Вестник Санкт-Петербургского университета. Медицина https://medicine-journal.spbu.ru/ <p>«Вестник Санкт-Петербургского университета. Медицина» — рецензируемый междисциплинарный научный журнал, публикующий работы российских ученых из различных медицинских организаций, университетов, научных институтов, а также результаты исследований авторов из зарубежных медицинских организаций и университетов стран ближнего и дальнего зарубежья, которые охватывают основные области фундаментальной и прикладной медицины.</p> Санкт-Петербургский государственный университет ru-RU Вестник Санкт-Петербургского университета. Медицина 1818-2909 <p>Статьи журнала «Вестник Санкт-Петербургского университета. Медицина» находятся в открытом доступе и распространяются в соответствии с условиями <a title="Лицензионный Договор" href="/about/submissions#LicenseAgreement" target="_blank">Лицензионного Договора</a> с Санкт-Петербургским государственным университетом, который бесплатно предоставляет авторам неограниченное распространение и самостоятельное архивирование.</p> Bioavailability Study of Recombinant Plasmid DNA Nerve Growth Factor after Intramuscular Injection by Electroporation https://medicine-journal.spbu.ru/article/view/5211 <p><span style="background-color: #ffffff;">Comparative analysis of plasmid DNA delivery into cells efficiency (with effective agent concentration 250 μg/kg), ensuring accumulation of nerve growth factor (NGF) after intramuscular injection and intramuscular administration using electroporation method on rats was performed. Application of electroporation method ensured over 4 times increase of DNA plasmid concentration in muscle tissue within the first hour after its injection and increased the duration of its determination. Higher bioavailability parameters were confirmed by 3 times increase in gene expression level, encoding NGF accumulation and 3 times increase in concentration of the target NGF protein in blood plasma. The results obtained allow us to recommend this method for introduction of NGF plDNA in its biological activity and effectiveness in models of nerve damage investigation.</span></p> Viktor V. Shilov Mikhail A. Yudin Nikolai G. Vengerovich Taras V. Shcherbakov Aleksandra S. Bogacheva Copyright (c) 2019 Viktor V. Shilov, Mikhail A. Yudin, Nikolai G. Vengerovich, Taras V. Shcherbakov, Aleksandra S. Bogacheva 2019-11-14 2019-11-14 14 2 89–97 89–97 10.21638/10.21638/spbu11.2019.201 Problems of diagnostics and treatment of diffuse — toxic goiter (Graves’ disease) https://medicine-journal.spbu.ru/article/view/4974 <p align="justify"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><span style="font-size: large;"><span lang="en-US">The article is devoted to prevalence, contemporary diagnostic methods and treatment of Grave’s disease. Advantages and disadvantages of different treatment options are discussed. The cause of the disease can be environmental conditions, infectious diseases, severe operational intervention, drugs, trauma, especially brain traumas, iodine deficiency and radiation damage of thyroid in iodine deficiency conditions, familial predisposition. The ideal treatment of Graves’ disease should ensure a fairly rapid elimination of clinical symptoms of thyrotoxicosis, return to an euthyroid state, with minimal risk of complications. The relapse rate of the disease can reach up to 80 %, using conservative treatment. The radioiodine ablation is relatively simple, non-invasive, effective and cheap. There are special indications for surgical treatment. Indications for surgical treatment: 1) large goiter (the volume of the thyroid gland is more than 45 ml); 2) frequent recurrences of thyrotoxicosis and failure of the drug and RIT; 3)malignancy of goiter; 4) allergic and toxic (leukopenic) reactions to thyreostatics. Patients with Graves’ disease should referred to a specialized center with multidisciplinary team.</span></span></span></span></p> Saydiganikxodja I. Ismailov Komila Kh. Khayitboyeva Copyright (c) 2019 Saydiganikxodja I. Ismailov, Komila Kh. Khayitboyeva 2019-11-14 2019-11-14 14 2 98–104 98–104 10.21638/10.21638/spbu11.2019.202 Ageing Acceleration and Disease Onset: Ontogenetic Specificity of Pathogenetic Mechanisms https://medicine-journal.spbu.ru/article/view/4986 <p><span style="background-color: #ffffff;">The article which unfortunately happened to be the last poshumous paper published by recently deseased Prof. Habil. Dan Riga, MD, PhD, DHc, is devoted to the problem of imperfection and vulnerability of the natural genetically determined adaptation mechanisms available to human being. All