No abstract

No abstract

ВСТУПСудинні ускладнення цукрового діабету (ЦД) 1-го типу у вигляді мікро-та макроангіопатій є найбільш значимими в структурі інваліди-зації та смертності хворих із цією патологією [1,2]. Ендотеліальна дисфункція -одна з найбільш показових ознак порушення функ-ціонального стану артеріальних судин, що характеризується неадекватною реакцією на вплив фізіологічних і фармакологічних регу-ляторів тонусу судин [3,4]. Незадовільний глікемічний контроль та тривалість ЦД 1-го типу вважаються основними факторами розвитку ендотеліальної дисфункції, що зу-мовлює формування пізніх ускладнень ЦД у вигляді діабетичної нефропатії, ретинопатії тощо [5]. Проте ступінь їх прогресування значно відрізняється у різних пацієнтів, що в літературі пов'язується із генетичною схильністю, а саме із певним набором алель-них варіантів -поліморфізмом поодиноких нуклеотидів (SNPs) [6,7]. Про можливе значення генетичних факторів у роз витку пізніх ускладнень ЦД 1-го типу свідчать наступні факти [8,9]: 1) значна індивідуальна варіабельність термінів де бю ту ускладнень та ступеня ураження орга нів -мішеней, що не завжди корелює із тривалістю захворювання та якістю компенсації порушень вуглеводного об-міну; 2) висока частота виявлення ускладнень, їх тяжкий перебіг та швидке прогресування в певних популяційних групах; 3) підвищений ризик тяжких ускладнень у хворих на ЦД 1-го типу, родичі яких також мають такі усклад-нення; 4) пік розвитку діабетичної нефропатії в межах 15-25 років тривалості захворювання

Objective: to analyze the outcomes of sphincter-sparing surgeries in patients with advanced distal rectal cancer depending on the therapy they receive.Materials and methods. This study included 289 patients with advanced (stage T3N0–2M0) distal rectal cancer who have undergone sphincter-sparing surgeries. Patients were divided into three groups according to their treatment scheme. In group 1, we used combination treatment that included a short course of neoadjuvant radiotherapy supplemented by 3 multidirectional radiomodifiers (local microwave hyperthermia, rectal administration of a biopolymer composition containing metronidazole, and chemotherapy with capecitabine). Patients in group 2 received combination treatment that included neoadjuvant radiotherapy alone. Treatment outcomes in patients receiving combination therapy was compared to those of patients with similar characteristics and location of rectal tumors who have undergone surgery alone in N. N. Blokhin National Medical Research Center of Oncology (group 3).Results. We observed a significant decrease in the incidence of locoregional cancer metastasis in patients from group 1 compared to those from groups 2 and 3 (0.8 % vs 7.9 % and 18.2 % respectively). Moreover, patients in group 1 demonstrated better relapse-free survival than participants in groups 2 and 3 (79.6 % vs 52.6 % and 51 % respectively). The new scheme of combination therapy developed by our team (used in group 1) did not increase the incidence of postoperative complications. The best local disease control in group 1 was achieved in patients with middle rectal cancer who have undergone sphincter-sparing surgeries: none of 81 patients developed relapses, whereas the relapse-free survival rate reached 83 % compared to 56.9 % in group 1 and 41.7 % in group 3.Conclusions. The new treatment scheme that includes neoadjuvant radiotherapy supplemented by 3 multidirectional radiomodifiers can be used as one of the options increasing efficacy of radiotherapy and, therefore, efficacy of combination treatment in patients with advanced rectal cancer who undergo sphincter-sparing surgeries.

Aim. To analyze studies focused on comparing laparoscopic and open simultaneous surgeries for synchronous metastases of colorectal cancer in the liver.Materials and methods. The electronic databases PubMed, Web of Science, Scopus, Embase, Cochrane Library were searched for the studies focused on the comparison of open and laparoscopic simultaneous surgeries for synchronous metastatic liver lesions, dated till October 20, 2020. Keywords: simultaneous resections, colorectal cancer, liver metastases, simultaneous laparoscopic.Results. Meta-analysis contains the results of 1211 simultaneous surgeries for simultaneous metastases of colorectal cancer in the liver: 450 laparoscopic and 761 open surgeries. Laparoscopic surgery was characterized with lower blood loss [weighted mean difference (WMD) = -131.77, 95% CI: -232.54 to -31.00, p = 0.01], a shorter postoperative hospitalization [WMD = -2.87, 95% CI: -3.41 to -2. 33, p < 0.00001], early first bowel movement [WMD = -0.99, 95% CI: -1.40 to -0.58, p < 0.0001], early initiation of enteral feeding [WMD = -1.20, 95% CI: -2.06 to -0.33, p = 0.007]), lower incidence of postoperative complications [OR = 0.60, 95% CI: 0.46–0.80, p = 0.0004]. A statistically significant advantage of laparoscopic access was established in overall [OR = 0.80, 95% CI: 0.64–0.99, p = 0.04] and recurrence-free survival [OR = 0.73, 95% CI: 0.60–0.89, p = 0.002].Conclusion. Perioperative and distant oncologic outcomes demonstrate safety and efficacy of laparoscopic simultaneous interventions for synchronous metastases of colorectal cancer in comparison with open interventions.

We studied the frequency distribution of dNA repairing genes allelic polymorphisms in the occupational group of asbestos-cement plants workers (n = 95). The aim of the work was to determine the probable molecular genetic markers of resistance to the development of bronchopulmonary pathology under the action of chrysotile-asbestos-containing dust. In 46 workers with chronic forms of bronchopulmonary pathology and 49 workers of the same professions without chronic diseases of the respiratory system, allelic polymorphisms XPd (rs13181, rs799793), ercc1 (rs11615), Xrcc3 (rs861539), Xrcc1 (rs25487), ATM (rs664677), Xrcc7 (rs7003908) and MLh1 (rs1799977) were determined using the real-time polymerase chain reaction.

Background. The search for molecular markers of colon diseases allowing highly specific and sensitive identification and differentiation of pathological processes is a clinically important problem. Expression levels of genes responsible for proliferation can reflect the changes in the affected tissues. The study objective is to perform comparative analysis of molecular and genetic markers of proliferative activity in benign and malignant neoplasms of the colon. Materials and methods. Analysis of the changes in proliferation markers (CCND1, с-MYC, Ki-67, HER2neu, TERT) in adenocarcinoma of the colon (n = 259), resection margin (about 15–20 cm from the tumor lesion) (n = 251), unchanged colon mucosa from healthy donors (n = 247), polyps (n = 28), unchanged colon mucosa intestinal polyposis (10–15 cm from the polyp) (n = 75) was performed using RT-PCR. Results and conclusion. It was shown that morphologically unchanged tissue of intestinal mucosa in malignant tumors has significant differences from normal tissue of healthy donors. Significant differences in the level of expression of genes responsible for the processes of proliferation, с-MYC, CCND1, TERT were found in benign hyperproliferative diseases (polyps). Moreover, these changes were specific to the type of pathological process, which allows us to consider these genes as the most promising candidates in the development of a differential method for diagnosing colon diseases.

No abstract