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Recent advances in the diagnosis and understanding of follicular lymphoma (FL) pathogenesis have had a significant impact on therapeutic tactics. The life expectancy of patients has increased significantly. Currently, the 5-year overall survival of FL patients achieved 90 %, and its median is approaching 20 years. However, FL remains an incurable disease with periods of remission and relapse, requiring multiple therapy courses throughout the patient’s life.The main problem is the treatment of patients with refractory/relapsed forms, especially after 3rd line of therapy, as well as with a primarily resistant course and early (in the first 2 years) relapses. Therefore, despite the indolent FL course in most patients, there remains a need for new drugs that can ensure increased treatment efficacy with minimal toxicity and simultaneously maintain a high quality of life, mainly in the presence of primary refractoriness, early progression and in later lines of therapy. In recent years, new targeted drugs have been studied – phosphoinositide 3-kinase, enhancer of zeste homolog 2 inhibitors, as well as immunological drugs (CAR-T therapy (CAR – chimeric antigen receptor) and bispecific antibodies).The article presents the possibilities of treatment for refractory/relapsed FL as 3rd and subsequent therapy lines.

The introduction of the complement component C5 inhibitor eculizumab has radically changed the prognosis and quality of life of patients with paroxysmal nocturnal hemoglobinuria. Up to 30 % of patients develop only a suboptimal response to C5 inhibition. One reason for this is activation of extravascular hemolysis, due to opsonization of erythrocytes with fragments of the C3 component. Pegcetacoplan, the first ever registered C3 inhibitor, is aimed at solving this problem.In Russia, 2 patients received pegcetacoplan as part of a phase 3, randomized, open-label, active-comparator controlled trial PEGASUS. The analysis includes data from the first year of therapy: the run-in period (pegcetacoplan 1080 mg SC twice weekly in addition to the current dose of eculizumab, 4 weeks), the randomized controlled period (both patients were randomized to eculizumab monotherapy, 16 weeks), and the open-label period of pegcetacoplan therapy (32 weeks). Data from the extension study to evaluate the long-term safety and efficacy of pegcetacoplan are also presented. The duration of follow-up on pegcetacoplan therapy in both patients exceeded 4 years.

Type 1 diabetes mellitus (DM) is one of the most common autoimmune disease that is treated with lifelong insulin therapy. Non-target indicators of glycemic control, which are observed in 71% of patients, lead to the formation and progression of diabetes complications, early disability and mortality. In this regard, the search for new approaches to the treatment and prevention of type 1 DM seems to be relevant. Various methods of immunological prophylaxis for the development of type 1 DM have been studied, in particular, the use of monoclonal antibodies. Thus, in November 2022, teplizumab was approved to slow down the clinical progression of the stage of type 1 DM. The prospects for the use of new options for islet cell transplantation are being studied — in June 2023, an allogeneic donor β-cell transplant obtained from the pancreas of donors after death was approved. Another pathogenetically substantiated method for the prevention and treatment of autoimmune diseases is high-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (HDIT-HSCT). HDIT-HSCT demonstrated its effectiveness and cost-effectiveness in various clinical trials. This review provides up-to-date information on modern methods of immunological prophylaxis of type 1 DM.

The article considers and compares two poems by A. S. Kushner with a common name – “Visit” (1977 and 1985). They are united by the situation of the lyrical hero returning to the places where he spent his childhood and youth. However, the author’s position is deprived of the nostalgic regret about the past years that is expected in such cases – in particular, due to the mismatch of memories with the real world of the past. Kushner continues the Russian tradition of lyrical “returns” (Pushkin, Baratynsky, Nekrasov, etc.), but correlates it with the new historical context and experience of the Soviet era, which undergoes critical re-interpretation in his poems. The second poem does not copy the first: the lyrical retrospective in it is more profound due to the motifs of infant and adolescent reading of the late Stalin era, childrens’ and “adult” (popular in the post-war years) volleyball games, and school studies. The article also analyzes the poetic technique used by Kushner, revealing its significance for the lyrical content of poems. A relatively short meter (iambic trimeter, anapestic dimeter), seemingly unexpected in the poems by Kushner, who gravitated towards the “long” line in the 70s and 80s, betrays a hidden polemic in relation to the epic poetry, a poetic theme seeming to lead up to it, but the epic poetry being consciously foreign to the poet himself. The article also touches upon another (the third) poem by Kushner called “Visit” (1973), which is only indirectly related to the other two, but which also contains the motifs of the Soviet history. As a result, all three poems fit into a series of poems by Kushner that recreate the socio-political atmosphere of the Soviet era.

On June 24, 2023, an Expert Council was held in St. Petersburg, during which leading experts in the field of hematology discussed current achievements and answered a number of unresolved issues of targeted therapy of paroxysmal nocturnal hemoglobinuria (APG) in order to further improve treatment results in Russia. During the Expert Council, the following aspects of targeted APG therapy were considered: • criteria for the suboptimal response of patients with APG to therapy with inhibitors of the 5th component of complement (C5); • efficacy and safety of the use of pegcetacoplan in APG in patients with insufficient efficacy of inhibitors of the C5 component of complement; • vaccination issues before starting therapy with complement inhibitors and the possibility of conducting treatment with pegcetacoplan at home.

The Arctic zone is a priority area for the development and for ensuring the national security of the Russian Federation. At the same time, the region's rich natural resources create conditions for military conflicts and armed struggle of states for possession of these resources. Such conflicts might culminate with an exchange of nuclear strikes. The modern system of metrological support of military dosimetry equipment does not provide the necessary reliability of the verification and calibration procedure under low temperatures in the Arctic zone. The aim of this work is to ensure the effective functioning of gas-discharge counters, used in the military dose rate meters, in the Arctic Zone. It is established, that the reason for the low reliability of readings of military dosimeters can be the generation of false pulses due to a decrease in the suppressing ability of the counter. False impulses may appear soon after the completion of the verification. It is shown in the article, that in order to increase the reliability of measurements for devices on gasdischarge counters, it is necessary to introduce a diagnostic unit into their measuring circuit, which makes it possible to detect the presence of false pulses directly during the measurement. The implementation of the results obtained will increase the reliability of dosimetry equipment in the Far North and will also ensure greater safety of its metrological characteristics. In future, there are good reasons to conduct a study on transfer of dosimetry equipment to electronic control of gas-discharge counters in order to assess the increase in the durability of the counters and reduce the cost of their production.

