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Background. Chronic lymphocytic leukemia (CLL) is the second most common hematological malignancy without a trend towards a decrease in its incidence. 66 % of patients with CLL experience bone fractures as a result of osteoporosis in all age groups, and the detection frequency is no more than 15 %. Insufficient understanding of the osteoporosis pathogenesis in CLL leads to problems in diagnosis, prevention and therapy.The aim of the study. To analyze modern data on the features of the osteoporosis pathogenesis in chronic lymphocytic leukemia.Results and discussion. Osteoporosis is formed when osteoresorption prevails over osteosynthesis due to intercellular interactions of bone tissue and the immune system, dysregulation of intracellular signaling pathways RANKL/RANK/OPG, Wnt, FoxO, RUNX2, initiated by cytokines, growth factors, prostaglandins, and hormones. The degree of osteoresorption in CLL is associated with the severity of the clinical course, chemotherapy and hormonal deprivation. The osteoporosis pathogenesis in CLL is considered as part of a complex set of events, including, firstly, the interaction between leukemic cells (overexpression of PTHrP, RANKL) and bone cells (synthesis of growth factors), which forms a vicious circle of osteoresorption and tumor growth. Secondly, pro-inflammatory markers in CLL (tumor necrosis factor α, interleukin (IL) 1β, IL-6, IL-8, IL-11, granulocyte-macrophage colony-stimulating factor, macrophage colony-stimulating factor, transforming growth factor β, prostaglandin E2) limit osteoblast-induced osteosynthesis and stimulate the expansion of osteoclasts from monocytic suppressor cells of myeloid origin with or without the participation of the RANKL/RANK system. Thirdly, oxidative stress in CLL and impaired efficiency of antioxidant protection with the participation of fibroblast growth factor 23, transcription factor Nrf-2 with activation of JNK, ERK1/2, NF-κB, and also an increase in the RANKL/OPG ratio lead to inhibition of osteoblastogenesis.Conclusion. Analyzing and systematizing data on the osteoporosis pathogenesis in CLL are instrumental for the development of diagnostic criteria for osteoporosis in chronic lymphocytic leukemia that are much-needed in clinical practice and for the improvement of therapeutic tactics.

Based on the analysis of stratigraphic, lithofacies, and geological and geophysical data, consideration is being given to the main stages in the formation of the basement and cover structures of the Alakol sedimentary basin. For this region, there was developed the substantiation of a scheme of tectonic zoning and there were proposed structural characteristics of faults and lithofacies features of the section. Evidence was found of a complex, multi-stage tectonic evolution. There were discovered potentially promising stratigraphic oil and gas complexes of the Late Paleozoic and Mesozoic. The deep-seated structure of the region is illustrated by a geological and geophysical section, spatially coincident with the "Turkestan" seismic profile. Based on the lithological and paleogeographic reconstructions, there were identified four major tectonic boundaries: Cambrian-Ordovician, Devonian-Carboniferous, Permian-Early Triassic, and Middle Triassic-Cretaceous. The correlation of the stratigraphic range of the hydrocarbon potential of the Alakol basin has been carried out. The criteria for forecasting hydrocarbon accumulations were substantiated.

Objectives. In order to determine the "security" of a special purpose informatization object, it is necessary to calculate the indicators of side electromagnetic radiation generated during the operation of devices with sensor input of information associated with information leakage through technical channels. It is also necessary to develop a list of actions to neutralize potential threats (including the development of an information protection system to protect against this type of threat).Method. The study of side electromagnetic radiation generated during the operation of devices with sensory input of information is carried out using expert documentary and instrumental methods.Result. The results of the study of side electromagnetic radiation generated during the operation of devices with sensor input of information are given and aspects of improving special measures for the protection of information at a special purpose informatization object are determined.Conclusion. The direction of this study is very relevant and requires further development of organizational and technical measures to implement the requirements of regulatory legal documents for the protection of information.

