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Introduction. This work was initiated by the problems of cardiovascular diseases, which are one of the main causes of mortality of the population of our planet. More than ten years ago, in 2012, approximately 3.7 million people died of acute coronary syndrome worldwide. The fight against such pathologies is carried out with the help of so-called stents, the manufacture of which can be carried out by the method of magnetic pulse «expansion» from hollow metal cylinders. The limited production possibilities of magnetic pulse «expansion» were caused by the minimum cross-sectional size of the inductor-instrument, which can be practically manufactured. Other tools are required to perform this operation. Novelty. A system of magnetic-pulse expansion of thin-walled pipes of small diameter with an inductor that excites an azimuthal electromagnetic field in the case of direct current passing through the processing object and in the absence of its connection in an electric circuit with an inductor is proposed. Purpose. The main analytical dependencies for the characteristics of the electromagnetic processes taking place in the inductor systems for the expansion of cylindrical conductive pipes of small diameter when direct passage of current through the processed object and when it is not connected to an electric circuit with an inductor (insulated billet) is derived. Methods. The solution of the boundary value problem with given boundary conditions was carried out by applying Laplace transforms and integrating Maxwell’s equations. Results. Analytical expressions were obtained for the main characteristics of the processes: the intensities of the excited electromagnetic fields and currents in the system depending on the parameters of the studied systems. The analysis of possible technical schemes for solving the given problem indicated the choice of the optimal variant of an effective system of magnetic-pulse «stretching» of thin-walled cylindrical conductors of small diameter. Practical value. Based on the qualitative analysis of the obtained results, recommendations for the practical implementation of the proposed system were formulated. The obtained dependences allow us to give numerical estimates of the effectiveness of excitation of magnetic pressure forces on the object of processing and to choose directions for further improvement of the magnetic pulse technology for solving such problems. References 23, figures 2.

Purpose: to study the association of the polymorphic marker T786C of the eNOS gene with various stages of primary open-angle glaucoma (POAG).Materials and methods. Peripheral blood of 90 patients aged 56 to 89 yrs (ave. 71 yrs) with POAG stages I, II, III was tested. DNA was isolated using a set of ribosorbents (Synthol company); subsequently, a real-time PCR reaction was performed on a DT-96 amplifier using the set to determine the polymorphic marker T786C in the eNOS gene.Results. For all groups of patients, the frequency of occurrence of alleles and genotypes was calculated, and the relationship between the emergence of POAG and the presence of an unfavorable polymorphic marker was determined. The main changes were revealed at POAG stages II and III, whilst at stage I no effect of polymorphism T786C of the eNOS gene was observed.Conclusion. For the first time, a comparative assessment was made of the distribution of alleles and genotypes by the polymorphic marker T786C in the eNOS gene of patients with various POAG stages.

Enzyme-linked immunosorbent assay (ELISA) has traditionally been used to diagnose infectious diseases, including ophthalmic ones. As a rule, however, investigators are only focused on differentiated detection of specific immunoglobulins (Ig) of varied classes, despite the fact that ELISA is able to register a wider range of emerging immune responses.Our purpose is to assess the effectiveness of the solid-phase version of ELISA for the etiological diagnosis of endogenous uveitis.Material and methods. 107 patients (114 eyes) aged 19 to 83 (ave. 45.2 ± 2.8 yrs) with various clinical forms of endogenous uveitis were examined by the traditional ELISA method. Along with the detection of specific Ig, the avidity of IgG and “paired” sera were studied.Results. In the primary serological examination, specific IgG were found in almost all patients (to herpes simplex viruses in 100 %, and to cytomegaloviruses in 96,3 %). Specific IgM were revealed in 3.7 % of cases. Specific IgG to T. gondii were found in 44.9 % of the patients and in 2 people, IgM. Specific IgG to C. trachomatis were found in 23 patients, and in two cases, IgM. By studying the avidity of antibodies, etiology was additionally deciphered in 1.9 % of patients. The study of “paired” sera helped determine the etiology of the disease in another 16 people.Conclusion. An integral approach using all diagnostic capabilities of ELISA, in particular the differentiated definition of specific Ig of various classes and the avidity of specific IgG, as well as the study of “paired” sera, made it possible to significantly increase the diagnostic capabilities of ELISA. As a result, the etiology was deciphered in 26 patients (24,3 %).

