Herald of Almaty State Institute of Advanced Medical Education

6-13

Authors: Zetov A.Sh., Erimbetov K.D.

The situation on tuberculosis in the state is a serious problem therefore actions were offered, making the National Program of fight against tuberculosis in the Republic of Kazakhstan. There are features aggravating a situation about the country: the big tank of the ТВ patients with multiple medicinal stability who are difficult giving in to drug treatment that is bound to inexact coverage and poor quality of a cultural research of a sputum on a micobacterium of tuberculosis with definition of medicinal stability, incorrect selection of patients on treatment in the DOTS-plus mode. The number of ТВ patients with multiple medicinal stability in the Republic of Kazakhstan in 2008 made 1562 persons - the testimony of the menacing nature of spread of tuberculosis, its negative influence on health of the population of the Republic of Kazakhstan in the present and future. 48% of cases among again revealed patients make tubercular processes with existence of destructions and selection of bacteria. Besides progressive body height of the contingent of patients with multi is observed - and weed resistance of МВТ to himiopreparats, at these patients sometimes it is not possible to stabilize process. In such cases and justified the surgical method of treatment is the most acceptable. Scientists of the countries of Europe, America, Asia hold the opinion indicating direct indications to use of surgical treatment at a multirefractory pulmonary tuberculosis and its complications. Drug resistant tuberculosis became a problem, because of low effectiveness of drug treatment the patients with refractory tuberculosis allocating drug resistant МВТ, long time remain selection of bacteria and can infect surrounding with the refractory activator. The refractory pulmonary tuberculosis at the patient has clinical, epidemiological and economic value.

19-24

Authors: Benberin V.V., Tnabayeva G.Z., Aimahanova G.T., Smailova F.K., Nurgaiieva G.K., Ahmentayeva D.A.

In article the analysis of a compliance (commitment to treatment) warmly - vascular diseases at the persons receiving single treatment within the guaranteed volume free medical in the Central hospital of Medical control center of affairs of the president is carried out. For comparison the group of persons from among city dwellers receiving constant dynamic observation and treatment is chosen. In these groupsmultivascular damage of coronary arteries is revealed that was the reason of the address to a cardiac surgery department. In group of city dwellers more composite combinations of defeat of vessels, ischemic heart disease complications, a decompensation of metabolic violations were more often noted. These processes were formed against the background of a smaller compliance to the carried-out therapy, than in group of comparison. A conclusion of this article is need of more close check and dynamic overseeing by patients at the level of primary medical link.

29-32

Authors: Beinikova I.V., Nurgaliyeva A.S., Demidchik L.A., Hendrikson V.

We studied the possibility of the formation of neutrophil extracellular traps in patients with chronic kidney disease different stages. The object of the study: whole blood of 63 patients with chronic kidney disease distributed in five groups depending on the degree of destruction of renal parenchyma. Formation of net-like structures during NETosis of neutrophil, called neutrophil extracellular traps, having in its composition of DNA, histones, defensins and enzymes (elastase, myeloperoxidase, gelatinase, lactoferrin and lysozyme), was triggered by interaction with lipopolysaccharide substances of exogenous (bacteria) and autologous origin (products of oxidative metabolism), which act through the Ғсү-receptors and activate NADPH-oxidase complex. The results of our study revealed the following picture of the detection of neutrophil extracellular traps: neutrophil extracellular traps were detected in 33% of patients with chronic kidney disease 1 stage; amount was in the range from 4 to 10 in 100 neutrophils, in the group with 2 stage - in 5% of patients; amount - 4 in 100 neutrophils, with 3 stage - in 25% of patients; amount was in the range from 1 to 7 in 100 neutrophils, with 4 stage - in 33% of patients in an amount from 2 to 12 in 100 neutrophils, in the group with 5 stage - in 35% of patients in an amount from 2 to 14 in 100 neutrophils. Thus, the highest frequency of detection and the maximum amount of neutrophil extracellular traps was noted in the groups of patients with chronic kidney disease 1, 4 and 5 stages. Some features in morphology of neutrophil extracellular traps different types have been found. Distinctive feature of the first type of neutrophil extracellular traps was hypertrophy of core segments with the concentration of the pellets inside the net-like DNA. Distinctive feature of the second type of neutrophil extracellular traps was rupture of membrane structures of organelles and plasmolemma of neutrophils. The appearance of neutrophil extracellular traps is an unfavorable factor that provokes the activation of procoagulant mechanism of the hemostatic system.

37-41

Authors: Akimov O.Ye., Kovalyova I.A., Kostenko V.A.