Introduction. Modern transplantation and biological therapy methods are associated with a wide range of adverse events and complications. Incidence and variety of neurological complications mostly depend on myelo- and immunosuppression severity and duration as well as on donor's and recipient's characteristics. The most frequent complications involving the nervous system include neurotoxic reactions, infections, autoimmune and lymphoproliferative diseases, and dysmetabolic conditions as well as cerebrovascular complications that potentially affect transplantation outcomes. Objective. To evaluate the impact of post-transplantation cerebrovascular events (CVEs) on transplantation outcomes in patients with hematologic malignancies. Materials and methods. We analyzed 899 transplantations performed at the Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology, and Transplantation, Pavlov First Saint Petersburg State Medical University, from 2016 to 2018. We assessed transplantation parameters and donor's and recipient's characteristics by intergroup comparison, pseudo-randomization (propensity score matching), KaplanMeier survival analysis, and log-rank tests. Results. Post-transplantatively, CVEs developed in 2.6% (n = 23) of cases: 13 (1.4%) ischemic strokes and 11 (1.2%) hemorrhagic strokes or intracranial hemorrhages were diagnosed. CVEs developed on days 99.5 39.2 post hematopoetic stem cell transplantation (HSCT). There were more patients with non-malignant conditions in the CVE group as compared to the non-CVE group (21.7% vs 7.9%; p = 0.017). Patients with CVE had a significantly lower Karnofsky index (75.6 21.3 vs 85.2 14.9; p = 0.008). Statistically, we also note some non-significant trends: patients with CVE more often underwent allogenic HSCT (82.6% vs 64.0%; p = 0.077) while donors were more often partially (rather than totally) HLA compatible for recipients (39.1% vs 21.1%; p = 0.33). Patients with CVE more often had a history of venous thromboses (13.3% vs 4.2%; p = 0.077). Post-HSCT stroke decreased post-transplantation longevity by approximately 3 times (331.8 81.6 vs 897.9 25.4 post HSCT; p = 0.0001). In the CVE group, survival during first 180 days post HSCT (landmarks post-HSCT Day+60 and Day+180) was significantly lower as compared to that in the CVE-free group. If CVE developed during first 30 days and 100 days post HSCT, vascular catastrophe did not affect post-HSCT survival significantly. Conclusion. Whereas ischemic stroke is a long-term HSCT complication (beyond D+100 post transplantation), hemorrhagic stroke is a short-term complication (D0D+100 post HSCT). CVEs affect survival in patients with hematologic malignancies, especially those developed between D+60 and D+180 post HSCT. History of venous abnormalities, low Karnofsky index at HSCT initiation, and the type of allogenic HSCT, especially from half-matched donors, can be considered as negative outcome risk factors in post-HSCT CVE.

Objective. To study the features of invasive aspergillosis (IA) due to A. non-fumigatus versus A. fumigatus in adult (≥ 18 years) recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 2016-2021. Materials and methods. The study included 33 patients with IA caused by A. non-fumigatus (n = 20) and A. fumigatus (n = 13). A comparative analysis of cases of IA, the results of therapy and outcomes in patients after allo-HSCT in the RM Gorbacheva Research Institute was performed. Diagnostic criteria EORTC / MSGERC 2020 were used. Results. Invasive aspergillosis caused by A. non-fumigatus made up the majority (60.6 %) of IA cases with an identified pathogen registered in patients after allo-HSCT in the period from 2016 to 2021. The main etiological agents in the A. non-fumigatus group were A. niger in 13 (65 %) patients, A. flavus – in 4 (20 %). The median day of diagnosis of A. non-fumigatus IAwas + 110 days (17–2093), for A. fumigatus it was + 46 days (2–866) (p = 0.171). Overall 12-week survival was 55 % and 59.2 % in the A. non-fumigatus and A. fumigatus groups, respectively (p = 0.617). The majority of patients in both the A. fumigatus (n = 10, 77 %) and A. non-fumigatus (n = 16, 80 %) groups received voriconazole as initial antifungal therapy. Second-linetherapy was required in 2 (10 %) patients with A. non-fumigatus IA: liposomal amphotericin B and echinocandins with or with-out posaconazole, and 2 (15 %) patients in the A. fumigatus group: liposomal amphotericin B and voriconazole in combination with echinocandins. A comparative analysis showed that in patients from the two groups, none of the assessed signs (gender, age, underlying disease, disease status at the time of transplantation, time from diagnosis to allo-HSCT, source of hematopoietic stem cells, conditioning regimen, donor type, antifungal prophylaxis, cytomegalovirus reactivation, severe acute and chronic graft-versus-host disease) did not differ significantly. Conclusions. A. niger is the main causative agent of IA caused by A. non-fumigatus. Patients characteristics, their treatment and outcomes did not differ significantly between the A. non-fumigatus and A. fumigatus groups.

Objective. To study epidemiology and impact of colonization by multidrug-resistant Gram-negative bacteria (MDRGNB) on bloodstream infections (BSI) during allogeneic hematopoietic stem cell transplantation (allo-HSCT). Materials and Methods. The retrospective study included 288 patients received the first allo-HSCT between 2018 and 2019. The median age was 32 (18–66) years, male – 53% (n = 152). The majority of patients had acute leukemia – 62% (n = 178) and received transplant from matched unrelated – 42% (n = 120) or haploidentical donor – 26% (n = 75). Relapse of underlying disease at the moment of all-HSCT was registered in 23% (n = 66) of patients. Results. Colonization of non-sterile sites before allo-HSCT by at least one MDRGNB was detected in 28% (n = 64). In most cases resistance is due to extended spectrum beta-lactamases (ESBL) – 86% (n = 55), while carbapenemases in combination with ESBL were detected in 14% (n = 9) of patients. After allo-HSCT the colonization was significantly higher than before transplantation (n = 161, 56%, p = 0.001), mainly due to carbapenemase- and ESBL-producing bacteria – 73% (n = 118) (p = 0.001). BSI in the early period after transplantation developed in 26% (n = 76), and in 56% (n = 43) was caused by MDRGNB. The etiology of BSI included K. pneumoniae – 51% in mostly cases. The etiology of BSI was the same bacteria that colonized non-sterile sites 2 weeks before the detection bacteria in bloodstream in 69% (n = 30) patients. Colonization by MDRGNB was associated with the development of BSI (p < 0.0001). The 100-day overall survival (OS) after all-HSCT was significantly lower in patients with colonization of non-sterile sites by MDRGNB compared with patients without colonization (60.6% vs 88.2%, p = 0.001). Conclusions. Colonization of MDRGNB after allo-HSCT reached 56%. K. pneumoniae was predominant etiology in both colonization and bloodstream infections. Colonization by MDRGNB was associated with the development of BSI and decreased OS after allo-HSCT.

Relevance. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) makes it possible to treat severe malignant and non-malignant hematopoietic disorders system. Pulmonary complications (PC) occur in 40–60 % of patients after allo-HSCT. However to date, the effect of HSCT on functional and morphological pulmonary changes in recipients remains insufficiently studied.The objective of current study was to evaluate risk factors affecting long-term survival in children and adolescents after allo-HSCT.Methods and materials. The current study was both retrospective and prospective. The analysis included 362 patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), aged 5 months to 18 years, who received allo-HSCT at Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation in 2000–2018. All the patients underwent chest computed tomography (CT). When detecting CT changes, we performed fibrobronchoscopy (FBS) with microbiological examination of bronchoalveolar lavage (BAL).Results. PC were diagnosed in 124 patients (64 %) who received allo-HSCT in 2014–2018. Decrease of overall survival (OS) is associated with PC development during the first year after allo-HSCT(р0.05). Graft source, donor type, HLA-compatibility, recipient gender did not affect the incidence of PC (p>0.05). When using graft-versus-host disease (GVHD) prophylaxis (ptCYvsATG), the 5-year OS in patients without PC was 78.8 % and 62.8 %respectively. The 5-year OS in patients with PC was 51.8 % and 42.4 % respectively (р=0.007). Decrease of OS in patients with PC is associated with chGVHD(58.3 %,) (р=0.03).Conclusion. Pulmonary complications (infectious and non-infectious) in allo-HSCT recipients are more likely to occur in the first year after transplantation. Among bacterial pathogens, the predominance of Gr(-) flora remains. The incidence of pulmonary complications was significantly lower when using ptCY as a prevention of GVHD.

