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The incidence of trigeminal neuralgia (TN) is 4–5 cases per 100,000 population per year, and the prevalence is about 20–50 cases per 100,000 population. According to the modern classification, the following types of TN are distinguished: classical, symptomatic and idiopathic. The cause of classical TN is a neurovascular conflict, of symptomatic TN – neoplasms in the petroclival area, vascular anomalies, multiple sclerosis, etc. In the absence of a reliable etiological factor, TN is considered idiopathic. TN pathogenesis remains one of the most challenging topics in neuroscience. Today, there are many theories and hypotheses regarding the peripheral and central mechanisms of trigeminal neuralgia. The most popular theory is the neurovascular conflict that occurs between the trigeminal nerve and the cerebral vessels, but this theory is not the only one. It is known that even after microvascular decompression, patients may continue to experience facial pain. Therefore, other pathogenetic mechanisms are discussed: short circuit theory, multineuronal mechanism, allergic and immune hypothesis, gate theory, bioresonance hypothesis, trigeminal convergence projection theory, “ignition” hypothesis and ion channel pathology. TN is a clinical diagnosis, and its establishing requires certain criteria proposed by the International Headache Society. Using instrumental research methods, namely magnetic resonance imaging of the brain, is necessary for the differential diagnosis of classical and symptomatic TN, and imaging results should always be interpreted in combination with clinical data to make correct decisions on further treatment tactics.

The aim of the work was to estimate the prevalence of HIV, HBV and HCV markers among pregnant women and their male partners in the Republic of Guinea.Materials and methods. The material of the study was blood plasma samples from 140 pregnant women living in Kindia prefecture and N’Zerekore prefecture, as well as 60 male partners who reported sexual contact with HIV-infected persons. The samples were examined for the presence of serological (HBsAg, HBeAg, antibodies anti-HBs IgG, anti-HBcore IgG, anti-HBe IgG, anti-HCV IgG, Ag/Ab-HIV) and molecular (HBV DNA, HCV RNA, HIV RNA) markers.Results and discussion. The age of the examined pregnant women ranged from 13 to 55 years and was on average (26.29±9.67) years. The age of men varied from 15 to 60 years, on average – (29.05±11.99) years. When assessing the prevalence of serological markers, antibodies to HCV were detected in 2.14 % cases in women and in 3.33 % cases in men. Antibodies to HIV were found in 6.43 % and 6.67 % women and men, respectively. Serological markers associated with HBV were detected in 80.71 % (HBsAg – 13.57 %) of women and 81.67 % (15 %) of men. In the pregnant women, HCV RNA was not detected, HIV RNA was revealed in 1 case, HBV DNA was identified in 26 cases (18.57 %), including 5 % HBsAg-negative hepatitis B cases. In the men group, HCV RNA and HIV RNA were detected in 3.33 % and 6.67 % cases, respectively. HBV DNA was determined in 16.67 % of men, including latent hepatitis B in one person. A significantly higher incidence of HIV in men compared to women is shown (χ2=3.907 at p

From the very onset of SARS‑CoV‑2 spreading, active involvement in the COVID‑19 epidemic process made the healthcare professionals (HCPs) a vulnerable group with higher risks of contracting the disease, severe course and fatal outcome.The aim. We aimed at studying the impact of specific and non-specific preventive measures on the risk of SARS‑CoV‑2 infection among the HCPs in a large industrial region settings during the COVID‑19 pandemic.Materials and methods. We analyzed the data obtained using 1 905 questionnaires for the personnel of infectious hospitals for treatment of COVID‑19 patients and non-core healthcare facilities in a large industrial region during the COVID‑19 pandemic, 100 questionnaires on adherence of the employees to hand hygiene and antiseptics, the results of the tests for specific IgG to the SARS‑CoV‑2 nucleocapsid (2 200 samples), as well as the results of assessment of viral and bacterial contamination of the outer surface of the personal protective equipment for infectious hospital staff (108 specimens).Results and discussion. In the course of the study, an effect of failure in the implementation of some specific and non-specific preventive measures on an increase in the incidence of COVID‑19 in various healthcare professionals has been identified. The COVID‑19 pandemic once again emphasized the need to save lives and health of the HCPs as socially significant category of citizens under the spread of pathogens with high epidemic potential, applying a complex of specific and non-specific measures that are not mutually exclusive.

Brushless DC (BLDC) motors are widely used in payloads of scientific space missions. To work with this type of motor it’s required to develop a complex control system considering basic technical requirements as well as the demands to reliability linked with the space application of the system. The basic technical requirements and the demands for the reliability of the system were formulated in the article. The block commutation algorithm was selected for the system since it’s simple and it doesn’t require using a high-performance processor and precision rotor position sensors. Based on the selected algorithm and the requirements structural scheme of the control system with redundancy features was designed. Further, schematics for output stages of the system were considered. They allowed connecting one set of motors and Hall sensors to both the main and the redundant control system. To test the structural and schematic solutions a prototype board was developed. The prototype was successfully tested and the solutions were verified.

