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The differential diagnostic of prostate cancer is the actual task of modern medicine. The existing methods lack accuracy and specificity. It’s the reason of hyper- or hypo-diagnostic of this disease. We developed and tested the new logistic regression model for diagnostic of prostate cancer in men of various age. The model includes age, the volume of prostate, concentration of prostate specific antigen (PCA), 2-pro-PCA in the blood, the presence of the concretion revealed during digital rectal investigation of prostate and hypoechogenic area in transrectal ultrasound investigation. The model was tested in 114 patients. It has shown the higher accuracy and specificity of the new regression model in comparison to other methods of differential diagnostic of prostate cancer.

More than 1,7 million people, 770 thousand people from HIV infection, died from tuberculosis worldwide in 2018. In accordance with the United Nations Sustainable Development Goals and the World Health Organization’s strategy to fight tuberculosis, all countries need to reduce the incidence of tuberculosis by 80% and reduce the death rate from tuberculosis by 90% by 2030. According to the Joint United Nations programme on HIV/AIDS (UNAIDS) goals of «90–90–90», countries should achieve the following indicators by 2020: «90% of people living with HIV infection should know their HIV status; 90% of those who know about their HIV infection should receive treatment, and 90% of those who are being treated should not have their viral load determined». Socially significant diseases are a serious problem for the Russian Federation (RF). The RF is one of 30 countries with a high incidence of tuberculosis and ranks 3rd place in multidrug-resistant tuberculosis and 6th place in the prevalence of HIV infection. Socially significant diseases present a serious problem for the Armed Forces of the RF. 150 new cases of tuberculosis, over 50 cases of HIV infection are diagnosed every year among military personnel of the RF Armed Forces.The purpose of the studyis to analyze the current epidemiological situation of tuberculosis and HIV infection in the armed forces of the Russian Federation and foreign armies, to generalize domestic and foreign experience in the organization of medical care for military personnel with these diseases.Data from reports of the medical service and a review of domestic Russian and foreign medical literature allowed us to assess TB and HIV sickness rate among military personnel in the RF and foreign states, as well as to characterize the current system of medical care for this category of patients.

The presented clinical practice guidelines of the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The guidelines were approved by the XXIII Congress of the GSSR and the 22nd International Slavonic-Baltic Scientifi c Forum “St. Petersburg - Gastro-2020 ON-LINE” (St. Petersburg, June 11, 2020). The presented clinical practice guidelines of the Russian Scientific Medical Society of Internal Medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The recommendations were approved at the XV National Congress of Internal Medicine, XXIII Congress of NOGR on the basis of the 1st edition, adopted at the 22nd International Slavic- Baltic Scientific Forum “St. Petersburg - Gastro-2020 ON-LINE”.

Sirtuins (SIRT) are a class of NAD-dependent proteins with deacetylase activity that are involved in the regulation of transcription, metabolic pathways, and cell aging via the deacetylation of histone and nonhistone targets. It was hypothesized that sirtuins play important role in the pathogenesis of neurodegenerative diseases, such as Alzheimer’s disease (AD). An age-related decrease in sirtuin expression leads to oxidative stress, which can cause neurodegeneration. This article examines the age-related dynamics of SIRT1, 3, 5, and 6 expression in patients with AD and in healthy individuals with immunohistochemistry and immunocytochemistry methods via immunofluorescent confocal microscopy. In elderly and senile health individuals, the SIRT1, 3, 5, and 6 expression in the hippocampus and buccal epithelium did not differ significantly. In AD patients, the SIRT1, 3, 5, and 6 expression in the hippocampus and buccal epithelium decrease by 1.5–5 times as compared with healthy elderly and senile individuals. The SIRT5 expression in the hippocampus and buccal epithelium does not depend on the age or AD diagnosis. Thus, the SIRT 1, 3, and 6 expression in the buccal epithelium can be a marker for intravital, noninvasive AD diagnosis in elderly and senile individuals.

Aim In this study we evaluated the effects of Riamilovir on SARS-CoV-2 viral shedding and on admission duration in patients with moderate COVID-19 Materials and methods We have used data from 69 health records of patients with moderate severe PCR confirmed SARS-CoV-2 infection Control group included 34 patients treated with off-label riamilovir 1250 mg per day for 5 days (250 mg 5 times a day), comparison groups - 35 patients, who received ribavirin and umifenovir 800 mg a day for 5 days The antiviral therapy was administered within 72 hours from the onset of the disease The primary endpoints were elimination of virus in oropharyngeal and nasopharyngeal swabs on 7 day of admission and discharge from the hospital by 14 day Results Patients assigned to riamilovir had significantly shorter time to clinical improvement as well as increased PCR negative rate by day 7 Conclusion Yearly administration of riamilovir as opposed to the umifenovir and ribavirin in therapy of moderate SARS-CoV-2 infection was associated with significant shorter time to clinical improvement by 14 day of hospitalization PCR negative rate by 7 days of hospitalization is significantly more likely in riamilovir group © 2021 Consilium Medikum All rights reserved

