Sibirskii nauchnyi meditsinskii zhurnal最新文献

{"title":"Assessment of the glutathione system and the biomolecules oxidation products contribution to the state of free radical homeostasis in women of two ethnic groups with insomnia","authors":"N. V. Semenova, A. S. Lesnaya, I. M. Madaeva, O. A. Nikitina, L. I. Kolesnikova","doi":"10.18699/ssmj20230509","DOIUrl":"https://doi.org/10.18699/ssmj20230509","url":null,"abstract":"Own and literature data showed a change in the free radical oxidation products and indicators of the glutathione system concentration in menopausal women with insomnia. The change in the studied parameters depended on the ethnicity of the patients. The aim of the study was to assess the informative value of these indicators and their contribution to the state of free radical homeostasis in menopausal women of Russian and Buryat ethnic groups with insomnia. Material and methods. The study involved women of the menopausal period of the Russian (n = 136) and Buryat ethnos (n = 94). The women underwent a general clinical examination and a questionnaire. Then they were divided into climacteric phases, control groups and groups with insomnia. Enzyme immunoassay, spectrophotometric and fluorometric methods of analysis were used to determine values of glutathione system and biomolecule oxidation products. The informative value of the studied indicators and their contribution to the state of free-radical homeostasis was assessed with the help of discriminant analysis. Results and discussion. The most informative indicators in the group of Russian women with insomnia in perimenopause were content of advanced glycation end products (AGEs), advanced oxidation protein products (AOPP), products of DNA oxidative modification, oxidized glutathione, glutathione reductase activity; in postmenopause – concentration of AOPP, products of DNA oxidative modification, and glutathione reductase activity. In Buryat perimenopausal women the most informative values were content of AGEs, of reduced and oxidized glutathione and their ratio, and in postmenopause – content of AGEs, of oxidized glutathione and glutathione reductase activity. Mathematical models have been developed that demonstrate the prevalence of the redox balance prooxidant component contribution in Russian ethnic group and the antioxidant component in Buryat ethnic group and allow characterizing patients with insomnia with high accuracy depending on the phase of menopause and ethnicity. Conclusions. In women of the Russian ethnic group with insomnia in the menopausal period, the greatest contribution to the state of free radical homeostasis is made by the products of oxidation of biomolecules, which characterizes the predominance of the processes of disadaptation. In women of the Buryat ethnic group, in response to insomnia in the climacteric period, the components of the glutathione system make the greatest contribution to the state of free radical homeostasis, which characterizes the activation of adaptive capabilities throughout the climacteric period.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":"226 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of an unfavorable course of COVID-19","authors":"V. Polyakov, Y. Nikolaev, Zh. A. Garina, I. Mitrofanov, E. Sevostyanova","doi":"10.18699/ssmj20230415","DOIUrl":"https://doi.org/10.18699/ssmj20230415","url":null,"abstract":"The aim of the study was to identify the features of the unfavorable clinical course of a new coronavirus infection.Material and methods. The analysis of clinical data, laboratory results and comorbidity of 168 patients with a confirmed diagnosis of a new coronavirus infection aged 65,0 [57,0; 74,0] years was carried out. Two groups of patients were distinguished – 126 persons with a moderate course and with clinical recovery in the outcome of the disease and 42 persons with a severe course and a fatal outcome of the disease. Transnosological polymorbidity was assessed by the average number of nosologies corresponding to the three-digit ICD-10 rubricification, transsystemic – by the number of affected systems. Hemogram parameters, blood content of C-reactive protein, creatinine, urea, glucose, prothrombin index, international normalized ratio, activated partial thromboplastin time, platelet count, D-dimer concentration were estimated.Results. In the group of patients with fatal outcomes, compared to patients with recovery, there were statistically significantly higher indices of transnosological and transsystemic polymorbidity (1.5 and 2 times, respectively), they were more likely to have ischaemic heart disease, myocardial infarction, transient ischemic attack in anamnesis, atrial fibrillation, chronic heart failure; blood concentration of C-reactive protein, fasting glucose, urea, D-dimer in the blood serum was higher, the number of thrombocytes was less.Conclusions. A high degree of transnosological and transsystemic polymorbidity, a history of myocardial infarction and transient ischemic attack, comorbid chronic heart failure, atrial fibrillation, an increase in D-dimer, CRP content, and a decrease in platelet number are predictors of severe course and the lethal outcome of COVID-19.