Search

The article is devoted to the analysis of the current state of regenerative and rehabilitative treatments of skeletal muscles, the possibilities of restoring the functioning of tissue lost due to aging, injuries or diseases. The study of the molecular genetic basis of mechanotransduction and mechanotherapy will allow the identification of genes and molecules, the expression levels of which can serve as biomarkers of the effectiveness of regenerative-rehabilitation measures. These mechanisms are potential therapeutic targets for stimulating of regeneration of skeletal muscles. The focus of the article is on the choice of an individual approach, both when conducting basic scientific research and developing rehabilitation programs. All this will significantly improve patient outcomes.

The review presents the pathogenetic, diagnostic, therapeutic and rehabilitation aspects of computer visual syndrome. The importance of an integrated approach to the implementation of treatment and rehabilitation measures is emphasized. The promising directions of scientific and practical activity on the problem of treating patients with computer visual syndrome symptoms from the standpoint of modern requirements for medical rehabilitation have been determined.

Despite the high level of modern technologies in the field of laboratory methods and imaging of the respiratory system, the problem of early and accurate differential diagnosis of inflammatory lung diseases remains important in practical medicine. It leads to improved treatment results and a reduction in the number of complications (pleural empyema, fistulas, mediastinitis, sepsis, etc.), and in some cases allows suspecting the presence of a primary purulent source in the body, such as that in the case of septic pulmonary embolism. The review covers the Staphylococcus aureus specifics as a pathogen of lung diseases, relevant epidemiology, pathogenesis, clinical features and imaging diagnostics of various types of inflammatory changes in the lungs with a focus on destruction.

Altres ajuts: Sponsorship for this study and the Rapid Service Fee were funded by JSC BIOCAD, Ul. Italianskaya 17, St Petersburg, Russia, 191186 Introduction: Netakimab (NTK), an original humanized anti-interleukin-17 monoclonal antibody, showed therapeutic efficacy in moderate-to-severe plaque psoriasis in a phase 2 clinical study. Herein we report the results of 54 weeks of a phase 3 PLANETA trial aimed to evaluate the efficacy and safety of two NTK regimens vs. placebo. Methods: Two hundred thirteen patients with moderate-to-severe plaque psoriasis were randomly assigned to receive NTK 120 mg once every 2 weeks (NTK Q2W), NTK 120 mg once every 4 weeks (NTK Q4W) or placebo. During the first 3 weeks, patients received subcutaneous injections of NTK or placebo (according to the allocation) once a week. Patients in the NTK Q2W group then received NTK at weeks 4, 6, 8 and 10. Subjects in the NTK Q4W group received NTK at weeks 6 and 10 and placebo at weeks 4 and 8. Patients in the placebo group received placebo injections at weeks 4, 6, 8 and 10. Treatment was unblinded at week 12. During the open-label phase, patients in both NTK groups continued to receive NTK Q4W. The primary efficacy endpoint was the proportion of patients in each group who achieved a ≥ 75% reduction from baseline in psoriasis area and severity index (PASI 75) at week 12. Results: A total of 77.7%, 83.3% and 0% of patients had a PASI 75 response at week 12 in the NTK Q2W, NTK Q4W and placebo groups, respectively (P < 0.0001, Fisher's exact test, ITT). The effect was maintained throughout the 1-year treatment. NTK showed a good safety profile and low immunogenicity. Conclusion: Treatment with NTK results in high rates of sustained clinical response in patients with moderate-to-severe plaque psoriasis. The study is ongoing; thus, long-term use efficacy and safety data are forthcoming. Clinical Trial Registration: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov; NCT03390101).

Introduction.Pathology of the inferior turbinates (IT) was found in 76.1% of patients with difficulty in nasal breathing. If nasal breathing cannot be restored with conservative measures, surgical intervention becomes the method of choice.Materials and methods.Under local infiltration anesthesia, the IT is fractured and retracted medially (medialization). In the anterior section of the HHP, a vertical incision 0.5 cm long to the bone is made, through which the mucosa is peeled off from the bone base of the concha with a raspator-suction and a small tunnel from 2 to 3 cm long is created. shell surfaces and a small area of the mucosa of the lateral surface of the IT and the lateral wall of the nasal cavity. After insertion into the created tunnel of the required size of the "spreader-implant" plate, treated with a thin layer of LTK glue, the shell is slightly pressed with a self-inflating latex-foam rubber swab introduced into the IT for 10–15 minutes. At the end of the operation, after removing the tampon, the edges of the incision are processed with LTK glue.Results.The results of the study demonstrate the effectiveness of the developed method for the rapid restoration of nasal breathing after rhinosurgical interventions. We use this technique in the overwhelming majority of cases of fibrous and bone forms of IT hypertrophy. In cases of the cavernous form, we perform a submucous conchotomy with a shaver, which makes it possible to very accurately remove exactly that part of the concha that violates the patency of the nasal cavity. In all cases, we consider it compulsory to carry out the IT lateroposition according to our method, which significantly improves the result of the operation. The surface of the shell remains completely covered with mucosa and as a result of matching the edges of the incision, the wound surface is absent. At the same time, after the operation, the shell remains full anatomically and functionally, i.e. consists of the bone skeleton and the corresponding volume of soft tissues.Conclusion.The question of how to predict in the long-term postoperative period the normal size of the modeled IT, apparently, is currently not answered even by highly qualified rhinosurgeons. In this regard, there remains a need to search for new technologies for treating patients with chronic hypertrophic rhinitis.

Colorectal cancer occupies one of the leading positions in the world in the structure of cancer incidence. The vital processes of cancer cells largely depend on the production of growth factors and their receptors. One of these is epidermal growth factor (EGFR), which is a tyrosine kinase receptor for cell membranes. Normally, binding of EGFR ligands and transforming growth factor alpha (TGFα) induces receptor activation, which triggers ERK and PI3K signaling pathways that control cell proliferation, migration, invasion, and many other processes. It was found that in 80% of cases, colorectal cancer occurs as a result of EGFR overexpression, which leads to increased growth and division of tumor cells due to hyperactivation of the RAS-RAF-MEKERK signaling cascade. The RAS-RAF-MEK-ERK cascade is a pathway that regulates cell proliferation, cell cycle, and cell migration. In the development of human cancer, mutations of the RAS/RAF family are most often the cause of dysregulation of signal transduction through this pathway. According to current data, about a third of all malignant neoplasms are associated with mutations in the genes of the RAS family, which include HRAS, KRAS, NRAS, RRAS, and other homologous proteins. Proteins of the RAS family are involved in the activation of tyrosine kinase signaling pathways, which leads to gene mutations. This process determines proliferative activity, ability to differentiate, metastasis, avoidance of apoptosis, induction of angiogenesis. Permanent RAS activation leads to malignant cell degeneration. Thus, the expression and mutation of the EGFR gene are associated with various variants of tumor progression and poor prognosis in malignant neoplasms of various localizations. Over the past decades, significant advances have been made in the treatment of metastatic colorectal cancer. However, the expansion of the spectrum of effective anticancer drugs also creates a number of difficulties in choosing the optimal drug therapy regimens in patients with metastases of colorectal cancer.

The purpose and objectives of the study: is to create an experimental model of a chemical burn of the esophagus with alkali to study the pathological transformation of the tissues of the upper gastrointestinal tract.Materials and methods. On the basis of the Department of Experimental Medicine with a vivarium of the Privolzhsky Research Medical University, the study of a chemical burn of the esophagus was carried out on 15 sexually mature male Wistar rats. The burn was simulated by exposure to caustic soda (NaOH) with a concentration of 20 %, 15 %, 10 % and 5 % in a volume of 1 ml. As part of the morphological study, the experimental material was fixed in 10 % formalin. After fixation, the preparations were sent to a standard histological wiring using an Excelsior ES apparatus (Thermo Scientific). Pouring into paraffin blocks using the “HistoStar” filling station (Thermo Scientific), staining with hematoxylin and eosin. For morphometric processing and creation of a video archive of the obtained material, a Leica 2500 microscope, ×4, ×10, ×20, ×40, objective, ×10 eyepiece based on the morphology department of NIITO PIMU was used.Results. Seeding with a 20 % alkali solution for animals turned out to be incompatible with life, since a day after the injection of the substance, 3 rats died, 2 were in an agonal state. Morphological examination revealed total necrosis (100 %) of the epithelial lining up to the muscle layer and partially in the muscle layer. When burned with a 15 % NaOH solution, the males were in a very serious condition, out of 5 inoculated in 2 cases, a lethal outcome was noted on the 1st day. Histological examination revealed massive necrosis (70 %) of the epithelial lining. The effect of 10 % alkali on the general condition of the animals did not show a pronounced severity of injury. Necrosis was diagnosed on 15 % of the area of the epithelial lining. A burn with 5 % sodium hydroxide solution did not provoke a severity incompatible with life. In this condition, focal necrosis was revealed, occupying about 5 % of the organ area.Conclusion. Seeds with 10 % and 5 % caustic solutions are relevant for further experimental research, since they make it possible to test different methods of diagnostics, treatment and prevention of scarring at different depths and morphological features of damage.

