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У статті пропонується експериментально дослідити гофрований конічний випромінювач з метою підтвердження теоретичних розрахунків р Г  коефіцієнта відбивання електромагнітного поля від розкриву досліджуваного гофрованого конічного випромінювача. Дослідження ґрунтуються на впливі електромагнітних полів на фізико-хімічні процеси в біологічних об’єктах. Теоретичні дослідження показали, що для промислового використання необхідний випромінювач з діапазоном частот 30-31 ГГц і діаметром не більше 30 мм, який повинен забезпечити ширину діаграми направленнності в межах 24-30 мм. Для дослідження використовувався виготовлений конічний гофрований опромінювач довжина якого від розкриття до фазового центру дорівнює 21 мм. Діаметр випромінюючого розкриву дорівнює 25 мм. Основні геометричні параметри гофри: h= 2,5 мм, с = 1,25 мм, b= 1,25 мм. Для живлення розглянутого випромінювача використовується перехід з прямокутного хвилеводу перетином 7,2 × 3,4 мм на круглий діаметром 7 мм. Вимірювання проводились на частоті 30 ГГц. Оскільки модуль коефіцієнта відбиття від випромінювача повинен бути близький до нуля, то для точних вимірювань необхідно використовувати метод рефлектометра.

The work is devoted to the development and testing of a solar-powered device with the functions of dust and other aerosol particles capturing both inside and outside the room, with the ability to regulate the light and heat fluxes into the room and with the greening function. The purpose of the device development is the use of solar energy in window household systems for: 1) night and adjustable daytime lighting of rooms; 2) cleaning the city’s air basin from dust and burning, 3) additional heat and sound insulation. A working model scaled down to 1:5 was created, where consumer functions were tested and finalized after modeling in AutoCAD. The device based on solar panels provides a combination of the mentioned consumer functions having three autonomous modules. They are placed on a united metal structure that is fixed in the opening and on the window frame. The model provides five static and three dynamic modes of device operation. The developed device can be used to improve the ecology of the urban environment.

The article is devoted to the practical implementation of changes in the current system of legal regulation in the fi eld of water supply and sanitation of apartment buildings. The results of the analysis of operational and design standards of water consumption are presented. The necessity of adjusting the normative and technical documents in terms of improving the methodological foundations of designing indoor cold and hot water supply systems for an apartment building and creating a legitimate methodological toolkit is shown. Recommendations have been developed to supplement the norms of the set of rules 30.13330.2016 “Internal water supply and sewerage systems of buildings. Updated edition of SNiP 2.04.01-85 *».

Background: Despite advances in surgery and pharmacotherapy, there remains significant residual ischemic risk after coronary artery bypass grafting surgery. Methods: In REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl–Intervention Trial), a multicenter, placebo-controlled, double-blind trial, statin-treated patients with controlled low-density lipoprotein cholesterol and mild to moderate hypertriglyceridemia were randomized to 4 g daily of icosapent ethyl or placebo. They experienced a 25% reduction in risk of a primary efficacy end point (composite of cardiovascular death, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina) and a 26% reduction in risk of a key secondary efficacy end point (composite of cardiovascular death, myocardial infarction, or stroke) when compared with placebo. The current analysis reports on the subgroup of patients from the trial with a history of coronary artery bypass grafting. Results: Of the 8179 patients randomized in REDUCE-IT, a total of 1837 (22.5%) had a history of coronary artery bypass grafting, with 897 patients randomized to icosapent ethyl and 940 to placebo. Baseline characteristics were similar between treatment groups. Randomization to icosapent ethyl was associated with a significant reduction in the primary end point (hazard ratio [HR], 0.76 [95% CI, 0.63–0.92]; P =0.004), in the key secondary end point (HR, 0.69 [95% CI, 0.56–0.87]; P =0.001), and in total (first plus subsequent or recurrent) ischemic events (rate ratio, 0.64 [95% CI, 0.50–0.81]; P =0.0002) compared with placebo. This yielded an absolute risk reduction of 6.2% (95% CI, 2.3%–10.2%) in first events, with a number needed to treat of 16 (95% CI, 10–44) during a median follow-up time of 4.8 years. Safety findings were similar to the overall study: beyond an increased rate of atrial fibrillation/flutter requiring hospitalization for at least 24 hours (5.0% vs 3.1%; P =0.03) and a nonsignificant increase in bleeding, occurrences of adverse events were comparable between groups. Conclusions: In REDUCE-IT patients with a history of coronary artery bypass grafting, treatment with icosapent ethyl was associated with significant reductions in first and recurrent ischemic events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01492361.

Objectives Therapy of patients with relapsed and refractory classic Hodgkin lymphoma (r/r cHL) after PD-1 inhibitors failure remains an unresolved issue. The aim of this study was to evaluate the efficacy and safety of the combination of nivolumab with brentuximab vedotin (Nivo + BV) after nivolumab monotherapy failure. Methods This study retrospectively analyzed 21 patients with r/r cHL who were treated with the combination of Nivo + BV after Nivo failure. The response was evaluated by PET–CT scan according to the LYRIC criteria. Adverse events (AEs) were assessed according to NCI CTCAE v.4.03. Results Median follow-up was 19 (9–47) months. The ORR was 57%. The median OS was not reached, 24 month OS was 80% (95% CI 50–93%). Median PFS was 12 months with 24 month PFS of 31% (95% CI 12–53%). Any grade AEs were observed in 12 patients (63%), 3–4 grade AEs in 2 patients (10%). Allogeneic hematopoietic stem cell transplantation (allo-HSCT) after Nivo + BV was performed in 8 (38%) patients. The median time between Nivo + BV and allo-HSCT was 8 (5–21) months. Conclusions Combination of Nivo + BV in r/r cHL after nivolumab monotherapy failure is potentially an effective and safe approach. Supplementary Information The online version contains supplementary material available at 10.1007/s10147-021-02085-6.

Introduction. The workers of coal mines are characterized by a high level of not only occupational diseases, but also oncological diseases. Modern knowledge in the field of studying pneumoconiosis contains many contradictions in the assessment of the pathogenetic mechanisms of lung damage, in particular, the morphogenesis of neoplastic changes in the respiratory system at the final stage of the disease with pronounced sclerotic changes. The study is devoted to the occurrence and development of tumor tissue in the miners working in the underground conditions. The task is to identify morphological trigger mechanisms for the development of oncological pathology in miners, relying on pathomorphological, immunohistochemical studies of the changes in the epithelial tissue of the airways, as well as various cellular communities of the bronchi, blood vessels of the lungs and lung tissue parenchyma using the example of epithelial-mesenchymal transformation under dust load. The purpose of this study was to determine the influence of the fibroplastic process on the development of oncological pathology in miners who worked in underground conditions. Materials and methods. Histological, immunohistochemical and morphometric studies of the respiratory system obtained during 50 autopsy works of a group of Kuzbass miners working in underground conditions was carried out. Cancer of various localization and histogenetic affiliation was previously diagnosed in 20 miners. The mucous membrane of the bronchi, respiratory tissue of the lungs, arteries and veins of the pulmonary circulation were studied. Immunohistochemical study was performed using monoclonal antibodies (marker of proliferation Ki-67, oncogene of proapoptotic activity Bcl-2, growth and neoangiogenesis factors, endothelial function factors CD-31 and CD-34, marker of epithelial tissue cytokeratin (cyt), muscle tissue markers - actin, desmin, vimentin, connective tissue markers - collagen, laminil, markers of intercellular interactions EMA, SMA). Results. Transformed fibroblasts, myofibroblasts are a cell population of dedifferentiated epithelial tissue with different expressions of nonspecific markers (desmin, actin, vimentin), capable of tumor transformation. Sclerotic tissue changes in pneumoconiosis are the areas of tumor transdifferentiation. Fibroblasts with an altered phenotype, namely myofibroblasts, are able to give rise to the growth of undifferentiated mesenchymal cell communities (tumor tissue), including atypical epithelial cells, adipocytes, chondrocytes and endotheliocytes. Conclusions. Epithelial-mesenchymal transformation can be a triggering mechanism for the development of tumor transformation from extensive fibrosed zones in miners with dust lung pathology. In this case, the main etiological factor of tumor progression is activated fibroplastic cells.

