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This article presents a novel examination of a pivotal aspect of the creation of the Fundamental State Laws enacted on April 23, 1906, specifically addressing the question of the Emperor’s judicial powers. It is noted that previous iterations of the Fundamental State Laws (1832) did not delineate these powers, despite the acknowledgment of the judicial supremacy of monarchs in constitutional monarchies, particularly their right to grant pardons. The article analyzes different definitions of the Tsar’s judicial powers as outlined in three drafts of new Fundamental Laws prepared for Nicholas II in late 1905. Among these drafts, the proposal by P. A. Kharitonov emerged as the leading version. In both the draft from the State Chancellery and that of Professor O. O. Eikhelman, the judicial powers of the autocrat were framed similarly to those characteristic of constitutional monarchies at the beginning of the 20th century. In March 1906, the State Chancellery’s draft was reviewed by the Council of Ministers, chaired by Count S. Yu. Witte. With his support, conservative amendments were introduced to the draft — abolishing the nonremovability of judges established by the Judicial Statutes of 1864, preserving the Tsar’s direct involvement in administering justice, and affirming his right to dispense justice. It is demonstrated that during a Special Meeting in April 1906, liberal officials opposed these amendments, while Nicholas II sided with their critics. In the final version of the Fundamental Laws, the judicial powers of the Tsar largely conformed to European constitutionalism of the early 20th century.

Interventional oncology is a rapidly evolving field of cancer treatment. Minimally invasive techniques, such as transarterial embolization with chemotherapeutic and radioactive agents, are common treatments and are found in many guidelines for the treatment of primary and metastatic liver lesions. It is known that the growth and development of a malignant neoplasm is primarily determined by angiogenesis. Rapid growth is ensured where the formation is directly related to the arterial bed. Therefore, when the drug is injected into the target vessel and providing tissue ischemia, it is possible to achieve a high degree of tumor pathomorphosis. This technique has an advantage for patients who, in some cases, cannot be treated surgically, and also increases the effectiveness of the chemotherapeutic effect. With the advent of necessary equipment in hospitals and the accumulation of experience in the use of minimally invasive interventions, it became possible to implement a new method of treating tumors of various localizations. In this review, we consider the results of domestic and foreign authors on the topic of intra-arterial chemoembolization before surgical treatment in patients with rectal cancer. It is noted that the analysis of the literature revealed a small number of works devoted to the chosen topic, despite the relevance of this problem for modern oncology.

Objectives. Radio engineering information transmission systems are widely used in robotic systems employed in various military and civilian services. If such systems are used in a harsh environment, where a large amount of retransmitted interference occurs, for example, if a complex is buried under rubble or is located in reinforced concrete pipes or other utility facilities, communication with the command post may be lost. Thus, the task of maintaining reliable communications under difficult conditions of radio wave propagation is very urgent. In the field of telecommunications, multiposition types of modulation are widely used, which, despite their good spectral characteristics, provide low noise immunity under conditions of nonfluctuating interference, especially in cases of retransmitted interference. Therefore, it is relevant to explore the possibility of using multiple frequency-shift keying (M-FSK) signals in radio systems with complex interference environments. The paper sets out to analyze the noise immunity of coherent reception of M-FSK signals against the background of retransmitted interference.Methods. Statistical radio engineering and mathematical modeling methods are used according to the theory of optimal signal reception.Results. A model of the M-FSK signal and retransmitted interference is provided. The statistical parameters of the distributions of random processes occurring in a multichannel coherent receiver of M-FSK signals against retransmitted interference are obtained; based on this, the bit error rate is calculated when receiving M-FSK signals of different positionality M against retransmitted interference with different intensities.Conclusions. The impact of retransmitted interference is shown to result in a decrease in the noise immunity of M-FSK signal reception, which is greater the higher its intensity. With increasing positionality of M-FSK signals at low intensity of retransmitted interference, the noise immunity of reception is significantly improved; however, high-intensity interference significantly increases the bit error rate. The presence of interference with a relative intensity of 0.5 causes energy losses from 4 to 6 dB depending on the positionality. When M > 4, M-FSK signals gain significantly in terms of noise immunity over signals with multiple phase-shift keying, quadrature amplitude modulation, and amplitude and phase-shift keying.

This article addresses the artistic embodiment of the category of the Other in the works of American journalist and writer Tom Wolfe. The study focuses on Wolfe’s early journalistic essays, compiled in collections published in the early 1960s, as well as his later novel “I Am Charlotte Simmons” (2004). These texts are separated by nearly the entire second half of the 20th century — a period marked by the emergence, flourishing, and decline of postmodernism. The aim of this work is to trace the diachronic evolution of the author’s understanding of the category of the Other, as represented in his early and late texts. The desire for otherness among young people in the first post-war decades signified a fundamental rejection of norms, rules, and laws in the name of rejecting all forms of totalitarianism, which led to the catastrophic destruction of humanity during World War II. As a journalist, Wolfe objectively and empathetically depicts the diverse lifestyles of a new generation. He illustrates the consequences of these emerging trends in his university novel written forty years later. The article demonstrates that this work presents the otherness of various status groups within the university community through a multi-layered conflict. However, these groups remain isolated and hostile towards one another. The abandonment of rational consciousness has led to the primitivization of individuality and the disintegration of education. The novel serves as a vivid illustration of the negative outcomes of postmodernism.

The article examines the process of solving the problem of managing the foreign policy of the Russian Empire when creating the Fundamental State Laws on April 23, 1906. It emphasizes the importance of retaining control over international relations by the monarch and the Ministry of Foreign Affairs, effectively removing it from the influence of the State Duma. The perspectives of the authors of three drafts of the Fundamental Laws — P.A. Kharitonov, A.P. Salomon, and Count A.F. Heyden — are presented. While Kharitonov and Salomon permitted the involvement of the State Duma in the conclusion of international treaties, Heyden excluded such participation. In January-February 1906, Kharitonov’s draft was revised by senior officials of the State Chancellery under the leadership of Baron Yu.A. Ikskul von Hildenbandt and Count D.M. Solsky. It is shown that in the Chancellery’s draft, both the emperor and the State Duma remained involved in the conclusion of international treaties. This draft was discussed in March 1906 in Count S. Yu. Witte’s cabinet, and in the Council of Ministers’ version, despite an expert review by Professor F. F. Martens, popular representation was stripped of its right to participate in international treaty-making. The necessity for this was also justified by a draft of the Fundamental Laws prepared by Professor O.O. Eichelman. Attention is given to the Special Conference chaired by Nicholas II in April 1906, which consolidated the monarch’s monopoly over foreign policy within the Fundamental Laws. Nevertheless, the author argues that these same Fundamental Laws indirectly ensured the influence of the State Duma in this area, as without its review and approval, the budget of the Ministry of Foreign Affairs and all related legislative proposals could not be submitted for the emperor’s endorsement.

Searching for methods of treating primary rhegmatogenous retinal detachment (RRD) is a highly relevant issue, since this disease often leads to disability in people of young working age. The history of surgical treatment of retinal detachment began more than 200 years ago and has undergone many changes due to the evolution of knowledge of this disease. In the early 20th century, sealing of retinal breaks was first shown to be a key principle in the treatment of RRD. The two most commonly used surgical techniques today are pars plana vitrectomy and scleral buckling. Over the years, various materials have been studied as possible buckling means. At present, soft silicone fine-pored tape is the gold standard for scleral sealing. Modern laser technologies open up new vistas for extrascleral surgery in the treatment of primary RRD. The advantages of specific individual approaches or combinations thereof are under active discussion.

