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Open Access
MOUSE CYTOKINE-INDUCED KILLER CELLS DEVELOPED FROM DIFFERENT SOURCES
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Issabekova, A.; Zhunussova, M.; Zhumabekova, M.; Ogay, V.
Introduction: In Kazakhstan, death from colorectal cancer is on the leading position among cancer-related deaths in the population, and since 2013 colorectal cancer is one of the three cancer diseases subject to the National Screening Program. The treatment protocol used for colorectal cancer therapy with metastases has very low efficacy. Another strategy in cancer therapy is immunotherapy with cytokine-induced killer cells (CIK cells). Human CIK cells are isolated from peripheral blood mononuclear cell fraction using IFN-γ, IL-2cytokine and anti-CD3 monoclonal antibodies. As a result, a heterogenous population which consists mainly of CD3+CD56-, CD3+CD56+ cells and of a small population of CD3-CD56+cells is obtained. Among the killer cells obtained, CD3+CD56+ have the greatest cytotoxic activity. For developed preclinical studies of CIK cells in murine model we search the best source of CIK cells within spleen, lymph nodes, bone marrow. Methods: CIK cells will be proliferated from mouse spleen, lymph nodes, bone marrow cells. Spleen, lymph nodes, bone marrow cells without monocytes and erythrocytes expanded with IFN-γ, IL-2cytokines and anti-CD3 monoclonal antibodies for 14 days. Positive selection of CIK cells against NK1.1and DX5 will be performed on immune beads (Miltenyi biotech). Results: CIK cells are characterized by both MHC-restricted and MHC-unrestricted anti-tumor cytotoxicity against a broad range of cancer cells. Mouse CIK cells have distinct phenotype from human CIK cells. NK1.1and DX5 are murine natural killer markers. According to literature data after culturing spleen cells for 21day NK1.1+ and DX5+ of TCRαβ+ CD3+ CD8+ T cells have the greatest cytotoxicity. We evaluated NK1.1+ and DX5+ cells after culturing cells isolated from spleen, lymph nodes and bone marrow for 14 days. NK1.1positive cells were 53,3% and DX5+ were 5% from bone marrow cells, but bone marrow cells showed low amounts of expanded cells. 21,8% of spleen cells showed NK1.1+ phenotype, 20% of DX5 (CD49b). Lymph nodes gave rise to 12,3% NK1.1+ cells. According to proliferation potential and portion of NK1.1+ and DX5+, spleen and lymph nodes are prospective sources of CIK cells. Conclusion: Spleen and lymph node cells may be sources for expansion of mouse CIK cells.
Open Access
HEREDITARY DISEASES AND CONGENITAL MALFORMATIONS REGISTRATION AND MONITORING INFORMATION SYSTEM
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Nazarova, L.; Tolegen, N.; Bayanova, M.
Introduction. Database on hereditary diseases is one of the main tasks of healthcare. Register of hereditary pathology allows to assess accurately the frequency of childbirths with various hereditary diseases and congenital malformations in the population. The purpose of this work is to present the frequency and structure of congenital and hereditary pathology based on the use of the original genetic database for monitoring of congenital malformations and hereditary diseases. Methods: Clinical-genealogical, cytogenetic, FISH method, molecular-genetic (MLPA, mass spectrometry and fluorimetry, Sanger sequencing, NGS), statistical. Results: Up to date, National Research Center for Maternal and Child Health’s genetic register database has registered 4564 patients and fetuses with congenital and hereditary pathologies. Congenital malformations prevail in the database with 2317 cases (50,8%), including congenital malfunctions of obligatory registration according to International Register (EUROCAT). Chromosomal pathology is identified in 1283 (28,1%) patients, monogenic – in 964 (21,1%) cases. In congenital malformations the largest proportion belongs to congenital malformations of blood circulation – 694 cases (29,9%), followed by congenital malformations of gastrointestinal tract – 304 cases (13,1%), multiple malformations – 275 cases (12,8%), congenital malformations of urinary system – 298 patients (12,8%), congenital malformations of nervous system – 217 cases (9,4%), congenital malformations of facial structures (187 patients, 8%) and of musculoskeletal system with 175 cases (7,5%). The most common of the chromosomal pathologies was registered Down syndrome with 616 cases (48,1%), Edwards syndrome – in 122(9,5%). Turner syndrome – in 101(7,9%) cases, Kleinfelter’s syndrome – in 66 (5,1%), Patau syndrome – in 30 (2,3%), other gender chromosome pathologies – 19 (1,5%), structural rearrangements – 329 (25,6%). Monogenic pathology was detected in 964 (21,1%) cases. Among monogenic pathology, the most common were osteogenesis imperfecta, chondrodystrophy, adrenogenital syndrome, congenital hypothyroidism, mucopolysaccharidosis, Prader-Willi syndrome. Conclusion: The formation of a database of congenital and hereditary pathologies with full coverage of all fetuses, newborns and children at an older age, a comprehensive examination of families and clarification of the diagnosis allows to establish the frequency, structure and dynamics of congenital malformations and hereditary pathology.
Open Access
THE ROLE OF THE STANDARD CYTOGENETIC STUDY OF BONE MARROW CELLS IN THE DIAGNOSIS OF ACUTE LYMPHOBLASTIC LEUKEMIA IN CHILDREN
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Zauatbayeva, G.; Tolegen, N.; Bayanova, M.
