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Recent investigations have demonstrated the involvement of neutrophils and neutrophil extracellular traps (NETs) in the initiation and progression of autoimmune inflammation in rheumatoid arthritis (RA) patients. Simultaneously, macrophages/monocytes, which are the main antigen-presenting cells, play a key role in the immune response as a result of disruption of antigen processing and presentation. Studying the role of monocytes and monocyte extracellular traps (METs) in RA pathogenesis is promising and is of particular interest. The aim of the research was to study the features of the main parameters of monocyte extracellular generation traps in RA patients depending on the stage of autoimmune inflammation. Material and methods. 37 RA patients and 30 healthy individuals were enrolled in study. Circulating monocytes were purified with centrifugation procedure using iohexol with a 1068 kg/m3 density gradient. Cells were identified histochemically, and the extent of monocyte activation was assessed using common nitroblue tetrazolium test. The generation of METs was stimulated by phorbol-12-myristate-13-acetate (PMA), and visualized using fluorescence microscopy with SYBR green. Results and discussion. In patients with inactive RA, the number of monocytes in a state of generating both spontaneous and PMA-induced METs is higher compared to the reference group. The transformation of autoimmune inflammation from remission to the active phase was accompanied by a further increase in the proportion of monocytes that form METs spontaneously and in the presence of PMA (by 114.7 % and 44.2 %, respectively, relative to the comparison group). The growth rate of spontaneous METs formation is 2.6 times higher than induced METs; RA activation is evidenced by an increase in the number of monocytes in the process of spontaneous formation of METs by more than 17.8 %. Conclusions. The obtained data suggest METs participation in the initiation and maintenance of RA autoimmune inflammation along with NETs presumably through exhibition their citrulline neoepitopes. METs could probably be considered as a new potential diagnostic biomarker.

Discoid (DLE) and systemic lupus erythematosus (SLE) are chronic inflammatory diseases of the connective tissue. Along with pathogenetic features, they have common characteristics. Immune disorders and oxidative stress are involved in pathogenesis of DLE and SLE. Development of oxidative stress is closely associated with the activation of xanthine oxidoreductase (XOR) enzyme system.Aim of the study was to reveal the features of XOR activities profiles in blood of DLE and systemic lupus erythematosus (SLE) patients.Material and methods. 31 patients with DLE, 56 patients with SLE, 35 apparently healthy individuals were enrolled in study. The activities of two convertible forms of XOR (xanthine dehydrogenase (XDG; EC 1.17.1.4) and xanthine oxidase (XO; EC 1.17.3.2)) were measured in plasma, lysed WBC and lysed RBC. The level of uric acid (UA) was determined in plasma.Results and discussion. In contrast to the control, XO activity was higher and XDG activity was lower in plasma of DLE patients; activities of both XOR forms were decreased in lysed lymphocytes. Activity of XO was lower in plasma, XO and XDG activities were higher in lysed lymphocytes in DLE regardless of the SLE activity. XDG activity in plasma of and XO activity in lysed erythrocytes DLE patients was lower than in low activity SLE, but higher than in the subgroup with moderate and high disease activity. XDG activity of lysed erythrocytes in DLE was higher than in patients with low and moderate SLE activities, but lower than in patients with high diseases activity. Uric acid content in plasma of DLE patients was not differ from the control values, its level was increased at II and III degrees of SLE activity.Conclusions. Changes in XOR activity in plasma and lysed WBC in DLE and SLE are unidirectional, but are more pronounced in the systemic form of the disease. Thus, DLE and SLE are characterized by some common changes in XOR activity, at the same time, XOR blood profiles have distinctive features, which are characteristic for nosology.