Isolated neuropathy of the superficial peroneal nerve (SPN) is a relatively rare type of peripheral neuropathy. It is linked to the mechanical entrapment of the SPN in predisposed locations of its anatomical pathway. Associated clinical findings are insufficient lifting of the latero-dorsal part of the foot, stepping on the lateral border of the foot, and commonly, a strong pain localized in the nerve dermatome.Case report. We describe a case of a 14-year-old female patient with right leg pain lasting 24 months. Repeated neurological examinations with negative findings on electromyography (EMG) were performed. The patient underwent a Steindler surgery for a suspected diagnosis of a heel spur, without any improvement. Despite complex pharmacotherapy, chronic pain developed. The patient was unable to walk, being bound to a wheelchair. Amputation of her lower limb under the knee was also considered. SPN entrapment was diagnosed at a physical examination at EuroPainClinics. Decompression of the SPN under local anaesthesia was performed at the clinic.Results. The symptoms improved immediately after the procedure, and following 2 months of rehabilitation, the patient was completely symptom-free. Her clinical state remains unchanged until this day.Conclusions. SPN entrapment is not a common diagnosis in the group of pain syndromes. Regarding the lower limb, it is imperative to include it on the list of differential diagnoses in cases of pain and functional disorders of the lateral muscle groups of the calf and leg. In the case of SPN entrapment, EMG findings may be negative.

The paper evaluates the effectiveness of the use of therapeutic laser exposure (photobiomodulation therapy – PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. The study included two groups of patients. Patients of the first group (31 patients) underwent septoplasty with standard management in the postoperative period. Patients of the second group (31 patients) also underwent septoplasty, and then added PBMT to the standard measures of the postoperative period at 3, 6 and 24 h after septoplasty (λ = 0.890 μm, P = 10 W, 2 min) and then intranasally 48 h after septoplasty (λ = 0.630 μm, P = 8 W, 2 min). In patients of both groups, heart rate variability and pain were assessed using a visual analog scale within 48 hours after septoplasty. In patients of the second group, after the use of PBMT, the indicators of heart rate variability had a significantly lower total power, compared with patients of the first group. So, after PBMT, the ultra-low-frequency component of the spectral analysis of heart rate variability in the first group was 18580 ± 2067 ms2, which is significantly higher than in the second group (8086 ± 3003 ms2) (p 2) compared to the second (1095 ± 190 ms2) (p

Despite the active introduction of surgical treatments for cardiac pathology and new synthetic cardiotonic drugs, cardiac glycosides (CG) remain an important component of the pharmacological treatment of heart diseases. Moreover, interest in this group of drugs is only increasing with the discovery of new pharmacological effects, such as antitumor and antiviral. However, despite many years of experience, the issue of managing patients with symptoms of both acute and chronic poisoning with cardiac glycosides remains one of the leading ones. The literature review provides a brief historical outline of cardiac glycoside poisoning and comprehensively describes the pharmacokinetics and pharmacodynamics of this group of drugs. The clinical picture of intoxication is described. We analyzed modern ideas and limitations of using antidote therapy such as digoxin immune Fab-antibody fragments, as well as the features of pathogenetic and symptomatic treatment of patients with acute glycoside poisoning.

Aim – to study the relationship between body composition and bone mineral density (BMD) in postmenopausal women with rheumatoid arthritis (RA).Material and methods. 68 postmenopausal women, median age 59 [54; 63] years, with RA were included in the study. Bone mineral density (BMD) and body composition were assessed with dual energy X-ray absorptiometry.Results. 33 (48.5%) women had osteopenia, and 17 (25.0%) – osteoporosis (OP). Low lean muscle mass was found in 10 (14.7%) patients. There were positive correlations between different areal BMD and body weight, trunk fat, trunk lean muscle mass and total lean muscle mass. In the multivariate linear regression analysis total lean muscle mass was associated with BMD of lumbar spine (β=0.638; p=0.001) and total hip (β=0.473; p=0.008), and appendicular lean muscle mass, estimated using the appendicular muscle index, with femoral neck BMD (β=0.360; p=0.014).Conclusion. 73.5% of patients with RA had a reduced BMD, and 14.7% women – low muscle mass. The revealed significant association between the lean muscle mass and BMD of lumbar spine and proximal femur indicates the importance of detecting and correcting low lean muscle mass, as well as preventing its decline in order to prevent loss of BMD and osteoporotic fractures.

The article presents a review of research conducted by foreign psychologists on the role of sign language in the communicative, cognitive and social development of children with hearing disorders. Each national sign language is a kind of linguistic system that has a complex grammar, specific vocabulary and syntax. The main problems that arise in deaf children in the situation of ignoring the possibilities of sign language are discussed. A number of studies have shown that deaf children of deaf parents are not inferior to hearing children in their cognitive capabilities, that the use of sign language has a positive effect on cognitive functions and leads to greater creative activity, a better understanding of spatial relationships, and greater flexibility in solving problems. Researchers recognize the need for early acquisition of sign language by deaf children, even in case of use of modern rehabilitation techniques. It is sign language that could make up for the lack of communication tools characteristic of the initial stages of a child's mental development, which would serve to develop the cognitive sphere and personality and create conditions for emotional well-being. The review focuses on the difficulties in using sign language that are observed when selecting diagnostic tools and conducting psychological examinations.

The views of Russian lawyers of the second half of the 19th century regarding the political and legal concepts of Catherine II are considered. Attention is paid to educational and scientific works on the history of Russian law and Russian state law, published in the second half of the 19th century. The author proceeds from the fact that professional and class factors influenced the assessment of the empress’s political and legal ideas by Russian lawyers. It is shown that the professional one consisted in the official introduction by Catherine II into the Russian political and legal turn of the achievements of European educators, contributing to the formation of a tendency towards the prevalence of the law over the will of the monarch. Particular attention is paid to the fact that most of the representatives of the legal profession were of noble origin, the 18th century was a relatively recent past for them, and family traditions and class identity formed a positive idea of Catherine’s rule and the empress herself. At the same time, it is shown that researchers associated with the merchants paid attention to the fact that the empress’s selective acquaintance with the works of European thinkers left her without attention to branches of law, for example, civil law, which was of fundamental importance for the estate employed in commerce and industry. The author notes that historians of law paid maximum attention to the state-legal concepts of the empress. It is proved that the conclusions made in the study correlate with the ambiguous assessments of Catherine II both among historians and Russian society as a whole.

The author examines the evolution of Cuban medical diplomacy under the governments of Raul Castro and Miguel Diaz-Canel. The author shows that the essence of the Cuban national health system, which developed after the 1959 Revolution, is its accessibility. At the time of collapse of the socialist bloc, the Cuban government managed to maintain and surpass the achieved level of development of medicine. The presence of a large number of medical specialists allows the socialist government of Cuba to organize cooperation with dozens of states around the world. Under the leadership of Castro, the export of medical goods and services has become the main source of foreign exchange earnings and a driver of economic growth, and medical diplomacy has become an important tool of soft power, which is used to form an attractive image of the state among the world community. In doing so, the government combines pragmatism, increasing the cost-effectiveness of the programs, and altruism, providing gratuitous aid to the countries most in need. The main difficulty in developing this direction in Cuba’s foreign policy is associated with the North American embargo. In 2018, the US government launched a large-scale campaign to discredit Cuban medical internationalism. This policy aims to further restrict already limited access to essential resources. The country was also negatively affected by the ‘right turn’ in the region: the neoliberal governments of several countries refused to continue medical cooperation with Cuba. At the same time, the trends of recent years indicate an imminent repetition of the shift to the left, which in the future can significantly strengthen the Cuban positions in the region. In addition, the coronavirus pandemic showed that the world community needs a rapid medical response force with Cuban missions serving as a basis thereof.