Introduction. The immune status is a multifaceted parameter quantitatively and qualitatively analyzing functional activity immune system state in immune organs as well as some non-specific mechanisms of antimicrobial protection. Peripheral blood level of T-receptor excision rings (TREC) and B-cell excision rings (KREC), respectively, can serve as surrogate markers of T- and B-cell maturation. Currently, the diagnostic kits available on the market have two significant disadvantages: i) the kits are aimed at diagnosing immunodeficiency conditions only in newborns and children, while keeping adult patients uncovered; ii) essentially, use solely single reference normalization gene for data normalization resulting in increased variability and decreased sensitivity of the assay data. The aim: to develop a highly sensitive method for laboratory assessment of the state of immunity in immunodeficient patients by using real-time PCR for assessing TREC and KREC level in children and adults. Materials and methods. There were used whole blood and dry blood spot samples obtained from newborns and adults, apparently healthy individuals as well as patients with verified PID and HIV-infection. A total of 2577 samples were examined. Commercial kits were used as comparison methods. Results. Multiplex PCR was carried out, analyzing the number of target molecules TREC and KREC, as well as fragments of the HPRT and RPP30 normalization genes analyzed with the developed series of plasmid calibrators. The established analytical range of TREC/KREC DNA measurements comprised 103 to 109 copies/mL. The accuracy of measurements on a tablet-type instrument (CFX) was 95.84%, on a rotary-type instrument (Rotor-Gene 3000) 95.11%, which corresponds to the standard indicator. The equivalence between the data obtained after assessing whole blood samples and dry blood drops was shown. The data analysis allowed to find out 100%-diagnostic specificity and sensitivity of the method proposed. Conclusion. The method developed by us allows to diagnose decline in T- and/or B-cell immunity in children and adults and can be used to detect TREC and KREC molecules both in peripheral whole blood samples and dry blood spots using Guthrie cards. Moreover, the uniform values of reference norms can be used regardless of the type of analyzed clinical material. The study data evidence about potential for effective use of multiplex PCR diagnostics both for complex primary testing/screening of newborns and assessing state of immunity to identify adult patients with PID and as a part of the diagnostic monitoring of patients with secondary immunodeficiencies, e.g., HIV infection.

The aim of the study was to assess the dynamics of seroprevalence to SARS-CoV-2 in various population groups during the initial period of herd immunity formation based on multivariate analysis using logit regression models.Materials and methods. The study involved 1561 individuals divided into three population cohorts: people living with HIV/AIDS (PLHA), healthy blood donors, medical workers. The presence of antibodies to SARS-CoV-2 was determined in blood serum through ELISA using commercial reagent kits. Multivariate analysis of the dynamics of seroprevalence to SARS-CoV-2 was carried out using logistic regression models.Results and discussion. It has been revealed that probability of detecting IgG antibodies to SARS-CoV-2 significantly increased among the donors and medical workers in the spring-autumn 2020 series (p=0.005 и p

Relevance. Due to the COVID­-19 pandemic a infectious diseases hospitals nationwide network has been deployed to treat patients infected with SARS­CoV­-2. The principles of their formation with a strict division into «infectious» and «clean» zones, despite the epidemiological justification, lead to the formation of a dynamic artificially created closed ecosystem. In such an ecosystem, on the one hand, patients who undergo a wide range of invasive and aggressive therapeutic and diagnostic manipulations, and medical personnel stay for a long time, on the other hand, pathogens of a viral and bacterial nature that can adapt to hospital conditions and form resistant strains circulate. As a result, high risks of contamination of environmental objects of hospitals and patients themselves are created, which can lead to the development of exogenous nosocomial infection.Aims. To study the features of viral and bacterial contamination of objects in the hospital environment of the infectious diseases hospital for the treatment of patients infected with SARS­-CoV­-2 during the COVID­-19 pandemic.Materials and methods. A study was conducted on 343 samples from the external environment of the infectious diseases hospital for COVID­-19 patients’ treatment during its planned work. Sample collection was performed during three days (Tuesday, Thursday, Sunday) at 20 unified sampling points: in the area where patients general hospital area as well as from the outer surface of personal protective equipment for medical personnel (overalls, gloves). The study used epidemiological (descriptive­evaluative and analytical), molecular genetic (SARS-­CoV­-2 PCR­RT, sequencing), bacteriological (isolation, cultivation and MALDI­TOF identification of bacterial cultures) methods. Statistical significance of differences was assessed by Fisher's point test (φ). Differences were considered significant at p≤0.05. Statistical data processing was carried out using the Microsoft Office 2010 application package, the online resource https://medstatistic. ru/, ST Statistica 10.Results. The study demonstrated a high level of viral and bacterial contamination of environmental objects in the intensive care unit of the infectious diseases hospital for COVID­-19 patients treatment – 11.1%, incl. objects of the general hospital environment – 9.3% (doctor's workplace – 16.7%); patient location area – 13.9% (electric pump – 27.8%, mechanical ventilation, manipulation table – 16.7% each); the outer surface of personnel gloves – 21.1–38.9%; the outer surface of protective overalls for personnel – 44.4–50.0%. SARS­-CoV­-2 isolated from the objects of the external environment of the hospital belonged to the genetic variant B.1.617.1 DELTA, which corresponded to the epidemiological situation at sampling collection period. The opportunistic microflora structure was dominated by Enterococcus faecalis (38.1%), Klebsiella pneumoniaе (21.4%) and Escherichia coli (16.7%), which demonstrated a high level of resistance (to 3 or more groups of antibiotics).Conclusion. Initially, the main sources of the infectious diseases hospital environmental objects contamination with SARS-­CoV-­2 are most likely patients. Further contamination of the infectious diseases hospital environmental objects with viruses and opportunistic microflora occurs with the medical personnel direct participation. The current situation requires a review of approaches to the rules for disinfection, the PPE use and employees hands antiseptic treatment in infectious diseases hospital during the COVID­-19 pandemic, as well as the length of staff work period length.

