Diagnostic technique for infected pancreonecrosis with establishing indications for surgical intervention
SUBSTANCE: invention describes a diagnostic technique for infected pancreonecrosis with establishing the indications for a surgical intervention by examining a patient, wherein acetic, propionic, butyric and isovaleric acids are measured in the blood by gas chromatography, and if the acetic acid concentration is more than 0.11 mmole/l enables stating infected pancreonecrosis, and if the concentration of any of three acids: propionic more than 0.095 mmole/l, butyric more than 0.0035 mmole/l, isovaleric acid more than 0.0003 mmole/l enables stating infected pancreonecrosis with active development of an anaerobic infection requiring one of versions of the surgical intervention.
EFFECT: invention enables providing the objective and accurate diagnosing of pancreonecrosis transformation into the stage of infection by using the qualitative parameters with no undesired side effects.
The invention relates to medicine, namely to surgery.
In recent decades, acute pancreatitis the rate of growth began to emerge on the first place among urgent surgical diseases. In 10-20% of cases the course of acute pancreatitis is severe destructive nature. The prognosis largely depends on the amount of necrosis of the pancreas and infection. Septic complications as a result of infection foci of necrosis remains a major cause of death. Identification of the transition of pancreatic necrosis in the infected form is carried out by clinical and laboratory data, markers of damage to the pancreas, the systems for assessing the severity of the patient, the results of instrumental methods of examination (Savel'ev V. S., Filimonov M. I., Burnevik S. Z. Pancreonecrosis. M: Honey. INF. AG, 2008. P. 36-49).
However, these criteria are not always specific and sensitive for the early diagnosis of infectious process. So up to the present time early diagnosis of infected pancreatic necrosis represents a significant challenge. Diagnostic errors in infectious complications of pancreatic necrosis occur in 40% of cases, leading to delay in the execution of surgical intervention, the development of sepsis and high mortality. Therefore, it is important RA�the development and introduction of new effective infection markers in a comprehensive diagnosis of infected pancreatic necrosis.
In recent years, much attention is paid to the definition of patients with various pathologies of the content of volatile fatty acids, which are metabolites of anaerobic and aerobic microorganisms. Method of gas-liquid chromatography for determining the concentration of volatile fatty acids in various biosubstrates features high accuracy, sensitivity, availability, and speed of obtaining results (minushkin., Ardatskaya M. D. Opportunities and perspectives for the study of short-chain fatty acids in the pathology of gastrointestinal tract for example, diseases of the intestines and organs of the hepatobiliary system // Clin. lab. diagnosis. 2004. No. 2. C. 19-20, 31-36).
Found that volatile fatty acids inhibit immune system, reducing the activity of the main links of the anti-infective protection: epithelial, tissue macrophages, T - and b-cells as well as intercellular interactions and the production of inflammatory mediators (Beloborodova N. In., Beloborodov CM. Metabolites of anaerobic bacteria and the reactivity of the microorganism // Antibiotics and chemotherapy. 2000. No. 2. Pp. 28-36).
Studies of the concentration of volatile fatty acids and other toxic metabolites by gas chromatography with mass spectrometry detection in biopsies of the pancreas and the blood proved the role of anaerobic non-clostridial infection in FLA�TII infected pancreatic necrosis. However, in the peripheral blood was examined only the total concentration of volatile fatty acids, which are metabolites only anaerobic microorganisms. Thus it was not defined the meaning of the individual volatile fatty acids, which are metabolites not only anaerobic but also aerobic microorganisms, which is also actively involved in the infection foci of pancreatic necrosis. Besides used complicated and inaccessible chromato-mass-spectrometric method. Therefore, determining the significance of the performance of individual volatile fatty acids for the timely diagnosis of infected pancreatic necrosis and the establishment of indications for an operative intervention to date was conducted.
The technical result of the offered method is achieved in that determine the content of acetic, propionic, butyric and isovaleric acids in the blood. When the acetic acid concentration is more 0,11 mmol/l establish the presence of infected pancreatic necrosis, and when the concentration of any one of three acids: propionic more 0,0095 mmol/l, more oil 0,0035 mmol/l isovaleric more to 0.0003 mmol/l to establish the presence of infected pancreatic necrosis with active development of anaerobic infections requiring one of the options of surgical intervention.