Objective: to study the effectiveness of the hypromellose-based medicine Artificial Tears®, eye drops, in the treatment of dry eye syndrome in students with myopic refraction. Patients and methods. A total of 147 students of Academician E.A. Wagner Perm State Medical University with different types of clinical refraction were examined. Among them 63 students with myopic refraction of various degrees in 110 eyes were included in the study (mean age — 22.6 ± 0.16 years, 49 (78 %) women, 14 (22 %) men). Dry eye syndrome was detected in 49 (78 %) participants in 82 eyes (74.5 %). According to the myopia correction method, 3 groups were formed: Group 1 — students with eyeglasses; Group 2 — students constantly using soft contact lenses; Group 3 — students who had excimer laser correction by LASIK method. The remaining students (n = 14) had no dry eye syndrome. The study was conducted in two stages: at baseline and then repeated after 4 weeks in students with dry eye syndrome who used daily the medicine Artificial Tears®. Subjective assessment was based on the Ocular Surface Disease Index (OSDI) questionnaire. Оbjective assessment included function tests, characterizing the precorneal tear film stability and total tear production level. Results. In the process of treatment a good tolerance of the given medicine was reported. Analysis of the overall results showed that the mean OSDI score decreased statistically significantly from 26.92 to 20.29 seconds (p ≤ 0.0001). The mean tear film break-up time increased from 7.95 to 11.25 (p ≤ 0.0001). The mean Schirmer’s test score was slightly changed: from 13.98 to 14.07 mm due to the presence of increased tear production in some students, which is characteristic of the dry eye syndrome initial manifestations. Conclusion. The medicine Artificial Tears® in the form of eye drops is well tolerated and is sufficiently effective in eliminating the dry eye syndrome manifestations after only 4 weeks of use. The treatment with the medicine Artificial Tears® showed a statistically significant reduction in the disease severity (according to the OSDI questionnaire data) and an increase in the tear film break-up time. The received results allow us to recommend the medicine Artificial Tears® for medical use in patients with various degrees of myopic refraction, regardless of the myopia correction method used.

Ophthalmological manifestations in COVID-19 infection are diverse, manifesting themselves in all anatomical structures of organ of vision, they occur both in the acute period of the disease and in the post-COVID period. Currently, the literature describes changes in the anterior segment of the eye more often, and also there are publications describing pathological changes in the posterior segment, and acute vascular pathology of the retina after COVID-19 infection in particular. It has been established that the comorbid background of the patient is of great importance in the development and the course of the disease. These findings are also confirmed by our two clinical observations of acute ocular vascular pathology after COVID-19. In the first case, retinovasculitis of the right eye complicated by thrombosis of the inferior temporal branch of the central retinal vein was described. The development of vascular pathology of the eye in this case was observed 1.5 months after the onset of the first symptoms of COVID-19 infection. The patient promptly turned to an ophthalmologist and was hospitalized to an eye hospital, where she received anti-inflammatory, hemostatic, anticoagulant, antibacterial, angioprotective, antioxidant therapy. As a result of treatment — the improvement of condition, restoration of visual functions. In the second presented case, we observed the development of an acute ischemic circulatory disorder of the retina of the left eye (thrombosis of the central retinal vein) 2.5 months after the onset of the disease with a new coronavirus infection. The treatment in an ophthalmological hospital included: steroid and non-steroidal anti-inflammatory drugs, antibiotics, mydriatics, haemostatics, angioprotectors, antioxidants, anticoagulants, vitamins. On discharge from the hospital, there was a slight improvement, but after 2 months, the condition of the left eye worsened again. The pathology of the organ of vision proceeded with the development of complication — secondary neovascular glaucoma of a refractory nature with an outcome to subatrophy of the eyeball. It was facilitated by the comorbid background of the patient: hypertension, type 2 diabetes mellitus, dyslipidemia.Based on the results of the analysis of clinical observations, the specific features of ophthalmological changes, their severity and dynamics on the background of comorbidity and the received therapy were established. The relationship between COVID-19 infection and complications of the organ of vision has been shown.

