From Big Medical Encyclopedia

CLINICAL BIOCHEMISTRY (synonym: chemical pathology, clinical chemistry) — the section of biological chemistry studying changes of biochemical processes in a human body at morbid conditions and at medical influences, and also developing methods of detection of these changes for diagnosis and the forecast of diseases. A subject and in a certain measure methods of a research of the clinical biochemistry which is one of the industries laboratory a wedge, diagnoses differ from a subject and methods of a research of medical biochemistry. The last makes that industry modern biochemical, sciences, edges solves fundamental problems of studying of the biochemical mechanisms which are the cornerstone of the processes of life activity proceeding in a human body, normal and features of their disturbances at patol, states for the purpose of interpretation biochemical, bases of a pathogeny of diseases both at molecular level, and at more difficult levels of the organization of living matter. She also develops rational methods of active influence by means of various chemical connections (both a natural origin, and synthetic) on the course certain biochemical, reactions in an organism for treatment or the prevention of these or those patol, states.

Having as the main object of researches experimental patol, the states modelled on various a lab. animals (but not on the person), the medical biochemistry applies to problem solving, close to those which stand before To., the methods of a research which are often already approved in the field of molecular biology and the general biochemistry, but not able to be used in To. Medical biochemistry, as well as To., actively interacts with pharmacology, a pathophysiology and other related subjects, significantly differing from these sciences in the main directions, the purposes and methods of researches. So, area and a research problem of medical biochemistry disclosure of pathogenetic value, features and the mechanism of disturbance of catalytic activity of this or that enzyme or system of enzymes at patol, states makes, search of chemical substances by means of which it is possible to prevent or eliminate disturbances of activity of enzymes. But the choice of substances from among the connections suitable for treatment of diseases of the person or perspective for further chemical modifying for the purpose of research of new pharmaceuticals, makes one of areas and tasks pharmakol, researches.

Distinguish the general and private To. A subject of studying of the general To. methodological and methodical problems of a research of disturbances are biochemical, processes in a human body, establishment of limits (borders) of the normal amounts studied biochemical, parameters the analysis of the reasons of mistakes and control methods of quality laboratornodiagnostichesky biochemical, researches. Private To. includes the sections devoted to features of frustration biochemical, processes and methods laboratory and diagnostic biochemical, researches in clinic of internal diseases, surgical clinic, clinic of obstetrics and gynecology, neurology and psychiatry etc. that reflects not only modern structure a wedge, medicine, but also existence of some specific features of disturbances biochemical, processes at patol, the states studied by each of these disciplines. Achievements in the field of the general and medical biochemistry, the general and medical genetics, normal and patol, physiology, biology, chemistry and physics constantly enrich To. new ideas and by methods of a research.

Already in Ancient India, Egypt, Greece doctors tried to compare a condition of the sick person with change of properties biol, liquids of its organism. In process of formation of chemistry as of science for studying of properties biol, liquids of a human body it is normal also at patol, states doctors began to use chemical methods that was estimated as important scientific and practical achievement. Still M. V. Lomonosov specified: «... the physician without happy knowledge of chemistry cannot be perfect». Among the first periodicals publishing in 30 — the 40th there are 19 century materials on use of chemical methods of a research in medical practice, was published since 1844 «Archiv fur physiologische und pathologische Medizin» (Vienna). Since 70th 19 century along with chemical methods of a research biol, liquids of an organism in laboratory and diagnostic practice began to use widely mikrobiol, methods, a mikroskopirovaniye of cells and bacteria in biol, liquids that reflected bystry development of the general microbiology and related subjects in the second half of 19 century. Further, in process of development organic and, in particular, biol, chemistry and medical biochemistry, use of chemical methods in clinical diagnostic laboratories quickly extended. To. gradually gained paramount value among other sections a wedge, laboratory diagnosis.

