The aim of this study was to investigate miRNA profiles of clarified urine supernatant and combined urine vesicle fractions of healthy donors and patients with benign prostatic hyperplasia and prostate cancer (PCa). The comparative analysis of miRNA expression was conducted with a custom miRCURY LNA miRNA qPCR panel. Significant combinations of miRNA pairs were selected by the RandomForest-based feature selection algorithm Boruta; the difference of the medians between the groups and a 95% confidence interval was built using the bootstrap approach. The Asymptotic Wilcoxon-Mann-Whitney Test was performed for miRNA combinations to compare different groups of donors. Benjamini-Hochberg correction was used to adjust the statistical significance for multiple comparisons. The most diagnostically significant miRNAs pairs were miR-107-miR-26b.5p and miR-375.3p-miR-26b.5p in the urine supernatant fraction that discriminated the group of healthy patients and PCa patients, as well as miR-31.5p-miR-16.5p, miR-31.5p-miR-200b, miR-31.5p-miR-30e.3p and miR-31.5p-miR-660.5p in the fraction extracellular vesicles that were different between healthy men and benign prostate hyperplasia patients. Such statistical criteria as the occurrence of individual significant miRNA pairs in the total number of comparisons, median ΔC_t difference, and confidence interval can be useful tools for determining reliable markers of PCa.

MiRNAs of blood and urine have been shown to represent a convenient source of biomarkers for prostate cancer (PCa) diagnosis and assessment of the therapy effectiveness due to their high stability and representation and the low invasiveness of sample collection. Here, we studied the influence of radical prostatectomy (RP) on the expression of 12 cell-free miRNAs previously shown as potential markers of PCa (i.e., miR-19b, miR-22, miR-92a, miR-378, miR-425, miR-30e, miR-31, miR-125b, miR-200b, miR-205, miR-375 and miR-660). The relative expression of the miRNAs combined into 31 paired ratios was evaluated in the urine extracellular vesicles (EVs), clarified urine (CU) and blood plasma of healthy donors, pre- and post-RP samples of PCa patients. Nineteen miRNA ratios based on combinations of ten of the miRNAs (miR-19b, miR-30e, miR-31, miR-125b, miR-200b, miR-205, miR-375, miR-378, miR-425, and miR-660) were altered by RP. The comparative expression analysis of the cell-free miRNA ratios between healthy donors and PCa patients revealed miR-125b/miR-30e and miR-375/miR-30e as potential markers for evaluating therapeutic efficacy. MiR-378/miR-19b, miR-425/miR-19b, miR-200/miR-30e, miR-660/miR-30e, and miR-205/miR-30e had minor prognostic value but could be used to increase the steadiness of the diagnostic system. The urine EVs had the highest potential as a source of markers.

Introduction: The use of minimally invasive surgery (MIS) results in fewer adverse and more improved outcomes. However, the literature data describing the factors increasing the number of complications, reoperation frequency and unscheduled re-hospitalizations in older patients after MIS are contradictory. In this study, a large number of patients was investigated for the complications of minimally invasive surgical treatment of degenerative disease of the lumbar spine in older patients. The objective of the study was to determine the predictors of unfavorable outcomes in such patients.Materials and Methods: 1,013 patients underwent MIS (decompression alone, TLIF, LLIF, ALIF) in 2013-2017. All operations were performed with the participation of the authors (neurosurgeons). The patient's average age was 66. The following data were collected: BMI; CCI; presence of postoperative complications according to the Dindo-Clavien classification; unplanned readmission at 90 days; hospital length of stay (LOS); surgical complexity (low, intermediate, and high); surgical time; and risk factors. The cumulative reoperation rate was determined at 5-years follow-up.Results: A total of 256 patients suffered a complication (25.2%), 226 classified as mild (grade I, II, IIIA), and 30 - as severe (IIIB, IVA). Such factors as the surgical complexity, BMI > 30, surgical time, number of operated levels were associated with a significant risk of developing a complication. For patients with and without complications, LOS was 9.3 and 6.3 days, respectively (p < 0.0001), the unplanned readmission rate was 1.3%. 104 patients underwent 133 revision operations. The 5-year cumulative reoperation rate was 15.2%, and the reoperation index was 12.1%. The CCI had no statistically significant effect on the complication incidence after MIS. A higher risk of complications was found in patients who underwent intermediate-complexity surgery (MIS TLIF) compared with uncompounded (decompression alone) and more complex (MIS LLIF, MIS ALIF) surgical procedures (p < 0.001 and p = 0.001, respectively).Conclusion: A register of postoperative complications is an important tool for health quality assessment and choosing the best surgical option that helps to establish measures to reduce such complications. Using MIS for the treatment of elderly patients reduces the number of severe complications.

The problem of timely diagnosis and proper management of patients with cystic fibrosis is crucial not only in our country, but throughout the world. Experts of the Union of Pediatricians of Russia have considered various issues of etiology, pathogenesis, epidemiology, diagnosis, and treatment of this genetic disease in a modern light. Particular attention was paid to screening methods for early diagnosis of cystic fibrosis. The principles of complex therapy were justified, including rational use of antibacterial and mucolytic drugs and enzyme replacement therapy that significantly determine the disease prognosis.