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Purpose: to analyze clinico-functional and aberrometric parameters of patients with the neovascular form of age–related macular degeneration (nAMD) treated by the anti-VEGF drug brolucizumab. Material and methods. The study involved 59 patients (59 eyes) aged 55 to 75 years, divided into two groups depending on the type of treatment. Group 1 consisted of 25 patients (25 eyes) who had previously received no anti-VEGF therapy and Group 2 had 34 patients (34 eyes) with an active nAMD form, who had previously been given anti-angiogenic therapy with aflibercept. All patients averagely received 5.48±1.5 brolucizumab injections in the “treat and extend” mode: 3 loading injections with monthly checkups followed by elongated intervals reaching 8 weeks. The treatment effectiveness was estimated by the change in maximum corrected visual acuity (MCVA) as measured by precision visometry, the aberrations parameters of the optical system of the eye, and the thickness of the central retinal zone (CRZ). In addition, the height of retinal pigment epithelium (RPE) detachment, the presence of intraretinal fluid (IRF), subretinal fluid (SRF), and fluid under RPE. Results. In group 1, BCVA whose initial value was 0.37 ± 0.16 reached 0.78 ± 0.25 (p = 0.02) by the end of treatment, while in group 2, the value rose from 0.35 ± 0.18 to 0.62 ± 0.22 (p = 0.02). After the 5th injection, Group 1 showed a statistically significant decrease in TCZV (ave. by 270.17 ± 92.37 μm, p=0.05), while Group 2 showed a less pronounced morphological result (a decrease from 480.54 ± 174.22 to 320.32 ± 109.53, p < 0.05). Both groups also showed, after the 5th injection, a decrease in the cumulative frequency of occurrence of various types of fluid (p < 0.02). A decrease in all components of higher order aberrations was also noted after the first 3 injections; this result remained stable until the end of the observation period (p = 0.04). Conclusion. In Group 1 patients, we succeeded in achieving high morphological and functional results and maintaining them at a stable level until the end of the observation period. Group 2, patients with an active nAMD, previously treated with other anti-VEGF preparations, showed a less pronounced, though stable improvement in morphofunctional parameters.

In preparing the review, articles on the functioning of the reverse transcriptase enzyme of endogenous repeat sequences LINE1, the mechanisms of action and antitumor activity of viral reverse transcriptase inhibitors. Articles available in the biomedical literature information databases SciVerse Scopus, PubMed, Web of Science, Russian Science CitationIndex (RSCI) were analyzed. The review used information from 140 publications, of which 95 and 39 were published, respectively, over the last ten and three years, 2 articles present the results of clinical studies, and 45 articles refer to results demonstrating the anticancer properties of the studied compounds in various models in vitro and in vivo. Aim. Based on data on the functional properties of the reverse transcriptase enzyme of endogenous repeat sequences LINE1 (long interspersed nuclear elements 1), analyze the potential use of viral reverse transcriptase inhibitors in oncology, presenting their classification and main mechanisms of action. About 98 % of the human genome consists of repetitive sequences, most of which are represented by mobil genetic elements, the activation of which leads to increased genome instability. These include long (LINE) and short (SINE) interspersed nuclear element repeated DNA sequences interspersed nuclear elements, respectively, which occupy about 45 % of the human genome. Increased expression levels of these sequences in the genome have been identified in many forms of malignant neoplasms. Their transposition occurs due to the expression of LINE1-encoded reverse transcriptase, whichis homologous to viral reverse transcriptase. To date, reverse transcriptase inhibitors of viruses of nucleoside and non-nucleoside structure have been developed and are successfully used in the clinic. These drugs demonstrate an inhibitory effect on both LINE1 reverse transcriptase and telomerase, which provides the tumor cell with the ability to overcome replicative senescence. Due to these properties, these compounds are expected to exhibit both their own antitumor activity and increase the sensitivity of tumor cells to the therapy of malignant neoplasms, which is experimentally confirmed in models of malignant tumors in vitro and in vivo. Use of reverse transcriptase inhibitors in combination therapy seems advisable both to prevent further genome rearrangements caused by LINE1 and to suppress the survival of tumor cells by inhibiting telomerase activity.