Introduction: Acute lymphoblastic leukemia is a disease of the hematopoietic system caused by a violation of certain functions of the bone marrow. The disease is characterized by excessive proliferation of white blood cells. Acute lymphocytic leukemia is one of the most common nosologies among pediatric oncology, which occupies 80% of the total number of available forms of leukemia. According to the clinical protocols (ALL IC-BFM 2009) for oncohematology, the standard cytogenetic study of metaphases in leukemic cells is one of the most important methods for diagnosing the most significant and common numerical and structural aberrations. Methods: The department of clinical and genetic diagnostics is accredited according to the ISO 15189-2012«Medical laboratories - Requirements for quality and competence» in this field of accreditation. The study involved 152children under the age of 18 with a diagnosis of acute lymphoblastic leukemia whose linearity was determined by cytological examination of the bone marrow and flow cytometry. Short-term cultivation of bone marrow cells in a medium with bovine serum and colcemide was performed using a standard method. Analysis of G-banding with a resolution of 550-bands was carried out using the Imager Z1(ZEISS) karyotyping system. Results: During the analysis of the obtained material 30 (20%) patients were found to have such aberrations as t(6;16)(q13;p13.1), t(8;21)(q21.3;q22), t(4;12)(p14;q13), t(1;11)(p36.1;q23), del(16)(p11), i(17) (q10), t(9;10)(q34;q22), der(9)(q32) and the presence of marker chromosomes. In the studied bone marrow cells, 16% of patients had a hypodiploid set of chromosomes (≤44) which gives a poor prognosis, since the survival rate of patients in this case is only 30%. However, 60% of patients had a hyperdiploid set (≥47) which according to some clinical data allows these cases to be attributed to a more favorable prognosis. 80% had a normal diploid set of chromosomes. Conclusions: Nowadays cytogenetic study of bone marrow cells in the diagnosis of acute lymphoblastic leukemia is one of the main and mandatory methods of biological characteristics of the disease that allows identifying chromosomal abnormalities that are of great importance to stratify the risks, treatment and prognosis of the disease.
Open Access
COMPARING SYMPTOMS OF KALACHI SLEEPING SYNDROME WITH KNOWN DISEASES AND CONDITIONS TO DETERMINE CLASSIFICATION OF CAUSAL AGENT. INCIDENCE DENSITY SAMPLING CALCULATIONS
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Zhalmagambetov, B.; Crape, Byron
Introduction. In 2011some of the residents of Kalachi were afflicted with a sudden acute syndrome, where they would abruptly fall into an immediate abnormal sleep. These episodes of losing consciousness could happen anywhere and anytime. By the end of 2015, news reports estimated than 1out of every 4 residents had developed this syndrome. Both children and adults were afflicted. Males and females were equally affected with no gender preference. The overall purpose of the study is to characterize signs and symptoms of the sleeping syndrome to confirm or reject the likely classification of causal agents, based on the various hypotheses. Those include viruses, fungi, bacteria, chemicals, radiation, mass sociogenic illness, and gases such as carbon monoxide and carbon dioxide intoxications. Second purpose will be to assess the risks of developing the syndrome 1st,2nd and 3rd times through incidence density sampling calculations. Methods: Analyses on comparisons and contrasts with signs and symptoms and frequencies of signs and symptoms of the Kalachi sleeping syndrome with those produced by various potential causal agents, as reported in the published scientific literature. The statistical package SPSS was utilized for data management and statistical applications. Analyses on the risks (overall hazard) of developing disease the first time versus the second or third time, to determine if the sleeping syndrome conveyed any “immunity”, utilized a probabilistic theoretical method sometimes utilized in survival analysis related to time to episode, called incidence density sampling. Results: Among the leading reported symptoms were spinning head, headache followed by fatique and memory loss, significantly less number of people reported fever. The probability of getting 1st episode equals to 0.2014 and 2nd episode equals to 0.3314. There is a statistically significant high chances to get 2nd episode if one already had a previous case (p=0.005). Finally, for the 3rd episode equals to 0.2615. Conclusion: Symptomatically and in line with the previous household investigation current hypothesis of incapacitant water transmission seems reasonable. Infectious nature of the cause is less likely due to absence of immunity after the first exposure as it is evidenced from density sampling calculations.
Open Access
DETERMINATION OF ANTIBACTERIAL SENSITIVITY OF BACTEROIDES FRAGILIS ISOLATED FROM INTRAABDOMINAL INFECTIONS
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Kozhakhmetova, S.; Zholdybayeva, E.; Atavliyeva, S.; Tarlykov, P.; Mukhtarova, K.; Syzdykov, T.; Khasenov, R.; Ramankulov, E.
Introduction: Modern intra-abdominal infections are characterized by rapidly growing antibiotic resistance. Gram-negative bacillus B.fragilis is one of the dominating anaerobic pathogens. Thus this research aims to study sensitivity of B.fragilis, isolated from patients’ peritoneal exudate , to antibacterial drugs. Methods: Clinical samples from 72patients from the surgical department of the City Hospital No. 1and the Multidisciplinary Regional Hospital No. 2(Nur-Sultan) from 2018 to 2019 were collected to form B.fragilis collection. All isolated bacteroid strains were identified using MALDI-TOF MS (with a score of ≥2) and via identification of a direct nucleotide sequence of the 16SrRNA gene fragment. Minimum inhibitory concentration (MIC) of antibiotics was determined using M.I.C. strips (Oxoid, England) with antibiotic concentration gradients plotted. Four antimicrobial agents were tested: ciprofloxacin, metronidazole, meropenem and clindamycin. Results: Overall, 9 strains of anaerobic bacteria B.fragilis were isolated from 72clinical samples of various intra-abdominal infections. It was found that in intraabdominal infections after B.fragilis extraction, often B. thetaiotaomicron, Parabacteroides distasonis, B. ovatus, less often B. clarus, Prevotella heparinolytica and B.salyersiae are extracted. After antibiotic sensitivity test of B. fragilis, it is found that most of the studied cultures (67%) are ciprofloxacin resistant and smaller part (14%) is resistant to metronidazole. 25% of the strains showed moderate sensitivity to meropenem, 33% to ciprofloxacin, 50% to clindamycin and 57% to metronidazole. 29% of the strains demonstrated high sensitivity to metronidazole and 50% to clindamycin. The highest sensitivity of B. fragilis (75%) was to meropenem (carbapenem) among all antimicrobial agents tested. Conclusions: Thus, obtained results help to elucidate inclusion of drugs that are the most active against the B.fragilis. Namely, inclusion of meropenem as monotherapy and metronidazole in combination with other antibiotics for the treatment of intra-abdominal infections.
Open Access
ETIOLOGICAL STRUCTURE OF ACUTE BRONCHIOLITIS IN YOUNG CHILDREN
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Turdalina, B.R.; Bayesheva, D.A.; Seydullaeva, A.Zh.; Omarova, A.K.; Esimkhanova, G.O.; Zhumabek, P.
