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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Forensic Medicine</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Forensic Medicine</journal-title><trans-title-group xml:lang="ru"><trans-title>Судебная медицина</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2411-8729</issn><issn publication-format="electronic">2409-4161</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">431</article-id><article-id pub-id-type="doi">10.17816/fm431</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Original study articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Оригинальные исследования</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="zh"><subject>原创研究</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Damage to neurons of the cerebral cortex in acute poisoning with baclofen and its combination with ethanol</article-title><trans-title-group xml:lang="ru"><trans-title>Повреждения нейронов коры головного мозга при острых отравлениях баклофеном и его cочетанием с этиловым спиртом</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>急性巴氯芬中毒及其与乙醇的结合对大脑皮层神经元的损害</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6356-9251</contrib-id><contrib-id contrib-id-type="spin">6727-9170</contrib-id><name-alternatives><name xml:lang="en"><surname>Romanova</surname><given-names>Olga L.</given-names></name><name xml:lang="ru"><surname>Романова</surname><given-names>Ольга Леонидовна</given-names></name><name xml:lang="zh"><surname>Romanova</surname><given-names>Olga L.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Biol.)</p></bio><bio xml:lang="ru"><p>к.б.н.</p></bio><email>olgpharm@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3165-0378</contrib-id><contrib-id contrib-id-type="spin">7890-2597</contrib-id><name-alternatives><name xml:lang="en"><surname>Golubev</surname><given-names>Arkady M.</given-names></name><name xml:lang="ru"><surname>Голубев</surname><given-names>Аркадий Михайлович</given-names></name><name xml:lang="zh"><surname>Golubev</surname><given-names>Arkady M.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>д.м.н.</p></bio><email>arkadygolubev@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1018-8257</contrib-id><contrib-id contrib-id-type="spin">8648-0654</contrib-id><name-alternatives><name xml:lang="en"><surname>Churilov</surname><given-names>Alexey A.</given-names></name><name xml:lang="ru"><surname>Чурилов</surname><given-names>Алексей Александрович</given-names></name><name xml:lang="zh"><surname>Churilov</surname><given-names>Alexey A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>sandro-knaz-him@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8173-8944</contrib-id><contrib-id contrib-id-type="spin">2968-7961</contrib-id><name-alternatives><name xml:lang="en"><surname>Sundukov</surname><given-names>Dmitriy V.</given-names></name><name xml:lang="ru"><surname>Сундуков</surname><given-names>Дмитрий Вадимович</given-names></name><name xml:lang="zh"><surname>Sundukov</surname><given-names>Dmitriy V.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>д.м.н.</p></bio><email>sundukov_dv@rudn.university</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9303-7640</contrib-id><contrib-id contrib-id-type="spin">3620-8930</contrib-id><name-alternatives><name xml:lang="en"><surname>Kislov</surname><given-names>Maksim A.</given-names></name><name xml:lang="ru"><surname>Кислов</surname><given-names>Максим Александрович</given-names></name><name xml:lang="zh"><surname>Kislov</surname><given-names>Maksim A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>д.м.н.</p></bio><email>smedik@gmail.com</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5758-8552</contrib-id><contrib-id contrib-id-type="spin">2059-3248</contrib-id><name-alternatives><name xml:lang="en"><surname>Ershov</surname><given-names>Anton V.</given-names></name><name xml:lang="ru"><surname>Ершов</surname><given-names>Антон Валерьевич</given-names></name><name xml:lang="zh"><surname>Ershov</surname><given-names>Anton V.