Aim. The study evaluates clinical effectiveness and safety of etiotropic antiviral medications with a direct mechanism of action (Riamilovir, Ribavirin, Umifenovir) for the treatment of moderate SARS-CoV-2 infection in adults. Materials and methods. The study used the data from 59 health records of patients with moderate PCR-confirmed SARS-CoV-2 infection. Control group included 29 patients treated with 1250 mg Riamilovir off-label per day for 5 days (250 mg 5 times a day), comparison group consisted of 30 patients, who received 800 mg Ribavirin and Umifenovir per day for 5 days. The effectiveness of the medications was assessed by the duration and severity of general infectious and respiratory syndromes, anosmia and ageusia, as well as the oxygen content in the blood, the timing of SARS-COV-2 virus elimination from the body according to the results of control studies of nasopharyngeal swabs using the PCR method and dynamics of blood tests results. Results. A statistically significant decrease in the duration of fever, cough, and anosmia and a more rapid elimination of the virus from the body were noted in the group of patients receiving Riamilovir. Decreased levels of non-specific inflammatory markers in blood serum, as well as normal values of liver enzymes were observed in control group during therapy, as opposed to the comparison group. No serious adverse events were noted when using the medication. Conclusion. Nucleoside analogue medication Riamilovir showed good effectiveness and safety profile in adult patients with moderate SARS-CoV-2 infection.

The article describes action of the Infectious Diseases Service of the Armed Forces in national biosecurity control through leveraging experience of military involvement, emergencies, infectious epidemic outbreaks, including rescue measures rendered during the SARS-CoV-2 pandemic.We utilise experience of military infectiologists to exemplify medical care management under admission influx of contagious patients. Principles are clarified of early clinical diagnostics of potentially pandemic infectious diseases and early active detection, isolation, sorting and evacuation of contagious patients in martial and close field conditions. Besides, specifics of providing specialised medical care to contagious patients, including preventive intensive care, is detailed.In 2020, healthcare and legal authorities worldwide recognised the critical capability to act under conditions close to real combat and so satisfy a minimum qualification standard of a military doctor, including infectiologist’s skills, at both systemic and individual levels of infection control, regardless of primary medical specialty. From this perspective, expertise of the Chair of Infectious Diseases (with training in medical parasitology and tropical diseases) of the Military Medical Academy can be an asset both in practice and teaching in medical universities country-wide.

Aim. In this study we evaluated clinical effectiveness and safety of nebulized prostacyclin in patients with Novel Coronavirus Disease (SARS-CoV-2). Materials and methods: We have included 44 male patients with moderate PCR confirmed SARS-CoV-2 infection in this study. Control group consisted of 23 patients treated with nebulized prostacyclin (PGI2). besides standard therapy. We compared intensiveness and duration of infectious intoxication syndrome, duration of fever, cough as well as SpO2 level, complete blood count and chemokine status values. Results: Statistically significant difference in duration of fever, cough, intensiveness and duration of infectious intoxication syndrome were observed. Lymphocyte and platelet counts were significantly higher in control group We have also noticed significantly lower level of proinflammatory mediators and C4-complement component in control group. Only 1 adverse effect associated with inhaled prostacyclin was reported. Conclusion. Nebulized prostacyclin showed therapeutic efficacy and good safety profile in adults with moderate COVID-19.

Meningococcal infection is an acute infectious disease caused by Neisseria meningitidis, characterized by a polymorphism of clinical manifestations from meningococcus carriage to invasive forms. They, in turn, pose a great danger to the patient’s life, since in most cases they have a severe course with the development of complications, fulminant course and high mortality. The success of treatment of invasive meningococcal disease largely depends on the timeliness of diagnosis and the timing of treatment initiation. The article describes a clinical case of a generalized form of severe meningococcal infection with a rapidly developing infectious toxic shock, disseminated intravascular coagulation syndrome in a soldier who had previously refused specific prophylaxis. Despite the mistakes made at the prehospital stage and, accordingly, late hospitalization, this case had a favorable outcome.

From the point of view of statistical reliability, the influence of various infusion therapy programs on homeostasis indicators of patients suffering from shockogenic trauma is considered. It has been revealed that when entering the intensive care and intensive care department in patients suffering from severe traumatic shock, against the background of algorithms of anti-shock measures at the pre-emergency and hospital stages there are significant individual intervals of examined homeostasis parameters, which indicates expressed personalized disorders of indicators of reflecting function of organs and systems of patients. The variation in the canonical space of the investigated parameters in patients increased after 12 hours, after admission to the intensive care and resuscitation department. Anti-shock therapy contributed to the fact that the distribution of patients of all three groups in the canonical space after the first 24 hours was dynamically compacted, indicating a decrease in differences between patients of each group during the treatment process. Cluster analysis and multi-dimensional scaling revealed the multilateral dynamics of the relationship between independent variables in various infusion therapy programmes. When patients were admitted to the intensive care and intensive care unit, almost the same orientation of the features of connections between independent variables was noted, however, their polarity was recorded during the treatment process. This shows that the infusion therapy program in patients suffering from severe traumatic shock should be carried out taking into account the dynamics of individual disorders of the investigated homeostasis parameters. It has been statistically proven that different infusion therapy programs have very different effects on homeostasis rates. The use of sterofundin isotonic and 4% modified gelatin in this category of patients has been proven to be the most effective and safe volemic recovery scheme.

The authors present the results of an investigation in Fe–Ni-Cr austenitic alloys of the low-temperature deformation-induced segregations of nickel that form in the micro regions being (i) located ...