Introduction: Bronchiolitis is most common in children under the age of 9 months in (90% of cases). Every year, 150 million cases of bronchiolitis are recorded in the world, 7-13% of which require inpatient treatment and 1-3% of hospitalization in the intensive care unit. We conducted a prospective study to analyze the etiological structure of acute bronchiolitis in young children. Methods: medical histories of 50 patients treated in the viral department with suspected acute bronchiolitis from the age of 1month to 1year for the period between September 2019 to December 2019 were analyzed. To determine the etiological structure, a PCR study of ARVI-screen FL was used on the basis of the clinical laboratory of Multidisciplinary City Children’s Hospital No. 3. Results: From 50 analyzed medical histories with the clinical criterion of acute bronchiolitis, but with a preliminary diagnosis of obstructive bronchitis, the subsequent diagnosis was confirmed as acute bronchiolitis in 42% of patients, 46% of obstructive bronchitis and 12% were confirmed as community-acquired pneumonia. 60% Of the analyzed patients were paratrophic by type of physique, which may serve as a factor affecting the preservation of prolonged bronchial obstructive syndrome in young children. The presence of shortness of breath is the main clinical symptom that determines the severity of the disease. In all analyzed patients bronchial obstructive syndrome (BOS) persisted for three days and only on the 4th day of hospitalization BOS was stopped in 84% of patients. In the remaining 16% of patients this syndrome persisted specifically in the second group of patients who were given a clinical diagnosis: Acute bronchiolitis. Using a PCR study of ARVI-screen FL, it was found that in the group of children with a clinical diagnosis of “Acute bronchiolitis”, in 64% of patients respiratory syncytial virus was found, and the virus was not isolated in 14% of patients, on third place was bocavirus (8 %). Conclusions: there is no preliminary diagnosis at the receiving ward level: Acute bronchiolitis. In the etiological structure of acute bronchiolitis the respiratory syncytial virus was dominant, which was confirmed in 64% of patients using PCR studies.
Open Access
ORIGINAL METHODOLOGY OF ANNULOPLASTY OF THE MITRAL VALVE WITH A STABILIZED AUTOPERICARDIUM IN DEGENERATIVE HEART DISEASES
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Zhurko, S.; Olzhayev, F.; Gamzaev, A.; Fedorov, S.; Pimenova, P.
Introduction: We have evaluated the results of using stabilized autopericardium for the correction of the mitral valve (MV) defects in patients with degenerative heart diseases. Methods: For the period from 2017-2019, MV plasty was performed in 51patients with a strip of autopericardium according to the original method. Among the patients who underwent surgery, men prevailed 64.7% (33). The average age is 55.6 (36 to 78) years. A strip 12x0.5mm in size was cut from the patient’s pericardium. Autopericardium stabilization was carried out by treatment with a 0.6% glutaraldehyde solution for 10 minutes. Processing of the autopericardium with glutaraldehyde allows preserving the positive properties of the autopericardium to eliminate the inconvenience of manipulating the autopericardial strip, increase its strength, reduce the cellular response from the body and prevent denaturation of the collagen fibers. Our proposed technique allows us to determine the optimal length of the strip, individually for each patient. Correction was considered adequate if, after surgery, regurgitation on MV did not exceed I degree. Results: No mortality was observed at the hospital stage. In one case, an early relapse of MV failure occurred, but the degree of mitral regurgitation did not exceed II degree and the patient was under observation. Conclusions: The use of a stabilized autopericardium as a material for the reconstruction of MV with an individual selection of the strip length allows increasing the strength of the fibrous ring and achieving optimal MV functioning and significantly improving tissue-specific biocompatibility of the autoimplant. The clinical results obtained using the original MV annuloplasty technique demonstrated high efficiency, low mortality and improved results of the correction of degenerative heart diseases and could be recommended for extensive clinical use in cardiac surgery.
Open Access
MULTIPLEX LIGATION-DEPENDENT PROBE AMPLIFICATION OF MICRODELETION SYNDROMS
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Uakhit, R.; Tolegen, N.; Bayanova, M.
Introduction: Microdeletion syndromes are an extensive group of diseases affecting various organs and systems. These diseases are caused by deletions of small sections of chromosomes. Previously, most microdeletion syndromes were described as pathologies of unknown origin and were not even associated with “chromosomal breakdowns”, since it was not possible to conduct subtle and accurate genetic diagnostics. Microdeletion and microduplication syndromes are defined as a group of clinically recognisable disorders characterised by a small (< 5 Mb) deletion or duplication of a chromosomal segment spanning multiple disease genes. Clinically well described syndromes, for which the involvement of multiple disease genes has been established or is strongly suspected, such as: 1p36 deletion syndrome, Wolf-Hirschhorn syndrome, Cri-du-Chat syndrome, Sotos syndrome, Saethre-Chotzen syndrome, Williams-Beuren syndrome, Williams-Beuren duplication syndrome, Langer-Giedion syndrome, WAGR syndrome, Prader-Willi syndrome, Angelman syndrome, Rubinstein-Taybi syndrome, Miller-Dieker syndrome, Lissencephaly-1, Smith-Magenis syndrome, Potocki-Lupski syndrome, Alagille syndrome, Di- George syndrome, 22q11.2microduplication syndrome, Phelan-McDermid syndrome. Methods: MLPA (Multiplex Ligation-dependent Probe Amplification) is the go-to technique for studying gene copy number variations (CNVs) associated with disease. The power of the technique lies in its versatility: MLPA can be used to detect copy number changes in anything from complete chromosomes to single exons. This SALSA MLPA probemix for detection microdeletion syndromes contains 52MLPA probes with amplification products between 130 and 483 nucleotides (nt). The probes detect sequences involved in a distinct subset of microdeletion and microduplication disorders. Results: At the clinical diagnostic laboratory, examined 57 children with suspected microdeletion syndrome. Among them, a heterozygous deletion was found of SNRPN-u5, SNRPN-CpGisl, UBE3A-10, UBE3A-1genes that corresponds to Prader-Willi/Angelman syndrome, heterozygous deletion ( DQ=0.5) CLTCL1-3, CDC45-1, GNB1L-8, DGCR8-2, ZNF74-2, MED15-10, SNAP29-3 genes (Di Georgia syndrome) and ELN-4, ELN-6, ELN-27 heterozygous deletion of Williams-Beuren syndrome. Conclusion: This diagnostic method allows you to detect microdeletions and microduplications, which are often not noticeable with standard cytogenetic analysis.