Glaucoma is one of the main causes of irreversible vision loss worldwide, its prevalence is increasing with age, reaching 10 % in individuals over 90 years old. Combined surgical treatment of cataract and glaucoma has proven to be safe and effective, reducing overall treatment costs. Minimally invasive glaucoma surgery (MIGS) combined with cataract surgery has become a popular alternative to traditional methods. One such intervention is endoscopic laser cyclodestruction (ELCD), aimed at reducing the production of aqueous humor.Objective: To evaluate the conditions for achieving maximum efficacy and safety of endoscopic laser cyclodestruction (ELCD) in the combined surgical treatment of glaucoma and cataract.Methods. A clinical study was conducted involving 110 patients (56 males and 54 females) with a mean age of 73.7 years, who underwent combined surgery (phacoemulsification + ELCD). Inclusion criteria were stages I-IV glaucoma and initial complicated cataract, while exclusion criteria included lens subluxation and presence of uveal processes or their consequences. ELCD was performed using the Endo Optiks Inc (USA) video-endoscopic ophthalmic laser device. Patients were evaluated preoperatively and followed up at 1, 3, 6, 9, 12, 18, 24, 36, 48, and 60 months postoperatively. The primary safety outcomes included the frequency of intraand postoperative complications, and efficacy outcomes were based on intraocular pressure (IOP) reduction.Results. No hemorrhagic complications were noted. An inflammatory reaction was observed in 18.2% cases, which was managed with subconjunctival injections of prourokinase. The frequency of postoperative IOP elevation correlated negatively with preoperative IOP levels. ELCD demonstrated a statistically significant reduction in IOP and medication burden, with a complete success rate of 52.7 % and a partial success rate of 90.3 %. The extent of cyclodestruction (180–360°) did not significantly affect IOP reduction outcomes.Conclusion. ELCD, performed as part of combined surgery for glaucoma and cataract, proved to be effective and safe, achieving significant IOP reduction and decreasing the need for antiglaucoma medications. Recommendations include avoiding vaporization effects during surgery and preferring patients with preoperative IOP above 27 mm Hg for optimal outcomes.

The article considers the strength issues of foundry cores manufactured by the Cold‑box‑amine process. It is shown that the properties of the core mix can be controlled by adjusting the formulation. Examples of the influence of binders’ consumption on the properties of the mixes are given: a decrease in resin and polyisocyanate leads to a decrease in strength and a decrease in life. In addition, the minimum consumption of binders varies from manufacturer to manufacturer. Recipes of mixes with special additives are given, which allow, by reducing the strength of the mix, to ensure the completeness of the polymerization reaction.

The intestinal barrier is one of the most important components that maintain gastrointestinal homeostasis, therefore changes in bacterial composition can lead to increased intestinal permeability and the development of intestinal translocation of opportunistic microorganisms, with the subsequent development or complication of various infectious diseases. A comparative description of the microbiota of the intestinal tract of calves with compensated, subcompensated and decompensated acute catarrhal bronchopneumonia of calves was carried out in the conditions of livestock farms of Vladimir and Moscow Oblasts. Calves aged 1–3 months with acute catarrhal bronchopneumonia (n = 37) were used for the study. The severity of the disease was assessed based on clinical and laboratory tests. The samples taken from clinically healthy animals (n = 8) were used as controls. It has been shown that in calves with compensated acute catarrhal bronchopneumonia, the qualitative and quantitative composition of the intestinal microbiome does not differ from clinically healthy animals. During the clinical manifestation of subcompensated and decompensated acute catarrhal bronchopneumonia in calves, a significant quantitative and qualitative shift in the microbiome occurs in the intestines, which indicates the occurrence of dysbiosis. We believe that this area is quite relevant and requires further scrupulous research.

Background. Acquired aplastic anemia (AA) is a non-tumor disease of the blood system and the pathogenesis is based on immune dysregulation directed against own hematopoietic stem cells, which leads to the development of bone marrow aplasia. Some modern research is directed to the study of intrinsic defects of hematopoietic stem cells, and one of which is the change in telomere length. Several large studies have shown the association of telomere shortening in AA patients with decreased overall survival, poor response to immunosuppressive therapy (IST), high rates of relapse and clonal complications.Aim. To study the influence of the initial telomeric DNA regions length in AA patients on the disease course.Materials and methods. 43 adult patients with acquired AA without previous pathogenetic therapy were included in the study. IST was performed according to a standard protocol including the use of hATG and cyclosporine. Flow-FISH was used as the method for measuring relative telomere length, and peripheral blood mononuclear cells were used as the study material.Results. Telomere length determined before IST did not differ between non-severe and severe AA, but there were significant differences depending on disease duration (p = 0.032). Initially short telomeres correlated with a lower rate of achieving hematologic improvement (53 % vs. 80 %; p = 0.059). In addition, significantly worse results were obtained in achieving partial and complete remission in patients with initially short telomeres compared to those with initially long telomeres (37 % vs. 62 % and 5 % vs. 23 %, respectively; p

Background. Aplastic anemia (AA) is a non-tumor and rare disease of the blood system, characterized by deep pancytopenia due to the development of bone marrow aplasia with immune-mediated damage of hematopoietic stem cells. Research results indicate the presence of antigenic effects leading to pathological activation and dysregulation of the T cells in the bone marrow with increased production of pro-inflammatory cytokines that damage hematopoietic stem cells. The triggering factor that initiates the cascade of immune reactions is currently unknown. The high efficiency of immunosuppressive therapy (IST), which allows achieving remission in the majority of AA patients, is evidence of the immune genesis of the disease. The pathogenesis of AA is currently being actively studied. The participation of T cell subpopulations in immune response is beyond doubt, but the issues of their significance in the AA pathogenesis have not been fully studied. A more detailed understanding of the AA development mechanisms is necessary for the development of long-term effective treatment.Aim. To investigate the T cells subpopulation in bone marrow of AA patients during IST.Materials and methods. The study included 41 patients over 18 years of age with newly diagnosed acquired AA without previous IST. Treatment was carried out according to a protocol including horse antithymocyte globulin and cyclosporine. Flow cytometry was used to detect T cell subpopulations. Bone marrow examination was performed at three time points: initially, 3 and 6 months after initiation of combined IST.Results. Multidirectional changes in the T cell subpopulations ratio before the start of IST were found in all AA patients included in the prospective study: most patients had a higher proportion of effector CD4+ and CD8+ T cells (61 and 83 % of patients, respectively), memory CD4+ T cells (63 % of patients), and a lower proportion of naive CD4+ and CD8+ T cells (81 and 51 % of patients, respectively) compared to donors (p

Background. Mycosis fungoides (MF) is classified as an orphan disease. Due to the rarity of pathology, and until recently the absence of an expert group and a specialized reference center for cutaneous lymphomas in Russia, possible treatment options for MF are presented by listing them without recommendations on the preferred indications for one or another option. This creates difficulties in choosing treatment methods and assessing their effectiveness.Aim. To characterize current treatment methods and their results in MF patients who were observed or received consultative and diagnostic care at the National Medical Research Center for Hematology.Materials and methods. The study included 210 patients: 115 with early disease stages and 95 with advanced stages.Results and conclusion. The most common treatment options were for early stages – local therapy, interferon therapy and systemic chemotherapy (CT), for advanced stages – combination therapy with interferon (+ PUVA therapy, methotrexate), interferon monotherapy and systemic CT. The frequency of systemic chemotherapy use in all lines of MF treatment was 21 %. When integrating statistical analysis using the probability of achieving an antitumor response, switching to 2nd line therapy, and accumulated incidence, the negative results of using chemotherapy in the MF treatment were clearly demonstrated.For the first time in Russia, a real practical situation of the applied MF treatment options is presented on our own large sample of patients. As the first line of therapy, the most common options were immunotherapy and phototherapy, however, in 12.4 % of cases, the use of systemic CT was registered, which is unjustified and leads to a decrease in the time to the next line of treatment and an increase in the cumulative incidence of adverse events. As a result of the use of non-chemotherapeutic approaches (interferon, etc.), the 3-year relapse-free survival rate is about 40 %, after chemotherapy – 9.4 %. Secondand third-line therapy provided more varied options, including combination treatment with interferon and methotrexate, as well as gemcitabine monotherapy, targeted therapy with brentuximab vedotin, and epigenetic therapy in the 3rd line. Studies with targeted agents in this patient population have demonstrated improved clinical outcomes, highlighting the need for their early use to achieve the best results.

Infectious diseases caused by ubiquitous bacteria with variability of virulence factors and multiple antibiotic resistance reliably often represent the structure of the general pathology of poultry. The aim of the study was to analyze dynamics of morph functional parameters of immune system of chickens in experimental pseudomonas infection. The initiation, development, and outcome of the experimental infectious process were considered using bacteriological and immunological methods with vital dye. Dissemination ofP. aeruginosabacteria revealed significant increase in extravasation of lung blood vessels, signs of hemodynamic disorders, and development of dystrophic and compensatory-adaptive processes. Pathogenic mechanisms are mediated by the dynamics of changes in reticuloendothelial and lymph epithelial systems: accidental transformation of thymus, atrophy of bursa of Fabricius, hyperplasia of esophageal and cecum lymphoid follicles, Meckels diverticulum, and spleen.

