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Background. More than 80 % of cases ovarian cancer are detected at stage III–IV. One of the most important predictive factors is the cytoreductive surgery without residual tumor. Aim. To determine the selection criteria for cytoreductive surgery in the advanced ovarian cancer patients. Materials and methods. The study included 190 primary IIB–IV stage ovarian cancer patients who underwent surgical treatment in the oncogynecological department of the N. N. Petrov NMRC on Oncology in the period from August 2017 to August 2020. All patients underwent pelvic magnetic resonance imaging, chest and abdominal computed tomography, and diagnostic laparoscopy. Assessment of the peritoneal carcinomatosis index (PCI) was performed according to P. Sugarbaker. The outcome of cytoreductive surgery was determined by the size of the residual tumor: complete – without a macroscopically detectable tumor, optimal – residual tumor ≤1 cm, suboptimal – residual tumor ≥1 cm. Results. The complete or optimal cytoreduction achieved in 72.6 % of cases (48.9 % (93 / 190) and 23.7 % (45 / 190), respectively), suboptimal in 22 % (42 / 190) of cases, 5 % (10 / 190) only a diagnostic laparoscopy due to the initial underestimation of the tumor dissemination. In the entire sample PCI value ranged from 0 to 35 points, the median was 4 points (2; 11). In the group of optimal cytoreductions PCI ranged from 0 to 19 points, median – 3 points (2; 6), in the group of suboptimal from 5 to 35 points, median – 19.5 points (15; 23) (p < 0.0001, Mann–Whitney test). No optimal cytoreduction was performed in PCI >20 points. The optimal cut-off PCI point was 9.5 points (sensitivity 92.1 %, specificity 86.2 %, overall accuracy 87.4 %), if PCI ≤ 9 points – the operation will be hypothetically optimal, if PCI ≥ 10 then hypothetically suboptimal. The main cause of non-optimal interventions (n = 52) were: diffuse carcinomatosis of the small bowel and its mesentery – 73 % (38 / 52), carcinomatosis of the hepatoduodenal zone – 9 % (5 / 52) and a total of 16 % (9 / 52) were other non-resectable tumors (paraaortal, intrathoracic lymph nodes, invasion of the pancreas or pleura, lung metastases). Radiation diagnostic and intraoperative revision were comparable in 60.5 % (115 / 190) of cases. The sensitivity of radiological diagnostic methods in detecting of the small intestine lesions was 23.7 %, the specificity was 90 %, while for laparoscopic diagnostics, the sensitivity in detecting of the small intestine lesions was 93.3 %, and the specificity was 100 %. In assessing of carcinomatosis of the hepatoduodenal zone, the advantage belongs to radiation diagnostic methods: the sensitivity of computed tomography was 66.7 %, the specificity was 97 %, while the sensitivity of diagnostic laparoscopy was 0 %. Conclusions. Determination of a high score in assessing the index of peritoneal carcinomatosis, detection of damage to the hepatoduodenal zone, diagnosed mainly by radiation imaging methods, detection of diffuse lesions of the small intestine, determined mainly by laparoscopic diagnosis reduces the frequency of suboptimal cytoreductive operations from 67 % to 13 %.

Background. Applied standard methods of cervical cancer (CC) treatment have several disadvantages in terms of local and systemic toxicity and the risks of local recurrence. Our study proposed the use of neoadjuvant chemotherapy (NACT) in a dose-dense mode, followed by radical hysterectomy, in order to improve the results of treatment of locally advanced CC (IB2-IIB stages) (FIGO)/T1b2-2bN0M0 (TNM).Aim. Improvement of immediate and long-term results in treatment of locally advanced CC IB2-IIB stages (FIGO), determining the immediate effectiveness of dose-dense NACT, based on magnetic resonance imaging (MRI) data, and the identification of prognostic factors for tumor response to chemotherapy.Materials and methods. Between April 2016 to November 2019 120 women with IB2-IIB stages (FIGO) were included in this study. Of these, 58 patients underwent 3 cycles of intensified NACT according to the AP scheme (cisplatin 75 mg/m2, doxorubicin 35 mg/m2) and 62 patients underwent NACT according to the TR scheme (cisplatin 60 mg/m2, paclitaxel 60 mg/m2). The assessment of the effect of intensified NACT was performed according to the RECIST 1.1 criteria according to MRI data. Also 2 retrospective groups of patients were recruited: group I - surgical treatment without preoperative chemotherapy (25 patients with IB2-IB3 stages (FIGO) from November 2009 to August 2019), group II - concurrent chemoradiotherapy (44 patients with stage IIB cervical cancer (FIGO) from January 2013 to June 2018).Results. Complete clinical response was detected in 12 (10.0 %) patients, partial response - in 69 (57.5 %) patients, stable disease - in 35 (29.2 %) patients, progression was observed in 4 cases (3.3 %). After NACT in a dose dense mode, due to an objective clinical response (complete response, partial response and stable disease for stage IIA according to RECIST 1.1 criteria), 99 (82.5 %) patients underwent surgical treatment. For 21 (17.5 %) patients due to the absence achievement of objective clinical response (stable disease for stage IIB according to RECIST 1.1 criteria or progression), performed concurrent chemoradiotherapy. During the observation period, 113 (94.2 %) patients remained alive. Mortality for the first year was 1.7 % (2 cases). There was a coincidence of the results of a complete response according to MRI in 11 (91.7 %) cases out of 12 cases with the pathology data. According to multivariate analysis, it was revealed that parametrial invasion, according to the histological examination of the surgical material, is an independent prognostic factor for recurrence. According to comparative evaluation of disease-free survival curves between groups of IB2-IIB stages (FIGO) patients who received and did not receive dose-dense chemotherapy, it was found that disease- free survival in the group with NACT was higher compared to the group without NACT (p = 0.03, the log-rank criterion).Conclusions. The use of dose-dense NACT is an effective treatment mode for patients with IB2-IIB CC (FIGO), which in most cases allows achieving a tumor response with subsequent improvement in immediate and long-term results and can be considered as an alternative to standard treatment for locally advanced CC.

The article presents the results of an empirical study on electronic petitions posted on the Change.org French-speaking segment, geographically linked to France. The relevance of the topic is due to the intervention of modern information and communication technologies in political reality and the need for scientific reflection of the consequences of digital changes in political processes. The authors of the article analyse the regional particularities of the online petition activity by the inhabitants of France on the material of 15 887 electronic petitions (January 2015 – October 2017), 570 of which are petitions with the status of “victory” (4 %). The authors note that the European territories of France form three main groups of online petition activity (with low, medium and high petition activity). Residents of France most often relate to social problems (social security, health care and education) in electronic petitions. In addition, Change.org is actively registering electronic petitions on issues related to crime and terrorism, discrimination, the environment, the economy and animal welfare. Electronic petitions about problems of culture, sports and problems of confessional relations are recorded relatively rarely. The greatest response from the recipients of the petition is caused by problems in the social sphere, education and health. The French society, through the prism of activity on the non-governmental Internet resource Change.org, appears as a modern society with post-industrial values, preoccupied with security issues, in an active and relatively productive dialogue with its political and business elite.

Due to insufficient oxygen supply to the fetus, which is called hypoxia, adverse changes occur in its body. In the total number of births, it is 10,5%. Fetal hypoxia is not an independent disease. It is a consequence of various pathological processes in the body of the mother, fetus and in the placenta. The health of a child is formed even during his intrauterine development, in this regard, fetal hypoxia at the present stage is an important medical and social issue, since it is directly related to the level of health of the population. The article analyzes the main factors contributing to the occurrence of hypoxia during pregnancy and childbirth. These can be diseases of the mother, such as: cardiovascular and pulmonary diseases, anemia, intoxication and others. It can also be a violation of the fetal-placental blood flow: gestosis, fetal prolongation, the risk of premature birth, pathology of the placenta and umbilical cord, various abnormalities of labor. The research was carried out on the basis of the Arzamas Maternity Hospital. Cases of development of fetal hypoxia, outcomes of pregnancies and childbirth in women with fetal hypoxia were analyzed. The aim of the study was to study the factors influencing the development of fetal hypoxia during pregnancy and childbirth in order to determine priority preventive measures to prevent this pathology in the city of Arzamas and Arzamas region. Retrospectively, 821 birth histories were analyzed – form No. 096/y, for the period 2017-2019, reporting data for the Arzamas maternity hospital. Based on the results obtained, in order to reduce fetal hypoxia, it is necessary to improve the quality of health improvement of the population at the pregravid stage, to allocate women with a complicated obstetric history to highrisk groups, to hospitalize women with pathology in the appropriate departments when their condition worsens and before childbirth. It is necessary to carry out psychoprophylactic preparation of pregnant women for childbirth, prohibit the work of women in hazardous work by law, organize physical culture breaks for women whose work is associated with physical inactivity.

Introduction. The study of the intensity of humoral immunity to the measles virus (Paramyxoviridae: Morbillivirus) (MV) remains relevant due to the ongoing registration of the cluster cases of measles (including nosocomial cases). The aim of the study was to analyze correlation between the intensity of the humoral immunity to measles virus and the measles incidence in different age groups of the Moscow residents. Material and methods. A simple analytic study was carried out under the framework of measles prevention improvement program conducted in the subjects of the Russian Federation. The study included the analysis of the reasons for the increase in the proportion of seronegative individuals and the comparison of the results of seromonitoring with the data of age-related measles incidence. Throughout 2018, total 1,855 blood serum samples obtained from employees of a large hospital center in Moscow who were previously vaccinated against measles were tested for IgG antibodies (ABs) to MV. The subjects were divided into 11 groups according to their age. Statistical analysis of the obtained data was performed using nonparametric criteria. Results and discussion. The proportion of seronegative individuals among the staff of the medical facility decreased with age, from 38.5% in persons aged 19–23 to 0% among employees aged 64 and over. Persons aged 19–43 years were the most susceptible to measles infection, which was confirmed also by the highest incidence rate at these age groups (from 6.93 to 14.03 per 100,000 population). The age group most protected against measles was those over 64 years of age, who were all seropositive and had the lowest rates of incidence. This is probably due to the fact that by this age most of them have had a measles infection and have formed a sufficient immune response. At the same time, younger individuals living in the post-elimination era have only vaccine-induced ABs to MV, the level of which declines rapidly to non-protective values in the absence of boosterization due to the exposure to the wild-type strain of the pathogen. Conclusion. The monitoring of the MV-specific IgG- AB levels is required for employees in the medical institutions under the age of 35. Administration of the single dose of the appropriate vaccine is recommended for seronegative individuals.