The article describes results of a study on the level of mental abilities in mod- ern children and in their peers from the last third of the 20th century. It was assumed that the mental abilities of modern preschoolers differ from those of their peers who were brought up in the pre-digital era. Developmental levels of sensory and intellectual abilities of preschool children aged 6-7 years (N=156) (studies from the 1970s), preschool children aged 5-6 years (N=100) (studies from the 1990s) were compared to those of children aged 5-6 years (N=184) and children aged 6-7 years (N=236) who attended preschool departments in Moscow, Moscow region, Smolensk and Ivanovo in 2015-2020. The level of development of sensory and intellectual abilities was assessed using specific tests (“Standards”, “Perceptual modeling”, “Schematization”, “Systematization”). The data was processed using statistical methods: descriptive statistics, the Fisher test, the Student’s t-test for samples with equal variances and samples with different variances. The results of the study show that the level of some sensory abilities of 21st-century preschoolers is lower than that of their 20th-century peers. On the other side, the level of intellectual abilities of preschoolers who were brought up in the early 21st century is higher than that of their peers from the 20th century.

Purpose: to establish the frequency and clinical significance of mutant variations of the HFE gene polymorphism in chronic hepatitis B (CHB) in children with iron overload syndrome (IOS).Materials and methods: 60 children with chronic hepatitis B with iron overload syndrome (IOS) were examined. When distributing children into groups, we took into account the criteria we developed for assessing the degree of life expectancy in children with CHB: CST>0.5 – mild degree of life expectancy (43,3% of children), CST˃0.5 – mild degree of life expectancy (43,3% of children), CST˂0,5 – moderate severity of life expectancy (31,7% of children) and CST˂0,2 – severe degree of SPL (25,0%). Virological verification of HBV was performed by ELISA and PCR. Using PCR Real Time and molecular genetic analysis, HFE gene C282Y, H63D, S65C mutations were detected from amplified DNA using the PRONTO Hemochromatosis reagent kit (Israel). The transferrin saturation coefficient (CST) was calculated using the formula CST = sTfR / log10.Ft. Results:Results: The study of the hemochromatosis gene HFE showed that the overwhelming majority (84,0%) of children with CHB with IOS were carriers of heterozygous, phenotypically different, mutant types. And only 16,0% of sick children were homozites of the wild (normal) HFE gene. Analysis of the phenotypic polymorphism of the hemochromatosis gene HFE revealed the presence of three point heterozygous mutations: H63D, S65C and combined variations in H63D / S65C, the latter of which is associated with severe forms of CHB and severe IOS.Conclusion. Children with CHB with IOS are characterized by a high incidence of heterozygous mutations in the HFE gene, the phenotypic manifestations of which were S65C, H63D, H63D / S65C. The comparability of the heterozygous combined mutation H63D / S65C with severe forms of CHB and a severe degree of IOS gives grounds to consider this phenotype of the HFE gene as a factor in the progression of the disease.

The objective: to compare efficacy and safety of Intellivent-ASV® with conventional ventilation modes during weaning in the patients after cardiac surgery.Subjects and methods. In this randomized controlled trial, 40 adult patients were ventilated with conventional ventilation modes and 40 with Intellivent-ASV after uncomplicated cardiac surgery. Eight physicians were involved in the study.Care of both groups was standardized, except for the modes of postoperative ventilation.We compared:- The physician’s workload, through accounting number of manual ventilator settings and time they spent near the ventilator in every group,- Duration of tracheal intubation in ICU,- Evaluation of ventilation safety by considering driving pressure, mechanical power, positive end expiratory pressure, and tidal volume level,- The frequency of adverse events, postoperative complications, and lethality.Results. There were significant differences in the duration of respiratory support in ICU: 226 ± 31 min (Intellivent Group) vs 271 ± 78 min (Control Group) (p = 0.0013).In Intellivent Group, the number of manual ventilator settings and time spent by physicians near the ventilator before tracheal extubation were significantly lower: 0 vs 4 (2–6), and 35 (25–53) sec vs 164 ± 69 sec respectively (p < 0.001 in both cases).Intellivent-ASV provided significantly more protective ventilation through reduction in the driving pressure, tidal volume, FiO2 and PEEP levels but no difference was noted between paO2/FiO2 ratio. ∆P and Vt were significantly lower in Intellivent Group – ∆P on mechanical ventilation was 6 (5–7) cm H2O vs 7.25 (6.5–9.5) cm H2O (p < 0.001); Vt on mechanical ventilation was 6 (5.2–7) vs 7 (6–9.5) ml/kg/PBW (p = 0.000003). PEEP and FiO2 levels were also significantly lower in Intellivent Group, PEEP on mechanical ventilation was 5 (5–7.5) cm H2O vs 7 (5–11.5) cm H2O and FiO2 level was 26 (22–30) % vs 34 (30–40) %.There were no significant differences between the groups in frequency of adverse events and duration of ICU and hospital stay.Conclusion. Application of Intellivent-ASV mode after uncomplicated cardiac surgery provides more protective mechanical ventilation and reduces the physician’s workload without compromising the quality of respiratory support and safety of patients.

The subject of research is the concept of practical ethics by Anatoly F. Koni who was an outstanding Russian lawyer in the late 19th – beginning of 20th centuries. Particular attention is paid to his ethical research in the article. The interest in this area is not accidental. The principles of professional ethics formulated by Koni have become largely a model for Russian lawyers.The purpose of the article is to identify the stages of the formation of Koni’s ethical theory, its main elements and sources, which made it possible to reconstruct the ideas of the famous lawyer.As the main research methods the authors applied the problem-chronological approach and the systemic approach, considering Koni's ethics as an emerging theory, which turned into a complete concept in the 1920s. The structure of the ethical concept was outlined by Koni in 1919 in the Program "Ethics of Cohabitation".The main results, scope of application. It was revealed that for Koni issues of legal ethics were only part of his colossal work on ethics. He has been developing ethical themes since the 1880s. He formed the foundations of the theory, developed the main types of ethics at the beginning of the twentieth century, and the idea crystallized in the 1920s. In particular, he formulated the types of ethics: public order, financial, literary, public events, medical, conscience, national, personal behavior, etc. After going through three successive stages in the course of the study Koni developed the foundations of practical ethics, which could serve as a model for creating relations in a new society as he assumed. Koni chose ethics as the object of his scientific research. He made great efforts to develop his deontology, which we will not find any analogues of. He contributed to the philosophy and philosophy of law. He summarized all his works on deontology in the work "Ethics of the Cohabitation", which was prepared in 1927, but have never been published.Conclusions. Koni not only collected moments of crisis in contemporary ethical manifestations, analyzed the works of the main deontologists, analyzed in detail the types of ethics (some of which he formulated for the first time in science), but also formed a harmonious practical ethics of human personal behavior. At the same time Koni assumed such a development of a sensitive personality that would be able to take into account the smallest men-tal characteristics of other people and behave tactfully as much as possible. He returned to ethical issues in numerous works over and over again whether he wrote about social ills, about psychology, about expertise. He saw the main causes of deformations in the destruction of ethical principles. "Moral perversions" threatened the very existence of the state. He perceived the fall of Russia in 1917 as a logical completion of the disintegration of ethics. Koni saw a future salvation in the revival of Russia. His ethical ideal was Christian in nature in many ways, although Koni himself almost never connected ethics with religion in his works. Here he acted as a Kantian, as a supporter of the categorical imperative.

Annually, up to 300 thousand new cases of kidney cancer and more than 134 thousand deaths associated with this disease are registered in the world. In the Russian Federation in 2019, 20,758 patients with a newly diagnosed renal cell carcinoma were registered; it should be noted that at the end of 2019, 177,755 patients with this diagnosis were registered. The issue of renal cell carcinoma metastasis seems to be quite relevant. The most common organs for metastatic renal cell carcinoma are lungs (up to 55 %), lymph nodes (up to 34 %), liver (up to 32 %), bones (up to 32 %), adrenal glands (up to 19 %), contralateral kidney (up to 11 %) and the brain (up to 5.7 %). The incidence of skin metastases in renal cell carcinoma ranges from 2.8 to 6.8 %, according to various authors.Our publication presents a case of treatment of a patient with a rare localization of renal cell carcinoma metastases in the external genital organs. The patient underwent palliative nephrectomy and vulvectomy. Taking into account the data on the prevalence of the disease, therapy with cabozantinib is carried out. Cabosantinib is an inhibitor of the tyrosine kinase domains of a number of growth factors, angiogenesis, abnormal bone remodeling, metastasis, and drug resistance.

