Journal of Clinical Medicine of Kazakhstan

3-5

Authors: Abay Baigenzhin

Dear friends! Scientific-practical journal “Clinical Medicine of Kazakhstan” turns a new page of its activity with the renewed staff, ideas. According to the order #1082 of the Chairman of Committee of Control on Education and Science of the Ministry of Education and Science of the Republic of Kazakhstan (Committee) dated July 10th, 2012, we were once again included into the List of Approved Scientific Journals of Kazakhstan. We opened own site for journal - www.clinmedkaz.org. New web-site of the journal, allows you to submit your publications online and to follow the process editing and accepting, as well as to communicate directly with the editors staff. Our renewed editorial staff and editorial board include leading foreign specialists. This way we hope to be able to raise our academic bar to a whole new, international level, and invite you to be a part of this. Our journal is now indexing in databases - Global Impact Factor, Open Academic Journals Index and International Impact Factor Services. These are one of the largest databases where conducted in-depth quantitative and qualitative analysis to assess the prestige periodical scientific publications in the world. The rating takes into account such factors as peer-review the original article, the quality of scientific and technical review, acceptance and rejection rate of the manuscripts and the periodicity of the publication numbers. In general, the stringent requirements for the selection of articles, high rejection rate of manuscripts are considered one of the important criteria of high peer review quality and prestige of the journal. Our impact factor in the system of Global Impact Factor is 0,542. Now, we conclude contracts with international scientific information platforms, such as the Russian Science Citation Index, Cross Ref, Index Copernicus, DOAJ (Directory of Open Access Journals), Bioline International, SCOPUS. Indexing in such databases will enhance the citation of articles published in our journal. The main purpose of the journal is to be indexed in the ISI Web of Science (Thomson Reuters) and in the PubMed. J Clin Med Kaz is fully committed to the Open Access Initiative and will provide free access to full text of all articles as soon as they are published and available from online system. All of the submitted articles will be considered free of charge. Thus, we go to the international level and strive for excellence. We hope that realization of Editors' plans will attract new readers and authors to the journal and will contribute to the development of scientific approach to problems of clinical medicine based on the principles of evidence-based medicine.

9-13

Authors: Abay Baigenzhin, Galiya Shaimardanova, Nadezhda Popova, Bakhit Zhussipova, Gulziya Ismailova

Existence of circulating tumor cells (CTCs) in blood of cancer patients, testifies about a dissemination of cancer cells to the peripheral blood stream, on the earliest stages of cancer development and very often testifies to an adverse clinical current, especially it is connected with formation of metastases. Besides, these cells can represent the minimum residual disease and quantitative monitoring of CTCs level in time of anti-cancer treatment provides researchers with valuable information. For today the role of epithelial-to-mesenchymal transit (EMT) and mesenchymal-to-epithelial transit (MET) in formation of various subpopulations CTCs, in expansion of cancer aggressive properties. In this article we want to prove the purpose and problems of our scientific research - the cytological molecular analysis of circulating tumour cells have isolated by the size dependent ISET technology (Isolation by size of epithelial tumor cells). To study the cyto-morphological and immunological characteristic, to identify targeted therapy markers and the metastatic response predictors to anti-cancer treatment on viable circulating cancer cells by the RT-PCR method (real-time polymerase chained action). To study of clinical profit from quantitative, immunological and molecular monitoring of CTCs, for elimination minimum residual disease, by application of individual targeted therapy, on the basis cytological molecular analysis of CTCs.

21-28

Authors: Gunay Akbarova

This article is devoted to the study of β-thalassemia, which is one of the most widespread hereditary diseases among the population of the Azerbaijan Republic. The pathology's genetic mechanism, clinical and laboratory manifestations are described. A complete analysis of references in this field since 60s was completed. The causes of this disease and methods of detecting the pathology in Azerbaijan are examined. Research of the β-thalassemia in Azerbaijan was carried out in 40 of the 66 administrative districts of the Republic. The article reviews the main types of β-thalassemia mutations found in Azerbaijan. The most characteristic mutations for the population are β0 - Fs codon 8 (-AA), β0 - IVS-II-1 (G>A), β+ - IVS-I-110 (G>A) and β+ - IVS-I-6 (T>C). The rarest mutations are codon 5 (-CT), -88 (C>A), β+-IVS-I-130 (G>C) and β0-codon 37 (TGG>TGA). The mutation frequencies are listed by administrative districts in Azerbaijan. The possibilities of β-thalassemia manifestation together with abnormal forms of hemoglobin in the Azerbaijan population are traced. The methods of treating, exploring and prevention of β-thalassemia by the general public, charitable organizations, foreign companies and the government of the Azerbaijan Republic are illustrated. Basic prevention methods and the importance of establishing a State register of β-thalassemia cases are reviewed.