The article covers different aspects of clinical manifestations, diagnosis, and treatment of vulvar, vaginal, and cervical sarcomas.

Objective: comparative evaluation of treatment methods for neoadjuvant intra-arterial chemotherapy and chemoembolization by drug-saturated microspheres followed by surgical treatment in II–IVa stages cervical cancer.Materials and methods. This study presents the results of complex treatment in 209 patients (average age – 40.57 ± 8 years) with II– IVa stages cervical cancer and 384 endovascular interventions as the first stage of complex treatment in the period from 2010 to 2016. The scheme neoadjuvant intra-arterial chemotherapy was carboplatin (AUC6 intra-arterial) + irinotecan (200 mg/m2 intravenously on day 1) every 21 days. Radical surgical treatment was performed basically after 2 cycles of chemotherapy. Patients who did not respond sufficiently to neoadjuvant intra-arterial chemotherapy underwent a radical course of chemoradiation therapy according to the standard scheme.Results. The overall response to neoadjuvant intra-arterial chemotherapy was 84.8 % and 79 % of patients in groups of chemoinfusion and trans-arterial chemoembolization, respectively (p >0.05). Operability was higher in group of chemoinfusion (69 % versus 46.4 %) (p

Objective: to assess the efficacy of dose-intensive platinum-containing neoadjuvant chemotherapy in patients with FIGO stage IB2–IIB locally advanced cervical cancer.Materials and methods. We evaluated the efficacy and toxicity of 3 cycles of intravenous dose-intensive neoadjuvant chemotherapy with either AP regimen (cisplatin 75 mg/m2 and doxorubicin 35 mg/m2) or TP regimen (cisplatin 60 mg/m2 and paclitaxel 60 mg/m2).Results. The study included 105 patients (75 in the AP group and 30 in the TP group) aged between 27 and 63 years (mean age 44 years) with primary verified cervical cancer (T1–2B0–2Nx–0M0). Surgery was performed in 66 patients (88 %) from the AP group and 24 patients (80 %) from the TP group. Six patients (8 %) receiving AP regimen and 1 patient (3.3 %) receiving TP regimen developed disease progression. Four women (2.8 %) from the AP group developed relapses, whereas none of the patients from the TP group had relapses. Dose-intensive chemotherapy did not cause any significant complications at both chemotherapeutic and surgical stages. Our findings suggest that dose-intensive neoadjuvant chemotherapy is an effective method with an objective response rate of 84 % (63 cases) and 56.7 % (17 cases) in groups AP and TP respectively. Fifty-nine patients (78.7 %) receiving AP regimen had pathological response; of them, 7 participants (9.4 %) demonstrated pathological complete response (ypCR). In the TP group, 19 patients (63.3 %) had pathological response and 4 patients (13.4 %) had pathological complete response. Median follow-up time was 16.7 months (range: 3–29 months) in the AP group and 9.1 months (range: 2.8–12.7 months) in the TP group.Conclusion. Dose-intensive neoadjuvant chemotherapy can be considered as an alternative to standard treatment of locally advanced cervical cancer; however, further studies are needed due to the small sample size in this study.

Ischemic stroke is still leading in terms of primary disability caused by residual neurologic de-fect in the majority of patients. Persistent motor disorders are observed even after timely and ade-quately carried out rehabilitation measures. The article discusses the possibilities of modern instru-mental technologies for diagnostics and further monitoring of the process of restoration of post-stroke deficit, which is based on the phenomenon of neuroplasticity.

Introduction. A new type of devices for collecting and accumulating energy – an air-inflatable collector – is considered. As a rule, inflatable collectors are installed permanently which does not imply the orientation of the collector following the solar motion. Due to the low costs of the products in question, it is necessary to offer and investigate the most efficient design. Materials and Methods. A collector consisting of seriesconnected closed cylindrical segments is considered. Cavities of the cylinders are filled with air which maintains the structure constancy. Mathematical modeling of the definition of the airinflatable collector temperature field is performed using the finite element method.Research Results. The temperature field distribution as a function of the direction of solar radiation flow is substantiated experimentally. Mathematical models are considered adequate. The increase in temperature of the heat-absorbing layer with respect to the ambient temperature is from 7 ° to 26.2 ° depending on the part of the collector segment. Discussion and Conclusions. In the course of simulation and experimental studies, it is established that the collector efficiency, apart from solar insolation, is affected by a range of environmental factors: air humidity, wind force, etc. In this case, it is necessary to take into account the device design, as well as the operational and thermophysical characteristics of the materials used. A detailed study of the severity of exposure of external and internal factors on the collector temperature field requires the subsequent development of the software package.

Generally recognized factor, which complicates the course of sepsis, is the development of hypercoagulation syndrome. The increase of thrombin coagulation indicates on the elevation of risk of thrombus formation in microcirculation vessels, which could cause the formation of multiple organ failure. The thrombin generation assay is a new method of the evaluation of homeostasis system status. The test reflects the fermentation activity of thrombin and shows the functional condition, which arises in the interaction of procoagulant and anticoagulant. The diagnosis of generalized peritonitis had 30 patients (18 men and 12 women, aged 61±18,3 years) and they were included in the research. It was shown, that the use of thrombin generation assay in patients with the abdominal sepsis could give the well-timed analysis of hypercoagulation changes and the assessment of protein C system investment in the thrombin generation.

Endometrial cancer (EC) is the third most common cancer. It comprises almost 10 % of all malignant tumors in women. Peak morbidity is observed at advanced age (62–64 years) and is associated with excess weight. At the time of diagnosis more than 70 % of patients have stage I disease and most of them have a concomitant pathology: diabetes, thrombosis, or hypertension. These patients require a low-trauma panhysterectomy which can be performed laparoscopically or laparotomically. Due to improvement of technological equipment in hospitals and development of surgical and anesthetic techniques, frequency of laparoscopic surgeries at large medical institutions is increasing. Comparative long-term results of oncological treatment allow to pose a problem of comfort in the postoperative period as a reason to prioritize laparoscopicaccess. In order to include the surgery into standard practice, it is beneficial to calculate economic costs for each type of surgical access. Objective. Evaluation of effective costs of panhysterectomy performed laparoscopically and laparotomically for treatment of early stage endometrial cancer. Materials and methods. We performed a retrospective analysis of medical histories of 170 patients with stage I EC who underwent panhysterectomy at the N. N. Petrov Research Institute of Oncology in 2010–2017. Calculations of direct medical costs took into account costs of surgery, drug therapy, treatment of complications, and in-patient care. Indirect costs were based on statistical data on salaries in 2016 and employment in the Russian Federation.Results. For laparoscopic panhysterectomy we observed significant decrease in intraoperative blood loss (82 %), number of drugs, rate of early postoperative complications (mostly associated with postoperative wound healing), and duration of postoperative rehabilitation characterized by short hospital stay and quick return to work. Cost component of the above-mentioned trends amounts to decrease in cost value of 4,000–5,000 rubles for every patient. Conclusions. In long-term perspective, initial investments into high-tech minimally invasive techniques lead to economic benefits due to decrease in costs of in-patient care and treatment of postoperative complications and quick rehabilitation. At the same time, at early stages of EClaparoscopic surgeries don’t affect oncological prognosis for these patients.

This study is aimed at exploring the use of thrombin generation assay (TGA) in platelet-poor plasma to assess the contribution of the protein C system to the hypercoagulation development in patients with coronary heart disease (CHD) after intracoronary stenting. The study material, the venous blood, was taken in 63 patients with CHD at the age of 53 to 77 before and on Day 1 after the planned percutaneous coronary intervention (PCI) who were treated with antiplatelet agents and antithrombotic agents in standard doses, and in 35 subjects of comparable age and sex without clinical manifestations of CHD who were not treated with these drugs for any other purpose. Laboratory examination included the standard coagulologic tests. To assess the effects of activated protein C system, the TGA in platelet poor plasma was modified by adding human recombinant trombomodulin (rh-TM) to the reaction mixture. The standard coagulologic tests revealed changes in hemostasis relevant to the pathogenesis of CHD and the effects of antithrombotic agents. The TGA results showed an increase in ETP and Peak Thrombin in patients with CHD after PCI with respect to the control and initial values which is evidence of the increased coagulation after the intervention. The test results also showed a reduction of TGA values per cent decline when adding TM. The ETR, Peak thrombin and ttPeak per cent decline was the most significant under the influence of TM which was evidence of the contribution of protein C activity reduction to the development of hypercoagulation after PCI. The modified TGA in platelet-poor plasma used in this study can be applied in clinical practice for estimating the plasma-coagulation hemostasis status and reduction in sensitivity to TM, which characterizes the protein C system activity by degree of decrease in results of the test that was performed in plasma without and with the addition of rh-TM.

The article presents an assessment of anticoagulant effect of rivaroxaban in 35 patients with thromboembolic diseases. The results of expressed anticoagulant effect of rivaroxaban were obtained during a day (or more). The data of increase in sensitivity to thrombomodulin indicated about work enchancement of protein C system against the background of rivaroxaban therapy.

