Цель исследования: оценить липидный спектр мембран мононуклеаров периферической крови у больных туберкулезом легких до и после интенсивной фазы химиотерапии, в том числе под влиянием препарата глицирризиновой кислоты (ГК)� Материалы и методы. В исследовании приняли участие 384 больных туберкулезом легких обоих полов в возрасте от 25 до 60 лет: 308 пациентов получили интенсивную фазу химиотерапии по первому режиму, 76-интенсивную фазу химиотерапии по первому режиму и курс препарата ГК� В группу контроля включено 36 здоровых добровольцев в возрасте от 24 до 58 лет� Определяли липидный спектр мембран мононуклеаров, полученных из периферической крови пациентов� Фракционирование фосфолипидов на классы выполняли посредством проточной тонкослойной хроматографии� Изучали следующие фракции: суммарные лизофосфолипиды, сфингомиелин, фосфатидилинозитол, фосфатидилхолин, фосфатидилсерин, фосфатидилэтаноламин� Результаты. У больных туберкулезом легких до начала химиотерапии зафиксировано изменение соотношения основных классов фосфолипидов мембран мононуклеаров периферической крови по сравнению со здоровыми лицами� Химиотерапия приводила к накоплению мембранодеструктивных лизофосфолипидов при одновременном снижении уровня фосфатидилхолина� Применение препарата ГК у пациентов позволило уменьшить (p < 0,05) негативное влияние химиотерапии на липидные мембраны мононуклеаров и нормализовать соотношение основных фракций фосфолипидов мембран (p < 0,05)� При химиотерапии с курсом препарата ГК увеличилась с 61 до 73% (p < 0,05) частота абациллирования мокроты к 2-месячному сроку интенсивной фазы химиотерапии� Ключевые слова: липидный спектр мембран, мононуклеары, глицирризиновая кислота, туберкулез Для цитирования: Рясенский Д� С�, Асеев А� В�, Эльгали А� И� Влияние глицирризиновой кислоты на состояние мембранных структур мононуклеаров у больных туберкулезом легких на фоне противотуберкулезной химиотерапии // Туберкулёз и болезни лёгких�-2018�-Т� 96, № 10�-С� 35-40�

In 2018 key changes were made to the recommended treatment for multi-drug resistant tuberculosis, the priority of oral medications over injectables was indicated. For the first time in history, a new, completely oral 20-month treatment regimen was proposed. The regimen recommends bedaquiline and linezolid together with levofloxacin / moxifloxacin, cycloserine / clofazimine. This treatment regimen differs from the standard 4 MDR-TB chemotherapy regimens adopted in Russia. Until recently, bedaquiline and linezolid were relatively unobtainable in the conditions of tuberculosis dispensaries, patients who needed such treatment were referred to specialized Federal tuberculosis facilities. The aim of the study was to study the long-term results of treatment of patients with drug-resistant pulmonary tuberculosis in cases of the ineffectiveness of previous therapy in an antituberculosis dispensary and referral to a specialized Federal tuberculosis institution. In 2010-2014, 143 people of both sexes in the age group from 20 to 60 years old were treated in the Tver Regional Clinical Antituberculosis Dispensary. Individual conversations, organizing communication with other patients who received effective anti-tuberculosis treatment, watching the training video “Tuberculosis: Questions and Answers”, studying the materials of the brochure “School of the Patient. A brochure for patients suffering from tuberculosis” developed by the charitable organization “Partners in the name of health” was used in the process of increasing adherence to treatment. When carrying out measures to increase adherence to treatment among patients with pulmonary tuberculosis, a positive result was obtained in 143 people. These patients agreed to possible surgical intervention in the Federal Tuberculosis Institution. Immediately after the surgical stage of treatment, cavity closure and/or abacillation were achieved in 132 (92.3%) people. In the postoperative period anti-tuberculosis therapy was continued in accordance with the drug-resistant pathogen, the discipline of patients in receiving anti-tuberculosis drugs increased significantly.