The article studies one type of current goods positioning, i. e. greenwashing. Greenwashing is company activity, in which various marketing communications (PR and advertising) are used to demonstrate its ecological orientation instead of real introduction of ecological practices aimed at cutting the negative impact on the environment. The author describes history of greenwashing, provides examples and discusses strategies that help check the current company positioning for using greenwashing. The difference between green marketing and greenwashing was explained. Green marketing is a marketing activity, as a result of which the company sells its products or services orientating only to their ecological properties. The article also studies the problem of transparency and corporate social responsibility. Corporate social responsibility means practice of sustainable development, whose goal is to ensure gains, such as economic, ecological and social benefits for producer and consumer. Complete transparency is a conviction that all organizations must be frank, open and honest in their work. Types of greenwashing regulation (legal, public, professional) are characterized.

The article deals with an acute topic connected with sustainable development, i. e. the development of green financing. Raising capital for green investment was limited due to micro-economic problems dealing with internationalization of external factors, informational asymmetry, inadequate analytical potential and vague definition of the notion ‘green’. Green bonds mean various debt tools, after flotation of which earnings go to financing or refinancing of effective or new green projects. The article describes stages of green bond market development, characterizes participants of this trend and shows voluntary standards of green bonds that should be used for their issuance. The principle goals of green finance are to internationalize ecological external factors and reduce risk perception, to stimulate investment that could provide ecological advantages. The author studies benefits and structure of green bonds by aims of using profits and shows pre-conditions of green financing development. They are creation of favorable environment, support of business climate, provision of bank regulation bodies with authorities to supervise ecological risks of the finance sector and law supremacy and investment regime, which could promote growth in green investment activity.

Abstract Background Dysferlinopathy has a high prevalence in relatively isolated ethnic groups where consanguineous marriages are characteristic and/or the founder effect exists. However, the frequency of endemic mutations in most isolates has not been investigated. Methods The prevalence of the pathological DYSF gene variant (NM_003494.4); c.200_201delinsAT, p. Val67Asp (rs121908957) was investigated in an isolated Avar population in the Republic of Dagestan. Genetic screenings were conducted in a remote mountainous region characterized by a high level of consanguinity among its inhabitants. In total, 746 individuals were included in the screenings. Results This pathological DYSF gene variant causes two primary phenotypes of dysferlinopathy: limb‐girdle muscular dystrophy (LGMD) type R2 and Miyoshi muscular dystrophy type 1. Results indicated a high prevalence of the allele at 14% (95% confidence interval [CI]: 12–17; 138 out of 1518 alleles), while the allele in the homozygous state was detected in 29 cases—3.8% (CI: 2.6–5.4). The population load for dysferlinopathy was 832.3 ± 153.9 per 100,000 with an average prevalence of limb‐girdle muscular dystrophies ranging from 0.38 ± 0.38 to 5.93 ± 1.44 per 100,000. Conclusion A significant burden of the allele was due to inbreeding, as evidenced by a deficiency of heterozygotes and the Wright fixation index equal to 0.14 (CI 0.06–0.23).

The article studies the most evident examples of fast growing business from start-ups to companies – unicorns, analyzes causes of their quick success and shows key trends of future start-ups. The authors identify trends of realizing business start-ups of future companies – unicorns, among which technological start-ups, fintech start-ups, start-ups in the field of transport, EdTech, medical start-ups, e-commerce. The authors review the most successful companies-unicorns of the new decade of the 21st century. They analyze different lines in business development from electronic on-line platforms for designing on-line games, education services, estimating the efficiency of ad campaigns and marketing analysis to production of grapheme nano-tubes with higher electro-conductivity and strength. The article identifies vectors of companies – unicorn evolution in view of demand for digital products (services, applications) on the part of internet- space market and information technologies, as well as needs of new technology and innovation market, where the major trend is development of unique materials (production). The role of entrepreneurship of new formation (for B2C market) is demonstrated in order to raise comfort, accessibility and ergonomic characteristics of products/services and at the same time to increase their basic functionality for convenience and relative simplicity for users. The article gives examples of home companies – unicorns that grew up from start-ups, whose capitalization exceeds $1bn. The authors study the most popular markets, where a considerable number of companies – unicorns are located and show statistics of successful start-ups of 2020–2021. Start-up trends and requirements to them aimed at attaining the status of successful company with high capitalization were characterized.

Introduction. A treatment for LFR for many years, the superiority of PPIs over placebos is still controversial. Of particular clinical importance is the metabolic rate of PPIs in hepatocytes using the cytochrome P450 system with the participation of the isoenzyme CYP2C19 and partially CYP3A4Аim. We set a goal to study the efficacy of omeprazole 20 mg in the treatment of LFR symptoms without esophageal syndrome in patients with gastroesophageal reflux (GERD), depending on the polymorphism of the CYP2C19 genotype.Мaterials and мethods. After the exclusion criteria, 100 people took part in the study, 94 people completed the study.Results. According to the results, 26.6% of patients in the study group (residents of the Moscow region) with LFR symptoms without esophageal syndrome belong to fast metabolizers of CYP2C19, 4.2% to ultrafast metabolizers, 52.1% to normal metabolizers, 16% to intermediate metabolizers and 1.1% to slow CYP2C19.Conclusions. In patients with a rapid metabolism, within 1 month after discontinuation of omeprazole, it is necessary to increase the amount of omeprazole 20 mg intake up to 2 times a day in the morning and in the evening and reduce the duration of treatment to 6 weeks.