Aortic valve (AV) stenosis is the most common acquired valvular disease with an increasing prevalence due to an aging population, requiring surgical or endovascular intervention. Transcatheter Aortic Valve Implantation (TAVI) represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk patients with severe symptomatic AV stenosis. TAVI allows for the correction of aortic defect in the most severe group of patients with chronic heart failure (CHF) with severe comorbidity, who are contraindicated for open surgery to replace AV, in order to interrupt the vicious circle in the progression of CHF, stimulate reverse myocardial remodeling, alleviate symptoms, improve the quality of life, and prognosis of patients, and also as a «bridge» to heart transplantation. With the development of next-generation devices, TAVI has evolved from a complex and dangerous procedure to an effective and safe technique. Currently, the greatest scientific interest is the study of valve durability and the possibility of expanding the indications for performing TAVI in categories of patients with low surgical risk, as well as in younger age groups.Стеноз аортального клапана (АК) — самое частое приобретенное клапанное заболевание с растущей распространенностью из-за старения населения, требующее хирургического или эндоваскулярного вмешательства. Транскатетерная имплантация АК (Transcatheter Aortic Valve Implantation, TAVI) представляет собой настоящую революцию в области интервенционной кардиологии для лечения пациентов старческого возраста или из группы высокого риска с тяжелым симптомным стенозом АК. TAVI позволяет выполнять коррекцию аортального порока наиболее тяжелой группе больных ХСН с выраженной коморбидностью, которым противопоказано выполнение открытой операции по замене АК, для прерывания порочного круга в прогрессировании ХСН, стимуляции обратного ремоделирования миокарда, облегчения симптомов, улучшения качества жизни и прогноза больных, а также в качестве «моста» к трансплантации сердца. Благодаря разработке устройств нового поколения, TAVI превратилась из сложной и опасной процедуры в эффективную и безопасную методику. Наибольший научный интерес в настоящее время представляет изучение долговечности клапана и возможности расширения показаний к выполнению TAVI у категорий пациентов с низким хирургическим риском, а также более молодого возраста.

To understand the pathogenesis of dilated cardiomyopathy (DCMP), it is necessary to establish the molecular-cellular mechanisms of myocardial aging, including those associated with programmed cell death, the molecular mechanisms of which have not been practically studied. The aim of this work is to study markers of apoptosis in cardiomyocytes of patients with DCMP in vitro. We used the method of primary dissociated cell cultures and the method of immunofluorescence confocal laser microscopy. Cells of the 3rd and 14th passages, corresponding to «young» and «old» cultures, were used to simulate cellular senescence. Results. At the molecular level, aging of cardiomyocyte cells was accompanied by a twofold increase in the expression of p16INK4a compared to «young cultures» both in the control group and in the group with DCMP. It was also found that the expression of p16INK4a in cultures taken from patients with pathology was 2 times higher than in similar cultures from healthy patients. The expression of p21 was increased in the group with DCMP compared to the control; however, with aging of the culture, the expression of p21 did not change, remaining at a significant level. The most significant differences were obtained when comparing the expression of Bax in the cell culture of cardiomyocytes from the group with DCMP in a «young» culture compared with the norm, 3,2 times. Aging of myocardial cells at the molecular level was manifested in an increase in the expression of the Bax protein, which is the triggering mechanism of the mitochondrial apoptosis pathway. It is possible that this pathway of cell death is prevalent in DCMP.Для понимания патогенеза дилатационной кардиомиопатии (ДКМП) необходимо установить молекулярно-клеточные механизмы старения миокарда, в том числе связанные с программируемой клеточной гибелью, молекулярные механизмы которого практически не изучены. Цель работы — изучение маркеров апоптоза в кардиомиоцитах у пациентов с ДКМП in vitro. В работе использовали метод первичных диссоциированных клеточных культур и метод иммунофлюоресцентной конфокальной лазерной микроскопии. Для моделирования клеточного старения использовали клетки 3-го и 14-го пассажей, соответствующие «молодым» и «старым» культурам. На молекулярном уровне старение клеток кардиомиоцитов сопровождалось повышением экспрессии р16INK4a в 2 раза по сравнению с «молодыми культурами» как в контрольной, так и в группе с ДКМП. Также установлено, что экспрессия р16INK4a в культурах, взятых от пациентов с патологией, была в 2 раза выше, чем в аналогичных культурах от здоровых пациентов. Экспрессия р21 была повышена в группе с ДКМП по сравнению с контрольной группой, однако при старении культуры экспрессия p21 не изменялась, оставаясь на высоком уровне. Наиболее значимые различия были получены при сравнении экспрессии Bax в культуре клеток кардиомиоцитов из группы с ДКМП в «молодой» культуре по сравнению с нормой в 3,2 раза. Старение клеток миокарда на молекулярном уровне проявлялось в повышении экспрессии белка Baх, именно он является запускающим механизмом митохондриального пути апоптоза. Возможно, этот путь клеточной гибели является превалирующем при ДКМП.

A narrow temperature range of changes in the mechanism and kinetics of structural-phase transformations during mechanical alloying under deformation in rotating Bridgman anvils was determined by the methods of Mössbauer spectroscopy, electron microscopy, and mechanical tests in the high-nitrogen chromium-manganese steel FeMn22Cr18N0.83. The experimentally established temperature region is characterized by a change in the direction of nitrogen redistribution—from an increase in the N content in the metal matrix during cold deformation to a decrease with an increase in the temperature and degree of severe plastic deformation. The change in the direction of nitrogen redistribution is due to the acceleration of the decomposition of a nitrogen-supersaturated solid solution of austenite with the formation of secondary nanocrystalline nitrides. The presence of a transition region for the mechanism of structural-phase transitions is manifested in the abnormal behavior of the mechanical properties of steel.

