bluuebunny/crossref_metadata_2025 huggingface dataset:
CURRENT APPROACHES TO DIAGNOSTICS AND COMPREHENSIVE TREATMENT OF TUMORS OF THE MAXILLOFACIAL REGION
Authors: Kochurova E. V , Nikolenko V. N , Kochurov V. A
Published: September 2020

Statistics says about the severity of the situation with cancer best of all. Despite a good visualization, and significantly expanding knowledge about the prevention and treatment of tumors of the maxillofacial region, the number of new cases is constantly increasing. Tumors of this region are the most difficult health and social problems in prosthetic dentistry. The morbidity rate of tumors of the maxillofacial region is constantly increasing, and the clinical diagnosis is based on visual inspection and palpation, biopsy and/or histopathological evaluation. Also, the lack of the treatment, late detection of tumors and the complexity of the anatomical structures of this region are the cause of volume of destructive interferences, leading to the complexity of the treatment and subsequent rehabilitation.
SENSITIVITY OF THE TRANSPLANTED HUMAN NEUROBLASTOMA TO ONCOLYTIC СOXSACKIE A7 VIRUS
Authors: Sosnovtceva Anastasiia O. , Karshieva S. Sh , Smirnova G. B , Borisova Yu. A , Lebedinskaya O. V , Shubina I. Zh , Treshalina H. M , Chumakov P. M , Chekhonin V. P
Published: September 2020

Oncolytic viral therapy is a promising approach to targeted therapy of malignant tumors. In this article we consider the therapeutic potential of a non-pathogenic Coxsackie A7 virus (CA7V) with neurotropic properties on a model of human neuroblastoma. Purpose to study in vitro/in vivo sensitivity of human neuroblastoma HNB (from cell line JMR-32) to Coxsackie virus A7 (CA7V). Objectives: еvaluation of cytolytic activity in vitro on NB cells verified by cytomorphology and assessment of dynamics of the growth of subcutaneous neuroblastoma xenografts in Balb/c nude male mice exposed to CA7V multiple i.v. injections. Material and methods. CA7V was produced in the cells of line-producer С-33А. Cell culture and the strain of transplanted NB (JMR-32) were obtained from the Collection of N.N. Blokhin Russian Cancer Research Center. Cytomorphologic verification of neuroblastoma and CA7V cytolytic activity were executed with the use of standard cultural methods, TCID50 and IC50 criteria. Experiments «in vivo» were performed on immunodeficient Balb/c nude male mice bred and reared in the N.N. Blokhin Russian Cancer Research Center. The experiments were made at day 6 when neuroblastoma subcutaneous xenografts developed to the Vmean = 79-82 mm3 by day 6. The treatment with CA7V at the i.v. single dose of 1×108 cells per mouse was performed 3 times with 72-hours intervals; evaluation of the efficacy was made according to standard criterion Т/С ≤ 42%; and control of the tumor growth rate (Vt/V0) in the dynamics. Statistical assessment was made with the software Excel for Windows 2007 with the use of T-test under p ≤ 0.05. Results. Cytolytic effect of CA7V on neuroblastoma cells was registered similar to basic parameters of the original line-producer С-33А: TCID50 = 0.99×10-4 pfu/cell, and IC50 = 1.11×10-4 pfu/cell; 48 and 72 hours after virus reproduction in NB cells the rate was 2.0 and 1.5-fold higher than in the line-producer cells. СA7V inhibiting effect on the growth of large subcutaneous neuroblstoma xenografts is registered after the first i.v. injection at the minimal level of T/C = 67% (criterion ≤ 42%) with the 1.5-fold decrease of the tumor growth rate and cancellation of early mice death by day 22 vs day 15 in the control group of untreated mice (n = 8). Conclusion. The obtained results allow to consider human neuroblastoma (JMR-32) to possess the low sensitivity to oncolytic effect of in vitro/in vivo. In order to obtain significant effect in vivo the treatment should be started in mice with 2-fold smaller tumors and a higher initial dose of the oncolytic agent.
NEUROENDOCRINE CARCINOMA OF THE THYMUS
Authors: Chekini A. K , Polotskiy B. E , Machaladze Z. O , Hasbulatov A. M
Published: September 2020

Diagnosis and treatment of neuroendocrine carcinoma of the thymus (NECT) is the significant problem in oncology. On the clinical course these tumors are much more aggressive than epithelial tumors of the thymus. In most of observations in NECTs there is pronounced macro- and microinvasion in the mediastinal tissue and in 30% of patients there are reveled remote metastases. The study included 17 NECT patients. Surgery is the only radical method in the treatment of such patients. 17 NECT patients were operated, 3 of them were operated again due to incomplete operations in other clinics. The vast majority of patients (58.8%) at the time of visiting had advanced stage of the disease. Out of the entire group in 7 patients NECT was associated with ectopic syndrome of varying severity. According to long-term results after surgical treatment of the overall 5-year survival rate was 62.2%.
TISSUE GROWTH FACTORS OF VEGF FAMILY IN DYNAMICS OF THE DEVELOPMENT OF OVARIAN CANCER
Authors: Kit O. I , Frantsiyants E. M , Moiseenko T. I , Verenikina E. V , Cheryarina N. D , Kozlova Larisa S. , Pogorelova Yu. A , Rosenko L. Ya
Published: September 2020