Introduction. The problem of transfusion safety in relation to parenteral viral hepatitis still remains relevant. Viral hepatitis B (HB) remains the most common viral infection transmitted through transfusion procedures. One of the natural phases of chronic hepatitis B (CHB) is occult hepatitis B infection (OBI), characterized by an undetectable HBsAg (regardless of the other serological markers content) in the presence of hepatitis B virus (HBV) DNA in the liver tissue and an extremely low, up to undetectable, level of viral load in the blood. In the Republic of Guinea, as in most countries on the continent, the prevention of HBV transmission through transfusion is still based on HBsAg serological testing of donors only. In this connection, OBI remains as a potential threat to blood transfusion safety. Detection of HBV DNA is a reliable preventive measure against transmission of the virus from donors with HBsAg-negative HBV infection, especially in highly endemic regions. In this regard, the study was conducted to substantiate recommendations for improving blood safety against the background of significant HBV prevalence in the Republic of Guinea. The aim of the work was the evaluation of serological and molecular markers of HBV infection in blood donors in the Republic of Guinea. Material and methods. We examined 250 blood samples obtained from donors living in Conakry, Republic of Guinea. Samples were tested for the presence of serological (surface antigen, HBsAg; antibodies (ABs) to surface (anti-HBs IgG) and core (anti-HBc IgG) antigens) and molecular (DNA) markers of HBV infection. Results and discussion. The overall detection rate of hepatitis B markers was 83.2%; HBsAg was detected in 16.4% of all individuals. The high incidence of HBsAg in men (19.55%) compared to women (8.45%) was shown, the relative risk of HBV infection with the formation of HBsAg-positive chronic hepatitis B in males was also significantly higher. The prevalence of the HBV DNA in the study group was 30.4%, the OBI cases accounted for 15.6%. The prevalence of this form of the disease was shown in donors aged 30–49 years (24.78%), in the group of people younger than 30 years, the incidence was lower (8.73%), and at the age of over 50 years, OBI was not detected. Based on the phylogenetic analysis of 76 virus isolates, it was shown that genotype E prevails in the examined group (85.53%). Cases of pathogen DNA detection occurred in HBsAg-negative blood donors in the presence of anti-HBs IgG (n = 4), as well as in the simultaneous presence of ABs anti-HBs IgG and anti-HBc IgG (n = 7). The viral load exceeded 200 IU/ml in OBI samples. Escape mutations were detected by sequencing in each OBI sample, contributing to the virus escaping from diagnostic based on screening for HBsAg. Conclusion. Assessment of the prevalence viral hepatitis B markers in blood donors, determination of genotypes and clinically significant mutations of virus variants are necessary to ensure safe medical manipulations, control and prevention of the spread of this infectious agent.

Introduction. The spread of the human immunodeficiency virus type 1 (HIV-1) has become a global concern and has approached the pandemic status. St. Petersburg, a major transportation, tourist, cultural, industrial center, and a border city, is characterized by high migration of the population. The growing number of migrants can contribute to importation and spread of new genetic variants of the virus and trigger recombination processes in the virus population in St. Petersburg and the Leningrad Region. The aim is to characterize the present-day HIV-1 subtype-specific profile and drug-resistance mutations among patients with virological failure on antiretroviral therapy (ART) in the Leningrad Region. Materials and methods. The study performed in 20162018 was based on clinical material from HIV-infected individuals living in the Leningrad Region and having confirmed virological failure on ART. The genetic diversity and distribution of drug-resistance mutations of the HIV-1 isolates were assessed through analysis of nucleotide sequences of the virus pol gene fragment that included regions encoding protease and the reverse transcriptase region. Results. In the group (n = 138), most of the patients had sub-subtype A6 (97.4%) common in Russia, though a few patients had subtype B and a recombinant containing circulating recombinant form CRF_03AB and sub-subtype A1. The tests showed that 95.79% of patients had at least one significant drug-resistance mutation; in most cases (73%) the virus was resistant to 2 classes of antiretroviral drugs and in some cases (8%) to 3 classes. A total of 105 different drug-resistance mutations were found at 35 positions of the virus genome. Conclusions. The high prevalence of HIV-1 drug-resistance mutations among ART patients with virological failure calls attention to surveillance of drug resistance of the virus both among ART-experienced patients and ARTnave individuals.