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>д.м.н.</p></bio><email>salavatprof@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Peoples’ Friendship University of Russia</institution></aff><aff><institution xml:lang="ru">Российский университет дружбы народов</institution></aff><aff><institution xml:lang="zh">Peoples’ Friendship University of Russia</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology</institution></aff><aff><institution xml:lang="ru">Федеральный научно-клинический центр реаниматологии и реабилитологии</institution></aff><aff><institution xml:lang="zh">Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">The First Sechenov Moscow State Medical University (Sechenov University)</institution></aff><aff><institution xml:lang="ru">Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)</institution></aff><aff><institution xml:lang="zh">The First Sechenov Moscow State Medical University (Sechenov University)</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2022-11-28" publication-format="electronic"><day>28</day><month>11</month><year>2022</year></pub-date><pub-date date-type="pub" iso-8601-date="2022-12-17" publication-format="electronic"><day>17</day><month>12</month><year>2022</year></pub-date><volume>8</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><issue-title xml:lang="zh"/><fpage>15</fpage><lpage>24</lpage><history><date date-type="received" iso-8601-date="2021-09-18"><day>18</day><month>09</month><year>2021</year></date><date date-type="accepted" iso-8601-date="2022-10-25"><day>25</day><month>10</month><year>2022</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2022, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2022, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2022,</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2025-01-01"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://for-medex.ru/jour/article/view/431">https://for-medex.ru/jour/article/view/431</self-uri><abstract xml:lang="en"><p><bold><italic>BACKGROUND</italic></bold><italic>:</italic> The number of poisoning with a muscle relaxant baclofen has increased recently. The brain is one of the target organs in baclofen poisoning.</p> <p><bold><italic>AIM</italic></bold><italic>: </italic>To identify and quantify cerebral cortex neuron damage in baclofen and baclofen ethanol poisoning.</p> <p><bold><italic>MATERIAL</italic></bold><italic> <bold>AND</bold> <bold>METHODS</bold>: </italic>A histological study of rat cerebral cortex was performed. The controls (<italic>n </italic>= 5) received neither baclofen nor ethanol. Groups 1 and 3 received baclofen (85 mg/kg), whereas groups 2 and 4 received baclofen (85 mg/kg) and ethanol (7 ml/kg). Groups 1 and 3 were euthanized 4 h after the drug administration, whereas groups 2 and 4 were euthanized after 24 h. Histological sections were stained with hematoxylin and eosin and by the Nissl method and examined by light microscopy (×400). The number of damaged neurons was calculated. Statistical processing was performed by the nonparametric Mann–Whitney method.</p> <p><bold><italic>RESULTS</italic></bold><italic>: </italic>Neurons with reversible and irreversible changes in the controls accounted for 13% and 9%, respectively. At 4 h after baclofen administration, neurons with reversible and irreversible changes accounted for 22% and 21%; 4 h after baclofen and ethanol administration, 24% and 29%; 24 h after baclofen administration, 25% and 37%, respectively. Baclofen and ethanol administration caused an increase in the share of neurons with reversible (27%) and irreversible (41%) changes. The differences between group 3 and the control group were significant, and the difference was significant when group 4 was compared with the control group and group 3.</p> <p><bold><italic>CONCLUSION</italic></bold><italic>:</italic> Understanding the processes in the brain during baclofen and baclofen ethanol administration will allow the provision of medical care to this category of patients more effectively. The signs of brain neuron damage, along with the results of forensic chemical analysis, can be used to establish the immediate cause of death.