The article considers the influence of different classes of sorbents on the metabolism of L-arginine, the processes of lipid peroxidation (LPO), the state of antioxidant systems (AO) in the blood of rats under chronic combined intoxication by sodium nitrate and sodium fluoride. Suspension of nanosized silica, suspension of hydrolysed lignin and activated carbon («Karbolayn») were used as enterosorbents. The experiment was conducted on 62 white Wistar rats for 30 days. Chronic intoxication reproduced by administration solution into the stomach, containing sodium nitrate and sodium fluoride at the dosage of 500 mg/kg and 10mg/kg, respectively. Metabolism of L-arginine was evaluated by determining the total activity of NO-synthases and total arginases activity. LPO processes were assessed by spectrophotometric determination of the products that react with thiobarbituric acid, and their increase after the 1.5 hour incubation in the iron-ascorbate, prooxidant buffer. Status of enzymatic AO systems was evaluated by determining the activity of superoxide dismutase and catalase. Analyzing the results of the study, it was found out that the suspension of nanosized silica more effectively restores function of AO systems and reduces lipid peroxidation indicators. Effect of studied sorbents on L-arginine metabolism under chronic combined intoxication by sodium nitrate and sodium fluoride suggests different sorption capacity of mentioned sorbents for fluoride ions, and nitrate ions.

46-50

Authors: Nijuzov B.S., Dinlosan O.P., Nijazova S.B., Eraaliev B.A., Aitimov G.I., Sabitov A.

This article presents the results of comparative studies of the healing of purulent wounds, in the treatment of wounds with ointment «Levomekol» during the period of deadaptation on the highlands after 3 and 30 day staying on the pass TuyaAshu in experiment. Established the best index of healing in a group of animals after 3-days stay at the altitude 3200 meters and the worst index in the group after 30-days staying on the high altitude. The feedback is based on the results of the dynamics of general and local clinical pictures, quantitative and qualitative microbiological tests, cytology of wound prints and planimetric studies.

58-66

Authors: Pozdnyakova A.P., Ashirbekov G.K., Adilgireyula Z., Kabdulin S.S.

The comparative analysis of incidence, according to official statistics, adult population of the village of Kuandariya and the village of Komekbayev of Karmakshynsky district adjacent to the area of accident of MBR RS-20 in 2006 in the Kyzylorda region, villages of comparison of Turmagambet, a rural population of the Kyzylorda region and the Republic of Kazakhstan is carried out. The certain statistical regularity of dynamics of incidence, connected with accident, are determined: rise in frequency of negotiability behind medical care in a year of accident, return to background level in 3-4 years. The elicited facts of increase of incidence in a year of accident, in the absence of chemical pollution of the habitat heptyl and products of its transformation, allowed to assume that the psychoemotional stress, connected with accident, could make negative impact. Serves as confirmation to it higher rates of a surplus, in comparison with data on a rural population of RK, indicators of those classes of diseases where the percent of psychosomatic pathology is high.

72-78

Authors: Yenin Ye.A., Khilko A.V.

Aim of research is practical application of the given classification of a pathology closely related kidneys allotransplantate and revealing the value of a complex of morphological researches in dynamics. Materials and Methods: was performed retrospective descriptive study, the depth of 5 years from January 2012 till February 2016. Sample - solid. Exclusion criteria - cadaver kidney transplantation. The work was conducted in the archive of pathomorphologic laboratory of National Scientific Surgery Center named after A.N.Syzganov. Results and discussion: it was about 48 cases of kidney transplantation. 64,58% (n-31) cases is related transplantations. According to Banff-07 classification they have been divided into groups by investigated signs. Diagnostic categories of Banff-07 classification renal allograft biopsias was following: the norm - 51,61 % (n-16), antibody associated rejection - 3,22% (n-1), boundary changes - 9,67% (n-3), acute rejection - 9,67% (n-3), chronic nephropathy of transplantate - 25,80 % (n-8), with inherent morphological signs. Conclusion: future advances in analysis of renal allograft biopsies can already be predicted, and the classification and grading of acute/active rejection will continue to evolve. The significance of specific morphologic findings-including glomerulitis, arteriolitis, and infiltrates with unusual cellular features-for acute and chronic allograft dysfunction and outcome will continue to be investigated. Emphasis in biopsy assessment will shift from diagnosis to prediction of later allograft function and outcome, potentially enabling early intervention. Results of research have shown that lifetime morphological research of kidney transplant biopsies allows to give full representation about dynamics of a current, a stage of pathological process, a qualitative and quantitative estimation.