Ovarian carcinoma is the leading cause of death from gynecological cancer. Aim of the study is to reveal the role of VEGF-C comparing to VEGF-А in the progression of ovarian cancer. Material and methods. Tissue samples obtained from 76 patients with epithelial ovarian cancer (serous cystadenocarcinoma: T1N0M0; T2N0M0; T3NxM0; T4Nx-1M0) and 47 patients with cystadenoma were studied. Histological control was performed in all cases. Ovaries of 20 patients obtained during the surgery for uterine myoma were used as the intact tissue. All patients were 50.9 ± 2.9 years old. Levels of the growth factor as VEGF-A and its receptor VEGF-R1, as well VEGF-С and its receptor sVEGF-R3 - were measured by ELISA with the use of standard test systems. Results. VEGF-А levels in cystadenomas and intact tissue were similar, while in cystadenocarcinomas VEGF-А was significantly higher at all stages of the tumor development. sVEGF-R1 receptor in cystadenomas was lower in comparison with the intact tissue, in the contralateral ovary in T1N0M0 and in the tumorous ovary in T4Nx-1M0. VEGF-С level was higher significantly in all tumors, in cystadenocarcinomas it was higher if compared to cystadenomas. Its increase in the contralateral ovary in T1N0M0 differed from other tissue values being average. sVEGF-R3 receptor increased significantly at the later stages of ovarian cancer - T3NxM0 and T4Nx-1M0; its level was low only in the contralateral ovary in T1N0M0, and the values in other tissues were similar to the intact ones. Conclusion. The results show a high rate of lymphatic vessel formation in benign tumors at all stages of the development of the malignant tumor. The significant increase in VEGF-C level in the contralateral (non-tumorous) ovaries, compared to the intact tissue, allows considering VEGF-C, along with VEGF-А, as a pathogenetic factor of ovarian tumor development.
MANAGEMENT OF SEVERE PERIOPERATIVE BLEEDING IN PATIENTS DURING EXTENSIVE LIVER RESECTIONS FOR COLORECTAL METASTASES
Authors: Mamontov K. G , Khays Sergey L. , Varnavskiy E. V , Mamontov A. K , Lazarev A. F
Published: September 2020

Aim of the study. To estimate an influence of the Cavitron ultrasonic surgical aspirator (CUSA) on intraoperative blood loss. Material and methods. An analysis of 185 cases of extensive liver resections in patients for colorectal liver metastases has been performed. All patients were assigned to CUSA group (n = 56) or clamp crashing group (n = 129). Patients from the first group received regional FOLFOX6 or FOLFOX6 + bevacizumab chemotherapy. Preoperative chemotherapy did not performed for second group of patients. Results. Liver transection with CUSA did not lead to the decline in intraoperative blood loss (p = 0.35). Conclusion. Median intraoperative blood loss was 1065 and 1180 ml respectively. Method for liver transection did not lead to the decline in intraoperative blood loss (p = 0.35). Intraoperative blood loss increases from standard to extensive liver resection (p = 0.0007). Resection of contralateral blood lobe metastases did not lead to statistically significant increase in blood loss as compared with standard mode of the operation (p = 0.005).
PROCATHEPSIN B AND ENDOGENOUS INHIBITORS OF CYSTEINE PROTEASES IN TUMORS OF REPRODUCTIVE SYSTEM
Authors: Gashenko Elena A. , Lebedeva V. A , Russkikh G. S , Tsykalenko E. A , Pupyshev A. B , Brak I. V , Korolenko T. A
Published: September 2020

Cysteine proteases are regulated by the rate of the conversion of their inactive proforms into active forms and by specific endogenous inhibitors (cystatins), playing the important role in their regulation, especially in tumor growth and metastasis process. The content of procatepsin B, endogenous inhibitors of cysteine proteases cystatin B and cystatin C in biological fluids (blood serum, ascites fluid) in women with malignant neoplasms of the genital organs was studied. The comparative study of the concentration of procotepsin B, cystatin B and C in blood serum in practically healthy women and women with tumors of the reproductive system was carried out with the use of the enzyme immunoassay nethod. A high content of procatepsin B was shown to be found in all the study groups. The concentration of cystatin B was within the limits of significance and concentration of cystatin C was not changed in same patients in the study groups as compared with the control. The level of cystatin C in the serum was found to be correlated with the progression of the disease. In ascitic fluid (in comparison with blood serum), a sharp increase in the concentration of procatepsin B was revealed, reflecting its elevated extracellular secretion by tumor cells.
THE EFFECTIVENESS OF COMBINED TREATMENT OF DISSEMINATED MALIGNANT PLEURAL MESOTHELIOMA, A DESCRIPTION OF THE CLINICAL CASE
Authors: Karpenko Tat’yana D. , Bychkov M. B
Published: September 2020

Modern approach to the individualization of the management of patients based on the careful observation for the minimal manifestations of the disease, prescription of pemetrexed at the first line of therapy, combination with platinum preparations and antiangiogenic targeted preparation bevazisumab allows control the disease at the advanced stage of pleural mezoteliom and support the good active state of patients during the long time.
THE CONTRASTING PROPERTIES OF A NEW OIL IODINATED PREPARATION LINOYODOL IN VITRO AND IN VIVO
Authors: Granov A. M , Yakunina Marina N. , Fadeev A. Ju , Treshalina H. M , Molchanov G. V , Dolgushin B. I , Makovetskaja K. N
Published: September 2020