Introduction. Ural Federal District (UFD) has been one of the most HIV-affected areas in the Russian Federation during past 20 years. The total number of people living with HIV/AIDS (PLWH) and receiving antiretroviral therapy (ART) exceeds 100,000 (61.7% of all PLWH in the UFD), which creates opportunities for the wide spread of resistant HIV strains. Research aim was to determine the distribution of HIV-1 subtypes, evaluate the genetic heterogeneity of HIV-1 strains, and analyze the prevalence of HIV-1 drug resistance mutations (DRM) and the incidence of acquired resistance to antiretroviral drugs (ARVDs) in PLWH receiving ART in the UFD. Materials and methods. 223 patients receiving ART at stage IIIIV of HIV infection living in the UFD were examined. To determine the subtypes and the DRM in the HIV-1 pol gene, molecular genetic studies were performed using the AmpliSense HIV-Resist-Seq kit by Sanger sequencing on the Applied Biosystems 3500 Genetic Analyzer. The genetic heterogeneity was evaluated by calculating the identity of the genome region of the isolated strains in comparison with the genomes of foreign HIV strains, as well as using phylogenetic analysis. Results. In the studied group of patients, 5 subtypes of HIV-1 were identified: subtype A6 prevalence was 91.03%, that of subtype B was 2.69%, 3 recombinant subtypes (CRF03_A6B, CRF02_AG, CRF63_02A6) accounted for 6.28%. Among analyzed HIV-1 strains, 43.9% had a significant genetic similarity (identity of at least 97%) with the strains isolated from patients from neighboring countries (Belarus, Kazakhstan, Kyrgyzstan, Uzbekistan, Lithuania), 35.9% were similar to the strains isolated from patients from far-abroad countries (USA, China, South Korea, Australia, Sweden, Germany). A high heterogeneity of the circulating genetic variants of HIV-1 strains in the territory of the UFD region was established, which is an unfavorable factor for the diagnosis and treatment of HIV. The most common DRMs to both nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) were detected in 81 specimens (36.3%). NRTI resistance-forming M184V DRM was more common than any other DRM with statistical significance (p = 0,0008) and was detected in 88 specimens (39.5%). Conclusion. In the subtype structure of HIV-1, the dominant subtype was subtype A6, the most common in the countries that were formerly part of the USSR. The heterogeneity of the HIV-1 strains circulating in the UFD suggests that HIV-1 infection continues to be introduced into the UFD from populations outside the Russian Federation. The findings confirm the high prevalence of DRMs (62.8%) and secondary drug resistance of HIV-1 (60.1%) among PLWH in the territory of the UFD. At the same time, high-level resistance was detected in 56.5% of patients, which requires increasing the coverage of HIV resistance testing, including the introduction of monitoring for primary resistance, in order to optimize first-line ART regimens.

The aim of this study was to assess the prevalence of serological and molecular biological markers of viral hepatitis B and C among apparently healthy residents of the Southern Vietnam. The study material was represented by 397 blood serum samples collected from apparently healthy residents of the Southern Vietnam. The ELISA examination for presence of HBV and HCV markers involved HBsAg, anti-HBs IgG, anti-HBcore IgG, and anti-HCV qualitative determination. For HBV DNA and HCV RNA detection, nucleic acids were extracted from serum blood, and a test for virus detection was carried out by real-time PCR with hybridization fluorescence detection. Amplification and subsequent sequencing of HBV and HCV were performed using nested PCR with paired overlapping primers jointly flanking the target regions. Analysis of the overall prevalence of serological markers showed that among the apparently healthy individuals anti-HBsAg and anti-HCV antibodies were detected in 12.3% (95% CI: 9.27–15.99%) and 3.27% (95% CI: 1.76–5.53%) of individuals, respectively. The prevalence of HBsAg in men (19.1%) significantly exceeded that of found in women (5.9%), χ2 = 14.688 with p = 0.0001, df = 1, calculated odds ratio OR = 3.751 (95% CI: 1.892–7.439). Among apparently healthy patients, taking into account HBsAg-positive and negative samples, HBV DNA was detected in 26.95% (95% CI: 22.65–31.6%). HBV phylogenetic analysis showed that subtype B4 prevalence comprised 64.49%. Subtypes C1 (14.95%), B2 (9.35%), C2 (6.54%), C3 (0.93%), and C5 (3.74%) were also identified. HCV RNA was detected in 7 samples, which accounted for 1.76% (95% CI: 0.71–3.6%). Phylogenetic analysis showed that all HCV isolates belong to genotype 6, subtype 6a (100%).