Today, gaming practices seem to be at the forefront of the formation of a future society. In the current era of global digital transformations, the moment of total public involvement in the new digital reality was recorded in 2016, when an augmented digital reality was widely introduced and adopted. Thus, the period of post-post-modernity started with the situation, in which a person is at a loss facing an elusive old world with new features rather than a “brave new world”. However, some grounds for forecasting future trends have been accumulated, which allows the authors to argue that behind the most striking manifestations of digitalization affecting social reality, there is the totality of their influence on many aspects of everyday life. The hidden restructuring of social practices that comes with every new multiplayer game is determined by both the gameplay of players involved and business structures that use psychological and digital tactical and strategic achievements for their own commercial purposes. The total gamification of social practices will become a new “bottleneck” for the contemporary civilization, if we do not manage to integrate a humanitarian approach and humanistic expertise into the strategic control centers for the development of digital technologies. The article presents the results of the survey conducted to reveal the general tendency in the youth’s attitude towards the key aspects of life under the increasing digitalization (socializing, communication and learning) and to find out whether gaming might positively contribute to them or, on the contrary, should be considered a potential threat. The results of the survey show that the youth define both offline and online communication as equally important parts of their life and tend to restrain from total gamification but only in the field of education. The danger of getting addicted seems to be the most notable disadvantage of gaming, although in general it is viewed rather as an entertaining pastime provided the ability to keep it under control.

Introduction. When manufacturing printed circuit boards (PCBs), including their prototypes, the proper alignment of PCB layers is mandatory. While the causes and preventive measures against misalignment in PCBs manufactured using conventional technologies are known, research into alignment errors in 3D-printed PCBs is still ongoing. Another task regarding 3D printing, which is related to topological accuracy (alignment errors in particular), consists in ensuring the opportunity to remove the printed part of the product in order to perform operations thereon, such as embedding components, followed by its return and continuation of the printing process.Aim. Numerical estimation and analysis of the causes of layer-to-layer alignment errors in PCBs manufactured using 3D printing.Materials and methods. The research was conducted using the following materials and equipment: Polyethyleentereftalaatglycol (PETG); an Ultimaker Cura slicer; an Ender 3 S13D printer; a brass nozzle with a diameter of 0.3 mm. The study was conducted using the facilities of the Additive Technologies Center, Bauman Moscow State Technical University. Interlayer alignment errors are estimated by microsection analysis and X-ray inspection, as well as using the misalignment decomposition method described by Yu.B. Tsvetkov for electronics.Results. The possibility of manufacturing PCB prototypes with three conductive layers is demonstrated, including a method for removing the printed part of the product and its further return in the printing process using printed pins. Large-scale distortions were found to make the largest contribution to the alignment error: on average, approximately 150 gm for each layer when compared to its 3D model and approximately 60 gm when comparing the topology of the top layer with the bottom layer. These values exceed the common misalignment value of 50 gm for the pin lamination process. This substantiates the need to control and minimize temperature effects, e.g., using 3D printers with a thermostatically-controlled chamber.Conclusion. The conducted analysis of possible causes of misalignment emergence determines the significance of temperature gradients that occur during 3D printing. The proposed manufacturing method allows the printed part of the product to be removed and further returned into the printing process, which can be used to produce PCB prototypes with three conductive layers.

Lipodystrophy syndromes are a heterogeneous group of extremely rare, inherited or acquired disorders that are characterized by total or partial fat loss or its improper redistribution. The prevalence of lipodystrophies is estimated to be 1:1,000,000 in the population, with approximately 1,000 cases currently described in the literature.Sarcoidosis is a multisystem disease of unknown etiology that is characterized by the formation of non-caseating epithelioid granulomas in the affected tissues. Despite the large number of studies, the etiology and pathogenesis of sarcoidosis still remain unknown. Most researchers allude to the possible autoimmune or immune-mediated genesis of the disease.This article presents a series of unique clinical cases of a combination of two rare diseases in one patient: sarcoidosis and familial partial lipodystrophy.

Chronic rhinosinusitis (CRS) is a disease caused by inflammation of the paranasal sinuses and its mucous membrane lasting for more than 4 weeks continuously. The aim of our study was to examine the main pathophysiological features of chronic IgE-mediated rhinosinusitis of bacterial etiology according to publications in the Russian Federation and in the world. A search was made through English- and Russian-language literature sources using the following databases: PubMed, MedLine, Web of Science, Russian Science Citation Index, Springer, Scopus, Scientific Research, Google Scholar, Crossref, eLibrary. The epidemiological features of CRS in the Russian Federation, bacterial pathogens and pathophysiological characteristics of CRS were analyzed. A 2-fold increase in the prevalence of CRS was registered over the past 20 years. Prevalence of the disease increases at longer age ranges. Chronic rhinosinusitis ranks first among all chronic diseases in the field of otorhinolaryngology. Allergic rhinitis, asthma, bronchiectasia, immunodeficiencies, cystic fibrosis, primary ciliary dyskinesia and autoimmune diseases are associated with CRS. The most common bacterial pathogens are S. aureus, Staphylococcus epidermidis and Propionibacterium acnes, Prevotella, Streptococcus and Veillonella, and some Gram-negative bacteria, e.g., Pseudomonas aeruginosa (P. aeruginosa), Proteus mirabilis and Klebsiella pneumoniae. Staphylococcus aureus (S. aureus) is involved in pathogenesis of nasal polyps. The colonizing bacteria may contribute to pathogenesis of CRS through the formation of biofilms. Alterations in the sino-nasal microbiome may also contribute to the development of CRS. An association of the CRS and CFTR gene mutations plays a significant role in the pathogenesis of chronic rhinosinusitis. An “immune barrier hypothesis” has been proposed as potential mechanism of CRS. Reduced expression of SPINK5, impaired STAT3 signaling, and T2R38 bitter taste receptor polymorphism have been identified in the pathogenesis of CRS. The T2R38 gene stimulates epithelial cells to produce nitrous oxide with a bactericidal effect, promotes mucociliary elimination of pathogens and prevention of upper respiratory tract infections, the polymorphism of this gene predisposes patients to gram-negative infectious diseases, and therefore is a risk factor for the development of CRS. In addition, antibody deficiency is the most common primary immunodeficiency associated with CRS.Hence, the pathogenesis of chronic IgE-mediated rhinosinusitis of bacterial etiology is associated with defects in innate immunity and mucociliary clearance, influence of the sinonasal microbiome, allergies, and genetic factors. A comprehensive assessment of these factors is necessary for the development of new preventive and therapeutic options for the correction of CRS.

Introduction. A review of foreign publications on 3D printing methods shows the possibility of their application for the manufacture of printed circuit boards (PCBs), while demonstrating the growth of interest in this field. One of the available methods is fused deposition modeling, which can be used to form substrates with channels for traces. At present, the minimum channel width comprises 100 µm, which corresponds to the 5th class of PCB accuracy. However, there is no data on how to obtain such dimensions or on the magnitude of their deviation from the given nominal values.Aim. To determine the influence of such factors as nozzle diameter and the number of contours on the dimensional characteristics of PCBs (linear dimensions; trace channel width; trace spacing; via diameters).Materials and methods. To obtain linear models, a full factorial experiment was carried out. The influence of the following materials was evaluated – polylactide (PLA), acrylonitrile butadiene styrene (ABS) and glass-filled ABS; slicers – Ultimaker Cura and PrusaSlicer; 3D printers – Picaso 3D Designer Classic 2016 and Hercules Strong 2017; brass nozzle with diameters ∅0.2 and ∅0.4 mm. The possibility of using brass nozzles coated with chemical nickel for printing with glass-filled filaments was considered. The study was conducted using the facilities of the "Center for Additive Technologies" of Bauman Moscow State Technical University.Results. The possibility of manufacturing PCBs up to the 2nd and 3rd accuracy classes using nozzles with a diameter of ∅0.4 and ∅0.2 mm, respectively, was shown. It was found that galvanic deposition of chemical nickel on a ∅0.2 mm brass nozzle makes it possible to increase the PCB wearability when printing with glass-filled filaments. Recommendations are proposed for selecting an optimal combination of nozzle diameter and the number of contours.Conclusion. The conducted analysis of mathematical models shows the significance of such parameters as nozzle diameter and the number of contours. The results can be used when creating new PCB layouts

When the body is infected with the bacterium Helicobacter pylori, a cytokine cascade is launched, which plays a key role in the progression of chronic inflammatory and destructive processes in the gastric mucosa. Thus, the secretion of a number of cytokines is stimulated, which in turn contribute to the attraction of immunocompetent cells and the development of inflammatory changes. However, hyperproduction of cytokines can lead to atrophic changes in the gastric mucosa and, as a result, degeneration into gastric cancer. Thus, the role of cytokines in precancerous conditions is ambiguous. On the one hand, they activate the immune response aimed at eliminating the pathogen. On the other hand, they themselves contribute to the progression of the disease.The complex clinical and laboratory study included patients: 60 with chronic gastritis (CG), 55 with chronic atrophic gastritis (CAG), 50 with gastric cancer (GC, stage I-II, morphological variant – adenocarcinoma) and 60 – control group. The diagnoses were verified according to international and Russian recommendations and confirmed by laboratory and instrumental studies. All patients were comparable in terms of gender and age characteristics (p > 0.05). All patients had specific IgG to H. pylori. The study was approved by the Local Ethics Committee of the FRC KSC SB RAS (protocol No. 11 dated November 11, 2013). All ethical requirements were observed, and the patients signed the informed consent form for participation. Patients and persons of the control group underwent a single blood sampling from the cubital vein upon admission to vacutainers with heparin.The levels of IL-2, IL-4, IL-8, TNFα, interferon-γ in the blood serum of patients and healthy individuals were determined using the enzyme immunoassay method using reagent kits manufactured by JSC “VectorBest”. Statistical data processing was carried out using the Statistica for Windows 8.0 application package.All patients with H. pylori-associated diseases (CG, CAG, GC) showed an increase in pro-inflammatory (IL-2, IL-8, IFNγ) with a significant increase in IL-8 in all patients and IFNγ in gastric cancer and antiinflammatory cytokine (IL-4) with a maximum value in gastric cancer. A combined Th1 and Th2 is found – a mediated immune response with a maximum violation of cytokine regulation in gastric cancer.

