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Sulfonylureas are widely prescribed all over the world, mainly because of their high effectiveness. At the same time, the heterogeneity of the group is obvious, primarily in relation to the effect of drugs on the risk of developing hypoglycemic events. The review presents the results of new studies, including «Comparative effectiveness of gliclazide modified release versus sitagliptin as second-line treatment after metformin monotherapy in patients with uncontrolled type 2 diabetes» and results of a model-based meta-analysis of 24 antihyperglycemic drugs for type 2 diabetes, confirming the higher efficacy of modified release gliclazide (gliclazide MB) compared to DPP-4, as well as a low risk of hypoglycemic conditions. The results of recent studies, as well as the results of the ADVANCE and ADVANCE-ON studies, suggest that gliclazide MB is safe to use as a second-line drug, especially in patients with chronic kidney disease.

Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in highly developed countries. The risk of developing NAFLD and associated complications varies greatly among people of different nationalities and is determined by environmental and genetic factors. Genome-wide studies have revealed strong and reproducible associations between gene variations such as PNPLA3, TM6SF2, MBOAT7, GCKR, HSD17B1, and NAFLD. In this article, we consider the influence of genes and environmental factors on the pathophysiological features of NAFLD. The use of a sufficient population sample with the analysis of SNP arrays and the use of sequencing methods (exome and genome as a whole) will lead to the discovery of additional genetic variants, will inevitably improve the understanding of the pathogenesis of NAFLD, and will allow the development of a technology for personalized risk in assessing the disease in a patient. The aim of our study was to study the genetic predictors of NAFLD based on literature data with the interpretation of the studies. There is now strong evidence that specific variants of genetic risk have a large effect on NAFLD, and their effect is comparable to that of major metabolic risk factors such as obesity and type 2 diabetes. The increased risk extends to the onset and progression of the entire spectrum of NAFLD manifestations, including overall mortality due to liver disease. Currently, individual genetic variants do not allow the creation of a personalized risk profile; therefore, the most expedient approach today is the development of polygenic risk assessments. The number of genetic loci associated with the prevalence and outcome of NAFLD remains limited. The use of a sufficient population sample with the analysis of SNP arrays and the use of sequencing methods (exome and genome as a whole) will lead to the discovery of additional genetic variants and will inevitably improve the understanding of the pathogenesis of NAFLD and will allow the development of a technology for personalized risk in the assessment of the disease.

Aim. To study the content of cytokines in the blood serum of patients with obstructive jaundice of gallstone origin before and after surgical treatment, depending on the development of postoperative complications.Materials and methods. The treatment group consisted of 70 patients with the diagnosis of obstructive jaundice of gallstone origin, verified following a comprehensive clinical and instrumental examination. In 54 patients, the postoperative period was uncomplicated, and in 16 patients, various infectious complications in the postoperative period were revealed. The control group consisted of 125 healthy volunteers. The concentration of six cytokines (interleukin (IL)-2, IL-4, IL-18, IL-10, tumor necrosis factor alpha (TNFα), and interferon gamma (INF γ)) was determined using reagent kits manufactured by Vector-Best LLC (Novosibirsk, Russian Federation) by enzyme-linked immunosorbent assay on the Thermo Scientific analyzer (BioMerieux, France).Results. We identified significantly high concentrations of proinflammatory cytokines in the blood serum of patients with obstructive jaundice of gallstone origin upon admission, compared with the data obtained in the study of blood serum in the control group and in patients with obstructive jaundice after surgery. In the postoperative period in patients with obstructive jaundice without complications, the proinflammatory cytokines are significantly reduced and IL-4 is increased, whereas with the development of infectious complications, the level of proinflammatory cytokines is significantly elevated.Conclusion. In the pathogenesis of obstructive jaundice, a local inflammatory process plays an essential role. This is confirmed by statistically significant changes in the studied cytokines. The established increase in the concentration of IL-4, which has anti-inflammatory activity, indicates its importance in the mechanisms underlying the absence of infectious complications in the postoperative period of obstructive jaundice of gallstone origin. The revealed increase in the levels of IL-18, TNFα, and INFγ in the blood serum of patients suggests their role in the pathogenesis of infectious complications in the postoperative period of obstructive jaundice of gallstone origin.

Introduction. The article presents an analysis of researches on the operation of public transport vehicles with an electric drive. Electric buses have been tested in megacities, and despite the advantages, problems were identi- fied both in the selection of the charging type, technological features and with the availability and operation of the charging infrastructure. The operation process is associated with a number of technical restrictions, which in prac- tice make it difficult to select routes for the electric bus operation. The aim of the study is to develop an algorithm for selecting a rational regular urban route for the electric bus operation and to test it on the example of the route network of Tyumen.Materials and methods. A structural diagram of the factors influencing the selection of the route for the electric bus operation has been formed. As a result of processing expert assessments, the most significant factors were identified. The diagram of the interconnections of these factors is identified and limitations for the algorithm are for- mulated based on the theory of systems analysis. The algorithm for selecting the rational regular urban route for the electric bus operation has been developed. It enables creating the simulation model for selecting a rational regular urban route for the operation of an electric bus.Results. The diagram of factors influencing the selection of a rational regular urban route for the operation of an electric bus, taking into account their mutual relations, has been formed. The algorithm and simulation model for se- lecting a rational regular urban route for the operation of an electric bus has been developed. Several urban routes in Tyumen were assessed for the rationality of the introduction of electric buses.Discussion and conclusions. Evaluation of five regular urban routes in Tyumen using the developed algorithm and the simulation model revealed three rational routes, and also showed the inefficiency of the other two. It due to the discrepancy between the duration of the charging session and breaks in operation, as well as the insufficient charge level of the traction battery to ensure the required autonomous movement of the vehicle. In the course of the continuation of these studies, the developed algorithm will be supplemented with the stage of economic assess- ment of routes for the operation of electric buses.