Avtolyubitelej gas chromatographic method for the concentration of acetic, propionic, butyric and isovaleric acids in the blood in patients with verified diagnosis of pancreatic necrosis. The authors found a statistically significant substantial increase in the average concentrations of these acids in the blood in patients with infected pancreatic necrosis compared with patients with sterile pancreatic necrosis (p<0,05). Most informative were the indicators M-m (the difference in mean concentrations and standard errors). They were selected as diagnostic criteria.
Comprehensive treatment in the ICU remains a priority in necrotizing pancreatitis. Performing surgery in sterile pancreatic necrosis is invalid because it often leads to serious complications. At the same time, despite ongoing conservative treatment, the transition to the stage of pancreatic necrosis infection can be a indication for minimally invasive or open extensive intervention, timely execution which largely improves the prognosis of this disease. To determine the indications for surgical treatment of infected pancreatic necrosis is ongoing research aimed at the development of the most informative criteria of timeliness and validity of the intervention.
Volatile fatty acids (VFA) are: TPU� the main bacterial products. They are therefore used as markers of infection. Leading role in the infection of pancreatic necrosis plays an aerobic-anaerobic Association of microorganisms entering through translocation from the gastrointestinal tract. Acetic acid is produced by aerobic and anaerobic flora, and propionic, butyric and isovaleric acids are primarily products of the metabolism of anaerobic bacteria. The beginning of infection of pancreatic necrosis is accompanied by an increase in the number of LFP in the affected lesions of the pancreas and in the blood. The level of LFP is possible to monitor the effectiveness of conservative treatment: a persistent decline in LFP indicates the effectiveness of exposure to areas of infection, and a further increase is about the progression of the infectious process. Therefore, determining the level of LFP, which are markers of infection may be diagnostic criterion stage of pancreatic necrosis requiring surgical treatment.
The method is carried out as follows. After a detailed examination and diagnosis of pancreatic necrosis on an empty stomach produce venous blood sampling from a peripheral vessel in a volume of 0.5 ml. Then on the background of the treatment over time (5-7 days and indications) are repeated blood samplings. Sample preparation includes the addition of UCF�the specified amount of blood 1 drop of 10% sulfuric acid. Gas-liquid chromatography for the quantitative determination of acetic, propionic, butyric and isovaleric acids is performed on a glass column (length 1 m, diameter 3 mm, filled with "Porapak" Q (USA) coated with phosphoric acid under isothermal conditions at a temperature of 200°C. the Chromatograph MESH, model 3700. The detector is a flame ionization detector, the carrier gas is helium. Identification and quantification of the acids was carried out using analytical standards.
The applied method enables the objectification stage of pancreatic necrosis and determines the algorithm further surgical treatment: continuation of intensive therapy or surgery. The use of this method improves the accuracy of diagnosis of infected pancreatic necrosis by quantitative parameters, and furthermore, this diagnosis does not entail complications.
To prove the accuracy of the diagnosis of infected pancreatic necrosis have compared the results obtained using the proposed method and the conventional methods. The diagnosis of pancreatic necrosis and its complications set in accordance with the modern domestic and foreign guidelines.
We examined 45 patients with confirmed diagnosis of pancreatic necrosis: 25 patients with sterile form of pancreatic necrosis and 20 patients inficirovannym pancreatic necrosis. In 26 patients performed various surgical procedures. The age of patients ranged from 21 to 72 years.
The proposed method has allowed to establish the transition to the stage of pancreatic necrosis infection of pancreatic necrosis in 19 of 20 patients (match final diagnosis was 95%).
Consequently, the concentration of acetic, propionic, butyric and isovaleric acids in the blood can be used for the diagnosis of transition to the stage of pancreatic necrosis infection. An example of applying the method in patients with sterile pancreatic necrosis.
Patient S., aged 24. Admitted to the hospital with a diagnosis of sterile pancreatic necrosis", parapancreatic infiltrate. Disease duration - 10 days: suddenly after drinking alcohol appeared intense pain in the upper abdomen, nausea, repeated vomiting, began to grow weak. With the onset of the disease was treated in RSD at the place of residence.