Low-energy fractures in rheumatoid arthritis (RA) are more common in patients with high activity and long duration of disease, and with high titers of anti-citrullinated antibodies (ACPA). Increased expression of angiopoietin-like protein type 4 (ANGPTL4) in bone tissue has also been noted in inflammatory arthritis. The purpose of the present study was to analyze the effect of ACPA and ANGPTL4 on systemic bone mineral density in RA patients. Antibodies to ACPA and ANGPTL4 content were detected in blood serum of 96 RA patients (women, 91.7%) by enzyme immunoassay. Mineral density of the lumbar vertebrae (BMDL1-L4), hip neck, and entire femur (BMDtotal) was measured by dual-energy X-ray absorptiometry (DXA). In study group, the ACPA and ANGPTL4 tests were positive in 61.5% and 41.7% of patients, respectively. Negative correlations were shown between ACPA and BMDtotal, and of ANGPTL4 with BMDL1-L4 (p < 0.05). Separation of the patients into groups with low (n = 34) and high (n = 62) DAS28 activity demonstrated a significant increase in ACPA with increasing RA activity (p = 0.042). ACPA and ANGPTL4 scores were also significantly higher in the group of 45 RA patients with osteoporosis (OP) compared to the RA group without OP (n = 51) showing significant difference at p = 0.002 and p = 0.028, respectively. Patients’ age, body mass index (BMI), duration and activity of the disease had no significant effect on ACPA in the general group of RA patients. However, the correlation between ACPA and DAS28 proved to be significant in the group of RA patients with OP (b = 0.31, p = 0.039). Among all presented variables, the disease duration was the only significant factor for ANGPTL4 in the total group of RA patients (b = 0.31, p = 0.039). In the regression model, BMDtotal showed similar correlations with patients’ age (b = -0.28), BMI (b = 0.25), and ACPA level (b = -0.26). A search for association between BMDL1-L4 and various RA characteristics demonstrated a strong correlation with ANGPTL4 only (b = -0.74; R2 = 0.57). The revealed correlation between ANGPTL4 and decreased BMD specifically in the spongy layer of bone allows us to identify the RA patients with high ANGPTL4 levels as a risk group specifically for spinal fractures thus considering ANGPTL4 as a potential target for treatment of osteoporotic disorders.

The study aimed to evaluate the association between cyclic citrullinated peptide antibody seropositivity and chronic Helicobacter pylori (H. pylori) infection in patients with rheumatoid arthritis (RA). We examined 92 women with moderate RA activity. Serum antibodies to cyclic citrullinated peptide (antiCCP), antibodies to H. pylori (anti-H. pylori-IgG), and total antibodies to H. pylori CagA antigen (antiCagA) were determined by enzyme immunoassay; the presence of anti-CagA-IgG positivity was confirmed by immunoblot. 68.5% of RA patients were positive for anti-H. pylori-IgG, and 44.4% of patients in this group were positive for anti-CagA-IgG. All the study participants were divided into three groups: I – H. pylori seronegative (H. pylori- ); II – H. pylori positive, CagA negative (H. pylori+/CagA- ); III – H. pylori positive and CagA positive (CagA+). The anti-CCP values in RA patients with CagA+ (group III) were significantly higher not only in comparison with patients seronegative for H. pylori (p < 0.001), but also in comparison with patients from group II (H. pylori+/CagA- ) (p = 0.041). A study of the influence of the RA activity, the presence of RF and H. pylori on anti-CCP content demonstrated a small proportion of anti-CCP variability (R2 = 0.09), with a high contribution of H. pylori (beta = 0.25). The addition of the CagA(+) index (beta = 0.503) to the presented model allowed us to describe the variability of anti-CCP in almost 30% of cases (R2 = 0.29). In the group of RA patients with anti-CCP values exceeding the established threshold value of 20 U/mL (normal index), there was an increase in the proportion of patients infected with H. pylori (p < 0.001), but not the proportion of CagA-positive patients (p = 0.06). When the threshold level was increased to 60 U/mL (three times the upper limit of normal) in patients with significantly high anti-CCP, the association with positivity for CagA became significant (p = 0.005). CagA is highly immunogenic and is capable of inducing an inflammatory response in the host that goes beyond the effect of H. pylori itself. Additional experimental studies are needed to investigate possible clinical and laboratory associations that may influence the treatment tactics of CagA+ patients with RA who are seropositive for anti-citrullinated antibodies, as well as to evaluate the possible effects of therapeutic intervention aimed at the eradication of H. pylori in this group.