Aim. A study of monocyte chemiluminescent activity at variant stages of gastric cancer.Materials and methods. The study enrolled 90 gastric cancer patients and 70 healthy donors. Spontaneous and induced chemiluminescence in monocytes was assessed for 90 min with a “BLM 3607” 36-channel chemiluminescence analyser (Russia). Opsonized zymosan-induced chemiluminescence enhancement was measured as a ratio of the areas under the induced vs. spontaneous chemiluminescence curves, the activation index. Statistical significance was estimated with the Mann—Whitney criterion (p < 0.05).Results. The maximal spontaneous monocyte chemiluminescence intensity significantly decreased in stage IV gastric cancer patients compared to the control cohort (p = 0.035). Time to maximum in spontaneous chemiluminescence increased in all gastric cancer patients vs. control (p = 0.001), and in stage IV gastric cancer vs. stage I patients (p = 0.043). The areas under a curve in spontaneous and induced monocyte chemiluminescence increased in all gastric cancer patients vs. control (p = 0.001), and in stage IV gastric cancer vs. stage I patients (p = 0.037). The activation index was higher in all gastric cancer cases compared to control (p = 0.001).Conclusion. All patients with gastric adenocarcinoma, irrespective of the stage, revealed changes in the monocyte chemiluminescence activity, i.e. a longer time to maximum in spontaneous chemiluminescence and larger area under the curve of spontaneous and induced chemiluminescence, the activation index. Maximal monocyte spontaneous chemiluminescence intensity diminished in stage IV gastric cancer compared to the control cohort. Immune activity reflected in monocyte chemiluminescence correlates with the stage of gastric adenocarcinoma.

In recent years, studies into the processes of bed agglomeration during the combustion of biomass have become increasingly relevant. The agglomeration processes are most largely influenced by the alkaline components of ash, which form low-melting eutectics by reacting with silicates. Therefore, it is very important to determine the critical concentration, primarily, of potassium that forms the most low-melting eutectics in the bed, at which the particles begin to sinter. The experimental studies are aimed at to investigate the effect of the temperature and the concentrations of alkaline elements on the process of particle agglomeration during the combustion of various types of biomass as well as biomass and coal, studying the presence of bed drain, determining the critical concentration of potassium in the bed, and calculating the estimated time before the start of sintering under conditions of an increase of potassium concentration in the bed. The experimental techniques and characteristics of the four studied types of biomass are described. Data on the fraction of agglomerated particles in the bed at different temperatures and concentrations of alkaline elements are given. Upon replacing a part of the sand by iron oxides, agglomeration is observed only at high temperatures (850°C and more). The obtained data are compared with the results of similar experiments carried out under conditions of the fluidized bed; in these experiments, the effects of the fluidization rate, particle size, and excess air on the agglomeration processes are considered. It is noted that the limiting potassium concentration is lowest in the case of a fixed bed. It is shown that real objects should be used when studying the dependence of the behavior of the potassium concentration in the bed on the operation time. The choice of the fraction of bed drain with the addition of a screened material or fresh sand is of practical interest. The calculation techniques and calculated data obtained with use of them on the behavior of the potassium concentration in the bed under various conditions are presented. The fractions of bed drain during combustion of sunflower husks and bark and wood waste are determined. In addition, it is shown that the joint combustion of husks and coal sharply reduces the probability of bed agglomeration.

The aim of the work is to increase the effectiveness of physical therapy of gross motor functions impairments in children with spastic cerebral palsy by using a therapeutic exercises program with partial body weight supporting and motivated walking on the device for the rehabilitation of people with impaired functions of the musculoskeletal system. The study included 30 children 6 to 11 years old with a spastic form of cerebral palsy. All patients were divided into 2 groups: in group I, in addition to the standard complex of physical therapy, walking according to the dynamic method was prescribed, in group II – according to the static method with partial body weight supporting. The duration of the program was 6 weeks. The survey was carried out before the start, at 2, 4 and 6 weeks of therapy. We studied the spatiotemporal characteristics of walking and activity of daily living indicators. The use of the developed program with the rehabilitation device positively influenced the spatiotemporal indicators of walking in both groups. The stride length, walking speed and the length of the covered distance increased statistically significantly. A significant increase in the volume of performed activities of daily living in the I group was found. At the same time, an increase in this indicator was also observed in group II, but it did not reach statistical significance. The use of the developed program of therapeutic exercises, including walking with motivated movement and partial body weight supporting on the developed rehabilitation device positively influenced the static and dynamic characteristics of walking, which improved the performance of activities important for children with cerebral palsy, especially walking and running. The optimal time for increasing the stride length is a 4-week program, for the development of general endurance and speed – a 6-week program of therapeutic training.

Chronic atrophic gastritis and gastric cancer represent distinct steps of one pathogenic process. The risk of developing cancer of the stomach is directly proportional to the degree of atrophic changes simultaneously detected in antral segment and in the body of the stomach. The role of immune system in transformation of precancerous diseases into cancer is beyond doubt. During development of the malignant disease, the changes in lipid peroxidation systems – antioxidant defense become significant and contribute to the progression of the tumor and the development of metastases. A simultaneous study of lipid peroxidation and antioxidant defense indices along with phagocytic activity will allow us to evaluate relative contribution of these processes to development of chronic atrophic gastritis and gastric cancer. Purpose of the present study was to assess correlations between the lipid peroxidation indices, i.e. antioxidant protection, and chemiluminescent activity of neutrophilic granulocytes and monocytes in chronic atrophic gastritis and gastric cancer. Forty patients with chronic gastritis, 22 patients with chronic atrophic gastritis and 40 patients with gastric cancer were examined. The control group consisted of 50 practically healthy age-matched volunteers. Evaluation of spontaneous and induced production of reactive oxygen species by neutrophils and monocytes was carried out by chemiluminescent analysis. The parameters of lipid peroxidation/ antioxidant protection were determined by spectrophotometric methods. Statistical data processing was carried out using the Statistica v. 8.0 program (StatSoft Inc., USA). The normal distribution of indices was tested using the Kolmogorov–Smirnov method (adjusted by Lillefors). Quantitative indicators, given the normal distribution, were described using the median (Me) and interquartile scatter (Q0.25-Q0.75). To study statistical significance of differences between quantitative characteristics, the Mann–Whitney test was used. To study strength of relationships of these indicators, the Pearson rank correlation coefficient (r) was calculated. The critical significance level (p) when testing statistical hypotheses was taken equal to 0.05. Correlation analysis showed that the weight of positive correlations increases in patients with chronic atrophic gastritis, and it decreases in patients with gastric cancer, the strength of the correlation dependence and new relationships appear between chemiluminescent activity of neutrophils and monocytes in a spontaneous and induced state, and the amounts of malonic dialdehyde, enzyme activities of superoxide dismutase and catalase. In chronic atrophic gastritis and gastric cancer we have established the features of correlation patterns between lipid peroxidation/antioxidant protection indices, and activity of neutrophils and monocytes.