Introduction. Surgery remains the main method of treatment for breast cancer patients. However, in surgery a large number of lymphatic vessels are crossed which inevitably leads to a lymph flow damage. The article discusses the problem of lymphorrhea in breast cancer patients after the radical mastectomy and radical resection. The aim of the study was to assess the effectiveness of minor pectoral myoplasty in the axillary region of the "dead space" for lymphorrhea prevention after radical mastectomy and radical resection.Methods. The case group included 30 patients who underwent 30 surgeries with myoplasty of pectoralis minor (Maddens radical mastectomy or radial resection) in the Tver Oncological Center at the Department of breast pathology from 2016 to 2017. The control group included 30 patients who underwent Maddens mastectomy or radical resection without myoplasty (conventional option).Results. In the case group, during the mastectomy, the patients with lymphorrhea had the drainage removed on the 5,31,2 day. The total amount of the drainage was around 235,43,6 ml. The average daily volume of the drained liquid was 47,12,7 ml. In the control group, during the radical mastectomy without myoplasty, the drainage was removed on the 12,71,4 day. The average total amount of the drained liquid was 1691,632,5 ml. The average daily drained volume was 130,32,5 ml.The patients after radical resection in the case group had the drainage removed on the 5,21,2 day. The total amount of the drained liquid in patients with lymphorrhea was 25 ml/day. The total amount of the drained liquid was 223,711,3 ml. The average daily drained volume was 44,62,3 ml. The patients after radical resection in the control group had the drainage removed on the 11,22,0 day. The average total volume of the drained liquid was 835,526,4 ml. The average daily drained volume was 69,92,2 ml.Conclusion. Application of A. Kh. Ismagilov intraoperative technique dead space closure in minor pectoral myoplasty (patent No. 2385673, issued April 10, 2010) with the simultaneous application of compression garments appears to be a simple and effective method for reducing postoperative lymphorrhea. Myoplasty was effective in reducing lymphorrhea regardless of the type of surgical intervention (radical mastectomy or radical resection). Lymphorrhea duration reduced in more than 2 times.

Introduction: Breast cancer (BC) is the leading pathology in the mortality structure of the female population in the world, reduces the quality of life (QOL), affecting all aspects of life. Objective: To study the features of the QOL associated with health, the level of reflexivity and existence women with BC. Materials and Methods: On the basis of TSMU a study of patients with BC who are being treated in the Tver Regional Clinical Oncology Center. The sample included 138 patients aged 30 to 80 years old with a confirmed diagnosis of BC of stages IA – IIIC, who underwent complex treatment. The volume of surgical treatment was not considered. We used the methods of SF-36, existential scaling A. Lange and K. Orgler, reflexivity questionnaires A. Karpov. The reliability of the results is provided by SPSS Statistics 22. Results and Discussion: The QOL associated with health patients with BC is formed by indicators of physical functioning (63.3 ± 23.0), role functioning (26.9 ± 36.9) and pain intensity (20, 4 ± 22.2), general health (60.9 ± 14.0), vitality (60 ± 13.1), social functioning (50.5 ± 26.5), emotional functioning (43.4 ± 39, 9) and self-esteem of mental health (56.5 ± 14.4). A study of the level of reflexivity showed that 25% have low rates and average - 75%. Patients with a high level were not identified. The study of existence showed that self-distance (33.5 ± 7.9) has a high degree of severity in 38%, low - in 17%. Self-transcendence (65.1 ± 13.1) in a high degree of severity in 53%, low - in 6%. Freedom (39.1 ± 6.9) has a high level in 8%, low - in 15%. Responsibility (53.6 ± 14.7) in a high level was recorded in 26%, low - in 7%. Conclusions: Patients with BC rate their own overall health, vitality, social functioning, and psychological health quite low. Such QOL indicators as physical, role and emotional functioning have an average level of ratings. Respondents highly rate their own experience of pain. Patients suffer physical and mental health components, which significantly increases the risk of complications in the postoperative period.