Method for prediction of heart rhythm disorder in patients with pre-excitation syndrome
SUBSTANCE: predicting heart rhythm disorder in the patients with pre-excitation syndromes is ensured by measuring patient's blood plasma matrix metalloproteinase-9 (MMP-9), and if the measured value is less than 90.6 ng/ml, the favourable clinical course accompanied by no heart rhythm disorders (HRD) is predicted, whereas the MMP-9 concentration of more than 90.6 ng/ml enables predicting HRD.
EFFECT: method enables predicting HRD in the patients with pre-excitation syndromes by high sensitivity and specificity of the method with its low invasiveness and no counterindications.
The invention relates to medicine, cardiology, Arrhythmology, namely to the early prediction of the development of various heart rhythm disorders (LDCs) in patients with syndromes of premature ventricular excitation (phenomenon and syndrome Wolff-Parkinson-White).
Congenital arrhythmic syndromes, including syndrome WPW, represent one of the most serious and unresolved problems in modern Arrhythmology. The significance of this problem is also increasing due to the fact that this disease affects the people of young, working age, including athletes. The entire burden of these syndromes is associated with risk of development of syncope and sudden cardiac death that afflict these patients. Among patients with the syndrome of Wolff-Parkinson-White (WPW), the likelihood of sudden death within 10 years is from 0.15 to 0.39%, which is above the General population risk (M. S. Kushakovskij, 2012). Diagnosis and definition of tactics of patients with syndromes of premature ventricular excitation is an important section of clinical Arrhythmology and electrophysiology of the heart.
In the study of scientific and medical literature identified a way to predict the development of LDCs in patients with syndromes of premature ventricular excitation: electrophysiological study (EP study) the conducting system of the heart, in particular complement�found ways of holding (Bredice Y. Y., M.: Medicine, 1967. - 180 p., Russia). But this method of forecasting is invasive, therefore, has a number of contraindications and limitations for use, in particular, is still under debate expediency of their use in asymptomatic patients and in early childhood. Also, not every health care facility (HCF) has qualified electrophysiology and appropriate equipment for carrying out this procedure. This fact is the basis for widening the search for new methods for early prediction of LDCs in patients with syndromes of premature ventricular excitation.
The technical result of the invention is the low invasiveness of the method, the absence of contraindications, the possibility of widespread implementation in health care facilities, while maintaining high sensitivity and specificity of this method.
The problem is solved in that in a patient serum determine the level of matrix metalloproteinase-9 (MMP-9) and if the value of this index more of 90.6 ng/ml predict the development of cardiac arrhythmias.
Structural remodeling of the left atrium is defined as a key mechanism in the development of LDCs, where interstitial fibrosis may be the dominant factor. Fibrosis may disrupt the orderly spread of electrical�of excitation, speaking as immediate obstacles. Also in recent years the importance of partial surrenders gap gap junctions between fibroblasts and cardiomyocytes in the area of pathological remodeling (S. Rohr, Cardiovasc Res. - 2004). Unchanged cardiac muscle cardiomyocytes is about 75%, most of the remaining cells is represented by fibroblasts. Fibroblasts synthesize interstitial collagen type I, III, V, VI, type I is about 85% of the total amount of collagen. MMP-9 is one of the metabolic products of type I collagen and is a marker of myocardial fibrosis (Fan D., Fibrogenesis Tissue Repair. - 2012).
The method is as follows. In a patient with the syndrome of premature ventricular excitation in the morning on an empty stomach take 5 ml of blood from a vein into a plastic tube containing citrate. Next, to obtain blood plasma samples centrifuged for 10 minutes at room temperature at 200×g. The level of MMP-9 in plasma was measured using an enzyme immunological test system. To assess the level of MMP-9, use a set of reagents "HumanMMP-9 ELISA" (BenderMedSystem, Austria). The analysis is performed in several steps. Initially, human MMP-9 present in the serum, associated with monoclonal antibody to human MMP-9, adsorbed in the cells of microplane�and. "Detection" polyclonal antibodies to MMP-9 binding molecules of the human MMP-9 captured by the first antibody. After incubation by washing of the cells remove unbound second anti-MMP-9 antibodies. Later in the cell adds a conjugate of monoclonal mouse anti-antibody after incubation and washing removes unbound enzyme conjugate. The next stage in the cell is added to the substrate solution, giving the interaction with the enzyme complex staining. The reaction is stopped by adding acid and the intensity of the color measured concentration of human MMP-9. The limit of sensitivity of this set is 0.8 ng/ml In samples of blood serum of healthy people, chosen at random, the levels of MMP-9 are in the range of 20.3-77,2 ng/ml, the average level of 43 ng/ml.