In the 1950s, the construction of hydropower facilities began in the regions of Siberia and the Far East, characterized by harsh climatic conditions, which should be taking into account to predict the stress state of dams. The aim of the study is an assessment of the conditions for the formation of temperature cracks in concrete dams and their influence on the further operation of the structure, as well as measures and technologies to combat cracking in massive concrete. Thermal stresses often exceed the stresses caused by the action of external loads and lead to the appearance of cracks in the concrete. Almost all modern concrete dams are subject to thermal cracking today. Appropriate design and technological measures must be provided for. When studying the thermally stressed state of lightweight concrete dams, the method of direct reproduction of thermal deformations on models made of brittle materials and computational methods oriented towards computer methods of solving problems are used. The results of modeling and computational studies of massive buttress dams are presented and the influence of the main influencing factors is considered, taking into account the effect of cracking on the operation of such dams.

Lack of knowledge about the causes of fatigue often leads to ignoring this symptom in rheumatoid arthritis (RA). The severity of fatiguein patients with RA can be significantly reduced by actively using non-pharmacological treatment strategies.Aim. To evaluate the effectiveness of aerobic exercise (walking) to reduce fatigue in RA patients during long-term follow-up.Material and methods. The study involved 102 patients with RA (women 100%; average age 54.38 ± 11.3 years; disease duration9.5[5;15] years; DAS28-ESR activity 2.85[2.32;3.06] points; fatigue on the VAS scale ≥50), who completed the stage of sanatoriumtreatment in full (21 days) and provided data on aerobic physical activity (steps quantity per day) and fatigue scores on the BritishRheumatoid Arthritis Fatigue Scale – Numerical Rating Scale (BRAF-NRS V2). RA patients were divided into two groups according totheir level of physical activity: group I (n=53) with a sedentary lifestyle (less than 5–6 thousand steps/day) and group II (n=49) witha recommended (mobile) lifestyle (more than 7–8 thousand steps/day). Assessment of RA patients’ adherence to physical activity wascarried out 2 months after return from the sanatorium, and the dynamics of BRAF-NRS fatigue indexes were recorded.Results and discussion. Seventy-six people (74.5%) agreed to participate in the final survey: 32 patients from a group I and 44 patientsfrom a group II. Commitment to daily aerobic activity (more than 5,000 steps per day) was maintained by 34% of participants in thegroup I and 59% in the group II (p=0.033). The majority of respondents (51.3%) decreased the physical activity level and significantlyreduced the time for aerobic exercise after returning from the sanatorium, citing a lack of incentives and time. 47% of the groupI patients (15/32) felt able to devote more attention to physical activity, but only 25% confirmed a strong belief that they would dedicateat least 30 minutes to aerobic exercise 5 times a week over the next three months. In the group II, 48% of patients (p=0.044) reportedmaintaining or even increasing the corresponding physical activity level, confirming the effectiveness of individual physical activityprograms formed during the sanatorium treatment and then integrated into daily life. Two months after returning from the sanatorium,group II patients showed lower fatigue scores on all BRAF-NRS scales: NRS-severity (p=0.04), NRS-effect (p=0.005), and NRS-overcoming(p=0.034). The analysis of variance revealed a decrease in the level of fatigue in the medium term (up to 2 months) regardless of thelevel of physical activity of the patients, but in RA patients committed to an active lifestyle and regular aerobic physical activity (groupII), the positive changes were most pronounced (p

Relevance. The experience of constructed cellular structures and the results of computational and model studies carried out in our country and abroad to assess the joint work of the complicated complex cellular frame - soil backfill of cells - foundation indicates the sufficient reliability of such hydraulic structures. The main difficulty in the design of cellular structures is to reproduce the volumetric work of the complex cellular frame - backfill soil - foundation soil to identify structural reserves. Objectives. To study, through laboratory studies, the interaction of the frame and backfill of the cell and the base at different soil moisture, taking into account such factors as the granulometric composition of the backfill soil, the role of the surface tension of moisture contained in the soil, the geometric parameters of the structure itself and a number of other factors. Methods. Experimental studies on the model of the operation of a cellular structure without a bottom on a non-rocky (sandy) foundation for stability, subject to the similarity criteria, as well as studies of cells with different geometry and sizes with changes in moisture and particle size distribution of the soil of the cells. Results. Based on the results of model studies, a dependence is proposed to take into account the effect of surface tension forces, considering the hydraulic radius of the cell cross-section, wetted perimeter, cross-sectional area of the cell, etc. The interaction of the cellular structure with the base is also explored, taking into account the above parameters. The results of laboratory studies on considering the interaction of the frame and backfill of the cell soil at different moisture content of the aggregate, taking into account the granulometric composition of the backfill soil surface tension of moisture contained in the soil, geometric parameters of the structure itself and a number of other factors.