Gastroesophageal reflux disease (GERD) is a disease of the gastrointestinal tract caused by the discharge of stomach contents into the esophagus. In GERD, both esophageal and extraesophageal manifestations are widespread, but, unfortunately, the latter are less well known. About one third of GERD patients have extraesophageal symptoms, which can occur even in the absence of the usual esophageal symptoms of GERD, which makes diagnosis difficult. The most common of these is laryngitis. In addition to reflux laryngitis, laryngopharyngeal reflux (LFR) can cause the development of contact granulomas, laryngeal stenosis, functional dysphonia, vocal fold nodules, Reinecke's edema, and laryngeal neoplasms. These symptoms disappear after taking antireflux therapy, but there is still no consensus on its duration.Aim. To evaluate the results of treatment of laryngeal manifestations of LFR with omeprasole 20 mg 30 minutes before meals in the morning.Methods. The study involved 531 patients with complaints of hoarseness, of which women 337 - 63.5%, men 194 - 36.5%. We prescribed omeprasole 20 mg 30 minutes before meals in the morning for 6 weeks. Patients were questioned using the Reflux Symptom Index (RSI) questionnaire and indirect laryngoscopy with an assessment of laryngeal changes according to the Reflux Signs Scale (RSS).Results. There was a statistically significant decrease in hoarseness 1 week after treatment, which continues to decrease 6 weeks after the initiation of treatment when evaluating the data on the RSI questionnaire. There was no statistically significant difference in the laryngoscopic picture before the start of treatment and after 1 week of treatment according to RSS; a statistically significant decrease in the quantitative assessment of RSS was revealed 6 weeks after the initiation of treatment.Conclusions. Omeprasole at a dose of 20 mg in 30 minutes reduces the symptoms of LFR already after 1 week, the decrease in the severity of symptoms continues by 6 weeks of its use. Improvement of the laryngoscopic picture with the appointment of omeprazole 20 mg 30 minutes before meals occurs by the 6th week of its use. A positive correlation was found between the severity of LFR symptoms, including hoarseness, and the severity of changes in the laryngoscopic picture.

The article investigates history of establishment and development of start-up unicorn-companies with capitalization over $ 1bn. The authors analyzed key types of unicorn-companies (unicorns, decacorns quinquagintacorns, gectacorns), identified their principle characteristics, showed criteria and factors of their success. The role of venture funds was studied, as they are major investors into promising business-projects. The article described trends of the 1-st half of 2020, the time of state restrictions and pandemic, such as distant work, IT entertainments, could services, on-line delivery, marketplaces, drop in business activity, which require clients' presence. It also showed the process of business-projects' passing from start-ups to companies with high capitalization. The authors pointed out that to create a successful company with capitalization of $ 1bn you do not need any special conditions, but there is certain logic concerning how the start-up can become unicorn-company. Basic points of this logic were provided. The authors substantiated the necessity of venture fund promotion among entrepreneurs and investors in order to speed up the start of start-ups and development of business-projects to the level of big companies.

The aim of this study was to evaluate the effectiveness of MRI in diagnosing combined renal and ureteral injuries at different periods of traumatic disease (TD). Methods and Results: We analyzed the results of diagnostics and treatment of 139 patients (80 women and 59 men) with renal and ureteral injuries aged between 18 and 72 years. There were 67(48.2%) patients in the period of acute reaction to trauma, 40(28.8%) patients with early manifestations, and 32(23%) patients in the period of late manifestations. In 127(91.4%) patients, an urgent plain abdominal X-ray was performed without any preliminary preparation. USI of the abdominal and retroperitoneal space was performed in 108(77.7%) patients in the stage of the primary assessment of renal injury as it was a rapid non-invasive investigation. A whole-body MSCT was performed in 131(94.2%) patients, using the nonionic contrast agents Ultravist (350mg I/ml) and Omnipaque (350mg I/ml). MRI was performed in 125(89.9%) patients, including cases of pregnancy and a medical history of allergies. Contrast-enhanced MSCT had a high diagnostic efficiency in assessing complications in kidney and ureteral injuries at different periods of TD (accuracy of 89.2% for acute reaction, 88.8% for early manifestations, and 89.5% for late manifestations). MRI of the kidneys and ureters was indicated in periods of early and late manifestations of TB to detect renal complications in cases with a discrepancy between clinical manifestations and the results obtained by ultrasound and MSCT (accuracy of 87.5% for early manifestations and 89.9% for late manifestations).