Ultrasound examination revealed changes in the pancreas in type of acute pancreatitis, the infiltrate in the projection of the omental Bursa and left the middle of the abdomen. Against the background of conservative therapy without improvement. The patient for further treatment directed to the Ivanovo regional clinical hospital.
At admission the General condition heavy, the complaints expressed weakness, moderate constant pain in�rhna the abdomen. Body temperature - 37,6° C, heart rate (HR) is 100 / minute, respiratory rate of 24 / minute, blood pressure (BP) is 140/80 mmHg.PT. On palpation, the abdomen is swollen, moderately painful and tense in the epigastrium and left hypochondrium, where palpable infiltration. In General, the analysis of a blood: erythrocytes - 4,1·1012/l, hemoglobin 114 g/l, leucocytes - 23,5·109/l (eosinophils - 4%, stab neutrophils - 2%, segmented neutrophils - 81%, monocytes - 3%, lymphocytes - 10%), toxic granularity of neutrophils +++, ESR - 30 mm/h. Amylase blood - 252 units, C-reactive protein - 100 mg/l. the Severity of the condition on a scale APACHE II - 11 points. With ultrasound, MSCT (with intravenous contrast) revealed a picture of a macrofocal with infiltrative necrotizing pancreatitis exudative component propagating in the region of the omental Bursa and left pararenal space with the transition to the region of the transverse colon with signs of summany fluid in these zones.
Also conducted to determine the content of acetic, propionic, butyric and isovaleric acids by gas chromatography in the blood. The following results are obtained: acetic acid 0.1 mmol/l, propionic - 0,0056 mmol/l, oil - 0,0025 mmol/l isovaleric - 0,00015 mmol/L. After the complex of intensive therapy, including in an intensive care Department�Oia, the patient's condition significantly improved: pain and fever disappeared, weakness decreased significantly. Decreased levels of amylase to 54 units and C-reactive protein of 5 mg/l, white blood cells to 5.5·109(eosinophils - 2%, stab neutrophils - 0%, segmented neutrophils - 63%, monocytes - 8%, lymphocytes - 27%). Ultrasound and CT-control positive dynamics visualized in the form of a significant reduction in infiltrative and exudative component, marked by the formation of the parapancreatic pseudocyst on the leading edge of the body and tail of the pancreas.
Re-examined the content of volatile fatty acids every 7 days, a significant reduction: acetic acid - up to 0.015 mmol/l, propionic - 0.001 mmol/l, oil - to 0,00052 mmol/l isovaleric - to 0,000077 mmol/L. the Patient was discharged on the 28th day in a satisfactory condition. Clinical, instrumental, laboratory, and chromatography data in a patient sterile form of pancreatic necrosis, confirming the results of the claimed method of diagnosis.
An example of applying the method in a patient with infected pancreatic necrosis.
Patient P., 38 years old. Transferred to the Ivanovo regional clinical hospital in the surgical Department of the NRB at the place of residence, where he was the medical�tion with a diagnosis of infected pancreatic necrosis, abscess of the omental Bursa". Disease duration - 12 days: after drinking alcohol for the first time noted the expressed pain in the upper abdomen zoster character, nausea, repeated vomiting. A day after the onset of the disease hospitalised in TSRB in serious condition with the clinic pancreatogenic shock. Was held conservative therapy, compared with 10 days the patient appeared febrile fever, began to increase abdominal pain and weakness. Ultrasound examination revealed liquid formation in the projection of the omental Bursa.
Upon admission to the Ivanovo regional clinical hospital the General condition heavy, the complaints of moderately expressed weakness, constant pain in upper abdomen, fever to 39.0° C with chills. Body temperature is 38.0° C, heart rate of 96 / minute, respiratory rate is 20-22 per minute, BP is 130/70 mm Hg.PT. On palpation, the abdomen is swollen, moderately painful in the epigastrium and left hypochondrium. In General, the analysis of a blood: erythrocytes - 2,86·1012/l, hemoglobin of 100 g/l, leucocytes - 19,8·109/l (eosinophils - 1%, stab neutrophils - 10%, segmented neutrophils - 78%, monocytes - 6%, lymphocytes - 11%), ESR - 56 mm/h. Amylase blood - 148, C-reactive protein - 152 mg/l. the Severity of the condition on a scale APACHE II - 12 points. MSCT (with intravenous contrast) revealed Subtotal picture of pancreatic necrosis with infiltr�tion parapancreatic tissue, encysted fluid in the omental Bursa, left-sided pleurisy.