At this moment differential diagnostic of the prostate cancer (PC) needs the new, more effective ways with regard of multifactor analysis. One of this factor is patient's age. Men older than 45 years old have expressed involution changes of prostate tissues. This fact must be take into account in valuation morphologic and laboratory criteria's in PC. The goal of the investigation is to take into account age-related changes of the prostate volume and laboratory criteria of blood analysis in PC. 632 patients in age from 42 to 88 years old were exanimated by trans rectal ultrasound examination (TRUS) method (volume parameters of the prostate) and by levels of prostate-specific antigen (PSA) and (-2) pro-PSA in blood. The increase of patient's age correlated with increase of the density of transient, peripheral and central zones of prostate. It correlates with the probability of the frequency of PC verification. Levels of PSA and 2-pro-PSA in blood of PC patients increase during the transition from middle to elderly age in 1,4-2,8 times. Thus the information, which was obtained during the examination of volume prostate characteristics by TRUS method and laboratory diagnostic of PC, must take to account patient's age.Дифференциальная диагностика рака предстательной железы (РПЖ) в настоящее время требует поиска новых, более эффективных подходов с учетом многофакторного анализа. Одним из таких факторов является возраст пациента. У мужчин старше 45 лет наблюдают выраженные инволютивные изменения тканей предстательной железы, что важно учитывать при оценке морфологических и лабораторных критериев при РПЖ. Цель работы — оценить возрастные изменения объема предстательной железы и лабораторных показателей анализа крови при РПЖ. У 632 пациентов 42–88 лет методом трансректального УЗИ (ТРУЗИ) оценивали объемные показатели предстательной железы и уровень простатспецифического антигена (ПСА) и 2-про-ПСА в крови. С возрастом наблюдают повышение плотности транзиторной, периферической и центральной зон предстательной железы. Это коррелирует с повышением частоты выявления РПЖ. Уровень ПСА и 2-про-ПСА в крови у пациентов с РПЖ повышается при переходе от среднего к старческому возрасту в 1,4–2,8 раза. Таким образом информация, полученная в ходе оценки объемных показателей предстательной железы по данным ТРУЗИ и лабораторного исследования при постановке диагноза РПЖ, должна учитывать возраст пациента.

The article presents a methodology for monitoring the implementation of integrated schemes for engineering support of territories of the Housing Stock Renovation Program in Moscow. The methodology is based on the concept of an enlarged network model, which defines the sequence of work execution and their relationships at different stages of the life cycle – construction and demolition of residential and non-residential facilities, relocation and construction of engineering infrastructure, resettlement – in the form of a combined calendar plan (Gantt chart), linked to a single timeline, and solves an important practical task: tracking the timing and volume of works performed at all stages of the implementation of the Complex scheme of engineering support for the territory of renovation. The continuity of the new methodology and previously developed and used by the Moscow Government tools for planning and coordinating urban development activities is shown. Keywords: complex scheme of engineering support, monitoring, enlarged network model, program of renovation.

Aim of investigation - to estimate efficacy and safety of direct-acting antivirus agents narlaprevir/ritonavir and sofosbuvir in non-cirrhotic patients with chronic hepatitis C Material and methods Treatment naive patients with chronic HCV infection GT1 were enrolled at the study (ClinicalTrials gov ID: NCT04246723) Patients received therapy with the combination of narlaprevir 200 mg QD, ritonavir 100 mg QD and sofosbuvir 400 mg QD Treatment duration was 12 weeks in group A and 8 weeks in group B Primary endpoint is sustained virologic response 12 weeks post treatment (SVR12) The results of the study (group B) are presented Results and discussion Most patients from group B (23/25) had fibrosis (F0-F1) and 2 patients had fibrosis F2 All enrolled 25 patients completed therapy and 96 0% (24/25) patients reached SVR12 (95% CI 79 6-99 9%) Virologic failure was confirmed for one patient (697 000 IU/ml on follow-up week 12) In total, 23/24 patients passed FU week 24 and reached SVR24 One patient was discontinued from the study before last visit (FU24) due to COVID-19 outbreak Adverse events (AEs) were registered in 5 (20%) patients No serious AEs occurred In total, therapy of narlaprevir/ritonavir and sofosbuvir for 8 weeks demonstrated good efficacy and safety profile Цель исследования - изучение эффективности и безопасности препаратов прямого противовирус ного действия нарлапревир/ритонавир и софосбувир у пациентов с хроническим гепатитом C без цирроза печени Материал и методы В исследование были включены пациенты с хронической инфекцией, вызванной вирусом гепатита С (ВГС) генотипа 1, ранее не получавшие противовирусную терапию (ClinicalTrials gov ID: NCT04246723) Пациенты получали комбинацию препаратов: нарлапревир 200 мг 1 раз в сутки, ритонавир 100 мг 1 раз в сутки и софосбувир 400 мг 1 раз в сутки Длительность терапии составила 12 нед в группе А и 8 нед в группе В Первичная конечная точка исследования - устойчивый вирусологический ответ через 12 нед после терапии (УВО12) Представлены результаты исследования для группы В Результаты и обсуждение У большинства (23 из 25) пациентов из группы B был фиброз стадии F0-F1, у 2 пациентов - стадии F2 Все включенные в исследование 25 пациентов завершили терапию, 24 (96,0%) из них достигли УВО12 (95% доверительный интервал 79,6-99,9) Вирусологическая неудача была подтверждена у 1 пациента (697 000 МЕ/мл на 12-й неделе наблюдения) В общей сложности 23 из 24 пациентов достигли УВО24 1 пациент выбыл из исследования перед последним визитом (24-я неделя наблюдения) в связи с пандемией COVID-19 Нежелательные явления во время терапии зарегистрированы у 5 (20%) пациентов Серьезных нежелательных явлений не отмечено В целом терапия нарлапревиром/ритонавиром и софосбувиром в течение 8 нед продемонстрировала хороший профиль эффективности и безопасности

The paper presents the results of a brief analysis of functional planning solutions of existing fitness centers on the example of buildings in St. Petersburg. The main functional zones and main types of placement are considered. The analysis of the functional content of fitness centers is made, which results in the definition of the concept of a fitness center as an independent structure; options for placing fitness centers in other structures and as independent objects are described; the composition of the main functional zones is determined; the functional content of fitness centers is systematized.

