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SummaryOver 12 years of cellular therapy in cardiology, some dictinct positive results are obtained in randomized studies. However, exact mechanisms of hematopoietic stem cell actions are still unclear under these clinical conditions. Paracrine effects of cell therapy cannot explain all these effects. Enhanced neoangiogenesis upon stem cell injection is a proven mechanism for improvement of blood supply to the heart. Meanwhile, a decreased revascularization effect 3-4 years after cell therapy is followed by repeated myocardial improvement 6-9 mo after repeated cell infusions with active development of collateral vessels, thus suggesting an additional mechanism for improvement of coronary blood supply. Restoration of regulatory functions of endothelium and smooth muscle cells, including increased NO synthase activity of endothelium and its interactions with myocardiocytes may represent a probable mechanism for this action.

Hydrocyanic acid, cyanides, and numerous nitrile derivatives are produced on a large scale and used in different fields of human activities in spite of their high environmental threat [1][2][3][4].Several chemical and physicochemical methods were proposed for the environmental control of hydrocyanic acid and its salts [5][6][7][8][9]. However, the development of rapid, sensitive, selective, and convenient methods has remained an issue of the day.Chemiluminescence analysis best meets the requirements for the determination procedure and apparatus [10]. An indicator system based on 3-aminophthalic acid hydrazide (luminol) is used in chemiluminescence analysis. In alkaline solutions, luminol strongly luminesces under the action of radical oxidants [11,12].We have observed the rapid development of the intense chemiluminescence of luminol in alkaline solutions in the presence of cyanide ions, p-nitrobenzaldehyde ( p-NBA), and hemin. This phenomenon was used for developing a procedure for the quantitative chemiluminescence determination of cyanide ions. EXPERIMENTAL Reagents.Chemically pure 3-aminophthelic acid hydrazide (luminol) was purified by double recrystallization from conc. HCl (GOST 3118-67). p-Nitrobenzaldehyde (GOST 14049-68) was doubly recrystallized from 40% ethanol. Reagent-grade hemin (Biokhimreactiv), analytical-grade EDTA disodium salt dihydrate (GOST 10652-63), ethanol (TU 19 P-39-69) purified by distillation, analytical-grade KOH (GOST 4203-65), and analytical-grade KCN (MRTU 6-09-3799-67) containing 98.9% KCN were used. Water was doubly distilled in a Pyrex distillation unit. Apparatus. The integral luminescence intensity of luminol in a solution was recorded on a Lik chemiluminescence analyzer for liquids (certificate no. 14437/270303, State Register no. 24512-03). A portable version of the analyzer with 220-V line supply and Lenpipetten DP-1 (200 µ L) and Justor 1100 (200-1000 µ L) Nichiryo samplers was used. Procedure for determining cyanide ions. Reagent solutions. To prepare a mixed luminol reagent, 0.1 g of luminol, 0.5 g of EDTA disodium salt (to mask transition metal ions), and 20 mL of ethanol were dissolved in 1.0 L of a 0.1 M aqueous solution of KOH. An ethanolic solution of p-NBA (10 mg/mL), a 0.01 M KOH solution, and a hemin solution (0.025 mg/mL) in 0.01 M KOH were used. A standard solution scale in the range from 10 -2 to 10 -7 mg/mL CN -was prepared from a solution of KCN (0.1 mg/mL CN -) in 0.01 M KOH using successive dilutions.Determination of cyanide ions in the range from 5 ¥ 10 -3 to 5 ¥ 10 -5 mg/mL. The luminol reagent (0.2 mL), 0.1 mL of a p-NBA solution, and 0.1 mL of a hemin solution were successively placed in the cell of the Lik analyzer. The microammeter readings corresponding to background luminescence due to the addition of hemin were compensated with an adjustable resistor. A sample solution (0.1 mL) was introduced, and a stopwatch was started simultaneously. The chemiluminescence intensity was recorded after 60 s. Blank experiments were conducted, in which 0.1 mL of 0....