The aim of this study was to characterize mutations in the hepatitis B virus (HBV) genome associated with HBsAg-negative form of the disease in patients receiving hemodialysis replacement therapy. Materials and methods. We used blood plasma samples obtained from hemodialysis centers in St. Petersburg, Russia – 173 patients and 108 patients from Belgrade, Republic of Serbia. The samples were examined for the presence of serological (HBsAg, antibodies anti-HBs IgG, anti-HBcore IgG) and molecular-genetic (HBV DNA) markers of HBV followed by whole-genome sequencing and determination of clinically significant virus mutations. Results and discussion. Antibodies to hepatitis B were detected in 7.5 % and 11.1 % of patients from St. Petersburg and Belgrade, respectively. HBsAg was identified only in 1.1 % of cases in the group from Russia and in 0.9 % of cases in the group from Serbia. HBV DNA was determined in 2.8 % of the studied samples from both, patients from Saint-Petersburg and Belgrade. Phylogenetic analysis of 9 viral isolates showed that genotype D virus (88.9 %) prevailed as compared to genotype A (11.1 %) in the examined group. Among the samples obtained from patients from St. Petersburg, four belonged to the D2 sub-genotype, one to the D3 genotype. Four samples obtained from Belgrade patients belonged to different sub-genotypes – D1, D2, D3, A2, respectively. When analyzing the nucleotide sequences of the HBV genomes, mutations in the MHR region were detected in all cases, but only in HBsAg-negative isolates, mutations were revealed in the region of 124–147 amino acids, including mutations P120T, R122K, A128V, Q129R, M133I, G145R affecting the recognition of HBsAg by anti-HBs antibodies and associated with the resistance of the virus to the vaccine. The results of this study indicate that transmission of blood-borne viral hepatitis agent in the hemodialysis departments of the Russian Federation and the Republic of Serbia still exists. The prevalence of the latent chronic hepatitis B, coupled with the presence of vaccine escape mutations in all identified cases, indicates the need to pay close attention to the occurrence of the virus mutant variants in hemodialysis centers.

Aim: To study the hepatitis A (HAV) and hepatitis Е (HEV) prevalence in the Southern region of Vietnam based on the frequency analysis of the antibodies to hepatitis A and E viruses detection in the local population and groups at increased risk of infection.Materials and methods. Serological markers of enteral viral hepatitis were determined in blood serum samples from adults aged 18 to 65 years of three groups: conditionally healthy individuals (n = 397), HIV-infected (n = 316), and patients with chronic viral hepatitis (n = 268). The ELISA method was used for the qualitative detection of anti-HAV IgG, anti-HAV IgM, anti-HEV IgG, anti-HEV IgM.Results. When analyzing the prevalence of anti-HAV IgG in samples obtained from conditionally healthy, HIV-infected, and patients with chronic viral hepatitis, no differences were found between the groups. The incidence of anti-HAV IgG in the general group (n = 981) was 80.1%, in the absence of anti-HAV IgM. There were no gender-age differences in the frequency of anti-HAV IgG in the examined groups. Antibodies anti-HEV IgG in the groups of conditionally healthy, patients with chronic viral hepatitis, and HIV-infected were present in the samples in 36,2%, 33,2%, and 39,8% of cases, respectively. The prevalence of anti-HEV IgM in these groups was 3,27%, 4,1%, and 3,79%, respectively. In the general group (n = 981), anti-HEV IgG was detected in 36,6% of cases, anti-HEV IgM in 3,66%, which corresponds to the prevalence of antibodies to HEV in endemic regions.Conclusion. A high incidence of enteral viral hepatitis markers was shown in residents of South Vietnam, including the groups of conditionally healthy, patients with chronic viral hepatitis, and HIV-infected. There is an obvious need for further studies of the spread extent of hepatitis A and hepatitis E in the Socialist Republic of Vietnam using currently available highly sensitive diagnostic methods, including sequencing of the virus›s nucleotide sequences.

This article provides a literature review of the past 60 years, conducted using keywords through the PubMed Internet resource, dedicated to the methods of surgical treatment of hemorrhagic stroke. The existing published results of clinical studies do not allow us to draw unambiguous conclusions about the superiority of conservative or neurosurgical treatment in relation to the functional recovery of patients. There is a statistical significance of the advantages of surgery based on the prevention of dislocation syndrome, control of intracranial hypertension, and prevention or at least reduction of the effect of blood and its degradation products on the surrounding healthy tissue. However, large randomized controlled trials have failed to demonstrate this benefit in terms of mortality or functional outcome.There are two main areas of hemorrhagic stroke surgery – open surgery and minimally invasive methods. The practice of open surgery is associated with high trauma rates, as well as with certain risks and complications. However, craniotomy is a lifesaving measure in critical situations with signs of persistent increased intracranial pressure leading to neurological impairment. The ability to control intracranial pressure provides a chance for the choice of more optimal tactics of surgical treatment.Today, the gold standard for intracranial pressure monitoring is the installation of invasive intraventricular or intraparenchymal transducers. The method is appreciated for its accuracy, however, there are a number of disadvantages in the form of the possibility of hemorrhagic and infectious complications, as well as the high cost of the sensor itself, which limits its routine use. The inability to measure intracranial pressure before surgery causes an unreasonable expansion of indications for choosing an open method of surgery, which reduces the possibility of a better functional outcome.All of these points make it urgent to search for a non-invasive method for measuring intracranial pressure, which would contribute to the timely choice of a surgical method without the danger of worsening the clinical outcome.