The effectiveness and quality of liver biopsy in rats are applicable to the aspiration and automatic liver biopsy system. Histological examination of 240 biopsy specimens in 100% of cases identified portal tracts. The number of portal tracts to determine the stage of liver fibrosis in rats of the 1st group who underwent liver biopsy was performed using an 18 G aspirating needle from the puncture liver set (Menghini type), which is 4-5, you have the 2nd group, which one-time guillotine soft tissue biopsy with a semi-automatic action of 16G×20 cm, Italy) - 7-8 portal tracts. The average size of the biopsy in the 1st group is 0,5 cm, in the 2nd group - 1 cm. Thus, the automatic biopsy system allows you to get liver tissue in 100% of cases. At the same time, the automatic system eliminates the additional traumatization of experimental animals, as well as minimizes efforts to separate the biopsy material from the organ. In addition, the automated system for liver biopsy allows to evaluate 7-8 portal tracts with a biopsy size of 1 cm, this provides a reliable histological assessment of pathological changes in liver tissue to assess the stage of fibrosis and the activity of the inflammatory process over time.

The short-range clustering enhanced by migration of non-equilibrium point defects generated under the high-pressure torsion in Bridgman anvils and ball milling is detected by means of Mossb...

The deformation-enhanced atomic redistribution, i.e., accelerated ordering upon warm (573 K) and disordering upon cold (298 K) high pressure torsion, has been investigated using Mossbauer spectroscopy in the binary invar Fe100 –xNix (x = 34.2–35.5 at %) alloys. Results of deformation-induced ordering and high-energy electron irradiation have been compared.

Cardiovascular diseases caused by atherosclerosis are one of the most important social and economic problems in many countries of the world due to the high morbidity and mortality rate of the working population. An immunological theory of atherosclerosis and coronary heart disease (CHD) has been actively developed of late, and markers of inflammation characterizing immuno- and atherogenesis have been sought. The buccal epithelium (BE) can be used as biological material for in vivo molecular-cellular studies, allowing CHD diagnosis via inflammation markers. The purpose of the work was a comparative study of the expression of IL-1β, IL-6, IL-10, MCP-1, and GDF-15 in BE in patients of different ages with CHD and without cardiovascular disease. The BE material in healthy donors and patients with second-stage CHD was divided into groups according to the age classification of the WHO: the first group included middle-aged people (45–59 years), and the second included elderly people (60–74 years). Control material was obtained from people of middle and old age without cardiovascular disease. According to the immunocytochemical study, the area of IL-1β expression in BE is three times higher in middle-aged CHD patients and 4.4 times higher in elderly people as compared to healthy individuals of the same age group. The area of IL-6 expression in middle-aged and elderly CHD patients was 7.9 and 7.4 times higher, respectively, than in the control group. In middle-aged and elderly CHD patients, the IL-10 expression was 1.6 and 2.8 times higher, respectively, as compared to healthy donors of the same age group. The MCP-1 expression in the BE of middle-aged and elderly people with and without ischemic heart disease did not differ. GDF-15 expression is 6.8 and 6.6 times higher in middle-aged and elderly CHD patients than in healthy people of the same age. The findings showed that the expression of the cytokines IL-1β, IL-6, IL-10, and GDF-15 increase in the BE of patients with CHD in middle-aged and elderly people as compared with persons of the same age group without cardiovascular disease. Thus, the BE can serve as an informative material for noninvasive molecular diagnosis of CHD in people of different ages.

Cardiopulmonary exercise testing is a diagnostic method, which can be used for oncological patients. It shows its perspectives in measuring reserve capacity of the human organism, determining the risk of postoperative complications, and long-term prognosis. The method is also useful for optimization of rehabilitation measures, which is actual for polymorbid aged patients. In this article we present data of cardiopulmonary exercise testing of 362 patients, men and women of different ages with lung and esophagus cancer. We performed a comparative analysis of aerobic ability of gerontological patients and patients from the other age groups. The patients showed higher ranges at rest in comparison to normal population, and lower rates on anaerobic threshold. Patients from the 40-49 age group showed the best values of aerobic exchange. Aged patients had lower oxygen uptake on anaerobic threshold than other groups. Women of all ages had higher values of peak oxygen uptake then men; aged patients showed better results in comparison to the normal ranges.Использование кардиореспираторного нагрузочного тестирования у пациентов со злокачественными новообразованиями играет важную роль в оценке риска послеоперационных осложнений и формировании отдаленного прогноза, оптимизации реабилитационного процесса, что особенно актуально для больных старших возрастных групп, имеющих полиморбидную патологию. В статье представлены результаты анализа кардиореспираторного нагрузочного тестирования у 362 пациентов различного возраста с онкологическими заболеваниями легких и пищевода, проведен сравнительный анализ аэробных возможностей у людей пожилого и старческого возраста и других возрастных групп. Средние значения анализируемых показателей покоя были выше, чем в популяции, при достижении анаэробного порога наблюдали обратную закономерность. Наиболее высокие показатели аэробного обмена были выявлены у пациентов 40–49 лет. Наблюдался ожидаемо более низкий уровень относительного потребления кислорода при достижении анаэробного порога у больных пожилого и старческого возраста по сравнению с более молодыми пациентами. Уровень пикового потребления кислорода у женщин всех возрастных групп был выше по сравнению с мужчинами; у пациентов старшего возраста регистрировали лучшие значения в процентном соотношении с нормой.