Rheumatoid arthritis (RA) is a frequent background for the development of renal pathology. Chronic kidney disease (CKD) is determined in more than 30% of patients with RA. Along with inflammation and other factors in the progression of the underlying disease, the development of renal damage in RA is facilitated by the presence of metabolic syndrome (MetS).The aim of this study is to assess the relationship of serum concentrations of angiopoietin-like proteins (ANGPTL) and antiphospholipid antibodies (aPL) with the development of renal dysfunction in patients with RA.We examined 158 patients with RA (91.8% – women and 8.2% – men) aged 21 to 80 years old and an average duration of the disease – 9 (4-15) years. The majority of patients were seropositive for rheumatoid factor and for antibodies to cyclic citrullinated peptide, with an advanced clinical stage and moderate activity (3.2 < DAS28 ≤ 5.1) of the pathological process.The ELISA test was used for the quantitative determination of angiopoietin-like protein type 3 and type 4 and antibodies to phospholipids (aРL-IgG/IgM) for total detection of antibodies to cardiolipin, phosphatidylserine, phosphatidylinositol, phosphatidylic acid and a complex of negatively charged phospholipid and β2-glycoprotein-I.More than half of the examined RA patients had the calculated glomerular filtration rate (eGFR) ranging from 89 to 60 ml/min/1.73 m2 (allocation by CKD stages: C1 – 21.5%; C2 – 58.9%; C3 – 19.6%). Signs of MetS (a combination of increased blood pressure, increased triglyceride levels and carbohydrate metabolism disorders against the background of central obesity) were diagnosed in 68 (43%) RA patients. Multivariable analysis of variance was performed to compare the studied parameters (ANGPTL3, ANGPTL4, aPL) depending on eGFR in groups of RA patients without signs of metabolic syndrome and RA patients with MetS. Significant differences in the level of ANGPTL3 (F = 8.86, p = 0.0034) and ANGPTL4 (F = 29.6, p < 0.001), but not aPL (p > 0,05) were found between RA patients with varying degrees of severity of metabolic disorders.Multivariable analysis of variance showed a significant increase in ANGPTL4 in the blood serum of RA patients with reduced eGFR (< 89 ml/min) (F = 18.5, p < 0.001) and pronounced metabolic changes (F = 24.2, p < 0.001). Thus, only two factors (renal dysfunction and the presence of MetS) had a direct effect on the ANGPTL4 content in RA patients, which could describe the variability of this sign in more than 30% of cases. The squared multiple correlation coefficient (R2 ) in this model was 0.33. ANGPTL type 4 should be considered as a key factor linking the development of renal dysfunction and metabolic changes caused by rheumatoid inflammation.