Sources To. in our country go back to I. M. Sechenov, I. I. Mechnikov, A. P. Borodin, I. P. Pavlov, M. V. Nentsky, A. Ya. Danilevsky, A. N. Bach, V. S. Gulevich's classical works. Especially bystry development of biochemistry in general and To. in particular began in our country after Great October socialist revolution. The needs of development of health care for the country were those objective premises, edges defined creation and growth of specialized biochemical research establishments. In these institutions the recent scientific trends arose and developed, shots of scientists of high qualification prepared. In 1920. The Soviet government headed by V. I. Lenin made the decision to support the proposal of the famous revolutionary and scientist-biochemist A. N. Bach on the organization in Moscow the first in our country biochemical, research establishment — Biochemical in-that the National commissariat of health care of RSFSR. In it in-those, to-rogo A. N. Bach was appointed the director, B. I. Zbarsky, W. A. Engelgardt, A. E. Braunstein worked. In 1923 in Moscow Ying t of occupational diseases of V. A. Obukh, biochemical was organized, headed laboratory in Krom Yu. M. Gefter. In this laboratory development and modification of methods of the microanalysis biochemical was carried out, it is normal of components of blood also at patol, states. Many scientists and practical doctors were trained in these methods. In 1925. A. V. Palladiya biochemical in-t, transferred later to Kiev will organize in Kharkiv Ukrainian. In 1932 in Moscow it was created All-Union by in-t of experimental medicine (VIEM), in Krom A. E. Braunstein, S. Ya. Kaplansky, V. N. Orekhovich and others executed many original scientific research which was important for development of the general biochemistry and To. In days of the Great Patriotic War as a part of the USSR Academy of Medical Sciences created in 1944 Ying t of biological and medical chemistry was organized. Ya. O. Parnas was the first director in-that. Since 1949 the in-t is headed by V. N. Orekhovich. In Ying-those biological and medical chemistry of the USSR Academy of Medical Sciences basic researches were successfully continued and the recent trends of researches having paramount value for the general biochemistry and for To are developed. So, e.g., opening of enzymatic transamination, comprehensive study of the chemical mechanism and biol, roles of this reaction by A. E. Braunstein and it sotr. was a basis for wide use of definition of activity of aminotransferases of blood in a wedge, practice with the diagnostic purposes. V. N. Orekhovich and it sotr. connective tissue proteins — procollagens, disturbance of structure and which exchange plays an important role at rheumatism and a number of other diseases were open and studied. By employees in-that new enzyme was discovered gamma amylase, disturbance of functions to-rogo in a human body plays an important role in a pathogeny of a generalized glycogenosis; new methods laboratory biochemical, diagnoses of different types of glycogenoses are offered. Successfully researches in the field of biologically active peptides and biogenic amines, directly related to urgent problems K develop. Successful development of researches and training of qualified personnel allowed to organize on the basis of a number of laboratories Ying-that biological and medical chemistry of the USSR Academy of Medical Sciences new scientific institutions. So, e.g., in 1965 Ying t of experimental endocrinology and chemistry of hormones of the USSR Academy of Medical Sciences led by N. A. Yudayev was organized. In are in-those are conducted important for the general biochemistry and To. researches of steroid hormones, prostaglandins, hormones of the polypeptide nature. In 1972 the Laboratory of enzymology of the USSR Academy of Medical Sciences was organized, the first head the cut became S. R. Mardashev, since 1974 S. S. Debov directs laboratory. The laboratory of enzymology of the USSR Academy of Medical Sciences developing a number of fundamental and applied problems of medical enzymology resolves issues of an enzimodiagnostika and enzymotherapy, important for health care.

Big contribution to development To. it is brought by works of the Soviet biochemists S.E. Severin, A. A. Pokrovsky, V. S. Ilyin, A. N. Klimov, B. A. Kudryashov, G.E. Vladimirov, etc.

Development To. it is closely connected with development laboratory business (see). In the 20th 20 century in our country along with expansion to lay down. - professional, networks the organization a lab was begun. services. At large-tsakh and policlinics clinicodiagnostic were organized laboratories (see), volume biochemical in which works continuously increased. In the late twenties at the scientific and methodical station of the Moscow city public health department, and then and at the National commissariat of health care of RSFSR were created a lab. the commissions which developed justifications for GOST on a lab. the equipment and reactants, and also a number of the provisions defining work of clinical diagnostic laboratories. Lab. the service in our country is continuously improved, the number of laboratories increased, their equipment by new devices and supply with reactants improved, work on professional development of employees is carried out. The tendency to increase in a share biochemical, analyses in relation to total number clinicodiagnostic a lab is noted. researches that reflects bystry development To. In 1969 in Moscow the All-Union scientific and methodical center for laboratory business conducting a lot of work on standardization of techniques a lab is created. researches, to control of their quality, implementation in practice of new means and methods a lab. diagnoses, to increase in professional qualification lab. workers.