Introduction. Viral infection is the main cause of damage to the ciliated epithelium of the nasal cavity mucosa, which in turn leads to disruption of mucociliary transport, increased viscosity and mucus hypersecretion in the sinuses and deceleration of its evacuation. Smokers suffer from chronic obstructive pulmonary diseases, in particular obstructive bronchitis. Their cough symptom complex sharply increases in acute respiratory viral infection (ARVI), especially when the mucociliary airway system is affected. The etiotropic treatment of this combined pathology is a therapy capable of affecting the entire mucociliary system of the upper and lower respiratory tract, including a drug based on ivy leaf extract, with the active ingredient of the saponin group.Aim of the study. To determine the effectiveness of phytopreparation in preventing exacerbation of chronic bronchitis of smokers in patients with acute viral rhinosinusitis.Materials and methods. Complex examination of 20 active smokers suffering from acute viral rhinosinusitis (AVR), including computed tomography of the lungs, was conducted. The randomized study included the use of phytopreparations in the complex therapy of acute rhinosinusitis in patients with obstructive bronchitis.Results and discussion. Use of medicines based on ivy extract in the complex treatment of acute rhinosinusitis in smokers allowed to achieve reduction of AVR symptom complex complicated by exacerbation of chronic bronchitis by the 5th day of the disease. Dynamics of cough complaints reduction in comparison groups reflects the beneficial effect of ivy extract in smokers with ARVI, complicated by AVR, and in the absolute majority of cases allows avoiding bacterial complications.Conclusion. The conducted study proved the effectiveness of Gedelix in the complex treatment of viral acute rhinosinusitis in smokers. In the absolute majority of cases (80% of the total number of patients in the group) it was possible to avoid long-term exacerbation of chronic bronchitis and bacterial complications.

The objective is to demonstrate possibilities of a harpoon biopsy under ultrasound guidance for malignant neoplasms early detection using a clinical example.Clinical case. A 65-year-old patient with morphologically verified laryngeal cancer (stage II, T2N0M0) underwent radiation therapy, which resulted in a complete tumor resorption. Subsequent ultrasound detected a neoplasm in the projection of the folding section. Percutaneous harpoon biopsy was performed under ultrasound guidance because standard clinical and instrumental studies were unable to confirm the diagnosis. Histological study of the biopsy material confirmed the “relapse of larynx squamous cell carcinoma”.Conclusion. A transdermal harpoon biopsy under ultrasound guidance followed by morphological biopsy study makes it possible to diagnose the disease and determine therapeutic approach as soon as possible.

Objectives In order to improve the security of departmental information technology systems and the rationality of the financial costs of hardware solutions in such systems, it is advisable to develop a simulation model of the information technology system of an internal affairs authority (ITS ATS) connected to the Internet to determine the likelihood of damage occurring denial of service attacks. Lead and clarify for the ITS ATS a classification of modern-time complex ITS, which will allow identifying possible threats to the ITS information resource ATS based on open federal and departmental regulatory documents in connection with Internet connection. Further development of the ATS ITS model was done in the Anylogic simulation environment, which makes it possible to simulate a denial of service attack on a departmental resource and investigate the likelihood of damage occurring. The expressions from the apparatus of queuing systems are given, which allow modeling the attack and calculating the probability of damage occurrence, which is advisable to use when designing such systems in ATS. Method. Analytical and mathematical modeling using the apparatus of queuing systems. Result. A simulation model of ITS ATS is proposed, which allows to determine the probability of a destructive impact on the departmental resources of such systems. Conclusion. The direction of this study is relevant and requires further development in order to develop a methodology for assessingthe occurrence of damage in ITS ATS.

Objective: to elaborate the magnetic resonance imaging (MRI) signs of prostate cancer (PC) in accordance with the PIRADS classification during multiparametric MRI (mpMRI).Material and methods. A total of 89 men aged 20 to 82 years were examined. A control group consisted of 8 (9%) healthy volunteers younger than 30 years of age with no urological history to obtain control images and MRI plots and 20 (22.5%) men aged 26–76 years, whose morphological changes were inflammatory and hyperplastic. The second age-matched group included 61 (68.5%) patients diagnosed with prostate cancer at morphological examination. A set of studies included digital rectal examination, serum prostate-specific antigen, and transrectal ultrasoundguided prostate biopsy. All the patients underwent prostate mpMRI applying a 3.0 T Achieva MRI scanner (Philips, the etherlands).Results. The patients have been found to have mpMRI signs that were typical of PC; its MRI semiotics according to the PI-RADS classification is presented. Each mpMRI rocedure has been determined to be of importance and informative value in detecting PC.Conclusion. The comprehensive mpMRI approach to diagnosing PC improves the quality and diagnostic value of prostate MRI.