The study covered 30 apparently healthy individuals and 38 patients with systemic scleroderma. The patients gave their consent to participate in the study in accordance with the World Medical Association Declaration of Helsinki in the current (2013) version (ACR/EULAR). The donors and patients had their blood tested for catalase antibodies with immunoenzyme assay and using magnetic sorbents upon hospital admission and before discharge. It was found that the patients with systemic scleroderma had a reduced oxidase activity of catalase as well as elevated catalase antibodies, compared with the controls. We revealed a statistically significant regularity that the concentration of catalase immunoglobulins is associated with activity and course of the disease. To assess the activity of systemic scleroderma we performed a complex evaluation of two parameters: enzymatic activity and catalase antibody levels. It was established that catalase autoantibodies are mostly revealed in patients with high-activity scleroderma, subacute and acute course of the disease, and when the lungs, skin, kidneys, joints and nervous system were involved, which was conclusively confirmed by a correlation analysis. It is especially important that catalase antibodies should be revealed at early stage of the disease development; they are of especial diagnostic importance, and their changes over time may form the basis for assessing efficiency of administered therapy. The changes in biochemical activity of catalase, elevated antibody titers provide additional criteria of diagnosis in systemic scleroderma. Monitoring of these parameters in hospital settings helps to evaluate the effectiveness of administered therapy and adjust its correction, which is confirmed by inclusion of such extracorporal techniques as plasma separation into the combined treatment schedules. Studying biochemical activity of catalase and formation of catalase antibodies expands our understanding of scleroderma development and opens new avenues for research.

Background. Rheumatoid cachexia is a pathological condition which appears in patients with rheumatoid arthritis with low fat-free mass and normal or high body mass index. Bone mass loss is one of the components of rheumatoid cachexia. Fetuin-A, a major noncollagen protein of bone tissue, regulates bone remodeling. Aim of the study was to investigate the prevalence of rheumatoid cachexia and the association of serum fetuin-A level with body composition components in patients with rheumatoid arthritis. Material and methods. 110 patients (8 male and 102 female) with rheumatoid arthritis were enrolled in our study. Serum fetuin-A level was determined by ELISA. Dual-energy X-ray absorptiometry with Total Body program was performed. The diagnosis of rheumatoid cachexia was based on the next criteria: fat-free mass index less than 10th percentiles with fat mass index above 25th percentiles. Results and discussion. We observed rheumatoid cachexia in 25 patients (22,7 %). According to the literature, such patients have an increased risk of developing metabolic syndrome, arterial hypertension and mortality. Positive significant (p < 0,05) correlations were observed between serum fetuin-A levels and right and left lower limb, trunk, gynoid region, both lower limbs and total body bone mass. No statistically significant relationships with other indicators were identified. Fetuin-A negative dynamic in patients with rheumatoid arthritis may be accompanied by the loss of bone mass, which requires the improvement of therapeutic approach. Conclusions. Almost a quarter of patients with rheumatoid arthritis have rheumatic cachexia. Positive correlation between serum fetuin-A levels and lower limbs, trunk, gynoid region and total body bone mass was observed.

Objective of study: refining immune diagnostics of systemic scleroderma through determining ceruloplasmin antibodies, its amount and enzymatic activity, as well as control of effectiveness of therapy with ceruloplasmin-based immobilized magnetocontrollable immunosorbents.Materials and methods. 30 apparently healthy individuals and 68 patients with systemic scleroderma were examined. The study included patients with referral diagnosis of systemic scleroderma who signed an informed consent. The study was performed in accordance with the principles of World Medical Association Declaration of Helsinki rev. 2013 (ACR/EULAR). All participants had their blood tested with the method of immunoenzymatic determination of antibodies to ceruloplasmin upon admission to hospital and prior to discharge.Results. It was established that patients with systemic scleroderma show reduced oxidase activity of ceruloplasmin, increased ceruloplasmin levels, as well as elevated antibodies to ceruloplasmin compared with the control group. A link between the amount of antibodies to the studied enzyme, and the activity, nature, course and stage of the disease was established. It was found that there is a reliable negative correlation between the level of ceruloplasmin antibodies, and the amount of RBCs, the hemoglobin level. For the first time a complex assessment of three parameters was employed, the parameters being the enzymatic activity, ceruloplasmin amount, and antibodies to ceruloplasmin. It was established that autoantibodies to ceruloplasmin are more often found in systemic scleroderma patients who show a high disease activity, subacute course with involvement of the liver, lungs, and with anemia. It was found that antibodies to ceruloplasmin are detected at early stages of systemic scleroderma development and can be used in timely diagnosis of the condition. It was shown that the change of parameters under study over time can serve as a basis on which to evaluate the effectiveness of administered therapy.Conclusion. Decreased enzymatic activity of ceruloplasmin, its elevated amount and increased antibodies to ceruloplasmin can be taken as additional diagnostic tools in evaluation of systemic scleroderma activity. These parameters promote a more accurate assessment of the disease activity and of the nature of the pathologic process; they can serve as an indication of a variety of clinical forms of the disease. Employing these parameters for monitoring of administered therapy in hospital settings permits a more accurate assessment of its effectiveness and making adjustments. Studying ceruloplasmin antibody formation, amount of ceruloplasmin and its biochemical activity extends the existing concept of rheumatic disease pathogeny, outlines a way forward for further research and reflects the involvement of antioxidant system in immune disorders.