To predict the development of LDCs in the blood plasma of the patient determine the level of MMP-9. If the value of MMP-9 more of 90.6 ng/ml predict the development of LDCs is unfavorable course of the disease. If the amount of MMP-9 would be less of 90.6 ng/ml, the development of LDCs is unlikely, i.e., predict a favorable course of the disease.
With the help of the inventive method improves the accuracy of predicting the course of the syndromes of predopredeny ventricles, with low invasiveness of the method and the absence of contraindications�th.
The sensitivity - 96,30%.
Specificity is 75%.
EXAMPLES of SPECIFIC APPLICATIONS
Example No. 1. B-Noah V., 18, inductee, medical history No. 3577. During the medical examination for military Commissariat on the surface electrocardiogram (ECG) registered short PQ interval is 0.1 s, QRS complex were 0.14 s, on the ascending part of the QRS complex was defined as the Delta wave. At the time of inspection the patient is actively complaints of the cardiovascular system did not show. Episodes of disruption of the heart, rapid and irregular heartbeat, syncope were noted. An objective examination in the cardiology Department: the condition is satisfactory, BP=120/70 mm Hg.CT., the pulse 72-74 per minute, rhythmic. Heart sounds clear, rhythmic, no noise. The rest of the system without features. When performing echocardiographic (Echo) survey structural pathology of the heart is not revealed. According to Holter ECG monitoring were recorded sinus rhythm with an average heart rate=71 min in LDCs by type of rare supraventricular extrasystole (SVPBS), just for a day - 86, up to 10 per hour (within normal limits). General blood analysis (KLA), urinalysis (OAM), key indicators of the biochemical analysis of blood (TANK) without deviations from the norm. Diagnosis: the Phenomenon of Wolff-Parkinson-White (WPW). MMP - At 79.3 ng/ml.
Conclusion: determining the level of MMP-9 has a high probability to say that the development of LDCs in this patient was unlikely and the clinical and laboratory data to diagnose WPW phenomenon. The favorable outcome of the disease.
Example No. 2. B-valued T., 32 years, teacher, medical history No. 6299. Asked the cardiologist in the polyclinic in a residence with complaints of palpitations, episodes of dizziness. The above complaints concerned the last 6 months. Episodes of disruption of the heart, irregular heartbeat, syncope denies. Chronic diseases cardiovascular system notes. Family history is not burdened. An objective examination: the condition is satisfactory, BP=130/75 mm Hg.CT., the pulse 79-81 per minute, rhythmic. Heart sounds clear, rhythmic, no noise. The thyroid gland is not enlarged. The rest of the system without features. At twelve-channel ECG registered short PQ interval is 0.1 s, the remaining elements in the normal range. When performing the Echo-KG structural pathology of the heart is not revealed. According to Holter ECG monitoring were recorded sinus rhythm with an average heart rate=80 min in LDCs by type frequent SVPBS, just for a day - 1679, up to 80 per hour, rare ventricular premature beats (vpbs), only 54 per day, up to 26 in cha�. Ultrasonic dopplerography (USDG) of the neck vessels, electroencephalography (EEG) without features. General blood analysis (KLA), urinalysis (OAM), key indicators of the biochemical analysis of blood (TANK), TSH, T4 without deviation from the norm. Diagnosis: Syndrome of Wolff-Parkinson-White (WPW). MMP-9 - of 189.4 ng/ml.
Conclusion: determining the level of MMP-9 has a high probability to say that at this patient at high risk for LDCs and the clinical and laboratory data to diagnose WPW syndrome. The adverse outcome of the disease.
Example No. 3. B-Noah K., 25 years old, athletic, medical history, No. 4022. During a basketball match syncopal condition with unstable hemodynamics, episode of asystole during 40 sec. Resuscitation with positive effect - restored sinus rhythm. Ambulance for emergency indications hospitalized in the cardiology Department of a hospital. On admission complained of heart palpitations, dizziness, discomfort in the heart region, General weakness. Episodes of disruption of the heart, palpitations, irregular heartbeat, syncope not previously disturbed. Chronic diseases cardiovascular system notes. Family history is not burdened. An objective examination: the condition is satisfactory, BP=110/65 �m RT.CT., the pulse 94-95 per minute, rhythmic. Heart sounds clear, rhythmic, no noise. The rest of the system without features. At twelve-channel ECG recorded sinus tachycardia with HR=98-99 per minute, the other elements in the normal range. Structural pathology of the heart when performing the Echo-KG not detected. Doppler ultrasound of neck vessels, EEG without features. According to Holter ECG monitoring were recorded sinus rhythm with an average heart rate=61 min in LDCs by type of rare SVPBS, just for a day - 52, up to 16 per hour, rare VES, just a day 9, to 3 per hour, intermittent WPW syndrome. General blood analysis (KLA), urinalysis (OAM), key indicators of the biochemical analysis of blood (TANK), TSH, T4 without deviation from the norm. Diagnosis: Syndrome of Wolff-Parkinson-White (WPW). MMP-9 - 251,2 ng/ml.