Objective: to study teratogenic effect – the long-term pregnant mother-taken antiepileptic drugs (AEDs) related consequences on paired child mental, social and intellectual development.Material and methods. There were enrolled 80 subjects: 40 children aged 3–9 years and paired mothers suffering from epilepsy for 3 to 35 years. Thirteen and 27 patients had generalized and focal epilepsy, respectively. Seven mothers were in prolonged remission without taking AEDs, 23 were on monotherapy and 10 were on polytherapy. Child research methods: T. Achenbach's clinical CBCL (The Child Behavior Checklist) scales (for children aged under 5 and 6–18 years), a questionnaire for detecting attention deficit hyperactivity disorder and other behavioral disorders modified by N.N. Zavadenko, Wechsler Intelligence Scale for Children (WISC), Luria batteries of neuropsychological tests adapted by J.M. Glozman (for children aged 3–6 and 7–12 years).Results. Neuropsychological study and assessment of intelligence revealed problems in the development of praxis, speech, gnostic functions and memory, as well as disproportion in the development of verbal and non-verbal structures of intelligence. The most common behavioral disorders in children were impulsivity, distraction, difficulties in controlling and organizing movements. The most affected spheres were praxis (motor awkwardness, fine motor disorders of the hands) and speech.Conclusion. The proposed hypothesis that the teratogenic effect of taking AEDs may result in unevenness or delay in developing mental functions in a child was confirmed.

Background: The new coronavirus infection (NCI) COVID-19 in pregnant women occurs in various types from asymptomatic to extremely severe ones with the development of multiple organ failure and sepsis. SARS-CoV-2 infection occurs at the cellular level through viral binding to angiotensin-converting enzyme 2 (ACE2) receptors, the presence of which in the myocardium and vascular endothelial cells explains the mechanism of severe cardiovascular complications of NCI. The development of the latter has been demonstrated in few studies, whereas favorable outcomes for the mother and fetus in the presence of overall lung damage and acute coronary syndrome have not been reflected in the literature. Case report: The article describes and analyzes the favorable outcome of extremely severe NCI Covid-19 in a pregnant woman with overall lung damage, the development of acute myocarditis and myocardial infarction in the postpartum period. Conclusion: The timely referral of a pregnant woman with extremely severe NCI COVID-19 to the obstetric hospital of an infectious diseases hospital for patients with NCI COVID-19 for specialized medical care using a multidisciplinary approach, as well as the consideration of possible cardiac complications in this disease, their timely diagnosis and correction made it possible to effectively prevent an unfavorable outcome for the mother and fetus. © 2021, Bionika Media Ltd.. All rights reserved.

the aim. Focused on optimizing the assortment portfolio of pharmacy organizations and improving the process of drug supply to end-consumers, the aim of the study was to analyze the regional pharmaceutical market for antihistamines.Materials and methods. In the study, the following methods were used: a content analysis of regulatory documents; a documentary observation method of the volume of antihistamines sales; a sociological survey method. The objects of the study were accounting registers in 32 pharmacy organizations for 2020, as well as the sociological survey results of 174 respondents – consumers of antihistamines.Results. The classification analysis of 38 international non-proprietary trade names of antihistamines, represented by 187 names of drugs, revealed the prevalence of the first-generation drugs (63%). On the Russian pharmaceutical market, there were also 55% of foreign production drugs. At the regional level, there are 66 types of drugs in circulation, 50% of which are second-generation ones. The cost analysis showed rather a wide rage of the pricing proposal and the economic availability of antihistamines for patients. The sociological survey revealed the fact that 46% of the consumers were ready to pay for the necessary drugs in the price range “over 100 and up to 500 rubles” (over $ 1.38 and up to $ 6.88) for one conventional package. A medical-demographic profile of the antihistamines consumer at the regional level has been made up, and guidelines for pharmaceutical specialists on managing the assortment portfolio of pharmaceutical organizations have been developed.Conclusion. As a result of the study, the following facts have been established: the seasonal peaks in the antihistamines consumption; a gradual renewal of the pharmacies assortment portfolio due to the increased consumption of the second and third generation antihistamines. The medical and demographic profile of the consumer should be taken into consideration when planning a drug provision for the patients with allergic pathologies, and it is connected with the growth in pharmacies profits due to the sale of drugs in the range from 100 to 500 rubles (from $ 1.38 to $ 6.88). The methodical recommendations have been brought to the attention of the management of regional pharmacy organizations.

Pigmented neoplasms of the skin and mucous membranes are a heterogeneous group of benign and malignant neoplasms, some of which are extremely rare in the practice of pediatric oncologist. Orolabial melanosis refers to a benign pigmented pathology of the skin and mucous membranes, requires differential diagnosis with ephelids, melanoma, and when localized on the tongue – with pigmented fungiform papillae of the tongue.This article presents a clinical case of orolabial melanosis with localization on the tongue in a 9-year-old child that was not previously described in the domestic literature. The clinical, dermatoscopic, immuno-morphological and differential diagnostic features of this pathology are described in detail.

BACKGROUND: Congenital disorders of vertebrae formation are a common pathology in children. Intraoperative neurophysiological monitoring is a mandatory procedure, although it may not be effective enough due to the immature neural structures and the use of inhalation anesthetics in young children. AIM: To study aims to investigate the characteristic features of intraoperative neurophysiological monitoring in children with a congenital deformity of the spine during dorsal resection of the hemivertebrae. MATERIALS AND METHODS: 42 patients aged 117 years with a congenital deformity of the spine underwent 46 resections of the abnormal vertebra from an isolated dorsal approach (egg-shell technique). Intraoperative neurophysiological monitoring at the stages of the operation included a muscle relaxant test (TOF), transcranial electrical stimulation of the motor cortex (TCeMEP), control of the approach to the nerve (N. Proxy), correct placement of the pedicle screw (Screw Integrity), and EMG recording of the electromyogram. The accuracy of the screw placement was assessed by the Gerzbien method, and the presence of neurological disorders was tested by the Frenkel scale. The effect of inhalation anesthetic (sevoran) on motor evoked potentials was monitored by regulating its delivery, and the dependence on the age of patients was evaluated. RESULTS: The average age of patients was 7.7 4.5 years, and the TOF value was 80.5 17%. In 41 patients, the N. Proxy test was unremarkable, while in one patient, the 812 mA value did not require a change in the trajectory of the screws. From the beginning of sevoran and intraoperatively, motor evoked potentials from all tested muscles were recorded in 54.8% of patients; in children over 8 years old, this was observed in 92.8%, in children under 8 years old in 35.7% of cases in their age groups. In other patients, motor evoked potentials were most often not recorded from the muscles of the thigh and lower leg after sevoran administration. In children over 8 years old in 7.2%, under 8 years old in 83.3% of patients; Interestingly, in 7.2% of patients who are under 8 years of age, motor evoked potentials were not initially recorded from any muscle. Withdrawal of sevorane in 30.9% of patients allowed intraoperative motor evoked potentials to be obtained from all tested muscles in 100% of cases. For adequate management of anesthesia, 5 patients (50%) 14 years old and one patient 6 years old (5.6%) did not receive sevoran, and motor evoked potentials were recorded from the abdominal muscles. This allowed to assess the conduction only at the thoracic level and are required increased vigilance of surgeons when carrying out any corrective manipulations. CONCLUSIONS: Intraoperative neurophysiological monitoring with dorsal hemivertebra resection is an effective method that allows controlling the neurological complications during manipulations on the spine.