The article analyzes the impact of measures to improve labor productivity within the framework of the national project “Labor Productivity” at enterprises – small businesses of the Rostov region with revenues from 100 to 400 million rubles for the period from 2019 to 2022 inclusive on the aggregate financial performance of companies involved in the project implementation. Based on the analysis of accounting data for the studied set of enterprises, we can conclude about correlation between the measures to improve labor productivity and financial performance within each specific enterprise, as well as in terms of the positive impact on total deductions to the budgets of various levels. It has been shown that total dynamics of payments to the budget for the analyzed period for the studied aggregate increased by 2.2 times, property status of the production complex – by 3.6 times, and profitability indicators – by more than 3 times. Positive influence of the national project “Labor Productivity” on the economy of Rostov region has been proved. The study results can be used as a basis for adjusting further trajectory of the project implementation in the region, which determines the relevance of the study.

The article compares the properties of kaolin and bentonite clays. It has been shown that kaolin clays have high fire resistance, and bentonites have high astringent properties. The experience of specialists from OJSC “MTW” in the joint use of various types of clays is considered. The combination of kaolin and bentonite in the suspension made it possible to increase the strength of the molding sand while maintaining moisture levels. The disadvantage of kaolin clay suspensions is that the moisture content increases with increasing dosage. When preparing bentonite suspensions, their short shelf life should be taken into account.

Conditionally pathogenic conjunctival microflora is the most frequent cause of endophthalmitis after cataract phacoemulsification (“PEC”).The purpose. To evaluate the sterility of the surgical field and anterior chamber fluid (ACF) during elective (PEC).Materials and methods. 75 eyes were examined. Patients in the group I underwent standard treatment of the surgical field, in the group IA — the standard technique was supplemented with mechanical delimitation of the upper eyelid margin, in group II additional treatment of the surgical field with povidone iodine after blepharostat installation was performed. Microbiological material was collected preoperatively from three loci (conjunctival cavity, eyelid free margin, lacrimal ducts) and at different stages of surgery from the conjunctival cavity (after standard treatment, after blepharostat placement, after additional treatment). In addition, anterior chamber fluid (ACF) was examined — also during surgery. Microorganisms were identified by the MALDI­-TOF method, sensitivity was determined by the disc­diffusion method.Results. S. epidermidis prevails among all microorganisms. The percentage of the surgical field contamination by S.epidermidis after blepharostat setting was 33,33 %, 26 % and 40 % in the I, IA, II groups respectively; after additional treatment 6,6 % in the II group; in the ACF it was found in 23,33 %, 13 % and 0 % in the I, IA, II groups respectively.Conclusion. The additional treatment of the surgical field is the most effective technique to reduce the contamination of the conjunctival cavity by S.epidermidis after placing a blepharostat and the only one in the study to ensure its absence in the ACF. Standard treatments with and without mechanical delineation are less effective and do not prevent the contamination of the ACF.

The objective of the study: to analyze characteristics of a standardized model of type B gunshot open global injury (open injury without intraocular foreign body).Methods: The experiment was carried out on 36 rabbits (71 eyes). Simulation of type B gunshot open global injury (GOEI) was accomplished using pump equipment. The complex of modern standard and high­technology diagnostic methods to study characteristics of type B GOEI in the control period was performed. Biomicroscopy, ophthalmoscopy, optical coherence tomography, electroretinography, ultrasound examination, MRI, enzyme multiplied immunoassay to determine vitreous fibronectin, and pathomorphological study of the eye globe were carried out. Non­parametric statistical methods of data analysis were used.Results: The above diagnostic methods being used, the GOEI experimental model characteristics were determined, including proliferative vitreoretinopathy (PVR) i.e.incidence rate and dynamics.Conclusion. High reproducibility (77–100 %) of microlevel signs of type B GOEI experimental model was demonstrated, that evidenced standardization of the developed model. The viability of the use of hyphema and hemophthalmia as the PVR and GOEI predictors was justified on the basis of correlation analysis in experiment. The analysis of proliferative signs being made when using different study methods (pathomorphological, indirect ophthalmoscopy, optical coherence tomography, ultrasound examination and MRI) proved their application as PVR markers possible. The interchangeability of the study methods used for PVR diagnosis was also justified.

Introduction. “One-day surgery” expands the possibilities of providing surgical care in a polyclinic with hospitalization for just one day. This area of medicine allows you to use the most effective method of treating hemorrhoids in a polyclinic – the operation hemorrhoidectomy.Aim. To substantiate the effectiveness of performing hemorrhoidectomy surgery in patients with stage 3–4 hemorrhoids in a day hospital of a polyclinic under the program “One-day surgery” with accelerated recovery of patients.Materials and methods. The main principle for performing hemorrhoidectomy surgery in a day hospital is a careful selection of patients. Closed hemorrhoidectomy with restoration of the anal canal mucosa (by Parks – Milligan – Morgan’s in the second modification of the State Research Center of Coloproctology) under spinal or general anesthesia is the surgery of choice for hemorrhoids treatment in the day patient department of a clinic. 138 surgeries were performed in the day patient department during 2 years and 10 months. After surgery, patients were placed in the surgical day-patient department wards for 3–5 hours until full activation. Then they were allowed to go home without being accompanied by a medical worker. The satisfaction of patients with the program was analyzed by a survey with a 5-point scale.Results. The timing of scheduled operations for patients has been shortened. The number of complications after hemorrhoidectomy in the early postoperative period was decreased, without long-term postoperative complications. The treatment of such patients in the surgical day-patient department demonstrated a good economic effect. The overall satisfaction with the one-day surgery program was very high (4.82). The results confirmed the effectiveness of this area of medicine.Discussion. Our experience of performing hemorrhoidectomy operations in a day surgical hospital for 3 years confirms the existence of a number of advantages over treating patients in a 24-hour hospital.Conclusions. The “One-day Surgery” and accelerated patient recovery programs expand the possibilities for treating patients with stage 4 hemorrhoids directly in the polyclinic, and thus reduce the burden on the surgical hospital.

We report a case of successful surgical treatment of a patient with locally advanced cutaneous squamous cell cancer (cSCC) originating from a burn scar. The burn scar cSCC tends to be more aggressive in nature than conventional skin SCC. treatment of patients with cSCC arising from a burn scar is complicated by the fact that the extensive defects formed after tumor removal are almost impossible to close with local tissues. Purpose: to demonstrate the feasibility of performing surgery for locally advanced cSCC using a thoracodorsal flap. Clinical case description. A 70-year old man presented with cSCC of the right shoulder. The patient had experienced a severe burn covering 70 % of his body surface area at a young age. To repair a large skin defect after tumor resection in the right shoulder, a thoracodorsal artery perforator flap was used. there were no complications in the postoperative period. At a follow-up of 7 months, no evidence of tumor recurrence was observed. Conclusion. The thoracodorsal artery perforator flap has contributed to the efficient reconstruction of extensive soft tissue defects in patients with locally advanced cSCC originating from a burn scar.

Background. Breast cancer is the leading oncopathology of women. The routine radical surgery performed in this pathology includes lymph node dissection, which provokes development of postmastectomy syndrome. However, the removal of non-metastatic lymph nodes is not rational according to the subsequent disability of the patients. This can be avoided by using a sentinel lymph node (SLN) biopsy procedure. At this stage of oncology development, there are several ways to visualize SLN. The fluorescent method is among the most promising. This technique has been used for many years. However, it is not sufficiently implemented in clinical practice. There are still several questions about the procedure for its performance. In addition, it requires the introduction and improvement of domestic developments, including reducing financial costs.Aim. To study the use of indocyanine green of domestic production (LLC Firm “FERMENT”, Russia) and the IC-GOR detection system (LLC “MedKomplekt”, Russia) for SLN biopsy in patients with early breast cancer.Materials and methods. From February to September 2023, biopsy of SLN using indocyanine green (LLC Firm “FERMENT”, Russia) was performed in 53 patients with early breast cancer without clinically detectable lesion of regional lymph nodes. In all cases, according to the clinical examination, the patients had an operable stage of breast cancer (cT1–3N0M0). 5 mg of indocyanine green, dissolved in 4 ml of water for injection, was administered after sanitizing of the surgical field intradermally and subcutaneously at 2 points in the upper-outer quadrant of the breast along the edge of the areola in 40 patients (75.5 %) or paratumorally in 13 patients (24.5 %). An incision in the axilla about 4 cm long was made no earlier than 10–15 minutes after injection of indocyanine green (when visualizing the track 1 cm beyond its distal end to avoid crossing the lymph duct, after which the drug can flow into the wound). After imaging, all detected lymph nodes were removed for planned morphological examination. Standard lymph node dissection of 1 and 2 level was performed in all patients. Middle age of patients was 64.5 years (from 37 to 85 year). In 40 patients (75.5 %) modified radical mastectomy was performed, breast conserving surgery was done in 13 cases (24.5 %).Results. SLN were visualized in 51 patients out of 53 (96.2 %). After the final morphological examination, the majority of patients in the group were ranged in the IA and IIA stages of the disease – 15 (28.3 %) and 28 (52.8 %), respectively. Metastasis in the SLN were found in 9 patients (17.0 %). Besides, in 3 cases (5.7 %) metastasis in the lymph nodes were found after lymph node dissection. In 4 cases (7.6 %) metastasis were found during lymph node dissection but were not detected in the removed SLN. Thus, in the study group 13 (24.5 %) patients had metastatic lymph node lesion despite negative clinical status. The total number of removed SLN in the study group was 169 (from 1 to 6), the average number of removed lymph nodes was 3.3. Any negative events, allergic and general reactions to indocyanine were not reported.Conclusion. Our technique of contrasting SLN with indocyanine green is adequate and reproducible. The frequency of detection of SLN with this method is 96.2 %, with an acceptable level of false negative results is 7.6 %. Indocyanine green (LLC Firm “FERMENT”, Russia) and the LED fluoroscopic cancer detector IC-GOR (LLC “MedKomplekt”, Russia) can be recommended for performing a SLN biopsy.