A clinical case of retinovasculitis with coronavirus infection COVID-19 involving a female patient in the late stage of HIV infection is reported. The patient had no antiretroviral therapy. Clinical features of eye changes, their severity and dynamics influenced by the ophthalmic therapy were revealed. A relationship between the course of COVID-19 and the state of immunodeficiency causes by HIV was found. As a result of the long disease duration and the complications, the patient died.

Purpose: to analyze eyeball and appendage damages inflicted by criminal injuries of patients who sought assistance by the emergency ophthalmological care unit in Perm.Materials and methods. The data of the patients’register and medical histories of the ophthalmological department of the State Clinical Hospital No. 2 named after Dr. F. H. Gral of Perm for 2018–2020 were retrospectively analyzed.Results. Out of 30428 cases of domestic injuries, 847 (2.8%) were received under criminal circumstances. The victims, predominantly male (77.6%), and of working age (93.7%), were delivered by ambulance in 51.6% of cases. The majority of people sought assistance within 24 hours (90%). The injuries were inflicted by strangers (59.5%) or acquaintances of the patients. 1257 eyes were injured. The prevailing conditions were contusions (46.9%), while the most common traumatizing factor was first punch (79.6%). Combined damages to the eyeball and appendage were more common, claiming 72.6%. Visual acuity fell below 0.1 in 5.6% of cases, 0.1–0.6 in 57.6%, 0.7–1.0 in 36.8% of cases. 45.9% of all cases were represented by eye burns: mainly they were chemical burns (99.5%) of which the overwhelming type was burns caused by gas spray irritants (97.9%). In burn cases, visual acuity was below 0.1 in 1.4% of cases, 0.1–0.6 in 62.6%, 0.7–0.8 in 36% of cases. The wounds inflicted to the eye amounted to 7.2%, the damaging factors being handgun bullet, glass, metallic objects. Injuries of the eyelids and the eyeball were observed. Most of the injuries were mild (91.3%). 5.83% of the victims needed hospitalization in an ophthalmological in-patient facility.Conclusion. The eye trauma, especially one of a criminal nature, is a social problem, and its analysis is highly relevant. The data obtained illustrates the need to increase the general culture of the population, to improve sanitary and educational work, and optimize medical care for those suffered.

Introduction. Pathologies of the visual organ (keratitis, glaucoma, etc.) occupy a leading place among the causes of vision loss and blindness. According to the literature, the immunopathogenesis of bacterial keratitis is associated with the activation of macrophages and oxygen explosion. The role of these mechanisms in the pathogenesis of primary open-angle glaucoma is not fully understood. There are isolated studies in which the development of this pathology is associated with nitric oxide NO, which is produced by endothelial NO synthase (nos). However, despite numerous studies, the role of immunogenetics in the pathogenesis of glaucoma remains insufficiently researched. The aim of the study is to explore the association of T786C, C774T, Glu298Asp polymorphic markers of the eNOS gene with development of POAG in residents of the Perm Territory. Materials and methods. The study was performed using peripheral blood collected from 93 patients with POAG and 96 patients with cataracts. The real-time polymerase chain reaction was performed after the DNA extraction. The frequencies of alleles and genotypes in the study groups were measured using the chi-square (2 ) test and Fishers exact test. Results with p 0.05 were seen as statistically significant. The calculated odds ratio and the 95% confidence interval were used to quantify the association between POAG development in patients and the existence of an unfavorable polymorphic marker. Results. The C774T and Glu298Asp markers did not show any significant differences in the distribution of genotypes and alleles of the eNOS gene. Higher frequencies of the homozygous TT genotype; and lower frequencies of the C allele of T786C polymorphic locus of eNOS gene were detected in patients with POAG. Conclusion. Polymorphic markers of the eNOS gene can be seen as factors associated with the risk of POAG.