Multiparametric magnetic-resonance imaging study was performed on 89 patients in magnetic-resonance imager 3 T. In 61 of them identified prostate cancer. Identified opportunities and the role of the complex magnetic resonance imaging in the clinical diagnostic algorithm for cancer of the pancreas, compared the diagnostic value of magnetic resonance spectroscopy, diffusion-weighted imaging and dynamic contrast-enhanced magnetic-resonance imaging. Dynamic contrast-enhanced magnetic-resonance imaging is one of the important methods for diagnosis of prostate cancer, specifying the location and staging of neoplastic process. Multiparametric magnetic-resonance imaging study of patients of prostate cancer has a great advantage compared with other clinical and diagnostic radiation methods in determining the localization of the true size of the tumor and its degree of aggressiveness.

The paper contains some proposals pertaining to modernization of tracked vehicle running gears, bogie hydro-pneumatic suspension, methodology for bench-tests and description of test-bench equipment which is applied for testing bogie hydro-pneumatic suspension. Test results of a hydro-pneumatic spring with parameter stabilization system are given in the paper.The paper presents description of tracked vehicle running gears with bogie hydro-pneumatic suspension which is equipped with a system for stabilizing a road clearance. Testing results of the gears being part of a test mule are cited in the paper.

The paper presents the developed principle for volumetric division of operating fluid flow in multi-motor hydraulic drive of working elements of construction and road machinery. Basic technical solutions and design parameters of discrete rotary-type hydraulic distributive valve have been determined in the paper.

Study of directions concerning development of military equipment, its modernization with the purpose to improve its military efficiency is an actual problem for the Armed Forces, military science, designers and researchers.The paper analyzes and estimates possibilities to use civil equipment for military purpose. Problems pertaining to technologies of double application, diversification of civil equipment in military engineering machinery are considered in the paper.

The paper contains formulated principles of forming metering systems of hydraulic drives of technological machines on the basis of tap-type hydraulic control valve usage. The paper considers directions in designing dividers, flow adders of multi-motor drives of technological machine working elements. Designs of metering systems ensuring possibility to create multi-flow hydraulic transmission.

Parameters of ground clearance stabilization system for caterpillar chassis with hydro-pneumatic suspension of support rollers are substantiated. The paper contains description of ground clearance stabilization system, test results of the system being installed on a running caterpillar chassis model are cited

Objective: to compare different modes of anesthesia maintenance for colonoscopy on the basis of internal audit of critical incidents. Subjects and methods. This investigation was conducted at the V. A. Negovsky Research Institute of General Reanimatology, Russian Academy of Medical Sciences, from 2009 to 2011. One hundred and fifty-six patients undergoing colonoscopy under different modes of anesthetic accompaniment were examined. Results. The authors made an internal audit of critical incidents during anesthetic accompaniment of colonoscopy on the basis of controlled sedation with propo-fol, total intravenous anesthesia, inhalational induction, and sevoflurane-maintained anesthesia. Controlled sedation with propofol was shown to have shortcomings. Conclusion. Inhalational induction and sevoflurane-maintained anesthesia are the most effective and safe method of anesthetic accompaniment. Key words: anesthesia, sevoflurane, sedation, propofol, colonoscopy, inhalational induction.

Aim. To establish the equivalent efficacy and comparable safety profile of biosimilar Acveris and referent eculizumab product Soliris used for the treatment of paroxysmal nocturnal hemoglobinuria (PNH). Materials and methods. Were included in the phase III multicenter 28 PNH patients, open-label clinical trial. Participants were randomized (1:1) into 2 treatment groups: investigational product (Acveris, n=14) and referent product (Soliris, n=14). Patients received eculizumab as the intravenous infusion 600 mg once a week during the first 4 weeks, 900 mg at week 5 and then 900 mg every 14 days (2 days) up to week 27 of the study. The efficacy, pharmacokinetics, pharmacodynamics, safety and immunogenicity of the compared products were analyzed after the end of 27 weeks of the study. The primary efficacy endpoint was the area under the curve LDH concentrationtime (AUCLDH) throughout the study period weeks 527. Results. The difference between the mean AUCLDH values between the Acveris and Soliris groups was 5380.0 [-38 773.87; 49 533.87] U/ldays. The 95% CI limits for the difference in mean AUCLDH values between the groups fit the preset 95% CI [-146 500.9146 500.9] U/ldays and establish the equivalent efficacy of the biosimilar and referent product according to the primary efficacy endpoint. The safety profile of both Acveris and Soliris was expected and comparable according to the proportion of patients with adverse events. The formation of binding antibodies to eculizumab was not detected in both the groups. Conclusion. The study established the equivalent efficacy of biosimilar product Acveris and referent eculizumab product with the evidence of effective suppression of intravascular hemolysis in PNH patients along with a comparable favorable safety profile.