The paper presents an analysis of the data obtained on the effectiveness of the inclusion of a pulsed low-frequency electrostatic field in the standard complex of medical rehabilitation in the long-term period in 60 patients who had an ischemic stroke with movement disorders in the form of hemiparesis with an increase in muscle tone by the type of spasticity, which were divided into 2 comparable clinically — functional characteristics of the group: the main group — 30 patients who underwent a course of massage with a pulsed low-frequency electrostatic field from the «Khivamat» apparatus in addition to the standard rehabilitation complex, consisting of exercise therapy, medical massage, kinesitherapy and medication support, and the control group — 30 patients, who received only the standard complex of medical rehabilitation and drug therapy. For a comparative assessment of muscle strength and range of motion in the extremities in patients after ischemic stroke in the initial state and after the course of treatment, we used the modified Ashfort spasticity scale (MAS), Bartel’s index, and goniometry indices. Research results. Before treatment, all patients with post-stroke spasticity included in the study had impaired motor functions of the upper limb in the form of moderate hemiparesis with high muscle tone and changes in the amplitude of movement. In the initial state, all patients included in the study showed motor changes in functions in the form of moderate hemiparesis with muscle hypertonicity, a decrease in the amplitude of movement of the upper limb and a decrease in the activity of daily life. After the course of treatment, the patients of the main group showed a pronounced positive dynamics of indicators, which was confi rmed by a significant decrease by 23.8 % (p < 0,05) in spasticity in the affected limb according to the MAS scale, which decreased after 6 months by 42,8 % (p < 0.01), and after 12 months by 38.0 % (p < 0,01). In patients of the control group, significantly less pronounced and unstable results were obtained and the studied indicator decreased after the course of treatment by 14,3 % (p > 0,05), after 6 months by 19,0 % (p < 0,05), and after 12 months approached the original value. The decrease in spasticity was confirmed by goniometric data, which indicated an increase in active functional use of the hand in the main group. Conclusion: The inclusion in a comprehensive rehabilitation program of patients after acute circulatory disorders with motor disorders in the form of hemiparesis with increased muscle tone by the type of spasticity of pulsed low-frequency electrostatic massage contributes to a significant decrease in the severity of spasticity, an increase in the range of motion in the affected limbs and an expansion of daily functional independence.

The number of the insulating materials, including fiberglass products, are widely used in the construction, industry, oil and gas facilities, agro-industrial complex, transport, and defense. When using fiberglass, like some other insulating materials, it is possible to encounter their destruction and perforation, followed by a transition to the source of double-sided corona effect. Sliding spark discharges of static electricity, capable of igniting a combustible or explosive environment, are also likely to occur. The formation of such discharges depends primarily on the electrostatic and electrical strength properties of the used materials. These parameters should be used when assessing the most dangerous consequences of the fiberglass application in the process pipelines, apparatus, and equipment under the conditions of electrification processes. Comparison of the electrostatic and electrical strength properties of the corona-forming air layer in the electrization processes with the similar indicators of non-conductive structural materials is the main criterion that determines the possibility of their perforation and the occurrence of spontaneous sliding spark discharges. Electrostatic intrinsic safety should be ensured by eliminating static electricity discharges that are capable to become the flammable substances source of ignition (materials, mixtures, products). Sliding sparks can be eliminated by managing the electrostatic load. But at the same time, the hazard of ignition by discharges would remain if they could occur. When replacing the metal element (the wall of an apparatus or vessel) electrified by a liquid (technological medium), a product made of an insulating material, including fiberglass, with similar geometric, technical, and operational parameters, it is possible to maintain the efficient protection of the metal structure by means of its grounding.

The steady increase in the prevalence of non-communicable diseases in the population, including obesity and allergic diseases, dictates the need to study both common causal factors and mechanisms of their development, and to search for new effective treatment and prevention strategies. However the resultsof epidemiologic, clinical and laboratory studies are still inconclusive, especially in pediatric population. In this review we present and discuss current data that may help to understand the possible relationship and mechanisms of mutual influence of allergy and obesity in children.

Non-steroidal anti-inflammatory drugs are among the top requested ones in the clinic of internal medicine. However, these drugs are associated with a wide range of adverse reactions involving a number of organs and systems, in particular the gastrointestinal tract, cardiovascular system and kidneys. The aim of the study is to characterize the effect of the combined use of cryopreserved placenta extract and diclofenac sodium on the prooxidant-oxidative system, the activity of inflammatory, destructive and cytolytic processes, as well as protein and lipid metabolism in rats with experimental rheumatoid arthritis. Results. The administration of diclofenac sodium and cryopreserved placenta extract to rats with adjuvant arthritis normalized the level of active products of thiobarbituric acid and hence was indicative of the neutralization of an arthritis-induced oxidative stress. A statistically significant (p=0.01) increase of in a superoxide dismutase activity (by 30.6% relative as compared with rats of the control group) has also been established. An increase in the anti-inflammatory properties of diclofenac sodium in the combined use of diclofenac sodium with a cryopreserved placenta extract has been found out. The level of C-reactive protein decreased (p

Background. Glutaric aciduria type 1 is an autosomal recessive disease caused by mutations in the GCDH gene, which encodes the enzyme glutaryl‑CoA dehydrogenase. Metabolic crisis in type 1 glutaric aciduria is an acute life‑threatening condition that requires careful diagnosis with a number of other conditions and the immediate initiation of pathogenetic therapy.Materials and methods. Clinical manifestations, neuroimaging characteristics of the disease were studied in 46 patients with diagnosed glutaric aciduria type 1 confirmed by biochemical and molecular genetic methods. Methods: gas chromatography with mass spectrometry, tandem mass spectrometry, Sanger sequencing, chromosomal microarray analysis of the exon level.Results and discussion. A retrospective analysis of anamnestic and clinical data was carried out, and the nature and age of disease manifestation, provoking factors, a spectrum of clinical manifestations and neuroimaging data were assessed.Conclusion. How initiated treatment prevents progression of neurological symptom relief and patient adaptation. With the help of the goal, it is necessary to inform pediatricians, neurologists and neuroradiologists about this feature of the course of glutaric aciduria type 1 in order to increase the clinical alertness of this disease.