The article considers a part of the essay “Coverage of classical sources on the history of Buddhism” by the outstanding Buryat scholar Lama Kensura Ngawang-Nima, dedicated to the history of the spread of Buddhist teachings in Mongolia. Some biographical information of the author of the essay is introduced. The materials of the fragment under study are presented, on the basis of which we can say that the author divides the spread of Buddhism in Mongolia, like many researchers, into three stages. Secular and religious figures who played an important role in the spread and formation of Buddhism among the Mongols are noted in the article. It is indicated that when writing his historical treatise, Kensur Ngawang-Nima relied on the works of his famous predecessors, such as the 5th Dalai Lama Ngawang Lobsan Gyatso, Taranatha Gunga Nyingbo, Thukwan Chokyi Nyima, etc., and a part of the essay devoted to the history of Buddhism in Mongolia, based on the work “Golden Book / Altan Debter” by the famous Mongolian scholar Lama Shagdaryn Zava Damdin. The peculiarity of the historical treatise under study is that it is the only known and published work written by a Buryat in the Tibetan language in the genre of Tibetan historical literature — choichzhun.

The aim of this work was to attempt to analyze the demographic structure, clinical and radiological forms of tuberculosis and COVID-19, as well as the course and outcome of the disease in patients with this coinfection in the light of a new and still poorly understood problem of the mutual influence of tuberculosis and COVID-19.Material and methods. Examination and treatment were carried out in the infectious-tuberculosis departments of the Botkin Clinical Infectious Disease Hospital. We examined 63 patients identified in the first seven months of the epidemic in the multimillion city of St. Petersburg (Russia). Tuberculosis, confirmed by conventional bacteriological and molecular genetic methods, had an active phase in all of them. The new coronavirus infection was verified by a positive polymerase chain reaction test for SARS-CoV-2.Results. Tuberculosis in 43 patients was detected simultaneously with COVID-19, in 20 people it preceded coronavirus infection. Disseminated forms of tuberculosis prevailed - 50.8%; in 36.5%, two or more organs and systems were affected, which is associated with a high proportion (54.0%) of HIV-positive patients with an advanced stage of the disease. Lung damage with COVID-19 was noted in 36.5%. Fatal outcomes ended in 20.6% of cases of coinfection, the structure of the causes of death is given.Conclusion. An assumption was made about the possibility of an aggravating effect of tuberculosis on COVID-19 in the case of severe or widespread forms of these diseases. The negative influence of HIV infection on the outcome of the disease has also been shown. Further follow-up is required to identify more reliable associations between tuberculosis and COVID-19.

Aim: to assess a rate and range of genetic and acquired thrombophilia in onco-gynecologic patients with ovarian cancer, uterine corpus cancer and cervical cancer.Materials and Мethods. A prospective controlled cohort non-randomized interventional study was conducted: within the years 2014 to 2020, there were examined 546 women with genital malignancies, divided into 2 groups: group I – 155 cancer patients with former thrombosis, group II – 391 women with female genital cancer without former thrombotic complications. Control group consisted of 137 patients with benign female genital tumors. The spectrum of circulating APA was studied: antibodies to â2-glycoprotein I (â2-GPI), annexin V and prothrombin as well as genetic thrombophilia due to mutations genes encoding factor V Leiden, methylenetetrahydrofolate reductase (MTHFR) including polymorphism in genes for prothrombin, platelet glycoproteins and plasminogen activator inhibitor-1 (PAI-1).Results. It was found that frequency of circulating APA as well as incidence rate of genetic thrombophilia between cancer patients from group I vs. group II significantly differed: APA in group I vs. group II was 86 (55.5 %; p < 0.01) vs. 92 (23.5 %) compared to 7 (5.1 %) in control group. Genetic thrombophilia was dominated in group I by mutated MTHFR (92.9 %), polymorphismin PAI-1 (28.4 %) and platelet glycoprotein (44.5 %) that were significantly higher (p < 0.05) compared to group II and control group. Hence, it allows to suggest that such identified thrombophilia markers are largely associated with a risk of developing thrombotic complications.Conclusion. Detected high percentage of patients with circulating APA and genetic thrombophilia among cancer patients with former thromboembolic complications corroborate a role for genetic and acquired thrombophilia in developing pre-thrombotic condition. Detecting a range of circulating APA and genetic thrombophilia allows to identify patients who might be referred to a high risk of thrombogenesis and require to preventive application of anticoagulant therapy.

This article presents data on clinical ophthalmological manifestations of COVID-19 described in the literature, clinical examples that we met in pandemic conditions, COVID-19 including early and late manifestations, as well as references to studies conducted decades ago and aimed to evaluate the effects of coronavirus infection on the visual organ. The purpose of the most studies was to study the effect of COVID-19 on the visual organ indicate that the most common ophthalmological manifestation of this disease is conjunctivitis, which occurs in 3–10 % of cases. Our observations showed that patients with COVID-19, when applying for an appointment with an ophthalmologist after 1–3 months, make complaints about the feeling of dryness, discomfort in the eyes, itching and redness of the eyelids. These complains arose immediately after the illness and persisted during the above terms. This phenomenon can be explained by the fact that any inflammatory process occurring on the eye surface disrupts the process of lacrimation and leads to the emergence of dry eye syndrome. It is necessary to pay close attention to complaints from the visual organ not only in patients with COVID-19 in the early stages of the disease, but also in the coming months after stopping the acute pathological process. As studies have shown, coronavirus can involve the posterior segment of the eye in the pathological process, since this virus has a retinotropic effect. This hypothesis can be confirmed by the reports of several authors who studied with optical coherence tomography (OCT) the state of the retina 11–33 days after the onset of symptoms in patients with COVID-19. OCT data indicate the presence of hyperreflexive zones at the level of the ganglion cell layer and the plexiform layer, the severity of these zones being greater in the papillomacular bundle region. In addition, cases of thromboembolic complications affecting the vascular system of the eye are described. Considering the fact that in the development of thromboembolism of the central artery and retinal vein, therapy is as effective as possible in the first hours from the beginning of this pathological process development, close attention should be paid to patients’ complaints to visual impairment occurred against the background of coronavirus infection. The data presented in this article open up a range of possibilities for conducting new scientific research that will help to preserve the vision and health of our patients as effectively as possible.

The article outlines the theoretical basis of the competence approach in early intervention aimed to children and their families, developed by the author. The concept, structural and functional aspects of competence are considered from the perspective of the theory of procedural analysis. Seven levels of competence development are identified: situational interest, pre-competence, minimal, initial, extended, adaptive and advanced competence. The main types of competencies in young children have been determined, including individually oriented, socially oriented, executive, universal and complex ones. A description of the properties of competencies is shown, including spontaneous activation, associated positive affect, openness and flexibility, the tendency towards explicitness, the ability to combine with other competencies. The following principles of the development of competencies were revealed: naturalness, involvement, autonomy, explicitness, balance, complexity and de-contextualization. The application of the approach is illustrated by 2 cases. The possibilities and limitations of the approaches are being discussed.

Relevance. The problem of respiratory diseases has been studied for a long time by many specialists and remains relevant to this day. This problem has been of interest to researchers for many years due to several factors. In many studies, it was demonstrated, that a signifcant relationship exist between the upper airway condition and jaw growth, craniofacial skeleton and TMJ dysfunction. Lateral cephalometric radiographs (LCRs) have been used to assess skull parameters, jaw bones and teeth, the morphology of the upper airway, the severity of airways obstruction and adenoid size. The present study aimed to determine the reliability of LCRs compared to CBCT in the assessment of the upper respiratory tract in order to determine which variables are reliable for potential use in clinical diagnosis.Aim. To analyze the literature on the effectiveness of the using Lateral Cephalogram in the assessment of the upper airway.Materials and methods. Electronic search of articles was carried out using search engines and databases: Cyberleninka, eLIBRARY, Google Scholar, Pub Med, SCOPUS. The publication date criterion was selected from January 2010 to January 2021. The electronic search was conducted using the following keywords: lateral cephalogram, upper airway, cone-beam computed tomography. A total of 10 studies from the literature met the selection criteria.Results. CBCT provides a good estimate of the transverse dimensions and volumetric measurement of the airway space. Linear measurements of CBCT and LCRs were quite reliable and reproducible. The most diffcult to study and differentiate area is the oropharynx, the variability of the pharyngeal segment cannot be predicted by LCs. LCRs method is advisable for adenoid pathology diagnosis due to its fnancial acceptability and availability. The cephalometric headflm provides a good general overall indicator for nasopharyngeal airway patency, adenoidal hypertrophy.Conclusions. The traditional lateral cephalogram remains not only a standard, reproducible and cost-effective diagnostic method in orthodontics, but also a reliable initial tool for screening upper airway obstruction, studying the nasopharyngeal morphology and assessment of adenoid size. Based on our results, the measurement of the nasopharyngeal space on lateral cephalograms can be used as an initial screening method to estimate the nasopharynx volumes. The results demonstrate that a lateral cephalogram can provide valuable information about the severe limitations and nasopharyngeal morphology