Hepatitis B, despite of being a controlled infection today, is one of the most common form of hepatitis in the world. According to the experts' evaluation there are about 3 million patients with chronic hepatitis B in our country. The global strategy of the World Health Organization includes the elimination of viral hepatitis by 2030.The program used in the North-West Federal District to eliminate acute hepatitis B has reduced the incidence rate due to the widespread vaccination coverage of children and the annual increase in adult immunization coverage.However, the relevance of HBV-infection in children still remains high which is associated with a high infection by hepatitis B virus in women of childbearing age and the possibility of the transmission of the infection from mother to her child. In case of perinatal infection the formation of chronic hepatitis B in children reaches up to 90%. The natural course of chronic hepatitis B is characterized by a change in pathogenetically determined phases, and HBsAg-negative infection, which is a latent (occult) form of hepatitis, was added to them in 2009. Occult hepatitis B is an epidemiological danger, for the child as well, if the mother suffers from this form of chronic hepatitis B. Monitoring of pregnant women is often limited to identifying only HBsAg, which is not enough to detect occult hepatitis B. Lately diagnosed occult HBV-infection can become a source of the infection for the baby, especially in cases when due to some reasons there are disorders in hepatitis B vaccination schedule after birth. The article presents an interesting clinical case of family hepatitis B.

According to the WHO, there is an increase in the number of cases of dengue fever worldwide. In many countries, where dengue fever is an endemic disease, blood-borne infections associated with hepatitis B and C viruses and HIV are widespread. The Socialist Republic of Vietnam is an endemic region for these pathogens. The unique epidemiological situation in the country provides an excellent opportunity to study the interaction between Arboviruses, agents of parenteral viral hepatitis B and C, and HIV infection in the body of sick people.The aim of this review was to analyze the literature data on the detection of cases of simultaneous infection with Dengue viruses of 1–4 types and agents of blood-borne infections in sick people in the Socialist Republic of Vietnam. Despite the fact that the simultaneous circulation of these pathogens in the patient's body can affect the pathophysiological mechanisms of the disease development, there were very few works devoted to co-infection with Dengue viruses and HIV, hepatitis C or B viruses, including in the regions adjacent to Vietnam. Therefore, research in this direction is promising for both fundamental science and practical medicine.

The trigeminal nerve is a mixed fifth cranial nerve, consisting of motor and sensory components. The sensitive component receives somesthetic information from the skin and mucous membranes of the face into the central nervous system, and the motor component is responsible for the innervation of chewing muscles. One of the manifestations of the pathology of the trigeminal nerve is pain syndrome. Trigeminal neuralgia occupies the main place among neurogenic pain syndrome in the face, is characterized by а severe course and the absence of sufficiently effective methods of treatment. According to the World Health Organization (WHO), the prevalence of trigeminal neuralgia in different countries is 2–5 cases per 100 thousand people per year. Trigeminal neuralgia is classified into 3 etiologic categories. Idiopathic trigeminal neuralgia occurs without apparent cause. Classical trigeminal neuralgia is caused by vascular compression of the trigeminal nerve root. Secondary trigeminal neuralgia is the consequence of a major neurologic disease, e. g., a tumor of the cеrеbеllоpоntine angle or multiple sclerosis. Today, there are many different options for the surgical treatment of trigeminal neuralgia. microvascular decompression of the root, radiosurgical destruction of the Gasser’s node, radiofrequency destruction, glycerol rhizotomy, balloon microcompression are considered the main effective and proven surgical methods for treating trigeminal neuralgia. But the questions of diagnosing the cause of the disease and choosing an adequate surgical method for treating therapeutically resistant trigeminal neuralgia for a particular patient remain open. The development of surgical methods begins from ancient times to the present day. The main stages in the development of neurosurgical treatment methods are presented. The following surgical techniques are described: open method – microvascular decompression, and closed percutaneous destructive methods – radiofrequency destruction, glycerol rhizotomy, balloon compression, radiosurgery, cryodestruction, laser destruction, botulinum toxin injections.