Insufficient knowledge age peculiarities of the clinical course of cardiac arrhythmias occurring asymptomatically as a manifestation of cardiotoxicity in women with breast cancer at the stage of radiation therapy, determines the high demand for research on this problem. The aim of the study was to identify and evaluate asymptomatic cardiac arrhythmias in elderly women with left breast cancer at the stage of radiation therapy. 48 women without a history of severe cardiovascular disease with HER2neu negative cancer of the left breast at the stage of 3D conformal radiotherapy were examined. Mean age 67 (64; 69). All patients at the previous stages were carried out mastectomy Madden followed by therapy with doxorubicin. The examination included ECG registration, 24-hour ECG monitoring and echocardiography. Before radiation therapy, asymptomatic arrhythmias were detected in 43 (89,6%) patients. After radiation therapy significantly increased the number of pathological supraventricular and ventricular arrhythmias as a manifestation of cardiotoxicity.Недостаточная изученность возрастных особенностей клинического течения бессимптомных нарушений сердечного ритма у женщин с раком молочной железы на этапе лучевой терапии определяет высокую востребованность посвященных данной проблеме исследований. Цель исследования ― выявление и оценка нарушений сердечного ритма, протекающих бессимптомно, у женщин пожилого возраста [средний возраст — 67 (64; 69) лет] с раком левой молочной железы на этапе лучевой терапии. Обследованы 48 женщин без тяжелой сердечно-сосудистой патологии в анамнезе с HER2neu отрицательным раком левой молочной железы на этапе 3D конформной лучевой терапии. Всем пациенткам на предшествующих этапах была проведена мастэктомия по Маддену с последующей терапией доксорубицином. Обследование включало регистрацию ЭКГ, мониторирование ЭКГ по Холтеру и эхо-КГ. Бессимптомные нарушения ритма были выявлены до начала лучевой терапии у 43 (89,6%) пациенток. После лучевой терапии выявлено увеличение количества патологической наджелудочковой и желудочковой аритмии, что можно объяснить кардиотоксичностью.

The solid-state mechanical alloying (MA) of high-nitrogen chromium-manganese austenite steel—MA in a planetary ball mill, —was studied by methods of Mössbauer spectroscopy and transmission electron microscopy (TEM). In the capacity of a material for the alloying we used mixtures of the binary Fe–Mn and Fe–Cr alloys with the nitrides CrN (Cr2N) and Mn2N. It is shown that ball milling of the mixtures has led to the occurrence of the α → γ transitions being accompanied by the (i) formation of the solid solutions supersaturated with nitrogen and by (ii) their decomposition with the formation of secondary nitrides. The austenite formed by the ball milling and subsequent annealing at 700–800 °C, was a submicrocrystalline one that contained secondary nano-sized crystalline CrN (Cr2N) nitrides. It has been established that using the nitride Mn2N as nitrogen-containing addition is more preferable for the formation and stabilization of austenite—in the course of the MA and subsequent annealing—because of the formation of the concentration-inhomogeneous regions of γ phase enriched with austenite-forming low-mobile manganese.

This paper presents the results of a M&ouml, ssbauer spectroscopy investigation of the processes in the binary alloys Fe100&minus, cCrc (c, at. % = 6.0, 9.4, 13.2) and of the short-range (SR) atomic ordering accelerated by applying warm severe plastic deformation via high pressure torsion (HPT). After warm HPT treatment, in the vicinity of the concentration c = 9 at. %, there was revealed to be an inversion of the sign of the SR order, the anomaly of the formation of a Fe&ndash, Cr solid solution, which was predicted ab initio and is observed at long-term anneals and exposures to irradiation by electrons. The acceleration of the SR ordering at HPT is due to the continuous generation and a large number density of mobile point defects.

A study is presented on the effectiveness and safety of various anticoagulants used in patients of an older age group with acute coronary syndrome during percutaneous coronary interventions. Bivalirudin was shown to be highly effective in comparison with unfractionated heparin and monafram in relation to the amount of bleeding that occurs in the postoperative period and adverse cardiovascular complications.Представлено исследование по изучению эффективности и безопасности различных антикоагулянтов, используемых у больных старшей возрастной группы с острым коронарным синдром при чрескожных коронарных вмешательствах. Показана высокая эффективность бивалирудина по сравнению с нефракционированным гепарином и монафрамом в отношении числа кровотечений, возникающих в послеоперационном периоде, и неблагоприятных сердечно-сосудистых осложнений.