defensive mechanisms encoded in human reactivity are principally imperfect and have to cause secondary harm. It means that the very defence is pathogenic, especially in chronic situations when the natural cost of adaptation increases to unbearably high level. That is central paradigm of the whole science of Pathophysiology. The imperfection and secondary pathogenicity of natural defence (autopathokinesis) was emphasized earlier, since first coined by August Weismann, for example in works published by L. P. Churilov. This article analyses the basic aspects of health and disease under the aforementioned bias, with original interpretation of the role of vulnerability and imperfection of human defensive mechanisms in chronic repeated stress and within the continuum of physiologic and pathological senescence. The principle is illustrated by several examples from the general pathology of typical pathological processes and with the correlations to most important geriatric syndromes and diseases. According the statements of the authors, the human being has an ontogenetic route, from childhood and youth health, through adulthood, towards old age (senescence) and related multiple pathology (including dementia). Human vulnerability is extremely complex and manifests at different levels: macromolecular, sub-cellular, cellular, tissual, of organs, of biological system, with additional specific traits for the central nervous system. Slowly, throughout individual ontogenesis, closely related to vulnerability, an etiopathogenic cascade (tetrad) develops: it is entropic, of structures disorganisation and disturbance of their functioning: distress wear-and-tear “ageing” poly-pathology. Its dynamics is self-sustained, aggravated, and<br>rendered more complex by vicious patho-physiological multiplication circuits.</span></p> Sorin Riga Magdalena Budisteanu Bogdan Budisteanu Vlad Dionisie Vitalie V. Scripnic Copyright (c) 2019 Sorin Riga, Magdalena Budisteanu, Bogdan Budisteanu, Vlad Dionisie, Vitalie V. Scripnic 2019-11-14 2019-11-14 14 2 105–122 105–122 Specifics of Hormonal Status in Combined Dishormonal Pathology of the Uterus and Mammary Glands in Reproductive Age https://medicine-journal.spbu.ru/article/view/4910 <p><span style="background-color: #ffffff;">The combined dyshormonal pathology of the uterus and mammary glands represents a great danger to the health of a woman, as well as impairs the quality of life, reduces the reproductive capacity of a woman and leads to premature loss of reproductive function. Steroid hormones play a large role in the regulation of proliferative changes in the uterus and mammary glands. Regulation of target organs, uterus and mammary glands, due to the presence of common mechanisms associated with the presence of the receptor apparatus in the tissues of these organs to sex hormones. The general links of pathogenesis and the high frequency of combined pathology of the uterus and mammary glands are of interest to study not only isolated forms of proliferation, but also the development of a unified systematic approach to the study of this pathology. In recent times, there are opposing views on the role of hormonal dysfunction as a factor in proliferative processes. The management tactics of patients with pathological changes in the mammary gland in various gynecological diseases is an assessment of endocrine status, normalization of hormonal and metabolic disorders, especially when progesterone and cortisol are excreted, testosterone levels are increased, and hyperprolactinemia is affected. Special attention should be paid to patients with menstrual disorders, reproductive health disorders. We believe that the problem of the hyperproliferative processes of the uterus and mammary glands should not be considered only from the perspective of gynecological or mammological practice. This pathology is polymorphic and should have broad interdisciplinary connections with such disciplines as oncology, endocrinology, gastroenterology, psychiatry, therapy, pathomorphology, histology, obstetrics and gynecology. Only by studying all possible links of etiopathogenesis, by combining interdisciplinary communication, it is possible to effectively fight for the quality of patients with a combined pathology of the uterus and mammary glands. Family planning, prevention of unplanned pregnancy, timely implementation of maternity, prevention of miscarriage, the use of modern contraceptives, support for breastfeeding is also of high importance for the prevention of disorders and the preservation, extension of reproductive capabilities, and the prevention of combined dyshormonal pathology of the uterus and breast.