Conducted to determine the content of acetic, propionic, butyric and isovaleric acids in the blood by gas chromatography. The following results are obtained: acetic acid and 0.29 mmol/l, propionic - 0,084 mmol/l, oil - 0,0042 mmol/l isovaleric - 0,00043 mmol/L.
Given the persistent hyperthermia and the ineffectiveness of conservative therapy, on the 3rd day after the transfer was urgently performed operation - DUJOTEKANA laparotomy, omentoplasty, necrosectomy, drainage and plugging stuffing bags and abdominal cavity. When interference is detected: abdominal effusion no, in the sphere of small and large glands - a large number of steatocranus. In the omental Bursa opened the abscess with purulent contents by volume to 800 ml. Large part of the body and tail of the pancreas nekrotizirovanne with sequestration, sequesters removed. The rest of the gland is increased in size, with areas of necrosis black, contact bleeding. Parapancreatic tissue with areas of necrosis and abundant thick purulent discharge. Conclusion: infected Subtotal pancreatic necrosis, parapancreatic abscess, abscess of the omental Bursa. The result of seeding of biopsy specimens of the pancreas: Escherichia coli, Bacteoides fragilis.
A day after surgery, a significant reduction in the concentration of volatile fatty acids in the blood: acetic acid - 0,11 mmol/l, propionic - 0,036 mmol/l, oil - 0,0019 mmol/l isovaleric - 0,00023 mmol/l At follow-up was performed five times remedial program relaparotomy with an interval of 2-3 days. Also in an intensive care unit was conducted a complex of intensive therapy, including the use of antimicrobial drugs: Meronem, ciprofloxacin, metrogyl (in relation to aerobic-anaerobic Association of microorganisms in the nidi). Marked by a gradual cleansing of necrosis, the wound was actively grained with scanty serous discharge. At last relaparotomy performed partial suturing of surgical wounds with drainage of the residual cavity. The patient's condition significantly improved: pain and fever disappeared. Decreased levels of amylase to 33% and C-reactive protein to 2 mg/l, white blood cells to 5.5·109/l (eosinophils - 1%, stab neutrophils - 2%, segmented neutrophils - 78%, monocytes - 6%, lymphocytes - 11%). Ultrasound and CT-control visualized positive dynamics in the absence of encysted fluid in the abdominal cavity and retroperitoneal space.
Repeated studies of the content of volatile fatty acids provodilis� every 7 days a significant decrease in the level of acetic acid - to 0,048 mmol/l, propionic - to 0,0058 mg/l, oil - to 0.0015 mmol/l isovaleric - up to 0.0002 mmol/L. the Patient was discharged from hospital on the 37th day in a satisfactory condition for outpatient therapy. Clinical, instrumental, laboratory, and chromatography data in a patient diagnosed as infected pancreatic necrosis with active development of anaerobic infection, which confirms the result of the application of the claimed method of diagnosis.
Therefore, the claimed method is objective and informative. Using the clinical signs of the disease and the concentration of acetic, propionic, butyric and isovaleric acids in the blood, it is possible to diagnose the infection foci of pancreatic necrosis.
This method allows to increase the objectivity and accuracy of diagnostics of the transition to the stage of pancreatic necrosis infection through the use of quantitative parameters without the appearance of undesirable side effects.
Method for the diagnosis of infected pancreatic necrosis with the establishment of indications for surgical intervention by examination of the patient, characterized in that the gas chromatographic method to determine the blood content of acetic, propionic, butyric and isovaleric acids, and at a concentration of at�ssnoi acid more 0,11 mmol/l establish the presence of infected pancreatic necrosis, and the same concentrations of any of three acids: propionic more 0,0095 mmol/l, more oil 0,0035 mmol/l isovaleric more to 0.0003 mmol/l to establish the presence of infected pancreatic necrosis with active development of anaerobic infections requiring one of the options of surgical intervention.