</p></abstract><trans-abstract xml:lang="ru"><p><bold><italic>Обоснование</italic></bold><italic>. </italic>За последнее время увеличилось число отравлений миорелаксантом баклофеном. Одним из органов-мишеней при отравлении баклофеном является мозг.</p> <p><bold><italic>Цель исследования</italic></bold> ― выявление и количественная оценка повреждения нейронов коры головного мозга при отравлении баклофеном и его комбинацией с этанолом.</p> <p><bold><italic>Материал и методы</italic></bold><italic>. </italic>Проводили гистологическое исследование коры головного мозга крыс. Группа контроля (<italic>n</italic>=5) не получала ни баклофена, ни этанола. Животные экспериментальных групп 1 и 3 (<italic>n</italic>=5) получали баклофен (85 мг/кг), групп 2 и 4 (<italic>n</italic>=5) ― комбинацию баклофена в той же дозе и этанола (7 мл/кг). Животных групп 1 и 3 выводили из эксперимента через 4 ч, а групп 2 и 4 ― через сутки после введения препаратов. Гистологические препараты окрашивали гематоксилином и эозином и по Нисслю, далее исследовали методом световой микроскопии (×400). Подсчитывали число нейронов с повреждениями. Статистическую обработку полученных данных проводили непараметрическим методом Манна–Уитни.</p> <p><bold><italic>Результаты</italic></bold><italic>.</italic> Проведено гистологическое исследование коры головного мозга 25 крыс. В контрольной группе содержание нейронов с обратимыми изменениями составило 13%, с необратимыми ― 9%. При введении баклофена через 4 ч обратимые изменения составили 22%, необратимые ― 21%. В эти же сроки совместное введение баклофена и этанола приводило к возрастанию как обратимых (24%), так и необратимых (29%) изменений нейронов. Через сутки после введения баклофена доля обратимых изменений нейронов составила 25%, необратимых ― 37%. При совместном введении баклофена и этанола возрастало содержание нейронов как с обратимыми (27%), так и необратимыми (41%) изменениями. Результаты статистической обработки свидетельствуют о достоверных изменениях через 4 ч по отношению к контролю, а через 24 ч статистически значимые различия регистрируются как по отношению к группе контроля, так и к результатам, полученным через 4 ч.</p> <p><bold><italic>Заключение</italic></bold><italic>.</italic> Понимание процессов, происходящих в головном мозге при отравлении баклофеном и его комбинацией с этанолом, позволит наиболее эффективно оказывать помощь данной категории пострадавших. Выявленные признаки повреждения нейронов головного мозга наряду с результатами судебно-химического анализа могут быть использованы в обосновании непосредственной причины смерти в таких случаях.</p></trans-abstract><trans-abstract xml:lang="zh"><p>论证。使用肌松剂巴氯芬的中毒事件最近有所增加。巴氯芬中毒的目标器官之一是大脑。</p> <p>该研究的目的是检测和量化巴氯芬中毒及其与乙醇结合时的皮质神经元损伤。</p> <p>材料与方法。对大鼠大脑皮层进行了组织学检查。对照组（n=5）既没有接受巴氯芬也没有接受乙醇。实验组1和3（n=5）的动物接受巴氯芬（85毫升/公斤），而2和4组（n=5）的动物接受相同剂量的巴氯芬和乙醇（7毫升/公斤）的组合。第1和第3组的动物在4小时后退出实验，第2和第4组的动物在给药一天后退出。组织学准备用苏木精和伊红以及Nissl染色，并通过光镜检查（×400）。对有损伤的神经元数量进行计数。采用非参数的曼-惠特尼方法对数据进行统计处理。</p> <p>结果。对25只大鼠的大脑皮层进行了组织学检查。对照组有13%的神经元有可逆转的变化，9%的神经元有不可逆的变化。当4小时后施用巴氯芬时，可逆变化为22%，不可逆变化为21%。在同一天，巴氯芬和乙醇的联合给药导致了可逆（24%）和不可逆（29%）的神经元变化的增加。服用巴氯芬一天后，可逆的神经元变化的比例为25%，不可逆的为37%。当巴氯芬和乙醇共同注射时，具有可逆（27%）和不可逆（41%）变化的神经元含量增加。统计结果显示，与对照组相比，4小时后有明显的变化，24小时后，与对照组和4小时后得到的结果相比，都有统计学上的显著差异。</p> <p>结论。了解巴氯芬中毒及其与乙醇结合所涉及的大脑过程，将能够对这类伤员提供最有效的护理。检测到的大脑神经元损伤的迹象，以及法医化学分析的结果，可用于证实此类案件的直接死因。</p></trans-abstract><kwd-group xml:lang="en"><kwd>poisoning</kwd><kwd>baclofen</kwd><kwd>ethanol</kwd><kwd>damage to neurons of the cerebral cortex reversible and irreversible</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>отравления</kwd><kwd>баклофен</kwd><kwd>этанол</kwd><kwd>повреждения нейронов коры головного мозга обратимые и необратимые</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>中毒</kwd><kwd>巴氯芬</kwd><kwd>乙醇</kwd><kwd>可逆和不可逆损害的皮质神经元</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">Livanov GA, Lodyagin AN, Razina AА, et al. 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