Rats with shock caused by mechanical injury or burn showed stereotypic and phasic variations of the absorptive capacity of hepatic reticuloendothelial system, plasma fibronectin content, and functional activity of peripheral blood neutrophils. The direction of alterations in these factors of nonspecific resistance pointed to a depression of the phagocytic system and correlated with the severity of the postinsult states.Key Words: shock; macrophages; neutrophils; fibronectin; phagocytosisThe phagocytic system plays an important role among the factors of nonspecific resistance which are largely responsible for adaptational changes occurring in the body after mechanical or thermal injury. There is convincing evidence that shock induces pronounced changes in the morphology and function of neutrophils and macrophages in some humoral factors. Special attention was focused on fibronectin (FN), a nonspecific opsonin of blood plasma [2,11,12,14,15]. Previously, we showed that the response to severe mechanical or thermal trauma involves a considerable decrease in plasma FN content and pronounced suppression the hepatic clearance provided by the reticuloendothelial system (RES), which is accompanied by destruction of stellate reticuloendothelial cells [9,10]. As we are aware, there is no literature data on the relationship between cellular and humoral factors of phagocytosis in shock. Thus, a question arises: how homeostasis is maintained after shock-producing injury? Therefore, we analyzed temporal changes in some factors of nonspecific resistance in animals after injury. MATERIALS AND METHODS Shock was induced in rats under light Hexenal anesthesia by the method of Cannon (traumatic shock)Department of Forensic Medicine, State Medical University, Kazan and the method of Kochetygov (burn shock). Plasma FN content was measured by enzyme immunoassay [3], gelatin-binding capacity of FN was determined as described [6], and the functional state of neutrophils was assessed by their phagocytic activity, phagocytic index, and their total and differential counts [1] 1-72 h after induction of shock. The absorptive capacity of hepatic RES was assessed by the clearance of gelatinized particles of casein ink [8] with determination of their elimination half-life and elimination rate constant. The results were statistically analyzed by parametric methods. RESULTSOur study confirmed that two types of reaction develop in response to a limited mechanical or thermal injury [9]. In 15-20% of rats, relatively mild shock and rapid stabilization of clinical and physiological parameters (type I reaction) were observed. Severe shock with increasing manifestations of multisystem insufficiency (type II) was observed in other rats, which had a low level of nonspecific defense.In rats with severe shock, the phagocytic function of hepatic RES was markedly suppressed. The blood clearance rate constant at the height of the torpid phase being only about 50% of the baseline value (Fig. 1). Blood content of immunoreactive and biologically active FN was redu...

Experiments on rats show a positive effect of prodigiosan phagocyte stimulation on humoral-cell interaction in the phagocytosis system in traumatic and burn shock accompanied by improvement of organism's resistance to extreme factors. Prodigiosan stimulation in the torpid phase against the background of altered phagocyte reactivity produced less pronounced and ambiguous effects.Key Words: shock; macrophages; neutrophils; fibronectin; phagocyte stimulation Our previous studies of the humoral and cellular components of phagocytosis at the early stages of traumatic and burn disease revealed complex structural and functional changes in stellate reticuloendotheliocytes (SRE), alveolar macrophages (AM), and neutrophils accompanied by shifts in the content of the nonspecific plasma opsonin fibronectin. It has been shown that macro-and microphage suppression against the background of hypofibronectinemia reflects the severity of postaggressive states and usually disappears in natural relieve of the shock [4][5][6]. These findings agree with the published data that organism's resistance to extreme factors strongly depends on the functional state of the phagocytosis system and plasma opsonizing activity [2,9,10,12,15]. In light of this, the search for new drugs that modulate phagocytic activity and improve nonspecific organism's resistance in shock is an important medical problem [4,8,11,13,14]. MATERIALS AND METHODSExperiments were carried out on albino rats. To stimulate phagocytes, 0.005% prodigiosan (bacterial polysaccharide) was injected intraperitoneally in a dose of 25 gg/100g body weight 24 h before mechanical or thermal trauma or at the peak of the torpid Department of Forensic Medicine, Kazan' State Medical University phase of traumatic or burn shock. Phagocytic capacity of the hepatic reticuloendothelial system was assessed by the clearance of gelatinized casein ink [3]. To this end, elimination half-time and elimination rate constant were calculated and SRE containing ink particles were counted a histological preparations. Total cytosis and cytogram of the bronchoalveolar lavage were determined, and dead cells were counted using the methylene blue exclusion test [3]. Functional state of AM and peripheral blood neutrophils was assessed using 24-h E. coil 065 culture. The parameters of phagocytosis, phagocytic index, and phagocytic number were determined with allowance for changes in total AM and neutrophil counts and shift in differential leukocyte count [7]. Oxygen-dependent metabolism was assessed by tetrazolium nitroblue (TNB) reduction in spontaneous (sTNB) and induced (iTNB) tests, coefficient of stimulation was also calculated. Plasma fibronectin was measured by enzyme-linked immunosorbent assay [1]. Samples for electron microscopy were prepared using routine techniques. The data were processed statistically using parametric ANOVA tests.

Kazan hosted the XXVII scientific-practical conference of forensic experts and criminalists of Tatarstan, dedicated to the 125th anniversary of the founding of the independent department of forensic medicine at Kazan Medical University. Opening the conference, Deputy Minister of Health of Tatarstan R.G. Yamaleev and Rector of the Medical Institute, Corresponding Member RAMS, prof. N.Kh. Amirov noted the increasing importance of expert research in improving the quality of medical and preventive care in solving crimes. In relation to the head of the Republican Bureau of Forensic Medical Examination of the Ministry of Health of the Republic of Tatarstan Yu.P. Kalinin, the main stages and prospects of the development of forensic medicine in Tatarstan were highlighted, and the speech of the head of the department, prof. G.M. Kharina was devoted to the history of the Kazan school of forensic doctors, its scientific directions and ways to improve teaching. Topical issues of licensing and accreditation of forensic medical institutions were discussed in the comprehensive service of the Chief Forensic Medical Expert of Russia Assoc. IN. Plaksin.

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When comparing the functional and morphological parameters of the liver in patients with chronic calculous cholecystitis in 64%, a discrepancy was found between the data of biochemical blood tests and the severity of diffuse organ damage. The results of morphometric analysis, indicating a change in the histophysiological parameters of the liver, also did not have the corresponding functional criteria. In order to improve the diagnosis and therapy of gallstone disease, it is recommended to supplement clinical and laboratory studies with an intravital morphological study of the liver.