SUBSTANCE: invention relates to medicine, namely to a method of predicting a probability of reduction of the glomerular filtration rate (GFR) after 3 months of observation after aortocoronary bypass surgery without artificial blood circulation (ACBS without ABC). The essence of the method consists in the fact that the concentration of a kidney injury molecule of type 1 (KIM-1) is determined in blood serum, the ratio of the biomarker KIM-1 concentrations in two time points after 48 hours and 7 days after the operation is calculated and if its value is higher than 1.5, a conclusion about the probability of (GFR) reduction in the remote period after ACBS without ABC is made.
EFFECT: application of the claimed method makes it possible to predict the probability of the glomerular filtration rate (GFR) reduction after 3 months of observation after aortocoronary bypass surgery without artificial blood circulation in an efficient and accurate way.
1 tbl, 1 dwg, 1 ex
SUBSTANCE: method includes determination of a titre of antibodies to cytomegalovirus, content of 2,3 DPG (2,3-diphosphoglycerate), and oxyhaemoglobin in erythrocytes. If the titre of the antibodies to cytomegalovirus increases to 1:1600, DPG increases to 6.7±0.3 mcmole/ml, content of HbO2 is 95.0±1.7%, with the reduction of the specific optical density of haemoglobin to 0.70±0.01, it is concluded that a threat of anaemia development is formed.
EFFECT: method makes it possible to study the character of haemoglobin oxygenation impairment by means of determination of the specific optical density.
SUBSTANCE: neurovisualisation examination of brain is carried out, Cirs comorbidity index and Kaplan-Feinstein comorbidity index are determined, cochleovestibular syndrome, eye-moving impairments, type of diabetes mellitus are identified. Value of discriminate function (D) is calculated. If D value is higher than zero, diagnosed are consequences of ischemic brain stroke (IBS) with hyperhomocysteinemia (HH), if D is lower than zero, consequences of IBS without HH are diagnosed.
EFFECT: method makes it possible to increase reliability of diagnostics of IBS consequences, which is achieved due to complex analysis of said parameters.
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 refers to medicine and aims at diagnosing vaginitis in females of a reproductive age. Expression levels of mRNA of TNF, IL18, GATA3 and TLR4 genes are measured in vaginal smears. Expression levels of mRNA of TLR4/GATA3 and TNF/IL18 genes are related, and the derived threshold cycles are used to predict a probability of vaginitis by formula. If P≤57% for nonpregnant females or P≤68.5% for pregnant females, the absence of vaginitis is stated. If P≥57% for nonpregnant females or P≥68.5% for pregnant females, vaginitis is diagnosed.
EFFECT: invention provides the effective diagnosis of vaginitis in the females of a reproductive age.
3 tbl, 5 ex
SUBSTANCE: group of inventions refers to medicine, namely to a method of analysing ex-vivo if a patient suffering a cancer is expected to respond therapeutically to a method of treating. To this purpose, a biological sample specified in a group consisting of total blood, plasma or serum samples is taken from the patient. The levels IL10 and IFNγ are measured in the above biological sample; the levels are determined with using the respective IL10 and INFγ specific antibodies. The IL10/IFNγ ratio is derived and compared to a threshold. If the IL10/IFNγ ratio of less than 4 shows that the patient is expected to develop the preventive or therapeutic response to the immunogenic composition. The group of inventions also refers to using IL10 and INFγ as biomarkers and a kit for analysing the above method.
EFFECT: using the given method enables predicting the sensitivity of the patient suffering cancer to the therapeutic treatment, as well as obtaining an algorithm for treatment modification for improving the patient's response to the treatment.
