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AIM: To evaluate the impact a fixed-ratio combination of insulin glargine(100U/ml) and lixisenatide(iGlarLixi) on the glycemic control in Russian study T2D population uncontrolled on OAD ± insulin therapy in real-world settings.MATERIALS AND METHODS: The Russian subanalysis of international, multicentre, prospective, observational SUCCESS study included 160 T2DM patients who had initiated iGlarLixi within 1 month prior to study inclusion from 11 regions of the Russian Federation. The primary endpoint — HbA1c change from baseline to month 6. Secondary endpoints: HbA1c change after 12 months, achievement of target HbA1c levels after 6 and 12 months; change in FPG and PPG, change in body weight after 6 and 12 months, iGlarLixi dose dynamics. Safety endpoints: adverse events, serious adverse events, adverse events of special interest, frequency of hypoglycemia during the study period.RESULTS: The average age of patients in the Russian population was 60.8±9.4 years; average duration of T2DM was 11.4 years, mean HbA1c — 9.3±1.5%; mean BMI 33.3 kg/m2. Prior to the study, most patients were on 2 (36.3%) and 3 OADs (27.5%), 32.5% — on insulin therapy. The mean change of HbA1c at month 6 was -1.81%, and -2.03% at month 12. 51.3% patients achieved individual HbA1c targets at month 12, 46.7% of patients achieved the HbA1c target without hypoglycemia and weight gain. The decrease of body weight in 12 months was -3.3±4.4 kg. During the study period, 17 cases of hypoglycemia were recorded (0.11 events per patient-year); 1 severe hypoglycemia (0.01 events per patient-year). The total number of adverse events (AEs) was 43(26.9%), serious AEs - 10 (6.3%).CONCLUSION: According to the results of this prospective real world sub-group analysis, initiation of iGlarLixi in Russian adults with T2DM uncontrolled on OADs ± insulin significantly improves glycemic control with low risk of hypoglycemia and no body weight increase.

Objectives. To synthesize 4,5-bis(diphenylphosphanyl)-H-1,2,3-triazole ligands and new chromium complexes based on them, in order to obtain a fraction of higher C10–C18 alpha-olefins from ethylene.Methods. The Schlenk technique was used to obtain the target chromium complexes. Diphenylphosphanyl triazole ligands can be characterized by nuclear magnetic resonance spectroscopy. The composition of the final products was confirmed by elemental analysis. The liquid phase of the oligomerization reaction was studied by gas chromatography.Results. L1–L9 ligands were obtained, and K1–K9 chromium complexes were synthesized based on the correspondent ligands using commercially available chromium (III) trichloride tris(tetrahydrofuran). The K1–K9 complexes thus obtained were tested in the process of ethylene oligomerization.Conclusions. Chromium complexes based on 4,5-bis(diphenylphosphanyl)-H-1,2,3-triazoles K1–K9 were produced in high yields using the Schlenk technique. It was found that systems based on the K4–K7 and K9 complexes enable the ethylene oligomerization process to be carried out with a sufficiently high level of productivity. It was shown that the introduction of a dialkyl zinc derivative increases the performance and selectivity of the catalytic system for the target fraction.

Traumatic brain injury (TBI) results in a significant inflammatory burden that increase the production of inflammatory mediators and biomarkers. The immune system plays a key role in the pathogenesis of traumatic brain injury. Neuroinflammatory mediators released from resident glia (activated microglia and astrocytes) inside the brain recruit immune cells where cytokines are small soluble proteins that confer instructions and mediate communication among immune and non-immune cells. Interleukin-6 (IL-6) is a proinflammatory cytokine known to be elevated after trauma, and a major contributor to the inflammatory response following TBI. Previous studies have investigated associations between IL-6 and outcome following TBI, but to date, studies have been inconsistent in their conclusions. The purpose of the current study was to assessment of cerebrospinal fluid (CSF) interleukin-6 (IL-6) and MBP levels in patients with TBI. Samples of cerebrospinal fluid of 85 patients with TBI were examined. Concentrations IL-6 were measured via xMAP multiplexing technology. The control was the course of CSF in patients with concussion. An increased content was found in all patients with traumatic brain injury: 19.59 pg/mL in the group with mild traumatic brain injury; 103.6 pg/mL in the group with moderate traumatic brain injury; and 2225 pg/mL in the group with severe traumatic brain injury load versus 2.58 pg/mL in the control group. A direct correlation was found with the presence of basic myelin proteins in the cerebrospinal fluid, which indicates the degree of damage and neurodegeneration processes. Identification of the features of IL-6 content in patients with brain injury may indicate its important role in the course of disease. It also requires additional more detailed study, including comparison with IL-6 content in peripheral blood.