Introduction. The risk of developing Hodgkin lymphoma (HL) with HIV infection is higher than in the general population, and the course of the disease itself is more aggressive. Currently, there is no unified approach to the treatment of HIV-related HL, and data on its epidemiology in the Russian Federation are limited.The objective was to study epidemiological characteristics, the used therapeutic tactics and the results of treatment for HIV-related HL.Methods and materials. The multicenter retrospective study included 46 patients with HIV- related HL treated in 9 centers of the Russian Federation. Descriptive statistics methods were used, the analysis of overall survival (OS) and progression-free survival (PFS) was performed using the Kaplan–Meier method.Results. HIV-related HL is more often represented by an advanced stage, B-symptoms, and extranodal lesions. The ABVD regimen was used as the first-line therapy in 60 % for HIV-related HL. The overall response to therapy was 81.6 %, and the 2-year OS and PFS were 85 % and 49 %, respectively. Factors that worsened OS were CD4+˂266 cells/mcL and general somatic status ECOG≥2.

Objective. To assess the course and outcomes of COVID-19 in recipients of allogeneic and autologous hematopoietic stem cell transplant (HSCT). Materials and Methods. The retrospective study included 44 adult recipients (allogeneic – 33 [75%] and autologous – 11 [25%] of HSCT who diagnosed with COVID-19 after transplantation. Group mostly represented by acute leukemia – 18 (41%) and lymphoma – 10 (22.7%). The median follow-up time since the development of COVID-19 was 231 days (1–818 days), after HSCT – 507.5 days (14–3723 days). Overall and progression-free survival was assessed using the Kaplan–Meier and Log-Rank method. We also evaluated the characteristics of the course of a new coronavirus infection. Results. Median time for the development of COVID-19 from the moment of HSCT was 122.5 days (-1–3490 days). Twelve patients (27.2%) were in grade 3–4 neutropenia at the time of COVID-19 diagnosis, 16 (36.4%) patients were in grade 1–2 neutropenia. Sixteen (48.4%) allo-HSCT recipients had active graft-versus-host disease (GVHD) at the time of COVID-19 development. Disease severity was mild in 19 (43.2%) and moderate in 13 (29.5%) patients. Overall, 200-day survival from the onset of COVID-19 was 78.8% (95% CI [63.1–88.4]). Anemia (p = 0.02) and thrombocytopenia (p = 0.01) significantly decrease OS in patients with COVID-19 after HSCT. Patients with GVHD at the time of COVID-19 onset had a better survival rate (p = 0.02). The timing of COVID-19 development after HSCT did not affect outcomes. Conclusions. The key points of the course of COVID-19 in HSCT recipients are the presence of cytopenia and graft-versus-host disease. Overall survival was 78.8%.

Background. Pregnancy in paroxysmal nocturnal hemoglobinuria (PNH) patients has historically been a high-risk situation. The combination of chronic complement-mediated hemolysis caused by the disease and physiological activation of the complement system during pregnancy, significantly worsened the prognosis for the life. For a long time, there were no effective methods for the PNH treatment, and pregnancy in patients seemed to be extremely risky, as it significantly increased the risk of life-threatening complications. The advent of targeted therapy with eculizumab turned the prognosis of this disease upside down: patients began not only to survive, but also to live comparable to healthy people. A comparative analysis of the course and outcomes of pregnancy in patients with PNH treated with eculizumab and in patients without targeted therapy was carried out. Aim. The study was to evaluate the course and outcomes of pregnancy in patients with PNH, depending on the therapeutic approach. Materials and methods. We analyzed data from 57 pregnancies in 49 women (31 used eculizumab, 26 with supportive care only) observed at the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology or with remote consultation (23 clinics from 19 cities of Russia). Results. The high probability of pregnancy complications and its adverse outcomes outside of targeted therapy indicates the vital need for its use: all observations were accompanied by complications of varying severity. The course of pregnancy with the eculizumab is generally more favorable: an apparently higher rate of live births and a lower likelihood of complications are registered. Without increasing the incidence of complications, eculizumab significantly improves pregnancy outcomes for both mother and fetus, and does not adversely affect the health of newborns. Conclusion. Thus, eculizumab allows not only to increase the survival rate of patients with PNH, but also to comprehensively improve their quality of life, including the possibility of safe childbirth.

Introduction. More than 50,000 haematopoietic stem cell transplantations (HSCTs) are performed worldwide each year to treat malignant blood cancers, solid tumours, bone marrow aplasia, primary immunodeficiency conditions, autoimmune disorders, and storage disorders. The success of HSCTs depends on many factors, including patient's past medical history. Purpose. To assess the effect of an acute cerebrovascular accident (CVA) that occurred before the HSCT on the transplantation outcome in patients with blood cancer. Materials and methods. We examined the results of 899 transplantations conducted between 2016 and 2018 at the R.M. Gorbacheva Research Institute for Pediatric Oncology, Haematology and Transplantation of the Pavlov First Saint Petersburg State Medical University. We analysed transplantation parameters, as well as donor and recipient characteristics. Apart from intergroup comparisons, pseudo-randomization was performed using the Propensity Score Matching method. The survival rate analysis was conducted using the KaplanMeier estimate and the log rank test. Results. Sixteen patients (1.8%) had cerebrovascular events in their past history before the HSCT: ischaemic stroke in 0.4% of cases and haemorrhagic stroke or intracerebral haemorrhage in 1.4% of cases. Patients with a history of cerebrovascular events included more people with leukaemia (p = 0.02), had more often received an allogenic transplant (р = 0.01), the donors more often had a partial rather than a full HLA match with the recipient (р = 0.06), had a lower body mass index (р = 0.02), and a lower Karnofsky/Lansky score (р = 0.01) than patients in the control group. The presence of a cardiovascular event had a statistically significant association with reduced overall survival rate of HSCT recipients (р = 0.0012). Conclusion. Patients with blood cancer and stroke preceding the transplantation do not typically have any 'classical' risk factors (diabetes mellitus, venous system disorders, decreased cardiac output, significant atherosclerotic changes in precerebral arteries), therefore, secondary prevention guidelines for CVA during treatment of the main disease may not be effective and cannot be relied on. This article discusses the most likely causes of CVA in patients with blood cancer. A history of CVA before HSCT may have a significant effect on the transplantation outcome, but is not a contraindication for this treatment method. Recipient selection is a very important stage in HSCT planning. A multidisciplinary team should find a balance between the indications and contraindications for performing HSCT from an unrelated donor.