Relevance. The success of treatment of children with hepatoblastoma (HB) is associated primarily with the optimization of diagnostic and therapeutic strategies. The introduction of a system of therapeutic definition of a risk group developed by the International Society for the Study of Liver Tumors in Children’s Hepatic tumors International Collaboration (CHIC) in patients with HB allows for effective risk stratification. Patients of the very low-risk group have a favorable prognosis and, unlike patients of other groups, they can perform surgery at the 1st stage, and children from the very low-risk group with a “pure” fetal version of the morphological structure of the tumor can be cured without chemotherapy – only by surgical method. This article presents an analysis of a series of observations of children with HB very low-risk.Methods and patients. A retrospective analysis of the data of 138 patients who received treatment at the Research Institute of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Centre of Oncology of the Ministry of Health of Russia from January 2006 to February 2018, all patients underwent examination in the following volume: computed tomography (CT) of the chest, ultrasound of the abdominal cavity and retroperitoneal space, CT and/or magnetic resonance imaging of the abdominal cavity with contrast enhancement. Serum levels of human chorionic gonadotropin and alpha-fetoprotein (AFP) were measured. The prevalence of tumor lesions was retrospectively evaluated using the PRETEXT system (Pre-Treatment Extent of Disease, assessment of the prevalence of the tumor process before treatment, 2017 version). Based on the data obtained, 18 (13 %) patients with hypertension were identified in the very low-risk group using the CHIC stratification system. Of 18 (100 %) patients of the very low-risk group, 8 (44.4 %) received therapy in the interval from January 2006 to October 2010 according to the treatment protocols of the SIOPEL group. The treatment included a combination of neoadjuvant chemotherapy with delayed surgery and adjuvant chemotherapy. Since November 2010, the Research Institute of Pediatric Oncology and Hematology adopted a protocol for the treatment of children with hypertension, suggesting the possibility of performing surgical treatment at the 1 st stage in patients with a localized stage of the disease with the spread of PRETEXT I/II. From December 2010 to November 2018, 10 (55.6 %) patients from the very low-risk group were operated on at the 1 st stage. A tumor biopsy was not performed before the intervention. After a histological examination, 4 (22.2 %) patients had an epithelial variant of the structure of HB that did not meet the criteria of a “pure” fetal variant. He was given adjuvant chemotherapy according to the SIOPEL protocol. And in 6 (33.3 %) patients, according to the results of a morphological study, the HB structure variant was interpreted as a “pure” fetal variant. Further therapy in this group of patients was not performed. The analysis of the results of treatment of these 6 patients without the use of chemotherapy is presented in our article.Results. The average age of patients is 3.7 (1–6) years, the median is 3.7 ± 2.0. Boys/girls – 4:2. In all cases, there was an asymptomatic course of the disease, a neoplasm was detected by chance during an ultrasound scan. All children had an elevated AFP level in the range of 95.2–695 (286.0 ± 116.8) IU/ml. Distribution according to PRETEXT I/II – 2 (33.3 %) and 4 (66.7 %) patients, respectively. Patients did not have additional PRETEXT criteria and metastases. Surgical treatment was performed by the laparoscopic method in 2 of 6 patients. Scope of operation: right-sided hemihepatectomy – 3, left-sided – 1, bisegmentectomy – 1, atypical resection – 1. Lymphatic dissection in the area of the hepatoduodenal ligament was not performed. There were no complications of treatment and repeated surgical interventions. The radicalness of the intervention in the volume of R0 was confirmed by histological examination in all patients. Morphological examination in all cases revealed a “pure” fetal version of the structure of the tumor. All patients are alive without signs of relapse at follow-up periods of 14.7 to 59.2 (32.0 ± 18.7) months.Conclusion. Using the system of therapeutic stratification into risk groups CHIC allows you to effectively distinguish patients with very low-risk groups, and for some children with a “pure” fetal version of the histological structure of the tumor, only the surgical approach can be used for treatment. At the same time, the short observation period for the patients and their small number do not allow us to draw final conclusions and dictate the need for a multicenter study. It should be noted that this cohort of patients requires careful observance of the post-therapeutic observation algorithm.

Background. Retinoblastoma is a malignant intraocular tumor developing from the retinal neuroectoderm and diagnosed primarily in young children. This type of cancer is associated with a high risk of multiple primary tumors emerging after treatment completion. Multiple primary tumors are two or more independent tumors developing in one patient. Treatment of this disease is challenging.Objective – to evaluate the impact of risk factors on the efficacy of therapy for multiple primary tumors and to analyze treatment outcomes.Materials and methods. A 2-year-old boy was diagnosed with bilateral retinoblastoma (OD – stage T3bN0M0 and OS – stage T3cN0M0). He received special treatment from September 2005 to November 2006. In 2012, the patient underwent cataract surgery: the lens was removed, then an intraocular lens was installed, and laser dissection of the posterior capsule of the lens was performed. Six years later, in August 2018, the patient was diagnosed with osteosarcoma. The boy received combination organ-sparing therapy according to the EURAMOS-1 treatment protocol for osteosarcoma. During therapy, he developed a secondary tumor, namely osteoblastic osteosarcoma. Both the boy and his father were found to have a mutation in the RB1 gene.Results. Currently, patient’s condition is satisfactory; he has no complains. The boy is in remission for 2 years.Conclusion. The development of secondary tumors depends on the genetic factors, type of treatment for primary tumor, and environmental factors. Therefore, it is extremely important to assess risk factors for multiple primary tumors at the moment of primary retinoblastoma detection. The results of such assessment will help to choose an optimal treatment strategy.

The Kasabach–Merritt phenomenon is a rare thrombocytopenic consumption of coagulopathy that occurs against the background of such vascular anomalies as kaposiform hemangioendothelioma and giant angioma. Timely diagnosis and treatment of Kasabach–Merritt syndrome which includes therapy for vascular tumors and life‑threatening conditions are critical in resolving this rare vascular anomaly. The aim of the study is to analyze radiation therapy as salvage therapy for kaposiform hemangioendothelioma and giant angioma associated with the Kasabach–Merritt phenomenon.

The article presents a retrospective of the main directions of research on the preservation of the health of the population and labor resources of the Siberian Federal District based on the long-term work of the Scientific Research Institute of Complex Problems of Hygiene and Occupational Diseases in Novokuznetsk. There is the ecological and hygienic definition and justification of optimal human life conditions; the development and implementation of methods for the prevention, treatment, and rehabilitation of occupational, production-related, and general diseases; planning the strategy of medical services and organizations in the management of healthcare, taking into account the peculiarities of population reproduction, the specifics of working conditions and socio-economic development of regions.

Distal transradial access (dTRA) has several advantages compared with proximal transradial access (pTRA) for cerebral angiography. The learning curve for transitioning from pTRA to dTRA has not been described.Retrospective analysis of the first 75 diagnostic cerebral angiograms performed with dTRA by a single operator was performed. Outcomes included time for sheath insertion, sheath to first vessel time, procedure duration, fluoroscopy time, radiation dose, and contrast volume. Their associations with procedure number were evaluated with multivariate linear regressions, segmented linear regression, and locally weighted regression (LOESS).The mean age of patients was 56.1 years and 61.3% were female. Seventy-four of 75 angiograms were successfully completed with dTRA. There were 3 minor and no major complications. After adjusting for covariates, sheath to first vessel time (β = -0.50, P0.001) and procedure duration (β = -0.26, P = 0.002) were associated with procedure number. Time for sheath insertion, fluoroscopy time, radiation dose, and contrast volume were not associated with procedure number. Segmented linear regression identified break-points of 33 for sheath to first vessel time and 11 for procedure duration, which corresponded to the procedure number after which these outcomes trended down. LOESS models for time to sheath placement, procedure duration, fluoroscopy time, and radiation dose predicted minimum values between procedures 40-50.Transitioning from pTRA to dTRA for diagnostic cerebral angiography is feasible and safe. The learning curve is overcome between procedures 11 and 33, and further refinement in performance occurs through procedures 40-50.