Actuality. One of the significant ophthalmic diseases is a dry form age-related macular degeneration (dAMD). The issues of etiology and pathogenesis are not completely cleared nowadays and they signify the subject of discussion. There are risk factors of dAMD (age, heredity, lifestyle etc.) which can cause metabolic disorders, changes hemorheological parameters which promote activation of druseogenesis and as a result an angiogenesis. Mostly an outcome of dAMD is geographical atrophy and decrease of central visual acuity. At the same time, it is known that similar metabolic and rheological disorders detected in other diseases are effectively corrected by extracorporeal rheoaferesis, in particular, using double filtration plasmapheresis. Thus, using of extracorporeal rheoaferesis with dAMD patients is pathogenetically well-reasoned, but in the available literature, a correct analysis of the effectiveness and safety of double filtration plasmapheresis in patients with intermediate stage of dAMD is presented poorly.Objective. To study along with data of OCT, OCT angiography, visometry, microperimetry and electroretinography structural and functional changes in the macular zone in patients with a dry form of age-related macular degeneration after the using of double filtration plasmapheresis.Patients and methods. The study included 63 patients (94 eyes) with an intermediate stage of dAMD. The patients were separated into two groups randomly. The first (main) group included 34 patients (52 eyes) who were performed double filtration plasmapheresis (DFPP) on an OctoNova device using a Plasmaflo plasma filter and a Cascadeflo EC40 fractionator in the amount of 4 procedures with a frequency of 1 time per week for 1 month. The second group (control) included 29 patients (42 eyes) who did not receive any specific treatment. In the main group of patients, OCT, OCT angiography, microperimetry and electroretinography were additionally performed in addition to standard ophthalmological examination before the DFPP course, after the DFPP course (1 month after the start of follow-up), 6 and 12 months later. Patients in the control group also underwent a similar examination at the specified time — 1, 6, 12 months after the start of follow-up.Results. In this study we found according to optical coherence tomography, optical coherence tomography-angiography, visometry, microperimetry and electroretinography, positive dynamics of structural and functional parameters of the macular retina is observed in patients with a dry form of age-related macular degeneration with using double filtration plasmapheresis. At the same time, a statistically significant difference between the two groups begins at 1 month and persists for 12 months of follow-up, which points to stabilization of the pathological process during the specified period.Conclusions. This study showed that after applying the double filtration plasmapheresis in patients with dry form of age-related macular degeneration, there is an improvement in structural and functional parameters of the macular zone, consisting in a decrease volume DOPES and stabilization of retinal light sensitivity.

Purpose: to evaluate the features and outcomes of penetrating keratoplasty in combined opto-reconstructive surgery for combat eye injury and its complications.Patients and methods. The study enrolled 17 eyes (16 men) aged 34.00 ± 12.51 years, divided into 2 groups: I — with inflammatory diseases of the anterior segment, complicated combat eye injury (4 eyes), II — with open eye injury (OGI, 13 eyes). Patients underwent examination to reveal and localize damaged intraocular structures and intraocular foreign bodies (IOFB), determine the prognosis of visual functions, as well as impression cytology. In all cases penetrating keratoplasty was performed, as well as complex of vitreoretinal surgery if it was needed. In the postoperative period, visual acuity, the timing of epithelialization, and graft transparency were assessed. Period of observation was 4,5 ± 2,1 months.Results. Group I had severe keratouveitis, when intraocular structures were intact also as electrophysiological parameters. The presence of mucosal cells was determined in 50 % of cases. The number of surgery was 2.00 ± 0.82. Graft epithelialization was completed in 38.99 ± 35.43 days. Postoperatively all grafts had transparent retention and complete epithelialization, also as had high visual acuity (0.25 ± 0.10) was noted. Group II had damaged several intraocular structures and varying electrophysiological parameters. The epithelial phenotype was corneal all over. The average number of surgical treatments was 3.00 ± 1.48. The time of graft epithelialization was significantly less — 17.66 ± 8.69 days (p = 0.014). Corrected visual acuity ranged from zero (30.77 %) to 0.3 (0.08 ± 0.11) and was significantly less than in group I (p = 0.018). The parameters that correlated low visual acuity were aphakia, the level of electrical sensitivity, the number of surgical interventions, and the age of patients.Conclusions. Penetrating keratoplasty functional results prognosis is better in group with infectious complications of combat eye injury with reduced cornea transparency than in patient with open globe injury. Besides light perception and conducting structures (retina, optical nerve) lesion, optico-reconstructive surgery in open globe injury often leads to single-chamber formation in silicone filled eye, which significantly worsens the functional prognosis of treatment.

Background. Vascular endothelial growth factor A (VEGFA) is one of the most important factors for regulation of hematopoietic stem cells differentiation. It is involved in leukemogenesis and central nervous system (CNS) damage in acute leukemia. According to the literature, the VEGFA production by blast cells is increased, but the values of serum concentration and the associations with CNS involvement are contradictory.Aim. evaluate the VEGFA, VEGFR1, VEGFR2 concentration in serum and cerebrospinal fluid of patient with different types of acute leukemia in disease onset and during treatment.Materials and methods. The concentration of VEGFA in serum and cerebrospinal fluid was studied in 74 primary patients with acute leukemia. The comparison group consisted of 67 healthy donors. VEGFR1, VEGFR2 were studied in serum and cerebrospinal fluid in 34 patients at the onset of the disease. The comparison group consisted of 10 healthy donors. For the analysis, an enzyme immunoassay was used on a semi-automatic Personal Lab analyzer (Adaltis) and Affymetrix eBioscience human VEGF-A Platinum ELISA reagents.Results. Serum VEGFA concentration was statistically significantly lower in acute leukemia patients than that of donors (median 149.78 and 432.19 pg/ml respectively; p

Background. Differentiation syndrome (DS) is a potentially fatal complication of therapy for acute promyelocytic leukemia (APL) with an incidence of up to 48 %. To date, no reliable DS risk factors have been found, with the exception of leukocytosis at the APL onset.Aim. To determine the risk factors associated with DS in patients with APL during induction therapy with arsenic trioxide (ATO) and tretinoin (ATRA).Materials and methods. The study included 39 patients with APL, 29 (74.4 %) of them were classified as low-risk according to ELN (European Leukemia Net), 10 (25.6 %) were classified as high-risk. At the disease onset, cytological and molecular (chimeric transcript PML::RARα, FLT3-ITD mutation) bone marrow studies were performed, the expression of 28 differentiation antigens by blood and bone marrow blast cells was determined (markers of early precursors, myeloid and lymphoid differentiation, cell adhesion molecules, chemokine receptors, integrins, selectin), body mass index (BMI) and the leukocytes number dynamics during induction course were assessed. All patients received ATRA and ATO therapy. Patients from the high-risk group at the onset received 1–3 injections of idarubicin (12 mg/m2) and dexamethasone (8–10 mg/m2 2 times a day) to prevent DS until leukocytosis reduced. In cases of DS, dexamethasone was prescribed at a dose of 10 mg/m2 2 times a day; in cases of severe DS, the induction course was interrupted.Results. Of the 39 patients, 12 (30.8 %) were diagnosed with DS: 20 % of high-risk patients (2/10) and 34.5 % of low-risk patients (10/29). There was no statistically significant association of leukocytosis more than 10 × 109 /L at onset, microgranular morphology of blast cells, bcr3-variant PML::RARα, FLT3-ITD mutation with DS. In multivariate analysis, the probability of DS was associated with BMI ≥30 kg/m2 and mean fluorescence intensity of CD38 antigen by blast cells, regardless of risk group. based on the results of the ROC-analysis, the threshold value of mean CD38 fluorescence intensity was set at 25,000 cu, if exceeded, DS is highly likely to develop.Conclusion. the high incidence of DS among low-risk patients is probably due to the lack of prophylactic glucocorticosteroids administration for the development of leukocytosis during ATRA and ATO therapy. BMI ≥30 kg/m2 and mean CD38 fluorescence intensity more than 25,000 cu were identified as statistically significant DS risk factors.