Введение. Несмотря на несомненные успехи в лечении пациентов с ишемической болезнью сердца (ИБС), пока не удается добиться существенного снижения смертности при данном заболевании. Учитывая это, в настоящий момент повсеместно ведутся работы в отношении исследования новых методик с целью увеличить эффективность уже существующих стандартов. Одной из таких перспективных методик является клеточная/регенеративная терапия аутологичными мононуклеарами костного мозга (АМНКМ). Однако несмотря на то что АМНКМ исследуются на протяжении более 10 лет, к настоящему моменту не получено однозначных данных по ряду вопросов. Цель. Провести оценку результатов трансплантации АМНКМ при выполнении операции аортокоронарного шунтирования (АКШ) в комбинированном лечении ИБС. Материалы и методы. Проанализированны данные 408 пациентов, поступивших в клинику с 2013-го по 2016 г. для планового хирургического лечения ИБС. В работу включено 117 человек согласно дизайну исследования. Проведена рандомизация в 3 группы: группа 0-операция АКШ и интрамиокардиальное введение 0,9% раствора NaCl-контрольная группа, группа 1-операция АКШ и интрамиокардиальное введение АМНКМ, группа 2-операция АКШ, интрамиокардиальное и внутришунтовое введение АМНКМ. Через 12 месяцев выполнена оценка динамики-функционального класса стенокардии напряжения и сердечной недостаточности, ЭхоКГ, speckle tracking (оценка степени деформации миокарда), тредмил-теста, теста с 6-минутной ходьбой, суточного мониторирования ЭКГ, опросников качества жизни, коронарографии. Качественные показатели рассчитаны при помощи критериев Пирсона (χ 2) и Фишера. Количественные показатели-критерии Краскела-Уоллиса и Вилкоксона. Для выявления определенных факторов тяжести и исследования однородности данных-факторный анализ. Для исследования ведущих характеристик, определяющих дифференцировку между группами, проведен дискриминантный анализ. Для анализа дисперсии с учетом различных факторов использовали модель дисперсионного анализа для зависимых выборок-Repeated Measures ANOVA. Результаты. В группах наблюдения повсеместно отмечено улучшение как систолической, так и диастолической функции миокарда. Тест с 6-минутной ходьбой показал статистически значимый прирост в группах 1 и 2 по сравнению с контролем:

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In 2017, the European Society of Cardiology outlined the importance of the problem of diagnosing myocardial ischemia-reperfusion injury following coronary artery bypass grafting. Myocardial injury can be accompanied by a critical decline in the cardiac index and an increase in cardiac troponin I plasma levels. The prognostic value troponin I elevation after coronary artery bypass grafting is poorly understood. Objective: to determine the prognostic value of troponin I plasma levels in relation to a fall in the cardiac index after coronary artery bypass grafting (CABG). Task: To determine the probability the cardiac index falling below 2.2 for troponin I levels in the first hours, and on days 1, 2, 3, 4 after CABG. Materials and methods. The single-center, non-randomized prospective study, running from 2016 to 2019, included 336 patients admitted for elective surgical treatment of coronary artery disease. The CABG patients were divided into three observation groups: off-pump (n = 175), on-pump (n = 128), and pump-assisted (n = 33). Troponin I levels were measured in the first hours, and on days 1, 2, 3, 4 after surgery using the Pathfast Compact immunoassay analyzer. Cardiac index was measured by invasive method. Results. In patients with a cardiac index higher than 2.2, troponin I level did not exceed 0.5 ng/mL in the off-pump group, 6 ng/mL in the on-pump group, and 3.5 ng/mL in the pump-assisted group. Patients with cardiac index lower than 2.2 have comparable troponin I levels in all groups - 21 ng/mL. Troponin I thresholds on day 1 after surgery, which, when exceeded, was associated with the likelihood of the cardiac index falling below 2.2, was 3.78 ng/mL in the off-pump group, 9.67 ng/mL in the on-pump group and 17.06 ng/mL in the pump-assisted group. Conclusion. After off-pump CABG, clinically significant myocardial injury should be expected at lower troponin I levels (3.78 ng/mL) than after on-pump CABG (9.67 ng/mL) and pump-assisted CABG (14.7 ng/mL).