Vol 22, No 1 (2018)

Modern approaches to diagnosis and prediction of course of urothelial cancer
Salnikova S.V., Slavyanskaya T.A., Sepiashvili R.I.

Urothelial cancer (UC) holds one of the leading positions amongst oncourological diseases. Rate of cancer is growing all around the world and according to experts the growth rate of cancer is estimated as alarming. Clinical implications of the early disease are so poor that they result in late detection of the decease. Understanding of tumor’s pathogenesis opened the door for development of new approaches for diagnosis of cancer, use of innovative methods and technologies. The modern UC diagnostics includes a variety of lab tests and special exams (invasive method and noninvasive methods). Considering low informative value and limited prospects of these methods, today there are researches in improvement of methods which are already being used and development of new methods for early diagnosis and forecasting of the decease being done. Detecting the most specific, vulnerable and informative markers or its combination of the UC is a pressing topic. In this article we consider questions of peculiarities of structure and site of the UC from all angles; we show directions of the UC phenotype research and results of molecular pan-cancer analysis; new tendencies in the UC classification based on study of genetic profile of the UC’s different forms; a short review of the researched molecular genetic markers of early detection of the UC and prognosticating its progression; prognostic value of somatic mutation in the UC; we evaluate the connection between gene expression, invasion, tumor’s prevalence and survivability in the UC patients; we give some data on our own researches in the UC diagnostics improvement, study of expression of cancer/testis antigen and detection of abnormalities in genetic code in the UC.

RUDN Journal of Medicine. 2018;22(1):9-21
New predictive factors determining the clinical flow of oral mucositis in patients with plane-cellar cancer of oropharyngeal region
Avanesov A.M., Gvozdikova E.N.

Mucositis is a common and severe complication of cancer treatment. The use of herbal medicinal products in patients with malignant tumors of the oral mucosa and maxillofacial region can be considered as one of the promising methods for the prevention and treatment of mucositis. The effectiveness of local treatment of mucositis may be identified through evaluation of hemomicrocirculation in the mucous membrane of the oral cavity. In 2016-2017 years, we evaluated microcirculation parameter (MP) of the oral mucosa in four randomly selected points from 23 patients with squamous cell carcinoma of the oropharyngeal region subjected to radiation therapy in combination with the use of long-acting plant-based medications. The study was performed in the “Russian Scientific Center of Roentgenology and Radiology” of the Ministry of Health of the Russian Federation. The results confirm the efficiency of these drugs for the prevention and treatment of oral mucositis compared with the common methods of mouth irrigations with a decoction of chamomile and oleotherapy. Indicators of hemomicrocirculation in oral mucosa in patients with squamous cell carcinoma of the oropharyngeal region appeared to depend on the severity of the clinical manifestation of mucositis.

RUDN Journal of Medicine. 2018;22(1):22-28
Viral and bacterial coinfection as a global problem of modern medicine
Balmasova I.P., Malova E.S., Sepiashvili R.I.
Coinfection is becoming increasingly medical-social value in the modern world, not only because of their high incidence, but also because a reliable methodological approach to their clinical evaluation, treatment and prevention is absent. This methodological approach should be based on knowledge of the mechanisms of interaction of pathogenic microorganisms with each other - direct and/or mediated through immune system. The most pathogens in сoinfections are bacteria and viruses, their association not only contributes to a severity of infection, but also greatly increases the frequency of its complications and deaths. In this review, based on the example of respiratory coinfections, malignant processes, human immunodeficiency virus associated microorganisms, the interaction of bacterial-viral pathogens examines to show their high diversity. Among the mechanisms of interaction of coinfecting agents, special attention is paid to the impact of viruses on bacterial toxin production, and bacteria on the infectivity of viruses. Coinfecting microorganisms contribute to overcoming epithelial barrier by each other, can mutually beneficial to modify the functions of the cells of the immune system and help to escape from the immune response. It was found that the gene expression of oncogenic viruses and HIV is governed by epigenomic changes caused by the bacteria that leads to carcinogenesis. It was shown that the diversity of bacterial-viral interactions in coinfections not only requires new approaches to their timely identification and control, but also generates new biotechnology and strategies for combating of coinfection development around the world.
RUDN Journal of Medicine. 2018;22(1):29-42
Proteins and microRNAs involved in papillomavirus infection
Klimov E.A., Sobolev V.V., Solov’ev A.M., Perlamutrov Y.N., Korsunskaya I.M.