Gaucher disease (GD) is the most common lysosomal storage disorder, resulting from a deficiency in the activity of a lysosomal enzyme glucocerebrosidase, which is involved in the catabolism of sphingolipids. The phenomenal progress in understanding the pathogenesis and development of specific therapy of this disease over the past 60 years dramatically changed the clinical phenotype of GD, turning a severe progressive disorder into an asymptomatic metabolic defect. The evolution of the understanding of GD associated with fundamental discoveries in the field of cell biology, biochemistry and genetics may be of interest to a wide audience as a model of the effective work of the scientific community in the treatment of rare metabolic pathology.Болезнь Гоше (БГ) наиболее распространенное и хорошо изученное заболевание из группы лизосомных болезней накопления, возникающее вследствие наследственного дефицита активности лизосомного фермента кислой -глюкозидазы (глюкоцереброзидазы), участвующего в катаболизме сфинголипидов. Без преувеличения феноменальные успехи в изучении патогенеза и разработке специфической терапии данного заболевания во 2-й половине XX начале XXI в. кардинально изменили клинический фенотип БГ, превратив тяжелое прогрессирующее заболевание в бессимптомный метаболический дефект. Эволюция представлений о БГ, тесно связанная с фундаментальными открытиями в области клеточной биологии, биохимии и генетики, может представлять интерес не только для узкой группы специалистов, занимающихся диагностикой и лечением БГ, но и для более широкой аудитории как модель эффективной работы научного сообщества в лечении редкой метаболической патологии.

The report shows that V.A. Karlov proved at the current level of knowledge the correctness of the ideas of the great English neurologist John Hughlings Jackson, author of works on localization of the projection motor centers of the cerebral cortex, on aphasia, and others.

Aim.To provide a rationale for the feasibility of using the succinate-containing drugs to treat hypoxia associated with COVID-19 based on the analysis of experimental and clinical studies.Materials and methods. 84 Russian and international literature sources concerning the pathogenesis of COVID-19 and the pathogenetic role of succinate in the management of COVID-19 associated hypoxia, oxidative stress and diaphragmatic dysfunction were analyzed. The literature search was performed using Pubmed and ELIBRARY.ru databases.Results.The literature analysis showed that tissue hypoxia, triggering the pathomorphological cascade of events and resulting in multiple organ failure is a central element of COVID-19 pathogenesis. Experimental and clinical studies show the positive impact of tissue hypoxia correction using succinate in both adult patients and children with various conditions associated with acute respiratory failure.Conclusion.The literature data provide a rationale for using succinate-containing drugs in the treatment of severe COVID-19.

B7-H3, also called CD276, is a type I transmembrane glycoprotein that is encoded on human chromosome 15. It was discovered back in 2001. The original study described it as a positive co-stimulant, as it can stimulate T-cell response and IFN-y production. However, recent researches have shown that B7-H3 is involved in T-cell inhibition. A B7-H3 receptor has not been yet identified, and this may explain the complex immunomodulatory activity of B7-H3, as it can have more than one binding partner with different functions. Expression of the B7-H3 protein has been found on activated immune cells such as T-cells, NK cells and antigen presenting cells. Interestingly, it is overexpressed in a wide range of tumor cells and is associated with disease progression and outcome. The soluble form of this protein is also of particular interest. Increased sB7-H3 levels in the plasma of bone tumor patients might be their important diagnostic criterion.

Currently, there are negative trends in the incidence of cataract, which, along with glaucoma, is the most common cause of visual impairment in various countries. Cataract prevalence continues to be high, necessitating the search for new treatment technologies and criteria for assessing the health and quality of life of this population. The purpose: to study the quality of life of patients with cataract against the background of ultrasonic phacoemulsification with implantation of soft intraocular lenses. Nei-VFQ-25 quality of life was studied in 182 patients with nuclear–cortical form of cataract before and after ultrasonic phacoemulsification. The integral index and components of the quality of life of patients with cataract before treatment are significantly reduced. The quality of life of patients with cataracts significantly increases in 3 months after surgical treatment in all indicators. Especially vision significantly improved in the distance, near vision, General health. Improving the quality of life of patients with cataracts after treatment indicates the effectiveness of the used ultrasonic phacoemulsification. In this case, the cause is a violation in the field of role-playing physical and emotional functioning. In the long-term period (6 months after treatment) there is an improvement in the quality of life of patients with mechanical trauma in many respects, except for the role of physical functioning. This study for the first time revealed the effect of ultrasonic phacoemulsification with implantation of soft intraocular lenses on the quality of life of patients with cataract. For the first time using a specific questionnaire NEI-VFQ-25 revealed the scale on which there is an improvement in the quality of life after surgery. The leading indicators of quality of life of patients with cataracts, characterizing the effectiveness of treatment with high-tech method of ultrasonic phacoemulsification, were established for the first time.

The article provides brief information on the history of microRNA studies. Today, their role in human pathology is regarded as key regulators of the expression of genes and the proteins encoded by them: miRNA molecules perform important physiological functions in cells and tissues of various organs. The specific mechanisms of their participation in the pathological process are insufficiently known. MicroRNAs were the first to be studied in patients with spinal muscular atrophy and leukemia. Publications devoted to the study of miRNAs and their role in the life of the eye appeared in 2002. Initially, miRNAs were studied in the tissues of the animals’ eyes (mice and zebras), and later the role of miRNAs of retinal pigment epithelium in inflammatory changes was studied in the experiment. The first information on the searches and isolation of microRNAs, their quantitative characterization in patients with primary open-angle glaucoma, age-related macular degeneration, autoimmune uveitis was analyzed. Encouraging results were obtained and the prospects of such studies in revealing the pathogenesis and the possibility of targeted treatment. Preliminary judgments were made about the role of miRNAs in the formation of various clinical forms of Graves’ ophthalmopathy (endocrine ophthalmopathy), which also gives hope for the emergence of targeted therapy for this disease. More publications have been devoted to the importance of miRNAs in the development of primary malignant intraocular tumors (retinoblastoma and uveal melanoma). Considerable attention is paid to retinoblastoma: the results of a study of various miRNAs as biomarkers of this tumor for early diagnosis with final access to targeted therapy, both in case of local lesion and in conditions of its metastasis, are presented. Most studies are limited to the study of miRNAs in tumor tissues. Over the past 5 years, a number of studies have been performed to highlight the spectrum of circulating miRNAs that have potential diagnostic value for early detection of metastases of uveal melanoma. The number of observations or experiments in the analyzed works is small, the studies are exploratory in nature and the publications all end almost with the phrase: “Further research is required”.

Vertical transmission of viral hepatitis B (HBV) is one of the main transmission ways in endemic regions. There is a relationship between structural changes in the placenta and the clinical course of HBV infection. The risk of vertical transmission of hepatitis B depends on the condition of the placenta.The goal of this work was to study the relationship between HBsAg and / or HBcorAg expression in placenta on the one hand, and clinical parameters of mothers and newborns on the other hand.The study included 19 patients with CHB who gave birth at the Botkins infectious disease hospital in 2019. The first group included patients with markers of HBV infection (HBsAg and / or HBcorAg) detectable via immunohistochemical examination in at least one of the layers of the placenta. In patients from the second group, no markers of HBV infection were detected in any layer of the placenta. Inflammatory changes in placenta were detected in all women from the first group and in 9 (64%) women from the second group. HBsAg in umbilical cord blood was detected in 3 (16%) newborns. In two patients, whose children had HBsAg in the umbilical cord blood, no markers of HBV infection were detected in placenta. In the first group, only one newborn had HBsAg in umbilical cord blood. In two patients receiving an antiviral treatment during pregnancy, markers of HBV infection were identified in the placenta. Markers of HBV infection in placenta were also detected in women with undetectable viral load.ConclusionsMarkers of HBV infection can be found in placenta at low maternal viral load.HBsAg in umbilical cord blood can be detected even in patients with no markers of HBV infection in placenta.Antiviral treatment during pregnancy does not prevent the possibility of placenta’s infection with HBV.