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41854081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anomalies in the development of the tracheobronchial tree (clinical case)","authors":"E. Semichev, N. Medvedeva","doi":"10.18699/ssmj20230417","DOIUrl":"https://doi.org/10.18699/ssmj20230417","url":null,"abstract":"According to the International Classification of Diseases the trachebronchial tree (TBT) anomalies are grouped into class XVII “Congenital anomalies (malformations), deformities and chromosomal disorders” (Q30–Q34, namely Q32.1 – “Other malformations of the trachea”).This paper presents a clinical case of congenital anomaly of TBT. Patient M., 18 years old, diagnosis of ICD-10 J90 Pleural effusion, not classified elsewhere, was referred from the pulmonology department to perform bronchoscopy for differential diagnosis with pulmonary tuberculosis. When the device was passed through the trachea, in the lower third towards the right main bronchus, a diverticuloid protrusion of the tracheal wall with deformation of the cartilaginous ring was found.Results and discussions. After examination, the conclusion was formed: Anomaly in the development of the lower third of the trachea (reduced tracheal bronchus on the right). Anomalies in the development of TBT are an extremely rare pathology, the pathology we describe is called “tracheal bronchus”. The tracheal bronchus, the rarest malformation of TBT with a frequency of no more than 1–2 % of cases, is the result of dysontogenesis. It is usually located on the right side of the trachea and may end blindly in the form of a diverticulum. In our description, there is no other anomaly of the TBT, so it can be attributed to the supernumerary variant of the tracheal bronchus. When anomalies in the development of TBT are detected, it is necessary to carry out differential diagnostics with tracheal diverticula, in which only its membranous part suffers.Conclusions. The clinical case we are describing refers to a supernumerary variant of the tracheal bronchus and requires the additional use of high-tech verification methods. We do not exclude that the environmental factors in the city of Zheleznogorsk could be the cause of its development.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44444997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atomic force microscopy of erythrocytes of patients with different severity of pancreatitis","authors":"R. Pakhomova, L. V. Kochetova, G. N. Gulikian, A. P. Martseva, V. V. Kozlov","doi":"10.18699/ssmj20230416","DOIUrl":"https://doi.org/10.18699/ssmj20230416","url":null,"abstract":"Aim of the study was to prove the possibility of using red blood cell probe microscopy as a predictor of the development of pancreonecrosis.Material and methods. Atomic force microscopy was performed in 143 people (82 were male and 61 were female). The study was performed on an Integra Aura probe microscope (ZAO NT-MDT, Russia). Each erythrocyte was scanned for cell membrane and cell as a whole. A total of 940 red blood cells were examined. According to the severity of acute pancreatitis, patients are distributed in three groups. As a control group, 37 people without somatic pathology were examined. Diagnosis and treatment of patients was carried out in the public health institution “Design Bureau” Russian Railways-Medicine “Krasnoyarsk” from 2015–2019.Results. The study showed that the shape of erythrocyte does not depend on the severity of pancreatitis and does not change, however, structural changes of the membrane occur in the form of the formation of multiple erosions on its surface. The membrane is deformed, and its adhesion increases. These changes reduce the transport capacity of the blood, which, in our opinion, leads to an increase in the general intoxication of the body and to a deterioration in the condition of the patient.Conclusions. Apparently, pancreatic enzymes entering the free bloodstream in the first phase of pancreatitis cause not only oxidative stress, but also the reorganization and destruction of the erythrocyte membrane. The increase in membrane rigidity and deformation of the erythrocyte surface cytoskeleton against the background of increased adhesion seems to disrupt the gas transmission function of erythrocyte and microrheological properties of blood, which in turn disrupts the exchange of amino acids, lipids and detoxification capabilities of blood. The appearance of erythrocytes in the free bloodstream with the presence of erosion on the surface of the erythrocyte membrane can serve as a prediction of a non-favorable course of acute pancreatitis and a predictor of a possible transition of edema pancreatitis to pancreonecrosis.