The review is devoted to the analysis of proteins, protein complexes and microRNAs involved in papillomavirus infection. The papilloma viruses belong to the family of DNA-containing papovaviruses (Papovaviridae) and infect the basal layers of the epithelium. Human papillomaviruses (HPV) have an oncogenic potential, which varies significantly. The ring genome HPV encodes 6 early proteins and 2 later proteins (envelope proteins), and uses the host cell proteins for its own replication. For infection the membrane proteins that bind to the host cell membrane are especially important. In this paper we analyzed the arrays of literature data on proteins and microRNAs involved in binding, internalization, transport of HPV virions, and virus multiplication. The analysis of literature data was carried out using the program PathwayStudio9 ® and the database ResNet13 ® of Elsivier (USA), as well as online services. Total was revealed 69 infection-related proteins and protein complexes and 3 microRNAs (72 in total). As a result of the subsequent detailed analysis of the literature, 17 proteins and microRNAs involved in the following processes were selected: penetration of virus particles into the cell (7), transport of the virus in the cytoplasm of the host cell (5), transfer of the virus DNA into the core of the host cell (1) and regulation of gene transcription HPV (4). These proteins and microRNAs are potential targets for drugs that can prevent and suppress HPV infection.

RUDN Journal of Medicine. 2018;22(1):43-49
Causes for the development of lipodystrophy among HIV and AIDS patients
Azovtseva O.V., Belous M.K.

Today, about 35 million people worldwide are infected with HIV. These patients often develop lipid metabolism disorder called lipodystrophy syndrome. Various clinical features of lipodystrophy are peripheral fat loss in the lower limbs, face and buttocks (lipoatrophy); central adiposity, i.e. excess fat accumulation in the abdomen, breasts or dorsocervical region (lipohypertrophy); lipoma development. These types of redistribution of the adipose tissue occur in isolation as well as combined. The article examines the following causes of the development of lipodystrophy: HIV-associated lipodystrophy, HAART-associated lipodystrophy and lipodystrophy caused by age-related changes. It is also pointed out that redistribution of the adipose tissue is more common among the HIV-patients who have had PI-based ART or nucleoside reverse transcriptase inhibitors-based ART (NRTIs).

RUDN Journal of Medicine. 2018;22(1):50-56
Positive effects of the immunomodulatory therapy in rehabilitation of children with congenital cleft lip and cleft palate on stages of the surgical treatment
Mitropanova M.N.

One of the priority areas in the treatment of children with congenital cleft lip and palate (CLP), suffering a high frequency of repeated acute viral and bacterial infections of the respiratory tract and ENT organs is the task of increasing the effectiveness of stage rehabilitation while reducing postoperative complications and restoring the functional activity of impaired segments of immune system. In the study was developed program of immunomodulatory Likopid therapy in the pre- and postoperative period, which showed a positive effect on the state of all the immune system elements, as well as the clinical effects, which is expressed in decreasing the frequency of acute respiratory viral infection, reducing the number of exacerbations of chronic foci of bacterial infection of the oral cavity and nasopharynx, regression of the number of postoperative complications, reducing hospital stay, reducing not only the number of courses of antibiotic therapy, but also the duration of antibiotic usage. Inclusion in the program of stage-by-stage rehabilitation of children with congenital CLP immunomodulatory therapy allowed to significantly optimize therapeutic tactic, first of all to provide timely surgical care to children with this pathology and to avoid negative clinical consequences during the recovery phase after surgical treatment, and at the same time increase resistance to respiratory infections.

RUDN Journal of Medicine. 2018;22(1):57-66
Mikroflora’s changes at gunshot wounds in the nearest postoperative period
Masljakov V.V., Barsukov V.G., Kurkin K.G., Uskov A.V.

Relevance of a subject. Wounds of a neck are among not the most widespread, according to literature such wounds happen in 5-10% in peace time and in 0,5-3% in military, at the same time lethality reaches 32,5%. Research objective. To study changes of microflora at gunshot wounds in the next postoperative period at gunshot wounds and their influence on development of complications. Materials and methods. For the solution of a goal the analysis of changes of microflora of wound contents at 348 patients was carried out. From all arrived wounded were distributed as follows: gunshot wounds of a breast have been noted at 127 (36,4%) wounded, gunshot wounds of a neck - at 86 (24,7%), the combined wounds of a breast and neck - at 135 (38,7%) wounded. All patients were male, average age 36 ± 7 years. In the majority of observations - 235 (67,5%) there were bullet wounds, fragmentation wounds have been registered in 113 (32,4%) observations. Single wounds have been noted in 279 (80,1%), multiple - in 69 (19,8%) observations. Results. As a result of the conducted research it is established that a condition of microflora at wounds of a breast depends on time of delivery of the wounded in medical institution. In case of receipt monocultures, in comparison with the data obtained at the wounded brought after 1 hour where associations of microorganisms prevailed till 1 o'clock. Some features as a part of microflora are revealed, however, essential changes in structure of microflora depending on time of delivery haven't been received. It should be noted that in the majority of observations the carried-out antibacterial therapy can be referred to irrational as antibiotics were appointed without sensitivity. In dynamics it is established that changes of microflora are noted, since fifth postoperative days.