Tree-crown and height are primary tree measurements in forest inventory. Convolutional neural networks (CNNs) are a class of neural networks, which can be used in forest inventory; however, no prior studies have developed a CNN model to detect tree crown and height simultaneously. This study is the first-of-its-kind that explored training a mask region-based convolutional neural network (Mask R-CNN) for automatically and concurrently detecting discontinuous tree crown and height of Chinese fir (Cunninghamia lanceolata (Lamb) Hook) in a plantation. A DJI Phantom4-Multispectral Unmanned Aerial Vehicle (UAV) was used to obtain high-resolution images of the study site, Shunchang County, China. Tree crown and height of Chinese fir was manually delineated and derived from this UAV imagery. A portion of the ground-truthed tree height values were used as a test set, and the remaining measurements were used as the model training data. Six different band combinations and derivations of the UAV imagery were used to detect tree crown and height, respectively (Multi band-DSM, RGB-DSM, NDVI-DSM, Multi band-CHM, RGB-CHM, and NDVI-CHM combination). The Mask R-CNN model with the NDVI-CHM combination achieved superior performance. The accuracy of Chinese fir’s individual tree-crown detection was considerable (F1 score = 84.68%), the Intersection over Union (IoU) of tree crown delineation was 91.27%, and tree height estimates were highly correlated with the height from UAV imagery (R2 = 0.97, RMSE = 0.11 m, rRMSE = 4.35%) and field measurement (R2 = 0.87, RMSE = 0.24 m, rRMSE = 9.67%). Results demonstrate that the input image with an CHM achieves higher accuracy of tree crown delineation and tree height assessment compared to an image with a DSM. The accuracy and efficiency of Mask R-CNN has a great potential to assist the application of remote sensing in forests.

Introduction. Aluminium production is characterized by the accumulation of impurities of various toxic and chemical compositions in the air of working areas, the predominant among which are fluoride compounds. The accumulation of fluorides in the body causes the development of osteoarticular and associated systemic pathology. The aim of the study was to evaluate the hygienic and medico-biological features of toxic liver damage in the conditions of chronic fluoride intoxication of the body. Material and methods. The hygienic working conditions of the workers of the primary professions in aluminium production were evaluated. The analysis of hepatobiliary dysfunction based on clinical and instrumental methods was carried out in 263 subjects with fluoride intoxication and a comparison group of 116 persons. Experimental studies of the morpho-functional liver state in modelling chronic fluoride intoxication were carried out based on toxicological, biochemical, pathomorphological methods with histological analysis of tissues. The toxic properties of sodium fluoride were studied in 117 white laboratory male rats with its peroral route intake into the body. Results. The qualitative composition of the air in the working areas in the electrolysis building was analyzed. The prevalence of pathological disorders of the biliary tract in metallurgists engaged in aluminium production was assessed. Clinical studies revealed a significant prevalence of toxic fluoride hepatopathy, fatty hepatosis, cholecystitis and other disorders in the group of patients with chronic fluoride intoxication. The harmful effect of sodium fluoride on hepatocytes, vessels of the portal tract was shown in an experiment. Hyperfunction of the reticuloendothelial system, Kupffer cell proliferation, irreversible destruction of hepatocytes, necrosis against the background of severe dystrophy, and decreased synthetic activity of the liver were determined. Conclusion. The structure of occupational diseases in the workers engaged in the aluminium production is dominated by hepatobiliary pathology caused by toxic liver damage with fluoride confirmed by experimental data on destructive violations of its morphostructure. Contribution: Yadykina T.K. — the concept and design of the study, collection and processing of material, statistical processing, writing a text; Mikhailova N.N. — the concept and design of the study, editing; Bugaeva M.S. — collection and processing of material; Gorokhova L.G. – collection and processing of material, statistical processing; Kislitsyna V.V. — collection and processing of material; Danilov I.P. — collection and processing of material; Kochergina T.V. — collection of literature data. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Conclusion of the Biomedical Ethics Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases: the clinical study was carried out with the informed consent of the subjects and complies with the ethical standards of the Bioethical Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases, developed in accordance with the Declaration of Helsinki by the World Association “Ethical Principles for Conducting Scientific Research with Human Participation” as amended in 2013 and “Rules of Clinical Practice in the Russian Federation” approved by the Order of the Ministry of Health of the Russian Federation No. 266 dated June 19, 2003 Research Institute for Complex Problems of Hygiene and Occupational Diseases. The study did not infringe on the rights and did not endanger the subjects. The experimental study on rats was carried out in accordance with the international rules “Guide for the Care and Use of Laboratory Animals” (Strasbourg, 1986) and the “Rules of laboratory practice in the Russian Federation (GLP)” (approved by order of the Ministry of Health of the Russian Federation dated 19.06.2003, No. 267). Acknowledgement. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest.

Thyroid cancer remains the most common malignancy of the endocrine system worldwide. The indicators of its morbidity and mortality rates have been increasing rapidly over the last decades. Most cases of differentiated thyroid cancer (follicular and papillary histotypes) are clinically manifested by nodular goiter frequently combined with uncertain results of cytological diagnosis (categories III and IV according to the Bethesda (Bethesda System for Reporting Thyroid Cytopathology) classification). All of that makes it difficult to choose a proper tactic for patient treatment. It is known that the development, progression, invasion, and metastasis of cancer cells are regulated by a variety of molecular mechanisms. This review describes several molecular aspects of thyroid nodules oncogenesis, as well as its most promising diagnostic tumor markers. Following molecular pathways are described in particular: gene mutations, protein tumor markers, and epigenetic effects of micro-RNA, histones, as well as DNA methylation. The study of the pathogenesis of this disease has a prognostic value and contributes to the search for effective therapeutic and diagnostic methods and their improvement. That is why we also reviewed modern test panels aimed at preoperative differential diagnosis of thyroid nodules. Summarizing the results of world research on this topic allows us not only to expand the understanding of the fundamental processes of oncogenesis, but also to outline promising areas for future experimental research projects. All of that together will contribute to developing new prognostic, diagnostic and therapeutic technologies, and as a result, will improve the quality of medical care for patients with thyroid cancer.

Dyskeratosis congenita (DC) is a hereditary syndrome of bone marrow failure, which develops because of telomeres defects and combines with cancer predisposition. Its classical clinical features are skin pigmentation, nail dystrophy, oral leukoplakia (skin-mucosa triad). The goal is to describe the algorithm of diagnosis, clinical specificities of DC and specific treatment for cases of DC in one family. The present report includes descriptions of diagnosis and treatment of family members diagnosed for the first time as having a DC. The report shows an importance of all diagnostic stages: from a medical history and clinical picture to an application of modern high-tech diagnostic methods (flow-FISH, NGS). The report underlines an importance of diagnosis of all family members for excluding an asymptomatic form after a case of DC has been already detected in that family. A high frequency of a toxicity and secondary neoplasia makes it necessary to realize an individual approach at treatment of each patient with DC (the earliest start of androgen treatment, prompt decision of implementation of allogenic hematopoietic stem cell transplantation). The knowledge of pathogenesis, clinical features and principles of diagnosis and therapy of this disease is relevant to pediatricians and hematologists.Врожденный дискератоз (ВД) наследственный синдром недостаточности костномозгового кроветворения, развивающийся вследствие нарушения биологии теломер и сочетающийся с предрасположенностью к опухолевым заболеваниям. Классическими клиническими признаками болезни (кожно-слизистая триада) являются ретикулярная пигментация кожи, дистрофические изменения ногтевых пластин, лейкоплакия слизистой оболочки полости рта. Цель описать алгоритм диагностики, особенностей клинического течения и выбора терапии семейного случая ВД. Представлено клиническое наблюдение диагностики и лечения членов семьи с впервые выявленным ВД. Данное наблюдение демонстрирует важность всех этапов обследования: от сбора анамнеза и клинической картины до применения высокотехнологичных современных диагностических методов (flow-FISH, NGS). Подчеркивается, что при выявлении ВД у больного показано обследование членов семьи на наличие бессимптомного течения болезни. Высокая частота органной токсичности и развития вторичных неоплазий диктует необходимость индивидуального подхода к лечению каждого больного с этим заболеванием (раннее начало приема андрогенов, своевременное рассмотрение возможности выполнения трансплантации аллогенных гемопоэтических стволовых клеток). Знание патогенеза, клинической картины, принципов диагностики и терапии этой нозологии актуальны как для врачей педиатрической практики, так и для гематологов.