All researches conducted in our country in the area K. are coordinated by Scientific council on problems of biological and medical chemistry at the USSR Academy of Medical Sciences. As a part of this scientific council the problem commissions «Biochemistry and a patokhimiya of a metabolism and mechanisms of its regulation» (head establishment — Ying t of biological and medical chemistry of the USSR Academy of Medical Sciences), «Medical enzymology, problems of an enzimodiagnostika and enzymotherapy» (head institution — Laboratory of enzymology of the USSR Academy of Medical Sciences), «Clinical chemistry» work (head establishment — Ying t of biological and medical chemistry of the USSR Academy of Medical Sciences).

Questions which are developed in the institutions combined by these problem commissions differ from the issues resolved in the relevant institutions of system of Academy of Sciences of the USSR, the medical orientation. So, e.g., paying the main attention to the characteristic of molecular and biochemical bases of hereditary diseases, biochemical, to diagnosis and replacement therapy of congenital anomalies of a metabolism, the Scientific council on biol, and medical chemistry does not duplicate work of the problem commission on biochemical, genetics and molecular biology of Academy of Sciences of the USSR.

The arsenal of biochemical, clinicodiagnostic methods quickly is replenished through a research of the increasing number of enzymes, hormones and other biologically active agents. From qualitative tests K. passes to specific quantitative methods even in express diagnosis more and more. The tendency of transition from one-time definitions of this or that biochemical, a component biol, liquids to dynamic overseeing by its quantitative and qualitative changes in development of a disease and its treatment, to studying of a day-night rhythm of content in blood or removal with urine of these or that biochemical, components of a cell, their predecessors or products of their exchange, to funkts, to the tests revealing reserves of compensatory opportunities of an organism, the hidden aberrations, early displays of diseases to simultaneous dynamic researches of activity of functionally interconnected enzymes is observed. Progress in a technique laboratory a wedge, diagnoses is considerably connected with implementation biochemical, concepts and methods in allied industries — hematology, immunology etc.

Further improvement lab. put in general and clinicodiagnostic biochemical, researches in particular the lab demands centralization. researches, equipment of clinical diagnostic laboratories modern lab. equipment, materials and reactants, widespread introduction of automation and mechanization lab. works, the maximum implementation in practice of well checked, reducing expense of time and reactants, available, but at the same time exact techniques at total failure from use of non-standard, quite often outdated methods of a research. More and more broad use special standard sets of reactants for definition of these or that biochemical, components in biol, liquids find the systems of the ultramicroanalysis which are allowing to reduce considerably quantity necessary for the analysis biol, material, sharply increasing labor productivity a lab in clinical diagnostic laboratories. workers at high precision and a standartizovannost of each analysis, biochemical, the automatic machines created on the basis of the latest developments of chemistry, biochemistry, biophysics and radio electronics.

Research in the area K. in our country Ying-that is carried out to Ying-those biological and medical chemistry of the USSR Academy of Medical Sciences, Ying-those experimental endocrinology and chemistry of hormones of the USSR Academy of Medical Sciences, food of the USSR Academy of Medical Sciences, Laboratory of enzymology of the USSR Academy of Medical Sciences, biochemical laboratories of in-t a wedge, a profile of the USSR Academy of Medical Sciences, M3 of the USSR, M3 of RSFSR and the Ministries of Health of federal republics, at departments of medical in-t and medical f-tov high fur boots and in-t of improvement of doctors, in the All-Union scientific and methodical center for laboratory business.

Abroad the most considerable achievements in the area K. are connected with activity National in-that health (USA), departments K. and laboratories of university clinics of the USA, England, Sweden, Germany, France, Japan and other countries. The contribution to development is considerable To. the scientific socialist countries — ChSSR, NRB, the Party of Russian Taxpayers, GDR, VNR working at departments K. high fur boots and in-t of improvement of doctors.

Teaching To. in medical higher educational institutions it is conducted on older years. In the USSR the greatest experience of teaching To. it is saved up in the 1st MMI of I. M. Sechenov where for students of the V—VI courses to lay down. f-that more than 10 Years the course of lectures is given and a practical training is given in this discipline. At the 2nd MMI of N. I. Pirogov in 1963 it was organized medical - biol, the f-t, one of tasks to-rogo is training of specialists in the area K.