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44445816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of immunotropic activity of the valine-containing neuropeptide compound of the glyprolin series under “social” stress","authors":"A. Yasenyavskaya, A. Tsibizova, L. A. Andreeva, N. F. Myasoedo, M. Samotrueva","doi":"10.18699/ssmj20230411","DOIUrl":"https://doi.org/10.18699/ssmj20230411","url":null,"abstract":"Aim of the study was to investigate the immunotropic activity of neuropeptide compound Pro-Gly-Pro-Val under “social” stress.Material and methods. The study was conducted on nonlinear male rats (6 months old) under conditions of “social” stress, modeled by formation of submissive and aggressive types of animal behavior under conditions of constant sensory contact. The rats were divided into groups: Control I, animals housed alone in a cage and receiving water for injection in an equivalent volume; Control II, groups of stressed animals with aggressive and submissive types of behavior; III groups of stressed rats to which Pro-Gly-Pro-Val at a dose of 100 μg/kg/day; IV groups of stressed rats to which imunofan (Arg-Asp-Lys-Val-Tyr-Arg) at an average therapeutic dose of 0.7 μg/kg/day were administered intraperitoneally. The immunotropic properties of the neuropeptide compounds were evaluated according to the following indices: delayed-type hypersensitivity reaction index, direct hemagglutination reaction antibody titer and leukocytic formula values.Results. Injection of the tested compound Pro-Gly-Pro-Val under study leads to correction of the immune changes occurring against the background of “social” stress, namely, to an increase in the delayed-type hypersensitivity reaction index and the level of anti-erythrocytic antibodies, to an enhancement in the total leukocyte count and a restoration of the percentage ratio between the form elements of the leukocytic formula. Obtained results correlate with the results of studying the immunotropic action of the comparison preparation immunofan under the conditions of “social” stress.Conclusions. The results of the study of the immunotropic action of the neuropeptide compound Pro-Gly-Pro-Val under “social” stress indicate the presence of its immunocorrective activity, which is manifested by the restoration of indices of cellular and humoral reactions and white blood cells.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41322805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of polymorphism of innate immunity receptor genes in patients with coronary atherosclerosis and in a population sample from Novosibirsk","authors":"S. V. Mikhailova, D. Ivanoshchuk, P. S. Orlov, L. D. Latyntseva, E. Kashtanova, Y. Polonskaya, Y. Ragino, E. Shakhtshneider","doi":"10.18699/ssmj20230410","DOIUrl":"https://doi.org/10.18699/ssmj20230410","url":null,"abstract":"Understanding the molecular mechanisms of atherosclerotic vascular lesions formation is necessary both for assessing the risks of cardiovascular diseases and for finding approaches to their therapy. The task remains relevant, despite the large number of studies carried out, because there are differences in the factors of genetic predisposition to atherosclerosis and its complications between different ethno-territorial groups. The aim of this study was to search for genetic variants of pattern recognition receptors associated with lipid metabolism disorders that can lead to the development of coronary atherosclerosis (CA).Material and methods. Analysis of exons and adjacent splicing sites of pattern recognition receptors genes in patients with CA (30 men), and then genotyping of a population sample from Novosibirsk (n = 1441) by real-time PCR for selected rs113706342 of the TLR1 gene and analysis of associations of its carriage with lipid metabolism were performed.Results and discussion. The frequency of the minor allele rs113706342 C of the TLR1 gene in the sample of residents of Novosibirsk was 0.0114 ± 0.0062, the carriage of this variant was associated with an increased level of low-density lipoprotein cholesterol in both women and men (p = 0.009 and p = 0.019, respectively). Women carriers of the minor allele C for rs113706342 also had a statistically significant increase in total serum cholesterol (p = 0.013) compared with TT homozygotes. To test the role of this variant in the development of CA, genotyping of an extended sample of patients is required. In one of the patients with CA, a previously undescribed single nucleotide variant chr16:3614637 G/C was found, leading to the Leu101Val substitution in the NLRC3 gene; segregation analysis is required to assess its functional significance.Conclusions. The association of rs113706342 C of the TLR1 gene with lipid metabolism disorders in the Russian population is shown.