12 cl, 2 dwg, 1 ex
SUBSTANCE: invention deals with early diagnostics of infectious complications in patients with acute lymphoblastic leukaemia (ALL), obtaining chemotherapy (CT). Claimed method consists in the following: concentration of fibrinogen, time of XIIa-dependent euglobulin lysis (XIIa-DEL), level of soluble fibrin-monomer complexes (SFMC), activity of protein C (prC) are analysed in ALL patients during CT 2-3 times per week. If at least 2 of 4 criteria are detected, namely: ≥41% increase of fibrinogen level, ≥76% increase of SFMC, ≥11% prolongation of XIIa-DEL time and ≥12% reduction of prC activity in comparison with previous analysis, development of infectious complications is predicted.
EFFECT: method provides early prediction of infection development in patients with acute lymphoblastic leukaemia during chemotherapy.
7 tbl, 4 ex
SUBSTANCE: level of anti-flu antibodies in blood serum from umbilical vein (A), concentration of middle molecular peptides in blood plasma from umbilical vein (units of optical density) (B), total number of T-lymphocytes (CD3+) in points: 1 point - CD3+ higher than 48%; 2 points - CD3+ 47%-41%; 3 points - CD3+ 40% and lower in venous umbilical blood are determined in term new-born babies at birth. After that, prediction of frequent development of acute respiratory viral infections is realised by means of discriminant equation: D=+0.008×A-111.694×B-1.537×C, where D is discriminant function with boundary value, equal - 34.16. If D is equal or is larger than boundary value, absence of development of frequent respiratory viral infections during the first year of life in term new-born babies with intrauterine flu A(H3N2) is predicted. If D is lower than boundary value, frequent development of acute respiratory viral infections during the first year of life in term new-born babies is predicted.
EFFECT: increased probability of correct prediction of frequent development of acute respiratory viral infections during the first year of life in term new-born babies.
SUBSTANCE: biological object, which contains mixture of hydroxybenzene and its monomethyl-substituted are crashed, processed twice with ethylacetate for 30 minutes with ethylacetate, ethylacetate extracts are combined, treated with ethanol solution of calcium hydroxide, solvent from combined ethylacetate extract is evaporated at 16-20°C, residue is repeatedly treated with acetone, containing hydrochloric acid in excess with respect to potassium hydroxide, present of residue, acidified acetone extracts are combined, treated with water solution of sodium hydroxide to neutralise residues of hydrochloric acid in acetone and create excess of alkaline medium, acetone is evaporated from combined extract, water-alkali residue is diluted with water, formed solution is acidified to pH 2-3, saturated with sodium sulphate, extracted with diethyl ether, extract is dehydrated, evaporated, chromatographed in column with silica gel with application of mobile phase hexane-diethyl ether with ratio 6:4 in volume, eluate fractions, containing hydroxybenzene and its monomethyl substituted, are combined, extracted with buffer solution with pH 12-13, water-alkali extract is acidified with 24% solution of hydrochloric acid to pH 2-3, saturated with sodium sulphate, extracted with dichloromethane, dichloromethane extract is dehydrated, analysed substances, contained in dichloromethane extract, are transferred into corresponding trimethylsilyl derivatives, for which purpose dichloromethane extract is treated for 20 minutes with N-methyl-N-trimethylsilyltrifluoracetamide under conditions of heating at temperature 60°C, qualitative and quantitative determination by physical-chemical method, such as chromate-mass-spectrometry, is performed in capillary column, 25 m long with internal diameter 0.2 mm with immobile phase (5%-phenyl)-methylpolysiloxane, with application of helium carrier gas, supplied at rate 0.6 ml/min, and mass-selective detector, working in electron impact mode, initial temperature of column thermostat constitutes 70°C, said temperature is maintained for 3 minutes, and then temperature is programmed from 70°C to 290°C at rate 20°C, final temperature of column is maintained for 10 minutes, injector temperature constitutes 250°C, quadrupole temperature - 150°C, temperature of ion source - 230°C, temperature of detector interface - 300°C, intensity of signal, conditioned by charged particles, formed in bombardment of analysed substance, leaving capillary column and getting into source of ions, with ionising beam of electrons with energy 70 eV, is registered, mass-spectrum is registered by full ion flow, qualitative determination of analysed substance is realised by time of exposure, set and intensity of signals of characteristic charged particles in mass-spectrum of its trimethylsilyl derivative, with quantity of determined compound being calculated by area of chromatographic peak of its trimethylsilyl derivative.