The aim – to study risk factors for severe COVID-19 in patients with rheumatic diseases (RD).Patients and methods. The study included medical histories of 464 patients with RD who were admitted at the V.A. Nasonova Research Institute of Rheumatology from September 27, 2021 to April 26, 2023Results. Age over 60 years, hypertension, obesity, lung disease, chronic kidney disease, coronary heart disease, diabetes mellitus, acute cerebrovascular accident or a history of pulmonary tuberculosis increase the risk of hospitalization in patients with RD with COVID-19 by 3–5 times. In addition, with an increase in the number of concomitant diseases, an increase in the risk of hospitalization was noted by 2–6 times. Taking glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, leads to an increase risk of hospitalization by 1.5–4.5 times, while patients taking hydroxychloroquine or tumor necrosis factor α inhibitors was more often required outpatient treatment.Conclusions. It has been established that older age, the presence of comorbid pathology and the use of glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, are risk factors for severe COVID-19.

Comparative effectiveness of veterinary antimastitis drugs in the treatment of subclinical and clinical mastitis of dairy cows was studied. During the experiment, two treatment regimens were used. Cows from the 1st and 3rd experimental groups were treated according to the traditional scheme for this farm - intracisternal administration of Mastiet Forte; for the treatment of cows from the 2nd and 4th experimental groups, Mamikur was administered intracisternally. The effectiveness of therapy was assessed by clinical signs, by the number of somatic cells in milk, response to Kenotest and hematological parameters. It was established that the use of Mamikur as a monotherapy for serous-catarrhal clinical and subclinical mastitis in cows is well tolerated and gives a positive effect when administered intracisternally in the volume of one dosing syringe three times with an interval of 12 hours.

Objectives. At the present time, amplitude-phase shift keyed (APSK) signals are actively used in satellite communication systems. In particular, they are applied in systems which operate in a limited radio frequency spectrum with increased data transmission quality requirements. Such systems use multi-channel type receivers with maximum likelihood decision on the received symbol (correlation receiver) or quadrature type receivers. The noise immunity of these receivers is directly dependent on the quality of the formation of reference oscillations. These oscillations are reference signals for correlation receivers and in-phase and quadrature components for quadrature receivers. The aim of the work is to analyze the influence of the amplitude and phase parameter spread of the in-phase and quadrature channels on the noise immunity of receiving APSK signals with a circular shape of the signal constellation.Methods. Methods of statistical radio engineering, theory of optimal signal reception, and computer simulation are used.Results. The study established the characteristics of noise immunity of the APSK signal reception depending on the spread of parameters of the quadrature converter. The theoretical calculations were confirmed by the results of modeling the transmission of APSK signals in a Gaussian communication channel. A comparison with systems using quadrature amplitude modulation (QAM) was carried out, in order to assess system stability in the presence of spread parameters among other similar systems.Conclusions. The studies enabled us to conclude that an imbalance of the quadrature reference oscillations can lead to a significant decrease in the noise immunity of radio systems using APSK signals. The minimum energy loss due to imbalance of quadrature reference oscillations is achieved when the imbalance value is less than 10% in amplitude and 2°–3° in phase. The amplitude imbalance of quadrature reference oscillations when receiving QAM signals is more pronounced than in the case of APSK signals. The phase imbalance affects approximately the same.

Background. Sentinel lymph node (SLN) biopsy is a reliable diagnostic method used to assess the spread of the malignant process in regional lymph nodes. Currently, this method is of great importance in treatment planning for early breast cancer and allows to avoid immediate and long-term complications of lymph node dissection. SLN detection can be performed using the radionuclide method, the disadvantages of which are associated with the peculiarities of working with radiopharmaceuticals and additional costs when using them. An alternative method is fluorescence lymphography (FL) with indocyanine green.Objective: performing a pharmacoeconomical study (cost-effectiveness analysis) comparing the cost-effectiveness of methods for detecting SLN in breast cancer: radionuclide diagnosis (RD) using a radiopharmaceutical based on sodium pertechnetate [99mТс] and FL using indocyanine green (Life Sciences OCPK LLC, Russia) and "IC GOR System" device (Central Design Bureau of Information and Control Systems JSC, Russia).Material and methods. The values of the cost-effectiveness ratio (CER) were calculated and compared for the two indicated methods of detecting SLN in breast cancer. Information on the RD method clinical efficacy was taken from the published data. SLN detection by the FL method with the use of indocyanine green and domestic apparatus was performed on the basis of the Regional Clinical Oncology Dispensary (Ryazan) in 53 patients with breast cancer. To assess the reliability of the obtained results a deterministic multivariate sensitivity analysis was performed.Results. The obtained CERFL values were significantly lower than the median CERRD values by average of 43.29% (p

This article describes two clinical observations of the use of mepolizumab in patients with severe uncontrolled asthma with a mixed granulocytic pattern of inflammation in the bronchi and comorbid pathology. The mixed granulocytic form of severe asthma is characterized by a combination of T2 endotype and non-T2 endotype. The most common mixed granulocytic pattern of severe asthma occurs in comorbid pathology, in particular, when it is combined with chronic obstructive pulmonary disease (COPD) or bronchiectasis.In the presented observations, both patients had an experience of smoking, a late manifestation of bronchial asthma with the development of centrilobular emphysema and an irreversible decrease in the FEV/FVC ratio as part of the development of COPD. A feature of one of the cases was the presence of cylindrical bronchiectasis in both lungs. The choice of mepolizumab as an additional maintenance agent at GINA stage 5 in both cases was justified by the uncontrolled course of asthma despite the use of a high dose of glucocorticosteroids in combination with other basic drugs and the need for the use of systemic corticosteroids > 50 % of the time per year, a history of recurrent exacerbations in previous 12 months, the presence of persistent blood eosinophilia (>150 cells/μl), as well as a combination of asthma with polypous rhinosinusitis in one of the patients.Overall, the use of mepolizumab 100 mg subcutaneously every four weeks in addition to regular maximum optimized maintenance therapy was characterized by rapid, signifi cant and sustained effi cacy, which was expressed in early achievement of asthma control within the fi rst 16 weeks of therapy.

Background. Community-acquired pneumonia (CAP) remains one of the most common diseases requiring urgent hospitalization, with a significant part of patients already receiving antibiotics before admission to the hospital. Aim. To assess the relationship between outpatient antibacterial therapy and in-hospital mortality and the severity of the CAP. Materials and methods. The retrospective study included the data of adult patients with CAP who were hospitalized in Tomsk from January 1 to December 31, 2017. Results. Among 1412 patients, 22.2% received antibiotics before admission to the hospital, the proportion of deaths in this group was significantly lower – 3.8% compared with 10.6% among patients without antibiotic therapy (p0.001). Subjects who received antibiotics on outpatient basis were less likely to require being in the intensive care unit and administering vasopressors, in contrast to patients without prior antibiotic therapy: 5.1 and 10.6% (p=0.003); 7.1 and 4.7% (p=0.018) respectively. In patients with severe CAP on a scale IDSA/ATS, only 11.8% of cases were detected with antibiotics before hospitalization, while in mild CAP the frequency of administration was 16.6% (p0.001). Conclusion. Ambulatory antibacterial therapy had a positive effect on the subsequent course and outcomes of CAP in a hospital setting. Patients had a predominantly mild course of the disease, needing for vasopressors, and being in the intensive care unit, but was not consistent with the need for invasive mechanical ventilation.

