Bulletin of RSMU

ISSN Print 2500–1094 ISSN Online 2542–1204

Bulletin of RSMU

BIOMEDICAL JOURNAL OF PIROGOV UNIVERSITY (MOSCOW, RUSSIA)

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Issue 4, 2026

Topic PRP for injuries

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Issue 5, 2025

Topic Age-related alterations in the immune system

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Issue 6, 2025

Topic Anxiety and depressive disorders

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Issue 1, 2026

Topic Miscarriage

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Issue 2, 2026

Topic Postmenopause

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Issue 3, 2026

Topic Meckel's diverticulum

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New articles

Abdulrazzaq S

Acinetobacter baumannii is a high priority pathogen, rapidly acquiring multidrug resistance. Limited temporal resolution at the proteomic and transcriptomic levels has constrained our understanding of real-time resistance acquisition, thus hindering the development of strategies to combat resistance. The study aimed to unveil the resistance acquisition processes. A total of 45 clinical A. baumannii strains from three geographic locations were exposed to sub-inhibitory levels of carbapenem, aminoglycoside and β-lactam antibiotics for 72 hours. Kinetic resistance acquisition was simultaneously monitored by Western blot for expression of resistance proteins (β-lactamases, efflux pumps, porins) and quantitative PCR (qPCR) for mRNA using custom TaqMan probes with highest temporal resolution (13 timepoints at 6h intervals). Western blot analyses identified novel biphasic induction of resistance proteins: early phase (0–18h) with 3.4-fold induction of OXA-23, and late phase (24–72h) with 7.8-fold induction of NDM-1. qPCR results found mRNA levels reached their peak 4–8 hours prior to peak protein expression, suggesting robust post-transcriptional regulation. New discovery: AdeB efflux pump protein showed 12.6-fold increase with only 2.1-fold mRNA increase, suggesting extreme translational amplification with protein/mRNA ratio of 6.1. Machine learning algorithm categorized response into three distinct patterns with profound clinical implications: early responders (89% treatment failure); late responders (45% failure); constitutive expressors (67% failure). Thus, integrative analyses identified novel temporal dynamics of resistance development, key 4–8 hour windows for intervention before resistance is irreversible. Post-transcriptional regulation is much more important than previously thought, and may be exploited for the development of new combination therapies and individualised anti-microbial therapies.

Received: 2026-07-31

Published online: 2026-10-31

DOI:

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VIEWS 123

Ershov DS, Egiazaryan KA

PemAvascular necrosis (AVN) of the humeral head worsens the outcomes of treatment of proximal humeral fractures. This study aimed to evaluate the frequency of AVN in patients with three- and four-part fractures of the proximal humerus and to improve treatment outcomes using a new reduction technique. By design, this work was a retrospective–prospective cohort study. We recruited 357 patients with three- and four-part fractures of the proximal humerus. In the main group, 200 patients (147 women [73.5%] and 53 men [26.5%]) underwent surgery with a condylus–plate system (RF patent No. 2705234). In the comparison group, 157 patients (120 women [76.4%] and 37 men [23.6%]) had surgery that relied on conventional techniques. At two years, 329 patients were available for follow-up. The designed reduction technique reduced the incidence of Cruess stage II–IV AVN from 28.8% to 17.3% (p = 0.015). The risk of AVN increased with age, diabetes mellitus, osteoporosis, and multimorbidity.