Purpose: this article is devoted to the study of issues and the creation of proposals for the formation of a model of indicative planning in the Russian Federation.Methods: the study is based on system analysis methodology. Program and strategic documents of the Russian Federation and modern scientific publications on the topic of research were used as materials for the work.Results: the author analyzed modern ideas about indicative planning and identified the problems of the lack of a systematic scientific and methodological approach in this area. Modern scientific literature does not have a single opinion on the theoretical and methodological provisions of indicative planning. Based on the analysis of foreign experience and Russian practice, the author presented proposals on the role and place of indicative planning in the system of strategic planning and project management documents in order to achieve the established development and security goals. On this basis, proposals are formulated for the formation of a domestic model of indicative planning. It was noted that the popular tools for implementing coherence, monitoring and adjusting goals through digitalization of strategic documents are part of indicative planning.Conclusions and Relevance: The approach to indicative planning is recommended as a process for the formation of a system of indicators (indicators) and the development of measures of state impact on economic processes based on indicators. In this regard, indicative planning should be considered as a combination: 1) the system of goals and objectives described by the corresponding indicators (indicators), 2) the system of measures aimed at achieving these indicators. This measure system also includes an indicative planning tool.As a toolkit, an approach is proposed that determines the conjugation of the two indicated blocks of indicative planning:architecture, which includes rules for building the system and structured on the basis of goals, objectives, indicators;tools that include balance calculations and mathematical modeling, as well as implementing on the basis of indicators the task of resource determination of goals for the development of a system of measures and management decisions.

Despite the fact that effects of thyroid hormones were noticed back in the 80s, the underlying molecular mechanisms have not yet been elucidated. Current review summarizes years of investigations upon molecular targets for the action of thyroid hormones, leading to changes in the electrical and mechanical activity of the heart; changes in hemodynamics, affecting the functioning of the heart muscle, are also touched.

Six years of the implementation of the Federal Law “On Strategic Planning in the Russian Federation” were focused on the development of documents and recommendations for them. This determined the fragmentation of public administration and strategic planning. However, according to the author, the basis of the strategic planning system that meets modern challenges and threats should not be documents, but processes. The introduction of new tools will allow the transition from project management and strategic planning to strategic management in the Russian Federation. Such tools include the introduction of management cycles of strategic planning, resource support for the realization of goals, the organization and implementation of the monitoring and control process, a system of continuous indicative planning and balance sheets.

The purpose of the study: is to establish the characteristics of the development of endogenous intoxication during experimental obstruction of the urinary tract. Materials and methods: to achieve this goal, one control and three experimental groups of animals were formed, in which blood was taken from the marginal ear vein on the 3rd, 7th, 14th and 21st day of the experiment. The following parameters were determined in blood serum: urea, creatinine, total protein and albumin. The level of endogenous intoxication was assessed by the indicators of medium-mass molecules, circulating immune complexes and malon dialdehyde. Results: statistical analysis of blood biochemical parameters and endogenous intoxication markers confirm the link between modern biomarkers of renal injury and morphological changes in the tissues of obstructive and compensatory organs. Conclusion: our findings point to the overstress adaptation mechanisms, the development of oxidative stress and exhibit a high level of endogenous intoxication, resulting in structural and metabolic changes in the affected and in the contralateral kidney.

Purpose: of the article is to prepare evidence-based proposals for the formation of document architecture, strategic planning, fundamental for modern needs and ensuring the integrity of the strategy for all levels of government and business, as well as to ensure the implementation of the principles of unity, integrity, continuity, continuity and delineation of powers in organizing and system functioning, strategic planning as part of a single management cycle. In the framework of the task of creating the architecture of documents, strategic planning also solves the important task of linking issues of socioeconomic development and ensuring national security, and as a result – improving the efficiency of public administration, ensuring coherence and coordination of the country's strategic priorities. Methods: the main method of work is the disclosure of the principles of strategic planning. The architecture of strategic planning documents under development is based on the disclosure of regulatory acts of the Federal Law dated 28.06.2014 N 172-FZ “On Strategic Planning in the Russian Federation”. Results: the absence of normatively fixed principles and a system for ensuring strategic planning, as well as the procedure for implementing strategic planning, leads to inconsistency of the approved strategies and forecasting, the development of new documents and studies in the Federal Law “On Strategic Planning in the Russian Federation” and other violations of the systematic approach. In this regard, it is necessary to determine the architecture of the system of strategic planning documents developed as part of the target definition, forecasting, planning and programming.Conclusions and Relevance: the architecture of strategic planning documents proposed in the article is based on the creation of a three-level document system with a central place in it the National Security Strategy of the Russian Federation as the main document of strategic goalsetting. In accordance with Federal Law N 172-FZ, the level of forecasting, target definition, planning and programming allows you to add a conceptual level that ensures the quality of the overall ideological superstructure, which should provide an idea of what kind of character for the state and its position in the world the strategic planning system should provide. Taking into account the task of minimizing amendments and clarifications to the Federal Law “On Strategic Planning in the Russian Federation”, the proposed changes are more in the nature of clarifying the provisions of this law. The architecture of the documents built in this way will allow implementing and, if necessary, further detailing the principles of strategic planning defined by law 172-FZ and, above all, the principles of continuity, balance of the strategic planning system.