[1] SZI «Strazh NT». Rukovodstvo administratora. URL: http://www.guardnt.ru/download/doc/admin_guide_nt_3_0.pdf (accessed: 25.05.2019) (in Russian). [2] Sistema zashchity informacii ot nesankcionirovannogo dostupa «Strazh NT». Opisanie primeneniya. URL: http://www.rubinteh.ru/public/opis30.pdf (accessed: 25.05.2019) (in Russian). [3] Popov A.D. Modeli i algoritmy ocenki effektivnosti sistem zashchity informacii ot nesankcionirovannogo dostupa s uchyotom ih vremennyh harakteristik v avtomatizirovannyh sistemah organov vnutrennih del: dis kand. tekhn. nauk. Voronezh / 2018. URL: https://vi.mvd.rf/Nauka/Dissovety/sostojavshiesja_zashhiti_dissertacij (accessed: 25.05.2019) (in Russian). [4] Ventcel' E.S. Teoriya veroyatnostej. – М.: Nauka, 1969. – 576 s. (in Russian). [5] Jensen K. and Kristensen L.M. Coloured Petri Nets Modeling and Validation of Concurrent Systems. Berlin: Springer-Verlag 2009. [6] Sinegubov S.V. Modelirovanie sistem i setej telekommunikacij. Voronezh: VI MVD RF, 2016. – 336 s. (in Russian). [7] Zaitsev D.A., Shmeleva T.R. Simulating Telecommunication Systems with CPN Tools: Students' book. – Odessa: ONAT, 2006. – 60 p. [8] Grigor'ev V.A., Karpov A.V. Imitacionnaya model' sistemy zashchity informacii. Programmnye produkty i sistemy. Tver': MNIIPU i NII «Centrprogrammsistem», 2005. №2. S. 26–30 (in Russian). [9] Piterson D.ZH. Teoriya setej Petri i modelirovanie sistem: Per. s angl. – M.: Mir, 1984. – 264 s. (in Russia). [10] Kotov V.E. Seti Petri. Moskva: Nauka. Glavnaya redakciya fiziko-matematicheskoj literatury, 1984. – 160 s. (in Russian). [11] Drovnikova I.G., Zmeev A.A., Popov A.D., Rogozin E.A. Methodology for investigating the probability-time characteristics of network attacks in the simulation modelling software environment. Herald of dagestan state technical university. Technical sciences. 2017. 44 (4). P. 99–113. DOI: https://doi.org/10.21822/2073-6185-2017-44-4-99-113 (in Russian). [12] Meedeniya D. A. Indika Perera Model based software design: Tool support for scripting in immersive environments. IEEE 8th International Conference on Industrial and Information Systems, 2013. P. 248–253. [13] Lukaszewski R., Winiecki W. Petri Nets in Measuring Systems Design. IEEE Instrumentation and Measurement Technology Conference Proceedings, 2006. P. 1564–1569. [14] Gehlot V., Nigro C. An introduction to systems modeling and simulation with Colored Petri Nets. 2010. P 104–118. [15] Shang Guan Wei [et. al.] Research of System Modeling and Verification Method Combine with UML Formalization Analysis and Colored Petri Net Third International Symposium on Intelligent Information Technology Application, 2009. P. 488–491.

AIM: To study the experience in managing patients with acute promyelocytic leukemia (APL) diagnosed in different periods of pregnancy/MATERIAL AND METHODS: Nine women with APL were treated in 1998-2013. When APL was diagnosed in the first trimester of pregnancy, the latter was terminated (n=1); when its diagnosis was made in the second trimester, chemotherapy (CT) followed by delivery (D) was performed (n=3); when it was done in the third trimester, D followed by CT was done in relation to gestational age (n=2) or these were performed at a later gestational age (n=1). APL was treated in 5 and 1 patients according to the AIDA protocol and the 7+3 plus ATRA one, respectively/RESULTS: All the patients with APL achieved remission after the first cycle of induction CT; 5 of the 6 patients did at the moment of delivery; one patient underwent emergency delivery during cytopenia after the cycle. The gestational age at delivery after CT was 34 (34-40) weeks. Spontaneous term labor occurred in 2 patients at an obstetric hospital. Cesarean section was made in 4 of the 6 patients. All babies were born alive, healthy, and without developmental abnormalities. Their age at the time of analyzing the results was 2.5 months to 15 years. Four of the 9 patients are presently alive. Late recurrences occurred in 3 (33%) patients. The median overall survival is 26 (0.25-128) months; the median relapse-free survival is 17.5 (0-127) months/CONCLUSION: APL treatment in pregnant women, which is aimed at saving two lives, is effective and reasonable.