Mantle cell lymphoma (MCL) is a rare and clinically aggressive lymphoma subtype. Current approaches have greatly improved patients outcomes, but relapse is inevitable. In phase IIIII clinical trials, ibrutinib has shown significant activity in patients with relapsed or refractory (R/R) MCL.To assess efficacy and toxicity of ibrutinib monotherapy in patients with R/R MCL in routine practice outside of clinical trials.The study enrolled patients with confirmed R/R MCL who had received at least one line of previous chemotherapy. ECOG 24, cytopenia, infectious complications, hemorrhagic syndrome were not exclusion criteria. Patients received daily oral ibrutinib 560 mg until progression or unacceptable toxicity.From May 2015 to September 2020 ibrutinib therapy was started in 106 patients with R/R MCL in 16 regions of Russia. The median age was 66 years; ECOG2 18%, blastoid variant (or Ki6740% or WBC50109/l) 43%. The median number of previous treatment lines was 2 (111). The ORR was 78.4% (CRR 27.4%). The median PFS was 13.6 months and OS 23.2 months. In the blastoid group the median PFS was 4.4 months vs 36.5 months in the alternative group (p0.001), the median OS 9.0 vs 41.0 (p=0.001). The median OS of patients after progression on ibrutinib was 3.2 months. The common complications are hemorrhages (63%), diarrhea (62%), myalgia and muscle cramps (60%), infections (31%), skin and nail toxicity 15%, arrhythmia 8%. None of recipients had to completely discontinue ibrutinib therapy due to complications.Ibrutinib is effective and well tolerated in routine practice of R/R MCL treatment and our results are consistent with international clinical trials. The favorable toxicity profile and the high response rate made it possible to prescribe ibrutinib in severe somatic status, cytopenia, and even in the presence of infectious complications.Обоснование. Лимфома из клеток мантийной зоны (ЛКМЗ) редкая и агрессивная В-клеточная лимфома. Интенсификация химиотерапии значительно улучшила результаты лечения, но развитие рецидива неизбежно. В исследованиях IIIII фазы ибрутиниб продемонстрировал высокую эффективность у пациентов с рецидивом и резистентным (р/р) течением ЛКМЗ. Цель. Оценить эффективность и токсичность монотерапии ибрутинибом у пациентов с р/р ЛКМЗ в повседневной практике. Материалы и методы. В исследование включены пациенты с подтвержденным диагнозом р/р ЛКМЗ, получившие не менее одной линии химиотерапии. Тяжелый соматический статус, цитопения, инфекционные осложнения и геморрагический синдром не служили противопоказаниями для начала терапии. Ибрутиниб назначался в дозе 560 мг ежедневно до прогрессирования или развития неприемлемой токсичности. Результаты. С мая 2015 по сентябрь 2020 г. включены 106 пациентов в 16 регионах России. Медиана возраста 66 лет; ECOG2 18%; бластоидный вариант (или Ki6740%, или WBC50109/л) 43%. Медиана предшествующих линий терапии 2 (111). Общий ответ достигнут у 78,4% (полная ремиссия 27,4%). Медиана беспрогрессивной выживаемости (БПВ) 13,6 мес, общей выживаемости (ОВ) 23,2 мес. При бластоидном варианте медиана БПВ составила 4,4 мес против 36,5 мес в альтернативной группе (p0,001), медиана ОВ 9,0 мес против 41,0 мес (р=0,001). Медиана ОВ при развитии резистентности к ибрутинибу 3,2 мес. Наиболее частые осложнения: геморрагии (63%), диарея (62%), миалгии и мышечные судороги (60%), инфекции (31%), кожная токсичность 15%, аритмия 8%. Ни одному из пациентов полностью терапию ибрутинибом из-за токсичности не остановили. Заключение. Ибрутиниб эффективен и хорошо переносится в рутинной практике терапии р/р ЛКМЗ, а результаты согласуются с данными международных исследований. Благоприятный профиль токсичности и высокая частота ответов позволили назначать ибрутиниб при тяжелом соматическом статусе, цитопении или наличии инфекционных осложнений.

Diagnosis of skin melanoma (SM) in children is a complex clinical and morphoimmunological problem. The rare occurrence, difficult interpretation of histological and immunohistochemical picture explain the error rate in the diagnosis of SM reaching 28.8 %. This article presents a clinical case of false-positive diagnosis of SM. As a result of a detailed assessment of the anamnesis, examination, revision of histological preparations and conducting an immunohistochemical study in the reference center, the diagnosis of SM was excluded.

The article examines cross-border tourism and changes in the tourism industry that occurred at the Russian–Chinese borderland since 2014. Using two city pairs—Blagoveshchensk/Heihe and Khabarovsk/Fuyuan—as case studies, the article reveals that owing to the altered structure of tourist flows after the 2014 devaluation of the ruble, Russian and Chinese border cities have customized their services for Chinese tourists. Fieldwork data and data collected from the media analysis allowed mapping the service sector openness of border cities and demonstrating that central districts of border cities concentrate the majority of businesses catering to clients from the neighboring state. This finding confirms the role of central districts of border cities as thermometers of cross-border dynamics as they react first to fluctuations in exchange rates and tourist flows. Based on an assessment of the impact of the COVID-19 pandemic on cross-border flows and the tourism industry at the Russian–Chinese borderland, it was concluded that an earlier reorientation towards domestic tourists (after 2014) allowed Heihe and Fuyuan to be more prepared for the next external shock. The tourism industry in Blagoveshchensk and Khabarovsk suffered significant losses and found itself in a situation of high uncertainty, in which it was impossible to predict the timing of resumed arrivals of Chinese tourists.

Background. According to current epidemiological studies, 94.9% of women suffering from sexually transmitted infections are diagnosed with the presence of human papillomavirus (HPV) DNA during the examination. Aims. The aim of the study was to study the effect of combined exposure to blue monochromatic polarized incoherent light and polychromatic visible and infrared polarized light in combination with imihimod 5% cream for external use on the state of systemic immunity in patients with HPV-associated cervicitis. Materials and methods. The study included 60 patients aged 2035 years with an HPV-associated cervicitis with a history of at least 1 year, who were randomly divided into 3 groups: in the main group (n=20), course effects of blue monochromatic polarized incoherent light on the projection of the carotid arteries and polychromatic visible and infrared polarized light on the cervix in combination with imihimod 5% cream for external use (complex 1); in the comparison group (n=20) exposure to polychromatic visible and infrared polarized light on the cervix in combination with imihimod cream for external use 5% (complex 2); in the control group (n=20) a course of local exposure to the cervix with imihimod cream 5%. The data of the survey of 20 healthy women of the same age were taken as the values of the norm. The state of systemic immunity in patients with HPV-associated cervicitis before treatment and after the course was evaluated by the indicators of mature T-lymphocytes (CD3+), CD4+, CD8+, immunoregulatory index (IRI = CD4+/CD8+), CD16+ (natural killer cells) and CD20+ (B-mature lymphocytes) in peripheral blood. Results. Before the start of treatment, the patients showed low levels of CD3+-lymphocytes and a decrease in the immunoregulatory index, which is the ratio of CD4+/CD8+ against the background of an increase in the relative content of CD16+ and CD20+, which indicates an imbalance in the cellular immunity. After the course of treatment, the most pronounced results were obtained under the influence of complex 1: a significant increase in the relative content of CD3+ and normalization of IRI against the background of a decrease to the reference values of the initially elevated levels of CD16 (%) and CD20 (%) in both the percentage and absolute ratio of these populations in peripheral blood. Patients treated with complex 2 also showed a positive, but less pronounced, trend towards an increase in CD3+ and IRI and a decrease in elevated CD16+ levels after the course of treatment. In the control group, there was no statistically significant difference between the indicators before and after treatment, and only a slight positive trend was observed for some of them. Conclusion. The combined use of blue monochromatic polarized incoherent light on the projection of the carotid arteries in combination with polychromatic visible and infrared polarized light and imihimod 5% cream for external use on the cervix in patients with chronic cervicitis associated with papillomavirus infection, to a greater extent than the local use of polarized light in combination with imihimod 5%, has a pronounced immunocorrective effect on the cellular link of immunity.