The dynamics and structure of the occupational morbidity rate in main branches of the industry in the Eastern Siberia for the 2000-2015 (on the example of the Irkutsk region) is presented in this paper. During the observation period there were noted the significant gain in the number of cases of occupational diseases registered in such different branches of industry as Coal and Lignite Mining, ship and aircraft building, and in some other branches (metallurgical production, air transport, pulp production, electric power distribution industry). In the structure of the occupational morbidity leading positions are occupied by diseases associated with the exposure to physical factors, industrial aerosols, physical overload and overexertion of certain organs and systems. The main reasons and factors contributing to the gain of the occupational morbidity rate are the imperfection of technological processes, working places, personal protective equipment and/or their lack, constructive defects of machines and equipment, the violation of safety regulations, regimen of the work and rest, insufficiently high level of medical and preventive maintenance, delayed making of decisions for the rational employment to the workers with the revealed early forms of occupational diseases. There pointed out priority directions of the prevention the implementation of which will allow to decline the level of the occupational morbidity rate. The main directions are the implementation of economically caused mechanisms of the interest in the preservation of workers ’ health; implementation of the regional aimed programs; the introduction of new processes, equipment and mechanisms meeting modern hygienic requirements; the assessment of occupational risk with the creation and implementation of the system of monitoring for the dynamics of working conditions and the state of the workers ’ health for the making corrective management solutions on the optimization and elevation of the efficacy and relevance of developed and implemented preventive health measures.

The article discusses the current principles of diagnostic radiology in theevaluation of suspected and verified cervical cancer (CC). Possibilities of magnetic resonance imaging in the primary diagnosis of the disease and effect evaluation of neoadjuvant treatment are described.Conditions and optimal MR-technique, as well asprinciples of data interpretation are discussed. The main prognostic factors for CC are consideredand, also, a brief review of treatment methods for various diseases stages is given.

Objective: comparative evaluation of treatment methods for neoadjuvant intra-arterial chemotherapy and chemoembolization by drug-saturated microspheres followed by surgical treatment in II–IVa stages cervical cancer.Materials and methods. This study presents the results of complex treatment in 209 patients (average age – 40.57 ± 8 years) with II– IVa stages cervical cancer and 384 endovascular interventions as the first stage of complex treatment in the period from 2010 to 2016. The scheme neoadjuvant intra-arterial chemotherapy was carboplatin (AUC6 intra-arterial) + irinotecan (200 mg/m2 intravenously on day 1) every 21 days. Radical surgical treatment was performed basically after 2 cycles of chemotherapy. Patients who did not respond sufficiently to neoadjuvant intra-arterial chemotherapy underwent a radical course of chemoradiation therapy according to the standard scheme.Results. The overall response to neoadjuvant intra-arterial chemotherapy was 84.8 % and 79 % of patients in groups of chemoinfusion and trans-arterial chemoembolization, respectively (p >0.05). Operability was higher in group of chemoinfusion (69 % versus 46.4 %) (p Conclusions. Neoadjuvant intra-arterial chemoinfusion and chemoembolization using irinotecan + carboplatin scheme are relatively safe treatment methods with acceptable toxicity and have a high cytotoxic effect. Patients in chemoinfusion group have a better prognosis compared with patients in chemoembolization group. Selective chemoembolization with subsequent surgical treatment or radiation therapy may be the treatment of choice for stage II cervical cancer complicated by bleeding.

Objective:to assess the efficacy of dose-intensive platinum-containing neoadjuvant chemotherapy in patients with FIGO stage IB2–IIB locally advanced cervical cancer.Materials and methods.We evaluated the efficacy and toxicity of 3 cycles of intravenous dose-intensive neoadjuvant chemotherapy with either AP regimen (cisplatin 75 mg/m2 and doxorubicin 35 mg/m2) or TP regimen (cisplatin 60 mg/m2 and paclitaxel 60 mg/m2).Results.The study included 105 patients (75 in the AP group and 30 in the TP group) aged between 27 and 63 years (mean age 44 years) with primary verified cervical cancer (T1–2B0–2Nx–0M0). Surgery was performed in 66 patients (88 %) from the AP group and 24 patients (80 %) from the TP group. Six patients (8 %) receiving AP regimen and 1 patient (3.3 %) receiving TP regimen developed disease progression. Four women (2.8 %) from the AP group developed relapses, whereas none of the patients from the TP group had relapses. Dose-intensive chemotherapy did not cause any significant complications at both chemotherapeutic and surgical stages. Our findings suggest that dose-intensive neoadjuvant chemotherapy is an effective method with an objective response rate of 84 % (63 cases) and 56.7 % (17 cases) in groups AP and TP respectively. Fifty-nine patients (78.7 %) receiving AP regimen had pathological response; of them, 7 participants (9.4 %) demonstrated pathological complete response (ypCR). In the TP group, 19 patients (63.3 %) had pathological response and 4 patients (13.4 %) had pathological complete response. Median follow-up time was 16.7 months (range: 3–29 months) in the AP group and 9.1 months (range: 2.8–12.7 months) in the TP group.Conclusion.Dose-intensive neoadjuvant chemotherapy can be considered as an alternative to standard treatment of locally advanced cervical cancer; however, further studies are needed due to the small sample size in this study.

The growth of capital investments in fixed assets requires an examination of the main problems of their accounting and reporting in the implementation of investment activities. From all forms of accounting (financial) reporting, indicators for investment activities are found in the statement of cash flow. When assessing the effectiveness of capital investments, interested users lack the information posted in the statements, they need indicators detailing the financial results obtained from capital investments in fixed assets, as well as the volume of output attributable to such objects. These calculations can be carried out only with additional internal information, which is not disclosed in the reports. The study considered the prospects for resolving these problems by state bodies and proposed options for improving accounting reporting to conduct an effective assessment of capital investments in order to ensure the financial security of the functioning of the economic entity. From the state, measures are being taken to resolve the problem of reflecting indicators for capital investments. A federal standard project has been developed. Major Russian economic entities are actively involved in the discussion and revision of the regulatory document project, taking into account its further practical application. Compilation of reports on committed capital investments is important, especially in capital-intensive organizations. Capital investments in non-fixed assets indicate not only an increase in the efficiency of the enterprise, but also a competent decision taken for production purposes, ensuring the financial security of the company's functioning in the future.