The article shows the development of research and design school for designing special vehicles. On the basis of creation of family of vehicles built on a base of wheeled and tracked chassis and the proposed design methodology, based on a scientific justification of chassis and formed a rational type for families of machines.

In the article the technique of computing experiment and algorithm of an estimation of a dynamic indicator of efficiency of program systems of information protection — «dynamic stability» — is resulted by their working out on a basis math models.

Aim. To comparatively analyze the toxicity of 4 treatment protocols in patients with acute myeloid leukemia (AML), which were used in the Russian multicenter center in 1992 to 2009. Materials and methods. The information obtained in 4 Russian multicenter studies conducted in 33 hematology departments of 26 cities and towns of the Russian Federation in 1992 to 2009 was analyzed. Randomization was made in 243 patients with AML (median age 38 years) in 1992-1995, 396 patients (median age 39 years) in 1995-1999, 392 patients (median age 39 years) in 2001-2006, and 137 patients (median age 40 years) in 2006-2009. The analysis excluded patients with acute promyelocytic leukemias who were recruited in the AML-92 and AML-95 studies. These patients' statutory forms adequately filled in were 60-70% therefore toxicity was analyzed on the basis of the data of 631 patients. Results. The baseline clinical and laboratory parameters in the patients enrolled in the studies in different years slightly differ in the count of leukocytes at the onset of the disease and in the level of lactate dehydrogenase (LDH): the recent studies revealed a larger number of high-risk group patients (leukocytes more than 30109/l; LDH more than 500 units) possibly due to the later diagnosis of AML. During the studies, the number of complete remissions remained as before (55%) after the first course and increased from 65 to 78% after the second course using cytosine arabinoside in high doses. Despite treatment intensification, mortality in the induction period remained as before (19-21%). Remission mortality decreased from 18 to 10-13%. The long-term results of using the aggressive therapy did not differ from those obtained during the standard treatment protocols. The duration of leucopenia after standard induction courses during the all studies remained equal (17-19 days); the exclusion was a HAM course as the second induction course after which the duration of neutropenia was much more than that of the standard course (17 and 10 days, respectively). During the study years, there was an increase in platelet transfusion volumes (from 20 to 53 doses during the first course and from 7 to 28 doses during the second course) and a reduction in the percentage of severe hemorrhagic complications. The incidence of pneumonias remained at the same level (40-50%) during the induction courses and that of septic complications and necrotic enteropathy considerably decreased from 40-46 to 17-19%. The incidence of invasive aspergillosis during the current programs from AML treatment was 10% (two induction courses), that of invasive candidiasis was 4.7% (two induction courses). Conclusion. The long-term results of treatment for AML were virtually unchanged regardless significant therapy intensification. Mortality remained high during induction treatment and in the postremission period. Its cause is severe infectious complications developing during myelotoxic agranulocytosis. The results of the analysis provide the basis for developing a new AML treatment protocol that should take into account all the merits and demerits of the previous protocols and provide a toxicity-treatment efficiency balance.

Dermoid nasal cysts (congenital nasal median heterotopias) are a rare congenital pathology in children., Objective: Yo consider the clinical picture, methods of radiation diagnosis and to study the surgical results of a dermoid cyst of the nose according to the literature., Materials and Methods: A retrospective review of medical histories with the diagnosis of "Dermoid cyst of the back of the nose and nasal cavity, epidermal cyst of the back of the nose, glioma, encephalocele" was conducted from 2017 to 2022 in the Pediatric Otorhinolaryngological Department of the National Medical Research Center for Otorhinolaryngology of the Federal Medical-Biological Agency of Russia. The case histories were analyzed by the nature of the lesion, the imaging techniques performed, the course of the operation and the results obtained., Material and Methods: A total of 16 medical histories were analyzed, the average age was 4.5 years (range 10 months - 15 years), over the past 5 years with a diagnosis of "Dermoid cyst of the nasal dorsum and nasal cavity, glioma, epidermal cyst of the nasal dorsum, encephalocele". All patients underwent magnetic resonance imaging (MRI) in the preoperative period, 14 patients also underwent computed tomography (CT)., Result: Of these, 7 had a confirmed dermoid cyst with a fistula, 3 patients without a fistula, 3 patients had glioma, and 1 had encephalocele, 2 patients had an epidermoid cyst. A fistulous opening of the dermoid cyst of the nasal dorsum and nasal cavity was observed in the upper third of the nasal dorsum in 3 children, in the middle third in 2 patients and in the lower third in 2 children. The article presents a scheme for the characteristics of the lesion and the tactics of surgical treatment in comparison with the data of foreign authors. Intraoperatively, intracranial spread occurred in 6 patients. Various surgical approaches for intracranial proliferation and a corresponding literature review are also presented. Catamnestic follow-up ranged from 1 to 5 years (on average, 3.5 years), no relapses or postoperative complications were noted., Conclusion: Nasal median heterotopias are a rare congenital anomaly. Preoperative preparation should include CT and MRI to assess the lesion and exclude intracranial spread. The surgical approach depended directly on the localization of heterotopia and its spread. All patients had a good cosmetic result after the surgical treatment performed by us according to the author's method.