</span></p> Mikhail S. Shelygin Nadezhda S. Guziy Viktoria S. Kaplitskaya Copyright (c) 2019 Mikhail S. Shelygin, Nadezhda S. Guziy, Viktoria S. Kaplitskaya 2019-11-14 2019-11-14 14 2 123–131 123–131 10.21638/10.21638/spbu11.2019.204 Growth hormone treatment strategies in assisted reproduction for the poor responder patients https://medicine-journal.spbu.ru/article/view/4898 <p><span style="background-color: #ffffff;">The goal of the study was to estimate the efficacy of growth hormone (GH) co-treatment to the antagonist protocol in IVF/ ICSI cycles in poor responders. A prospective observational study involved 75 patients. All patients underwent standard antagonist protocol with or without GH co-treatment. GH additional was given a daily subcutaneous injection of 1.33 mg (equivalent to 4 IU) of GH from day 1 of ovarian stimulation until the day of human chorionic gonadotropin (hCG). Concentrations of GH, insulin-like growth factor I (IGF-I) and IGF binding protein-3 (IGFBP-3) in serum and follicular fluid were analyzed. The GH co-treatment significantly lowered effective dose of gonadotropins, duration of stimulation, IGFBP-3 level in serum and follicular fluid day of oocytes retrieval. The number of oocytes recovered, metaphase II stage (MII) oocytes, 2 pronucleus (2 pn) zygote, good-quality transferred embryos were significantly higher in the GH+ group. Only patients GH+ group became pregnant. Positive correlation was found between IGF-I level in follicular fluid, dynamics of IGFBP-3 level changes during stimulation protocol and number of good-quality transferred embryos in the GH+ group. GH administration in IVF/ICSI cycles for poor responders raises ovarian sensitivity to the gonadotropin exogenous influence, this way, increasing number of high-quality embryos and the probability of pregnancy.</span></p> Liailia Kh. Dzhemlikhanova Ksenia V. Ob’edkova Dariko A. Niauri Igor Yu. Kogan Maria A. Mazilina Inna O. Krikheli Irina D. Mekina Elena A. Lesik Evgenia M. Komarova Copyright (c) 2019 Liailia Kh. Dzhemlikhanova, Ksenia V. Ob’edkova, Dariko A. Niauri, Igor Yu. Kogan, Maria A. Mazilina, Inna O. Krikheli, Irina D. Mekina, Elena A. Lesik, Evgenia M. Komarova 2019-11-14 2019-11-14 14 2 132–140 132–140 10.21638/10.21638/spbu11.2019.205 Single-nucleotide Polymorphisms of AGT, SOD2, CAT in Risk Estimates for Arterial Hypertension among Young People https://medicine-journal.spbu.ru/article/view/5012 <p><span style="background-color: #ffffff;">Arterial hypertension is one of the most common cardiovascular diseases and one of the main causes of mortality and disability of population. Opportunity to predict emergence of arterial hypertension and to take preventive measures in pre-nosological diagnostics of disease arouse research interest in this issue. Possibility to predict progression of arterial hypertension based on polymorphic variants of AGT gene (C521T, rs4762) identification, which encodes angiotensinogen protein in combination with polymorphic variants of CAT (–262C/T, rs1001179), encoding catalase, and polymorphic variants of SOD2 (C47T, rs4880), encoding mitochondrial superoxide dismutase, are discussed in this article. Decrease of antioxidant enzymes (catalase and superoxide dismutase) activity leads to accumulation of reactive oxygen species in cells. They may activate NF-kB transcription factor, which increases expression of individual genes involved in sodium homeostasis and in blood pressure control, including angiotensinogen. Increased angiotensinogen concentration in blood constitutes a risk factor in arterial hypertension development. In our opinion, combination of polymorphic variants of AGT, CAT and SOD genes expands the possibilities of personalized medicine.Performed investigation involved 65 medical students of St Petersburg State University. DNA was extracted from epithelial cells of the oral cavity. Genotyping of DNA samples was determined by real-time PCR. Obtained results of our investigation enabled to reveal AGT genotypes associated with hypertension in 12 students. The article discusses combinations of TT and CT genotypes of AGT with unfavorable alleles of antioxidant enzymes.Carriers of heterozygous SOD2 genotype and homozygous CC genotype CAT are in more unfavorable conditions compared to carriers of the CC genotype SOD2 and СТ genotype CAT, as SOD2 is a key antioxidant enzyme protecting from ROS.