Background: Type 2 diabetes mellitus (T2DM) and hypogonadism are mutually aggravating diseases associated with the development and progression of cardiovascular pathology. The status of endothelial function in men with T2DM and hypogonadism hasn’t been studied.Aims: To assess the effect of hypogonadism on endothelial function in men with T2DM.Materials and methods: Patients underwent clinical studies, assessment of carbohydrate and lipid metabolism, the content of sex hormones (total testosterone (T), sex hormones binding globulin, free T, luteinizing hormone) and markers of endothelial function (nitric oxide (NO), endothelial nitric oxide synthase type 3 (eNOS3), endothelin, adhesion molecules ICAM-1, VCAM-1, p- and e-selectins, cadherin), ultrasound examinations of endothelium-dependent vasodilation (EDVD) of the brachial artery (BA) and carotid arteries with an assessment of the thickness of intima-media complex (TIM) were performed.Results: The study included 276 men with T2DM (age 54.0[49;60] years), who were divided into 2 groups: 1–124 patients with hypogonadism; 2–152 eugonadal patients. Reduction of the endothelial vasomotor function was detected in 32.4% of patients in the 2st group and in 55.3% of the 1nd group (χ2=6.1; p=0.01), which was associated with a decrease in EDVD by 29.8 % (p

Traumatic brain injury (TBI) is one of the most common pathologies of the central nervous system in the world, and the use of structural neuroimaging methods – computed tomography (CT) and magnetic resonance imaging (MRI) – often doesn’t allow assessment of the severity of the brain injury that has occurred. This situation predetermines the need to search for new methods of differential diagnosis of the severity of TBI and predicting the risk of consequences.One of these promising areas is the study of the immune status, since traumatic brain injury is characterized by a high rate of complications.One of these promising areas is the study of the immune status in patients with TBI in the acute period. It is now known that in response to brain damage, a response from the immune system is triggered.The reactions from the immune system, which develop after brain injury and directed against its own antigens, in the early period of the disease are related to damage to the nervous tissue. However, according to the latest available data, they are subsequently able to stimulate the processes of repair and regeneration in the brain tissue. In the course of damage to the nervous tissue, in response to endogenous molecules formed during the destruction of cells and the extracellular matrix, the cells of the immune system are activated.Current evidence indicates that T-cells play a role in both the formation of secondary damage and repair mechanisms. They are able to protect neurons through the production of neurotrophic factors such as brain neurotrophic factor (BDNF), which stimulates the growth of neurons, the formation of synapses.Using multicolor cytometric analysis within the framework of this work, a study was carried out to determine the number of the main subpopulations of CD3+CD4+-lymphocytes. The relative number of Th17 (CXCR5- CXCR3- CCR6+CCR4- ) and Th17/Th22 (CXCR5- CXCR3- CCR6+CCR4+), Th1/Th17 (CXCR5- CXCR3+CCR6+CCR4- ) among total CD45RA-negative CD3+CD4+-cells population is significantly increased in comparison with the values in the control group, in turn, the Th1(CXCR5- CXCR3+CCR6- CCR4- ) subpopulations among total CD45RA-negative CD3+CD4+-cells are significantly decreased with the values in the control group. The results obtained so far make it possible to consider immune responses among the key links in the pathogenesis of brain contusion TBI. And, perhaps, a comprehensive immunological examination of the victims in the first day after the injury will determine the parameters that will help predict the nature of possible complications in patients with brain contusion.