Open Access
СОЗДАНИЕ СИСТЕМЫ ОЦЕНКИ РИСКА ВЛИЯНИЯ ТЕХНОГЕННЫХ ФАКТОРОВ НА СОСТОЯНИЕ ЗДОРОВЬЯ МЕДИЦИНСКИХ РАБОТНИКОВ ЯДЕРНЫХ ЦЕНТРОВ РК И ВНЕДРЕНИЕ АЛГОРИТМА ПРОФИЛАКТИЧЕСКИХ МЕРОПРИЯТИЙ
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Абзалиева, Д.С.; Джаканова, М.Т.
Концепция ВОЗ о производственно-обусловленных болезнях открывает новые подходы для профилактики болезней трудоспособного возраста. В основе развития медицины труда, как системы в современном ее понимании, лежит теория оценки и управления профессиональными рисками, которая предполагает проведение анализа и оценки состояния здоровья работников в причинно-следственной связи с условиями труда, информирование о риске субъектов трудового права, контроль динамики показателей риска, а также проведение мероприятий по управлению профессиональными рисками. Стратегия развития отечественного здравоохранения на современном этапе предусматривает переход от системы, ориентированной на лечение заболеваний, к системе охраны здоровья граждан, основанной на приоритете здорового образа жизни и направлений, в первую очередь, на профилактику болезней. Создание системы предупреждения заболеваний и устранения факторов риска является важнейшей социально- экономической и медицинской задачей государства. В последнее десятилетие в РК развивается новая высокотехнологичная отрасль медицины- Ядерная медицина, данное направление включает в себя три траектории: производство радиофармпрепаратов, радионуклидная терапия и радиоизотопная диагностика. Соответственно, растет и необходимость в таких специалистах как: радиофармацевт, физик - ядерщик, радиохимик, врач радиоизотопной диагностики и медицинские сестры и др. С момента создания радиационно- опасных объектов в основном проводилась работа радиационно-гигиенического направления, с целью обеспечение безопасных уровней облучения для работников. В настоящее время, назрела задача оценки воздействия радиационного фактора в различных диапазонах доз на состояние здоровья персонала и населения. Одним из главных способов создания базы данных для радиационно-эпидемиологических исследований является формирование и поддержание автоматизированных регистров работников, занятых непосредственно с источниками ионизирующего излучения. К настоящему времени создан ряд масштабных регистров: Японии, США, Великобритании, Канады, России и некоторых других стран, однако отсутствует в Казахстане. Внедрение автоматизированной системы дозовой нагрузки с определением оценки радиационного риска для работников занятых непосредственно с источниками ионизирующего излучения в медицине, создаст условия для проведения ранней диагностики, профилактики и реабилитации профессионально-обусловленных заболеваний, связанных с радиационными факторами. Использование информационно-аналитических систем принятия решений при статистическом анализе данных медико-дозиметрических регистров будет служить в качестве информационного обеспечения при разработке программ социального развития и позволят повысить обоснованность мер, направленных на профилактику и снижение заболеваемости (с использованием моделей доказательной медицины).
Open Access
СОВРЕМЕННОЕ СОСТОЯНИЕ И ПЕРСПЕКТИВЫ РАЗВИТИЯ РФП В ИЯФ
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Гурин, А.Н.
Институт Ядерной Физики основной производитель изотопов медицинского назначения в Республике Казахстан, который является научной и производственной базой, осуществляющей полный жизненный цикл от разработки технологий получения и контроля качества новых радиофармпрепаратов (РФП) до серийного производства. Имеющиеся уникальные установки: реактор ВВР-К, изохронный циклотрон У-150 и циклотрон С30 позволяют нарабатывать все типы изотопов, а высококвалифицированный персонал обеспечивают бесперебойную работу. Производственная площадка НТЦ РПИ при ИЯФ сертифицирована по правилам GMP и производит такие РФП, как 18F-фтордезоксиглюкоза и Na99mTcO4 получаемый из 99Mo/99mTc гель-генератора, разработанного по собственной технологии. Разработаны и пройдены этапы доклинических и клинических испытаний таких препаратов как: о-131J-гиппурат, Na131I для диагностики и терапии, 153Sm-ЭДТМФ. Отработана технология производства наборов реагентов для генератора 99mTc таких, как ДТПА, МДФ и ФИТАТ. В настоящее время указанные препараты находятся на различных этапах регистрации. В НТЦ РПИ отрабатывается технология получения РФП 177Lu-DOTA-TATE для терапии нейроэндокринных заболеваний, 18F-холин и 18F-ФЛТ. Выполняется грант [No. AP05134384, 2018] МОН РК по разработке РФП для терапии трижды-негативного рака молочной железы на основе DOTA-ELA меченного изотопом 177Lu. Начаты работы по получению 18F-PSMA, 177Lu- DOTA-PSMA и 99mTc-PSMA.
Open Access
АКТУАЛЬНЫЕ ВОПРОСЫ РАЗВИТИЯ ЯДЕРНОЙ МЕДИЦИНЫ В КАЗАХСТАНЕ
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Джаканова, М.Т.