The research is devoted to the study of the contrasting properties of new iodinated oil drug Linoyodol (100% solution) by in vitro (monitoring: well-known contracter Omnipak and saline) and in vivo under intraarterial injection of 0.1-1.0 ml to a. femoralis of rats with a intramuscular tumor (n = 18) with the aid of X-ray and СT. In vitro contrasting was shown to be less intensive, than in Omnipak, and in vivo is manifested in a lethal dose of 1.0 ml of highly viscid solution. The conclusion was drawn concerning low contrasting of Linoyodol in vitro with the limitation of its administration of the viscid solution to rats into artery of rather small size. The last demands the use of larger laboratory animals with an artery of sufficient size and decrease of the viscosity of the injection solution.
CARDIOVASCULAR COMPLICATIONS OF ANTICANCER THERAPY: DEFINITION, ETIOLOGY, EPIDEMIOLOGY, PATHOGENESIS, CLASSIFICATION (PART I)
Authors: Vatutin N. T , Sklyannaya E. V , El-Khatib Mariam A. , Taradin G. G
Published: September 2020

The given review is devoted to the problem of the cardiotoxicity of chemotherapeutic agents. Modern cytostatics cause clinically significant manifestations of cardiotoxicity - myocardial injuries, reducing both quality and life expectancy of oncological patients. Many of chemotherapeutic agents can cause cardiovascular complications such as the development of the left ventricular dysfunction and heart failure, myocardial ischemia, arterial hypertension, thromboembolism, QT prolongation and arrhythmias. The toxic influence of the most often used chemotherapeutic agents on heart (antimetabolites, alkylating agents, platinum compounds, taxanes, vinca alkaloids, monoclonal antibodies, anthracycline antibiotics, topoisomerase and protein kinase inhibitors, immunomodulatory agents and cytokines) has been described. The results of recent studies on etiology, epidemiology, classification and pathogenesis are presented in the first part of review. Most attention is paid to recent research in pathogenesis of chemotherapy induced cardiotoxicity. Given the numerous aspects of cardiotoxicity are not completely studied yet, obviously the further researches are needed in this field.
SOME FEATURES OF CHOLESTASIS IN CANCER PATIENTS DURING THE REDUCTION OF LIVER FUNCTIONAL RESERVES
Authors: Okhotnikov Oleg I. , Yakovleva M. V , Grigoriev S. N. , Pakhomov V. I.
Published: September 2020

Purpose. To determine the indications for the supra - and transpapillary externally-internal drainaging of the biliary tree in case of jaundice syndrome. Material and methods. The results of minimally invasive treatment of 246 patients with external-internal drainage of the biliary tree were analyzed. Among patients with proximal tumor block the external-internal drainage is made in 92 cases, in 42 (45,7%) out of them in suprapapillary embodiment and in 50 (54,3%) - via transpapillary approach. In 154 cases with distal tumor (obstruction peripapillary cancer) transpapillary drainage was performed. Results. The technical success of the external-internal drainaging was achieved in 242 patients (98,4%). It was failed to pass the duodenum in 4 patients with the cancer of common bile duct (3) and cancer of papilla of Vater (1). There was no complications related to the technique of external-internal drainage. In 18 patients (8,8%) out of 204 with transpapillary location of the drainage, we were forced to temporarily return to full outer bile outflow because of acute cholangitis. The syndrome of an acute blockade of the papilla of Vater arising after transpapillary external-internal drainaging required endoscopic papillosphincterotomy in 42 (84%) out of 50 patients with proximal tumor block bile outflow and in 7 (4.5%) out of 154 patients with peripapillary cancer. Conclusion. Suprapapillary and transpapillary embodiment of the drainage are equivalent in terms of the efficacy of cholestasis elimination. Syndrome of an acute blockade of papilla of Vater is the most often complication of the transpapillary external-internal drainage requiring the carrying out of endoscopic papillotomy «on drainage». This syndrome arises very frequently in a case of transpapillary external-internal drainage due to the proximal tumor obstruction of the biliary tree. The risk of acute cholangitis due to regurgitation after manipulation is absent in the suprapapillary location of the external-internal drainage, and with its transpapillary position is realized only with a concomitant violation of the outflow of bile.
DIGITAL TECHNOLOGIES IN ONCOLOGICAL EDUCATION
Authors: Cherenkov Vyacheslav G. , Petrov A. B
Published: September 2020

The problem of modern oncology is not the correspondence between the achievements of medical science and technology and the understanding of general practitioners to conduct a survey and the ability to apply them and to detect cancer at a stage when the cure rate can be of 80-100%. It is necessary to train doctors who do not know so much, how much can determine the optimal diagnostic tactics. The semiotics of the cancer of individual localizations in the educational literature is usually described at the stage of the clinical phase, without having a specific system. The goal is to systemize the manifestation of heart failure in the form of signal (pathogenetic) supporting symptoms, taking into account the phase of tumor development and using digital technologies to conduct objective testing of knowledge to improve cancer literacy and efficiency of screening. The proposed signal system of basic symptoms of development of malignant neoplasms (MN) and described in the textbook and training manual [Сherenkov V.G., 2017], allow the student or general practitioner to remember them «not on their fingers», but from the position of the visual system. The examination of patients is directed, first of all, to the exclusion of direct and indirect signs of «reference symptom number 1», factors and reasons for the possible development of MN. The application of the Russian system «Votum» with a set of consoles, software developed by ourselves for «Oncology» test control with visualization elements in the application «presentation» - shortens the time for the survey and increases it to learn practical skills. The interactive system allows you to solve tactical tasks, conduct lessons more vividly with the visual perception, and carry out instantly objective and transparent control of knowledge for participants, present them in the form of graphs and time spent on answers. Preliminary experience of combining traditional forms of education and modern digital technologies testifies to the effectiveness of the increase of the oncological literacy and alertness of students and general practitioners.
ANALYSIS OF PROTEIN EXPRESSION OF PD-L1 IN MALIGNANT PLEURAL MESOTHELIOMA
Authors: Karpenko Tatyana D. , Kozlov N. A , Lubchenko L. N , Rotobelskaya L. E , Bagrova S. G , Safronova V. M , Laktionov K. K , Bychkov M. B
Published: September 2020