Background. Assessment of lung injury in oncohematological patients is a relevant problem, since the spectrum of pathological changes is wide and includes pulmonary infections, tumor cell infiltration, cardiogenic and non-cardiogenic pulmonary edema, bronchiolitis obliterans, interstitial pneumonitis, post-radiation and post-inflammatory pneumofibrosis, pulmonary vasculopathy and pleural effusion. At the moment there are no approved recommendations with criteria of differential diagnosis for these conditions, in particular, with differences between the most common therapy complication represented by pulmonary infections and poorly explored drug-induced toxic lesions.Aim. Identification of criteria for pneumotoxicity, allowing for differential diagnosis with pulmonary infections developing during chemotherapy, according to data routinely obtained in real clinical practice.Materials and methods. The study group included 38 patients with cytotoxic and autoimmune lung injury caused by specific therapy (group 1); the comparison group included 38 patients with infectious lesions receiving the same antitumor drugs (group 2). The data of the anamnesis, clinical course, instrumental studies and standard laboratory tests was studied retrospectively. For statistical analysis, the Mann–Whitney, χ2, Kruskal–Wallis tests were used. ROC analysis was performed to assess the sensitivity and specificity of various factors in relation to toxic damage.Results. Patients with lymphomas predominated in group of toxic lung injury (63 %). In patients who underwent allogeneic hematopoietic stem cells transplantation, toxic complications developed in the period from 35 to 1289 days, infectious – from 4 to 43 days. Statistically significant differences were obtained in the presence of a concomitant state of an altered immune response: 32 % of patients in the toxic lesion group versus 5 % in the infectious group had a history of allergy, and, in contrast to the infectious lesion group, in the toxic lesion group autoimmune diseases were detected. The main symptom in patients of the first group was shortness of breath, which was observed in 68 % of cases, of the second – an increased body temperature, observed in 92 % of cases; cough was also a common symptom – in 19 % and 13 % of patients respectively. In 58 % of patients of the second group, concomitant mucositis was detected, while in the first group this complication did not occur in any of them. The most common radiological pattern (71 % of cases in each group) was ground-glass opacities, in patients of the second group often combined with infiltrative changes and thickening of the bronchial walls (in 53 and 42 % of cases respectively). Among laboratory results, the largest differences between groups were observed in the leukocyte levels (with an average level of 2.5 . 109 / L in the infectious group versus 6 . 109 / L in the toxic group), eosinophils (with an average of 3.6 % in the toxic group versus 1.75 % in the infectious group), C-reactive protein (with an average level of 146.7 mg / L in the infectious group versus 52.4 mg / L in the toxic group), and creatinine (with an average of 0.085 mmol / L in the toxic group versus 0.071 mmol / L in the infectious group).Conclusion. The data obtained in this research indicates the value of taking an anamnesis and the importance of performing additional studies in patients with suspected drug-induced lung injury, as well as identifies risk groups. Based on the revealed differences, a scale for the differential diagnosis of drug-induced toxic and infectious lung damage, which includes the results of publicly available research methods, with high sensitivity and specificity, was proposed. Further research for more specific, but, at the same time, universal for various drugs, criteria for toxic lung damage is relevant.

There is an increase in the incidence of multiple sclerosis in the world. Only in half of the cases, standard therapy allows for a short time to achieve control over this disease. High-dose immunosuppressive therapy and autologous hematopoietic stem cells transplantation is a promising and effective method of treating autoimmune diseases, including multiple sclerovsis. Over the past 20 years, progress has been made in understanding the immune mechanisms of the method. At present, the frequency and severity of adverse events of therapy significantly decreased by reducing the intensity of conditioning regimens. The objective of this review was to analyze scientific publications on the effectiveness of the method, and the data on the optimal conditions and criteria for its use in multiple sclerosis.

Research was carried out at the Ufa Industrial Center on the territory of recreational zone. Morphological changes in birch leaves (Betula pendula Roth) during the growing season of 2019 are shown. Model birch trees grow on a permanent trial plot. On the trees, 10 leaves were numbered. During the growing season (June - September) photographs of each leaf were taken. The integral indicator of the stability of leaf development is calculated on five grounds. Statistical processing of the data obtained. It has been established that there are deviations in the morphological development of birch leaves. It is shown that an individual trajectory of morphological development is characteristic of leaves. The phenomenon of adaptive polymorphism of birch leaves is noted. Moreover, the morphological and functional features of the leaf are inextricably linked.

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.

Introduction. The article examines the processes of transformation of the institutional environment of the regional timber industry enterprises in Karelia in the 1990s. The aim of the study was to identify the impact of this transformation at the level of socio-economic development of the Republic of Karelia as a Finno-Ugric region with the predominant development of the branches of the timber industry. Materials and Methods. The research methodology is based on the use of a predominantly institutional approach. Its application makes it possible to trace the changes that occurred in the structure of the institutional environment of regional timber industry enterprises with the beginning of market transformations in the 1990-ies, as well as the degree of effectiveness of the interaction of this enterprise with various economic entities. Results and Discussion. The analysis of the changes that took place in the first post-Soviet decade in the institutional environment of regional timber industry showed a number of negative aspects. First of all, the role of the state greatly reduced, which was unable to form effective “rules of the game” for the timber economy. The Forest Code adopted in 1997 infringed upon the rights of Karelia as a subject of the Federation, since only a part of the forests could be transferred to the ownership of the Republic. In the current difficult conditions, with the absence of the party and state control departments, and the difficult financial situation of the region, the role of regional authorities in solving the problems of forestry enterprises increased. In the context of spontaneous privatization and the collapse of the financial system, timber industry enterprises faced numerous problems of interaction with suppliers, customers, consumers and banks. This period was the time of the strengthening of the role of foreign companies in the work of timber enterprises. Unfortunately, having received a controlling stake in a number of domestic enterprises, foreign entrepreneurs were in no hurry to invest in their development. Conclusion. The transformations that took place in the institutional environment of the regional forestry enterprises in the 1990-ies negatively affected the level of the socio-economic development of Finno-Ugric region, based on the development of branches of the timber industry complex.

Acute symptomatic epileptic seizures are one of the complications of hematopoietic stem cell transplantation. The etiological factors leading to the development of this complication differ from those in the general population, while the significance of each of them is different depending on the time after transplantation. We analyze the literature data on the role of drugs, metabolic disorders and infectious complications, as well as the structural pathology of the brain substance in the development of acute symptomatic seizures in patients with oncohematological pathology. We also consider the clinical features of symptomatic epileptic seizures and the possible prognostic significance of their development in patients who underwent hematopoietic stem cell transplantation.

A method is proposed for recognizing pre-emergency conditions of rotary installations based on the use of the Hamming window and advanced Deep Learning techniques in retrospective analysis of the results of accounting for the factors of operation of a turbine generator, diagnostics and control under critical impacts. A program of experimental studies on the model of a turbine plant with simulation of faults and receiving vibration signals has been developed. An experiment based on the homostatic method of checking the signal with Hamming windows, in the frequency, time and modulation domains and common initial data, allows one to determine the most promising signal characteristics for identification. A method has been developed for monitoring the state of turbine generators in an automatic mode for timely notification of the CHPP personnel about the appearance of signs of pre-emergency situations, as well as about the nature of faults by the method of predicting the state of a pre-emergency situation using convolutional neural networks implemented in the form of a recurrent autoencoder. Clustering is applied and clusters are identified that correspond to the spectrograms of pre-emergency situations. The effectiveness of the use of the homostatic method in combination with correlation analysis is based on the decision-making model described in more detail in other works.