The purpose: to study the species composition of the lacrimal fluid microbiota in patients with endogenous uveitis and the biological properties of dominant species of bacteria.Patients and Methods. A bacteriological study of the lacrimal fluid of 107 patients (114 eyes) with endogenous uveitis and 28 practically healthy persons (control) was carried out. The research was performed using the conventional methods. The isolated microorganisms were identified up to the species. We studied the main biological properties of bacteria — the presence of persistence and virulence factors of isolated dominant species.The results. 43 strains of various types of bacteria were isolated from the lacrimal fluid of patients with uveitis, bacteria of the genus Staphylococcus prevailed, S. aureus was isolated in 23.3 % of cases, and the remaining strains were representatives of coagulase-negative staphylococci. The species composition of the bacteria isolated from practically healthy individuals did not differ in essence. Isolated strains of S. aureus had a significant set of virulence factors. All isolates lysed sheep red blood cells, 80 % of the cultures had lecithovitellase and 60 % — DNA-se activity. Representatives of coagulase-negative staphylococci were characterized only by hemolytic activity. In the study of persistence factors, it was found that all the studied strains of S. aureus and the vast majority of representatives of coagulase-negative staphylococci isolated from tears were resistant to lysozyme. Biofilm formation was more typical for S. aureus strains 90 % versus 34.4 % for representatives of coagulase-negative staphylococci (t = 2.194, p = 0.034). Similar patterns were found in relation to complement resistance, 90 % of S. aureus cultures and 37.5 % of coagulase-negative staphylococci (t = 2.055; p = 0.046).Conclusion. Among the microorganisms isolated from the lacrimal fluid, Staphylococcus bacteria prevailed, from which S. cohnii was most often isolated. S. aureus to a greater extent than coagulase-negative staphylococci had a certain set of virulence and persistence factors. The microbiocenosis of the lacrimal fluid of patients with endogenous uveitis did not differ from practically healthy individuals. The presence of S. aureus in lacrimal fluid is a risk factor for the development of endogenous uveitis in cases of chronic oral and ENT organ diseases.

Nowadays, 37.9 million people live with the human immunodeficiency virus (HIV) in the world, while about 8.1 million are not aware of their HIV-status. Chronic inflammation with damage to all organs and systems, including the organ of vision, is characteristic of HIVinfection. Often, diseases occur atypically against a background of reduced immunity that is why any doctor, including an ophthalmologist, should be ready to treat such patients.The purpose. To present a clinical case of eye damage in a patient with terminal stage of HIV-infection.Мethods. According to the Perm Regional Clinical Infectious Diseases Hospital, a retrospective analysis of medical records of the HIV-infected patient S. with the eye damage and fatal outcome was made.Results. The diagnosis of HIV-infection was first established in the presence of ophthalmological disease. The lack of timely diagnosis and adequate treatment led to the death of the patient.

Purpose. To evaluate antihypertensive efficiency and safeness of Xenoplast, Glautex, and Ex-PRESS drainage during glaucoma surgery. Material and methods. 249 patients with primary open angle glaucoma (253 eyes) underwent antihypertensive operations with Xenoplast (group I, 121 patients aged 68.6 ± 7.7 yrs), Glautex (group II, 49 patients aged 66.8 ± 7.7 yrs) and Ex-PRESS (group III, 79 patients aged 67.9 ± 8.3 yrs). In groups I and II, drainages were implanted during penetrating and non-penetrating surgery. Long-term results were traced for 2 years. Results. In the early postoperative period, all groups had complications typical for antiglaucoma surgery without drainage: I — 14.8 %, II — 16.8 %, III — 16.8 %. An absolute success of the operation (normalization of IOP without additional antihypertensive therapy) was achieved as follows. In group I for patients with non-penetrating deep sclerectomy it was achieved in 98.4 % of cases at the moment of discharge from hospital, whereupon the figure fell to 15.4 % in 18 months. In group I patients, with trabeculectomy the success was achieved in 96.7 %, dropping to 6.7 %. In group II for patients with non-penetrating deep sclerectomy the success claimed 96.3 %, but after 12 months it vanished completely. In group II with trabeculectomy the success reached 95.7 %, but dropped to 16.7 % after 24 months. In group III the success rate at the moment of discharge was 96.3 % but it dropped to 16.7 % after 24 months. In cases if target pressure could not be achieved the surgery was repeated. Conclusion. The absolute success originally achieved in all groups (96.3–98.4 %) was not persistent and after a 2-year observation, tended to disappear. The effect lasted longer in eyes after trabeculectomy with Glautex and Ex-PRESS. The hypotensive effect of primary antiglaucoma surgery was higher in penetrating operations.