Malignant pleural mesothelioma is associated with poor prognosis and resistance to chemotherapy. This gives reason to search for as well new effective methods of treatment as predictive factors. Programmed cell death receptor PD-1 and its ligands PD-L1 and PD-L2 are the representatives of the system of the «immunologic checkpoint» whose main function is the regulation and modulation of immune response, the decrease of the immune cell damage in organs and tissues and also prevention running of an autoimmune process. Tumor cells are able to use a PD-1/PD-L1-signaling pathway to evade the immune system. The assessment of the level of expression of PD-L1 is regarded as a prognostic marker of the life expectancy, but also as a predictor of response to anti-PD-1/PD-L1 immunotherapy.
STEREOTACTIC RADIOTHERAPY FOR THE TREATMENT OF CLINICAL STAGE I-IIA LUNG CANCER PATIENTS. THE EXPERIENCE OF N.N. BLOKHIN NATIONAL MEDICAL RESEARCH CENTER OF ONCOLOGY
Authors: Borisova Tatiana N. , Nazarenko A. V , Allakhverdiev A. K , Tkachev S. I , Alieva S. B , Trofimova O. P , Glebovskaya V. V , Laktionov K. K , Breder V. V , Meshcheryakova N. A , Marinov D. T , Fedorova A. A
Published: September 2020

Introduction: Nowadays the stereotactic radiotherapy (SRT) of clinical stage I-II lung cancer patients is the choice of the treatment modality for functionally inoperable patients. It shows safety and high efficiency in achieving local control. Though there is a range of unsolved issues connected with the prediction of the treatment efficiency and frequency of complications, an integration of new technologies in the planning and treatment process allows widening the search of the predictive factors. Material and methods. Since 2014, 39 patients (17 T1N0M0 patients, 22 T2N0M0 patients) with clinical stage I-IIa lung cancer have undergone SRT. The majority of patients (35) have been recognized as functionally inoperable due to the concurrent broncho-pulmonary pathology, 4 conditionally operable patients have refused an operation. 11 patients had the primary multiple tumors in their anamneses. 36 patients had a peripheral tumor. The options for the fractionation were: 10 Gy × 5 fractions (n = 26) and 7 Gy × 8 fractions (n = 13) - BED = 100 Gy. Results. The median follow-up was 26 months (range: 3-38 months). The 2-year local control was 94%. The isolated local recurrences were not registered. Overall and 2-year recurrence-free survival rate was 84% (95% CI, 70-99) and 83.2% (95% CI: 70.5-99) respectively. During the first year, 4 patients (10%) had the locoregional and distant progression and 3 of them died. 7 patients had experienced pulmonary toxicity of grade 2 or more. One patient with central tumor died from pulmonary hemorrhage (toxicity of grade 5). Grade 3 chest pain was observed in 2 patients, one of them had a rib fracture. One-factor analysis, revealed a reliable influence of the fractionation regimen (р = 0.04) and, close to reliability, the initial SUVmax level (р = 0.07) on the prognosis. A reliable relationship between the radiation toxicity level and dosimetric radiation index (V10, V5, MLD) was not registered. There was a tendency to reliable correlation with the total lung capacity indices (р = 0.058). Conclusions. A search for additional treatment efficiency and toxicity predictors of SRT treatment should include modern approaches to planning and delivery. The total dose delivery regimen and initial tumor SUVmax can be predictive efficiency factors, while the pulmonary tissue volume can be a predictive toxicity factor.
MULTIPLE PRIMARY TUMORS IN CHRONIC LEUKEMIA AND GENERALIZED LYMPHOMAS
Authors: Buevich E. I , Kotovshchikova Elena F. , Lazarev A. F , Ganov D. I
Published: September 2020

There are presented results of the analysis of case histories of 418 patients with generalized lymphomas and chronic leukemia, among whom 49 patients had information about multiple primary cancers. Among these patients, 37 were diagnosed as generalized lymphoma, 8 - multiple myeloma and 4 - chronic myelomonocytic leukemia. Most often hemoblastosis combined with skin cancer (17 patients), bowel cancer (11 patients) and lung cancer (9 patients). 3 patients had hemoblastosis combination with prostate, as well as kidney, stomach, and thyroid malignant diseases. Among all cases, 44 patients had two multiple primary tumors, 4 patients had three tumors. In this work, the analysis of patients is given according to the age-gender structure, time of the onset of the development of tumors. As an example, the short information about 4 patients with hematological malignancies in combination with other tumors is given.
KI-67 INDEX AND TYPE OF HSP70 EXPRESSION IN THE FORMATION OF PROGNOSTIC GROUPS OF PATIENTS WITH PAPILLARY THYROID CANCER
Authors: Ivanov Anatoliy A. , Avdalyan A. M , Lushnikova E. L , Molodykh O. P , Zorkina Yu. N , Kruglova N. M , Lazarev A. F
Published: September 2020