Introduction.The biological heterogeneity of chronic lymphocytic leukemia (CLL) is reflected in the rate of progression, the need for therapy, and the response to treatment. Analysis of prognostic factors contributes to improving the quality of treatment and rational distribution of healthcare resources.Materials and methods. Among 890 patients with documented stage of CLL, 405 (45.5 %) received treatment. As the first-line of treatment, 173 patients received intensive regimens (FCR or BR), 6 – new agents, and 226 – all other regimens. The initial stage of the disease, mutation status of IGHV, del17p with or without complex karyotype were analyzed as prognostic markers.Results. Immunochemotherapeutic regimens were shown to be highly effective in case planned amount of treatment was completed. The combination of such prognostic parameters as the initial stage of the disease, the mutation status of IGHV, and the presence of del17p and/or complex karyotype allows us to clearly identify a group of patients with an unfavorable prognosis, for which it is advisable to use either intensive programs or new agents in the first-line therapy.

Green spaces of the city are an integral part of its ecological framework. When planning urban space, information is needed on their actual distribution, condition and dynamics. To do this, it is advisable to use satellite images. The purpose of the work is to conduct remote monitoring of green spaces of Ufa using Landsat satellite images over the past 30 years. Image processing, including radiometric calibration, reducing the amount of data from 6 channels to 3 main components, uncontrolled classification of images, grouping classes to 5 types of underlying surface (open soil, no vegetation, grassy vegetation, tree and shrub vegetation, underwater), matrix construction changes were made using the tools of the SAGA GIS software product. As a result, a map was constructed showing spatial changes of the tree-shrub vegetation type over 30 years. The plots on which this type is preserved make up 16 073 ha, on which it was replaced by another type of underlying surface - 3700 ha. Plots characterized in 1988 by other types, and in 2018 converted to the tree-shrub vegetation type, occupy 8665 ha. On the one hand, there is a positive trend in the conservation and increase in the area of tree-shrub plantings. But this is not characteristic of the entire urban district, but mainly of the forests of the Ufa urban forestry, which are located mainly on the outskirts, around the central part of the city. For intracity tree-shrub plantings that are not related to the forest fund and located in the built-up part of the city, stable negative dynamics and a change in other types of underlying surface are characteristic.

Introduction. Because of urban development the volume of municipal and industrial wastewater are growing. Along with them the amount of sewage sludge (SS) also increases. Millions of tons of SS are currently accumulated on the territory of the Russian Federation and contain various pollutants, including heavy metals (HM). In this regard, the search for effective methods of SS treatment from HM is an urgent problem. The main methods of SS treatment are drying, dehydration, thermal methods, UV and microwave wave treatment. These kinds of disinfection eliminates many pathogenic microorganisms, but they are quite expensive and not effective against HM. Reagent methods include SS disinfection with quicklime (CaO). However, decontamination requires large doses (up to 30%) and it is also ineffective against HM. Humic-mineral reagent are more effective, they are based on crushed caustobiolites, their cleaning capacity from HM is 19–87%. Methods and materials. The authors have previously shown the effectiveness of wastewater treatment from HM using sorbents based on dolomite, quartzite, and waste from mining and processing plants. Therefore, a method for SS treatment from HM using sorbents based on dolomite, humates, and CS containing CaCO3 and humic compounds was proposed. In this regard, a method was proposed for SS treatment from HM using three types of sorbents based on: 1) waste of thermal power plants (TPP) – conditioned sludge (CS) containing CaCO3 up to 68% and humic compounds up to 12% – sorbent 1 (S1); 2) dolomite – Mg and Ca carbonate in a composition with sodium humate (25%)– sorbent 2 (S2); 3) modified dolomite with sodium humate (1%) – sorbent 3 (S3). Results and discussion. In laboratory experiments, the cleaning capacity of SS was studied using a dolomite-based sorbent modified with humate (1%). In field tests, a decrease in the concentration of HM in SS was studied with the use of sorbents based on CS and the complex sorbent dolomite-humate (75:25). The cleaning capacity of SS from HM increases in the series: sorbents based on waste from TPP – CS containing CaCO3 and humates (cleaning capacity E = 4.8–48.6% for dried SS and 29.3–53.3% for dehydrated SS) < sorbent based on a composition of dolomite with humate (E = 65.1–92.1% for dried and 56.6–89.4% for dehydrated SS) < a dolomite-based sorbent modified with humate (E = 90.8–99.9%). Conclusions. The maximum cleaning capacity is shown by a dolomite-based sorbent coated with a nano- and micro- sized layer of sodium humate.

The article presents the results of creating a new state primary standard for the specific heat capacity unit and means for transmission of the unit to other devices, namely, reference measures from various materials. The main structural features of the created calorimeter, its metrological characteristics are described. The data on the specific heat capacity of some materials, considered as the reference measures of specific heat, are shown. The experimental data are compared with data, published by other researchers.

Aim.Was to evaluate clinical efficacy, adverse events and changes in the gut microbiome after fecal microbiota transplantation (FMT) in patients with gastrointestinal (GI) form of graft-versus-host disease (GVHD). Materials and methods.The prospective single-center study in R.M. Gorbacheva institute included 27 patients with GI GVHD after allogeneic stem cell transplantation. 19 patients received FMT, 8 patients received placebo. Clinical scales for GI autoimmune diseases were used to evaluate response. Microbiome alterations were assessed with multiplex PCR. Results.After FMT higher overall bacterial mass (р=0.00088), higher bacterial numbers ofBifidobacteriumspp. (р=0.021),Escherichia coli(р=0.049) andBacteroides fragilisgr. (р=0.000043) compared to placebo group. Also higher bacterial mass was observed in patients with clinical response (р=0.0057). The bacterial mass after procedure in non-responders was compared to the placebo group (р=0.31). Partial response of GVHD was achieved faster in the FMT group compared to placebo (median 4 days vs 48 days,p=0.014). Complete response was observed in 8 (42%), 14 (74%) and 16 (84%) at 30, 60 and 90 days respectively, while in the placebo group only 0%, 1 (13%) and 4 (50%) achieved complete response at the same time points. The incidence and severity of adverse events was comparable between FMT and the placebo group. Conclusion.FMT in patients with refractory GI GVHD was associated with favorable clinical outcomes and recovery in certain marker bacterial populations. Multiplex PCR can be used to assess an engraftment of a donor microbiota. FMT in GI GVHD was not associated with life-threatening adverse events, but further studies are required to validate clinical efficacy.