EFFECT: increasing sensitivity and reduction of determination duration.
6 tbl, 1 dwg, 5 ex
SUBSTANCE: invention relates to medicine, namely to method of predicting development of terminal stages in patients with chronic myeloleukaemia. Essence of method consists in the fact that activity of two degydrogenases - glycerol-3-phosphatedehydrogenase (G3PDH) and lactatedehydrogenases (LDG) is determined in lymphocytes of peripheral blood of chronic leukaemia patients in open stage. In case of combination of G3PDH in the range from 0 to 0.02 mcE and activity of LDG in the range from 0.04 to 5.02 mcE development of terminal stage is predicted.
EFFECT: application of claimed invention makes it possible to diagnose progress of disease, correct plan and tactics of treating given category of patients and improve results of their rehabilitation in due time.
FIELD: medicine, hepatology.
SUBSTANCE: one should detect the level of hepato-specific enzymes (HSE) in blood plasma, such as: urokinase (UK), histidase (HIS), fructose-1-phosphataldolase (F-1-P), serine dehydratase (L-SD), threonine dehydratase (L-TD) and products of lipid peroxidation (LP), such as: dienic conjugates (DC), malonic dialdehyde (MDA). Moreover, one should detect the state of inspecific immunity parameters, such as: immunoregulatory index (IRI) as the ratio of T-helpers and T-suppressors, circulating immune complexes (CIC). Additionally, one should evaluate the state of regional circulation by applying rheohepatography (RHG), the system of microhemocirculation with the help of conjunctival biomicroscopy (CB) to detect intravascular index (II). In case of increased UK, HIS levels up to 0.5 mcM/ml/h, F-1-P, L-SD, L-Td, LP products, CIC by 1.5 times, higher IRI up to 2 at the norm being 1.0-1.5, altered values of regional circulation, increased II up to 2 points at the norm being 1 point, not more one should diagnose light degree of process flow. At increased level of UK, HIS up to 0.75 mcM/ml/h, F-1-P, L-SD, L-TD, LP products, CIC by 1.5-2 times, increased IRI up to 2.5, altered values of regional circulation, increased II up to 3-4 points one should diagnose average degree of process flow. At increased level of UK, HIS being above 0.75 mcM/ml/h, F-1-P, L-SD, L-TD, LP products, CIC by 2 and more times, increased IRI being above 2.5, altered values of regional circulation, increased II up to 5 points and more one should diagnose severe degree of process flow.
EFFECT: higher accuracy of diagnostics.
FIELD: medicine, infectology, hepatology.
SUBSTANCE: in hepatic bioptate one should detect products of lipid peroxidation (LP), such as: dienic conjugates (DC), activity of antioxidant enzymes, such as: catalase (CAT)and superoxide dismutase (SOD). One should calculate by the following formula: C = DC/(SOD x CAT)x100, where DC - the content of dienic conjugates, SOD - activity of superoxide dismutase, CAT - activity of catalase. At coefficient (C) values being above 65 one should predict high possibility for appearance of cirrhosis, at 46-645 - moderate possibility and at 14-45 -low possibility for appearance of cirrhosis.
EFFECT: higher accuracy of prediction.
FIELD: medicine, clinical toxicology.
SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
EFFECT: higher accuracy of prediction.
2 ex, 3 tbl
FIELD: medicine, juvenile clinical nephrology.
SUBSTANCE: disease duration in case of obstructive pyelonephritis should be detected by two ways: either by detecting the value of NADPH-diaphorase activity, as the marker of nitroxide synthase activity in different renal department and comparing it to established norm, or by detecting clinico-laboratory values, such as: hemoglobin, leukocytes, eosinophils, urea, beta-lipoproteides, lymphocytes, neutrophils, the level of glomerular filtration, that of canalicular reabsorption, urinary specific weight, daily excretion of oxalates, arterial pressure, and estimating their deviation against average statistical values by taking into account a child's age.
EFFECT: higher efficiency of detection.
7 dwg, 1 ex, 6 tbl
FIELD: clinical medicine, pulmonology.