Rationale. Countries of Africa, especially countries in sub-Saharan Africa, represent a region characterized by high incidence of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Methods for detection of HBV and HCV in low and middle-income countries differ from those that are used in countries having access to high-cost technologies. The Republic of Guinea is a region with high prevalence of hepatotropic viruses, however, the information on HBV and HCV prevalence in the area is extremely limited, thus emphasizing the significance of this study.The purpose of the study is to evaluate the need for improving laboratory diagnostics of parenteral HBV and HCV infections in the Republic of Guinea.Materials and methods. A total of 2,616 samples of blood serum were tested, the samples were collected from apparently healthy residents of the Republic of Guinea during the routine medical checkup. The testing included qualitative detection of HBsAg, anti-HBs IgG, anti-HBcore IgG, anti-HCV IgG antibodies as well as HBV DNA and HCV RNA.Results. The detection frequency of serological markers of HBV and HCV infections was 80.77% and 18%, respectively. However, HBsAg was detected only in 16.01% of individuals. Tests for detection of HBV DNA were performed among seropositive patients and patients seronegative by other HBV markers, HBV DNA was detected in 22.36% of cases, including 6.07% of HBsAg-negative cases. HCV RNA was detected in 2.2% of cases. Both HCV RNA and HBV DNA were detected in 27 people, including 19 HBsAg-negative cases, thus accounting for 1.03% of the examined group.Conclusions. The markers that are currently used for laboratory detection of HBV and HCV in the Republic of Guinea are not efficient enough to diagnose reliably all cases. Undoubtedly, there is an urgent need to improve laboratory diagnostics for timely detection of parenteral viral hepatitis. Routine laboratory operations need assays for additional serological and molecular markers of HCV and HBV infections.

Purpose: to assess the efficacy and toxicity of concurrent chemoradiotherapy with accelerated hyperfractionation in the treatment of oral cancer. Material and Methods. A total of 79 patients with oral cancer were enrolled in this study. Accelerated hyperfractionated radiation therapy was administered using terabalt unit concurrently with two cycles of pF chemotherapy. The daily dose of 2.5 Gy was divided into two fractions of 1.0 Gy and 1.5 Gy which were delivered to high- and low-risk areas with 5–6-hour-interval between each treatment, 5 days per week to a total dose of 60.0 Gy and 50.0 Gy, respectively. Results. Complete response, partial response and stable disease were achieved in 63.3 %, 35.4 % and 1.3 % of and relapse-free survival rates for the entire group of patients were 54.5 % and 50.4 %, respectively. In the subgroup of patients with T3–4 stage tumors, the five-year overall survival rate was 50.8 %, and the five-year relapse-free survival rate was 47.2 %. Severe oral mucositis (grade 3) was noted in 36.7 % of patients. Grade 1 dermal toxicity was observed in 85 % of patients who experienced radiation-induced skin reactions. In 8.9 % of patients, osteoradionecrosis of the mandible occurred. All the patients included in the study completed the course of chemoradiotherapy as planned. Conclusion. Concurrent chemoradiotherapy with accelerated hyperfractionation (1.0 Gy + 1.5 Gy) appears to be an effective treatment option for oral cavity cancer patients in whom surgery is contraindicated.

The aim of our work was to compare the HBV, HCV and HIV vertical transmission risk in the Republic of Guinea.Materials and methods. The material for the study was 305 blood plasma samples from pregnant women living in Conakry, Republic of Guinea. The samples were examined for the presence of serological (HBsAg, antibodies antiHBs IgG, anti-HBcore IgG, anti-HCV IgG, Ag/Ab-HIV) and molecular (HBV DNA, HCV RNA, HIV RNA) markers.Results and discussion. When assessing the overall prevalence of serological markers among patients, the incidence of HBV markers was 76.06 %. Antibodies to HCV were detected only in 1 case, which amounted to 0.32 %. HIV markers were detected in 3 cases, which amounted to 0.98 %. The prevalence of HBsAg in the group under examination significantly differed between the groups of pregnant women aged 13–19 years (17.33 %) and 20–24 years (12.12 %), p

Background. The development of direct acting antivirals (DAAs) has spurred a revolution in treatment of patients with chronic hepatitis C. However, there are cases showing no response to treatment. In 5% of cases, the viral breakthrough is most likely caused by DAA resistance mutations in the hepatitis C virus genome.The purpose of the study is to detect drug resistance mutations of hepatitis C virus in patients with DAA treatment failure.Materials and methods. The study was performed on plasma samples from 3 patients diagnosed with chronic hepatitis C virus infection and demonstrating DAA virological treatment failure. All isolates had genotype 1b. Drug resistance mutations were detected by using direct sequencing of NS3, NS5A, and NS5B genome regions. The detection technique was developed at the Pasteur Research Institute of Epidemiology and Microbiology.Results. Drug resistance mutations were detected in all cases. By using the Geno2pheno [hcv] 0.92 tool, nucleotide substitutions were detected in different viral genome regions and presumably caused resistance or decreased sensitivity to antivirals both present and absent in the sofosbuvir + daclatasvir combination therapy. Antiviral treatment failure in patients with chronic hepatitis C is caused by drug resistance mutations.Conclusions. The developed technique is efficient for detection of drug resistance mutations in NS3, NS5A, and NS5B regions in cases of virological failure of DAA treatment.