Cognitive disorders are one of the relevant problems of modern clinical medicine. This is due to both their high frequency of occurrence and significant negative impact, which has a violation of higher cortical functions on the quality of life of patients due to the deterioration of their social communication, as well as reducing the effectiveness of professional and household functions. The main cause of cognitive disorders is Alzheimer’s disease. At the same time, according to statistical studies, a significant increase in the incidence of the number of persons in the human population as a whole suffering from this pathology is predicted. At the heart of Alzheimer’s disease is a complex of pathobiochemical changes leading to synaptic dysfunction, accompanied by the development of atrophic changes in certain areas of the brain, against which a specific clinical picture is formed. The earliest and most important manifestation of Alzheimer’s disease is memory impairment for current events, which are subsequently joined by a number of other symptoms. The literature describes certain risk factors that contribute to the development of the disease, among which a certain place is occupied by infectious pathology. However, this aspect remains largely outside the traditional study of the pathogenesis of Alzheimer’s disease. In the review the analysis of the results of modern studies confirm the possible involvement of infections in the development of dementia of Alzheimer’s type.

Purpose: to evaluate the effect of the degree of severity of obesity on metabolic profile, the LAP index, leptin levels and C-reactive protein (CRP) in men with type 2 diabetes c.Materials and methods: 120 male patients aged 40-65 years with obesity and Type 2 diabetes (mean age 54.3 ± 5.3 years). To assess the influence of the degree of severity of obesity on metabolic parameters was undertaken a comparative analysis of the data, depending on the body mass index (BMI). The metabolic profile was evaluated in terms of lipid profile, fasting glucose, of HbA1c, insulin resistance index HOMA. The study of leptin and CRP concentrations produced using laboratory kits for ELISA eBioscience (Austria). We used a new indicator for the integrated assessment of metabolic and cardio-vascular risks — LAP index.Results: analysis revealed no significant differences in fasting glucose, HbA1c and total cholesterol (TC) between the groups. In all groups, the study revealed an increase HOMA index from the first to the fourth group, which indicates an increase in the severity of insulin resistance.Summary: the increase in body mass index is a factor that by enhancing insulin resistance and adipokines production, leading to aggravation of metabolic disorders and the rise of cardiovascular risk in men with obesity and type 2 diabetes. LAP index is a more accurate marker of metabolic disorders than conventional carbohydrate and lipid metabolism.

The authors give the results of their investigations of and the generalized data available in the literature on the significance of neuroimaging techniques in the diagnosis of cognitive impairment of different origins. Special attention is given to the importance of applying current diagnostic methods for functional neuroimaging both in early and advanced dementias: in Alzheimer's disease, vascular dementia, and mixed pathology.

Clinical, neuropsychological, and neuroimaging examinations were made in 65 patients (52 men and 13 women) aged 65.6±10.1 years who had experienced ischemic stroke. Cognitive impairments (CI) were heterogeneous; regulatory functions, attention, and counting were most significantly affected in moderate CI. In mild dementia, mainly poor attention and regulatory dysfunctions were added by clearly-cut impairments of memory, orientation, and visual-spatial function. Brain atrophy, white matter changes, and small focal gray matter damages along with focal post-stroke changes were revealed by neuroimaging in most patients. It was found that besides the volume and location of a damage focus, the signs of impaired integrated mental activity of the brain, regulatory dysfunctions in particular, should be a necessary condition for the verification of post-stroke CI.

Purpose: To study changes in carbohydrate and lipid metabolism in patients with type 2 diabetes, with different tactics and lowering lipid-lowering therapy. Materials and Methods: Analysis of metabolic efficiency of various therapeutic regimens for type 2 diabetes and dyslipidemy at 124 patients Results: The most favorable changes in lipid metabolism in patients with type 2 diabetes and dyslipidemia achieved by supplementation of fenofibrate and statin combination of exenatide and metformin Summary: Therapy based on a combination of inkretinomimetik, fibrate and statine, normalizes the metabolism of carbohydrate and lipid in diabetes mellitus with dyslipidemia and is a promising treatment option.

Отражены данные литературы о патогенезе постгипоксической энцефалопатии (ПЭ), каскаде патобиохимических реакций, развивающихся в головном мозге при ишемии/гипоксии. Особое внимание уделено возникновению синаптической дисфункции в условиях энергетического дефицита и дестабилизации мембран нервных клеток. Представлены сведения об основных клинических синдромах, алгоритме диагностики, принципах лечения ПЭ. Обсуждается применение актовегина в комплексной терапии ПЭ.