Background: Among the bacteria that affect the central nervous system, Listeria monocytogenes (facultative intracellular bacterium) is one of the most lethal to humans and animals. Listeriosis affects domestic and farm animals (pigs, small and large cattle, horses, rabbits, less often cats and dogs), as well as domestic and ornamental birds (geese, chickens, ducks, turkeys, pigeons, parrots and canaries). L. monocytogenes can be detected in fish and seafood (shrimp). The source of L. monocytogenes infection are animals in which the disease may manifest itself or occur in erased and asymptomatic forms followed by the transition to a long-term carriage. This pathogen is found throughout the world in foodstuffs, and most cases of infection occur through the ingestion of contaminated food. Particularly susceptible to the disease are embryos, newborns, the elderly and individuals with immunodeficiencies and chronic diseases. L. monocytogenes can cause intracranial hemorrhage, meningitis, meningoencephalitis, and rhombencephalitis. Clinical case description: This paper presents our own clinical observation of the development of severe listeriosis meningoencephalitis in a 47 year-old patient against the background of the new coronavirus infection (COVID-19). We describe the details of the clinical presentation, the treatment and the favorable outcome in our patient. Conclusion: Invasive listeriosis is a rare disease. The knowledge about the clinical manifestations of this disease is needed not only for epidemiologists and infectious disease specialists, but also for physicians of other specialties. Untimely diagnosis and inadequate antibacterial therapy are dangerous leading to severe somatic and neurological complications with a lethal outcome or disability both in children and adult persons.

Анафилактический шок — это серьезная опасная для жизни неотложная ситуация, которая требует быстрого распознавания, быстрого реагирования и терапии, спасающей жизнь. Поэтому анафилаксия может развиваться как в лечебном учреждении, так и вне его (амбулаторно), и к лечению этого состояния должны быть готовы врачи любых специальностей. В связи с этим в России разработаны клинические рекомендации по анафилаксии. Предыдущая редакция рекомендаций одобрена Российской ассоциацией аллергологов и клинических иммунологов и Федерацией анестезиологов и реаниматологов и утверждена на заседании Научно-практического совета Минздрава РФ (протокол № 2020 № 743/12). Во второй редакции сделаны важные уточнения в этиологии, эпидемиологии, классификации, клинике, диагностике, лечении и профилактике анафилаксии, а также конкретизированы некоторые определения для оперативного реагирования, в том числе и у пациентов с сопутствующими заболеваниями. Клинические рекомендации по анафилаксии предназначены для практикующих врачей всех специальностей, студентов и преподавателей медицинских вузов, ординаторов, аспирантов.

The article analyzes the characteristics of bentonites used in the foundry industry of the Republic of Belarus. It is concluded that GOST 28177‑89 allows one to effectively assess the quality of bentonites depending on production conditions. It has been shown, that the wet tensile strength is the most important characteristic of bentonites.

Objectives. Radio-technical information transmission systems are widely used in various sectors of our life, not only for telecommunications and associated domestic needs, but also for the functioning of various special services, such as emergency response units, which increasingly use robotic complexes in the course of their work. In the event of an emergency, robot devices can be used to get in under rubble, in concrete pipes or other municipal facilities, which typically result in a sharp deterioration of the necessary conditions for the propagation of radio waves. In this regard, the problem of ensuring reliable communication with the robotic complex becomes rather acute. The aim of the present work is to reduce the effect of multipath propagation of radio waves in the communication channel under complex interference conditions.Methods. The methods of statistical radio engineering and mathematical modeling are used according to optimal signal reception theory.Results. The presented model for a multi-element, spatially-distributed, in-phase receiving antenna of various configurations, featuring an electronically adjustable radiation pattern, is designed to ameliorate the multipath nature of signal propagation. A simulation of a multipath communication channel was carried out in the presence of one main and three reflected beams of radio wave propagation, as well as with harmonic interference at two angles of its arrival and different frequency detuning relative to the frequency of the useful signal. The probability of a bit error when receiving discrete information using the proposed antenna is estimated.Conclusions. The proposed signal processing algorithm on the receiving side can be used to partially compensate for the influence of the multipath effect. As a result, the noise immunity of information reception in comparison with reception on an omnidirectional antenna with one antenna element increases: for a bit error probability of 10−3, the energy gain ranges from 2 dB for two beams to 7–10 dB for three or four beams. In the presence of concentrated harmonic interference in the radio channel, its simultaneous spatial (by the antenna) and spectral (by the demodulator) filtering is also observed, the effectiveness of which depends on the direction of arrival and the frequency detuning of the interference, which also leads to a significant decrease in the error probability.

The main source of intraocular lens (IOL) power calculation errors in phacoemulsification (PE) is axial length (AL) measurement inaccuracy in cases if optical biometry cannot be used.bto describe an original double-step method of IOL power calculation in lens opacities which exclude AL measurement with optical biometry.Material and methods. Patient S. (male, 71) with a bilateral immature cataract underwent right eye phacoemulsification (PE) with no IOL implantation. After that, AL was measured in the aphakic state with transparent optical media and used in combination with preoperative anterior segment biometry data to calculate the IOL power. In the second stage, a selected lens with an extended focus range was implanted.Results. The patient was examined and discharged on the second day after surgery with visual acuity OD 0.3 sph +0.25 cyl -0.75 ax150 = 0.5 and signs of moderate postoperative keratopathy. After 2 weeks, uncorrected visual acuity was as high as 0.9 and could not be further corrected by spectacle lenses. The patient was admitted for surgical treatment of the left eye cataract and also operated in two stages. The AL measured by the optical method in the aphakic state, was 0.31 mm less than that measured before the operation. Six months after PE with IOL implantation, distance visual acuity in both eyes was 1.2, the patient could use binocular vision for reading and PC work with no difficulty.Conclusion. The double-step approach to IOL power calculation is justified in cases of strong decrease of crystalline lens transparency, especially in complicated cases, for example, in high myopia or “premium” lens implantation, in which patients are especially sensitive to correct target refraction, even though this approach requires a delayed IOL implantation, which should take place after a precise calculation of AL taken in the aphakic state.

Introduction. With the emergence of empagliflozin in the pharmaceutical market, there has been an increase in publications on the primary and secondary pharmacodynamics of the drug, and the list of potential indications for the use of this sodium-glucose co-transporter inhibitor is increasing. Hypotheses about pharmacological effects and mechanisms of their implementation are tested both in large-scale clinical studies and in animal experiments.Aim. The purpose of this work was to study the effectiveness of empagliflozin by echocardiographic, histological and molecular biological analyses at the three most significant points of the dynamic transition from acute myocardial infarction to post-infarction chronic heart failure in laboratory male rats.Materials and methods. The experiment was performed on 60 male outbred rats. Myocardial infarction was modeled in narcotic animals by permanent ligation of the left coronary artery. Based on echocardiographic (EchoCG) study data, animals were randomized to two groups: control infarction: untreated pathology group treated with placebo and pathology group treated with empagliflozin 1 mg/kg per os intragastric daily from the first day of the experiment. At 10, 20 and 30 days after the operation, the animals were also subjected to EchoCG testing, and a group of 10 animals from each group were euthanized for histological examination and molecular analysis.Results and discussion. Empagliflozin use in animals after myocardial infarction modeling contributed to a significant increase in myocardial performance on days 10, 20 and 30, reaching a maximum on day 20 (47.58 ± 1.87 %). The drug promotes long-term preservation of the area of damage to the heart muscle with early formation of mature connective tissue, and also increases myocardial resistance to hypoxia by increasing the amount of HIF-1.Conclusion. Based on the studies carried out, it can be concluded that it is possible to use the sodium-glucose cotransporter type 2 empagliflozin in the formation of post-infarction chronic heart failure in the conditions of normoglycemia.