Received: 2026-10-21

Published online: 2026-10-31

DOI: 10.24075/brsmu.2026.066

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VIEWS 162

Shpilevaya MV, Arbuzova NV, Khodak YuA, Vorobiev II, Nosov NYu

Pemphigus vulgaris is a severe autoimmune disorder resulting from production of anti-desmoglein 3 (Dsg3) antibodies. An accessible standardized antigenic component, the recombinant Dsg3 extracellular component, is necessary to develop domestic diagnostic ELISA kits. The retrospective experimental study aimed to produce a recombinant Dsg3 ectodomain (ЕС1-ЕС5 domain) in the heterologous expression system and assess its immunoreactivity with autoantibodies of patients having pemphigus vulgaris when used as a target antigen in ELISA. The synthetic gene encoding the Dsg3 ЕС1-ЕС5 domains was cloned into eukaryotic expression vectors p1.1-Tr2 and p1.2-GS. The resulting constructs were used for transfection of CHO-4BGD cells. The target protein was purified by affinity chromatography on the Ni-Sepharose FF sorbent. Immunoreactivity of the recombinant Dsg3 as an antigenic substrate was assessed by ELISA using sera from patients with pemphigus vulgaris (n = 12) and healthy donors (n = 5) under two buffer conditions: with EDTA (Dsg3-EDTA) and with added Ca2+ ions (Dsg3-Ca2+). The Euroimmun commercially available ELISA kit (target antigen: Dsg3 ectodomain) was used for reference. As a result, transient cultures of the cells producing the Dsg3 ЕС1-ЕС5 domains were obtained. The protein with the purity > 90% was isolated by affinity chromatography. When performing ELISA in the Dsg3-EDTA buffer, 33.3% of samples were classified as positive, while 50.0% were considered positive when using the Dsg3-Ca2+ buffer; the effect of adding Ca2+ was heterogeneous: 58.3% of samples showed the signal increase and 41.7% showed the decrease. The findings suggest the need to switch to the Dsg3 expression in human cells (HEK293).

Received: 2026-05-12

Published online: 2026-10-27

DOI: 10.24075/brsmu.2026.065

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VIEWS 151

Larionova IV, Rakina MA, Kalinchuk AYu, Sudarskikh TS, Vasilchuk VN, Yatskovskyi AM, Villert AB, Kolomiets LA, Tashireva LA

High-grade serous ovarian carcinoma (HGSOC) remains a major challenge in oncology. This study aimed to assess the spatial and phenotypic heterogeneity of EpCAM, HER2, TROP2, and pan-cytokeratin expression in primary tumor cells, peritoneal metastases, and the ascitic tumor compartment (ascites), comprising spheroids and single cells, and to determine whether the identified subpopulations were associated with neoadjuvant chemotherapy (NACT) and disease progression. The study is prospective, single-center; it involved 27 patients with histologically confirmed HGSOC; EpCAM, HER2, TROP2, and pan-cytokeratin expression were assessed by immunofluorescence. The proportions of EpCAM−HER2− cells were different in the primary tumor, peritoneal metastases, and ascites, and were highest in single cells from ascitic fluid and metastatic tissue (p = 0.0012). CK–TROP2– cells were more frequent among single cells (73.50% [51.00–91.25%]; p = 0.0249). The proportion of CK+TROP2– cells was higher in solid tumor lesions, accounting for 83.00% [65.00–95.00%] of cells in primary tumors and 94.50% [47.00–98.00%] in metastatic tissue (p < 0.0001). In patients who received NACT, the proportion of EpCAM+HER2+ cells in primary tumors and metastatic lesions was higher than in patients who did not undergo pre-surgery therapy (42.50% [6.25–71.25%] vs. 0.00% [0.00–5.00%]; p = 0.0333). The clinical significance of the EpCAM−HER2− subpopulation depended on its organization within ascites. An increased proportion of EpCAM−HER2− cells among single ascitic cells, but not within spheroids, was independently associated with a higher likelihood of progression (OR [95% CI], 1.256 [1.010–7.769]; p = 0.0322) and shorter progression-free survival (OR [95% CI], 1.118 [1.001–1.518]; p = 0.0459). HGSOC is characterized by pronounced phenotypic heterogeneity across tumor compartments. The ascites may reflect the phenotypic state of disseminated tumor cells.