Stomach cancer is in the top ten in terms of prevalence and ranks 4th in terms of causes of death worldwide. The most common and most aggressive variant of gastric cancer is adenocarcinoma. The monocytic link of immunity provides the main line of the body's fight against malignant cells, while in patients with adenocarcinoma it is insufficiently studied. The purpose of the study was to evaluate the functional activity of monocytes in patients with gastric adenocarcinoma at different stages of the disease.Individuals (n = 164) were examined, among whom 85 were diagnosed with stage I-IV stomach adenocarcinoma. The study also involved 79 apparently healthy donors. The functional activity and oxygen-dependent phagocytosis of monocytes were assessed by the chemiluminescent method. Luminol was used as a chemiluminescence inducer. The respiratory burst was activated with opsonized zymosan.In patients with stomach adenocarcinoma, at rest (spontaneous chemiluminescence), an increase in the time the curve reached the maximum intensity of chemiluminescence (Tmax = 7957 s), the area under the chemiluminescence curve (Squr = 0.2 x 106), the activation index (1.89 c. u.) and a decrease in the maximum value of chemiluminescence intensity (Imax = 424 c. u.) relative to the control group (Tmax = 5533 s, Squr = 0.011 x 106, activation index = 0.88 c. u., Imax = 424 c. u., p < 0.05) were seen. When chemiluminescence is induced in patients with stomach adenocarcinoma, a statistically significant predominance of Squr is fixed (0.46 x 106, in the control group Squr = 0.031 x 106). Also, in the group of patients with stomach adenocarcinoma, monocytic phagocytosis was reduced by more than 2 times (29% vs 84% in the control group, p < 0.05). When analyzing the studied parameters, depending on the stage of the disease, it was found that the violation of the chemiluminescent reaction in patients with stomach adenocarcinoma is fixed already at an early stage. At the same time, in patients with stage IV stomach adenocarcinoma, the indicators of spontaneous and induced chemiluminescence are more than 2 times different from those in the control group and patients at stage I of the disease. The identified features indicate a decrease in the effectiveness of immune reactions of the monocytic link in stomach adenocarcinoma already in the early stages of the disease and can be used to detect early signs of immune disorders and optimize therapeutic approaches in this disease.

Conflicting data on the role of the metabolic syndrome (MS) in the development of hepatocellular carcinoma (HCC) require studies on the influence of molecular factors that are important in the development of HCC in MS, which was the goal of our review. Publications (scientific articles and reviews) over the past 10 years were studied and analyzed using the databases Web of Science, Scopus, PubMed, RSCI. The terms used for the search were “metabolic syndrome and non-alcoholic fatty liver disease”, “metabolic syndrome and non-alcoholic steatohepatitis”, “metabolic syndrome and hepatocellular carcinoma”. The total number of publications studied in all databases exceeded 570 units, while the review presents the most significant results at the present stage. Insulin resistance and obesity, through the development of a systemic chronic inflammatory state, lead to increased inflammation and fibrosis in the liver, which are prodromal signs of hepatocarcinogenesis, increase the production of insulin-like growth factor-1 and disrupt the regulation of the insulin-like growth factor pathway. People with HCC have been shown to overexpress IGF-2. IGF-binding proteins, due to the reduced bioavailability of free IGF-1 and IGF-2 in the circulation, are able to inhibit the growth of HCC. In MS, a pro-inflammatory state is detected, which is caused by the production of cytokines by adipocytes (IL-6, IL-8, IL-1β, tumor necrosis factor α (TNFα), VEGF and chemokine ligands 2 and 5), which recruit immune cells, promoting angiogenesis and enhancing chronic inflammation. Transcription factors (PPAR) are involved in hepatocarcinogenesis, the significance of different factors is not fully understood. Leptin has a positive prognostic value in HCC, improving overall survival, and visfatin has a negative effect on hepatocarcinogenesis. Activation of PAI-1 inhibits the progression of HCC through PPARγ stimulation. Adiponectin may be a prognostic marker in HCC, with a lower serum concentration positively correlated with worse prognosis.

Non-alcoholic fatty liver disease currently affects more than 30% of the population. Recent studies highlight the role of genetic polymorphisms in genes associated with fat catabolism and anabolism in the manifestation of this condition and its progression. The work analyzes foreign publications on the molecular and biochemical aspects of these polymorphisms, as well as works studying their effect on the state of the liver and markers of its pathology over the past 10 years. Thus, polymorphisms of the PNPLA3, MBOAT7, and TM6SF2, affecting the functionality of the proteins they express, lead to a change in the metabolism of fatty acids in the liver, which in turn leads to the development of NAFLD and its progression. Despite the fact that the contribution of the rs738409 polymorphism of the PNPLA3 gene is well described both in foreign and Russian articles, polymorphisms of the MBOAT7 and TM6SF2 genes and their effect on NAFLD, as well as the molecular biochemical mechanisms underlying it, have been studied much worse in foreign studies and are little mentioned in Russian ones. In addition, the issue of the severity of the influence of the above polymorphisms on populations of different ethnic and age groups requires additional research. This work attempts to systematize the available data on these issues.

Introduction. The scheduling a transportation route of overweight and oversize goods by road is necessary to perform taken into account road traffic safety and security of artificial engineering structures (bridges, railway crossing and others). The monitoring and control of these procedures are performed by a licensing system in Russia. During the delivery a driver must carry out the transportation of such cargo within the approved route that is specified in a particular paper (authorization) located in the vehicle. Issues appear mostly during first shipment organization and when the route is outside the permanent vehicles location, when road network and bypass schemes are not familiar for the driver and the current GPS-systems bases do not include formal designations of roads according to state register. The authors suppose digital technologies implementation has to facilitate easier abnormal load shipments violations-free sufficiently.The Materials and methods. A transportation organisation model of abnormal loads by BPMN notation has been developed. The key control points have been determined by the authors on the base of their own experience.The results. An information model of forming and transmitting to the carrier authorization to transport abnormal load within the approved route has been developed. In the authorization the link to the cartographic resource is inserted in one of the QR-code field. Such approach makes possible to identify approved route clearly and unambiguously.Uniqueness and practical meaning. The information model uniqueness consists of the transmission way of approves route to the customer – not the sequence of transit localities, but the cartographic resource. The practical implementation of such decision is addressed to help a carrier (a driver) to perform the abnormal load transportation strictly within the approved route.

Mucocutaneous bleeding and thrombocytopenia are commonly encountered in pediatric patients. It is important for pediatricians to recognize when these signs and symptoms warrant further investigation and subsequently what investigations are most helpful and when referral to pediatric hematology is necessary. The most important part of an evaluation for a platelet disorder in a well-appearing child is the history, including family history, and physical examination. Platelet function test for children is a highly demanded investigation. The cornerstone laboratory test is the complete blood cell count. Individual laboratories may vary in their reference ranges for platelet count, but the normal range of platelet count remains 150 to 450 × 109/л. Platelet dysfunction is often not diagnosed, since of throm bocytopathies in most cases do not have clear symptoms, in some cases clinical manifestations of platelet dysfunction are even absent. Meanwhile complete blood count cannot completely reflect changes in the patient's platelet step of hemostasis. For more comprehensive assessment of platelet function in the initial step of the hemostasis it is necessary to evaluate the function of platelets in the whole blood. Whole Blood Impedance Aggregometry measures the change in electrical impedance between two electrodes when platelet aggregation is induced by an agonist. The method is performed using whole blood and so eliminates the need to generate platelet rich plasma. Platelet function testing may have a role to optimize antiplatelet therapy to reduce bleeding and ischemic events. Platelet aggregation function tests with different inductors make it possible to estimate the effectiveness of antiplatelet therapy, select individual doses of drugs and conduct drug monitoring. Platelet aggregation in patients on the antiplatelet therapy is induced by inductors: arachidonic acid (ASPI test), adenosine diphosphate (ADP test) and thrombin (TRAP test). The high prognostic significance of the Impedance Aggregometry results makes it possible to decide on the drug of choice for patients after thrombosis and intravascular interventions, as well as to prevent bleeding during and after surgical procedures.

Obesity and metabolic syndrome are one of the major public health problems in the 21st century due to their prevalence. Nonalcoholic fatty liver disease, dyslipidemia, type 2 diabetes mellitus, arterial hypertension, chronic inflammation and anemia are non-communicable diseases accompanying obesity. With obesity, there is a violation of iron metabolism, iron deficiency, which further contributes to the development of metabolic disorders. Iron is the second most abundant metal on Earth, and its bioavailability is reduced due to the formation of insoluble oxides, while iron deficiency is the most common nutritional disorder. Iron metabolism in the body is associated with the formation of reactive oxygen species involved in lipid peroxidation processes. Iron metabolism in the human body is regulated at all levels; dysregulation of any stage of metabolism can lead to iron deficiency and the development of anemia associated with obesity. This review article summarizes data on molecular and cellular abnormalities in iron metabolism in obesity and metabolic syndrome. The aim of our study was to study, according to the literature, pathophysiological disorders in iron metabolism in the development of obesity and metabolic syndrome. In the future, more research is required to study iron metabolism in obesity with the aim of their preventive and therapeutic effects. The role of oxidative stress in impaired iron metabolism in obesity has not been fully studied, while iron deficiency enhances lipid peroxidation processes in antioxidant deficiency. Under these conditions, oxidative stress can damage cells and destroy red blood cells. The question arises whether the restoration of iron homeostasis in obesity can improve metabolic, inflammatory disorders and reduce the manifestation of oxidative stress, becoming a new innovative approach to the treatment of concomitant metabolic diseases associated with obesity.