Aim: To establish the equivalent efficacy and comparable safety profile of biosimilar Acveris and referent eculizumab product Soliris used for the treatment of paroxysmal nocturnal hemoglobinuria (PNH)., Materials and Methods: Were included in the phase III multicenter 28 PNH patients, open-label clinical trial. Participants were randomized (1:1) into 2 treatment groups: investigational product (Acveris, n=14) and referent product (Soliris, n=14). Patients received eculizumab as the intravenous infusion 600 mg once a week during the first 4 weeks, 900 mg at week 5 and then 900 mg every 14 days (2 days) up to week 27 of the study. The efficacy, pharmacokinetics, pharmacodynamics, safety and immunogenicity of the compared products were analyzed after the end of 27 weeks of the study. The primary efficacy endpoint was the area under the curve LDH concentrationtime (AUCLDH) throughout the study period weeks 527., Results: The difference between the mean AUCLDH values between the Acveris and Soliris groups was 5380.0 [-38 773.87; 49 533.87] U/ldays. The 95% CI limits for the difference in mean AUCLDH values between the groups fit the preset 95% CI [-146 500.9146 500.9] U/ldays and establish the equivalent efficacy of the biosimilar and referent product according to the primary efficacy endpoint. The safety profile of both Acveris and Soliris was expected and comparable according to the proportion of patients with adverse events. The formation of binding antibodies to eculizumab was not detected in both the groups., Conclusion: The study established the equivalent efficacy of biosimilar product Acveris and referent eculizumab product with the evidence of effective suppression of intravascular hemolysis in PNH patients along with a comparable favorable safety profile.

Objective: to elaborate the magnetic resonance imaging (MRI) signs of prostate cancer (PC) in accordance with the PI-RADS classification during multiparametric MRI (mpMRI)., Material and Methods: A total of 89 men aged 20 to 82 years were examined. A control group consisted of 8 (9%) healthy volunteers younger than 30 years of age with no urological history to obtain control images and MRI plots and 20 (22.5%) men aged 26-76 years, whose morphological changes were inflammatory and hyperplastic. The second age-matched group included 61 (68.5%) patients diagnosed with prostate cancer at morphological examination. A set of studies included digital rectal examination, serum prostate-specific antigen, and transrectal ultrasound-guided prostate biopsy. All the patients underwent prostate mpMRI applying a 3.0 T Achieva MRI scanner (Philips, the Netherlands)., Results: The patients have been found to have mpMRI signs that were typical of PC; its MRI semiotics according to the PI-RADS classification is presented. Each mpMRI procedure has been determined to be of importance and informative value in detecting PC., Conclusion: The comprehensive mpMRI approach to diagnosing PC improves the quality and diagnostic value of prostate MRI.

Aim: To study the experience in managing patients with acute promyelocytic leukemia (APL) diagnosed in different periods of pregnancy., Subjects and Methods: Nine women with APL were treated in 1998-2013. When APL was diagnosed in the first trimester of pregnancy, the latter was terminated (n = 1); when its diagnosis was made in the second trimester, chemotherapy (CT) followed by delivery (D) was performed (n = 3); when it was done in the third trimester, D followed by CT was done in relation to gestational age (n = 2) or these were performed at a later gestational age (n = 1). APL was treated in 5 and 1 patients according to the AIDA protocol and the 7+3 plus ATRA one, respectively., Results: All the patients with APL achieved remission after the first cycle of induction CT; 5 of the 6 patients did at the moment of delivery; one patient underwent emergency delivery during cytopenia after the cycle. The gestational age at delivery after CT was 34 (34-40) weeks. Spontaneous term labor occurred in 2 patients at an obstetric hospital. Cesarean section was made in 4 of the 6 patients. All babies were born alive, healthy, and without developmental abnormalities. Their age at the time of analyzing the results was 2.5 months to 15 years. Four of the 9 patients are presently alive. Late recurrences occurred in 3 (33%) patients. The median overall survival is 26 (0.25-128) months; the median relapse-free survival is 17.5 (0-127) months., Conclusion: APL treatment in pregnant women, which is aimed at saving two lives, is effective and reasonable.