Abstract Recurrent nerve laryngeal schwannoma is a rare benign tumor that, in expert hands, can be treated by transoral CO2 laser surgery.

Objective: analyze the validity of destructive treatments for cervical diseases in clinical practice.Materials and methods: analyzed archival medical documentation (medical records of an inpatient patient, form 003/y) of 258 patients who underwent surgical treatment of cervical diseases in 2017 – 2018. Statistical data were calculated on a personal computer using the Microsoft Excel 2011 for Mac program and the «Statistica» statistical program.Results: an analysis of medical documentation revealed that a complete set of diagnostic methods, regulated by the clinical recommendations “Benign and precancerous cervical diseases from the perspective of cancer prevention” (2017), including HPV genotyping, was carried out in 28.7 % women. Before surgical treatment, a cytological examination of the cervix was carried out in 89.5 % cases, HPV-test — 31.4 % patients. As a result of the comparison of 258 histological and pre-operative clinical diagnoses, overdiagnosis of low- and high-grade cervical lesions (LSIL and HSIL) was noted in 16 (23.2 %) patients who did not have a history of childbirth and 42 (22.0 %) women who had previously given birth, which determined the use of destructive treatments without indications in 58 (22.5%) cases. An underestimation of the severity of cervical damage among unborn patients was found in 9 (13.0 %) patients, as well as in 40 (21.2 %) women with a history of childbirth.Conclusions: overdiagnosis of the degree of intraepithelial cervical lesions entails the unreasonable use of destructive methods of treatment in young unborn women who violate the anatomic-functional integrity of the cervix and the architectonics of the cervical canal.

Acute otitis media (OSA) is one of the most common diseases in children and adults and the most common cause of antibiotic therapy, often unreasonable. 20–70% of respiratory infections in adults and children is complicated by the development of CCA. Despite the fact that only 10% of CCA has a viral etiology, the vast majority of CCA are also viral-bacterial co-infection. The article presents the main pathogenetic mechanisms of the development of CCA, such as viral and virus-induced. The term “heat-generating” microorganisms is introduced. A review of the most common pathogens of CCA viral and bacterial. An otomicroscopic picture is described based on the generally accepted domestic classification of CCA. The main tympanometric curves and their types during CCA are presented. Much attention is paid to the modern principles of pathogenetic and symptomatic therapy. In particular, local anti-inflammatory and analgesic therapy using ear drops containing lidocaine. Some progress in the prevention of acute otitis media is discussed, which has led to a decrease in the frequency of visits to doctors about otitis media and the appointment of antibiotics. This is due to the widespread use of vaccines, as well as the introduction of “wait-and-see” tactics in mild and moderate cases of CCA without initial antibiotic treatment. Success in reducing the incidence of CCA will depend mainly on preventing the colonization of the nasopharynx by otopathogens, as well as reducing the incidence of viral infections. According to international and domestic recommendations, the basis for the prevention of acute otitis media is vaccination against pneumococcus, hemophilus bacillus and influenza virus.

Introduction. Despite significant progress achieved in the surgical treatment of cicatricial laryngeal stenosis and cervical trachea in recent decades, this issue appears relevant, especially among people of young and working age.Aim of the study: To develop tactics for surgical treatment of post-intubation laryngeal stenosis using a CO2-laser.Materials and methods: During the period from 2015 to 2019, surgical treatment was performed for 105 patients with post-intubation cicatricial stenosis of the larynx using microsurgical techniques and a CO2-laser, provided that the cartilage frame of the larynx was preserved, which was determined in a preoperative examination.Results and discussion: In the postoperative period, patients were monitored from 6 months to 3 years. Localization of cicatricial post-intubation laryngeal stenosis in the vestibular region is quite rare. According to the results of the study, achievement of a stable functional result was obtained in 20 (84%) of 24 patients with lesions of the vocal section of the larynx, in one case a cicatricial membrane of this section of the larynx was required to be excised after one year, and laryngoplasty with extra laryngeal access in four cases. Post-intubation stenosis of sub-folded localization is most widespread, and in our observations they amounted to 79%. The use of endolaryngeal access using a CO2-laser made it possible to achieve a good functional result in 66% of cases, reconstruction of the larynx by extra-laryngeal access was required in 33%, and laryngotracheal resection in 1%.Conclusion: It is shown that the use of a CO2-laser in the surgical treatment of chronic post-intubation laryngeal stenosis significantly expands operational capabilities due to the high accuracy and low level of damage to surrounding tissues. This method allows the formation of minimal wound surfaces by submucosal excision of scar tissue and makes it possible to cover the wound with microlosks of the mucous membrane, reducing the time of epithelization in the intervention area, which is an important prevention of repeated stenosis. In the surgical treatment of extended stenosis of the middle part of the larynx, there are prerequisites for repeated wound replacement with scar tissue, which in our observations was avoided by using endoprostheses. The defeat of the sub-follicular part of the larynx is prone to restenosis even in the absence of data for the defeat of the cartilaginous framework of the larynx.