Obstructive jaundice caused by cholangiocarcinoma takes a special place among malignant disorders and surgical pathology in Russia. Involvement of nonspecific immunity and the role of neutrophils in carcinogenesis are ambiguously evaluated. The aim of this study was to study functional activity of peripheral blood neutrophilic granulocytes and their phenotype in obstructive jaundice caused by cholangiocarcinoma. The study included 56 patients with obstructive jaundice associated with cholangiocarcinoma at the T2- 3N0- 1M0 stage (clinical stages II-III), and 90 apparently healthy volunteers of similar age group. Neutrophilic granulocytes were isolated from peripheral blood by means of double-density Ficoll-Urografin gradient.Venous blood was collected in patients into vacutainers with heparin upon admission to the hospital, before the surgery was performed. Spontaneous cytokine production (IL-8, IFNá) was determined by enzyme-linked immunosorbent assay using Vector-Best diagnostic kits. To assess phagocytic activity of neutrophilic granulocytes, the phagocytic index (according to Hamburger), number of phagocytes (according to Wright) and the index of completed phagocytosis (according to Rudik, 2006) were calculated. Immunophenotyping of neutrophilic granulocytes was carried out using an FC500 flow cytometer (Beckman Coulter, USA) with monoclonal antibodies to CD11b+, CD16+, CD95+. The results were statistically analyzed using the Statistica v.12.0 software (StatSoft Inc., USA). To assess intergroup differences, the nonparametric Kruskal-Wallis tests (for three or more comparison groups) and Mann-Whitney tests (for pairwise comparison) were used. Comparison of groups for a qualitative binary trait was carried out using the two-sided Fisher’s exact test. Data are presented as Median (25 quartile-75 quartile).The study of the functional activity of peripheral blood neutrophiles in obstructive jaundice patients caused by cholangiocarcinoma revealed an increase in their relative and absolute number, increased phagocytic index and decreased phagocytic number of neutrophilic granulocytes, increased expression of CD11b+, CD16+, CD95+ immunological markers. The changes in neutrophil secretory activity were characterized by a decrease in cytokine production (IL-2, IFNá). An increase in functional activity of neutrophilic granulocytes, along with a decrease in their cytokine production suggests that, in obstructive jaundice observed in cholangiocarcinoma at clinical stage T2-3N0-1M0, an equilibrium stage is revealed between the cells of immune system and malignant tumor.

The development of the electric bus fleet, observed in the world and, in particular, in the Russian Federation, leads to the emergence of new scientific and practical problems that need to be addressed. So, at present, when electric buses are put into operation, in practice, problems arise with the choice of a rational urban regular route and the organization of charging infrastructure on it. To solve this problem, you need to know the power consumption of an electric bus, which depends on the operating conditions. This article analyzes scientific research in the field of modeling electricity consumption by an electric bus. Such an analysis and study of the experience of operating an electric bus in Tyumen made it possible to single out the factors on which electricity consumption depends. In the course of the study, a hypothesis was formulated: the factors characterizing the operating conditions on the route can be taken into account by one indicator «speed of communication». At the same time, until now, no direct influence of the ambient temperature on the power consumption of an electric bus has been revealed. Therefore, the aim of the study is to study the effect of traffic speed and ambient temperature on the electricity consumption of an electric bus on a regular urban route. To achieve this goal, a passive experiment was carried out, during which data was obtained on the functioning of electric buses, the technical parameters of the charging stations and the ambient temperature. To test the hypothesis, the initial amount of experimental information was processed using statistical data processing methods. It was found that a decrease in the speed of communication causes an increase in the consumption of electricity by an electric bus. During the analysis of the influence of the ambient air temperature on the considered output parameter, it was revealed that when it deviates from the value equal to + 4 °C, an increase in the consumption of electricity by the electric bus is observed. As a result, the established regularities of the influence of the speed of communication and the ambient air temperature on the electricity consumption of an electric bus and their mathematical models will become the basis for further research for the development of a methodology for rationing electricity consumption by an electric bus on a regular city route.

Background. The problem of gastric cancer remains unresolved throughout the world, while chronic atrophic gastritis (CAG) increases the likelihood of its development by 15 times. In the Russian Federation, the incidence of gastric cancer (GC) is among the highest, with it prevailing among males. One of the leading mechanisms in molecular pathology of membranes is lipid peroxidation (LPO). The severity of oxidative membrane damage depends on concomitant diseases, contributing to emergence and progression of pathological processes and development of cancer. Currently, the problem of LPO is unsolved in biological systems.The aim of this study was to investigate the state of LPO and antioxidant defense system in CAG and GC. Materials and methods. The parameters were studied in 45 patients with CAG and 50 patients with GC. The control group included 50 practically healthy volunteers without gastrointestinal complaints, who did not have changes in the gastric mucosa according to the fibroesophagogastroduodenoscopy (FEGDS) findings.Results. In patients with CAG, an increase in malondialdehyde, superoxide dismutase, catalase, glutathione S-transferase, and glutathione peroxidase was found in the blood plasma compared with the control group. In patients with CAG, lipid peroxidation was activated, and the malondialdehyde level increased by 3.5 times relative to normal values. At the same time, the body fought against oxidative stress by increasing the activity of antioxidant enzymes, such as superoxide dismutase, catalase, glutathione S-transferase, and glutathione peroxidase. All patients with GC showed pronounced oxidative stress in the blood plasma in the form of a 45-fold increase in malondialdehyde. The activity of the main antioxidant enzyme superoxide dismutase was reduced in GC. Catalase was activated, which indicated pronounced oxidative stress, significant damage to blood vessels, and massive cell death. Glutathione-related enzymes (glutathione S-transferase and glutathione peroxidase) and the antioxidant protein ceruloplasmin were activated, which also indicated significant oxidative stress and severe intoxication in patients with GC.Conclusion. Depending on the stage and type of cancer, an in-depth study of lipid peroxidation and factors of the antioxidant defense system can be used to correct therapy and prevent cancer and can serve as markers of progression and prognosis in gastric cancer.

One of the main ways to fine-tune the adaptive potential of wheat cultivars is to regulate the timing of flowering using the genes of the Vrn-1 locus, which determines the type and rate of development. Recently, with the use of introgression and isogenic lines of bread wheat, it was shown that this locus is involved in the genetic control of root length and weight both under irrigation and drought conditions. It turned out that the VrnA1 gene is associated with a significant decrease in the size of the root system in a winter genotype. The Vrn-A1 gene had the strongest effect on the reduction of the root system in comparison with the homoeoallelic genes Vrn-B1 and Vrn-D1. The aim of this work was to determine whether the allelic composition of the genes at the Vrn-1 locus affects the root size in seven spring cultivars and in two lines of bread wheat differing in flowering time under conditions of normal watering and drought. The research was carried out in a hydroponic greenhouse; drought was created at the tillering stage. In this work, we have shown that early flowering wheat cultivars with the dominant Vrn-A1а allele have more lightweight and shorter roots under normal watering conditions compared to the late flowering carriers of the dominant homoeoalleles Vrn-B1 and Vrn-D1. In drought conditions, the root length decreased insignificantly, but the weight of the roots significantly decreased in all genotypes, with the exception of Diamant 2. It has been hypothesized that the level of the transcription factor VRN-1 at the onset of drought may affect the size of the root system. The large variability in root weight may indicate the participation, in addition to the Vrn-1 locus, of other gene networks in the formation of this trait. Breeders working to develop early maturing varieties should consider the possibility of reducing the root size, especially in arid conditions. A significant increase in the root size of line 821 with introgressions into chromosomes 2A, 2B, and 5A from T. timopheevii indicates the possibility of using congeners as a source of increasing the trait in wheat.

The aim of our study was to evaluate the clinical-anamnestic, serological, immunological and biochemical tests used for early diagnostics of gastric cancer associated with Helicobacter pylori infection in the adult population of the Krasnoyarsk Territory. Materials and methods. The control group consisted of 104 apparently healthy blood donors, the comparison group – 97 patients with chronic atrophic gastritis as well as a group of patients with early gastric cancer comprising 98 subjects. Assessment of monocyte and neutrophil spontaneous and induced chemiluminescence (CL) was carried out on a 36-channel biochemiluminometer BLM-3607. Phagocytosis was measured by using a Beckman Coulter FC 500 flow cytometer. A Varian Cary Eclipse spectrofluorometer was used to study lipid peroxidation and factors of the antioxidant defense system. Results and discussion. While studying the phagocytic arm of immunity, it was found that all patients with early gastric cancer were reported to have parameters of the maximum intensity for neutrophil spontaneous CL from 17 831 c.u. and lower, whereas induced CL reached at least 30 000 c.u. Phagocytic activity of neutrophilic granulocytes in patients with early gastric cancer was 36% or less. While studying the indicators of monocytes, it was found that spontaneous and induced CL decreased from 454 c.u. and 1186 c.u., respectively, in the patients with early gastric cancer. Monocytic activity in early gastric cancer was 34% or less. In the study of lipid peroxidation, an antioxidant defense in patients with chronic atrophic gastritis and gastric cancer had increased malondialdehyde (MDA) level. Patients with gastric cancer had decreased activity of the enzyme catalase (CAT), whereas subjects with chronic atrophic gastritis had reduced glutathione peroxidase (GPO) level. In contrast, patients with early gastric cancer were featured with increased GPO activity. We have proposed coefficients for assessing the factors of the antioxydant defence system in patients: the ratio for superoxide dismutase to catalase activity (SOD/CAT) as well as the ratio for superoxide dismutase to glutathione peroxidase activity (SOD/GPO). Conclusion. During the study, threshold values of parameters were obtained for assigning groups at high risk of developing early gastric cancer, which can be used for screening in adult population.