Background. The non-canonical activity of retinoic acid (RA) was discovered relatively recently and consists in the rapid activation of intracellular signaling pathways by the mechanisms not related to the transcriptional activity of the RA nuclear receptors. Separate data suggest that this activity can stimulate the processes of malignancy and contribute to the formation of tumor cell resistance to RA as a therapeutic agent. However, little is known about the mechanisms of this activity. It is also unclear how universal this effect is; does the RA-dependent activation of different signaling protein kinases occur in the same cells, and whether activation of these kinases is interrelated.Materials and methods: cultivation of non-small cell lung cancer cells and neuroblastoma cells under standard conditions and with incubation with all-trans retinoic acid (ATRA); immunoblotting.Results. Here we studied the effect of ATRA on the activation of Akt and Erk1/2 protein kinases depending on the incubation time. The analysis revealed RA-dependent activation of both kinases in all studied non-small cell lung cancer and neuroblastoma cell lines. Activation of Akt and Erk1/2 occurred at five minutes of incubation, which corresponds to the non-transcriptional (non-canonical) activity of the RA, however, further activation kinetics of the two kinases differed essentially.Conclusion. We found that ATRA causes rapid activation of Erk1/2 and Akt protein kinases in both non-small cell lung cancer and neuroblastoma cells. The differences in the kinetics of RA-dependent stimulation of these two kinases suggest that their activation is mediated by independent mechanisms.

MicroRNA miR-155 is one of the most characterized and actively studied microRNAs that regulate processes closely related to carcinogenesis, including cell differentiation, adhesion, migration and invasion of the tumor cells, metastasis, apoptosis and immunosuppression. In addition, this miRNA is involved in differentiation of hematopoetic cells and developing of inflammation. The association between specific deregulation of the expression of miR-155 and carcinogenesis is confirmed by a number of both fundamental and clinical studies and is due to the posttranscriptional regulation of the most important genes of the tumor associated pathways. Modulation of the levels of expression of miR-155 is associated with the emergence of a number of leukemias and lymphomas, as well as some solid tumors. An increase of the level of cellular and/or circulating miR-155 in some cancers can serve as a marker for progression and drug resistance. In addition, inhibition of the expression of miR-155 can be a promising method for developing new approaches in antitumor therapy.

Aim. To evaluate the clinical efficacy and tolerability of etoricoxib and meloxicam in patients with gonarthrosis. Subjects and methods. A postregistration, open-labeled, prospective, comparative randomized study was conducted. 40 patients aged 37 to 75 years with primary knee osteoarthritis were examined. Therapeutic effectiveness was evaluated determining the functional index WOMAC with the use of a visual analogue scale (VAS). The tolerability of the drugs was assessed according to the opinions of a patient and a physician. Results. Both drugs caused a reduction in WOMAC and VAS scores for pain and the severity of the disease. Etoricoxib demonstrated a significantly high rate of occurrence and completeness of its analgesic effect. Meloxicam showed a less pronounced decrease in joint stiffness and an insufficient analgesic effect. The incidence of side effects was similar in both groups. Conclusion. Both drugs demonstrated a good tolerability and a low incidence of side effects. The efficacy of etoricoxib was significantly higher than that of meloxicam.