Colorectal cancer is one of the most common malignant diseases in Russia worldwide making up 5-6% of all human malignant tumors. Neutrophilic granulocytes are actively involved in development of antitumor response. A key role in tumor regression is assigned to active forms of oxygen produced by neutrophils. In connection with these pre-requisites, our goal was to study functional characteristics of spontaneous and induced chemiluminescent activity of neutrophil granulocytes in patients with rectal cancer before starting pathogenetic therapy and in subsequent dynamics. The paper presents some laboratory results, i.e., functional indices of neutrophilic granulocytes’ activity in 36 patients with rectal cancer being at different stages of oncological process. The control group consisted of 112 practically healthy volunteers, comparable in sex and age to the group of patients under study. To perform the study venous blood was taken from patients to vacuum test tubes with lithium heparin in the morning time before surgical treatment, and on day 7 after the surgical intervention. Evaluation of spontaneous and induced chemiluminescence was performed for 90 minutes in a 36-channel “CL 3606” chemiluminescence analyzer (Russia). The following characteristics were determined: time of the curve transition to maximal chemiluminescence intensity (Tmax), maximal value of chemiluminescence intensity (Imax), integral area under the chemiluminescence curve (S). Luminol was used as the chemiluminescence enhancer. Opsonized zymosan was used to induce the respiratory explosion. Chemiluminescence amplification induced by opsonized zymosan was evaluated by the ratio of induced-tospontaneous chemiluminescence (Sind/spont) designated as an activation index.Analysis of chemiluminescence activity in neutrophilic granulocytes showed a significant increase in spontaneous chemiluminescence activity at the stages III and IV of the disease. The production of active oxygen forms induced in neutrophilic granulocytes by opsonized zymosan increased in all the study groups, relative to control parameters. The area under the curves of spontaneous and induced chemiluminescence in patients with colorectal cancer at all stages of the oncological process is less, as compared to the control group, which, despite high indices of maximal chemiluminescence activity, may indicate insufficient total production of reactive oxygen species. The time-to-peak values of the chemiluminescence curves in patients with rectal cancer at all stages of the disease did not show statistically significant differences from the control group.

Ischemic stroke is still leading in terms of primary disability caused by residual neurologic de-fect in the majority of patients. Persistent motor disorders are observed even after timely and ade-quately carried out rehabilitation measures. The article discusses the possibilities of modern instru-mental technologies for diagnostics and further monitoring of the process of restoration of post-stroke deficit, which is based on the phenomenon of neuroplasticity.

The article reveals the experience of the Southern Federal University Scientific Library in accompanying the scientific and publishing activities of the university. The methods of conducting main library services are described, including that of the following areas: full-text databases access provision and user councelling, publication activity monitoring of the university and its subdivisions, identification of scientific publications in international citation bases. The experience of councelling university staff in forming a strategy of research results publication is given.

A new numerical method for finding roots of the characteristic equation in problems of radio wave propagation in tropospheric ducts with a piecewise linear profile of the refractive index is proposed. For the selected model of the vertical profile of the refractive index of an surface duct, dynamics of propagation constants of modes and features of the behavior of the attenuation function of the electromagnetic field as functions of the troposphere parameters and the wavelength are studied. The contribution of the whispering gallery modes is also estimated.

At present, organic materials modified by the laser irradiation are frequently used for the development and production of optical elements. Poly(methyl methacrylate) (PMMA) is one of the polymer materials which are most widely used in optics and optoelectronics. A broad transparency window and the ease of industrial processing are the main advantages of PMMA. Laser modification of PMMA allows creating color centers with radiation in a wide spectral range.

Mechanical jaundice (MJ) of malignant genesis is a clinical syndrome caused by obturation of bile ducts due to malignant tumor growth. It is characterized by specific pigmentation of skin, mucous membranes and sclerae due to increased accumulation of bilirubin in blood serum and other fluids and tissues of the organism. Various immune disorders are detected in patients with mechanical jaundice. Immune reactivity in mechanical jaundice is affected by toxic, infectious, or tumor factors. In connection with these findings, the aim of our study was to measure levels of some pro-inflammatory (IL-2, IL-18, TNFα, IFNγ) and antiinflammatory (IL-4 IL-10) cytokines in patients with malignant disease, depending on serum bilirubin levels. The study included 50 patients with MJ by malignant origin. A control group consisted of 125 practically healthy volunteers comparable with the study group by sex and age. Blood serum cytokine contents in patients and controls was determined by enzyme immunoassay using reagent kits produced by ZAO Vector-Best. Statistical evaluation of data was carried out by means of Statistica for Windows 8.0 and Microsoft Excel software. The levels of IL-2, TNFα, IFNγ and IL-18 were increased before surgery in the patients with mechanical jaundice of malignant genesis, while IL-4 and IL-10 values were reduced in comparison with healthy controls. Altered cytokine regulation in the MJ group manifests as increase in proinflammatory and immunostimulatory cytokine levels, along with decrease in anti-inflammatory cytokine amounts. Predominant feature of immune response may be regarded as prevalence of Th1-immune response when taking into account cytokine levels in blood serum of patients with MJ of malignant genesis. The features of cytokine regulation of patients with malignant MJ depend on the bilirubin content in blood serum. These changes were most frequent in patients with bilirubin level exceeding 60 μmol/L. In general, the quantitative indices of cytokines exhibited unidirectional changes in the groups of MJ patients with different bilirubin levels, except of IL-10. This parameter showed almost 6-fold increase in MJ patients with bilirubin level < 60 μmol/L against control group, and approximately 40 times with respect to the remaining 2 groups. This biological effect may occur due to malignant etiology of the MJ.

Insulin glargine, synthesized using recombinant DNA technology in a concentration of 100 U/ml, was the first once-daily longacting insulin analogue introduced into clinical practice in 2000. Glargin has a well-established record of efficacy and safety and is the most widely used insulin worldwide. In February 2015, the drug lost its US patent protection, which opened the door for biosimilar competitors.