Aim. A study of the overlap syndrome of uninvestigated dyspepsia and heartburn at an industrial hub city of Eastern Siberia.Materials and methods. A total of 1,382 subjects (684 men and 698 women, mean age 40.6 years) were randomly selected and examined for the central district of Krasnoyarsk. The clinical check-up and interviewing results were registered with a standard questionnaire. Heartburn was diagnosed as per the Montreal Consensus. Since no endoscopic patient examination had been performed, dyspepsia was assumed uninvestigated. Dyspepsia was diagnosed as per the Rome IV criteria. The study conduction complied with ethical standards. Each participant signed an informed examination consent, in accordance to the regulations by the World Medical Association’s Declaration of Helsinki. The survey data were analysed with common statistical methods.Results. Heartburn, uninvestigated dyspepsia and their overlap syndrome had prevalence of 12.4, 21.1 and 5% in study population, respectively. Uninvestigated dyspepsia was registered in 40.4% patients with and 18.4% — without heartburn (p < 0.001). The risk factors of overlap syndrome were age >40 years (p = 0.002), obesity (p = 0.002), nonsteroidal anti-inflammatory drug and/or aspirin intake (p = 0.004) and tobacco smoking (p = 0.007). Among total patients with the heartburn/uninvestigated dyspepsia overlap syndrome, only 33.3% systemically had proton pump inhibitors, and only 17.4% had a prokinetic therapy.Conclusion. The heartburn/uninvestigated dyspepsia overlap syndrome is an actual issue in the Krasnoyarsk population. Attention is warranted to this problem to optimise treatment and prevention measures.

Sulfonylureas are widely prescribed all over the world, mainly because of their high effectiveness. At the same time, the heterogeneity of the group is obvious, primarily in relation to the effect of drugs on the risk of developing hypoglycemic events. The review presents the results of new studies, including «Comparative effectiveness of gliclazide modified release versus sitagliptin as second-line treatment after metformin monotherapy in patients with uncontrolled type 2 diabetes» and results of a model-based meta-analysis of 24 antihyperglycemic drugs for type 2 diabetes, confirming the higher efficacy of modified release gliclazide (gliclazide MB) compared to DPP-4, as well as a low risk of hypoglycemic conditions. The results of recent studies, as well as the results of the ADVANCE and ADVANCE-ON studies, suggest that gliclazide MB is safe to use as a second-line drug, especially in patients with chronic kidney disease.

Introduction. The article deals with the actual problem of disposal of industrial waste (sewage sludge). According to the literature data, possible directions of the use of sewage sludge in the production of building materials are identified and considered. Special attention is paid to the proposed variant of systematization of materials, which is based on the dependence of the aggregate state of the sediment on the type of building material. It is proposed to use sewage sludge as a complex additive to improve rheological properties at all stages of heavy concrete hardening.Methods and materials. Studies of the basic properties of raw materials and concrete based on them were determined using standard methods and the requirements of national standards. The material and chemical composition of the sediments, their physical and mechanical characteristics were determined on the basis of the laboratory of the plant of chemical concentrates (Novosibirsk).Results. As a result of the experimental work, the optimal percentage of sewage sludge in the composition of heavy concrete was determined, as well as the ratio of the chemical modifying additive, the optimal composition of concrete was investigated.Conclusion. As a result of the experimental work, the influence of the introduction of sewage sludge modified with plasticizing additives into the concrete composition was established. It has been established that sewage sludge is advisable to use in heavy concrete as a corrective additive without reducing the strength characteristics. In further studies, it is planned to solve the problems of structure formation and study of the interface between the phases of sewage sludge in the composition of concrete; to investigate the relationship between the chemical composition of precipitation and the physical and mechanical properties of a building material.

Aim. To study the content of cytokines in the blood serum of patients with obstructive jaundice of gallstone origin before and after surgical treatment, depending on the development of postoperative complications.Materials and methods. The treatment group consisted of 70 patients with the diagnosis of obstructive jaundice of gallstone origin, verified following a comprehensive clinical and instrumental examination. In 54 patients, the postoperative period was uncomplicated, and in 16 patients, various infectious complications in the postoperative period were revealed. The control group consisted of 125 healthy volunteers. The concentration of six cytokines (interleukin (IL)-2, IL-4, IL-18, IL-10, tumor necrosis factor alpha (TNFα), and interferon gamma (INF γ)) was determined using reagent kits manufactured by Vector-Best LLC (Novosibirsk, Russian Federation) by enzyme-linked immunosorbent assay on the Thermo Scientific analyzer (BioMerieux, France).Results. We identified significantly high concentrations of proinflammatory cytokines in the blood serum of patients with obstructive jaundice of gallstone origin upon admission, compared with the data obtained in the study of blood serum in the control group and in patients with obstructive jaundice after surgery. In the postoperative period in patients with obstructive jaundice without complications, the proinflammatory cytokines are significantly reduced and IL-4 is increased, whereas with the development of infectious complications, the level of proinflammatory cytokines is significantly elevated.Conclusion. In the pathogenesis of obstructive jaundice, a local inflammatory process plays an essential role. This is confirmed by statistically significant changes in the studied cytokines. The established increase in the concentration of IL-4, which has anti-inflammatory activity, indicates its importance in the mechanisms underlying the absence of infectious complications in the postoperative period of obstructive jaundice of gallstone origin. The revealed increase in the levels of IL-18, TNFα, and INFγ in the blood serum of patients suggests their role in the pathogenesis of infectious complications in the postoperative period of obstructive jaundice of gallstone origin.

Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in highly developed countries. The risk of developing NAFLD and associated complications varies greatly among people of different nationalities and is determined by environmental and genetic factors. Genome-wide studies have revealed strong and reproducible associations between gene variations such as PNPLA3, TM6SF2, MBOAT7, GCKR, HSD17B1, and NAFLD. In this article, we consider the influence of genes and environmental factors on the pathophysiological features of NAFLD. The use of a sufficient population sample with the analysis of SNP arrays and the use of sequencing methods (exome and genome as a whole) will lead to the discovery of additional genetic variants, will inevitably improve the understanding of the pathogenesis of NAFLD, and will allow the development of a technology for personalized risk in assessing the disease in a patient. The aim of our study was to study the genetic predictors of NAFLD based on literature data with the interpretation of the studies. There is now strong evidence that specific variants of genetic risk have a large effect on NAFLD, and their effect is comparable to that of major metabolic risk factors such as obesity and type 2 diabetes. The increased risk extends to the onset and progression of the entire spectrum of NAFLD manifestations, including overall mortality due to liver disease. Currently, individual genetic variants do not allow the creation of a personalized risk profile; therefore, the most expedient approach today is the development of polygenic risk assessments. The number of genetic loci associated with the prevalence and outcome of NAFLD remains limited. The use of a sufficient population sample with the analysis of SNP arrays and the use of sequencing methods (exome and genome as a whole) will lead to the discovery of additional genetic variants and will inevitably improve the understanding of the pathogenesis of NAFLD and will allow the development of a technology for personalized risk in the assessment of the disease.

Introduction. The article presents an analysis of researches on the operation of public transport vehicles with an electric drive. Electric buses have been tested in megacities, and despite the advantages, problems were identi- fied both in the selection of the charging type, technological features and with the availability and operation of the charging infrastructure. The operation process is associated with a number of technical restrictions, which in prac- tice make it difficult to select routes for the electric bus operation. The aim of the study is to develop an algorithm for selecting a rational regular urban route for the electric bus operation and to test it on the example of the route network of Tyumen.Materials and methods. A structural diagram of the factors influencing the selection of the route for the electric bus operation has been formed. As a result of processing expert assessments, the most significant factors were identified. The diagram of the interconnections of these factors is identified and limitations for the algorithm are for- mulated based on the theory of systems analysis. The algorithm for selecting the rational regular urban route for the electric bus operation has been developed. It enables creating the simulation model for selecting a rational regular urban route for the operation of an electric bus.Results. The diagram of factors influencing the selection of a rational regular urban route for the operation of an electric bus, taking into account their mutual relations, has been formed. The algorithm and simulation model for se- lecting a rational regular urban route for the operation of an electric bus has been developed. Several urban routes in Tyumen were assessed for the rationality of the introduction of electric buses.Discussion and conclusions. Evaluation of five regular urban routes in Tyumen using the developed algorithm and the simulation model revealed three rational routes, and also showed the inefficiency of the other two. It due to the discrepancy between the duration of the charging session and breaks in operation, as well as the insufficient charge level of the traction battery to ensure the required autonomous movement of the vehicle. In the course of the continuation of these studies, the developed algorithm will be supplemented with the stage of economic assess- ment of routes for the operation of electric buses.

In recent years, more and more cases of cardiovascular diseasesin children have been registered, they often have a long-term asymptomatic course and start with thrombotic manifestations, which can lead to disability and death. Currently, there is insufficient data on the effect of beta-blockers on the vascular-platelet link of hemostasis and monitoring of the effectiveness of therapy in children with cardiovascular diseases. The aim of our study was to develop a technology for monitoring patients with cardiovascular pathologywho receive beta-blockers and antiplatelet agents to optimize the pharmacotherapeutic strategy for their treatment. A complete clinical, laboratory and instrumental examination was performedin 50 patients with suchnosological forms of cardiovascular pathology, as cardiomyopathy, congenital heart disease, valvular pathology, rhythm and conduction disorders, arterial hypertension. The assessment of the platelet aggregation function was emphasized, which revealed changes in aggregation during therapy in 80% of cases.According to the results of the study, platelet aggregation intervals were established, which allow to prescribe appropriate doses of drugs, a model of personalized management of children with cardiovascular disorders was developed, including an in-depth study of hemostasis, a possible potentiated interaction of beta-blockers and antiplatelet agents, and a method for determining the optimal individual sensitivity to the drug.