Conclusion: determining the level of MMP-9 has a high probability to say that in this patient was high risk for the development of LDCs and the clinical and laboratory data to diagnose WPW syndrome. The adverse outcome of the disease.
Thus, our studies have revealed the criterion on the basis of which it is possible to predict the course of the syndromes of predopredeny ventricles. This knowledge will enable cardiologists and arrythmology to predict the development of LDCs in these patients, prescribe the proper medication therapy and�and to opt for surgical treatment. A significant advantage of the inventive method is the small amount of blood required for testing, low invasiveness of the method, in combination with high sensitivity and diagnostic accuracy. Furthermore, the method is not traumatic and has no contraindications. The method was tested on clinical material and find application in the practice of cardiology and arrhythmologists.
A method of predicting the development of cardiac arrhythmias in patients with syndromes of premature ventricular excitation, namely that in the blood plasma of the patient determine the level of matrix metalloproteinase-9 and its value is more of 90.6 ng/ml predict the development of cardiac arrhythmias in patients with syndromes of premature ventricular excitation.
SUBSTANCE: technique consists in measuring a pinopod count in the germinal epithelium, an expression level of progesterone and oestrogen alpha receptors in the endometrial stroma, calculating their ratio, and determining an expression level of implantation LIF factor on the 21st-24th day of the menstrual cycle ('implantation window'). If the pinopod count is less than 35%, the expression ratio of progesterone and oestrogen alpha receptors in the endometrial stroma less than 3.5, as well as the LIF expression level of less than 2 points, disturbed fertility associated with uterine myoma is diagnosed.
EFFECT: technique enables applying the differentiated approach to managing the patients planning pregnancy, suffering uterine myoma undeforming the uterine cavity, as well as with myomatous nodule up to 5,0 cm in diameter.
2 ex, 4 dwg
SUBSTANCE: method involves sampling a biological tissue, introducing a biologically active substance therein, keeping the prepared mixture in a thermostat at 37°C and incubating, performing microscopic examination for identifying the forms of trichomonads. The sampled biological tissue represents the urogenital mucosa that is incubated for 24 h in a nutrient medium. The prepared sediment is separated and added with the biologically active substance nitrosoguanidine in an amount of 500 mcg/ml. That is followed by incubating for 15 min at +37°C; a phosphate buffer with pH 5.6 heated to +37°C is added and centrifuged twice at 1000 rpm for 10 min. The material is placed into the nutrient medium for trichomonad growing, incubated for at least 24 hours, and microscopic examination is used to identify atypical nonflagellate and typical round and amoeboid forms of trichomonads.
EFFECT: using the declared invention enables the effective, fast and reliable identification of typical changed and atypical forms of trichomonads.
3 dwg, 3 ex
SUBSTANCE: method involves measuring pregnant women's blood anti-cytomegalovirus antibody titre and glutathione reductase activity in erythrocytes of the obstetric patient suffering the cytomegaloviral infection. If the anti-cytomegalovirus antibody titre is 1:1600, whereas the measured glutathione reductase activity is below 4.48±0.22 units/gHb, the aggravated cytomegaloviral infection is diagnosed.
EFFECT: higher diagnostic technique.
SUBSTANCE: group of inventions relates to medicine, cosmetology, production of food products, vitamins, food supplements, drugs and describes versions of device for realisation of non-invasive potentiometric determination of oxidant/antioxidant activity of biological tissues, which includes device for measuring potentials and double-sided electrode, made in form of plate with similar working surface, covered with electricity-conducting gel, containing mediator system. Electrodes are fixed on biological tissue in such a way that one working surface, playing role of measuring electrode, is in direct contact with biological tissue via gel, second working surface pale role of comparison electrode. Electrodes contact with each other via gel, with oxidant/antioxidant activity being determined by formulae with application of difference between final and initial potentials.
EFFECT: simplification, as well as increase of accuracy and reliability of determination, is achieved.