Aim. To study the oxygen transport function in red blood cells and energy balance in patients suffering from epistaxis of various progress severities. In case of epistaxis a single blood loss is insignificant, yet in case of recurrent epistaxis there is a threat of a tissue hypoxia development. However no indicator blood values demanding transfusion therapy exist these days. This is a study of the blood oxygen transport function and energy balance in the red blood cells in those suffering from single epistaxis, recurrent moderate epistaxis and recurrent severe epistaxis. Materials and methods. In patients’ red blood cells a contents of 2.3-diphosphoglyceric acid (2.3-DFG) and hemoglobin oxygen affinity (Р50) were estimated; energy balance was assessed by the activity of glucose-6-phosphate-dehydrogenase (G-6-FDG), lactate-dehydrogenase (LDG), as well as by the lactate and pyruvate contents in the red blood cells and plasma. Tissue hypoxia severity was assessed by the lactate/pyruvate ratio in blood plasma. Results. It has been determined that in case of single epistaxis the studied parameters do not differ from normal ranges. In case of recurrent epistaxis the level of hemoglobin and P50 goes down, plasma LDG activity goes up, the pyruvate content goes down, while plasma lactate retains within the normal ranges. Conclusion. The stated changes in the carbohydrate metabolism in the red blood cells and blood plasma of patients suffering from severe recurrent epistaxis suggest a breakdown of compensatory mechanisms, which manifests itself in the reduced cell energy reserve and disturbed red blood cell membranes. The obtained data testify that the severity of the state of patients suffering from epistaxis is not only defined by a quantitative loss of red blood cells and hemoglobin, but also by the adaptive capacities of the body, which determine its resistance to hypoxia. The guide link in the pathogenesis of disturbed gas transport function of blood in patients suffering from epistaxis is metabolic acidosis developing as a consequence of tissue hypoxia.

Chronic gastritis is the most common disease of gastro-intestinal tract. Precancerous potential is among most important epidemiological features of chronic gastritis. Immune system plays a distinct role in transformation from precancerous state to malignancy. In this context, the aim of our work was a study of spontaneous and induced chemiluminescence activity of neutrophilic granulocytes in patients with chronic superficial gastritis, chronic atrophic gastritis and gastric cancer. The work presents results of comprehensive laboratory examination of patients with chronic gastritis (CG) (a total of 85 persons. 25 patients with chronic atrophic gastritis (CAG), and 50 patients with gastric cancer (GC) at the age of 19 to 70 years were enrolled. Control group included 115 healthy donors without gastrointestinal complaints at the age of 19 to 67 years. The study was performed with venous blood samples taken from cubital vein into Vacutainer tubes with sodium heparin (5 U/mL) prior to starting any pathogenic treatment. Evaluation of spontaneous and induced chemiluminescence was performed for 90 minutes at a 36-channel “CL 3606” chemiluminescence analyzer (Russia). In our study, patients with gastric cancer showed clear unidirectional changes in chemiluminescent activity of neutrophilic granulocytes (NG). When measuring spontaneous and induced NG chemiluminescence, we diagnosed a decreased phagocytic activity characterized by prolonged time-to-peak and area under the curve for spontaneous and induced CL, thus presuming longer activation time required in cases of reduced phagocytic function. The NG activity in patients with chronic gastritis is not impaired, but, similar changes of time-to-peak and area under were detected. Chemiluminescent activity of NG is increased in the group of CAG patients, and, considering similar changes in activation time and area under the curve, NG also produce greater amount of reactive oxygen species. Thus, for all H.pylori-associated diseases, the blood NG take longer time to activate, whereas their functional activity is not disturbed in CG, enhanced in CAG patients, and reduced in gastric cancer.

Textile auxiliaries of different chemical types were tried in fiber finishing application for polyester, woolen, and blended textile materials. All the tested chemicals were produced in the Russian Federation. Investigation covered the influence of the chemicals on the antistatic, frictional, and deformational properties and mechanical strength of the textile materials. The most effective products were selected, whose application in the fiber finishing process makes it possible to improve the physicochemical properties of textile materials: decrease the fiber‒metal dynamic friction coefficient by 15‒20%, increase the tensile strength of the fibers by 8‒10%, and increase the electric conductivity of the textile material.

Endometrial cancer (EC) is the third most common cancer. It comprises almost 10 % of all malignant tumors in women. Peak morbidity is observed at advanced age (62–64 years) and is associated with excess weight. At the time of diagnosis more than 70 % of patients have stage I disease and most of them have a concomitant pathology: diabetes, thrombosis, or hypertension. These patients require a low-trauma panhysterectomy which can be performed laparoscopically or laparotomically. Due to improvement of technological equipment in hospitals and development of surgical and anesthetic techniques, frequency of laparoscopic surgeries at large medical institutions is increasing. Comparative long-term results of oncological treatment allow to pose a problem of comfort in the postoperative period as a reason to prioritize laparoscopic access. In order to include the surgery into standard practice, it is beneficial to calculate economic costs for each type of surgical access. Objective. Evaluation of effective costs of panhysterectomy performed laparoscopically and laparotomically for treatment of early stage endometrial cancer. Materials and methods. We performed a retrospective analysis of medical histories of 170 patients with stage I EC who underwent panhysterectomy at the N. N. Petrov Research Institute of Oncology in 2010–2017. Calculations of direct medical costs took into account costs of surgery, drug therapy, treatment of complications, and in-patient care. Indirect costs were based on statistical data on salaries in 2016 and employment in the Russian Federation. Results. For laparoscopic panhysterectomy we observed significant decrease in intraoperative blood loss (82 %), number of drugs, rate of early postoperative complications (mostly associated with postoperative wound healing), and duration of postoperative rehabilitation characterized by short hospital stay and quick return to work. Cost component of the above-mentioned trends amounts to decrease in cost value of 4,000–5,000 rubles for every patient. Conclusions. In long-term perspective, initial investments into high-tech minimally invasive techniques lead to economic benefits due to decrease in costs of in-patient care and treatment of postoperative complications and quick rehabilitation. At the same time, at early stages of EC laparoscopic surgeries don’t affect oncological prognosis for these patients.

A review of literature dedicated to the creation and development of concepts of the potential vegetation and ecosystem cover has been performed. The developmental stages of these concepts are presented in relation to changes in paradigms and the development of historical ecology as a science, allowing an estimation of the depth, intensity, and transformation mechanisms of the natural ecosystem cover. The modern synecological concepts of the structural–functional organization and dynamics of ecosystems have been integrated into a system enabling further development of the concepts of the potential vegetation and potential ecosystem cover at the current level of knowledge. The first results of model reconstructions of the potential forest cover in the European part of Russia have been summarized. The prospects for further development of the concept of potential ecosystem cover are outlined. They are essential for the accomplishment of theoretical and practical conservation objectives.