Lipid rafts are lateral assembles of cholesterol, sphingomyelin, glicosphingolipids and specific proteins within cell plasma membrane. These microdomains are involved into a number of important cellular processes including membrane rearrangement, protein internalization, signal transduction, entry of viruses into the cell. Some of lipid rafts are stabilized by special microdomain-forming proteins such as caveolins, SPFH domain containing superfamily, tetraspanins, galectins, which maintain integrity of rafts and regulate signal transduction via forming of “signalosomes”. Involvement of the different lipid rafts is necessary in many situations such as binding of growth factors with their receptors, integrin regulation, cytoskeleton and extracellular matrix rearrangements, vesicular transport, etc. However, such classes of microdomain-forming proteins are still considered separately from each other. In this review we tried to perform complex analysis of microdomain-forming proteins in regulation of cancer assotiated processes.

Osteoarthritis (OA) is one of the most common rheumatic diseases. Knee OA is particularly frequently encountered among all forms of OA, the prevalence of knee OA being about 25% in the general population. Despite multiple guidelines for the management of knee OA, which have been prepared by the European League Against Rheumatism (EULAR), the American College of Rheumatology (ACR), and the Osteoarthritis Research Society International (OARSI), many problems of its treatment policy remain to be solved. The same holds true for not only the symptomatic and disease-modifying effects of chondroprotectors, but also topical therapy options.Objective: to evaluate the clinical efficacy and safety of Carmolis gel in patients with knee OA.Subjects and methods.The trial included 280 patients with knee OA (a study group consisted of 190 patents; a control group comprised 90 patients). The mean age was 58.3±9.3 years in the study group and 59±10.5 years in the control group. The disease duration was 10.3±5.5 and 10.1±4.1 years, respectively. Carmolis gel was applied to the region of the most painful knee joint up to 4–5 times daily, followed by massage of this skin area. The treatment cycle lasted for 2 weeks. No therapy was performed in the control patients. The clinical efficacy was determined by the changes in joint pains at rest or on movement and palpation, according to a visual analogue scale (VAS), WOMAC questionnaire, the synovitis intensity (assessed by ultrasonography), patient and physician global assessments of disease activity (Likert scale), and the possibility of reducing the daily dosage of nonsteroidal anti-inflammatory drugs (NSAIDs). The onset the therapeutic effect of the gel and the duration of its action were recorded.Results and discussion. The topical application of Carmolis gel caused a statistically significant reduction in joint pain at rest and on movement from 57.7±6.8 to 12±1.8 mm (р < 0.01) and from 52±5.3 to 17±2.7 mm, respectively (р

Importance of molecular genetics-based essays in clinical oncology is now unquestionable due to the fact that all oncological diseases and their progression are based on cascading accumulation of genetic aberrations involving more than 20 different genes. Essentially new capacities of clinical oncology are uncovered with the help of modern molecular biology methods that allow to determine structural and functional changes of genes and their products. This review examines approaches to improve criteria for creating diagnostic essays, evaluation of treatment efficiency and molecular factors of clinical course. In order to determine relevant markers, special consideration should be given to the research of signal transduction pathways involving key genes responsible for tumor growth and their partners. The correct formation of patient’s groups and selection of samples is very important. It is emphasized that integrated clinical programs should combine traditional methods of diagnostics and treatment with modern molecular testing and bioinformatics methods.

Objective: to evaluate the efficacy, tolerance, and safety of Carmolis topical gel in patients with gonarthrosis. Subjects and methods. The investigation enrolled 60 patients with knee osteoarthrosis (OA) who were divided into two groups: 1) 40 patients received Carmolis topical gel in addition to nonsteroidal anti-inflammatory drugs (NSAIDs); 2) 20 patients took NSAIDS only (a control group). The treatment duration was 2 weeks. In both groups, therapeutic effectiveness was evaluated from changes in the WOMAC index, pain intensity at rest and during movement by the visual analog scale (VAS). The disease activity was also assessed by a physician and a patient (a Likert scale), local swelling and hyperthermia of the affected joint, the efficiency of treatment, and daily needs for NSAIDs were deter- mined. Results. The performed treatment in both patent groups showed positive clinical changes. Combination therapy involving Carmolis gel displayed greater reductions in WOMAC pain and resting and movement pain than in the con- trol group (as assessed by VAS). On completion of the investigation, considerable improvement was, in the physicians' opinion, noted in 38 (95%) patients using Carmolis, which coincided with self-evaluations of the patients. During Carmolis application, the starting dose of NSAIDs could be reduced in 18 (45%) patients. Adverse reactions occurred infrequently and required no therapy discontinuation. Conclusion. Carmolis topical gel is effective in relieving clinical symptoms in patients with gonarthrosis, well tolerated, and safe, which can recommend its use in the combination treatment of knee OA.