A laboratory study of the cytokine profile and the content of the intercellular adhesion molecules was performed in 38 patients with initial signs of aortic hemilunus calcification. It has been determined that the content of IL-6 and IL-8 had significantly higher values compared with the control group, which indicates the direct role of nonspecific chronic inflammation in the development of calcifying aortic valve damage. A significantly lower content of sE-selectin was also identified, which may indicate the absence of activation of adhesion molecules at the initial stage of aortic valve calcification. Further study of the dynamics of sE- and sP-selectins content in the process of development of acceleration of blood flow in the aortic valve and the formation of stenosis is needed.Выполнено лабораторное исследование цитокинового профиля и содержания молекул межклеточной адгезии у 38 пациентов с начальными признаками кальциноза аортальных полулуний. Определено, что содержание IL-6 и IL-8 имело достоверно более высокие значения по сравнению с контрольной группой, что свидетельствует о непосредственной роли неспецифического хронического воспаления при развитии кальцинирующего поражения клапана аорты. Также было выявлено значимо более низкое содержание sE-селектина, что может говорить об отсутствии активации молекул адгезии на начальном этапе формирования кальциноза клапана аорты. Необходимо дальнейшее изучение динамики содержания sE- и sP-селектинов в процессе развития ускорения кровотока на аортальном клапане и формировании стеноза.

The effect of doping the ferrite alloy Fe-16Cr by the oversized impurities Sb and Au on the mechanism of the short-range ordering induced by &ldquo, warm&rdquo, severe plastic deformation was studied using the method of M&ouml, ssbauer spectroscopy. A comparison between the results obtained and the positron annihilation data on the evolution of the defects of vacancy type stabilized by the impurities Sb and Au was performed. It has been established that the impurities Sb and Au entail a shift of the temperature region of short-range ordering realization in conditions of applying pressure torsion towards greater temperatures by 250 and 100 К, respectively.

Chronic hepatitis C remains one of the most important socially significant infections for world health. The use of modern highly effective drugs with direct antiviral action allowsto achieve a sustained virological response in patients. At the same time, in a significant number of cases after elimination of HCV infection, the progression of fibrosis continues with the development of its terminal stages and an unfavorable outcome for patients. The article focuses on comorbid pathology, which is a leading factor in this process in patients with chronic hepatitis C who have achieved a sustained virological response and presenting a serious challenge to modern hepatology.

The problems of the incidence of meningococcal disease and the epidemiological situation in the world, in the Russian Federation and in the Armed Forces are consecrated. In the past decade, there has been a global decline in the incidence of meningococcal disease, but there is still the possibility of new outbreaks and epidemics. From 1996 to 2016, a decrease in the incidence of meningococcal disease was also noted in Russia. In certain regions of the Russian Federation, an increase in incidence was recorded, which did not affect the general trend. Against this background, the idea was formed that in the coming years, thanks to a favorable epidemiological situation and the possibility of preventing meningococcal infection with the help of a vaccine, it is possible to achieve control of this infection. However, meningococcus showed all the classic properties of variability and fitness. Changes in the structure of circulating serogroups of meningococcus led to the formation of a non-immune layer of the population in the face of increasing pathogenicity of the dominant serogroups. The activity of the epidemic process is indirectly indicated by the high diversity of genetic and serological clonal complexes, serogroups and serotypes of the pathogen. The incidence of meningococcal disease over the past ten years in the Armed Forces of the Russian Federation can be assessed as low, but mortality has high values. The peak incidence was in 2010, but the maximum percentage of mortality was in 2017-18,2%. The increase in mortality from invasive forms of meningococcal infection, on the one hand, is associated with an increase in the total number of sources of this infection, on the other hand, with errors in early diagnosis and, as a consequence, in the incorrect provision of emergency care at the prehospital stage, which recur from year to year and are of a similar nature.

This review article examines the possibilities of surgical treatment of one of the socially significant diseases of modern society - arterial hypertension. The reasons for the development of parenchymal arterial hypertension have been disassembled. The reasons for the development of renovascular hypertension are discussed. Illuminates the pathogenesis of nephrogenic hypertension, statistical data on its prevalence. The issue of embolization of renal arteries in the treatment of nephrogenic arterial hypertension is considered. The forms of nephrogenic arterial hypertension in which the use of embolization is indicated. The etiology and pathogenesis of arterio-venous fistulas of the kidneys are described. Details of the world literature concerning the treatment of arterio-venous fistula and malformations of the kidneys are considered in detail. A review of literature data on materials used in embolisation of renal arteries in patients with arteriovenous fistula and malformations of the kidney is given. The etiology and pathogenesis of arterio-venous malformations of the kidneys are highlighted. The goal of embolization of the renal arteries in the preparation of patients with terminal renal failure and resistant arterial hypertension to kidney transplantation is described. The issue of preoperative preparation of patients before embolization of the renal arteries, the choice of operative access is considered. Methods of embolization of the renal arteries, possible complications and methods of their prevention are described. The data of the world literature concerning application of selective and superselective embolization of renal arteries in patients with parenchymal arterial hypertension are covered. The issue of potential use of renal artery embolization in other forms of nephrogenic arterial hypertension is also highlighted.

The better characteristics of the long-term strength of the EP-450-ODS (oxide dispersion strengthened) steel are determined compared to the well-known oxygen-free reactor steels. Using the Mossbauer analysis of the deformed powder mixture 56Fe3O4 + 57Fe, the possibility of the deformation-induced dissolution of iron oxides in the steel matrix, which makes it possible to obtain high quality ODS steels in the process of subsequent high-temperature annealing (sintering), is shown. The enhanced strength characteristics are obtained in recrystallized samples of ODS iron (YS0.2 ~ 570 MPa, UTS ~ 632 MPa) in the absence of any other alloying elements except for oxygen of air.