Neurons of cranial cervical, stellate and celiac sympathetic ganglia containing calbindin (CALB) were studied in rats (n = 60) aged 3-90 days using immunohistochemical method. The results obtained indicate that the largest population of CALB-immunopositive neurons was located in the stellate ganglion. The proportion of CALB-containing neurons in sympathetic para- and prevertebral ganglia decreased during the development. Final formation of CALB-immunopositive group of neurons was observed by the end of the first month of life.

Afferent neurons containing substance P (SP) were studied immunohistochemically in the sensory ganglion of the spinal nerve in 30 rats aged 10-90 days. The results obtained indicated that SP-immunoreactive neurons are present in thesel ganglia from the moment of birth. During the development, the percentage of SP-containing neurons decreased till day 10. SP-immunoreactive neurons were represented by the cells of very small or small size.

Expression of vanilloid receptors in sympathetic and afferent ganglionic neurons was studied in rats of different ages (newborn, 10-day old, 20-day old, 30-day old, 60-, 180-day old) using immunohistochemical methods. The results obtained indicate that the majority of the afferent neurons in the nodose ganglion of vagus nerve (GNVN) and in the spinal ganglia (SG) were TRPV1-positive from birth onwards. The percentage of neurons containing TRPVT receptors in SG slightly increased with age up to 30 days postnatally. In the GNVN, the percentage of TRPV1-positive neurons was higher in comparison with the SG in all age groups. The vast majority of the sympathetic neurons were TRPV1-positive from birth onwards, and the percentage of TRPV1-immunoreactive neurons substantially decreased during further development. In 20-day old and older animals, we observed only few TRPV1-immunoreactive neurons in sympathetic ganglia. Finally, the percentage of neurons containing these types of neurons, become similar to adult animals to the end of the first month of life.

Morphological features of the TRPV1-immunoreactive neurons were studied in thoracic spinal nerve sensory ganglion in 10-, 20-, 30-, 60- and 90-day-old rats under normal conditions and after chemical deafferentation caused by capsaicin (100 mg/kg) subcutaneous injection at postnatal day 2. TRPV1-immunoreactive neurons differed in their morphometric characteristics: positive neurons had very small and small sizes, negative cells had the small, medium and large sizes. Capsaicin treatment of newborn rats was shown to change age dynamics of TRPV1-positive neurons resulting in the reduction of the average cell cross-sectional area and cell numbers during the whole period of observation.

Background discharges of single neurons were studied from the superior cervical ganglion in newborn, 10-, 20-day-old, 1-, 2- and 6-month-old rats. In all age groups, the largest proportion of neurons exhibited aperiodic activity. The percentage of neurons with respiratory rhythmic was less. In newborn and 10-day-old rats, the frequency of discharges was low. Discharge frequency increased in 20-day-old rats. In 20-day-old and more adult rats, we found neurons bursting with cardiac frequency. The means of frequency did not statistically differ in 1-, 2- and 6-month-old rats. Thus, the pattern of neuronal activity is formed during the development in 20-day-old rats. Final maturation of this pattern is observed in 1-month-old rats.