Introduction. Diabetic macular edema (DME) is a common manifestation of diabetic retinopathy and an important cause of visual impairment in people with diabetes. DME is the most common cause of decreased vision in patients with diabetes. It can accompany any stage of the disease and occurs on average 10% of patients with diabetes. In this case, due to structural changes in the endothelium of retinal vessels violation of the retinal barrier increased permeability of blood vessels wall and fluid accumulation in the intercellular space retinal optical coherence tomography (OCT) is a method of diagnostic morphological structure of the retina and allows high precision of the DME diagnose, assess the severity and observe the dynamics. Materials and methods. During the work general ophthalmic examination, OCT, PAH and immunological studies were performed in all patients. Total 64 patients (128 eyes), including 28 women (43.8%) and 36 men (56.3%), whose average age was '58 (SD 10), 24 to 78 years with diabetes type II diabetic macular edema of various kinds took part in the study. Diffuse (occlusal and unocclusal kind ) and complicated (occlusal and unocclusal ) DME were studied. Diffuse occlusal DME was diagnosed in 33 cases, diffuse unocclusal DME – in 35 cases, complicated occlusal DME - in 28 cases, complicated unocclusal DME - in 32. Statistical analysis was performed in the program MedCalc 9.0. Results and Discussion: In this clinical study there is a clear pattern between the type and the presence of DME. Conclusions: We can talk about the use of the criterion of the presence or absence of RPE detachment to differentiate species (occlusion or unocclusual) diffuse and complicated DME in patients with diabetes type II.

Objective. To improve quality of diagnosis of systemic lupus erythematosus (SLE) and systemic sclerosis (SS). Material and methods. 30 pts with SLE and 30 with SS were included. Besides complex clinical, instrumental and laboratory examination activity and isoenzymes of succinate dehydrogenase (SDG), fumarate hydrase (FH), malate dehydrogenase (MDG), cytochrome oxidase (CO) were evaluated trice (at admission, after two weeks and at discharge) with original methods. 30 healthy persons were included in the control group. Results. SLE and SS pts had significant changes of energy metabolism enzymes depended on clinical features of the disease. Enzyme indices at minimal activity of SLE and SS were more informative than most of traditional laboratory tests. Comparative analysis of enzyme indices in SLE and SS pts revealed some features with along with clinical, instrumental and traditional laboratory data should be consider in diagnosis of these diseases. Enzyme indices correlated with changes of pts clinical state what allow to use them as criteria of treatment efficacy.

Aim. To evaluate effectiveness of a natural mineral bishofit in combined treatment of rheumatoid arthritis (RA). Material and methods. The study included 71 RA patients with minimal activity of the pathological process and articular disorders of stage II. Bishofit was used in baths and compresses. 33 AR patients of group 1 took bishofit baths (14 procedures) and non-steroid anti-inflammatory drugs (NSAID), 27 RA patients of group 2 were treated with bishofit compresses (14 procesures) and NSAID, 11 patients of group 3 (controls) received NSAID alone. The effect of the treatment was assessed on the basis of clinical data, the length of the affected joint circumference, antitryptic blood activity, activity ofmalate dehydrogenase, lactate dehydrogenase isoenzymes, plasmin, plasminogen, ESR, sialic acids. Results. Bishofit-treated patients showed earlier (by 5-6 days) and greater (by 25-35%) decrease of the pain, joint and inflammatory indices as well as duration of morning stiffness, length of the affected joint circumference and joint mobility, improvement of the tests' results. A response and an appreciable response to combined therapy with bishofit were achieved in 62.9-63.6% of cases vs 45.5% in the control group. Bishofit baths and compresses did not differ considerably by therapeutic efficacy.