The aim of our work was to determine the possibility of stratification of papillary thyroid cancer (PTC) patients into prognosis groups depending on the Ki-67 index and the type of HSP70 expression. The study included 89 patients with a known prognosis for the period of 2005-2017, treated for PTC over the period of 2005-2013. The immunohistochemical study was carried out with Ki-67 and HSP70 antibodies on the Ventana XT Steiner device using standard protocols. The method of tissue matrices was used to standardize the study. Different variants of PTC, depending on the level of Ki-67 expression in combination with the HSP70 response allowed identifying 3 groups of PTC prognosis. The favorable prognosis group included patients with samples with cytoplasmic type of HSP70 expression and Ki-67 response < 6.3%, with mixed type of HSP70 expression and Ki-67 response < 6.3%, with cytoplasmic HSP70 expression and Ki-67 response > 6.3%. The intermediate prognosis group consisted of patients with tumors with mixed type of HSP70 expression and Ki-67 response > 6.3%, with nuclear HSP70 expression and Ki-67 response < 6.3%. The group of poor prognosis included patients with nuclear HSP70 expression and Ki-67 response > 6.3%. In the group of favorable prognosis, the 10-year survival rate was 89.6 ± 3.5%. In the intermediate prognosis group, the 10-year survival rate was 45 ± 14.5% and in the unfavorable prognosis group, no patient survives 6 years.
BIOPSY OF SIGNAL LYMPHATIC NODULES IN PATIENTS WITH BREAST CANCER AFTER NEOAVARIANT CHEMOTHERAPY
Authors: Bit-Sava Elena M. , Anchabadze M. G , Monogarova M. A , Moiseenko V. M
Published: September 2020

One of the advantages of systemic cytotoxic therapy is the «transformation» of positive axillary nodes into negative nodes (cN+ → cN-); a similar concept is used in randomized clinical trials with «post-neoadjuvant» sentinel lymph node - pNsn. In studies of ACOSOG Z1071, SENTINA, SN FNAC, was evaluated the frequency of a false-negative result with a biopsy of the sentinel lymph node (BSLU) after neodjuvant chemotherapy. It was proved that there was no need for immunohistochemical examination of lymph nodes using the BSLU technique followed by adjuvant therapy, since the detected micrometastases did not worsen overall survival. As for patients with biopsy of signaling lymph nodes after neodjuvant chemotherapy, nowadays particular interest of prognostic in significance for micrometastases and individual tumor cells in the lymph nodes, as well as an estimate of the frequency of false-negative result.
FEATURES OF MODERN TREATMENT OF PATIENTS WITH OBSTRUCTION OF BILE DUCT OF NEOPLASMATIC GENESIS
Authors: Tseimakh A. E , Lazarev A. F , Bedian N. K , Teplukhin V. N , Mitshenko A. N , Shoykhet Ia. N
Published: September 2020

It is analyzed the tactics of managing patients with obstruction of bile duct of neoplasmatic etiology in two nosologically comparable groups of patients. The first group of 716 patients underwent complex treatment of complications with the use of minimally invasive interventions in the X-ray angiographic block, while the second group of patients, who made up from 1,301 patients, had complex treatment of complications without the use of minimally invasive interventions. On the background of the active introduction of minimally invasive interventions in the first group of patients both at the diagnostic stage (ante- and retrograde cholangiography) and the implementation at the treatment stage of various minimally invasive procedures for decompression of bile ducts to eliminate complications of malignant neoplasms of the hepatopancreatobiliary zone, both for palliative treatment, and with the purpose of preparation for radical surgical treatment, it is established: a decrease in the number of open biliodigestive anastomosis in order to eliminate obstruction of bile duct, which reduced the incidence of postoperative complications and mortality, improvement of the quality of life of patients who are not candidates to radical surgery; an increase in the number of radical operations to remove malignant neoplasms of the hepatopancreatobiliary zone.
CASE OF FULL RESPONSE TO THE TREATMENT OF PATIENT WITH AGGRESSIVE FORM OF METASTIC MELANOMA OF THE SKIN
Authors: Yargunin Sergei A. , Lazarev A. F
Published: September 2020

The issues of diagnosis, clinical course, the results of surgical treatment, immunotherapy and combined methods of treatment of patients with metastatic skin melanoma are considered. An attempt has been made to personalize the therapy. Received a complete response to treatment, improving the quality of life while maintaining robustness in a young patient. Methods. Patient B., 30 years old, who was diagnosed with melanoma of the skin of the back in GBUKKOD№1, was operated on in the surgery department of tumors of the skin and soft tissues. After identifying the progression of the disease, the patient was operated on with subsequent adjuvant immunotherapy and radiation therapy. After the progression of the disease was detected, the patient was prescribed a combination of targeted therapy with a full response. When a sustained full response was obtained, the patient was transferred to treatment with PD-1 inhibitors, against the background of which the progression of the disease was revealed, which required a return to the combination targeted therapy, as a result of which a full response was obtained again. Results. Personalized therapy was performed on a patient with progressive MK. The resulting increase in overall duration and quality of life. A full response to the combined targeted therapy with vemurafenib and cobimetinib was obtained twice after surgery, radiation therapy, immunotherapy (interferon-α) and treatment with control point inhibitors (nivolumab).
ACCOMPANYING PHYTOTHERAPY - AS PREVENTION OF IMMUNOLOGICAL COMPLICATIONS OF SPECIAL TREATMENT IN PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER
Authors: Korepanov S. B , Lazarev A. F , Nikolaeva M. G , Petrova Valentina D.
Published: September 2020