Background. Urinary fistulas (UFs) are one of the most significant complications after partial nephrectomy. Placement of an ureteral stent eliminates urine extravasation in the majority of patients. However, some of them have persistent UFs despite upper urinary tract drainage. Such cases require retrograde injection of fibrin glue into the renal cavity through a ureteroscope or via the percutaneous approach. Some authors reported cases of simultaneous use of 2 stents and percutaneous cryoablation of the fistula, but these techniques are rare and, therefore, it is problematic to evaluate their efficacy.Objective: to evaluate the results of the new treatment method for the elimination of persistent UFs using the retrograde endoscopic percutaneous approach.Materials and methods. This study included 5 patients (3 males and 3 females) with UFs developed after kidney resection. Mean age of the patients was 55.8 years. The tumor size was 2.5 to 4.8 cm; mean R.E.N.A.L. score was 7.8. All patients had earlier undergone minimally invasive partial nephrectomy; the time between surgery and UF development varied between 3 and 10 days. Four out of 5 patients had a large amount of discharge from their paranephral drainage system, examination of which confirmed high creatinine level. Patients underwent flexible ureteropyelography in the lithotomy position. During this procedure, we identified the damaged calyx and then performed percutaneous puncture targeting the distal end of the endoscope at this calyx, ensuring that the tip of the needle appeared in the paranephral cavity in front of the injured calyx. Using the flexible ureteroscope, we inserted the needle into the pelvis, dilated the puncture opening along the string, and installed a nephrostomy drainage system (12 Fr). Then the endoscope was removed and the ureter was additionally drained with a stent. The stent was removed after 8-10 days with subsequent antegrade pyelography. If there was no extravasation, the nephrostomy tube was removed and the patient was discharged from hospital to continue treatment in outpatient settings.Results. All patients with UFs resulting from partial nephrectomy was successfully operated on. No complications were registered. The mean surgery time was 45.0 ± 20.5 min (range: 40-65 min). Only two patients had some discharge from the fistula within 1 day after nephrostomy tube removal and it stopped without any additional interventions. Three patients had their fistula healed immediately. The treatment efficacy during the whole follow-up period of 18 ± 4 months (range: 6-26 months) was 100 %.Conclusion. Ureteral stenting ensures elimination of UFs in the majority of patients after partial nephrectomy. In individuals with persistent UFs, retrograde endoscopic percutaneous drainage of the pelvicalyceal system is the method of choice, because it allows rapid and effective treatment of UFs.

To date, liver transplantation remains the only effective treatment for patients with cirrhosis. Due to lack of other effective, alternative therapeutic methods, the search and development of new treatment technologies is problem number one. The development of cellular technologies is promising for use in clinical practice. Using this observation as an example, the safety and efficacy of cell therapy technology for prolonged stay on the liver transplant waiting list by a patient with cirrhosis is shown. After intraportal injection of autologous bone marrow-derived mononuclear cells, liver cirrhosis stabilized on the CTP and MELD-Na scales for 22 months of observation, which allowed the patient to wait for an organ and successfully undergo liver transplantation.

The purpose of this work is to review the literature data on the role of optical coherence tomography in the diagnosis of diseases of the closed angle of the anterior chamber. The analysis of the use of modern technical devices — optical coherence tomography of the posterior segment, models with a frequency-modulated source (Swept Source) is presented. The emergence of new imaging technologies such as SS-OCT contributes to understanding the pathogenesis of primary angle closure diseases in terms of involvement of the choroid in the process. A thicker choroid in the macular area may be an anatomical risk factor for closed angle disease. The expansion of an abnormally thick choroid in combination with the structural features of the anterior segment in eyes with a short axial length, including against the background of psychoemotional stress, can lead to an attack of angle closure. Visualization of the structures of the posterior segment of the eye is an important part of the strategy aimed at solving the problem of identifying risk factors, diagnosing, monitoring and evaluating the effectiveness of treatment of diseases of primary angle closure. Qualitative and quantitative data analysis based on optical coherence tomography significantly increases the diagnostic accuracy, allows to determine its progression and to predict its course. This plays a key role in the choice of treatment tactics for the anterior chamber angle closure. The review considers the effect of local antihypertensive eye drops on the choroid. Conclusion . Optical coherence tomography is a standard in modern diagnostics and evaluation of the effectiveness of treatment of diseases of primary angle closure, allowing a better understanding of the pathogenesis of the disease and its complex nature. Imaging improves the ability to accurately diagnose and choose the right treatment strategy.

Background. High-risk prostate cancer (PCa) occurs in 15-25 % of newly diagnosed cases and is a life-threatening condition that requires active treatment. In recent years, the percentage of high-risk PCa has significantly increased, as well as the number of prostatectomies performed in patients with unfavorable morphologic features. However, the high-risk group criteria are not fully defined yet. According to various medical associations, a locally advanced or localized disease may have a high risk of progression. Study objective: to evaluate early and long-term results of treatment of patients with high-risk PCa depending on the high-risk group criteria. Materials and methods. The analysis includes results of radical surgical treatment of 832 patients with localized or locally advanced high-risk PCa treated in three medical institutions in St. Petersburg in the period from 2001 to 2019. Clinically high-risk group included patients with one of the following criteria: prostate specific antigen level >20 ng/ml, Gleason score >8, stage (cT); according to the last criterion two groups of patients were identified: HR-EAU (≥cT2c; n = 408) and HR-NCCN (≥cT3a; n = 282). Results. The average prostate specific antigen level was 21.09 and 26.63 ng/ml, respectively, in HR-EAU and HR-NCCN groups (p< 0.0001). The incidence of positive surgical margin, positive lymph nodes (pN+), five-year recurrence-free, cancer-specific, and overall survival did not differ significantly between the clinically high-risk groups. When evaluated according to the criteria obtained from pathomorphological examination of the removed prostate, the HR-NCCN group showed higher frequency of positive surgical margin (24.8 % vs. 19.2 %) and frequency of pN+ (22.4 % vs. 10.4 %). Analysis of long-term outcomes showed less favorable 5-year results in the HR-NCCN group (recurrence-free, cancerspecific, overall survival - 54.8, 87.0, 83.7 %) compared to the HR-EAU group (recurrence-free, cancer-specific, overall survival - 71.0, 92.1, 88.2 %) (p Conclusion. Differences in the high-risk group criteria by clinical indicators between associations do not affect early (frequency of positive surgical margin, pN+) and long-term (recurrence-free, cancer-specific, overall survival) outcomes. Pathomorphological indicators are less favorable when evaluated according to NCCN. According to our results, any of the proposed models can be used before radical prostatectomy to determine the prognosis of high-risk PCa patients. However, the NCCN morphological prognostic factors allow better prediction of outcomes and, in accordance with them, prescribe treatment that corresponds to the aggressiveness of the disease.

The objective: to evaluate the international practice of using calcium salts when weaning from cardiopulmonary bypass after cardiac surgery in adult patients.Design: a multiple-choice survey about the current practice of calcium salts use when weaning from cardiopulmonary bypass based on the SurveyMonkey platform.Participants: cardiac surgical hospitals around the world.Estimation and main results. Totally 112 emails were sent to Russian and foreign centers inviting them to participate in the survey. 100 centers from 32 countries replied to this request. Generally, the majority of centers (88%) administer calcium salts during surgery with cardiopulmonary bypass, and in 71 (71%) centers out of 100, calcium salts are used to improve hemodynamics. Among 88 centers that use calcium salts during surgery, 66% (58/88) of respondents use calcium chloride, 22% (19/88) use calcium gluconate, and 12% (11/88) use both drugs. Most centers (55 (77%) out of 71) use doses of 5 to 15 mg/kg as a bolus or infusion for 1 min.Conclusion: Our survey shows that the majority of cardiac surgery centers use calcium in adult cardiac surgery patients especially during weaning from cardiopulmonary bypass. There is variability in the type of drug, dose, and route of administration.