Aim. To study changes in the indices of prooxidant and antioxidant systems in plasma in men with atrophic gastritis and gastric cancer. Materials and methods. The study included 60 healthy men, 42 patients with atrophic gastritis and 50 men, nicardipine patients with gastric cancer stage II according to TNM. All patients underwent serological diagnosis of diffuse atrophic gastritis (definition of pepsinogens and gastrin-17) and Helicobacter pylori infection. The diagnosis of "atrophic gastritis" was verified by morphological examination of biopsy specimens obtained during fibroesophagogastroduodenoscopy. Diagnosis of gastric cancer was carried out in the Krasnoyarsk regional oncologic dispensary on the basis of a comprehensive instrumental and morphological examination. All patients spectrophotometric methods in plasma was determined the content of diene conjugates (DC), malonic dialdehyde (MDA), glutathione-S-transferase (GST), glutathione peroxidase (GPO), superoxide dismutase (SOD) and catalase. Results. The concentration of SOD, GST, GPO and catalase had no significant differences in patients with atrophic gastritis and gastric cancer and prevailed in comparison with healthy persons. Patients with cancer of the stomach content in the blood plasma DK 2.7 times and MDA at 35.2 times higher than healthy individuals, indicating severe oxidative stress in patients with cancer. In patients with atrophic gastritis was observed similar but less pronounced pattern. Conclusion. The results indicate the presence of oxidative stress in men with atrophic gastritis and gastric cancer.

The article shows the features of the use of information technology in the medicine. In the modern world, computer technology is an integral part of a medicine. With the help of information technologies, the doctor is able to visualize information at various stages of work, create and maintain a data bank associated with various information medical systems, and have access to expert systems for making a diagnosis. With the support of 3D modeling, 3D scanning and 3D printing, it has become permissible to form medical products that are extremely adapted to the individual characteristics of the person. This article discusses the positive aspects of the introduction of information technologies in medicine and the problems that hinder their implementation, at the same time, some ideas are proposed that are necessary to improve the quality of healthcare.

Transport safety assessment plays a huge role in theory and practice of implementation of transport management systems. It should be noted that ensuring the transport safety is inextricably linked to identification of potentially dangerous transport situations and their risk assessment. To better manage transport risks we propose to apply a new integrated approach which allows to take into account the source of the threat, the degree of objects’ protection, kinds of threats, extent of damage in the event of dangerous situations, magnitude of the dangerous situation. This approach is anchored to systematic analysis of causes and conditions of formation of dangerous situations. Also, it provides timely forecasting of their development and consequences. Therefore, it is necessary to develop a new approach to transport risk assessment which will be able to effectively evaluate occurrence of dangerous transport situations. In this paper we present components of transport safety and provide a list of typical objects of transport infrastructure. Transport safety model and algorithm for identification of potentially dangerous transport situation is proposed. Also, we consider a new integrated approach based on transport risk assessment method. It is worth highlighting that the proposed method of transport risk assessment allows taking into consideration the uncertainty linked to the occurrence of dangerous transport situations and their conditions. The specified method can be widely used in modern geographic information systems for analysis of transport emergencies.

The status of patients with nose bleedings (NB) depends not only on the volume of blood loss, but also on the degree of compensation for hypoxia accompanying hemorrhage. Aim . The main aim of our research was to study the antioxidant properties of blood serum and the intensity of LPO processes in erythrocyte membranes of patients with epistaxis of varying severity. Materials and methods . 82 patients with nose bleeding of varying severity were examined. The antioxidant activity of the blood serum of patients was studied by the chemiluminescence method induced by divalent iron ions. The processes of lipid peroxidation were studied by evaluating the activity of antioxidant defense enzymes – superoxide dismutase (SOD) and total peroxidase activity in blood erythrocytes, as well as the content of the final product of LPO-malonic dialdehyde (MDA) in erythrocytes. Results. It has been established that the potential of antioxidantprotection of serum and formed elements of blood is one of the most important links in the pathogenesis of NB. Conclusion. High capacity of antioxidant protection can significantly reduce the risk of irreversible changes in erythrocytes and the development of clinical signs of deep tissue hypoxia in patients with epistaxis.

About 50-85% of patients suffer from stump and phantom pain after amputations. These chronic pain conditions are often debilitating and result in disability, sleep and psychosocial disorders, impairment of day-work and the substantial decline in the quality of life. In some patients pharmaceutical therapy may fail to bring satisfactory pain relief or follows severe adverse events. Operations such as rhizotomy, cordotomy and stump revision are often unsuccessful in treating post-amputation chronic pain. The solitary case reports about the using of minimally invasive technique of pulsed radiofrequency (PRF) for treatment of chronic stump and phantom pain have been published only. Our current clinical observation is about successful using of the PRF spinal ganglions in patient with chronic pharmaceutical-resistant post-amputation stump pain.

To study the effectiveness of enhanced recovery after surgery (ERAS) protocol versus traditional perioperative management in patients with hepatopancreatobiliary tumors undergoing pancreatoduodenectomy.The study included 111 patients who have undergone pancreatoduodenectomy between January 2014 and December 2019. Patients were divided into 2 groups: perioperative ERAS protocol (85 patients) and traditional treatment (26 patients). Postoperative complications, length of hospital-stay and incidence of readmissions were analyzed.Mean length of hospital-stay for ERAS protocol was 13.4±7.6 days, conventional management - 16.5±7.5 days (Enhanced recovery after surgery protocol is safe, reduces the number of postoperative complications, length of hospital-stay and rate of readmissions.Стратегия протокола ускоренного восстановления (ERAS) пациентов, перенесших обширные операции на органах брюшной полости, направлена на снижение количества послеоперационных осложнений, уменьшение срока пребывания в стационаре и количества повторных госпитализаций.Изучить эффективность ERAS по сравнению с традиционным периоперационным ведением у пациентов с опухолями гепатопанкреатобилиарной зоны, перенесших панкреатодуоденальную резекцию.В исследование вошли 111 пациентов, перенесших панкреатодуоденальную резекцию в период с января 2014 г. по декабрь 2019 г. Пациенты разделены на 2 группы: прошедшие периоперационное лечение с использованием ERAS (Средняя продолжительность пребывания в стационаре для пациентов, пролеченных с использованием ERAS, составила 13,4±7,6 дня против 16,5±7,5 дня (Следование требованиям протокола ускоренного восстановления безопасно, приводит к снижению частоты послеоперационных осложнений и продолжительности госпитализации.