Objective: to study the efficacy and safety of the Gam-COVID-Vac vaccine in patients with immunoinflammatory rheumatic diseases (IRD) in a prospective study.Material and methods. The study included 42 patients with IRD and 57 individuals without IRD (control group) who received at least one component of Gam-COVID-Vac. Immunization with the first component of the vaccine was carried out from March 25th to August 1st, 2022, the second – 3 weeks after the first dose. On days 1, 3 and 7 after administration of the first and second components, the study participants provided information on adverse events (AEs) by telephone. All subjects were examined by a rheumatologist 1, 3 and 6 months after complete immunization. The observation period after immunization with the second dose was 6 months.Results and discussion. 42 patients received the first component of the vaccine, and 39 patients received two components. In the control group, 57 subjects were immunized with two components of the vaccine. 30–180 days after vaccination with two components of Gam-COVID-Vac, 3 (7.7%) patients were diagnosed with SARS-CoV-2 infection, which was confirmed by polymerase chain reaction. In all cases, a mild course of COVID-19 without signs of pneumonia was observed. There were no cases of COVID-19 in the control group. After immunization with the first component, a combination of at least one local and one systemic AE (SAE) was documented in 28.6% of patients with IRD and 33.3% of individuals in the control group (p>0.05). No AEs were recorded in 42.9% and 36.8% of cases respectively (p>0.05). After vaccination with the second component, a combination of ≥1 local AE and SAE was recorded in 15.4 % of patients with IRD and 22.8% of individuals in the control group (p>0.05). No AEs occurred in 71.8% and 56.1% of cases respectively (p>0.05). In 10.3% of patients with IRD and 12.3 % of those without IRD (p>0.05), a combination of local and systemic AEs was recorded after the introduction of both first and second components. No AEs were observed in 35.9% and 28.1% of cases, respectively (p>0.05). The overall rate of IRD exacerbations was 4.8%.Conclusion. Based on the available data, vaccination against COVID-19 appears to be effective and quite safe in patients with IRD.

This paper examines the mechanism of functioning of the artistic space of the Egyptian noble tomb of the Old Kingdom period as a system of pictorial and architectural components. The purpose of the burial and the mechanism of functioning of the system to a great extent determined the themes and content of the plots, which contributes a special relevance to the study. A systematic analysis of reliefs from more than a hundred burials of the necropolises of Giza and Saqqara is used, with a focus on the design of the large tombs of Yasen and Chi. The paper emphasizes the fact that the universal mechanism for the functioning of the level system “a large image of the owner – a nearby scene” is a stable correlation between the elements of the attribute set of the nobleman and the content of the plots. Moreover, a large image of the nobleman is valuable not only as an image itself, but also as a set of necessary attributes that allow one to engage in “contemplating” on the images corresponding to these attributes. A new unusual variant of correlation has been identified by depicting a nobleman without the required attribute, however in a certain pose in which this attribute is usually present. Thus, the combination of the necessary insignia, combined with the pose of the depicted nobleman, endowed the large image of the owner with additional functions, allowing it to correlate with several plots and scenes of different content.

Background. The rapid advancement of modern surgical methods for treating pelvic bone fractures has underscored the necessity for developing a new terminological framework. This is because the classical anatomical terminology of the pelvis no longer aligns with the demands of the therapeutic process and scientific research in this field. The traditional set of anatomical names and landmarks falls short in providing detailed descriptions of all intricacies of injuries when employing contemporary surgical techniques. The existing terminology system needs to catch up with the level of contemporary pelvic surgery, enabling a comprehensive and understandable characterization of existing pathology and the treatment being administered for all medical professionals. Purpose of the study was to create names for certain parts of the pelvic bones and their areas that currently lack specific designations and to propose the developed terms for professional discussion. Methods. A retrospective analysis was conducted on X-rays and computer tomography scans of patients with pelvic bone injuries, performed from 2020 to 2022. A list of potential new anatomical terms was compiled through a literature review. Results. In several cases, we encountered a deficiency of terms in diagnosing pelvic injuries and describing surgical procedures. New terms were developed to denote areas of the pelvis and their injuries, including the pubic bone base, vertical fractures of the pubic bone base, longitudinal fractures of the pubic bone base, incomplete rupture of the pubic symphysis, the base of the ilium, longitudinal fracture of the iliac base, fracture-subluxation and fracture-dislocation of the iliac base, calcar of the iliac bone, calcar spike, and the bone corridor. Conclusions. The incorporation of new anatomical terms into clinical practice will help enhance the precision of diagnosis and surgical planning in pelvic fractures. Standardizing the terminology will promote uniformity in approaches and knowledge sharing among specialists, ultimately improving the quality of surgical care for patients with pelvic injuries.

The Sloboda Geodynamic Intersection is considered as an area of convergence for major segments, aulacogens, faults, and suture zones of the East European Platform.Between 2020 and 2022, researchers from the Geological Faculty of Lomonosov Moscow State University and the Geoelectromagnetic Research Center (GEMRC IPE RAS) conducted deep magnetotelluric surveys in this region. The surveys were performed along the Pushkiny Gory – Andreapol, Sebezh – Velikiye Luki – Rzhev, and Ostrov – Ostashkov profiles. Through qualitative analysis of the collected data, the dimensionality of the studied medium, the total longitudinal conductance of the sedimentary cover, and the dominant strike direction of conductive structures were assessed. Quantitative interpretation using 1D, 2D, and 3D inversions resulted in geoelectric models comprising a conductive sedimentary cover and a highly resistive basement. Within the depth range of 10–40 km, transcrustal zones of enhanced electrical conductivity were consistently identified, interpreted as the southwest extension of the Ilmen-Ladoga anomaly. These conductivity anomalies are attributed to the deep submergence of heavily tectonized and metamorphosed sedimentary rocks, initially saturated with organic and carbonate matter.

The purpose of the research is to develop a comprehensive bioconversion of secondary processing products (SPP) of pea flour: liquid whey and insoluble starch-protein residue (ISPR), formed during the isolation of food protein concentrate (PC) using various enzyme preparations. The research was carried out in 2021-2023. The bioconversion of whey and ISPR into fodder yeast (FY) was performed with the association of cultures of S. cerevisiae 121 and G. candidum 977 (1:1). There was created a mathematical model of the dependence of biomass growth on whey on technological factors, and the optimal parameters were determined: pH, temperature, amount of inoculum. In the process of biomass synthesis microorganisms absorbed glucose, xylose, galactose, fructose from whey. The parameters of ISPR hydrolysis and the conditions for its joint bioconversion with whey with the same microorganisms were established: the amount of residue added to the mass of whey, pH, temperature, process duration, pressure. With insoluble starch-protein residue hydrolyzed at pH 1.8, the amount of protein in the biomass increased by 2.2 times, reducing sugars – by 6.1 times, compared with the original whey. At the same time, glucose and maltose were absorbed. Dry FYs contained 51.09-61.68 % protein, 2-8 % lipids, and ash content 5-8 % per dry matter. The amino acid score of proteins was 90-247 %, the ratio of saturated (23.5 %) and unsaturated fatty acids (71.67 %) – 1:3, omega-6 fatty acids – 19.73 %, trans-isomers – 5.0 %. Yeast is rich in sodium, potassium, calcium, magnesium, zinc. The mass fraction of nucleic acids and heavy metals in FYs were within the normal range, in vitro digestibility was 85.73-89.74 %. The data indicated the expediency of utilization of pea flour secondary processing products into high-quality FY by comprehensive bioconversion.

For the first time in scientific historiography, with the involvement of previously unknown archival documents, the problem of ensuring freedom of conscience is considered when creating the Fundamental Laws on April 23, 1906, which became the first national constitution in force. It is shown that P. A. Kharitonov, A. P. Salomon and Count A. F. Heyden paid attention to this problem, that is, the authors of bureaucratic drafts of new Fundamental Laws, which by December 1905 were prepared for Emperor Nicholas II. The main one turned out to be Kharitonov’s project, considered at a Meeting of the highest ranks of the State Chancellery. In the future, the consolidation of freedom of conscience in the Fundamental Laws was facilitated by the discussion of the draft State Chancellery in the Council of Ministers under the chairmanship of Count S.Y. Witte in March 1906 and the drafting of another draft of Fundamental Laws by Professor O. O. Eichelman at the same time. It is emphasized that the controversy that arose as a result of the April Special Meeting chaired by Nicholas II among his key figures about the limits of freedom of conscience influenced the final version of the corresponding article of the Fundamental Laws established personally by the tsar. It is concluded that this version reflected the conservative-liberal nature of the views shared by the direct participants of the constitutional reform of 1906.

The article studies possibility to use mathematic modeling to resolve practical business-tasks with regard to the necessity to work-out progressive unified approach to the development of company efficiency in conditions of high competition, in particular for defining strategies of interaction of the corporate center and companies with divisional structure. On the basis of theorico-gaming approach methods of building pay matrix were studied to settle conflicts between divisions and corporate center, strategy options for each party and choice of these options were identified and description of cells with prizes and losses was proposed. At the same time transition to 3D pay matrix was put forward, which takes into account time factor focusing on the importance of making decisions in the most appropriate time period.