For professional development of the doctors and scientists dealing with problems K. and Related subjects, Ying t of biological and medical chemistry of the USSR Academy of Medical Sciences together with department of biochemistry of the Central Order of Lenin in-that improvements of doctors carries systematically out cycles of improvement (with courses of lectures and a practical training) in Moscow and other large cities (Chelyabinsk, Vilnius, Minsk, etc.) * Cycles of improvement on To. are carried out also at departments a wedge, laboratory diagnosis of in-t of improvement of doctors of federal republics.

In the USSR public and medical activity of specialists on To. it is carried out both within All-Union scientific about-va doctor-laboratory assistants, and in medical section All-Union biochemical about-va. On all-Union biochemical, congresses (1964, 1969, 1974) and the All-Union congress of doctor-laboratory assistants (1973) problems K were in detail discussed.

Scientific works in the area K., carried out in the USSR, are published in magazines «Laboratory Business», «Questions of Medical Chemistry», «Bulletin of Experimental Biology and Medicine», «Problems of Endocrinology» and in many magazines a wedge, a profile.

See also Biochemical methods of a research , Biochemistry .

Bibliography Biochemical methods of a research in clinic, under the editorship of A. A. Pokrovsky, M., 1969; Introduction to clinical biochemistry, under the editorship of I. I. Ivanov, L., 1969; Gorzheysha Ya., etc. Fundamentals of clinical biochemistry in clinic of internal diseases, the lane from Czeches., Prague, 1967; Ivanov I. I., Korovkin B. F. and Markelov I. M. Introduction to clinical enzymology, L., 1974, bibliogr.; Kliniko-biokhimichesky researches at medical labor examination, under the editorship of E. A. Selkov and A. A. Shatalova, L., 1968; Mosquitoes F. I., Korovkin B. F. and Menshikov V. V. Biochemical researches in clinic, L., 1976; M and r-d and sh e in S. R. Biochemical problems of medicine, M., 1975, bibliogr.; Molecular bases of pathology, under the editorship of V. N. Orekhovich, M., 1966; Semenov N. V. Biochemical components and constants of fluid mediums and tissues of the person, M., 1971, bibliogr.; Modern methods in biochemistry, under the editorship of V. N. Orekhovich, M., 1977, bibliogr.; Chorus of t And. Molecular pathology, the lane with polsk.; M, 1967, bibliogr.; Shamray E.F. and Pashchenko A. E. Clinical biochemistry, M., 1970, bibliogr.; A biologist’s guide to principles and techniques of practical biochemistry, ed. by B. L. Williams a. K. Wilson, N. Y., 1975; B o u 1 a n-g e r P. e. a. Biochemie m6dicale, fasc. 1 — 2, P., 1968 — 1969; Clinical chemistry, ed. by R. J. Henry a. o., Hagerstown, 1974; G of and at Page H. H o w o r t h J. Clinical chemical pathology, L., 1978; The laboratory in clinical medicine, ed. by J. A. Hals-ted, Philadelphia, 1976; Richterich R. Klinische Chemie, Basel u. a., 1971; Wootton I.D. P. Microanalysis in medical biochemistry, Edinburgh, 1974.

Periodicals — Biochemistry, M., since 1936; Questions of medical chemistry, M., since 1955; Laboratory business, M., since 1955; Molecular biology, M., since 1967; Advances in Clinical Chemistry, N.Y. — L., since 1958; Advances in Metabolic Disorders, N. Y. — L., since 1964; Arztliche Laborato-rium, V., since 1955; American Journal of Clinical Pathology, Chicago, since 1931; Analytical Biochemistry, N. Y. — L., since 1960; Annales de biologie clinique, P., since 1943; Clinica chimica acta, Amsterdam, since 1956; Clinical Biochemistry, Toronto, since 1967; Clinical Chemistry, N. Y., since 1955; Journal of Clinical Investigation, Baltimore, since 1924; Journal of Clinical Pathology, L., since 1947; Journal of Laboratory and Clinical Medicine, St Louis, since 1915; Laboratory Investigation, Philadelphia, since 1952; Medizi-nische Laboratorium, V., since 1958; Scandinavian Journal of Clinical and Laboratory Investigation, Oslo, since 1949; Zeitschrift fur klinische Chemie und klinische Biochemie, V., since 1967 (1963 — 1966 — Zeitschrift fur klinische Chemie).

B. 3. Gorkin, V. V. Menshikov.