Purpose: to estimate the results of the clinical and laboratory survey among patients with uveites for refinement of the disease’s etiology.Patients and Methods. 107 patients with uveites (114 eyes) were under control. A standard ophthalmologic survey was done with them; a serodiagnosis (immunoassay analysis) towards Toxoplasma gondii, Herpes simplex virus Ist, IInd types, Citomegalovirus, Chlamidia trachomatis; a bacteriological examination of tear fluid, some material from nose and cavity to definite factors of virulence and antibiotic sensitivity of exuded microorganisms. A molecular and genetic survey (PCR) of tear fluid towards Toxoplasma gondii , Herpes simplex virus Ist, IInd types, Citomegalovirus was done among 30 people.The results. Provocative factors of the disease were detected in 42 % of cases. Concomitant diseases were in 77 %. Diseases of cardiovascular system prevailed in 49 %; ceiling of mouth cavity in 42 %; systemic diseases in 29.3 %. The most widespread were anterior uveites in 60.5 %; recur character prevailed in 51 %; deteriorations progressed in 58.8 % of cases. A chronic infection with herpes viruses was among almost all the patients (HSV I, II — 100 %, CMV — 96.3 %). To Toxoplasma gondii specific IgG were detected in 44.9 %, IgM in 2.8 %; to Clamidia trachomatis specific IgG in 21.5 %. 66 strains of bacteria were selected: from tear fluid — 34, from mouth — 17, from nasal cavity — 15; gram-positive bacteria of Staphylococcus prevailed in 83.3 %. In some cases of revealing S. aureus, which were isolated from all three biotypes, they were close to their phenotypic characteristics, which indicates to their etiologic importance in uveites’ progress. The research of tear fluid in PTSR turned to be less informative. Based on the anamnesis and the results of a complex survey it managed to become possible to decipher the etiology of the disease in 74.6 %. Among them were 67.1 % of infectious and infectious-allergic uveites; 80.7 % of bacterial uveites; 15.8 % of virus uveites and 3.5 % of parasitic uveites. 28.2 % of inflammations occurred on a background of system and syndromic diseases, the majority of diseases were on a background of Behterev’s disease and rheumatoid arthritis, 45.5 % for each. Non-infectious autoimmune and toxical-allergic reasons were set in 4.7 % of cases.Conclusion. It is more expediently to use a complex diagnostic approach with taking into account clinical and anamnestic information and laboratory information of the survey in the investigation of uveitis etiology.

Objective — analysis of survival rate among the patients with uveal melanoma eyeball removal in Perm Region. patients and methods. Retrospective analysis of medical documentation of 108 patients treated in ophthalmologic departments in the cit y of Perm has been carried out. Patients have undergone the surgery for uveal melanoma eyeball enucleation (2005–2014).Results. Analytic period involved 108 uveal melanoma eyeball removal in 108 patients aged 17–89 (61,61,6 years in average). There were 61 (56,5%) women and 47 (43,5%) men. Practical blindness was identified in 63,8% eyes, and in remaining eyes it was detected in 0,005–1,0 cases. Melanoma was localized in choroid in 79,6%; ciliary body — 10,2%; iris — 4,6%; and ciliary body and iris — 5,6%. Histology revealed mixed cell form in 68,5% cases; sarcomatoid form — 28,7%; epithelioid cell form — 2,8%. The outcome was determined in 99 (91,7%) patients. Follow-up period was from 6 months to 10 years after enucleation. Among those 27 (27,3%) patients died within the analytic period. Five-year survival rate was observed in 79,8% patients with average lifespan 3,4 yrs. Cause of death was established in 19 (70,4%) individuals. Association with oncologic diseases was determined in 6 (31,6%), and non-oncologic in 13 (68,4%) subjects.Conclusion. At the place of residence life-long observation by ophthalmologist and oncologist is essential for these patients. Outpatient physicians should have oncologic alertness while working with patients of any age for early diagnosis of eye neoplasm.