14 cl, 3 tbl, 4 dwg
SUBSTANCE: invention represents a method for the prediction of preeclampsia in the second trimester of pregnancy by blood examination, differing by the fact that the activity of acid and neutral proteinases is measured in blood serum of the women 7-8 weeks pregnant; if the activity of acid proteinases is more than 5.6 mcmole/l, while the activity of neutral proteinases is more than 3.9 mcmole/l, the preeclampsia progression in the second trimester of pregnancy is predicted.
EFFECT: higher accuracy and specificity of the method for the prediction of gestational toxicosis.
SUBSTANCE: invention relates to medicine, namely to a method of automated morphometric myelofibrosis diagnostics. The method essence consists in the fact that overview images of zones with different optical properties with determinable fibrous and heamopoietic properties of a biological tissue are performed. Ratios of areas of the said zones of at least three paraffin cuts of trepanobiopsy samples are calculated. The coefficient (Cop) is calculated as the ratio of the fibrous tissue area to the area of the heamopoietic tissue by formula. If the value Cop ≥14.5%, myelofibrosis is diagnosed.
EFFECT: application of the claimed method makes it possible to increase the accuracy and improve the efficiency of myelofibrosis diagnostics.
7 cl, 1 tbl, 4 dwg, 1 ex
SUBSTANCE: testicular germ cells are measured quantitatively. That is ensured by 50-day oral administration of selexen and ascorbic acid into male white rats in doses 1.5 and 500 mg/kg of animal's body weight respectively once a day. 14 days later, administering the selenium-containing biocomplex is accompanied by the 30-minute daily exposure to microwave radiation at 42 GHz (λ=7.1 mm) for 30 days. Once the experimental exposures are completed, the corrective properties of the biocomplex as having an effect on the morphofunctional state of epididymal sperm cells are assessing by formula: MFSI=A+B, wherein MFSI is a morphofunctional state index, A is a portion of normal sperm cells in relation to the reference, and B is a portion of moving sperm cells in relation to the reference. If the MFSI value is 1.3 or more, the spermatogenesis correction is considered to be ineffective, while the MFSI value being more than 1.3 shows the effective spermatogenesis correction if exposed to microwave radiation.
EFFECT: invention enables assessing the spermatogenesis correction efficacy with underlying administration of the biocorrector.
2 tbl, 3 dwg, 3 ex
SUBSTANCE: invention relates to field of medicine, in particular hepatology. Method of quantitative estimation of histological activity in liver biopsy materials in case of chronic diffuse liver diseases results in protocol of counting in absolute numbers, percent and points of pathological signs, identified in the course of morphological analysis of liver biopsy materials from patients with chronic diffuse liver diseases, by sections: necrosis of hepatocytes, globular and atomised fatty hydropic degeneration of hepatocytes, small cell dysplasia of hepatocytes, portal, periportal, intralobular and central infiltration. After that conversion of absolute values into point system is performed by means of said protocol, and histological activity is determined by number of points.
EFFECT: method makes it possible to create quantitative unification of obtained results in case of said diseases.
FIELD: veterinary science.
SUBSTANCE: method includes detection of leukocytes, protein, haemoglobin in faeces, and PH-reaction of faeces. A sample of faeces is dissolved in distilled water and applied drop by drop onto appropriate test fields of a test strip designed for urine testing. By variation of colour within 1 minute the reaction is assumed as positive. If pH is less than 7.0 or more than 7.5, and faeces contain soluble protein, haemoglobin and leukocytes at the same time, availability of the inflammatory process in the intestines is confirmed.
EFFECT: invention makes it possible to quickly and accurately diagnose inflammatory process in intestines.
2 cl, 2 ex
SUBSTANCE: invention relates to medicine and is intended for the treatment of patients with the perforation of gastric and duodenal ulcer. A laparotomy is performed, operative aid concerning the ulcer perforation is realised, during the operation an exudate is sampled from the abdominal cavity, pH of the exudate is determined. If Ph of the said material is 6.6 and lower, a conclusion about the presence in it of anaerobic flora is made and serves the basis for the administration of an antibacterial preparation, influencing the anaerobic flora, into the scheme of initial antibacterial therapy.
EFFECT: method makes it possible to administer specific antibacterial therapy without waiting for culture results.
FIELD: medicine, psychiatry.
SUBSTANCE: one should isolate DNA out of lymphocytes of peripheral venous blood, then due to the method of polymerase chain reaction of DNA synthesis one should amplify the fragments of hSERT locus of serotonin carrier gene and at detecting genotype 12/10 one should predict the risk for the development of hallucino-delirious forms of psychoses of cerebro-atherosclerotic genesis.
EFFECT: more objective prediction of disease development.
FIELD: medicine, urology.