Ядерная медицина – это один из разделов клинической медицины, который использует для диагностики и лечения заболеваний радиофармацевтические лекарственные препараты, которые имеет в составе одно или несколько радионуклида, являясь одним из приоритетных направлений развития медицинской науки, а также методы ядерной медицины применяются в лучевой терапии. На сегодняшний день ядерная медицина развивается в трех основных направлениях: • радионуклидная диагностика (позитронно-эмиссионная томография (ПЭТ)); • лучевая терапия (прямое облучение раковой опухоли); • радионуклидная терапия (радиоактивный изотоп вводится в опухоль). Радиоактивные изотопы используются во всех трех направлениях. Точность исследований с помощью радиоактивных изотопов помогает выявлять рак на ранних стадиях, а также эффективно с ним бороться. При этом радиофармпрепараты обладают коротким и не слишком вредным для человека периодом полураспада (минимальный вред здоровью человека, и с максимальной пользой от лечения и диагностики). Ядерная медицина позволяет провести исследования всех органов человеческого тела, ее применяют в кардиологии, эндокринологии, пульмонологии и в других направлениях медицины. В Казахстане имеются все возможности для развития ядерной медицины. Пережив сложный переходной период, ядерная медицина нашей республики обретает тенденцию к восстановлению. Первый в Республике ПЭТ-центр открылся в 2010 году в нашем Республиканском диагностическом центре (РДЦ) в г. Астана. Центр имеет полный производственный цикл и на сегодняшний день оснащен с двумя ПЭТ/КТ-сканером и ОФЭКТ-сканером. Появление ПЭТ технологий позволило улучшить оказание современной конкурентоспособной медицинской помощи онкологическим больным. Для увеличения количества потребителей генератора и расширения применения в клинической медицине столь необходимого метода, как радионуклидная диагностика, следует открыть новые лаборатории радионуклидной диагностики. В современной радионуклидной диагностике новым качественным показателем является применение циклотронных очень короткоживущих радионуклидов (111In, 123I, 18F, 13N, 11С, 68Ga, 82Rb и др.), т.е. освоение ПЭТ-технологии. Современный ПЭТ-центр – сложный дорогостоя- щий комплекс, состоящий из медицинского циклотрона, радиохимической лаборатории и лабо- ратории радионуклидной диагностики. Развитие ПЭТ/КТ и связанных с ним технологий революционизирует диагностические исследования, однако существует необходимость в более эффективных стратегиях для радиофармацевтических продуктов (РП) по доступности. Это РФП, основанные на генераторных разработках, включая радионуклидную терапию, могут иметь существенные преимущества. Кроме того, необходимо развивать получение РФП, которые в большей степени отвечают местным клиническим потребностям и обеспечит доступ к клиникам только качественных, безопасных и эффективных радиофармацевтических препаратов. Сегодняшний день по всему миру быстро развиваются применение генераторных ПЭТ-препаратов и для диагностики, и для терапии как 68Ge/68Ga, 99Mo/99mTc, 225Ac/213Bi, 188W/188Re, 82Sr/82Rb. Для полноценного функционирования Ядерной медицины в Республике необходимо организовать центр радионуклидной терапии. Радионуклидная терапия обоснована на клеточном механизме злокачественного роста, обеспечивающая повреждения в метаболической активной фазе.
Open Access
РАДИОНУКЛИДНАЯ ДИАГНОСТИКА В КАРДИОЛОГИИ
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Дустов, А.
Мезенхимальные клетки CD133 были обогащены с использованием магнитного микробусиново- го антитела против CD133 из мононуклеарных клеток костного мозга (BMMNCs). Анализ с помощью проточной цитометрии и иммуноцитохимического анализа с использованием специфических ан- тител показал, что эти клетки по существу представляли собой 89 ± 4% CD133 + и 8 ± 5% CD34 +. CD133 + / CD34 + BMMNCs секретируют важные биоактивные белки, такие как кардиотрофин-1, ангиогенные и нейрогенные факторы, морфогенетические белки, а также провоспалительные и ремоделирующие факторы invitro.Однократные внутрикоронарные инфузии аутологичных BMMNCCD133 + / CD34 + являются эффективными и уменьшают размер инфаркта у пациентов, как анализируется сцинтиграфией миокарда Tc99mMIBI. Большинство пациентов проходили ле- чение через левую коронарную артерию. Через девять месяцев после клеточной терапии 5 из 8 пациентов продемонстрировали чистый положительный ответ на терапию в различных областях сердца. Поглощение изотопа Tc99 и ревитализация области сердца в инферосептальной области более выражены () по сравнению с областями апекса и переднеспинки после интракоронарного введения стволовых клеток. Клетки, выбранные здесь, обладают свойствами, необходимыми для их потенциального использования в клеточной терапии, и сцинтиграфия может без труда отсле- живать их возвращение. Предлагаемая здесь клеточная терапия является безопасной и должна осуществляться, как мы обнаружили, в сочетании с сцинтиграфическим наблюдением участков сердца, которые оптимально реагируют на инфузию аутологичных CDM1+ / CD34 + BMMNC.
Open Access
ПЭТ/КТ ДИАГНОСТИКА С РФП НА ОСНОВЕ ГЕНЕРАТОРА GA68
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Рыскулова, Г.О.; Джаканова, М.Т.
Введение. По данным ВОЗ, ежегодно диагноз «рак» ставят 14 млн человек в мире. К 2020 году прогнозируется, что количество больных увеличится до 19 млн. В Казахстане ежедневно выявляется 100 новых случаев онкологических заболеваний. Методы. Позитронно-эмиссионная томография, совмещенная с компьютерной томографи- ей (ПЭТ/КТ) – это один из современных методов молекулярной радионуклидной визуализации, позволяющий invivo оценить активность определенных метаболических процессов, наиболее точно определить распространенность опухоли. В 90% случаев ПЭТ/КТ исследования проводится с аналогом глюкозы ультракороткоживущим радиофармацевтическим препаратом (РФП) 18-фтордезоксиглюкоза – (18F-ФДГ). Однако не все злокачественные новообразования (далее- ЗНО) активно накапливают FDG (н/р, низкий или отсутствие захвата при высокодифференцированных аденокарциномах, почечноклеточном раке, нейроэндокринных опухолях, муцинозной карциноме и т.п.) Результаты. В Казахстане по данным 2016г. РПЖ прочно занял 4-ое место среди ЗНО у муж- чин и составил 9,4% в структуре онкозаболеваемости. ПЭТ/КТ диагностика с Ga68-ПСМА стал зо- лотым стандартом для диагностики рецидивирующего рака предстательной железы. У больных с умеренной и высокой агрессивностью РПЖ ПЭТ/КТ Ga68-ПСМА широко применяется для оценки распространенности заболевания, проводятся исследования в изучении роли ПЭТ/КТ Ga68-ПСМА в прицельной биопсии предстательной железы и возможности определения точной тактики ле- чения. ПЭТ/КТ Ga68-ПСМА широко используется в мониторинге всех методов лечения РПЖ. Были получены высокие диагностические показатели ПЭТ/КТ с генераторным радионуклидом Ga68, а также доказана способность выявлять мелкие метастатические очаги даже при низком уровне ПСА. Нейроэндокринные опухоли (НЭО) представляют собой гетерогенную группу новообразований, происходящих из нейроэндокринных клеток эмбриональной кишки, обладающих биологически активными свойствами. НЭО встречаются во всех органах, имеющих нейроэндокринные клетки. По данным SEER, 50% больных на момент установления диагноза уже имеют локорегиональные или отдаленные метастазы. Различают 6 подтипов соматостатиновых рецепторов: sst1, sst2A, sst2B, sst3, sst4, sst5. Именно это свойство клеток и было положено в основу визуализации карци- ноидов, а последствии и терапии НЭО с использованием РФП, меченные Ga68: Ga68-DOTA-TOC, Ga68-DOTA-ТАTE, Ga68-DOTA-NOC. Вывод. Современное развитие ядерной медицины характеризуется разработкой новых уни- кальных РФП, которые позволяют оценивать состояние различных органов и тканей организма на клеточном уровне. Мировое производство и потребление радиофармацевтических препара- тов растет ежегодно на 10-15 %. В этом направлении в Казахстане решением будет внедрение РФП на основе генератора Ga68 -DOTA в диагностике ЗНО на базе Республиканского диагностического центра г. Нур-Султан.