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44868513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of minimally invasive technologies in the diagnosis and treatment of adhezive intestinal obstruction","authors":"I. A. Yusubov","doi":"10.18699/ssmj20230414","DOIUrl":"https://doi.org/10.18699/ssmj20230414","url":null,"abstract":"One of the serious intra-abdominal complications after surgery is intestinal obstruction of adhesion origin (IOAO). Mortality during postoperative intestinal obstruction is 16.2–52.5 %. Aim of the study – laparoscopic diagnosis of IOAO in the early postoperative period and optimization of adhesiolysis.Material and methods. In the early postoperative period 70 patients with IOAO of upper gastrointestinal tract were examined and treated; laparoscopic operation was performed to 46 patients (the main group), an open method (laparotomy) – to 24 patients (the control group).Results and discussion. It was revealed that upper-middle and lower-middle incision laparotomies are more likely to cause intestinal obstruction. The sensitivity of preoperative ultrasound diagnosis of movable visceroparietal adhesions of small intestinal loops is 94.6 %, and the sensitivity of laparoscopic diagnosis is 99.2 %. When using minimally invasive technology, the frequency of intraoperative (4 (8.7 %) and 8 (33.3 %), respectively, p < 0.05) and postoperative complications (5 (10.9 %) and 13 (54.1 %), p < 0.05), mortality (0 and 4 (16.6 %), p < 0.05) and length of stay in hospital (5.7 (3–8) and 14.3 (10–17) days, p < 0,05) was less compared to laparotomy.Conclusions. Using of laparoscopic adhesiolysis and anti-adhesion barrier is appropriate in patients with I-II grade adhesion process. In cases where technical difficulties arise during laparoscopic adhesiolysis, it is more pathogenetically justified to separate adhesions by passing through a mini-laparotomy incision. If this is not possible, it is advisable to perform complex anti-adhesion measures, including conversion to laparotomy and systemic enzymotherapy after adhesiolysis.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44003183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disorders of depressive nature in migrants of the Far North with metabolic syndrome and arterial hypertension","authors":"R. Yaskevich, E. Kasparov, N. Gogolashvili","doi":"10.18699/ssmj20230413","DOIUrl":"https://doi.org/10.18699/ssmj20230413","url":null,"abstract":"The available data convincingly show the presence of multiple pathophysiological links that explain the high probability of developing metabolic syndrome (MetS) in patients with affective disorders, and MetS itself has been proposed as a premorbid condition in patients with depression in cardiovascular diseases and type 2 diabetes mellitus. The aim of the study was to investigate the association of depressive disorders with MetS and its components in migrants of the Far North with arterial hypertension after moving to new climatic and geographical living conditions.Material and methods. 267 patients of both sexes with arterial hypertension who arrived from the regions of the Far North for permanent residence in Central Siberia were examined. MetS verification was carried out in accordance with the clinical recommendations of the All-Russian Scientific Society of Cardiology (2009). To identify and assess the severity of depressive disorders, the hospital scale of anxiety and depression HADS was used.Results and discussion. Among migrants of the Far North with hypertension symptoms of depression and depressive disorders of a clinically pronounced nature occurred more frequently (36.3 and 14.1 %, respectively) compared to persons permanently residing in Krasnoyarsk (21.4 and 6.1 %, respectively, p = 0.001 and p = 0.011). Former residents of the Far North with signs of depression were much more likely to have three- and four-component combinations of MetS. Migrants of the Far North with MetS suffering from depressive disorders are characterized by the highest frequency of the five-component cluster of MetS.Conclusions. Among migrants of the Far North with hypertension, the incidence of depression in general, and especially of a clinically pronounced nature, is significantly higher compared to patients permanently residing in Krasnoyarsk; when their depression level rises, three- and four-component MC combinations become more common. The results of the correlation analysis suggest the existence of relationships between the level of depression and lipid metabolism in migrants of the Far North.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42065071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superoxide dismutase and glutathione peroxidase content in children with type 1 diabetes mellitus","authors":"Yu. V. Bykov, V. A. Baturin","doi":"10.18699/ssmj20230412","DOIUrl":"https://doi.org/10.18699/ssmj20230412","url":null,"abstract":"Type 1 diabetes mellitus (T1D) is one of the most frequently diagnosed chronic diseases of childhood. Oxidative stress (OS) is considered as one of the possible mechanisms of its development and complications. The aim of the study was to analyze the content of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GP) in children and adolescents with adequately controlled T1D.Material and methods. A total of 58 children were examined, including 34 children with type 1 diabetes (study group) and 24 