37-41

Authors: Natalia Abramova, Natalia Pashkovskaya

The aim of the study. To study the dependence of expression of vascular endothelial growth factor (VEGF) and endothelial cell desquamation intensity in patients with the metabolic syndrome (MS) according to the body mass index and dependence of levels of thyroid hormones on the level of VEGF and content of desquamated endothelial cells in venous blood serum. Methods. We have determined the level of VEGF and desquamated endothelial cells in the serum of venous blood in 68 patients with MS (48 obese and 20 non-obese patients), and indicators reflecting the metabolism of thyroid hormones namely thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone/free triiodothyronine ratio (TSH/fT3), thyroid stimulating hormone/free thyroxine ratio (TSH/FT4 ), thyroid index (TI), the total thyroid index (TTI), free triiodothyronine/free thyroxine ratio (fT3/fT4). Results. Expression of VEGF as well as the number of desquamated endothelial cells in venous blood serum increased significantly with enhancement of the degree of obesity. Desquamated endothelial cells correlated positively with TSH, TSH/fT3, TSH/fT4 (p <0.05) and negatively with thyroid index, fT3/fT4 (p <0.05). Also we found a positive correlation between the expression of VEGF and TSH, fT4, TSH/fT3, TSH/fT4 (p <0.05) and negative with T3, fT3/fT4 and TTI (p<0.05). Conclusions. Expressoin of vascular endothelial growth factor and endothelial cell desquamation enhances with increasing of the degree of obesity, which are associated with the level of thyroid hormones metabolism and the functioning of the pituitary-thyroid axis.

47-51

Authors: Igor Kutko, Irina Terуshina

The aim of the study – investigation of metabolic active preparation cytoflavin influence on dynamic of nitric oxide (NO) metabolites (nitrates / nitrites) in patients with reccurent depressive disorder (RDD) in the ambulatory conditions. Methods. For aims realisation the clinicalpathopsychologycal, immunologycal and statistical methods were used. To implement the objectives of the study were examined two randomized groups of patients with RDD (F33.0, F33.1, F33.2) - main (98 patients) and comparison (94 patients). Patients of both groups received on-commonly accepted maintenance therapy with antidepressants and antipsychotic on an outpatient basis. In addition, patients of the main group during the treatment yielded an additional cytoflavin. Results. Found that before treatment in patients with RDD levels of NO metabolites - nitrate / nitrite were lower than the corresponding parameters in healthy donors. Violations of nitrogen metabolism indicators were the same type for all three types of RDD gravity, but differed in quantitative traits. The use of modern metabolic active drug cytoflavin in the treatment of patients with RDD contribute to the normalization of NO metabolites - nitrates / nitrites. Conclusion. The use of modern metabolic active drug cytoflavin in the treatment of patients with RDD has pathogenetic base and clinical perspective.

60-65

Authors: Abduzhappar Gaipov, Daniyar Abishev, Saltanat Moldakhmetova, Natalya Kim, Assem Nogaibayeva, Mukhit Dossov, Bolat Bekishev, Adilzhan Albazarov, Nadezhda Popova, Saltanat Tuganbekova

The aim of our pilot study was to determine the relation between the intraoperative parameters and levels of urinary neutrophil gelatinase-associated lipocalin (uNGAL) in patients after cardiac surgery. Methods: Twenty four adult (mean age 55.3±11 years) patients with coronary heart diseases whom planned cardiac surgery were included to study. All patients had initially normal kidney function (GFR > 60 ml/min). Diabetic patients were excluded from the study. Clinical survey included assessment of kidney and heart functions, routine laboratory assays. uNGAL levels were tested at 2nd and 12th hours after conducted cardiac surgery. We investigated association between the intraoperative factors such as extracorporeal circuit (pump on) time, intraoperative blood loss, duration of surgical operation and level of uNGAL. Results: General clinical characteristics of patients were followings: GFR 92±20.6 ml/min, Hb 13.4±1.8 g/dL, WBC 6.9 x103/mm3, left ventricle ejection fraction 53.8±8.4%. All patients received standard surgical and anesthesiological protocols during the cardiac operation. Mean extracorporeal circuit time and duration of operation were 93.2±42.1 and 184±47.1 minutes respectively, intraoperative blood loss calculated 205±47.8 ml. Urine NGAL levels at 2nd and 12th hours after cardiac surgery made up 68.5±90.6 (0.8 - 267.2) ng/ml and 20.4±21 (0.3 - 92.4) ng/ml respectively. Mean staying days in intensive care unit (ICU) were 2.79±6.4 (1 - 32) days. In result of cardiac surgery, two patients developed acute kidney injury (AKI), and one patient died in result of multiorgan dysfunction syndrome. Urine NGAL of 2nd hour positively correlated with extracorporeal circuit time (r=0.625, p=0.001), duration of operation (r=0.576, p=0.003), intraoperative blood loss (r=0.60, p=0.002) and with ICU staying time (r=0.449, p=0.022), whereas there were no correlation of these parameters with serum creatinine levels. Development of AKI were related with extracorporeal circuit time (r=0.436, p=0.033). CONCLUSIONS: Prolongation of extracorporeal circuit time and duration of operation as well as excessive intraoperative blood losses was associated with increased uNGAL levels. Extracorporeal circuit time has an indirect relationship with the risk of AKI in patients after cardiac surgery.