SUBSTANCE: one should conduct subcutaneous prevocational tuberculin test and, additionally, both before the test and 48 h later it is necessary to perform the mapping of prostatic vessels and at decreased values of hemodynamics one should diagnose tuberculosis. The information obtained should be documented due to printing dopplerograms.
EFFECT: more reliable and objective information.
1 ex, 1 tbl
FIELD: molecular biology.
SUBSTANCE: the suggested innovation deals with the fact that nucleic acids should be isolated directly out of the sample without pipetting stage but with the help of interconnected reservoirs being prepared beforehand. The above-mentioned vessels should be applied either separately or being interconnected according to standard microtitrating format. The sample should be mixed with a lyzing buffer and nucleic acids are bound with matrix in closed system including, at least, two interconnected reservoirs. Forced movement of sample's mixture and buffer back and forth from one reservoir into another one for several times through narrow passage provides their thorough intermixing. The method provides quick and safe isolation of nucleic acids.
EFFECT: higher efficiency.
44 cl, 4 dwg, 1 ex
FIELD: medicine, phthisiology, microbiology.
SUBSTANCE: diagnostic material is poured preliminary with chlorohexidine bigluconium solution, homogenized, kept at room temperature for 10-12 h and centrifuged. Precipitate is poured with Shkolnikova's liquid medium, incubated at 37oC for 3 days, supernatant part of Shkolnokova's medium is removed, fresh Shkolnikova's medium is added, and precipitate is stirred and inoculated on the dense cellular egg media. Sensitivity of the strain is determined in 3 weeks by the presence of growth in the control tube only. Invention provides enhancing precision and reducing time for assay. Invention can be used in assay for medicinal sensitivity of tuberculosis mycobacterium.
EFFECT: improved assay method.
FIELD: medicine, biotechnology, pharmacy.
SUBSTANCE: invention relates to agents used for treatment of pathological states associated with disorder of synthesis of neuromediating substances. Method involves the development of pharmaceutical composition and a method for it preparing. Pharmaceutical composition represents subcellular synaptosomal fractions: synaptic membranes, "light" synaptosomes and "heavy" synaptosomes prepared from gray matter of cerebral hemispheres from experimental animals based on the goal-seeking modification of humoral mediators of nerve endings transformed to synaptosomes in development and regression of malignant processes. The composition provides inhibiting the growth of tumor cells, to elevate span-life of patients with ascite Ehrlich's sarcoma, breast adenocarcinoma Ca-755, Wolker's carcinosarcoma-256.
EFFECT: valuable medicinal and anti-tumor properties of composition.
12 cl, 3 tbl, 3 ex
SUBSTANCE: method involves carrying out microscopic examination of blood serum samples taken from femoral vein and cubital vein. Femoral vein sample is taken on injured side. The examination is carried out before and after treatment. The blood serum samples are placed on fat-free glass slide in the amount of 0.01-0.02 ml as drops, dried at 18-30°C for 18-24 h. The set of pathological symptoms becoming larger or not changed after the treatment in comparison to sample taken before treatment, and morphological picture of samples under comparison taken from the cubital vein showing no changes or being changed to worse, the treatment is considered to be effective.
EFFECT: enabled medicamentous treatment evaluation in course of treatment to allow the treatment mode to be changed in due time; avoided surgical intervention (amputation); retained active life-style of aged patients.
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: medicine, urology.
SUBSTANCE: the present innovation deals with differential diagnostics of prostatic cancer and other prostatic diseases at the stage of primary inspection. The method includes the detection of PCA and calculation of probability coefficient for prostatic cancer (PCC) by the following formula: where e - the foundation of natural logarithm (e=2.718…), PCA - the level of total blood PCA in ng/ml, V - patient's age in years. At PCC value being above 0.2 one should diagnose prostatic cancer and to establish final diagnosis one should perform polyfocal prostatic biopsy. The method enables to increase accuracy of diagnostics at decreased number of unjustified prostatic biopsies.
EFFECT: higher efficiency of diagnostics.
FIELD: medicine, biology.
SUBSTANCE: invention relates to nutrient medium used for accumulation of cells for the following cytological and/or immunocytochemical analysis carrying out. Invention relates to medium containing salts NaCl, KCl, anhydrous CaCl2, MgSO4 x 6 H2O, MgCl2 x 6 H2O, Na2HPO4 x 2 H2O, KHPO4, NaHCO3, and also glucose and Henx's solution, 10% albumin solution and polyglucin taken in the ratio 1:1:1. Invention provides enhancing the preservation of cells.
EFFECT: improved an valuable properties of nutrient medium.