Open Access
APOPTOTIC EFFECT OF ELECTROMAGNETIC FIELD ON ASTROCYTES
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Begimbetova, Dinara; Baiskhanova, Dinara
Introduction: Over the past decade, the use of mobile phones in many countries of the world has increased by almost 100%, and this increase has raised concerns about possible risks to human health. In addition to the emission of mobile phones and, effects of base stations of mobile communication are also possible. Compared to other organs, the brain is subject to relatively high specific absorption rates due to the close proximity of the cell phone device to the user’s head. The data show that even ultra-low EMF is powerful enough to disrupt biological processes at the cellular level, but more research is needed in this direction to understand the basic mechanisms. Methods: The experiments used primary cortical astrocytes obtained using the standard procedure for stratification of cells from abortion material of laboratory rats Rattus Norvegicus. Portable Faraday cage with electromagnetic signals up to 6 GHz. EMFaraCage® (Standard EMFaraCage® RF Shielding Test Enclosure) was used with the EMF emitted by the antenna. Cells were exposed to EMFs with a power of 900 and 1800 MHz at time intervals of 10, 30, 60, minutes, and 24 and 48 hours. Early apoptosis levels using CellEvent ™ Caspase-3/7 Green Detection Reagent (Invitrogen) fluorescence reagents and Propidium Iodid Blue (Invitrogen) late apoptosis on a Cytation 5 multifunction cell imaging reader. Results: The experimental results showed a statistically insignificant increase in the frequency of early and late apoptosis when exposed to EMF with a power of 900 MHz at all time intervals. When exposed to an EMF with a frequency of 1800 MHz, the activation of Annexin Caspase 3/7 and propidium iodide was statistically insignificant in temporary exposures of 10, 30, 60, minutes, and 24 hours. An increase in the level of early apoptosis when exposed to EMF with a frequency of 1800 MHz for 48 hours was statistically significant (p ≤ 0.01). The level of late apoptosis (propidium iodide) of this exposure remained at the level of intact exposure. Thus, a significant negative effect of apoptosis was noted at its early stage with maximum exposure to EMF. To further study the mechanism of induction of apoptosis of EMF, the genotoxic effect of EMF will be investigated. Acknowledgements: This work was supported by grant to Dinara Begimbetova from MES RK grant AP05133910, “Bio-effects of Electromagnetic Radiation from Mobile Phones and Wi-Fi on DNA of brain cells”.
Open Access
ASSESSMENT OF PERSONNEL DOSE BURDEN AND QUALITY OF OPERATIONAL PARAMETERS OF X-RAY RADIOLOGICAL EQUIPMENT OF MEDICAL ORGANIZATIONS OF THE NUR-SULTAN CITY
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Bakhtin, M.M.; Kashkinbaev, Ye.T.; Aumalikova, M.N.; Ibrayeva, D.S.; Sharipov, M.K.; Kazymbet, P.K.
Introduction: The results of the assessment of the radiation situation of the workplace, the dose burden of medical personnel, as well as the results of monitoring the operational parameters of X-ray radiological units of medical organizations in Nur-Sultan city are presented. Methods: Personnel dosimetric control measured with TLD, monitoring of operational parameters of X-ray diagnostic equipment at the Piranha dosimeter. Results: The average annual effective dose for X-ray diagnostic department workers is 0.72mSv, for intervention department workers it is 1.27mSv, which in permissible level. At workplaces of the Department of Radiology and Nuclear Medicine, the dose rate of X-ray radiation varies from 0.01μSv/h to 0.04μSv/h. At the workplaces of the personnel of the catheterization department, the X-ray dose rate varies from 0.01μSv/h to 0.91μSv/h, which does not exceed the standard value. According to the results of monitoring operational parameters in 2radiographic and 3 fluoroscopic devices, deviations from the image quality standard were revealed. The difference between the edges of the light and radiation fields exceeded 1.5 to 2times the permissible value. The divergence of the edges of the light and radiation fields leads to irradiation of the undiagnosed zones of the body and neighboring internal organs. The deviation of the perpendicularity of the beam exceeded the permissible value of 1.5°. Deviation of the perpendicularity of the beam affects the incorrect diagnosis, as the displacement of organs. In the mammography apparatus, the difference between the edges of the light and radiation fields exceeded the permissible value by 3 times. During the research, traces of scratching the compression spoon were found in the images in the mammography apparatus of a pure phantom. When monitoring the compression force of compression of the mammography apparatus, the parameter maximum force of automatic compression exceeded the permissible value. Values of the parameters of the anode voltage, radiation yield and dose linearity as dose repeatability in radiographic, fluoroscopic, angiographic and mammographic devices in permissible value. Conclusion. The revealed deviations in the operational parameters of medical X-ray equipment indicates the need for periodic monitoring to identify technical malfunctions, as reduce the high dose burden for patients and medical personnel.