The method of visually identifying microregions with increased nickel concentration in austenitic Fe–Ni alloys by the appearance of dark diffraction contrast in electron-microscopic images has been laid a foundation for. The appearance of such a contrast can be explained by the microdistortions arising as a result of local changes of the lattice parameter due to the changes in the composition, and also as a result of magnetostriction dilatation in these regions with increased Curie temperature.

The dependence of the direction and degree of short-range ordering on the temperature of severe plastic deformation has been determined in the Fe86.8Cr13.2 binary alloy using Mossbauer spectroscopy. The stratification decreases upon cold (80–298 K) deformation and increases upon warm (453–573 K) deformation. The enhancement of stratification during warm deformation is caused by the continuous generation of point defects and their increased mobility.

The effect of the nitriding temperature in electron beam plasma on the structural and phase composition of the surface layers of metastable austenitic stainless steels is studied. Conversion electron Mossbauer spectroscopy shows that nitriding at 350°C results in the transition of the austenite into the α (bcc) phase by the shear mechanism in the surface layers of a plate (tenths of a micron). A nitrogen supersaturated austenite and a mixture of nitrides with a predominant configuration of three nitrogen atoms in the environment of iron are formed in layers 1–5 μm thick. Nitriding at a temperature of 500°C and above leads to nitrogen supersaturated austenite decomposition, the escape of chromium and nitrogen from the matrix into nitrides CrN, Fe4N, and FexN, and the subsequent γ → α phase transformation.

The modern doctrine of treating ischemic heart disease (IHD) is aimed to choose a method, which maximizes the effectiveness and safety for patients. Currently there are three approaches for treatment of stable IHD: optimal medical therapy, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Each approach has own indications and contraindications, based on international recommendations. Separate controversial group of patients are the elderly and senile patients. Limited physical activity, comorbidities, high complications risk in post-PCI double antiplatelet therapy and after CABG, requires strongly individualized approach and proved treatment method. Surgery is possible only after myocardial ischemia is proved by noninvasive imaging methods, assessment of fractional flow reserve (FFR) or its alternative – instant wave-free ratio (iFR) during the coronary angiography. Determination of hemodynamically significant stenosis helps interventional cardiologists to avoid unreasonable revascularization and PCI-related complications.

The physical and mathematical principles of bistatic radar are considered in the article, the essential characteristics are considered when constructing a mathematical model of a spatially distributed radar system. The necessity of software implementation of such a model for further investigation of bistatic radars is substantiated. The article discusses the necessity of upgrading radar equipment to improve the quality of the detection and identification of small flying machines and means of achieving this. Discusses the physical and mathematical principles of non-emitting radar system with diversity receiver and the transmitter upon detection of air targets on the background of the underlying surface, are analyzed essential when constructing mathematical models of spatially-separated radar systems. Provides a general description of the scheme, non-emitting radar station and timing diagram of signals within the system with diversity receiver and the transmitter. Analyzed analytical expressions for modeling non-emitting radar - which allows you to analyze the system in different variations, on the basis of the results obtained by theoretical calculations and experimental studies. The necessity of a software implementation of this model for further research on bistatic radar.

The main pathogenetic aspects of non-alcoholic fatty liver disease as a comorbid factor of chronic hepatitis C are considered. Non-alcoholic fatty liver disease is currently the most common liver disease worldwide, both among adults and children. It is usually accompanied by obesity, insulin resistance and diabetes mellitus. Non-alcoholic fatty liver disease includes a spectrum of pathologies from simple fatty liver infiltration to non-alcoholic steatohepatitis, which is characterized by inflammation with potential progression to fibrosis and cirrhosis over time. On average, non-alcoholic fatty liver disease occurs in 55% of patients with chronic hepatitis C, which is significantly higher than the prevalence of each disease individually. This condition leads to a greater rate of progression of fibrosis, as well as a continuing high risk of developing cirrhosis and hepatocellular carcinoma even after achieving a sustained virological response. In this regard, complex therapy aimed at normalization of the nutritional status, optimization of body weight, correction of impaired intestinal microflora, reduction of severity of liver steatosis and achieving a sustained virological response is a priority task in the treatment of patients with chronic hepatitis C.

We studied the expression of MMP-2, MMP-9, and inhibitor TIMP-1 in myocardial autopsy samples from subjects of different age and in cardiomyocyte cultures in the norm and in dilated cardiomyopathy. In autopsy samples of normal myocardium and in cardiomyocyte cultures, expression of molecules involved in extracellular matrix remodeling did not change during aging. In dilation cardiomyopathy, expression of MMP-2, MMP-9, and TIMP-1 and their ratios in autopsy material and in cultures was elevated by 1.5-9 times. Remodeling of extracellular matrix plays an important role in the pathogenesis of dilated cardiomyopathy. MMP-2, MMP-9, and their inhibitor TIMP-1 and the MMP/TIMP ratios can be regarded as promising predictors of dilated cardiomyopathy and used for evaluation of the effectiveness of treatment of this conditions in patients of different ages.

Methods of Mossbauer spectroscopy and electron microscopy have been used to study the effect of the severe plastic deformation by high pressure torsion in Bridgman anvils on the dissolution and precipitation of chromium nitrides in the austenitic and ferritic structure of an Fe71.2Cr22.7Mn1.3N4.8 high-nitrogen steel. It has been found that an alternative process of dynamic aging with the formation of secondary nitrides affects the kinetics of the dissolution of chromium nitrides. The dynamic aging of ferrite is activated with an increase in the deformation temperature from 80 to 573 K.