Currently, the main pathogenetic method for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) is the treatment with recombinant monoclonal antibodies that block the C5 component of the complement system. Eculizumab is the first biotechnological drug, which is a monoclonal antibody, with proven clinical efficacy and safety for the treatment of patients with PNH, which is used in world clinical practice. In Russia, in the framework of the state program Development of the pharmaceutical and medical industry for 20132020 was developed Elizaria (JSC GENERIUM) the first biosimilar of the original drug eculizumab. Aim.To evaluate the pharmacokinetic and pharmacodynamic parameters, as well as safety and immunogenicity parameters of the drug Elizara in the induction phase of therapy in previously untreated patients with PNH. Materials and methods.The study included 11 patients with PNH aged 26 to 75 years who had not previously received eculizumab. Each of the study participants was injected with the studied drug Elizaria at a dose of 600 mg intravenously once a week for 4 weeks. Results.During the clinical study, it was noted that the concentration of the studied drug significantly increased by the time the infusion was completed and then gradually decreased to a minimum at the end of the dosing interval. The average concentration of eculizumab 5 minutes before the administration of the study drug at all visits exceeded 35 g/ml, the minimum concentration sufficient to completely inhibit intravascular hemolysis in patients with PNH. The pharmacodynamic efficacy of the drug Elizaria was confirmed by a decrease in the concentration of the membrane-attack complex (MAC) after the first infusion of the drug was maintained at stable levels until visit 5. A persistent decrease in the level of MAC and a four-fold decrease in the average values of lactate dehydrogenase to visit 5 from 1286.4 to 280.9 U/l demonstrated a marked decrease in activity and stabilization of the hemolytic process against the background of the induction of therapy with Elizaria at a dose of 600 mg once a week and confirmed the effecacy of the study drug. Among the 9 adverse events, only 5 had a relationship with the studied drug, including one serious adverse event in the form of an allergic reaction, which, according to the researcher, had a possible cause-effect relationship with the infusion of the studied drug. In 2 patients, low-titer binding anti-drug antibodies were detected without neutralizing activity during treatment with the studied drug, which may indicate its low immunogenicity. Conclusion.The study evaluated the pharmacokinetic and pharmacodynamic properties of the drug Elizaria in the regimen of induction therapy in previously untreated patients with PNH, confirming its efficacy. The study demonstrated the safety and low immunogenicity of the study drug.

Approaches to constructing a mock-up of a system for focusing laser radiation on distant objects using both adaptive optics elements and nonlinear-optical wavefront reversal methods providing compensation for turbulent distortions are considered. Numerical calculations were preliminarily performed, in which the split-step method was used as a numerical method for solving a second-order partial differential wave equation for the complex amplitude of the wave field of a laser beam. This method, combined with methods of spectral-phase Fourier transforms and statistical tests, is the most effective way to obtain reliable quantitative results for solving engineering problems of atmospheric wave optics. Quantitative data are obtained on the effect of turbulent atmospheric distortions along propagation paths on the main parameters of coherent laser beams – focusing, effective average radius, and the proportion of the beam energy in its diffraction spot. The preliminary results obtained of the system mock-up performance confirm the conclusions of the theory.

Objective: to identify the most effective method for anxiety assessment in athletes. Materials and methods: the selective criteria were formulated and comparative analysis of 9 most commonly used methods of assessing the level of anxiety was made. 79 athletes of combat sports were tested (34 men, 45 women) in the preparative period of training with Lusher's color test and the integrative anxiety test by A.P. Bizyuk, L.I. Wasserman, B.V. Iovlev. Results: among nine methods most frequently mentioned in the literature, Lusher's color test with the calculation of diagnostic coefficients and the integrative anxiety test by A.P. Bizyuk, L.I. Wasserman, B.V. Iovlev were most consistent with the stated criteria. There were significant correlations between the calculated indices of Luscher's color test, which have physiological explanation: the correlation between the vegetative coefficient and the total deviation from the autogenic norm, mental working capacity, situational anxiety, and between total deviation from the autogenic norm and mental performance, sex (increase in the deviation from the autologous norm corresponds to a decrease in mental performance, an increase in the level of anxiety, parasympathetic tone, and need for rest and energy accumulation). The athletes have the low level of situational anxiety and an average level of personal anxiety if compared with average population values. Conclusions: the findings complement the results of other researchers who also confirmed the validity of use of color test and integrative anxiety test in professional sports to identify the threatening breakdown of mental adaptation and psycho-correction work among athletes.

Objective of research: The purpose of this study is the investigation of Dirofilaria infection in tracking dogs from kennels of the Administration of the Federal Penitentiary Service of the Russian Federation for Astrakhan region, and preventive measures for dirofilariasis. Material and methods: Research was conducted in 2004-2009 at the Parasitology Lab of the Center for Hygiene and Epidemiology for the Astrakhan region and at the Department of Infectious Diseases Epidemiology of the Astrakhan State Medical University. Totally, 2907 dogs of various breeds, both genders, aged from 1 to 13 years were investigated. From 2004 to 2009 the examination of dogs was conducted twice a year during the periods of mosquito flight activity. Blood tests were performed by a modified method using 1% of acetic acid solution. Results and discussion: Dirofilariasis was mostly observed in dogs 1 to 5 years of age (86,1 %). Dirofilaria immitis was detected in 17,4 % of 1 year-old dogs; in 22,6% of 2 year-old dogs; 18,3,% of 3 year-old dogs; 10 %-of 4yo dogs and 14,8 % of 5yo dogs. The extensity of infection with Dirofilaria immitis in dogs 6 and 7 years of age was 5,2 and 3,5 %, respectively. It was found that 0,9 % of dogs 8, 10 and 13 of age were infected. Dirofilariasis was not registered in senior dogs. 47 (3,6 %) of 1289 female dogs and 68 (4,2 %) of 1617 male dogs were infected. German shepherds were most infected with Dirofilaria immitis (39,1 %). In urban areas, the infection extensity (92,2 %) is higher than in the suburbs (7,8 %). The highest level of Dirofilaria immitis infection in tracking dogs (24,1 %) was determined in 2004. After using the preparation Dironet in 2008, the infestation level decreased several times and was 3,2 %. Because of the fact that dogs are brought to the kennels from the regions unfavorable on dirofilariasis it is necessary to investigate dog’s blood twice a year to detect microfilariae and to perform timely prophylactic treatments with Dironet.

This article is about the successful treatment of the patient with such heavy complications of a perforative duodenal ulcer as heavy abdominal sepsis, with the subsequent formation of fistulas of gastrointestinal tract. Application of the technique of «open abdomen» using vacuum assisted closure, allowed in this case to realize the principle of «sourcecontrol» and to achieve stabilization of the condition in multiple organ failure and septic shock. It is worth noting the advantage of stage reconstructive surgical interventions to this category of patients that allows to gradually improve quality of life of the patient without high operational risks of big simultaneous reconstructive operations.

Current trends involve the use of waste, what makes the enterprise more environmentally friendly. One of the direction is using woodworking wastes for receiving building materials. Before obtaining the necessary building material sawdust is subjected to pretreatment – to improve the technical characteristics of the future product. This article describes the method of obtaining insulation material from sawdust with special pretreatment: processing in cavitator and then pressing. Comparative characteristics of heat-insulating properties with analogues are given, advantages and disadvantages are revealed. Using sawdust as raw material for production ecological heat-insulating building materials allows to create closed production cycle. Besides this method can significantly decrease negative influence of woodwork production on the environment. As conclusions, it is proposed to use hydrodynamic processing as a method to improve the technical characteristics of the product without significantly increasing the cost of the material.