Aim: To comparatively analyze the toxicity of 4 treatment protocols in patients with acute myeloid leukemia (AML), which were used in the Russian multicenter center in 1992 to 2009., Materials and Methods: The information obtained in 4 Russian multicenter studies conducted in 33 hematology departments of 26 cities and towns of the Russian Federation in 1992 to 2009 was analyzed. Randomization was made in 243 patients with AML (median age 38 years) in 1992-1995, 396 patients (median age 39 years) in 1995-1999, 392 patients (median age 39 years) in 2001-2006, and 137 patients (median age 40 years) in 2006-2009. The analysis excluded patients with acute promyelocytic leukemias who were recruited in the AML-92 and AML-95 studies. These patients' statutory forms adequately filled in were 60-70% therefore toxicity was analyzed on the basis of the data of 631 patients., Results: The baseline clinical and laboratory parameters in the patients enrolled in the studies in different years slightly differ in the count of leukocytes at the onset of the disease and in the level of lactate dehydrogenase (LDH): the recent studies revealed a larger number of high-risk group patients (leukocytes more than 30 10(9)(/l; LDH more than 500 units) possibly due to the later diagnosis of AML. During the studies, the number of complete remissions remained as before (55%) after the first course and increased from 65 to 78% after the second course using cytosine arabinoside in high doses. Despite treatment intensification, mortality in the induction period remained as before (19-21%). Remission mortality decreased from 18 to 10-13%. The long-term results of using the aggressive therapy did not differ from those obtained during the standard treatment protocols. The duration of leucopenia after standard induction courses during the all studies remained equal (17-19 days); the exclusion was a HAM course as the second induction course after which the duration of neutropenia was much more than that of the standard course (17 and 10 days, respectively). During the study years, there was an increase in platelet transfusion volumes (from 20 to 53 doses during the first course and from 7 to 28 doses during the second course) and a reduction in the percentage of severe hemorrhagic complications. The incidence of pneumonias remained at the same level (40-50%) during the induction courses and that of septic complications and necrotic enteropathy considerably decreased from 40-46 to 17-19%. The incidence of invasive aspergillosis during the current programs from AML treatment was 10% (two induction courses), that of invasive candidiasis was 4.7% (two induction courses). CONCLUSION; The long-term results of treatment for AML were virtually unchanged regardless significant therapy intensification. Mortality remained high during induction treatment and in the postremission period. Its cause is severe infectious complications developing during myelotoxic agranulocytosis. The results of the analysis provide the basis for developing a new AML treatment protocol that should take into account all the merits and demerits of the previous protocols and provide a toxicity-treatment efficiency balance.

The aim of this work was to study the anatomical characteristics of the stellate ganglion (SG) and the morphometric characteristics of its neurons in rats of different age groups (newborn, 10-, 20-, 30-, 60- and 180-day-old) using anatomical and histological methods. The results obtained indicated that in rats since birth there were three variants of branch origin from the medial margin of SG. No differences were observed in these variants between right and left SG. The sizes of both SG and its neurons increased during the first two months of postnatal development. The density of neurons in SG sections decreased from the moment of birth until the six months of age. The number of SG neurons did not change significantly in the postnatal ontogenesis. Thus, SG in rats is anatomically formed by the moment of birth, while the sizes and morphometric characteristics of SG neurons become finally stabilized by the second month of age.

Aim: Systematization of the results of 20-year multicenter randomized trial of the efficacy of treatment of acute myeloid leukemia (AML) of adults; presentation of the design of the study of the strategy of consolidation and maintenance therapy after high-dose consolidation initiated in 2007., Material and Methods: Treatment outcomes on the protocol AML-01.01 are presented for 354 AML patients from 29 hematological centers located in 22 towns of Russia and 2 towns of Ukraine. The patients were randomized into 3 groups by variant of therapy: 124 patients (62 males and 62 females; age median 42 years) received 4 courses of 7+3+VP-16 and 5 courses of maintenance therapy (7+3 with thioguanin); 130 patients (65 males and 65 females, age median 41 year) received 2 courses of 7+3+VP-16, 2 courses 7+3, maintenance--5 courses 7+3 with thioguanin; 126 patients (57 males and 68 females, age median 40 years) were given 2 courses of 7+3+VP-16, 2 HAD courses, treatment discontinuation., Results: A complete remission after the first course of 7+3+VP-16 was achieved in 55% patients, after the second course--in 30% after the course 7+3+VP-16 or 7+3 with mitoxantron, in 70%--after NAM. Overall and recurrence-free survival were 18 and 35%; 30 and 20%; 36 and 30%, respectively. There was no significant difference in efficacy of the treatment scheme., Conclusion: The multivariate analysis has shown that a leading factor having impact on treatment results was the number of randomized patients: the less patients were randomized, the worse were the results.

Altogether 21 patients were examined for an erythropoiesis inhibitor contained by the IgG fraction of the blood plasma. All these patients suffered from hemopoiesis depression. The inhibitor identified in the immunoglobulin fraction of the blood plasma of 40% of the patients manifested itself at the stage of erythroid precursors of bone marrow cells. The role of the humoral inhibitor in the development of erythropoietic disorders in these patients is under discussion.