40 adolescents aged 15–17 years with functional cardiovascular pathology of vegetative origin underwent a 24-hour blood pressure monitoring (using the oscillometric method BPLabVasotens, Peter Telegin LLC, Nizhny Novgorod) with an assessment of central blood pressure parameters and rigidity of the main arteries.The scientists found significantly higher values of central systolic pressure during the day and night hours in the group of adolescents with arterial hypertension (n=13) compared to adolescents with normal blood pressure (n=27). They determined significantly higher values of the pulse wave velocity both during 24 hours and in the day and night hours in the group with arterial hypertension compared to the group of adolescents with normal blood pressure. No differences were found in the parameters of the propagation time of the reflected pulse wave and the augmentation index. The time of the reflected pulse wave propagation was significantly lower at nighttime compared to the daytime. In the group with arterial hypertension, the rate of pulse wave propagation in the aorta correlated only with the values of diastolic pressure over 24 hours and diastolic pressure in the daytime. In the adolescents with normal blood pressure, the pulse wave velocity correlated with systolic and pulse blood pressure. The augmentation index in the group of adolescents with arterial hypertension correlated with diastolic pressure, in contrast to the group of adolescents with normal blood pressure, where such a correlation was not detected.

Juvenile myoclonic epilepsy (JME) is the most common form of genetic generalized epilepsy. Patients with JME are at risk of life-threatening heart rhythm and conduction disorders as well as sudden death syndrome due to several potential mechanisms: genetic, clinical, neuroanatomical, pharmacological, psychological, comorbid. This lecture reviews important elements of knowledge about the pharmacological predictors of cerebral-cardiac syndrome and sudden unexpected death in epilepsy. The arrhythmogenic potential of antiepileptic drugs most often used in JME (valproic acid, levetiracetam, lamotrigine, topiramate and zonisamide) is considered, none of which can be classified as class A (drug without risk of QT interval prolongation or TdP) regarding a risk of QT interval prolongation and cardiac arrhythmias. Patients with JME require dynamic video-electroencephalographic monitoring and 24-hour electrocardiographic monitoring to reduce a risk of life-threatening cardiac arrhythmias.

Yellow fever is an acute infectious disease of viral nature, the causative agent of which is vector-borne –is transmitted through the bites of infected mosquitoes. Massive epidemics caused by the yellow fever virus are observed in the countries of Africa, South and Central America annually. Imported cases are also registered in non-endemic territories. The review presents the currently available data on the distribution, structure and classification of the yellow fever virus, the identification of its genetic variants depending on the geographical distribution, as well as modern methods of detection and identification of the pathogen in samples taken from sick and dead people. It considers the possibility of using virological, immunoserological and molecular-genetic methods for the diagnosis of yellow fever in different periods from the onset of the disease and in retrospective studies. The lists of diagnostic drugs of domestic and foreign production for the detection of agent markers (antigen, RNA), as well as specific antibodies of IgM and IgG classes, approved for use on the territory of the Russian Federation, are provided. The relevance of further development, improvement and introduction into laboratory practice of reagent kits that allow to detect the yellow fever virus in samples from sick people in a short time, with high efficiency and specificity is demonstrated. This will help to establish a diagnosis promptly and conduct timely anti-epidemic measures, as well as to determine the level of the population stratum immune to the pathogen in endemic regions and evaluate the effectiveness of immunization for the vaccinated contingent.

The search for sensitive and specific markers enabling timely identification of patients with a life-threatening novel coronavirus infection (COVID-19) is important for a successful treatment.The aim of the study was to examine the association of molecular biomarkers of air-blood barrier damage, surfactant proteins SP-A and SP-D and Club cell protein CC16, with the outcome of patients with COVID-19.Materials and methods. A cohort of 109 patients diagnosed with COVID-19 was retrospectively divided into two groups. Group 1 comprised survivor patients discharged from the ICU (w=90). Group 2 included the patients who did not survive (w=19). Association of disease outcome and SP-A, SP-D, and CC16 levels in blood serum, clinical, and laboratory data were examined taking into account the day of illness at the time of biomaterial collection.Results. The non-survivors had higher SP-A (from days 1 to 10 of symptoms onset) and lower CC16 (from days 11 to 20 of symptoms onset) levels vs survivors discharged from ICU. No significant differences in SP-D levels between the groups were found.Conclusion. According to the study results, the surfactant protein SP-A and Club cell protein CC16 are associated with increased COVID-19 mortality.

Introduction. The literature highlights isolated studies examining approaches to the treatment of patients with a combination of stones and urethral stricture. In this regard, the problem of creating optimal tactics for managing such patients remains relevant.Purpose of the study. To analyze of own experience in treating patients with a combination of stricture and urethral stone using balloon dilation with urethral stone extraction.Materials and methods. The study included 7 men with short urethral stricture and stone, who underwent balloon dilation with urethral stone extraction. The age of patients ranged from 47 to 65 years (median - 52 years). The length of the urethral stricture ranged from 3 to 10 mm (median - 7 mm). The stricture in 2 (28.6%) cases was localized in the penile part of the urethra and 5 (71.4%) in the bulbous part. An etiology of urethral strictures: traumatic - in 2 (42.9%) patients, inflammatory - in 1 (14.3%) of cases, idiopathic - in 4 (57.1%) of cases. All patients had 1 urethral stone. The sizes of the stone ranged from 4 to 9 mm (median - 6 mm).Results. The operation time ranged from 11 to 19 min (median - 13 min). No patient had any intraoperative complications. UTIs was observed in the early postoperative period in 1 patient. The duration of postoperative hospital stay ranged from 1 to 5 days (median - 3 days). Postoperative follow-up ranged from 3 to 24 months (median - 14 months). Only 1 (14.3%) patient had a recurrence of urethral stricture 18 months after treatment. Thus, the overall treatment success in this group of patients was 85.7% (6/7).Conclusion. We used this conjunction approach when combined stricture and urethral stone in men for the first time in the world. It seems quite promising given the results.

The question is raised about the correlation of mythological ideas with scientific information and the corresponding object of reality. It is noted that, the cognitive potential of myths continues to remain inaccessible to the perception of a modern person due to his metaphorical language. The novelty of the research is seen in an attempt to verify the semantics of the mythological image of Yuryung Aiyy Toyon in natural science discourse. The research involves a general scientific synergetic approach, lexical-semantic, contrastive-comparative, structural-semantic types of analysis, the method of mutual interpretation. In addition, special methods of depersonification, demetaphorization, and dehyperbolization of the mythological image were applied. Particular attention is paid to isolating the initial meaning of the lexeme үрүҥ — the component that generates the semantic space of the name Yuryung Aiyy Toyon. As a result of a comparative analysis, the essential content of the mythological image of a single origin and the supreme creator Yuryung Aiyy Toyon is revealed in a new light, as a basic concept of the existence of the universe from the point of view of modern science — light, the spread of which is a key factor in determining the fundamental categories of the flow of time and the length of space.

Introduction. Extrapulmonary tuberculosis (EPTB) still has many features: there is a different approach to its definition in different countries, there is no screening, diagnosis is extremely difficult and requires financial costs, and bacteriological verification does not exceed 46%, complex restorative and reconstructive operations are used in treatment. the proportion of patients with isolated extrapulmonary localizations among tuberculosis patients is low.Purpose of the study. To study the structure of tuberculosis (TB) in children with the accentuation of EPTB in the current conditions to determine the development areas of preventive and diagnostic measures.Materials and methods. A retrospective two-stage study was carried out in the period from 1989 to 2018 among in-patient children aged 0 - 14 yrs. At the first stage, the structure of clinical forms of TB was assessed in 2306 children. Three comparison groups were formed following ten-year periods. At the second stage, 4 groups were identified according to age: early age, preschool age, primary school age, prepubertal age. The data obtained in the course of the study were statistically processed using the Microsoft Office 2007 (Microsoft Corp., USA) and Biostat 2009 (AnalystSoft Inc., USA) software package. The differences between the groups were determined using the χ2 test, and significant differences were considered when the value of the p < 0.05 criterion.Results. It was found that throughout the entire observation period in the region, the predominant localization of the specific process was respiratory TB. The proportion of isolated extrapulmonary lesions in children decreased from 11.1% in the period from 1999 to 2008 to 3.4% in the period from 2009 to 2018 (p = 0.000). At the same time, the most frequent localization (60.4 - 77.8% of cases) among EPTB remains urinary TB. In the dynamics from 1989 to 2018, the number of cases of the disease with combined forms of tuberculosis increased (from 3.1% to 7.2%; p = 0.000), mainly due to the establishment of several localizations of the lesion. The frequency of bacteriological confirmation of the diagnosis was significantly different at various localizations of the specific process. In children of the compared periods of childhood, the predominant localization of the specific process was isolated respiratory TB. The isolated extrapulmonary process localizations were more common in the age groups 7 - 11 and 12 - 14 yo, where it accounted for 10.8 - 12.4% of TB cases (p = 0.000). The localization of the EPTB also depended on the children's age. So, young children often developed damage to the osteoarticular system, in preschool children - the genitourinary and lymphatic (peripheral lymphadenopathy) systems, in younger schoolchildren and preschoolers - the genitourinary system. The frequency of bacteriological confirmation of the EPTB increased with the age. The combined forms of a specific process were more often observed in the age group of 7 - 11 yo, in the other groups their share was 77.4%, 87.1%, and 95.0% of cases. Respiratory TB and TB of other organs was confirmed bacteriologically more often in the age group 7 - 11 yo (19.4%), and in the group 12 - 14 yo in 12.9%, 4 - 6 yo in 10.0%, early age in 9.7%, which is much more frequent than confirmation of isolated respiratory TB.Conclusions. EPTB in children has not lost its position and due to the widespread introduction of the recombinant TB allergen and CT into clinical practice. It has become more often detected in combination with respiratory TB. Among the EPTB, genitourinary tuberculosis prevailed, which can be verified in contrast to damage to other organs. Raising the level of awareness of paediatricians and phthisiatrician-paediatricians about the frequency of EPTB occurrence makes it possible to form alertness in terms of the possibility of their development and to timely detect the disease at an early stage.