</span></p> <p>&nbsp;</p> Irina V. Astratenkova Alexandra V. Kovaleva Natalya E. Golovanova Olga G. Orlova Oksana V. Rybalchenko Copyright (c) 2019 Ирина Викторовна Астратенкова 2019-11-14 2019-11-14 14 2 141– 146 141– 146 10.21638/10.21638/spbu11.2019.206 Development of medical insurance in the Russian Federation. At the crossroads. What's next? https://medicine-journal.spbu.ru/article/view/5365 <p><span lang="EN-US" style="margin: 0px; line-height: 115%; font-family: 'Times New Roman',serif; font-size: 12pt;">The RF health care reform is gaining momentum. A thorough consideration should be given to the discussion on the need to exclude health insurance companies from the compulsory health insurance system (CHI). Formation of the National Health Care System of Russia is the main problem of the national health care at this stage of reforms. Additional payment for medical services in the CHI by the general public is not advisable. Changes in the regulatory framework of the CHI system is deemed to be the basis for reforming the system of compulsory and voluntary health insurance in Russia.<span style="margin: 0px;">&nbsp;&nbsp;&nbsp; </span></span></p> Igor M. Akulin Lubov Yu. Zhiguleva Copyright (c) 2019 Igor M. Akulin, Lubov Yu. Zhiguleva 2019-11-14 2019-11-14 14 2 147–157 147–157 10.21638/10.21638/spbu11.2019.207 The development of Russian Medicine in the Petrine era and the role of Dutch doctors in this process https://medicine-journal.spbu.ru/article/view/6152 <p><span style="background-color: #ffffff;">During the reign of Peter the Great and his successors most significant achievements in the field of public health in Russia took place. In order to train domestic doctors, especially for the army and navy, Peter I organized the training of the best representatives of Russia at the leading medical universities in Europe, and especially at the University of Leiden. He also created the first medical surgical schools in Moscow and St. Petersburg. In the seventeenth and eighteenth centuries, close ties in the field of medicine between Russia and the Netherlands were established. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; A significant number of doctors, graduates of the Leiden University practiced in Russia and held very high positions in Russian medical services. This contributed to the advancement of advanced European technologies in the provision of medical services and medical education in Russia. Therefore the role of Dutch doctors in the development of Russian medicine in the Petrine era is extremely significant. Under their leadership, the first hospitals and medical schools were established, the first textbooks were developed in Russian and scientific research was conducted. The Academy of Sciences created by Peter the Great was the centre of scientific achievements of Imperial Russia.</span></p> Inge F. Hendriks James G. Bovill Dmitrii A. Zhuravlev Ivan V. Gaivoronskii Fredrik Boer Pancras C. W. Hogendoorn Copyright (c) 2019 Inge F. Hendriks, James G. Bovill, Dmitrii A. Zhuravlev, Ivan V. Gaivoronskii, Fredrik Boer, Pancras C. W. Hogendoorn 2019-11-14 2019-11-14 14 2 158–172 158–172 10.21638/10.21638/spbu11.2019.208 Arrangement of social aid for children with orthopedic pathology considering their psychological constitution https://medicine-journal.spbu.ru/article/view/5131 <p style="margin: 0px; text-align: justify; text-indent: 1cm;"><span style="background-color: #ffffff;">Modern society development is accompanied by increase of number of physically challenged individuals, including children. In Russia, about 15 million people are disabled. The social sphere is developing and improving, the priority direction of which is the creation of an optimal system of life support for children with disabilities. One of the most numerous handicapped children groups is a group with orthopedic pathology. Today information concerning number of handicapped children is coming from three different sources which are not harmonized internally. The work presents comparative analysis of statistical data form, containing information on handicapped children prevalence in relation to orthopedic pathology; dependence of handicapped children prevalence in relation to orthopedic pathology on the number of children with pathology, revealed for the first time. All the data concerning psychological particularities of handicapped children with orthopedic pathology was systematized. Directions of social aid improvement were justified.</span></p> Olga I. Kopytenkova Galina V. Pyatakova Valery V. Umnov Copyright (c) 2019 Olga I. Kopytenkova, Galina V. Pyatakova, Valery V. Umnov 2019-11-14 2019-11-14 14 2 173–180 173–180 10.21638/10.21638/spbu11.2019.209