In a randomized clinical study, the effect of accompanying therapy with drugs from medicinal plants (phytotherapy) on the dynamics of blood immunological parameters in patients with locally advanced cervical cancer during special treatment was studied. In both groups: the main, receiving phytotherapy, and the comparison group, a decrease in the total number of leukocytes, lymphocytes in peripheral blood, a decrease in the number of CD4+ and CD8+ lymphocytes and the ratio of CD4+/CD8+ during treatment was found. All patients had multidirectional dynamics of levels of immunoglobulins of classes A, G and M in blood. In the main group, immunological status indicators were higher than in the comparison group, and these differences were statistically significant.
COMPARATIVE EVALUATION OF THE RESULTS OF IMMUNOFLUORESCENCE AND HEMOFILTROCYTOLOGICAL RESEARCH IN CANCER PATIENTS
Authors: Chimitov A. A , Shoihet J. N , Strazhev S. V , Lazarev A. F , Khankhashanova T. D , Boldohonov Tsiren S.
Published: September 2020

Immunofluorescence is a unique immunochemical method that combines the ability to conduct a detailed morphological analysis and use the specificity of the immunological reaction. The advantage of the immunofluorescence method is its high sensitivity and resolution. The immunofluorescence method was used to survey cell films of venous blood filtrate of cancer patients, and with usage of an apparatus for blood micro-screening, the successful extraction of circulating cancer cells was confirmed.
RNA-SEQ IN THE STUDY OF VIRUS-ASSOCIATED TUMORS: CERVICAL CANCER (REVIEW)
Authors: Kurmyshkina O. V , Bogdanova A. A , Spasova A. P , Kovchur P. I , Volkova Tatyana O.
Published: September 2020

For the last few years Next Generation Sequencing technique and its applications has took the leading position in the arsenal of analytical methods that are used for studying the mechanisms of neoplastic progression. Among various experimental opportunities Next Generation Sequencing provides, RNA-sequencing (RNA-Seq) is of great importance as it makes possible unraveling the highest levels of genome expression regulation, which define the molecular phenotype of cells in composition of a tumor. Considerable amount of current studies carried out with the use of RNA-Seq method are designed as pan-cancer integrated research, in which special attention is payed to virus-associated tumors, including papillomavirus-dependent cervical cancer. This review paper summarizes the results of RNA-Seq studies published world-wide within 2017-2019 years and carried out using clinical samples from cervical cancer patients. New facts concerning such hot topics as genomic and transcriptomic instability, neoantigen load, cellular and molecular heterogeneity, tumor epigenetics, antitumor and antiviral immune response, chronic inflammation, immune exhaustion, phenotypic plasticity and tumor cell resistance, are considered. The whole spectrum of issues that are actively discussed in published literature is systematized according to three levels of organization: «molecular», «cellular» and «organismal». The findings reviewed in the paper convincingly illustrate that wide usage of RNA-Seq technology for profiling primary tumors does facilitate moving to a new level of our understanding of the mechanisms of carcinogenesis and emergence of new directions in cancer treatment, namely targeted and immune-therapy.
The influence of plastic techniques in surgery of primary skin melanoma on patient survival
Authors: Yargunin S. A. , Shoyhet Y. N. , Lazarev A. F.
Published: September 2020

Objective. To analyze the feasibility of performing plastic surgery in patients with primary skin melanoma (SM).

Material and methods. We studied patients with primary MK treated in our institution in 2013 (n = 333), who were randomized to a group of 2 blind selection methods to the main one (n = 168), in which the tumor removal operation in patients ended with a tissue defect repair and a comparison group ( n = 165) (after removal of the tumor, simple linear suturing of the wound was performed). A statistically significant difference was found in the comparison groups in the occurrence of negative dynamics (ND), progression-free survival (PFS) and overall survival (OS) in patients with MK 0-IIA st during the follow-up period up to 36 months.

Results. It was found that patients with 0-IIA st who underwent plastic surgery to close the defect when removing primary SM have a statistically proven advantage in ND, PFS, and OS compared with patients without plastic surgery for up to 36 months. In general, the use of plastics has a statistical tendency towards the dynamics of an increase in PFS and OS in the early stages of SM.

Discussion. In the early stages (0-IIA) up to 36 months, cases of negative dynamics (4.2%) were observed 2.3 times less frequently than in the comparison group (9.7%) (p = 0.048), and fatal outcomes in the main group (1.8%) were observed 3.7 times less than in the comparison group (6.7%) (p = 0.028). The analysis also shows that in patients who underwent surgery using plastic surgery statistically significantly reduces the risk of distant metastasis by 3 times (p = 0.05), but significantly more often (in every third patient) (p = 0.022) than in the control group (without plastic surgery) met transient metastases. The appearance of ND, as well as an increase in PFS, OS depended on the plastic replacement of the defect after excision of the primary SM in patients with SM 0-IIA st during the observation period up to 36 months.