The aim of the review is to identify current possibilities of carbon dioxide laser application in microsurgical treatment of chronic laryngeal cicatricial stenoses. Currently, laser endolaryngeal surgeries are one of the main standards in surgical treatment of patients with this laryngeal pathology, including when providing high-tech assistance. Various types of lasers and methods of surgical treatment of the larynx are used. The choice of these methods is primarily determined by the opinion of the operating surgeon. The review highlights the principles of laser surgery in general, and when using carbon dioxide laser in particular. The use of micromanipulators makes it possible to combine the work of carbon dioxide laser with the operating microscope, affecting target tissues noninvasively with maximum precision. This technology makes it possible to expand the range of surgical manipulations in endolaryngeal surgeries. The main operating modes of the carbon dioxide laser, applicable for different clinical situations, such as power, impulse, laser power density (PD) are considered. In addition, the combination of a micromanipulator with an operating microscope allows the use of additional techniques aimed at preventing restenosis, such as the use of microflaps, submucosal laryngeal cicatricial tissue vaporization. The possibilities of the recurrence of cicatricial stenosis by different variants of stenting are presented. The risk of complications of this technique is not higher than in other types of larynx laser surgeries, and with proper preventive measures can be minimized. In the review, possible complications, both early and late, measures of their prophylaxis, as well as ways to eliminate their consequences are analyzed in detail.

Aim. The aim of the research has been: the study of the conceptual foundations of sustainable development of the region, identification of the main factors, signs, patterns, principles, preconditions for sustainable development of the region as an ecological and socio‐economic system and the proposition of new approaches to the analysis, assessment and modeling of the development of the region from the standpoint of a systematic approach.Material and Methods. The research carried out by the authors was based on statistical data from the Federal State Statistics Service, characterising the ecological and socio‐economic development of the Republic of Dagestan. Analysis of the degree of influence and assessment of the prerequisites, factors, conditions of the ecological, socio‐economic development of the region made it possible to substantiate the choice of research methods, most of which are deterministic or probabilistically deterministic in the nature of information. In this regard, the study used methods of quantitative research, which are based on factorial, genetic and normative approaches, including methods of expert assessments, balance planning methods, economic and mathematical methods of optimization and assessment of economic efficiency.Results. The authors propose new approaches to the study of the problems of assessment, modeling and forecasting of the ecological, socio‐economic development of the region, which will make it possible to identify emerging trends that drive its development. Based on the research of indicators that characterise the basic and auxiliary processes in the region, life support processes and processes that hinder the development, an assessment of the quantitative transformations of ecological‐socio‐economic development in Dagestan was carried out. Conclusion. The methodology used made it possible to obtain a qualitative characteristic of the regional space to analyze and assess the transformation processes in the ecological‐socio‐economic development of the Republic of Dagestan and to provide an integrated assessment of regional processes.