The article attempts to outline new approaches to the study of the timber industry complex as one of the main instruments of interaction between the State and Karelia, as the Finno-Ugric region, during the second half of the 20th century. The aim of the study is to find the theories and concepts that could form the basis for the systematic analysis of the interaction. The urgency of the study is related to the fact that for many forest-producing regions of Russia, including Karelia, the result of the regional state social and economic policy during the studied period turned out to be largely negative. The research methodology is based on the use of modernization theory and the concept “center – periphery”. The article is based on the research of international and Russian scholars which interpret these concepts. The comparison of theoretical material with the historical experience of development of Karelia in the second half of the 20th century allows to draw a conclusion about the possibility of successful combination of the noted research approaches. Various interpretations of the theory of modernization made it possible draw a conclusion about the peripheral nature of the modernization processes in this region in relation to socio-economic development of Karelia. Using the concept “center – periphery”, according to which the unevenness of economic growth and the process of spatial polarization inevitably generate disparities between the so-called center and periphery, has shown its potential in the study of the peculiarities of interaction between the state and the Finno-Ugric region. Comparison of these two concepts makes it possible to draw a conclusion about the high degree of their mutual complementarity and the possibility in the long term to propose the realization of a center-peripheral model of regional modernization in the social and economic development of Karelia.

The article attempts to consider the role of the timber industry in the development of the Finno-Ugric regions of the USSR, and then the Russian Federation during the second half of the 20th century through the prism of historiography. The purpose of the study is to determine the scientific contribution of specialists from various branches in the study of this topic. The relevance of the study is related to the fact that for many Finno-Ugric regions of Russia, including the Finno-Ugric regions, timber industry complex was and remains the basis of sustainable socio-economic development. The research methodology is based on traditional principles and methods for historiographic research. These include the principle of historicism, the problem-chronological and comparative historical methods. The study of the works of various authors on this topic allows us to distinguish three stages in the study of the problem. The first stage can be attributed to studies of the Soviet period, in which a lot of attention was paid to the technological, economic and historical features of the development of timber industry in the Finno-Ugric regions. However, many problems of development of timber industry in Finno-Ugric regions for various reasons have not been thoroughly studied. Since the late 1980s, and especially during the 1990s due to the combination of economic, political and cultural factors the role of timber industry in the development of the Finno-Ugric regions of Russia moved to the periphery of the interests of most researchers. However, in the early 2000s with the beginning of political and economic stabilization, it became necessary to reconsider the historical experience of socio-economic development in the Soviet and post-Soviet periods, which led to a revival of interest among researchers and specialists in the subject matter. Analysis of the research has shown that the role of timber industry as a tool for the development of Finno-Ugric regions has not yet received a comprehensive analysis.

In this paper, we investigate efficiency of software transactional memory implementation in GCC compiler. The authors propose software tools for instrumentation to profiling programs with software transactional memory, and describe the method of reducing false conflicts. The method performs the tuning of transactional memory parameters value in GCC implementation (libitm runtime-library) by using the profiling results (profile-guided optimization). The static instrumentation allows to optimize dynamic properties of execution transactional sections. The efficiency of reducing false conflicts is investigated on the STAMP benchmarks.

The article describes the special characteristics of innovation systems to obtain a synergistic effect. The reasons for the Russia’s lag in the innovative development are identified; the authors conclude that the state as such has not yet formed an order for the innovative product. The authors hypothesized that in spite of the real legal conformity of economic development and the complication of the market mechanisms, the Russian government acknowledges the money capital as the main regulator of the market, and not as an element of technical progress. As a result, the innovation lag from advanced countries does not reduce but increases. The article emphasizes the specificity of the innovation system as aset of necessary basic elements and relationships between them, providing synergistic effects. The authors reveal the special characteristics of innovative systems and give them a characteristic; the demand for the innovative systems for the Russian economy is proved.

Background: The purpose of this study is to identify common and specific trends in the implementation of models of Soviet and post-Soviet modernization of the timber industry in Russia. Methods: The methodology of the research is based on the use of theoretical approaches of historical and economic sciences. Such a wide range of methodological approaches used in the work is related to the complexity of the study, which included analysis of the interaction of the state, the timber industry complex and the region at the macro-, meso- and microlevels of social and economic interaction. Findings: The dynamics of the development of the domestic timber industry complex during the period under review was characterized by a hasty growth, then a stage of maturity and, subsequently, a stage of decline. Moreover, this dynamics was marked both in production and economic indicators, as well as in capital investment indicators that affected the industrial and social infrastructure of the timber industry, as well as on quantitative and qualitative indicators of the development of mechanization in the timber industry and the achievement of scientific and technological progress. The final transition of the domestic timber industry complex from a group of stable industries of the old technological order to the problem group has become an obvious proof of the counter-modernization model of development. However, we need a search for new transformational solutions. At the present stage, Russia needs an urgent transition to the process of building a cluster policy in the timber industry. Such a policy should be carried out both at the regional and national levels, as well as in the context of international cooperation. Application: The findings of the study will be helpful for specialists who deal with the issues of economic or industrial history.

The published lecture was delivered by an outstanding scientist, academician Alexander Panchenko (1937–2002) at the Philological Faculty of Leningrad State Pedagogical Institute (now the Herzen State Pedagogical University of Russia) and is devoted to Lomonosov’s poetry. Lomonosov is considered in historical and cultural context: the origins of the poet's creative works, his connection with the baroque tradition, the influence of German authors, aspects of versification.

Goal: to demonstrate the rare case of transfusion-associated graft-versus-host disease (TA-GvHD) after transfusion of blood components. The cause of TA-GvHD is implantation of donor lymphocytes, contained in blood components, which is related to immunological HLA-homology between the donor and recipient, that does not eliminate the donor cells. Mortality makes 90-100%. 68 year old patient had planned surgery - aortocoronary bypass. In the post-operative period under pressure anemia three doses of unirradiated packed red blood cells were transfused. On the 17th day after transfusion the patient developed febrile fever and manifested erythematous cutaneous rush. On the 24th day after transfusion neutropenia developed. Evaluation results of allele discrimination of high-polymorphic markers confirmed the diagnosis of TA-GvHD. HLA-typing of the donor's and recipient's blood was done retrospectively. The donor was homozygous in five loci in low resolution and in loci of HLA-А*, HLA-В*, HLA-DRB1* he had the gene common with the patient. On the 34th day after the transfusion the patient died of infectious complications. X-ray or gamma-irradiation of blood components in order to inactivate the donor's viable T-lymphocytes is considered to be the only way to guarantee the prevention of TA-GvHD. Since there is no effective therapy for TA-GvHD, prevention of risk to develop the disease, strict indications to blood transfusions and capacity for early diagnosis become crucial.

The article is devoted to the choice of antireflux procedure in surgery of gastroesophageal reflux disease. The mechanisms of the most popular antireflux operations are described. The criteria for selecting options of reconstructions gastroesophageal junction are presented in the article. The theoretical propositions are supported by the results of clinical observations.