conditionally healthy children (control group). The content of glycated hemoglobin, blood plasma glucose per day, post-prandial glucose, total protein, creatinine and urea were determined by conventional methods, as well as the level of SOD and GP in the blood serum by ELISA.Results and discussion. A significant decrease in the content of both enzymes was found in type 1 DM patients compared to conditionally healthy children. In patients with the chronic form of the disease, SOD and GP level was significantly lower than in patients with incident T1D. An inverse correlation was revealed between the antioxidant enzymes level on the one hand and age, duration of the disease, and the number of episodes with a poor glucose history on the other hand. The decrease in SOD and GP concentration was associated with an increase in glycated hemoglobin and plasma glucose level over a 24-hour period in patients with chronic type SD 1. The decrease in SOD concentrations was associated with an increase in glycated hemoglobin in patients with T1D chronic type. The discovered abnormalities indicate that decreased antioxidant enzyme level represent a manifestation of OS in patients with adequately controlled type 1 DM.Conclusions. Content of antioxidant enzymes in children with T1D provides an important criterion for the assessment of OS manifestations in this disease.","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45817211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience in the development of a system for repeated prosthetic heart valves","authors":"E. Ovcharenko, K. Klyshnikov, A. Stasev, A. Evtushenko, I. Khalivopulo, D. V. Borisenko, T. Glushkova, A. Ivanova, I. V. Dvadtsatov, S. Krutitsky, Y. Kudryavtseva, O. Barbarash, L. Barbarash","doi":"10.18699/ssmj20230408","DOIUrl":"https://doi.org/10.18699/ssmj20230408","url":null,"abstract":"The failure of heart valve bioprostheses, requiring repeated intervention to replace them, is a serious drawback that narrows the scope of such devices. The present study demonstrates the experimental investigation of a medical device designed to partially solve the problem of repeated interventions on heart valves, primarily with an emphasis on reducing the duration and trauma of such procedures due to the sutureless balloon implantation method of the «valvein- valve» method.Material and methods. The paper presents a series of in silico, in vitro and in vivo experiments to evaluate various aspects of the device under development. Numerical modeling of the final shape setting to the supporting frame of the heart valve prosthesis to select the most promising concept for prototyping was carried out in the Abaqus/CAE (Dassault Systèmes, France) based on the finite element method. The selected optimal support frame model was prototyped in the form of a series of prosthesis samples of four standard sizes for hydrodynamic studies of quantitative characteristics in vitro. The study was carried out in the Vivitro Labs unit (Vivitro Labs, Canada), imitating the physiological mode of the heart, the prostheses were examined for the mitral position. The developed prototypes of the device were supplemented with related products, an implant holder and a balloon catheter, after which the proposed method of sutureless fixation was validated in an in vitro implantation procedure on a bovine heart model and a series of in vivo (n = 3) chronic experiments on animals.Results. In the course of numerical simulation, it was shown that in Model No. 3 of the supporting frame of the prosthesis, the smallest stresses occur – with an amplitude of up to 490 MPa. For other concepts (Models No. 1 and No. 2), this indicator was significantly higher, 543 and 514 MPa, respectively. Prototypes obtained on the basis of the selected shape of the support frame demonstrated satisfactory hydrodynamic characteristics: effective hole area 190-261 mm2, regurgitation volume 6–9 ml/cycle, average transprosthetic gradient 4.4–6.4 mmHg, depending on size. The study of the technology of sutureless balloon implantation in an in vitro model of the heart and the subsequent chronic experiment on sheep confirmed the main idea of the system – the possibility of a significant reduction in the duration of repeated prosthetics. It has been shown that the time of suture implantation of the “classic” frame prosthesis of the mitral valve is 23–29 minutes, with a total access time of 41–52 minutes. When implanting the experimental device, the sutureless prosthesis itself took 4–6 minutes, access time 24–29 minutes. At the same time, one-month results of an echocardiographic study of the operation of the prosthesis demonstrated satisfactory hemodynamics.Conclusions. This work demonstrates a consistent series of tests of the system being developed for repeated heart valve replacement, which substantiates som","PeriodicalId":33781,"journal":{"name":"Sibirskii nauchnyi meditsinskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44582169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}