Aim of the study: to develop a tactic of surgical treatment of cicatrical lesion of the middle larynx depending on the localization and length of stenosis.Materials and methods: from 2014 to 2019, 43 patients with cicatrical stenosis of the folded larynx underwent surgery. The average age of the patients was 39 years and ranged from 18 to 78 years. Depending on the clinical situation, patients were divided into 4 groups, in which different methods of surgical treatment were applied – removal of scars of the middle larynx using CO2-laser and additional application of keel-shaped implant (n = 21), microflaps in the area of commissure (n = 10) and intraretynoid region (n = 4), endoprosthesis covered with xenopericord (n = 8).Results: in the postoperative period endoscopic examination of the larynx was carried out in dynamics during the period up to 1 year. Patients were examined daily while in hospital, then monthly. In addition to endoscopic examination, the study of voice function was carried out by the method of determining the time of maximum fonation. The estimation of respiratory and voice rehabilitation was carried out and stable positive effect was received in 90% in the first group, 70% - in the second, 75% - in the third, 75% – in the fourth. The obtained data allow to develop an individual approach to surgical treatment of cicatrical stenosis of the larynx depending on the localization and extent of cicatrical lesion.Discussion: the optimal method of treating cicatrical lesion of the middle larynx is to create conditions that prevent the contact of wound surfaces and their separation. For this purpose, methods that are individually addressed to the main clinical situations in this problem have been developed. In addition, the use of CO2-laser in the surgical treatment of cicatrical lesions of the middle larynx significantly expands operational capabilities due to high accuracy and low level of damage to surrounding tissues.Conclusions: in case of cicatrical lesion of the middle larynx up to 4 mm in length, in the absence of a tracheostoma an effective method of restoration of respiratory and vocal function of the larynx is the use of microflaps formed by microsurgery with th e help of CO2-laser; stenoses in the area of middle larynx commissure of more than 4 mm require additional stenting for the period of epithelization of the wound surface and remodeling of the scar, which is 3–4 weeks. In the presence of a tracheostoma in patients with prolonged stenosis of the middle laryngeal commissiure, an implant coated with xenopericardium and chlorhexidine ionic-covalent immobilization, which helps to avoid inflammatory changes during the period of stenting, has proved to be a good choice.

Limb-girdle muscle dystrophy 2Q is one of the rarest forms of plectinopathies and is represented by an isolated muscular dystrophic syndrome, according to two previously described literature reports. There are five forms of plectinopathies, including limb-girdle muscle dystrophy 2Q, are caused by mutations in the PLEC gene, the alternative splicing of which determines the synthesis of 9 isoforms of the plectin protein (1, 1a, 1b, 1c, 1d, 1e, 1f, 1g, 3) performing cytolinker function in the neuronal, epithelial and muscle tissue.The article describes the family observation of three sick siblings with the limb-girdle muscle dystrophy 2Q phenotype due to the presence of a new homozygous mutation (NM_201378.3:c.58G>T, NP_958780.1:p.Glu20Ter) in the isoform 1f PLEC revealed by whole-exome sequencing. Clinical, electromyography, visualization and histopathological features of limb-girdle muscle dystrophy 2Q were analyzed in detail. The onset of clinical manifestations in all the described siblings was observed in early childhood with moderate weakness mainly in the pelvic girdle muscles and proximal lower limbs with minimal involvement of the muscles of the shoulder girdle. A distinctive aspect is the stagnation of the myodystrophic process until 20—21 years, followed by the progression and development of episodes of respiratory failure, as well as the formation of rigidity of the cervical, thoracic spine and moderate contracture of the Achilles tendons. Typical features are marked atrophy of paravertebral muscles with the formation of pterygoid scapula and the presence of hypertrophy m. gastrocnemius, m. quadriceps femoris, m. deltoideus and m. triceps brachii. Histopathological examination m. vastus lateralis revealed myodystrophic process without inflammatory infiltration, muscle fiber cytoskeleton disorganization resulted from the plectin loss.Electrocardiography signs of the early repolarization syndrome, focal cardiosclerosis and sinus tachycardia are described. For the first time, involvement in the pathological process of pulmonary tissue in the form of noninfectious bronchiolitis, atelectasis, and the development of the myasthenic syndrome causing episodes of respiratory failure resulted in the death of two described siblings aged 29 and 31 years. Discussed pathogenetic role of PLEC 1f isoform in the development of described syndromes, expands understanding of rare nosology limb-girdle muscle dystrophy 2Q.

Photodynamic diagnosis is a promising method in the treatment of laryngeal papillomatosis, which includes an assessment of the increased visual and spectrometric contrast of papillomatosis masses against the background of the introduction of the photosensitizer. We have developed a method of treatment of laryngeal papillomatosis in two stages: intraoperative diagnosis using the domestic preparation of 5-aminolevulinic acid hydrochloride and subsequent surgical treatment using a carbon dioxide laser. Using the new method, we treated 21 patients, of which 13 (61.9%) had the inter-recurrent period longer than 12 months.