Conclusion. The use of plastic methods for closing a wound defect reduces the risk of distant metastasis by 3 times compared with linear suturing, provides a reduction in mortality in patients with SM 0 IIA st for 60 months, prolongs the patients life by an average of 10 months and is the operation of choice in this category.
Efficacy and safety of aranoza-based therapy in neuroendocrine neoplasms. Prognostic role of O6-methylguanine DNA methyltransferase expression in tumor tissue
Authors: Polozkova Svetlana A. , Gorbunova V. A , Delektorskaya V. V , Orel N. F , Kozlov N. A , Kuzminov A. E , Markovich A. A , Odintsova A. S , Emelyanova G. S , Stepanova E. V , Kuznetsova A. A
Published: September 2020

Aranoza (3-a-L-arabinopyranosyl-1-methyl-nitrosourea) is nitrosourea derivative, as streptozotocin STZ. O6-methylguanine DNA methyltransferase (MGMT) is an enzyme involved in chemotherapy resistance to alkalyting agents. Material and methods. There were observed 117patients with neuroendocrine neoplasms (NENs) received Aranoza-based therapy. They included 52 cases with pancreatic neuroendocrine tumors (P-NETs), 52 patients with non-pancreatic (notP-NETs, 13 NET patients with metastases without revealed primary tumor focus). There was investigated the radiologic response to the treatment according to Response Evaluation Criteria In Solid Tumors (RECIST) Score, version 1.0), biochemical response, median progression-free survival (PFS) by Kaplan-Meier estimator), toxicity (according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0) and the impact of MGMT expression (immunohistochemistry method) in tumor tissue on the efficacy of the treatment. Results. Objective response rate (ORR) in PNET cases accounted for 39% (20/52) whereas in nonP-NETpatients - 12% (6/52) (p = 0.0032). Median PFS accounted for 15.3 months in PNET patients and 16.6 months in non-PNET cases (p = 0.78). The most common types of the toxicity grade III-IV included thrombocytopenia (17from 871 courses) and neutropenia (11 from 871 courses). In samples of the tumor tissue the lack of MGMT expression was observed in 29 out of 35 P-NET cases, 12 out of 31 non-PNET cases (p = 0,0006). Objective response was recorded in 20 of 44 patients with MGMT-deficient tumors and in 1 out of 27patients with MGMT intact tumors (p = 0.0001). In the lack and presence of the MGMT expression in the tumor tissue median PFS accounted for 20.6 months and 14.4 months correspondingly (p = 0,022). Conclusion. Aranoza-based therapy demonstrated an antitumor activity and good safety profile in NENpatientss. MGMT deficiency in PNETs was more common than in non-PNETs and explained the susceptibility of some PNETs to treatment.
Analysis of the main indicators of efficiency of realization of individual programs of rehabilitation of invalids of young age for 2007-2013 in the Ulyanovsk region
Authors: Soloveva Natal'ya N.
Published: September 2020

In an article there is presented the need for the implementation of the rehabilitation of disabled persons of the young age (from 18 up to 44 years) in the Ulyanovsk region in dynamics for seven years (2007-2013) in the main directions: medical, professional and social rehabilitation. There was executed the assessment of indices of the implementation and efficacy of rehabilitation measures. There was revealed a tendency towards to the increase in indices of the efficacy of all rehabilitation measures. The performed analysis allowed to reveal a need for the improvement of the quality of the vocational rehabilitation.
Analysis of the cohort of persons rerecognized to be disabled due to the eye and adnexa diseases in the adult population in the Altai region
Authors: Makogon Svetlana I. , Makogon A. S , Chechulina S. V
Published: September 2020

There was performed a study of the cohort of persons re-recognized to be disabled (PRRD) due to the eye and adnexa diseases in the adult population of the Altai region over 2004-2013. In the structure of occasional disability in PRRD the first four ranking places are occupied by such nosological forms as complicated myopia, optic nerve disease, glaucoma and retinal degeneration. Their proportion in the total structure amounted to 71.9%. In the structure ofPRRD according to disability groups with taking into account the gender and nosology,amongpersons having group III and II disability there were dominated male cases with glaucoma (68.7%) and diseases of the optic nerve (64.1%) and female cases with myopia (63.5%). In the structure of PRRD in terms of the age and nosology there were prevailed retirement age patients disabled due to glaucoma (64.9%) and young and middle age patients disabled due to complicated myopia (32.9% and 42.8%, respectively), diseases of the optic nerve (49.8% and 29.9%) and retinal degeneration (34.1% and 26.4%, respectively).
The use of oscillometric higly accurate blood pressure monitor for the determination of the ankle-brachial index in examination of patients at suspicion on lower limbs arteries atherosclerosis
Authors: Karlov A. A , Karlova Nataliya A. , Zolozova E. A , Mazur N. A , Sayutina E. V , Chigineva V. V
Published: September 2020

Atherosclerotic involvement of lower limbs arteries is a common disorder associated with a high risk of cardiovascular morbidity and mortality, requiring an early start of the comprehensive therapy. Typical clinical manifestations of this disease are found only in some patients that encumbers to make timely diagnosis. Determination of ankle-brachial index (ABI) is a reliable approach of the assessment of the state of blood flow in the lower extremities, but the classical technique requires the participation of specially trained personnel and expensive equipment. In the article there is discussed the use of widely available oscillometric blood pressure monitors for the determination of ABI. In a group of 39 patients with high risk of the development of atherosclerosis there was performed a comparison of the results of the determination of ABI with the help of oscillographic blood pressure monitors and ABI evaluated by the method of volumetric sphygmography. There was shown the sufficient accuracy of the determination of ABI with the aid of oscillographic blood pressure monitors and the interrelationship of this index with the risk of detection ofsignificant atherosclerotic involvement of lower limbs arteries according to Doppler ultrasound data. There was demonstrated that this method can be used at the stage of outpatient examination of patients with a high risk for atherosclerotic involvement of lower limbs arteries.
Features of the organization of outpatient drug supply for certain population groups in the Russian Federation
Authors: Malichenko Vladislav S. , Malichenko S. B , Yavisya A. M
Published: September 2020