SUBSTANCE: one should carry out complex estimation of interleukin-1β) concentration in blood, saliva, bronchoalveolar liquid. Moreover, one should detect distribution coefficient (DC) for IL-1β as the ratio of IL-1β blood content to IL-1β salivary content. At increased IL-1β blood content by 10 times and more, by 2 times in saliva, unchanged level of bronchoalveolar IL-1β, at DC for IL-1β being above 1.0 one should predict bronchial obstruction. The method enables to conduct diagnostics of the above-mentioned disease at its earlier stages.
EFFECT: higher efficiency of prediction.
FIELD: medicine, diagnostics.
SUBSTANCE: the present innovation deals with genetic trials, with diagnostic field of oncological diseases due to analyzing DNA by altered status of gene methylation that take part in intracellular regulation of division, differentiating, apoptosis and detoxication processes. One should measure the status of methylation in three genes: p16, E-cadherine and GSTP1 in any human biological samples taken out of blood plasma, urine, lymph nodes, tumor tissue, inter-tissue liquid, ascitic liquid, blood cells and buccal epithelium and other; one should analyze DNA in which modified genes of tumor origin or their components are present that contain defective genes, moreover, analysis should be performed due to extracting and purifying DNA out of biological samples followed by bisulfite treatment of this DNA for modifying unprotected cytosine foundations at keeping 5-methyl cytosine being a protected cytosine foundation followed by PCR assay of bisulfite-treated and bisulfite-untreated genes under investigation and at detecting alterations obtained according to electrophoretic result of PCR amplificates, due to detecting the difference in the number and electrophoretic mobility of corresponding fractions at comparing with control methylated and unmethylated samples containing normal and hypermethylated forms of genes one should diagnose oncological diseases. The method provides higher reliability in detecting tumors, detection of remained tumor cells after operation.
EFFECT: higher efficiency of therapy.
1 cl, 3 dwg, 4 ex
FIELD: medicine, gastroenterology.
SUBSTANCE: one should carry out diagnostic studying, moreover, on the 5th -6th d against the onset of exacerbation in case of gastric and duodenal ulcerous disease one should detect the content serotonin, histamine and acetylcholine in blood, then during 2-3 wk one should conduct medicinal therapy to detect serotonin, histamine and acetylcholine level in blood again and at serotonin content being by 2-3 times above the norm, histamine - by 1.15-1.4 times above the norm and acetylcholine - by 20-45% being below the norm one should predict the flow of gastric and duodenal ulcerous disease as a non-scarring ulcer.
EFFECT: higher accuracy of prediction.
SUBSTANCE: method involves taking blood from ulnar vein (systemic blood circulation) and from large vein of the injured extremity proximal with respect to lesion focus (regional blood circulation). Spontaneous NST-test value is determined and difference is calculated in systemic and regional blood circulation as regional-to-systemic difference. The difference value is used for predicting clinical course of pyo-inflammatory disease in extremities.
EFFECT: high accuracy of diagnosis.
4 cl, 2 tbl
FIELD: medicine, gastroenterology.
SUBSTANCE: one should introduce biologically active substance, moreover, in patient's blood serum one should detect the content of acetyl choline and choline esterase activity followed by 2-h-long intragastric pH-metry at loading with biologically active substance as warm 40-45%-honey water solution at 35-40 C, and at increased content of acetyl choline being above 1.0 mM/l, choline esterase being above 0.5 mM/l/30 min and pH level being 6.0-6.9 it is possible to consider apitherapy to be useful for treating ulcerous duodenal disease.
EFFECT: higher efficiency and accuracy of detection.
FIELD: medicine, gastroenterology.
SUBSTANCE: it has been suggested a new method to detect pharmacological sensitivity to preparations as acidosuppressors. After the intake of the preparation a patient should undergo fibrogastroduodenoscopy 3 h later, then, through endoscopic catheter one should introduce 0.3%-Congo red solution intragastrically and the test is considered to be positive at keeping red color that indicates good sensitivity to the given preparation, and in case of dark-blue or black color the test is considered to be negative that indicates resistance to this preparation. The suggested innovation widens the number of diagnostic techniques of mentioned indication.
EFFECT: higher efficiency of diagnostics.