The study objective is to compare the characteristics of physical and sexual development of boys aged 11–13 years living in different ecological and geographical areas of the Republic of Dagestan and to determine the effect of chronic iodine deficiency on the onset of puberty.Materials and methods. In a lowland area containing 11 districts, 501 subjects were examined; in a mountain area containing 17 districts, 325 subjects were examined; in a submontane area containing 7 districts, 274 subjects were examined. In total, 1100 boys aged 11–13 years were randomly selected.Results. Physical development of the boys was mostly characterized as normal but with a clear tendency toward lower values, especially in the submontane districts. In boys living in the areas with severe iodine deficiency, delayed onset of puberty was observed 3.2 times more frequently than in their counterparts living in the districts with mild iodine deficiency. Total fraction of boys with signs of delayed sexual development was 38.5 %, and they mostly lived in the submontane area.Conclusion. Emerging in Russia tendency toward lowered characteristics of physical development of boys is observed in the Republic of Dagestan. This confirms the negative effect of chronic iodine deficiency on sexual development of boys which manifests through delayed sexual maturity.

The objective of the study was to evaluate the long-term results of endoscopic papillosphincterotomy in cases of choledocholithiasis and papillary stenosis.Material and methods. We carried out retrospective analysis of the results of endoscopic papillosphincterotomy (EPST) due to the presence of choledocholithiasis (group 1, n=117) and papillary stenosis (group 2, n=55) along with the combination of the above (group 3, n=6) in a total of 178 patients. Clinical and endoscopic results of the intervention were studied in all patients in the long-term (from 1 to 30 years).Results. Based on the analysis of the complex examination, including endoscopic functional tests, treatment results were evaluated as good in 80 % of patients, satisfactory in 16 % of patients and unsatisfactory in 4 % of patients (after endoscopic correction of papillary stenosis).Conclusion. The cicatrisation process in the papillotomy opening exhibits the most intensively in patients with papillary stenosis combined with choledocholithiasis and without it, lasts until 4.5–5 years after surgery. Dynamic observation of patients after EPST is obligatory for early diagnosis of restenosis in the papillotomy opening.

Purpose: to assess the effectiveness of combined treatment of macular edema (ME) of varied etiology. Materials and methods. The results of combined treatment of 32 patients (38 eyes) aged 55 to 75. Of these, 13 patients (15 eyes) had postocclusion MO, 12 patients (14 eyes) had diabetic MO and 7 patients (9 eyes) had an exudate form of age-related maculardegeneration. Two groups of patients were formed depending on the treatment administered. Group 1 (14 patients) intravitreally received an inhibitor of neoangiogenesis, Ranibizumab, whilst group 2 (18 patients) received combined treatment which included a prolonged corticosteroid (Diprospan) administered into sub-Tenon’s space, laser coagulation and intravitreal administration of Ranibizumab. All patients underwent high-definition optical coherent tomography examinations (HDOCT, OCT 4.000 Cirrus Humphrey - Zeiss, San Leandro, USA) and computer tonometry, performed on a visual field analyzer Peritest 30/50/100 using the Macula software. Results. The combined treatment of patients with ME resulted in a stable improvement of visual acuity (averagely by 0.55 in 88 % of cases), rapid retinal edema reduction (its thinning) in 74 % of cases, reduction of risk of neovascular complications, and stabilization of the results achieved. Conclusion. Due to a number of components involved and pathogenetic emphasis, the combined treatment promotes the effectiveness of functional rehabilitation of patients with ME of varied origin // Russian Ophthalmological Journal, 2017; 1: 5-8. doi: 10.21516/2072-0076-2017-10-1-5-8

Aim. To assess the specifics of endoscopy presentation of mucosal lesions of upper gastrointestinal tract (UGIT) in patients with chronic coronary heart disease (CCHD) with no rhythm disorders and with atrial fibrillation (AF).Material and methods. Esophagogastroduodenoscopy was done in 100 CCHD patients. All patients were selected to 2 groups comparable by age and gender. First group (n=50) included CCHD patients, the second (n=50) — CCHD with AF. The investigations were performed with videoendoscopic equipment byOLYMPUS systemic videocenters CV-150 and CV-180 EVIS EXERA II.Results. Evaluating the results of endoscopy, in all 100 patients there were various changes of the mucose of UGIT. No statistically significant differences found, however in CCHD group with rhythm disorder there was noted slight predominance of patients with superficial gastritis, as erosions in anthral part of the stomach. One of explanation of the erosions is due to excessive drug intake per os, that could influence the mucose of UGIT.Conclusion. All CCHD patients, who have been prescribed the therapy for main disease, are in need for preventive intake of the drugs protecting UGIT.