Modern methods of assessment of efficiency of functioning of the industrial enterprises are directed to a possibility of carrying out the factorial analysis of the generalizing efficiency indicator as which the indicator of profitability of equity on the basis of multiplefactor model of Dupont is widely used. Production infrastructure is the important component of the modern industrial enterprise providing and supporting conditions of its normal functioning and sustainable development. In article the analysis of private indicators is carried out, the generalizing indicator of efficiency of functioning of infrastructure division and the infrastructure complex of the enterprise in general is offered and reasonable. Examples of application of the offered technique in relation to infrastructure of the mining enterprise are presented. The factorial analysis of the generalizing indicator of efficiency of functioning of infrastructure divisions will allow to reveal the existing problems which solution will allow to provide sustainable development of production and economic systems of the mining enterprise.

Relevance. Peripheral T-cell lymphomas (PTCL) comprise a heterogeneous group of aggressive lymphoproliferative malignancies that account for approximately 10% of adult non-Hodgkins lymphomas. Despite the variety of PTCL subtypes, CHOP-like regimens are the standard first-line therapy in most cases. At the same time, the level of complete remissions at the using these schemes is about 39%, the 2-year event-free survival rate does not exceed 45%. The possibilities of subsequent therapy of patients are very limited: the median overall survival after relapse is only 6.5 months. The most significant results were obtained only in patients with relapses of anaplastic large cell lymphoma after the use of the targeted drug brentuximab vedotin BV (conjugate of a CD30-directed monoclonal antibody and an antitumor agent). Given the favorable safety profile of this drug, a phase 3, double-blind, randomized study (ECHELON-2) was initiated and conducted comparing the efficacy and safety of the combination of BV with CHP (cyclophosphamide, doxorubicin, prednisolone) (BV+CHP) and standard CHOP regimen in previously untreated patients with CD30-positive PTCL. Aim. Discuss the entire spectrum of unmet medical needs in the treatment of patients with PTCL and adapt existing approaches taking into account new therapeutic options (results of the protocol ECHELON-2). Results. The advantages of the BV+CHP regimen in the treatment of previously untreated patients with CD30-positive PTCL were recognized as convincing. Given the lack of real therapeutic options, it is recommended to register in Russia a broad indication for BV: treatment of previously untreated CD30-expressing peripheral T-cell lymphomas (in combination with CHP). It was considered expedient to include the BV+CHP regimen in the updated Clinical Guidelines for the Treatment of Lymphoproliferative Diseases.

Building a music recommender systems is one of information retrieval tasks. This research is devoted to a content- based music recommender system. The main peculiarity of our work is that the developed recommendation system is based on the acoustic similarity of musical compositions. Two approaches of building a content-based music recommender system are considered in this paper. The first is a quite common approach that uses acoustic features analysis. The second approach includes deep learning and computer vision methods application in order to improve the results of the recommender system.

Histological and morphometric studies of brain autopsy material showed that the development of hypoxic changes in miners starts at the early stages of working in the dusty atmosphere. Edema of the pericellular and perivascular zones and the pia mater, degenerative changes in some nerve cells and even their loss and formation of gliosis foci were identified. The revealed changes in neurons progressed with increasing the duration of working under hazardous conditions.

The aim of this study was to describe the immunophenotype of leukemic cells in acute myeloid leukemia (AML) with inv(16) (p13.1q22)/CBFb-MYH11 and t(16;16)(p13.1;q22)/CBFb-MYH11 in children. This study is supported by the Independent Ethics Committee and approved by the Academic Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. We investigated bone marrow samples from 36 pediatric patients with initially diagnosed AML with inv(16)(p13.1q22)/t(16;16)(p13.1;q22)/CBFb-MYH11. Immunophenotypic profile of leukemic cells was very heterogeneous: cells expressed antigens of early stages of differentiation (CD34, CD117, CD123) as well as markers of mature monocytes (CD11c, CD14, CD64) and neutrophils (CD65, CD15). Moreover, in 55.6% of cases lymphoid coexpressions were noticed (CD2 – the most frequent one). Furthermore, in 83.3% of cases we detected the separation of leukemic cells population into two parts: more “immature” – myeloblastic, which expressed early markers of differentiation (CD34, CD117), and more “mature” part, expressing monocytic antigens (CD11b, CD14, CD33). There was no clear separation between these parts of population. Despite the immunophenotypic similarity between monocytic part of leukemic population and normal monocytes, in 87.5% of studied cases there were same lymphoid coexpressions on these cells as on leukemic myeloblasts. Moreover, we showed that levels of CBFb-MYH11 expression in leukemic monocytes and myeloblasts were comparable. Presence of these characteristics in monocytes allows to consider them as part of leukemic cells population and take into consideration during the total immunophenotype reporting.

Introduction. The systemic violation of the body's homeostasis under the conditions of the negative impact of production factors scientists determine by the mismatch of neurohumoral mechanisms of regulation of metabolic processes. There are endocrinopathies. They occur with disorganization of the metabolism and violation of the thyroid gland's functional activity with disorganization of the metabolism, infringement of the thyroid gland's available action. The study aimed to learn the nature of endocrine dysfunction, histological changes of the thyroid gland associated with the dynamics of chronic fluoride intoxication of the body. Materials and methods. We analyzed the state of bone tissue and assessed the degree of articular syndrome during the large-scale structural reconstruction of the skeleton in aluminum production workers. The scientists examined the workers using double photon densitometry. The researchers studied the metabolic parameters based on a range of biochemical and instrumental methods. The experiment involved sexually mature male white laboratory rats with a bodyweight of up to 300 grams. We analyzed hormonal status disorders with an assessment of the degree of morphological changes in the thyroid gland. Results. The researchers analyzed the severity of disorders of individual endocrine mechanisms of homeostasis regulation and thyroid morph structure in hyperfluorosis. We treat fluorosis as a polyfunctional pathology. A high proportion of endocrinopathies is a clinical syndrome. It increases the pathological course of chronic fluoride intoxication in workers. We confirm the study with experimental data on metabolic disorders with a persistent toxic effect. We revealed hyperfunction of the thyroid gland against the background of a decrease in glucocorticoid activity, stable electrolyte, and mineral shifts. The researchers conducted an experiment on the late stages of fluoride intoxication. Conclusions. Clinical studies of individuals with chronic fluoride intoxication and concomitant endocrinopathy revealed a significant increase in the number of workers with abdominal obesity, musculoskeletal disorders, mineral metabolism disorders. Also, with deforming osteoarthritis of the joints, osteoalgia against the background of thyroid insufficiency. Experimental data confirm this. The fluorine accumulation in the body causes multidirectional disorders of the hormonal mechanisms of regulation of metabolic processes, alternation of hypo- and hyperfunction changes in the thyroid gland associated with fluoride duration intoxication. Ethics. We conducted a comprehensive study of aluminum workers in the central and auxiliary professions under the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases and the principles of conducting scientific and medical research with human participation (2013) in the hospital of the clinic of the Research Institute of Complex Problems of Hygiene with the informed consent of patients.