Aim. A study of monocyte chemiluminescent activity at variant stages of gastric cancer.Materials and methods. The study enrolled 90 gastric cancer patients and 70 healthy donors. Spontaneous and induced chemiluminescence in monocytes was assessed for 90 min with a “BLM 3607” 36-channel chemiluminescence analyser (Russia). Opsonized zymosan-induced chemiluminescence enhancement was measured as a ratio of the areas under the induced vs. spontaneous chemiluminescence curves, the activation index. Statistical significance was estimated with the Mann—Whitney criterion (p < 0.05).Results. The maximal spontaneous monocyte chemiluminescence intensity significantly decreased in stage IV gastric cancer patients compared to the control cohort (p = 0.035). Time to maximum in spontaneous chemiluminescence increased in all gastric cancer patients vs. control (p = 0.001), and in stage IV gastric cancer vs. stage I patients (p = 0.043). The areas under a curve in spontaneous and induced monocyte chemiluminescence increased in all gastric cancer patients vs. control (p = 0.001), and in stage IV gastric cancer vs. stage I patients (p = 0.037). The activation index was higher in all gastric cancer cases compared to control (p = 0.001).Conclusion. All patients with gastric adenocarcinoma, irrespective of the stage, revealed changes in the monocyte chemiluminescence activity, i.e. a longer time to maximum in spontaneous chemiluminescence and larger area under the curve of spontaneous and induced chemiluminescence, the activation index. Maximal monocyte spontaneous chemiluminescence intensity diminished in stage IV gastric cancer compared to the control cohort. Immune activity reflected in monocyte chemiluminescence correlates with the stage of gastric adenocarcinoma.

One of the essential tasks of sustainable forest management is to maintain native biodiversity. Primary forest research is one of the ways to understand what this biodiversity is. Matherials and methods. The primary, as confirmed by their land-use history and structural peculiarities, mesic dark-conifer forests remain in Visim and Pechora–Ilych nature biosphere reserves (boreal and sub-boreal zones respectively, the Ural Mountains, Russian Federation). We compared the primary forests and post fire 100-year small-leaved deciduous forests by diversity of vascular flora and soil invertebrate macrofauna. Results and discussion. The diversity of some functional groups of species (low boreal herbs, earthworms) in post fire forests is lower than in primary forests, the research shows. These species largely depend on deadwood and other tree-related microhabitats common in the primary forests but not so in the 100-year post fire forests. Repeated fires at intervals of several decades, as is the case with the use of prescribed fires in forest management, will be expected to reduce the biodiversity quality of these specialist species. Additionally, we revealed that post fire forest flora is more synanthropic in the woodland of a small area (Visim reserve) than in the intact forest landscape (Pechora–Ilych reserve). It demonstrates that, within extensive woodlands, native forests are more resilient to sporadic stand-replacing disturbances than small woodlands. Conclusion. Strict conservation of intact forest landscapes is necessary as they serve as large buffer areas around the remaining primary forests to maintain native biodiversity.

Chronic atrophic gastritis and gastric cancer represent distinct steps of one pathogenic process. The risk of developing cancer of the stomach is directly proportional to the degree of atrophic changes simultaneously detected in antral segment and in the body of the stomach. The role of immune system in transformation of precancerous diseases into cancer is beyond doubt. During development of the malignant disease, the changes in lipid peroxidation systems – antioxidant defense become significant and contribute to the progression of the tumor and the development of metastases. A simultaneous study of lipid peroxidation and antioxidant defense indices along with phagocytic activity will allow us to evaluate relative contribution of these processes to development of chronic atrophic gastritis and gastric cancer. Purpose of the present study was to assess correlations between the lipid peroxidation indices, i.e. antioxidant protection, and chemiluminescent activity of neutrophilic granulocytes and monocytes in chronic atrophic gastritis and gastric cancer. Forty patients with chronic gastritis, 22 patients with chronic atrophic gastritis and 40 patients with gastric cancer were examined. The control group consisted of 50 practically healthy age-matched volunteers. Evaluation of spontaneous and induced production of reactive oxygen species by neutrophils and monocytes was carried out by chemiluminescent analysis. The parameters of lipid peroxidation/ antioxidant protection were determined by spectrophotometric methods. Statistical data processing was carried out using the Statistica v. 8.0 program (StatSoft Inc., USA). The normal distribution of indices was tested using the Kolmogorov–Smirnov method (adjusted by Lillefors). Quantitative indicators, given the normal distribution, were described using the median (Me) and interquartile scatter (Q0.25-Q0.75). To study statistical significance of differences between quantitative characteristics, the Mann–Whitney test was used. To study strength of relationships of these indicators, the Pearson rank correlation coefficient (r) was calculated. The critical significance level (p) when testing statistical hypotheses was taken equal to 0.05. Correlation analysis showed that the weight of positive correlations increases in patients with chronic atrophic gastritis, and it decreases in patients with gastric cancer, the strength of the correlation dependence and new relationships appear between chemiluminescent activity of neutrophils and monocytes in a spontaneous and induced state, and the amounts of malonic dialdehyde, enzyme activities of superoxide dismutase and catalase. In chronic atrophic gastritis and gastric cancer we have established the features of correlation patterns between lipid peroxidation/antioxidant protection indices, and activity of neutrophils and monocytes.

Helicobacter pylori is the most widespread human pathogen, with prevalence reaching up to 20—40% and 80— 90% of adult infection in developed and developing countries, respectively. Many authors consider this infection as a major factor in the development of gastric cancer. In case of H. pylori infection, free homogeneous oxidation is augmented, that elevates the blood amount of POL products. Hyperproduction of reactive oxygen species stimulates free radical POL, accompanied by membrane destruction, damage to proteins, lipids, and DNA. Thus, the destruction of the intracellular and cell outer membranes occurs resulting in cell death. In diseases associated with H. pylori infection, there is a dysregulation of the lipid peroxidation system — antioxidant defense contributing to inconsistency in the regeneration phases triggering disease progression. The aim of our work was to study indicators of POL (diene conjugates, malonic dialdehyde) and antioxidant protection (AOP) (superoxide dismutase enzymes, catalase) in chronic gastritis and chronic atrophic gastritis associated with H. pylori infection. In patients with CG associated with H. pylori as well as CAG and CAG associated with H. pylori they were featured with increased amount of primary (↑DC) and end TBA-active products of lipid peroxidation (↑MDA), whereas activity of superoxide dismutase was decreased, additionally highlighted with reduced catalase activity (↑CAT) in CAG and CAG associated with H. pylori. H. pylori just triggers the mechanisms of ROS generation in host cells. The energy of redox reactions is used by the microorganism to carry out its physiological functions and serves as a factor in its own pathogenicity, the ROS generated in such reactions can have a damaging effect on the structure of gastric mucosa. In addition, examining H. pylori genome has shown that it bears the genes encoding oxidative metabolism enzymes, such as SOD, catalase, nitroreductase, flavodoxin oxidoreductase. Long-term persistence of H. pylori in the gastric mucosa paralleled with its increased biomass accounts for it being the main source of ROS production able to augment lipid peroxidation and cause damage to the membrane structures and DNA of gastric epithelium cells.

Purpose: this article is devoted to the study of issues and the creation of proposals for the formation of a model of indicative planning in the Russian Federation.Methods: the study is based on system analysis methodology. Program and strategic documents of the Russian Federation and modern scientific publications on the topic of research were used as materials for the work.Results: the author analyzed modern ideas about indicative planning and identified the problems of the lack of a systematic scientific and methodological approach in this area. Modern scientific literature does not have a single opinion on the theoretical and methodological provisions of indicative planning. Based on the analysis of foreign experience and Russian practice, the author presented proposals on the role and place of indicative planning in the system of strategic planning and project management documents in order to achieve the established development and security goals. On this basis, proposals are formulated for the formation of a domestic model of indicative planning. It was noted that the popular tools for implementing coherence, monitoring and adjusting goals through digitalization of strategic documents are part of indicative planning.Conclusions and Relevance: The approach to indicative planning is recommended as a process for the formation of a system of indicators (indicators) and the development of measures of state impact on economic processes based on indicators. In this regard, indicative planning should be considered as a combination: 1) the system of goals and objectives described by the corresponding indicators (indicators), 2) the system of measures aimed at achieving these indicators. This measure system also includes an indicative planning tool.As a toolkit, an approach is proposed that determines the conjugation of the two indicated blocks of indicative planning:architecture, which includes rules for building the system and structured on the basis of goals, objectives, indicators;tools that include balance calculations and mathematical modeling, as well as implementing on the basis of indicators the task of resource determination of goals for the development of a system of measures and management decisions.

Six years of the implementation of the Federal Law “On Strategic Planning in the Russian Federation” were focused on the development of documents and recommendations for them. This determined the fragmentation of public administration and strategic planning. However, according to the author, the basis of the strategic planning system that meets modern challenges and threats should not be documents, but processes. The introduction of new tools will allow the transition from project management and strategic planning to strategic management in the Russian Federation. Such tools include the introduction of management cycles of strategic planning, resource support for the realization of goals, the organization and implementation of the monitoring and control process, a system of continuous indicative planning and balance sheets.