Aim. The aim of the research if to study variability of the sprout of S. daghestanica, included in the list of endemic species of the Eastern Caucasus and listed in the Red Book of Dagestan.Methods. Collection of species at the flowering stage was held in three districts of Dagestan: Gergebilskaya (751 m above sea level), Akushinsky (1058 m above sea level.) and Karabudakhkent (747 m above sea level). From each collected sample we randomly selected 30 shoots, 3 sprouts from 10 plants, morphometric features of which were taken into consideration.Results. The group with the highest coefficient of variation of the studied traits of the S. daghestanica sprout is characterized by: "the length of the apical generative sprout", "the length of the developed lateral generative sprout", "the number of nodes on the generative part", "the number of nodes on the vegetative part" "the number of flowers on the main generative sprout", "the number of lateral generative sprouts". The variability of feature "total length of the sprout" proved to be the lowest. The relative stability of this trait, in our opinion, is due to the optimal conditions for the realization of the growth potential.Conclusion. For such characteristics as "the number of nodes on the generative part", "the number of nodes on the vegetative part", "number of lateral generative sprouts", "the length of the developed lateral generative sprout" are under the significant influence of environmental factors. No differences could be identified or they were not valid, concerning the following characteristics: "the total length of the sprout", "the length of the generative part", "the length of the vegetative part", "the length of apical generative sprout", "the number of flowers on the apical sprout", "diameter of the vegetative part at the base", "diameter of the generative part at the base".

Aim. To evaluate the influence of gene СYP2C9 activeness via losartan test on the warfarin dosage management in earlier and long-term post-operational periods.Material and methods. Totally 33 patients included with artificial heart valves. All patients underwent assessment of genes carriage by polymorphic marker СYP2C9 by PCR after preparing of DNA from whole blood. The activeness of СYP2C9 was assessed with losartan concentration and its metabolite (E-3174) in urine after single intake of losartan 50 mg.Results. The level of losartan and its active metabolite (E-3174) in urine was a prognostic marker determining therapeutic dose of warfarin in cardiac surgery patients in long-term post-operation period.Conclusion. The СYP2C9 assessment by losartan concentration and E-3174 in“losartan test” might help to determine warfarin treatment dosage in delayed postoperational period that might improve the efficiency and safety of pharmacotherapy in valve prosthesis patients.

The work is the research of features of vermins insects in agriculture. The role of butles – chrysomelidae for agriculture as harmful for plants is revealed.

Anthropogenic pollution becomes the essential factor, reducing photosynthetic efficiency of microalgae of Caspian sea. Methods of registration of chlorophyll fluorescence can be used for detection of toxic action of heavy metals on microalgae.

Influence of a mineral nourishment on the growth, optical parameters and activity of the photosynthetic device of the plants which have sprouted on water, sandy and soil environments was investigated. The received results of researches expand representations about possibility of the decelerated to fluorescence use for express diagnostics of environment condition.

The results of research of 9 populations Hypericum perforatum L. collected from different heights in natural conditions are presented in article. Variability of vegetative and reproductive members depending on an origin is revealed.

Plectinopathies are orphan diseases caused by PLEC gene mutations. PLEC is encoding the protein plectin, playing a role in linking cytoskeleton components in various tissues. In this study, we describe the clinical case of a 26-year-old patient with an early onset plectinopathy variant “limb-girdle muscle dystrophy type 2Q,” report histopathological and ultrastructural findings in m. vastus lateralis biopsy and a novel homozygous likely pathogenic variant (NM_201378.3:c.58G>T, NP_958780.1:p.Glu20Ter) in isoform 1f of the gene PLEC. The patient had an early childhood onset with retarded physical development, moderate weakness in pelvic girdle muscles, progressive weakening of limb-girdle muscles after the age of 21, pronounced atrophy of axial muscles, and hypertrophy of the gastrocnemius, deltoid, and triceps muscles, intermittent dyspnea, and no skin involvement. Findings included: non-infectious bronchiolitis and atelectasis signs, biopsy revealed myodystrophal pattern without macrophage infiltration, muscle fiber cytoskeleton disorganization resulted from the plectin loss, incomplete reparative rhabdomyogenesis, and moderate endomysial fibrosis. We have determined a novel likely pathogenic variant in PLEC 1f isoform that causes limb-girdle muscle dystrophy type 2Q and described the third case concerning an isolated myodystrophic phenotype of LGMD2Q with the likely pathogenic variant in PLEC 1f isoform. In addition, we have demonstrated the presence of severe lung injury in a patient and his siblings with the same myodystrophic phenotype and discussed the possible role of plectin deficiency in its pathogenesis.

The effect of CdCI2 (0.25 mg /l) on the proteolytic enzyme activities of the carp tissue are studied. The results confirm the involvement of cathepsin D and neutral protease in the development of the organism's response to the action of cadmium ions.