Open Access
STRONG RESONANCES AT HIGH EXCITATION ENERGY IN 17O+ALPHA RESONANCE SCATTERING BY TTIK APPROACH
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Nauruzbayev, D.K.; Goldberg, V.Z.; Nurmukhanbetova, A.K.; La Cognata, M.; Di Pietro, A.; Figuera, P.; Golovkov, M.S.; Cherubini, S.; Gulino, M.; Lamia, L.; Pizzone, R.G.; Spartà, R.; Tumino, A.; Serikov, A.; Gazeeva, E.M.
Recently, first measurements of 17O+alpha resonance scattering were performed in Astana [1]. These measurements revealed a very strong group of the states in the vicinity of a high energy limit of data [1]. These resonances could not be analyzed because they were too close to the edge of the spectrum. Therefore we performed new measurements at higher energy of 17O beam at 54.4 MeV using the TTIK method at the INFN-LNS tandem. An array of four single Si detectors of 500 μm thickness and one dE-E telescope of Si detectors (75 and 1080 μm) were placed at the back of two meter diameter chamber to detect light recoils at different angles including 0º (laboratory system) in steps of 5º. The dE-E telescope was needed to evaluate the contribution of protons to charge particle spectra. At present, the most interesting result of this work is an observation of very strong resonances at high excitation energies of 16 MeV. At this excitation energy the density of states in 21Ne is well over 100 levels per 1MeV. These resonances are also over 10 MeV above the neutron decay threshold. It is not evident, how to obtain additional information about these remarkable resonances. For instance, their observation is practically impossible in a simple 20Ne(n,p) reaction. The data are analyzed in the framework of R-matrix approach. a) b) Fig. 1. a) Excitation function for the 17O(α,α) 17O elastic scattering at 180° degree from INFN-LNS Tandem. b) dE-E spectrum of 17O+4He interaction. More specifically, we are the only group that is developing experimental methods to study resonance reactions in Kazakhstan. Various applications of the resonance nuclear reactions in elemental analysis, in the dating, nuclear medicine and attributing of art objects, in forensics are well known. It is naturally to expect that the developed experimental TTIK methods will be asked by Kazakhstan industry and life.
Open Access
THE STUDIES OF THE EFFECTS OF INTERNAL EXPOSURES BY RADIOACTIVE MICROPARTICLES
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Hoshi, Masaharu
Starting with the first Soviet nuclear test on August 29, 1949, 456 nuclear tests were repeated in the 40 years to October 19, 1989. As a result, it is estimated that at least hundreds of thousands of people are affected by radiation exposure. We at Hiroshima University have been studying radiation doses and the risks to radiation exposure in Hiroshima and Nagasaki, Chernobyl, Fukushima, and Semipalatinsk. In particular, the problem of Semipalatinsk has been studied since 1994 to the present. Recently, studies of exposed people in Hiroshima have revealed that the effects of internal exposure to radioactive dust contained in radioactive clouds are greater than the normally considered internal and external exposures. So, I started animal experiments to prove the effects using the reactor in Kazakhstan. There, we conducted animal experiments using manganese dioxide-56, which is small radioactive particles of 3 microns. As a result, it was found that the lungs of rats were 20 times more damaged than external exposure. We are currently preparing a new study for risk assessment of people living in the Semipalatinsk region. Also, such animal experiments are planned to perform together with the international groups of Kazakhstan, Russia, Germany, France, Japan and so on. The progress and current status of these studies is presented on the pages 70-72of the Science Impact article http://impact.pub/Impact2020-maydigitaledition/.
Open Access
RECENT PROGRESS IN TARGETED RADIOISOTOPE THERAPY (TRT) AT QST, JAPAN
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Higashi, Tatsuya
Targeted Radioisotope Therapy (TRT) is known as a radiotherapy using cytotoxic radioisotopes which are administered orally or intravenously in a patient and accumulate in a targeted organ or a tumor. Recently, QST started a joint clinical trial of our newly-developed TRT agent, Cu-64 ATSM , a radionuclide which emits β-rays, with National Cancer Center Hospital for the treatment of brain tumors. This is the first time in Japan to have a clinical study of Japan-made TRT agent. Although only beta emitters had been utilized, an alpha emitter, Radium-223 (Ra-223), was introduced in this field recently. The treatment number of Ra-223 therapy is increasing rapidly world-wide and also in Japan. Alpha emitters are known with its high LTE (linear transfer effect), high RBE (relative biological effect) and their short ray range in the body. Because of these characteristics, several alpha emitters are expected to be promising TRT agents. In this session, I would like to talk about Actinium-225 (Ac-225) and Astatine-211(At-211) and their radiolabeled agents. In Japan, several At-211radiolabeled agents have been developed and showed their strong therapeutic effects. In our QST, Ac-225 was synthesized by cyclotron for the first time in Japan, recently. In TRT, treatment eligibility can be confirmed through molecular imaging with diagnostic RI on the same (or similar) chemical structure of a radiopharmaceutical replacing therapeutic RI. “Theranostics” is a new term which means the combination of therapy and diagnosis and has become a new field of medicine. In QST, this “theranostics” research is also conducted actively. For the development of TRT, we have to overcome several technological barriers and social obstacles. We will show you some of our social activities.
Open Access
ВИТАМИН Д: ОТ МОЛЕКУЛЯРНЫХ ОСНОВ ДО КЛИНИЧЕСКОГО ПРИМЕНЕНИЯ В ПОДДЕРЖАНИИ АКТИВНОГО ДОЛГОЛЕТИЯ
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Вейцман, И.А.; Пергаева, Ю.С.; Андриенко, А.В.