RUDN Journal of Medicine. 2018;22(1):67-74
Integrated approaches in diagnostics and therapy of allergic diseases
Guryanova S.V.
Allergic diseases are a serious problem in both developed and developing countries. Based on the World Health Organization data over 30-40% of the population have one or more allergic diseases. According to forecasts, by 2050, up to 4 billion people in the world will suffer from asthma, allergic rhinitis or atopic dermatitis. Solving problems related to the complexity of differential diagnosis, false positive and false negative results of clinical and laboratory studies, genetic characteristics of patients and many others, can be realized by integrating approaches of bioinformatics and systems biomedicine based on massive databases of experimental studies on one side and, on the other - on advanced technologies of genotyping and detection of biomarkers. The review analyzes the main resources of international databases on allergens, which help to determine the main characteristics of allergens: molecular weight, epitopes, cross reactivity, geographical prevalence, availability allergens in food. Different approaches are considered in the systematization of data obtained in the study of the genome, transcriptome, microbiome, comparison of data obtained from healthy donors and patients with allergic diseases, genetic mutations, transcriptome and microbiome profiles that cause severe course of allergic diseases. Several ways of depicting relationships in the construction of signaling networks (KEGG, sbvIMPROVER, Cyto scape) are shown, both on the basis of direct influence (KEGG, Cytoscape) and on the basis of OpenBEL - the open-access biological expression language - sbvIMPROVER, capable of displaying complex semantic links between components of the system under consideration.
RUDN Journal of Medicine. 2018;22(1):75-85
Clinical and diagnostic value of the determinantion of fractalkine in atopic dermatitis in children
Ben M.M., Yanchevskaya E.Y., Mesnyankina O.A.

Atopic dermatitis belongs to the most common dermatoses observed in practice. In 2016 it was in 647 cases of atopic dermatitis (439,2 per 100 thousand population), while the main group of cases were children aged 0 to 14 years (64%). Aim. The aim of the study was to improve the diagnostics of allergic skin diseases in children. Materials and methods: the study included 135 children with atopic dermatitis and 29 children in the control group. Clinical and laboratory examination of patients was carried out in accordance with the standards of diagnosis of atopic dermatitis. Additionally, we determined the level fractalkine in blood serum using enzyme immunoassay kit for the quantitative determination fractalkine in biological fluids. Results. For children with atopic dermatitis regardless of clinical manifestations, characterized by elevated concentrations of fractalkine in blood serum depending on the duration of the process. Conclusions. Definition of fractalkine seems to be promising in the assessment of severity of dermatosis using it for monitoring and forecasting the further course of the process, and for assessing the effectiveness of therapeutic interventions.

RUDN Journal of Medicine. 2018;22(1):86-91
Especially diseases of the cardiovascular system in patients with severe and medium-severe plaque psoriasis
Batkaeva N.V., Batkaev E.A., Gitinova M.M., Malyarenko E.N., Golovinov A.I.

Background. Psoriasis is a chronic inflammatory disease that associated with a decrease in life expectancy mostly due to cardiovascular disease. But prevalence of cardiovascular comorbidity in psoriasis patients has limited data. Objectives. To compare the prevalence of cardiovascular comorbidity in a hospital-treated cohort patients with severe psoriasis and psoriatic arthritis. Methods. 890 patients (M. - 516/F. - 347) with severe plaque psoriasis mean duration 25.7 ± 16.6 years, mean age of patients were 51.9 ± 11.6 years accordingly were included. Psoriasis patients with cardiovascular disease, including coronary heart disease, arterial hypertension, atherosclerosis and cerebrovascular accident were identify in the hospital Database reporting and coding by International Statistical Classification of Disease and Related Health Problems (ICD-10) between 2010-2015 years. M ± m, t-test, (%) were calculated. All p < 0.05 were considered to indicate statistical significance. Results. Male and Female patients were at the same age. 303 out of 890 patients (34.0%) had psoriatic arthritis, 587 out of 890 patients (66.0%) had severe plaque psoriasis with mean PASI 49.4 ± 0.5. 516 out of 890 patients (59.0%) had cardiovascular disease. Cardiovascular disease coding as I 00-I 99 were found significantly often in patients with psoriatic arthritis compare to patients with psoriasis - in 206 out of 303 patients (68.2%) and in 310 out of 587 patients (52.8%) accordingly (p < 0.05). Arterial hypertension coding as I 10-I 15 were found in significantly more cases in patients with psoriatic arthritis compare to patients with psoriasis - in 206 out of 303 patients (68.2%) and in 310 out of 587 patients (52.8%) accordingly (p < 0.05). Coronary heart disease and atherosclerosis coding as I 70 were found in significantly more cases in patients with psoriatic arthritis compare to patients with psoriasis - in 129 out of 303 patients (42.7%) and in 205 out of 587 patients (34.9%) accordingly (p < 0.05). Cerebrovascular accident coding as I 65 - I 66 were found in significantly more cases in patients with psoriatic arthritis compare to patients with psoriasis - in 50 out of 303 patients (16.6%) and in 64 out of 587 patients (10.9%) accordingly. Conclusions. Psoriatic arthritis and cardiovascular comorbidities are common for hospital-treated cohort patients. Patients with severe plaque psoriasis and psoriatic arthritis tend to suffer from cardiovascular disease and arterial hypertension.