Introduction. The fundamental mechanisms of the body's pathological reaction to coal and dust exposure are hypoxia, excessive activation of free radical processes, structural and metabolic disorders in various organs. Organ-specific molecular defense mechanisms begin to function in the form of changes in the level of proteins with antihypoxic (HIF-3a), chaperone (HSP72), and antioxidant functions (HOx-1 — heme-oxygenase, Prx-1 — peroxiredoxin) under damaging effects. Its high level contributes to the restoration of cells' functional state or indicates significant damage in tissues. Hypoxia and free radical processes are known to lead to severe brain damage and behavioral disorders. To date, little is known about the expression of protective proteins and morphological changes in the brain under prolonged exposure to coal-rock dust on the body. The study aimed to learn the level of intracellular protective proteins HIF-3a, HSP72, HOx-1, Prx-1, and morphological changes in the brain in the dynamics of long-term dust exposure. Materials and methods. Sixty white male Wistar rats weighing 200-250 g of the same age took part in the experiment. Dust exposure was modeled by way of dynamic inhalation priming of rats with coal-rock dust (coal of a gas-fat brand) in an intermittent mode for 12 weeks. We perform morphological studies of the brain after 1, 3, 6, 9, and 12 weeks of dust exposure. The cytosolic fraction of brain tissue researchers determined the expression level of HIF-3a, HSP72, HOx-1, and Prx-1 by Western blot analysis. We selected the activity of free radical processes in the brain tissue. Results. Long-term exposure to coal-rock dust on the body at the morphological level in the brain revealed changes that indicate the development of hypoxia and activation of free radical processes: microvascular disorders, pericellular edema, severe dystrophic damage to neurons, focal loss of neurons, activation of glial cells. Activation of the protective proteins HIF-3a, HSP72, HOx-1, and Prx-1 in the early stages (1–3 weeks) of coal-dust exposure provided compensation for free radical processes in brain neurons. An increase in the duration of dust exposure of more than six weeks influences a low level of HSP72, but high HIF-3a and Prx-1, indicating an increase in hypoxic and free radical damage brain. Conclusions. The results obtained to expand the understanding of the morphological and molecular mechanisms that occur in the brain tissue during prolonged dust exposure to the body are essential for developing methods for organ-specific pharmacological correction. Ethics. We keep, fed and remove the animals from the experiment by the requirements of the guidelines of the Ministry of Health and Social Development of the Russian Federation "On Approval of the Rules of Laboratory Practice" (No. 199n of 01.04.2016), as well as the Guide for the Care and Use of Laboratory Animals (Guide for the Care and Use of Laboratory Animals, 1996). The study was approved by the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases (Protocol No. 2 of October 25, 2018).

This review focuses on the causes and consequences of nutritional deficiencies in the pregnant woman’s diet, as well as on the possibilities of its supplementation. It has been shown that inadequate intake of vitamins and minerals during pregnancy is accompanied by a lack of nutrient supply to the fetus, which can cause growth retardation, low birth weight and other obstetric and perinatal complications.According to the analysed guidelines and recommendations, the body’s need for vitamins and minerals increases at least twice as much during pregnancy. Adverse effects of the environment, a number of gastrointestinal and liver diseases, chronic diseases, antibiotic therapy, etc. increase this need.However, adequate nutritional support of the fetus is the result of several steps. These include the frequency of maternal food intake, the availability of nutrients in the food and the ability of the placenta to transport substrates effectively to the fetus.The most recommended vitamin for consumption in pregnancy is folic acid, alone or in combination with other B vitamins, as its deficiency leads to birth defects in the child.The authors of this review have reviewed a number of large studies conducted over the past decade that recommend iron and folic acid for pregnant women, regardless of dietary intake, as they have proven beneficial effects on the course and outcome of pregnancy. Folic acid, according to current recommendations, must be prescribed to every pregnant woman in the form of 400 mcg tablets daily regardless of her diet. Other most important and necessary vitamins for pregnant women are: vitamins A, C, D, E, K, B1, B2, B6, B12, PP, pantothenic acid, biotin.

Blinatumomab with subsequent haematopoietic stem cell transplantation was applied in 13 infants with acute lymphoblastic leukaemia (ALL). Eight patients were treated in first remission due to slow clearance of minimal residual disease (MRD); one for MRD-reappearance after long MRD negativity, one for primary refractory disease and three during relapse treatment. In slow MRD responders, complete MRD response was achieved prior to transplantation, with an 18-month event-free survival of 75%. In contrast, only one of five patients with relapsed/refractory ALL is still in complete remission. These data provide a basis for future studies of immunotherapy in very high-risk infant ALL.

This article describes such modern formats of literary and graphic genres as manga and comics (including ranobe, manhwa, and manhua). Graphic novels are currently relevant all over the world, especially among young people. Graphic novels of this type are actively promoted in the mass media and pop culture. These picture books received the attention and adaptation not only of small film studios and book publishers, but also of the cinematic giant – Hollywood. Due to the interest of the younger generation in the format of comics, this genre can be used to promote ethnocultural traditions in the education and education of the younger generation with an orientation on the national characteristics of the country and the values ​ ​ of Kazakh art and culture. Such an axiological dialogue of the culture of near and far ethnic systems will certainly contribute to the development of interest in national heritage, since the conversation will be conducted in an accessible language of images and in the original presentation using modern graphic formats and genres.

The article presents information on the current state of keratobioimplants production and clinical use in Ukraine. Thanks to the cooperation of the State Enterprise Bioimplant of the Ministry of Health of Ukraine with 13 ophthalmological institutions, keratobioimplants have been successfully used to treat corneal diseases since 2014. Over 7 years the enterprise has manufactured and provided for treatment 1799 keratobioimplants from the donor cornea of the human eye for various types of keratoplasty.The donors were analyzed by age, infection level, optimal timing of keratolimbal discs retrieval as well as morphometric parameters of endothelial cells.Long-term clinical outcomes demonstrate high quality of engraftment and steady increase in visual acuity in patients after penetrating keratoplasty. In 99.4% of the patients undergoing curative keratoplasty, the inflammatory process was stopped, the destruction of the cornea was stopped, and the eyes were preserved for further surgical ophthalmological interventions.

The aim of this work was to determine the values of plaque accumulation indices and oral hygiene indices, to conduct a comparative assessment before the start of multimodality therapy in patients with mild and moderate parodontitis and after its completion among the adult population of the Chuvash Republic. The study of index evaluation values of 146 patients aged 33–62 years with a diagnosis "chronic generalized parodontitis of mild and moderate severity" was conducted. The age range was determined by the criteria for dividing the age groups according to WHO data – early adult (25–35 years), middle adult (36–45 years), late adult (46-60 years). The examination was carried out according to standard clinical methods of simplified oral hygiene index OHI-s (according to Green – Vermillion), dental plaque hygiene index (PI) Silness-Loe (1964), evaluation of the state of periodontal tissues PI (by Russel). The authors present the criteria for evaluating the indices before the start of standard treatment and after its completion for all the studied patients and in groups with mild and moderate severity of chronic generalized parodontitis. The authors give as well a comparative analysis of the patients’ index assessment depending on the severity of the disease, the dynamics of the infection resolution in groups with different degrees of of parodontitis severity.