Aim. To estimate the blood levels of primary, secondary, tertiary and unconjugated bile acids in patients with non-alcoholic fatty liver disease.Methods. The study included 74 patients with non-alcoholic fatty liver disease (males - 30, females - 44) and 51 healthy individuals (males - 14, females - 37). All patients underwent anthropometry and complete clinical, biochemical and instrumental examination (measuring the subcutaneous fat layer). 64 patients had hepatic steatosis, 10 - steatohepatitis. Serum levels of bile acids (primary: cholic, chenodeoxycholic; secondary: lithocholic, deoxycholic and tertiary: ursodeoxycholic) were measured by gas-liquid chromatography on «Chromos GC-1000» (Russia) scanner.Results. Unconjugated primary, secondary and tertiary bile acids were detected in the blood of healthy individuals and patients with non-alcoholic fatty liver disease. In healthy individuals, there were no gender differences found in the bile acids levels. Patients with non-alcoholic fatty liver disease had higher level of bile acids compared to healthy controls. There was a significant difference in the concentrations of secondary and tertiary bile acids in patients with hepatic steatosis and steatohepatitis.Conclusion. Blood bile acids levels were significantly higher in patients with non-alcoholic fatty liver disease than in healthy individuals. At steatohepatitis, females had higher levels of cholic, chenodeoxycholic and deoxycholic acids and lower levels of lithocholic and ursodeoxycholic acids compared to males. Significant difference in patients with hepatic steatosis and steatohepatitis was revealed only in levels of secondary and tertiary bile acids.
Background. Production of pro-inflammatory cytokines including interleukin 6 (IL-6) is activated in COVID-19. Using olokizumab which inhibits IL-6 production in treatment of COVID-19 is pathogenetically justified.The aim. To study in real clinical practice the efficacy and safety of using the IL-6inhibitor (olokizumab) in treatment of patients with confirmed COVID-19 pneumonia.Materials and methods. The first group included 41 hospitalized patients with confirmed COVID-19 pneumonia having complex therapy including olokizumab. The control group consisted of 66 patients with confirmed COVID-19 pneumonia who did not have therapy with IL-6 inhibitor. We analyzed clinical (volume of lung involvement, respiratory failure degree, body mass index) and laboratory data (levels of T-troponin, lactate, procalcitonin, natriuretic peptide, C-reactive protein, fibrinogen, D-dimer, ferritin, erythrocyte sedimentation rate, glomerular filtration rate).Results. The groups did not differ in gender, age, body mass index of patients, volume of lung tissue injury, and duration of hospitalization (p > 0.05). Respiratory failure of 2–3rd degree was more common in patients of the first group (χ2 = 6.3; p = 0.010). The initial levels of C-reactive protein (50.9 [34.2; 76.2] and 32.2 [9.9; 69.1] mg/L respectively; p = 0.009) and fibrinogen (6.0 [5.3; 6.7] and 5.2 [4.3; 6.2] g/l respectively; p = 0.005) in patients having therapy including olokizumab were significantly higher than in the control group. The levels of erythrocyte sedimentation rate, fibrinogen and ferritin, D-dimer, detected upon admission of patients to the hospital, didn’t have statistically significant differences. At discharge, the erythrocyte sedimentation rate in patients receiving olokizumab was statistically significantly lower (9.0 [5.5; 14.5] and 13.0 [7.0; 27.0] mm/h; p = 0.018).Conclusions. Using olokizumab in the treatment patient with COVID-19 pneumonia has demonstrated a positive effect on clinical and laboratory parameters (erythrocyte sedimentation rate, fibrinogen level) in patients with pronounced inflammatory changes and respiratory impairment.
The process of urbanisation has dramatically changed the cultural reality of the late 20th-early 21st centuries. A number of academic claims that cities (not states) play the most important role in it today. This article analyses the opportunities of using city space as an open educational space, the conditions determining the pedagogic impact of the urban environment on its inhabitants are also discovered. The experience of implementing participatory educational projects in Nizhniy Tagil, an industrial city in the Urals, is presented. Two cycles of historical quests are described. Both were initiated by the pedagogic university in order to enhance the historical memory of the city dwellers. The commemorative cycle includes the quests dedicated to the events of the Russian Civil War and the Great Patriotic War, as well as political reprisals. The second cycle, the Addresses of Child Creativity, presents the supplementary education system in our country. The authors come to the conclusion that a modern city can be seen as an open educational space, comprising various educational content in terms of its scope and quality. The open educational city space is used more intensively in bigger cities, where there are more informational, organisational, financial and other resources. The experience of Nizhniy Tagil shows that it is possible to enhance the open educational space in medium-sized and smaller cities through participatory commemorative projects. Historical quests in the city are a good example of such projects. Various historical institutions take part in developing these projects. Apart from the educational results, these quests help to shape the city's identity and to found social partnerships between cultural and educational institutions. The inclusion of monuments and memorial plates on the buildings into the quest itinerary allows attracting the attention of the city-dwellers to the problem of the preservation of cultural legacy.
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