On different types of transport, the issues of cargo classification are not presented equally and it diverse even within the same mode of transport. A number of cargo classifications are fixed by law (hazardous, excisable, production and consumption wastes, and others). There are a number of procedures regarding state regulation (obtaining a license, permit, vehicle admission) when certain types of cargo are produced by road in the Russian Federation. The requirements have been developed and are aimed at improving road safety, and their violation leads not only to administrative fines, but also to a threat to the lives of traffic participants, loss (damage, death) to the cargo and a decrease in the efficiency of logistics distribution. Licenses and permits for the transportation of certain types of goods must be obtained in advance and in various supervisory and control departments of the Russian Federation, information on these procedures is not systematized and is presented in various federal laws. The issues of assigning cargo that the carrier accepts from the shipper to certain types of cargo can be considered relevant. The aim of the study is to develop a cargo identification scheme to comply with regulatory requirements. The object of study is the transportation of various types of cargo by road. Subject of research is the compliance with regulatory and legal requirements for the transportation of certain types of cargo. This article discusses the existing approaches to the division of goods into groups from the point of view of state regulation of the transportation process in road transport in Russia. At the first stage, eight groups of administrative-legal methods of state regulation of the transportation of commercial goods by road were identified. Through a thought experiment, using an analysis of the conceptual terminology of regulatory acts in the Russian Federation, four groups of individual types of cargo were identified: excess, dangerous, special and separate, which constitutes the scientific novelty of research. The direction of further research may be the creation of an expert system for the unambiguous definition of measures of state regulation of the carriage of goods by road through the Russian Federation. During the experiment, using an analysis of the conceptual terminology of regulatory acts in the Russian Federation, four groups of individual types of cargo were identified: excess, dangerous, special and separate, which is the scientific novelty of research. The direction of further research is the creation of an expert system for the unmistakable determination of measures of state regulation of the carriage of goods by road through the Russian Federation.

At present, the level of Helicobacter pylori infection is determined by geographic area, gender and age of the examined individuals, and can reach up to 95% of the total population. Environmental adaptation of H. pylori is exhibited in its ability to adhere to the gastric mucosal epithelium and modulated expression of its own virulent factors. Current concepts implicate that H. pylori can survive inside epithelial cells, evading host immune response. Cytokines are produced by immune cells and act to regulate its major stages. A cytokine cascade launched after Helicobacter pylori infection triggers immune reactions, progression of chronic inflammatory and destructive processes in the gastric mucosa. The role of cytokines in precancerous diseases of the stomach is ambiguous because, on the one hand, they activate immune response aimed at eliminating the pathogen, whereas on the other hand, they do contribute to the disease progression. The aim of our study was to examine profile of some cytokines and features of cytokine regulation in H. pylori-infected middle-aged males with chronic gastritis (CG) as well as chronic atrophic gastritis (CAG). In patients with CG with H. pylori, CAG and CAG with H. pylori, an increase in the cytokine IL-2 was observed that might contribute to augmented damaging effect of cytotoxic lymphocytes, as well as implementation of antitumor effect. CAG with H. pylori was featured with IL-8 hyperproduction, which resulted in increased absolute numbers of band neutrophils in peripheral blood and their decreased phagocytic activity evidencing about altered host defense mechanisms. There was increased amount of IFNy involved in recognition of malignantly transformed cells and upregulated expression of the major histocompatibility complex molecules on antigen-presenting cells. In patients with CG with H. pylori and CAG with H. pylori, production of IL-4 was increased, which might serve as a contributing factor to the chronicity of H. pylori-associated diseases. Overproduction of type 1 and type 2 cytokines indicates about activated Th1 and Th2 type immune reactions in H. pylori-associat-ed CG. A potent pro-inflammatory cytokine cascade triggers inflammatory changes in gastric mucosa with developing neutrophil infiltration and lymphocyte activation. Damage and death of epithelial cells upon inflammation form erosive and ulcerative defects, or changes manifested as gastric mucosal atrophy, metaplasia and neoplasia. The data obtained may be used as additional diagnostic criteria in early diagnostics of precancerous stomach diseases.

Type 2 diabetes mellitus (T2DM) is a serious medical and social problem leading to early disability of patients and high mortality from cardiovascular complications. The development of cardiovascular events is associated not only with the degree of coronary artery stenosis, but also with the structure of the atherosclerotic plaque. Aim. This study aimed to characterize structure and composition of coronary artery atherosclerotic plaque in target lesion of T2DM patients and patients without diabetes using intravascular ultrasound (IVUS) and IVUS with virtual histology (IVUS-VH). Materials and methods. We observed 25 patients with coronary artery disease (CAD) with T2DM and without T2DM, which admitted to Endocrinology Research Centre to perform percutaneous coronary intervention (PCI). Patients with CAD and T2DM were included at group 1 and patients with CAD and without T2DM were included at group 2. IVUS and IVUS-VH assessment of target lesion were performed prior to stent implantation. We observed 24 plaques at group 1 and 10 plaques at group 2. Results. In grey - scale IVUS 2D analysis there were no differences in mean cross - sectional area of the vessel (12.5 [10.4; 15.8] mm2 vs. 13.5 [12,7; 16.5] mm2; p=0.223, respectively) and lumen area (3.71 [2.5; 4.5] mm2 vs. 3.2 [2.7; 3.8] mm2; p=0.589, respectively). Plaque burden were higher in patients without T2DM (71.6 [65.5; 75.7] % vs. 77.6 [74.4; 80.4] %; p=0.008, respectively). IVUS-VH analysis showed that percent of necrotic core and dense calcium areas were significantly higher in the T2DM group (31.3 [25.3; 36.5] % vs. 21.65 [14.3; 27.8] %; p=0.01 and 4.7 [2.3; 7.8] % vs. 2.45 [1.2; 4.05] %; p=0.046, respectively). Percent of the fibrotic tissue were higher in non-T2DM group (55.35 [49.7; 63.6] % vs 67.7 [61.8; 76.5] %; p=0.004, respectively). There were no differences in percent of lipidic tissue in both groups. Conclusions. IVUS-VH assessment of coronary artery atherosclerotic plaques showed greater amount of necrotic core and dense calcium in patients with T2DM compared to patients without diabetes.

The purpose of the study: is to establish the characteristics of the development of endogenous intoxication during experimental obstruction of the urinary tract. Materials and methods: to achieve this goal, one control and three experimental groups of animals were formed, in which blood was taken from the marginal ear vein on the 3rd, 7th, 14th and 21st day of the experiment. The following parameters were determined in blood serum: urea, creatinine, total protein and albumin. The level of endogenous intoxication was assessed by the indicators of medium-mass molecules, circulating immune complexes and malon dialdehyde. Results: statistical analysis of blood biochemical parameters and endogenous intoxication markers confirm the link between modern biomarkers of renal injury and morphological changes in the tissues of obstructive and compensatory organs. Conclusion: our findings point to the overstress adaptation mechanisms, the development of oxidative stress and exhibit a high level of endogenous intoxication, resulting in structural and metabolic changes in the affected and in the contralateral kidney.

Purpose: of the article is to prepare evidence-based proposals for the formation of document architecture, strategic planning, fundamental for modern needs and ensuring the integrity of the strategy for all levels of government and business, as well as to ensure the implementation of the principles of unity, integrity, continuity, continuity and delineation of powers in organizing and system functioning, strategic planning as part of a single management cycle. In the framework of the task of creating the architecture of documents, strategic planning also solves the important task of linking issues of socioeconomic development and ensuring national security, and as a result – improving the efficiency of public administration, ensuring coherence and coordination of the country's strategic priorities. Methods: the main method of work is the disclosure of the principles of strategic planning. The architecture of strategic planning documents under development is based on the disclosure of regulatory acts of the Federal Law dated 28.06.2014 N 172-FZ “On Strategic Planning in the Russian Federation”. Results: the absence of normatively fixed principles and a system for ensuring strategic planning, as well as the procedure for implementing strategic planning, leads to inconsistency of the approved strategies and forecasting, the development of new documents and studies in the Federal Law “On Strategic Planning in the Russian Federation” and other violations of the systematic approach. In this regard, it is necessary to determine the architecture of the system of strategic planning documents developed as part of the target definition, forecasting, planning and programming.Conclusions and Relevance: the architecture of strategic planning documents proposed in the article is based on the creation of a three-level document system with a central place in it the National Security Strategy of the Russian Federation as the main document of strategic goalsetting. In accordance with Federal Law N 172-FZ, the level of forecasting, target definition, planning and programming allows you to add a conceptual level that ensures the quality of the overall ideological superstructure, which should provide an idea of what kind of character for the state and its position in the world the strategic planning system should provide. Taking into account the task of minimizing amendments and clarifications to the Federal Law “On Strategic Planning in the Russian Federation”, the proposed changes are more in the nature of clarifying the provisions of this law. The architecture of the documents built in this way will allow implementing and, if necessary, further detailing the principles of strategic planning defined by law 172-FZ and, above all, the principles of continuity, balance of the strategic planning system.

Background. Acute hemorrhage remains the leading cause of death on the operating room in emergency surgery. However, the correlation of the central hemodynamics, oxygen balance and homeostasis in such victims during emergency surgical treatment with the outcomes of surgical treatment has not yet been evaluated.Material and methods. We examined 100 patients with acute massive blood loss, who had emergency surgery. We determined heart rate, arterial pressure by direct and indirect methods, central venous pressure, oxygen saturation of blood, cardiac index, systemic vascular resistance, gas and acid-base contents of arterial and venous blood, oxygen consumption, oxygen delivery, oxygen extraction ratio according to generally accepted formulas. Two groups of patients were formed of 50 people, depending on the oxygen balance (Group 1 - subcompensation, Group 2 - decompensation).Results. At the time of admission to the operating room and after the surgery, the indicators of systemic hemodynamics in patients of both groups did not differ statistically significantly. In the Group 2, at the time of admission to the operating room, there were statistically significantly higher VO2 (195 (158, 256) ml/(min-m2) and 112.5 (86; 145.3) ml/(min-m2)), ERO2 (50 (45.1, 60) % and 25.1 (19.6, 33.2) %) and low SvO2 (54.4 (48.5, 67.5) % and 75.1 (67,8; 83) %) (p