RUDN Journal of Medicine. 2018;22(1):92-101
Clinical case of successful resolution of bilateral pneumonia caused by Burkholderia cepacia complex in a patient with cystic fibrosis
Sergienko D.F., Averina I.A., Krasovskii S.A., Afanasyeva M.V.

The article presents a clinical case of development cepacia syndrome in a patient with cystic fibrosis and the detailed 4-month therapy, which is repeatedly adjusted depending on the condition of the patient.

RUDN Journal of Medicine. 2018;22(1):102-105
Evaluation of chemical composition and energy value of of the diets of highly skilled athletes
Radzhabadiev R.M., Evstratova V.S., Solntseva T.N., Samoilov A.S., Diel F., Khanferyan R.A.

159 highly skilled athletes were surveyed in the pre-competition period of sports training. A comparative assessment of the energy value and chemical composition of athletes diets on the basis of the questionnaire method of 24-hour (daily) reproduction of nutrition showed significant variability and dependence on the type of sports specialization of activities and gender of athletes. In particular, statistically significant (p <0.05) increase in the energy consumption value of rations in biathlonists was shown in comparison with athletes specializing in bullet shooting of various specializations of bobsleigh (overclockers and pilots) both in the male group (33.4%, 14, 8%, 31.5%), respectively, and female (33.9%, 13.8%, 41.7%), respectively. In the bobsledder of both sex groups specializing in overclocking, the energy values of rations were also statistically higher than those of athletes from the group of bullet shooting and bobsleigh pilots: by 21.7% and 19.6%, respectively, in the male group and 23.2% and 32.3%, respectively, in the female. Depending on the type of athletic activity and gender of athletes, the consumption of the main macro-intravenous animals varied significantly. In particular, the amount of protein ranged from 119.2 to 200.2 g/day in men and from 79.5 to 170.1 g/day in women; fat - 119.1-164.2 g / day for men and 84.6-148.8 g/day for women; carbohydrates - 385.1-594.6 g/day, in men and 285.5-475.6 in women.

RUDN Journal of Medicine. 2018;22(1):106-119
Changes in rabbits’ liver morphological parameters in simulation of hypoxia corrected by the use of the modified isotopic D/H composition in the water
Bykov M.I., Chikhladze M., Shchava V.V., Elkina A.A., Bykov I.M., Popov K.A., Moiseev A.V., Baryshev M.G.
The aim of the research was to study the effect of the water menu with a low D/H on morphological hepatocytes parameters in rabbits in modeling of an acute hypoxic liver damage. Methods: morphological research of liver tissues of the experimental animals had been done by cytological and histological methods, which had been prepared impression smear of the studying organ after which it had been stained with azur-eosin according to a common procedure; the blood plasma had been done by the pulsing nuclear magnetic resonance spectrometer JEOL JNM-ECA 400MHz, evaluate an isotopic composition of rat lyophilized liver tissues had been used an isotopic mass-spectrometer DELTAplus. Results: There are the statistics presented in the given study reveal the feature of the water menu with the low deuterium concentration decreases the liver tissue damage in hypoxia simulating by the compression of a hepatoduodenal ligament. It was demonstrated that the use of the deuterium depleted water (DDW) reliably decreases the deuterium concentration in a blood plasma (by 32%) and in liver tissue (by 9%), which shows the effectiveness of the correlation of isotopic composition of internal environment and organs by the products with the low deuterium concentration. Conclusion: It has been established that the use of the DDW as a hepatoprotective measure is equal in its effectiveness to some of lipophilic antioxidants. This allows to use vegetative antioxidant factors and a water menu with a low deuterium concentration (40 ppm) as a combined measure, in order to correct morphological liver defects in its ischemic damage.
RUDN Journal of Medicine. 2018;22(1):120-126

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