delivery, including anaesthetics into the patients being in the vertical position, due to a possibility to retain the solution hermetically in the external ear canal with no additional conditions provided.
23 cl, 12 dwg