Received: 2026-09-14

Published online: 2026-10-26

DOI: 10.24075/brsmu.2026.062

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VIEWS 169

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Popular articles

Saadoon SJ, Atiyah AM, Ibrahim AH, Mostafa FM

Secondary hyperparathyroidism (SHPT) is a common and progressive complication of chronic kidney disease (CKD), often intensifying as patients reach dialysis. Although alfacalcidol and other active vitamin D analogs are often used, improper administration can raise the risk of hypercalcemia and hyperphosphatemia. This study aimed to assess, using clinical criteria indicated by guidelines, whether alfacalcidol should be prescribed to hemodialysis patients with SHPT. Records of 136 adult patients treated in An-Naseria hemodialysis units were reviewed and analyzed using SPSS (version 26). The appropriateness of prescribing alfacalcidol was evaluated in accordance with KDIGO 2017 guidelines, taking into account levels of phosphate, calcium, and parathyroid hormone (PTH). Patients were divided into groups based on whether their prescriptions were appropriate or possibly inappropriate. Patients were 55.1% male and had an average age of 51.42 ± 11.5years. The majority of patients exhibited biochemical values (phosphate: 79.4%, calcium: 74.3%, and PTH: 77.2% normal) within goal ranges. 72 patients (52.9%) were categorized as potentially inappropriate for alfacalcidol medication, whereas 64 patients (47%) were recognized as having appropriate indications based on criteria consistent with guidelines. The mean PTH levels of patients in the appropriate group were substantially higher (923.14 ± 379.59 pg/mL) than those in the inappropriate group (274.71 ± 179.69 pg/mL, р < 0.001). Age, sex, calcium, and phosphate levels did not significantly correlate with prescription appropriateness. This cohort may have a significant percentage of alfacalcidol prescriptions that may not follow current guidelines. The sensible use of vitamin D analogs in hemodialysis patients may be improved by better adherence to evidence-based guidelines and routine biochemical monitoring.

Received: 2026-04-13

Published online: 2026-05-30

DOI: 10.24075/brsmu.2026.025

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VIEWS 1131

Gabriyanchik MA, Antonova OY, Taylakov ME, Grachev VA, Pirogov KS, Startseva OI, Kanev IL

Reconstruction of peripheral nerves remains an urgent surgical problem. Autologous nerve grafting is the gold standard for bridging nerve defects, but it is limited by the shortage of donor material, which drives interest in biocompatible polymers for artificial conduits. The aim of this study was to evaluate biocompatibility in vitro and tissue response to subcutaneous in vivo implantation of perspective microstructured materials. The cytotoxicity of porous polycaprolactone (PCL), PCL–collagen composite, fibrous PCL, and nanofibrous polyamide was assessed on L929 fibroblasts. For in vivo testing, material samples were implanted into C57BL/6 mice, and histological analysis was performed after 14 days. In vitro porous PCL exhibited the highest viability and adhesion, while fibrous PCL showed the lowest. In vivo porous PCL and nanofibrous polyamide caused minimal inflammation, whereas PCL–collagen composite and fibrous PCL induced granulomatous inflammation, macrophage infiltration, and formation of fibrous capsule. The most biocompatible materials — porous PCL and nanofibrous polyamide — show promise for a biomimetic conduit with an outer barrier shell of porous PCL and an inner aligned scaffold of polyamide nanofibers.

Received: 2026-04-14

Published online: 2026-06-12

DOI: 10.24075/brsmu.2026.029

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VIEWS 966

Special Project Author's Work

Secrets of a quality research study and a good manuscript

At the end of 2015, Bulletin of RSMU saw an important change in its typographic design and content. We formulated new editorial policies and established strict ethical standards for submitted manuscripts in accordance with the guidelines of reputable international bodies. As a result, about a quarter of the submitted works have been rejected, the primary reason being the author trying to submit a previously published article. Sometimes authors believe that by making slight changes to the introduction, excluding a few people from the study, performing a new statistical analysis, and thus obtaining totally new results they will turn their old manuscript into a novel work. That is why we would like to talk about scientific integrity, honesty, plagiarism, and self-plagiarism in our special project “Author’s work”.

American physicist Richard P. Feynman, a Nobel laureate, was always very scrupulous about the quality of a research study. During his commencement address at the California Institute of Technology in 1974, he talked about scientific integrity and honesty and warned young researchers “not to fool” themselves. A must-read for anyone who believes he/she is a true scientist.

In 1918, Russian physiologist Ivan Pavlov, a Nobel laureate, delivered two lectures: on the mind in general and the Russian mind in particular; on those mind qualities that determine the success of a research work and on how these qualities are present in the Russian mind. Pavlov's thoughts are an effective vaccine against poor intellectual work.