Background. Rapp-Hodgkin syndrome is a rare genetic disease from the ectodermal dysplasia group. It manifests with damage of ectodermal structures — layer of embrional tissue that provides the development of many organs and tissues in the body, such as: skin, sweat glands, hair, teeth, and nails. Disease symptoms may range from mild to severe and include dental abnormalities, fragile, thin or no hair, abnormal nails, hypohidrosis (due to the reduced number of sweat glands), cleft lips and palate. Hidradenitis suppurativa is a chronic inflammatory disease that predominantly affects apocrine glands areas. This nosology is characterized by painful nodes, abscesses, and fistulas, prone to relapses and leading to scarring.Clinical case description. The authors present a clinical case demonstrating the combination of Rapp-Hodgkin syndrome and severe hidradenitis suppurativa in 17-year-old male patient.Conclusion. The heterogeneous clinical findings of hidradenitis suppurativa and history of rare genetic disease result in patients' admissions to various medical specialists. Thus, it leads to delayed verification of the diagnosis and incorrect treatment methods. As a result, patients have persistent cosmetic skin defects, possible complications of irrational treatment, and decreased quality of life by the time of diagnosis.

Background. Linear IgA dermatosis is a rare autoimmune bullous disease characterized by vesiculo-bullous subepidermal lesions (affecting the skin and mucous membranes) and by linear homogeneous IgA deposition in the epidermis basal membrane.Clinical case description. Clinical case of linear IgA dermatosis in children is presented. Clinical data assessment, histological examination of the skin biopsy (to determine the depth of bullous), immunofluorescent examination (to reveal IgA deposition in the epidermis basal membrane) are crucial for reliable disease diagnosis according to the studies. Altogether it helps to establish the final diagnosis and determine the patient's management. Dapsone is the first-line treatment for this disease, it has proven to be an effective and safe medication.Conclusion. This case of linear IgA dermatosis is of concern due to disease severity and its rarity in clinical practice. Differential diagnosis is rather complicated and clinically requires high-tech research methods. Only immunofluorescent examination allows to diagnose linear IgA dermatosis accurately. Lesions' regression was achieved due to systemic therapy with dapsone (1.8 mg/kg/day).

Background. Pemphigus herpetiformis is a rare atypical bullous dermatosis of autoimmune nature. It is characterized by rashes in the form of plaques with papules and vesicles at peripheral areas, or in the form of grouped papules, vesicles or tense bubbles with clinical similarity to During's herpetiformis dermatitis. Pemphigus herpetiformis diagnosis in pediatric practice is difficult due to the similarity of clinical manifestations to bullous dermatoses of other etiology, the rarity of the disease in children, and small number of scientific publications.Clinical case description. Clinical case of pemphigus herpetiformis in a child is described. All necessary diagnostic algorithms for diagnosis and therapeutic tactics for patient management are presented. Dapsone and prednisolone were used as first-line drugs during the patient's treatment. They have shown its efficacy in management of such patients.Conclusion. Differential diagnosis of pemphigus herpetiformis and other bullous dermatoses in children is presented. The results of successful drug treatment are shown.

Background. Netherton syndrome is a severe autosomal recessive disease based not only on genetically determined keratinization disorders, but also on immune system dysregulation.Clinical case description. Boy K., 9 years old, diagnosed with severe atopic dermatitis and revealed Netherton syndrome during examinations. The dupilumab was administered due to the presence of severe polysensitization and clinical signs of allergic process. Wave-like course of the disease was observed during this therapy. Patient had acute exacerbation — generalized pustular rash — at the 7th month of treatment. The therapy with secukinumab was initiated according to the foreign literature on pathogenetic treatment of Netherton syndrome with interleukin (IL) 17 inhibitor. It has shown positive dynamics. Currently patient is administered with the combined therapy of IL-17 and IL-4/13 inhibitors with significant positive effect.Conclusion. Genetically engineered biologic drugs targeting both the Th17 and Th2 have shown their efficacy in Netherton syndrome management.

According to the WHO data, the number of infected people exceeded 765.2 million people during the COVID-19 pandemic. The severity of patient’s condition is determined by immune system hyperactivation. Activation of T- and B-lymphocyte subsets plays a prominent role in the control of infectious process. A content of small circular DNA molecules — T-cell receptor excision circles (TREC — T-cell receptor excision circles) and B-cell (“kappa”) excision rings (KREC — Kappa-deleting recombination excision circles) — in the peripheral blood can be used as a marker of the functionally active T and B cells maturation. The purpose of this work is to quantify peripheral blood TREC and KREC level in patients with the new coronavirus infection COVID-19 of varying severity.Materials and methods.The material consisted of 1028 blood samples from patients with a confirmed diagnosis of COVID-19, as well as 717 blood samples from apparently healthy volunteers. The content of TREC and KREC DNA fragments in the total DNA fraction was assessed by quantitative Real-time PCR using the “TREC/KREC-AMP PS” test system (St. Petersburg Pasteur Institute, Russia). Blood cell phenotyping was carried out using flow cytometry.Results.TREC/KREC levels were significantly reduced in COVID-19 patients (p 0.0001 at 95% CI). A significant direct correlation was established between the levels of peripheral blood TREC molecules and level of CD45+CD3+CD19–T cells (r = 0.59, p 0.0001), as well as between KREC level and count of CD45+CD3–CD19+B cells (r = 0.66, p 0.0001). The level of TREC molecules in patients with severe vs. moderate infection was significantly reduced in patients aged 30–39 years old (p = 0.0404) and 40–49 years old (p = 0.0356). The negative correlation between severity of COVID-19 clinical manifestations and TREC level in the blood of patients in 30–49 year age group indicates about an opportunity of using this analyte as a diagnostic and prognostic laboratory marker of patient’s condition. A simple PCR analysis algorithm makes it relevant to use the described method for assessing a state of immunity in coronavirus patients in the context of systemic negative impact of the SARS-CoV-2 virus on human organism.

Purpose: to study optical coherence tomography (OCT) characteristics of intravitreal particles in vitreous hemorrhage and posterior uveitis. Patients and methods. 29 patients with posterior uveitis (43.1 ± 19.4 years, 10 females and 19 males) and 29 patients with vitreous hemorrhage (62.3 ± 11.6 years, 9 females and 20 males) were included. All patients received standard ophthalmological examination and multimodal imaging, including OCT. The size and reflectivity of preretinal intravitreal particles was assessed on crosssectional OCT scans. Results: Intravitreal particles in eyes with posterior uveitis had a statistically significantly larger size compared to the particles in vitreous hemorrhage, 47.0 ± 29.0 and 41.3 ± 22.6 pixels, respectively (p < 0.001). At the same time, intravitreal particles in eyes with posterior uveitis had lower mean reflectivity compared with eyes with vitreous hemorrhage, 126.0 ± 10.5 and 135.2 ± 11.1, respectively (p < 0.001). The maximum reflectivity of intravitreal particles in eyes with posterior uveitis was also lower than that of particles in eyes with vitreous hemorrhage, 186.2 ± 24.9 and 166.3 ± 23.7, respectively (p < 0.001). Conclusion. Intravitreal particles displayed with OCT in posterior uveitis are less reflective and larger than those in vitreous hemorrhage.

Age related macular degeneration is a leading cause of vision loss and an increasing problem of disability throughout the world among adults. That revue covers historical points, risk factors, pathogenesis, classification and current treatment ways of that pathology. The causes of age-related macular degeneration are not fully understood, in spite of keeping a great amount of knowledge at etiology, pathogenesis, diagnosis and modern types of treatment. The problem of age-related macular degeneration treatment has remained actual nowadays. Now, the medicine doesn’t have etiotropic treatment of AMD, because we still don’t know a definite etiologic factor of this developing disease. The main treatment for wet AMD is the injection of medications called anti-VEGF agents. Currently, treatment of dry age-related macular degeneration includes modification of risk factors (stop smoking, healthy life style and etc) and dietary supplements containing a combination of certain ingredients (vitamin C, vitamin E, zinc, copper, and lutein with zeaxanthin or beta-carotene) may be able to slow the progression of the disease. The disadvantage of current treatment methods is a narrow focus at one of the pathogenesis components or using as symptomatic therapy. The analysis of literature date has allowed noticing of using of an extracorporeal hemocorrection as perspective way at exploration of new methods of treatment of dry age-related macular degeneration.