In this paper, we theoretically analyze the recombination and spin dynamics of excitons in an inhomogeneous ensemble of colloidal nanocrystals, which consists of several subensembles with different lifetimes and degrees of circular polarization of exciton photoluminescence (DCP). Each subensemble is described within a three-level model of interacting exciton states, including two excited states and a ground state. Various ratios of parameters, leading to a nontrivial time-dependent DCP and a difference in the integral and equilibrium DCP characteristics, are considered. It is shown that the presence of subensembles with different polarizations and lifetimes results in nonmonotonic dependence and a change in the sign of the DCP in magnetic field and as a function of time can occur. The theoretical model was implemented to describe the time dependences of the DCP in ensembles of colloidal CdSe nanoplatelets synthesized in the air and argon atmosphere.

The reconstruction of the verbal pre-anthropogenic Northern Eurasia forest cover has been proposed on the basis of paleontology and historical ecology data analysis. It was used as a basis for evaluating the ability of the reserves in the studied area to act as reference objects capable of performing the ecosystem living soil cover functions. The analysis indicated immense anthropogenic transformation of the Biota in this territory and the requirement for urgent measures to restore the full-fledged Biota of the reserves at the state and global levels. A list of necessary activities for the initial phase of Biota recovery in the modern protected areas has been proposed.

Vegetable protein synthesis systems for industry, medicine, and research are becoming increasingly popular. The technology of protein production in plants has certain advantages, compared with the expression systems of bacteria and yeast. The rich variety of promoters, regulatory elements, affinity tags, and fusion partners that are used in molecular biology and plant biotechnology can create hybrid genetic constructs adapted to the solution of various tasks associated with protein synthesis and purification. New methods of modification of plant systems are being developed for the synthesis of functionally active human proteins whose structure is close to the natural analogues. This review shows current approaches to increase the yield of the target protein, facilitating the procedures of its isolation and purification and preventing degradation.

Despite the emergence of new antidiabetic drugs, diabetes type 2 treatment remains a relevant issue. In order to standardize and optimize medical care to patients with diabetes, global and national algorithms for type 2 diabetes treatment were developed. [1, 2] The current algorithms focus on an individual approach, safety and effectiveness of treatment. A balance should be maintained between achieving optimal glycemic control and safety of therapy.

Background : Infectious complications — the leading cause of mortality in patients with multiple myeloma (MM), their appearance is regarded as an adverse prognostic factor in the course of the disease. Objective : The aim of our study was to evaluate the clinical and immunological features of infectious complications in patients with G- immunochemical MM to find the most informative indicators in their forecasting. Methods : A randomized controlled trial was made. All patients were divided into 3 groups for comparison: Group 1 (n =47) — MM patients, G-immunochemical variant with infection, Group 2 (n =54) — MM patients, G-immunochemical option no infectious complications, and Group 3 (n =125) — healthy volunteers. Research material was deoxygenated blood taken on admission of a patient to the hematology department before the pathogenetic treatment. Identification of G-variant was carried by immunofixation and electrophoresis. The immune status was assessed by indirect immunofluorescence. The concentration of IgA, M, E and G, and the levels of IL 2, IL 4, IL 8, TNF α, IFN γ in serum was determined by enzyme immunoassay. The activity of neutrophil granulocytes (NG) was studied by chemiluminescent analysis of spontaneous and induced production of reactive oxygen species. Statistical analysis was performed using the software STATISTICA v. 8.0 (USA). Results : We analyzed data from 101 patients with MM and 125 healthy volunteers. The average age of MM patients was 60.53±6.78 years. The group of healthy volunteers was similar in sex and age to groups of patients with MM. In patients with MM in the presence of infectious complications the researchers detected combined secondary development of T and B cell immunodeficiency, changes in non-specific immunity depended on the stage of the disease, unidirectional irregularities in spontaneous and induced chemiluminescence activity NG in II stage disease and multidirectional irregularities in stage III (p =0.045). Prevalence of the content of proinflammatory cytokines on inflammatory (p

Reviewed the clinical case of empty extrapleural oleothorax. The data of laboratory study, computed tomography and surgcal tactics are given.

Cytokines are wide-range modifiers of biological reactions. Cytokine regulation provides proliferation, differentiation, cell function, cell-cell and inter-systemic interaction, direction and nature of immune response to invasion of infectious and non-infectious pathogens. There are several distinct groups of cytokines: pro-inflammatory, anti-inflammatory factors, regulators of cellular and humoral immunity etc. A distinct role of cytokines is not excluded for infectious complications accompanying multiple myeloma (MM). Cytokine regulatory effects on immune defense in the organism as a whole, and a balance between proand anti-inflammatory cytokines in blood of MM patients depend on the stage of multiple myeloma progression and possibility of infectious complications. Therefore, the aim of our study was to evaluate proand anti-inflammatory cytokines and cytokine regulation in patients with MM G-immunochemical option. Our study involved 101 patients with MM (IgG-variant), their age ranging between 40 and 76 years. The diagnosis was verified by clinical and laboratory examinations. The G-variant of MM was verified by immunofixation and electrophoresis. The definite diagnosis and disease staging was confirmed by a combination of diagnostic criteria. Heparinized blood samples were taken from the cubital vein in the morning (8 to 9 hours), in fasting state upon admission, prior to the starting a pathogenetic therapy. Dynamic monitoring of patients was carried out over the period of their staying in hospital. All patients were staged according to Durie and Salmon (1975) (stages II, III). At each stage, we discerned two sub-groups: A, without renal disease, B, with renal impairment. The control group consisted of 125 healthy volunteers matched for age and sex with the main group. IL-2, IL-4, IL-8, TNFα, and IFNγ levels in sera of the patients and healthy individuals were determined by enzyme immunoassay kits (JSC “Vector-Best”,Novosibirsk). In the myeloma patients, we have revealed an imbalance between pro-inflammatory (IL-2, IL-8, TNFα, IFNγ), and antiinflammatory cytokines (IL-4), with a predominance of pro-inflammatory factors. This finding does not exclude their potential pathogenetic role in growth and stimulation of tumor progression, and occurrence of infectious complications at any stage of the disease. The disturbances in cytokine regulation in MM patients may manifest as a deviation of cellular immune response by Th-1 way. As seen from our data, TNFα, IL-2 and IL-4 are the most significant cytokines for MM progression.