Abstract. The effects of 'Profetal', a drug containing liophylized, dextran-stabilized human alpha-fetoprotein as main active component, were investigated on peripheral donor blood mononuclear leukocytes (ML), with respect to their functional properties and the potential to generate mature dendritic cells (DC).Addition of the drug to cell cultures at optimal doses was shown to cause significant increase in their proliferative capacity and ML blastic transformation levels, and enhanced cytotoxicity towards K562 tumor cells, as well as to induce maturation of antigen-presenting dendritic cells.On the basis of the data obtained, a conclusion is made that 'Profetal' is an active immunomodulatory factor, and it may be applied for generation of cytotoxic lymphocytes and mature DC, aiming to apply them for the biotherapy of oncological and infectious diseases.

Abstract. Examination of immunomodulatory actions and clinical efficiency of myelopidum when included into complex therapy that was carried out in 24 male patients with severe (stage 3) penetrating eye injury in the course of trauma treatment. The levels of C-reactive protein, lactoferrin, interleukin (IL)-1β, IL-6, and activity of complement system were measured in peripheral blood, and concentrations of lactoferrin and IL-8 were determined in tears. An increase in lactoferrin, C-reactive protein, IL-1β, IL-8, and C5 complement component levels was detected during early post-traumatic period, as compared with data from the control group. As compared to effects of steroid and non-steroid anti-inflammatory drugs included into standard therapy, treatment with myelopidum has led to a more favorable clinical course of traumatic process, and resulted into more pronounced anti-inflammatory effect that was manifested by decrease in lactoferrin and C-reactive protein levels, reduction of IL-1β concentration, and C5 complement component activity. (Med. Immunol., 2008, vol. 10, N 2-3, pp 239-244).

We have performed immunophenotyping of lymphocytes in 150 HIV-positive patients, by means of flow cytometry. All the persons under study were classified into three groups, depending on absolute contents of CD3+CD4+T-lymphocytes in peripheral blood, according to HIV infection staging in adults and adolescents, as amended by CDC (USA). It was revealed that, at each subsequent stage of disease, a decrease in absolute numbers of T-helpers is accompanied by drop in relative and absolute numbers of lymphocytes, as well as in total T-lymphocyte numbers, and decreased amounts of absolute cytotoxic T-lymphocytes levels, combined with increase in their relative contents, along with decreased CD3+CD4+/CD3+CD8+ ratio, diminished levels of double-positive subpopulation, decrease in relative and absolute levels of αβТ-lymphocytes and significant drop in absolute levels of γδТ-cells, while their relative amounts remained normal. These findings demonstrate a pattern typical to the absence of immunological reactions in response to antigens persisting in the organism.

Abstract. The effects of 'Profetal', a drug containing liophylized, dextran-stabilized human alpha-fetoprotein as main active component, were investigated on peripheral donor blood mononuclear leukocytes (ML), with respect to their functional properties and the potential to generate mature dendritic cells (DC).Addition of the drug to cell cultures at optimal doses was shown to cause significant increase in their proliferative capacity and ML blastic transformation levels, and enhanced cytotoxicity towards K562 tumor cells, as well as to induce maturation of antigen-presenting dendritic cells.On the basis of the data obtained, a conclusion is made that 'Profetal' is an active immunomodulatory factor, and it may be applied for generation of cytotoxic lymphocytes and mature DC, aiming to apply them for the biotherapy of oncological and infectious diseases.