Введение: продолжительность жизни человека неуклонно растет, но вместе с тем увеличиваются и количество age-ассоциированных состояний. Уровень витамина D в сыворотке имеет обратную корреляцию с выраженностью и частотой возраст-ассоциированных заболеваний. К группе риска по дефициту витамина D относятся пожилые люди, так как с возрастом продукция витамина D в коже под действием ультрафиолетового облучения снижается в 4 раза и на этом фоне отмечается снижение активности VDR- рецепторов. Дефицит витамина D у лиц пожилого возраста достигает 80 процентов. Методы: обзор литературных данных. Биотрансформация витамина D происходит в почках и печени, образуя 25-гидроксивитамин D3 (кальцидиол) и 1,25-дигидроксивитамин D3 (кальцитри- ол). Физиологические эффекты витамина D осуществляются посредством геномных и негеномных механизмов. Геномные механизмы опосредованы взаимодействиями рецептора витамина D (VDR) с геномной ДНК. К настоящему времени выявлены множественные биологические роли витамина D - поддержание стабильности генома (в том числе цикл деления клетки, ремонт ДНК, реструктурирование хромосом), поддержка процессов синтеза и деградации белков, иммунитета, энергетический метаболизм. К геномным ролям витамина D также относятся эффекты нейротрофических и ростовых факторов, регуляция свертывания крови и апоптоз. Имеется эпигенетический потенциал витамина D, осуществляющийся посредством нормализа- ции ацетилирования гистонов - специальных ДНК-стабилизирующих белков. В 2008 году ВОЗ опубликовала обзор на тему связи витамина D и раковых заболеваний. Hataikarnetal. показали прямую зависимость уровня витамина D с адипонектином и обратную с индексом массы тела у лиц с предиабетом. S. Pilz выявила обратную зависимость между уровнем 25 гидроксивитамина D и уровнем артериального давления. Копенгагенское семилетнее наблюдательное исследование выявило наличие обратной J-образной корреляции между уровнем смертности и низкими уров- нями витамина D. При дефиците витамина D риск снижения когнитивной функции и деменции повышается. Результаты и выводы: учитывая рост продолжительности жизни человека, актуальна концепция здорового долголетия - увеличение срока здоровой жизни с сохранением функциональных возможностей. Применение холекальциферола у пожилых людей безопасно и показано для первичной и вторичной профилактики age- ассоциированных состояний. Необходимо выделение пациентов с высоким риском, проведение исследований для подбора оптимального режима до- зирования для поддержания оптимальных значений 25 гидроксивитамина D в сыворотке крови на уровне 50-70 нг/мл.
Open Access
БАТЫС ҚАЗАҚСТАН АЙМАҒЫНДА ТҰРАТЫН ДЕНСАУЛЫҒЫМЕН ӘЛЕУМЕТТІК ЖАҒДАЙЫ БОЙЫНША БАЛАЛАРМЕН ЖАС ӨСПІРІМДЕРДІҢ ЖЫНЫСТЫҚ ЕРЕКШЕЛІКТЕРІ
(International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana, 2020) Доскабулова, Д.Т.; Изденова, Н.Р.
Кіріспе: Health Behavior in school-aged children (HBSC) - мектеп жасындағы балалар мен жасөспірім- дердің денсаулығына қатысты әлеуметтік жағдайын бағалау мақсатында жүргізілетін зерттеу. HBSC - 11,13,15 жас аралығындағы ер бала мен қыз балалардың денсаулығы мен мінез-құлық сипатын зерттейді, мектепте, отбасымен және достарымен ара қатынасын бағалауға бағытталған зерттеу болып табылады. Мақсаты – балалар мен жасөспірімдердің денсаулығына қатысты әлеуметтік жағдайын анықтауға жүргізілген анкеталық сауалнама нәтижелер көрсеткіштері бойынша жынысты қайырмашылық тарынанықтау. Материалдары: HBSC әдістемесін қолдану үшін ҚР ДСМ Қоғамдық Денсаулық сақтау Ұлттық орталығының келісімімен жүзеге асырылды. Зерттеу Батыс Қазақстанның Ақтөбе, Атырау, Ақтау және Орал қалаларының мектептерінде өткізілді және 5,7,9 сынып оқушылары алынды. Нәтижелері: Әлеуметтік контекст: Отбасы. Зерттеу нәтижелері бойынша: көптеген жасөспірімдерге әкелерімен салыстырғанда анасымен сөйлесу оңайырақ екені анықталды. Ал 15 жастағы ер балалардың 75% олардың әкелерімен сөйлесу оңай екенін айтады. Достары. Қыздардың 57% және ер балалардың 46% достарының қолдауын, достарымен күнделікті кездесулерді және күнделікті әлеуметтік желілерде отыратынын хабардар етеді. Мектеп. Мектепті ұнататындығын білдіретін балалардың үлесі өте төмен (орта есеппен 28% қыздар және 26% ер балалар), мектепке деген төмен көзқарастар жасына қарай жоғарылайды. Денсаулық көрсеткіштері. Өз денсаулығын қанағаттанарлықсыз немесе нашар деп санайтын балалар мен жасөспірімдердің үлесі төмен (қыздар 22% және ер балалар 12%). Дене салмағы. 11жастағы ер балаларда және 13 және 15 жастағы қыздарда көрсеткіштердің едәуір өсуі байқалады. Тамақтану. Қыздар таңертеңгілік тамақты ер балаларға қарағанда аз тұтынады. Алкогольсіз газдалған қант бар сусындардың күнделікті тұтыну деңгейі қыздарда (11% -дан 25% -ға дейін) және ер балаларда (13% -дан 26% -ға дейін) жоғарылаған. Дене белсенділігі. 13 және 15 жастағы қыздар компьютерде көп уақыт өткізеді, бұл әлеуметтік желілердегі достарымен белсенді қарым-қатынасқа немесе үй тапсырмасын мұқият орындауға байланысты болуы мүмкін. Қорытынды: Батыс Қазақстан аймақтары Ақтөбе, Атырау, Ақтау және Орал қалаларының мектеп оқушылары арасында жүргізілген HBSC зерттеу қорытындысы Жалпы алғанда, мектеп оқушыларының дене белсенділігінің деңгейі біртіндеп артып келеді. Сонымен қатар, алкогольсіз газдалған қант бар сусындарды жиі қолданады; қыздар ер балалармен салыстырғанда достарымен жиі араласуға әлеуметтік желілерді күнделікті қолданады және бұл көрсеткіштер жасына қарай жоғары.