The article presents an analysis of results of 24 384 endoscopic examinations of the upper gastrointestinal tract in population of the Leningrad oblast with symptoms of gastric dyspepsia during the period from 2007 to 2011. The detection of the columnar-celled metaplasia was 1.1%, adenocarcinoma of the esophagus — 0.045%. Esophageal adenocarcinoma occurred in 3.95% of cases of the column-celled esophagus. Barrett’s esophagus was revealed in males more often than in women (56.5% and 54.5% respectively). The peak incidence of esophageal adenocarcinoma in males was at the age from 46 to 60 years (36.4% of patients), in females — from 61 to 75 years (27.3% of patients). Intestinal metaplasia was detected in 72.7% of cases with esophageal adenocarcinoma. The diagnosis of long and short segment of column-celled esophagus revealed no significant difference in the development of esophageal adenocarcinoma.

In this work the processes of an internal structure formation in copper-bearing nanoalloys of silver, cobalt and palladium were studied using molecular dynamics with a modified tight-binding potential. For each bimetallic system, five chemical compositions with different proportions of copper atoms were investigated. Non-structural clusters, obtained by melting the primary fcc nanoparticles, were then subjected to freezing procedure at room temperature with a fixed cooling rate. It is shown that upon cooling from the liquid superheated phase it is possible to form structural domains of different internal structure, including multiple nuclei of icosahedral symmetry. Some criteria for obtaining the ordered structure of the nano-melting core with a dense packing of atoms are determined.

The article analyzes the basic indicators of efficiency of the institute of socio-professional adaptation of workers of timber industry complex of Karelia in the first postwar decade. The factors that had the greatest influence on the effective functioning of the system of social and professional relationships were revealed. These factors were classified as the presence of a comfortable production and social infrastructure, as well as the level of professional training and in-service training of personnel. Based on the analysis of the scientific literature, and input into scientific circulation of new archival sources, the author concludes that the institution of the social and professional adaptation had serious shortcomings in the process of its functioning. One of these consisted in a lag in the development of social and industrial infrastructure in comparison with the rate of logging in the country. Trying to create a public policy level of normal living conditions for workers in the timber industry has transformed in creation of temporary housing for the workers, which became the basis of the residential fund industry for many decades. As a result, one could not talk about the social adaptation of the workers in terms of creating conditions for their leisure in the period under review. At the same time, despite the creation of an extensive network of professional schools and colleges for a complete term of professional adaptation of workers in timber enterprises had not been established. By the early 1950s, due to major changes in the technical equipment of the logging companies, contradictions started to emerge between the low qualification level of training of workers and industry mechanization.

Relevance. The use of inhaled glucocorticosteroids (IHCs) is one of the main basic treatment options forbroncho-obstructive diseases.IHCs suppress chronic inflammation in the bronchial tree, but can be associated with the risk of pneumonia due to impairment of bronchus mucosal immunity and increased microbial colonization in the mucosa.Aim. The aim of this study was to evaluate the incidence and risk factors of pneumonia during the IHCs therapy in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and with combination of COPD and asthma.Materials and methods. The retrospective study included patients with confirmed COPD, BA and combined COPD and asthma. The endpoint of this analysis was the incidence of pneumonia. Potential additional risk factors (age, gender, smoking, diagnosis, duration of the disease) were analyzed.Results. A total of 220 patients with broncho-obstructive pathology were included in the retrospective analysis. 184 patients received IHCs. 34 patients obtaining the basic therapy with IHCs developed pneumonia with a cumulative incidence of 36 % after 10 years. The primary diagnosis, gender, age and smoking did not significantly impact the risk of pneumonia.Conclusions. IHCs therapy is associated with a risk of pneumonia, which should be taken into account when planning long-term control of broncho-obstructive pathology.

Investigations of thermodynamic and structural characteristics of cobalt nanoclusters in the process of phase transition melting/crystallization with the goal to identify characteristics of their behavior typical for the clusters with the «magic» number of atoms. The melting point of nanoclusters was determined using the temperature dependence of the specific internal energy of nanoclusters.

Мета роботи. Визначення максимальних величин струмових та кутових похибок трансформаторів струму та характеру їх зміни в усталених та перехідних режимах енергосистеми, за яких можливий вихід величин похибок за межі діапазону нормованих значень, а також у порівнянні ступеня зміни струмових та кутових похибок трансформаторів струму, призначених для живлення вторинних кіл пристроїв релейного захисту, за цих режимів. Методи досліджень. Дослідження проведено шляхом застосування методу імітаційного моделювання та візуалізації на ПВМ функціонування трансформатора струму, призначеного для живлення вторинних кіл пристроїв релейного захисту, в усталених та перехідних режимах енергосистеми та за різних умов його експлуатації. Отримані результати. Авторами було визначено у відсотковому співвідношенні максимальні струмові та кутові похибки трансформації первинного струму до вторинного кола трансформатора струму, які обумовлені наявністю струму намагнічування та активних втрат в магнітній системі досліджуваного трансформатору струму, виконано їх порівняння, а також зроблені висновки щодо їх зміни в усталених та перехідних режимах, зокрема, встановлено той факт, що струмові похибки в аварійних режимах змінюються в значно більшому ступені, ніж кутові та за певних умов можуть виходити за межі нормованих державними стандартами значень. Наукова новизна. Авторами було розроблено сучасний метод дослідження струмових та кутових похибок трансформаторів струму, призначених для живлення вторинних кіл пристроїв релейного захисту, заснований на використанні комп’ютерної моделі ідеального трансформатора струму з лінійною безгістерезисною характеристикою намагнічування, що має подібні характеристики та параметри первинного і вторинного кола з досліджуваним реальним трансформатором струму. Практична значимість. Отримані результати можуть бути використанні при визначенні оптимальних умов експлуатації трансформаторів струму та розробці нових принципів виконання вимірювальних та логічних органів пристроїв релейного захисту елементів електричних станцій та мереж, зокрема, було зроблено висновок про те, що для забезпечення більш чутливого та селективного захисту можуть бути використані пристрої, що за принципом своєї дії реагують лише на фазні співвідношення між струмами трансформаторів струму приєднань, які мають бути відлаштовані лише від кутових похибок вимірювань.

In this paper, a series of computer experiments on heating of clusters in the form of a truncated box is made by a molecular dynamics method ( NPT ensemble). Clusters of the stoichiometric compositions AB and A3B were investigated for Cu-Ag and Au-Ag bimetallic systems. We used a modified many-body tight-binding potential. It was found that the temperature range of the structural stability for bimetallic nanoparticles (nanoalloys) have combined influence of the following factors: nanoparticle size and initial geometric form, nanoparticle composition, type and degree of atomic ordering, external pressure.

The article analyzes the experience of application of polymeric (mesh) implants for hiatal closure in patients with gastroesophageal reflux disease (GERD). The authors showed the main principles of the choice of mesh implants and recommendations to their usage. Principal technical stages of surgery are described. It is noted, that the application of prostheses had the high efficiency and safety in antireflux surgery.

An algorithm of formation of a conflicting situation for the Full Flight Simulator is described. The algorithm calculates the trajectory of the intruder that potentially can lead to the collision with "evading aircraft" - FFS. In case of near miss, traffic collision avoidance system (TCAS) triggers, after which the crew trains collision avoidance techniques.