Aim. To identify the occupational risk of developing chronic generalized periodontitis and bruxism in limestone quarry workers.Materials and methods. We examined 214 workers of the limestone quarry, of which 66 patients were diagnosed with chronic generalized periodontitis, aggravated by bruxism, these patients were taken for treatment. Investigated the indices of hygiene, bleeding, periodontal, measured the depth of periodontal pockets. Electromyography of the temporal and masticatory muscles, microcirculation of periodontal blood flow, and radiography were performed. Established professional conditioning. The patented treatment we proposed: a children's phytogel for teeth and gums Karmolis was introduced into the pathological pockets and along the gingival margin, after which lasertophoresis was carried out according to the labile technique on the upper and lower jaws segmental. Fluctuorization, mouthguards, remedial gymnastics, self-massage – all these are the therapeutic measures offered by us.Results. After the treatment we carried out, the index of the indices improved, the speed and volume of blood flow in the periodontium increased, the temporal and masticatory muscles became less tense, all this indicates a favorable course of the therapy.Conclusions. Moderate CGP, aggravated by bruxism, are occupational diseases in limestone mining workers.

The results of studying the effect of isoliquiritigenin on animal survival in the model of staphylococcal infection and the function of human and animal phagocytes are presented in this article.The aim of the investigation was to study the effect of an isoliquiritigenin preliminary administration on the survival of animals against the background of staphylococcal infection, as well as on the function of phagocytes in mice and humans.Materials and methods. To assess the survival of Balb/C mice, a model of infection caused by Staphylococcus aureus J49 ATCC 25923 with the construction of Kaplan-Meier curves, was used. The effect on the phagocytes functions was studied by assessing the peptone-induced migration of phagocytes into the abdominal cavity of Balb/C mice, the absorption activity of phagocytes (neutrophils and monocytes) of human blood, as well as their production of reactive oxygen intermediates (ROIs) using а flow cytometry.Results. It was found out that a preliminary triple intraperitoneal administration of isoliquiritigenin (30 mg/kg) increases the survival rate of Balb/C mice in staphylococcal infection caused by Staphylococcus aureus J49 ATCC 25923. At the same time, isoliquiritigenin dose-dependently activates the production of reactive oxygen intermediates by human neutrophils and monocytes without statistically significantly suppressing a phagocytic activity of monocytes and neutrophils against fluoresceinisothiocyanate-labeled S. aureus J 49 ATCC 25923, as well as peptone-induced migration of phagocytes into the abdominal cavity of mice.Conclusion. Thus, a preliminary administration of isoliquiritigenin increases the survival rate of mice with staphylococcal infection and increases the production of reactive oxygen intermediates by phagocytes. The data obtained, can become the basis for further research of antibacterial and immunotropic effects of isoliquiritigenin in order to find new drugs for the treatment of staphylococcal infection.

The problem of staffing in innovation management is one of the main resources of the modern Russian economy. Based on the data of the Ministry of Education and Science of Russia, in-depth interviews with representatives of large companies, and government authorities, the authors attempted to identify the most relevant and popular approaches to solving the problem of staffing the venture capital industry in the corporate sector. The article defines the general vector of development of the corporate venture capital sector in Russia, analyzes the contribution of universities and large companies to the creation of a talent pool. It is concluded that universities do not cover the need for training highly qualified personnel for innovation management, while large companies are building up competencies in the field, using and using effective training tools for working with venture projects.

Background. About 25,000 (2018 - 24,291) new cases of kidney cancer (KC) are registered in Russia annually, in the Northwestern Federal District of Russia in 2018 - 2504.Kidney cancer refers to localizations with a relatively low mortality rate. Mortality in the first year of observation is about 20 %. At the same time, an unfavorable trend in the dynamics of morbidity should be noted. Over the past 10 years, the annual growth rate for both sexes was 3.18%, mortality practically did not change, which indicates certain success in the treatment of patients.Materials and methods. The materials of the research were the monographs of IARC “Cancer on five continents”, reference books of the P.A. Herzen Moscow Oncology Research Institute and the database of the population cancer register of the Northwestern Federal District of the Russia own materials. Standard methods of statistical analysis were used.Results. The study revealed positive trends in the quality of registration of patients with kidney cancer, dynamics of mortality and survival of patients.Conclusion. The positive dynamics of the incidence rate of the population of Russia with kidney cancer has been established, and its place in the world community has been determined. Age-specific levels are close to those in the United States.Particular attention is paid to the need to use the Russian population cancer register database to obtain reliable data for an objective assessment of the activities of the oncological service in relation to kidney cancer.

The work aims are to study the concept of a business ecosystem as a new stage in the life cycle of an organization. At the same time, there is an attempt to establish the process of forming a business ecosystem as an element that is part of the “intellectual management” of managing an organization. One of the main thoughts is that all used classifications of life cycles, namely the models of L. Danko, R. Daft, I. Adisis, and L. Greiner, have similar stages. Based on the analysis of the history of Yandex, it was found that the formation of its own business ecosystem allows avoiding falling into the “extinction” stage, since the entire formation process is accompanied by the constant activity of the organization in different directions. The importance of digitalization of business before the transition to the formation of its business ecosystem, and the need for at least one completed cycle, or its main part, with the consolidation of the company’s key product in the market, was emphasized. The material mainly uses the historical and abstract-logical research method with methods of analysis and synthesis.

Kagocel® is used in Russia for the treatment of viral infections. In terms of its chemical structure, Kagocel® active ingredient is a copolymer of gossypol polyphenol and carboxymethylcellulose. The study investigated antiviral and cytokine-inducing activity of Kagocel®, as well as its toxic effects. The aim of the study was to investigate the effect of Kagoce ® active ingredient on the induction of expression of the innate immune system receptor genes (Toll-like receptors, TLR) in the THP-1 human acute monocytic leukemia cell line with different levels of differentiation. Materials and methods: the effect of Kagocel active ingredient was investigated at the concentrations of 0.2 and 2 mg/mL in the THP-1 human acute monocytic leukemia cell line with different levels of differentiation: non-differentiated monocytes, and monocytes differentiated into macrophage-like cells. Comparative analysis of the activity of TLR 2, 3, 4, 7, 8, 9 genes was carried out by quantitative RT-PCR. The study determined standard deviations of the levels of gene expression in the experimental cells (2deltaCq ± SD) relative to the expression in the control cells. Results: Kagocel active ingredient at the concentration of 0.2 mg/mL induced activation of TLR2 expression in THP-1 monocytes by 3.5 times, TLR3 by 2 times, TLR4 by 1.6 times, and at the concentration of 2 mg/mL also induced activation of TLR7 and TLR8 by 1.4 times, and TLR9 by 2 times. The levels of TLR2, TLR3, TLR9 induction were significantly higher in THP-1 monocytes partially differentiated into macrophage-like cells, and the highest stimulation level was observed for TLR2 (8 times). Conclusions: the results obtained characterise Kagocel® as a stimulator of TLR genes in the THP-1 cell line. The number of TLR genes induced in THP-1 monocytes was shown to increase with the increase in the product concentration. THP-1 monocyte differentiation into macrophage-like cells enhances susceptibility to Kagocel®. The positive regulation of TLR genes activity may account for antiviral and interferon-inducing properties of Kagocel®, and also suggests the possibility of expanding the use of the product for various immune-associated diseases.