Changes in the scope and structure of morbidity increase the cost of health care, medical and social services, especially in terms of drug supply. The cost of medicines amounts to the third largest component of costs in the health sector. The Russian Federation possesses the one out provisuinfastest growing pharmaceutical market. However, for the time being the current system of drug supply in the Russian Federation was faced with a number of systemic issues that have a direct effect on the availability of medicines, the quality and timeliness of care. Within frameworks of the executed analysis there was demonstrated the ineffectiveness of the existing drug supply system in an outpatient setting, as well as there was supposed a number of measures to optimize government programs of drug provision in the current economic situation.
Aspects of modern medical-social expertise and rehabilitation of disabled persons in Republic of Tajikistan
Authors: Gaibov Amonullo G. , Lukyanov N. B , Chudinov A. V
Published: September 2020

The prevalence of adult and children disability in Tajikistan is relatively low and accounts for 2% of the total population. In 70% of the cases it is caused by chronic diseases of various etiology, including congenital pathology. At that, everyfifth disabled person considers his health condition to be satisfactory. The medical service and social expertise as well as the criteria used for determination of the status of the disability are considered to fail to correspond to the current models and classifications, approved by the legislation in 2010. The solution of the multifactorial problem of disability in the country (gross per capita income less than $ 1200) with 32% poverty rate, and pensions three times lower than the cost of the consumer basket, demand the targeted optimization of the system ofmedical and social expertise and rehabilitation both in the urban and, particularly, in the rural areas.
Efficacy of the comprehensive antiresorptive therapy at different stages of surgical rehabilitation in dentition defects in female patients with postmenopausal osteoporosis
Authors: Mashchenko E. A , Khesin R. A , Malichenko S. B , Kozlova M. V
Published: September 2020

Question of the interrelationship of systemic disorders of bone remodeling and the condition of the bone tissue of the alveolar bone, as well as the efficiency of comprehensive antiresorptive therapy at different stages of surgical rehabilitation in dentition defects in female patients with postmenopausal osteoporosis (PMOP) requires further clarification and remains a subject of active discussion of scientists and clinicians. In the study there was demonstrated that in PMOP female patients with atrophy of the alveolar process of the maxilla in edentulous area there is noted was a significant excess in indices of bone turnover (TNF-alpha level - by 184%, IL-1 - 224%, IL-6- 85%, CTx -156% osteocalcin - 32.9%, PTH- 55%) against the background of the reduced level of a D(OH)25 (by 25.8%) in comparison with patients of reproductive age without osteoporosis. These data correlate with a significant increase in indices of osteosynthesis (index level of the osteoid volume - by 17.6%, index of total resorptive surface by - 51.5%) and a decrease in bone quality indices (index level of the total volume of trabecules - by 60%, index of average width of trabeculae - by 40 %) according to results of the histological examination of bioptate of the process from the edentulous area. At that in PMOP patients with concomitant accompanying somatic pathology the level of TNF-a, IL-1, IL-6 and CTx was significantly higher than in patients of this the group without comorbidity. Appointment of the comprehensive antiresorptive therapy at all stages of surgical rehabilitation (open sinus lifting, dental implantation) in PMOP patients with atrophy of the maxilla in edentulous area during the year before and after sinus lifting significantly increasedthe efficiency of the dental implant. Supplementation of NSAIDs (Arcoxia 60 mg per day) for 2 months prior to dental implantation and within 1 month after a comprehensive antiresorptive therapy in PMOP patients with concomitant estrogen-induced pathology also significantly increases the efficiency of the dental implant in comparison with given indices in patients which received no combined therapy.
Analysis of disability due to tuberculosis in the Novgorod region in the dynamics throughout 2010-2014
Authors: Orlova Viktoriya M.
Published: September 2020

The article presents analysis of primary and second disability due to tuberculosis in the Novgorod region in dynamics throughout 5 years period based on age, disability groups, compared with the same official data of the Russian Federation, Northwestern Federal District. The level of disability rate caused by tuberculosis tends to decrease. In the structure of disability in 2010-2014 the prevalence of the second group of disability is dominated.
Spinal Cord Independence Measure (SCIM-III). Preparation of the Russian-language version
Authors: Vasilchenko Elena M. , Zoloev G. K , Kislova A. S , Kostrov V. V , Lyakhovetskaya V. V , Karapetyan K. K , Zhatko O. V , Palatkin P. P , Makarov D. N , Filatov E. V , Yurkovetskaya N. D
Published: September 2020

There was accomplished the procedure of linguistic and cultural adaptation of a questionnaire Spinal Cord Independence Measure (SCIM-III) specifically designed for the assessment of disorders of life activity in patients with traumatic disease of the spinal cord. In the work there are presented: the Russian-language version of the questionnaire, instructions on features of the filling and evaluation of results.