Abstract Background HIV infection is a major health problem in Russia. We aimed to assess HIV prevalence in different population groups and to compare the characteristics of 4th generation immunoassays from Abbott, Bio-Rad, Vector-Best, Diagnostic Systems, and Medical Biological Unit. Methods The study included 4452 individuals from the general population (GP), 391 subjects at high risk of HIV infection (HR) and 699 with potentially interfering conditions. HIV positivity was confirmed by immunoblot and by HIV RNA, seroconversion and virus diversity panels were also used. HIV avidity was employed to assess recent infections. Results The prevalence in GP was 0.40%, higher in males (0.62%) and in people aged

The Mediterranean Sea consisting of numerous seas is enclosed by three continents — Europe, Asia and Africa. It is a specific phenomenon in terms of geography, oceanology and world history. This is the only place in the world where many cultures and civilizations mutually enriching each other and giving to the world the benchmarks for development have appeared and alternated. As E. Bradford wrote “Each part of the Mediterranean Sea is really specific. One is apt to violence, other is more serene, the third is prone to periodical outbursts of fervor, the fourth is dangerous and unpredictable as schizophrenic.” The therapy of nature and man that lasted for many centuries has played its positive role having turned the Mediterranean into the center of trade, fishery and tourism. The countries surrounding the sea (there are twenty-one of them) are well described and well known that is why we concentrate on eleven water areas each of which makes a part in the general Mediterranean Sea puzzle.The factor of the sea improves our perception of the land-sea interface and this can be described in such comprehensive scientific and popular publication as encyclopedia. Today when Russia with all its navy power returns to the World Ocean, in particular to the Mediterranean, using its renovated Mediterranean fleet the extension of navigation knowledge in this water area which had always been in the focus of tsars, emperors and presidents of Russia becomes a very important factor.

Background. Exact notion about the timing of acute traumatic intracranial hematomas (ATIH) generation is very important to gain a better understanding of the primary and secondary traumatic brain injury (TBI) pathophysiology. The variety of TBI and individual anatomical features of the victims determine the complexity of the issue, as well as the relevance of studies that bring it closer to its solution.Aim of the study was to assess the possibility of using multispiral computed tomography (MSCT) to determine the average timing of the formation of epidural and subdural ATIH.Materials and methods. It is a retrospective study of 84 MSCT investigations of 55 patients with ATIH (epidural – 15, subdural – 40) in Irkutsk City Clinical Hospital N 3 (2018–2019). The ATIH volume calculated by the MSCT. The correlation of ATIH volumes with the period of trauma was studied, as well as a comparison of average volumes of ATIH among patients distributed in groups in line with the hour of primary MSCT after injury. The dynamics of ATIH of small volumes (up to 40 ml) were assessed in 21 patients left under observation.Results. The volume of epidural ATIH and the time of their detection had no a direct correlation in the period 1 to 4 hours after the injury (p = 0.05). There was no reliable difference in their average volumes per hour of diagnosis, amounting to a total of 54.1 ± 19.7 ml. A direct correlation between the volume of subdural ATIH and the duration of trauma was identified during periods of 1–2 hours (p = 0.02) and 1–3 hours (p = 0.002; t = 3.77) after injury; a true difference in their average volume of 1 and 2 hours after the injury (52 ± 20.2 ml and 106.4 ± 14 ml, respectively). Increase in small ATIH found in 14.3 % of patients left under observation.Conclusions. The MSCT allows us to estimate the average timing of the formation of the main volume of ATIH when hospitalized victims with TBI. The average rate of accumulation of ATIH is about 50 ml per hour, and the direct correlation of their volume and time of diagnosis is reliable the first 2–3 hours after the injury for subdural ATIH only.

Objective of our work was to assess prevalence of the primary HCV drug resistance mutations in the NS5b gene in patients with newly diagnosed HIV infection.Materials and methods. The study material was 196 blood plasma samples from patients living in the North-Western Federal District with newly diagnosed HIV. Samples were examined for the anti-HCV antibodies and HCV RNA presence. If HCV RNA was detected, amplification was performed using three primers pairs that co-flanked the NS5b gene. After sequencing the indicated gene nucleotide sequence, the virus subtype was determined and drug resistance mutations were detected.Results and discussion. Antibodies to HCV were detected in 18.87 % of HIV-infected individuals. HCV RNA was detected in 18.36 % of the patients, including 89.18 % anti-HCV-positive and 1.88 % anti-HCV-negative. It was shown that co-infection is more common in men (77.8 %) compared to women (22.2 %) – χ2 = 3.996 at p = 0.0456, df = 2. The difference in the HIV viral load between the groups with HIV monoinfection and with HIV + HCV coinfection was demonstrated (χ2 = 6.284 at p = 0.0432, df = 2). A significant difference between the groups by the CD4 + lyphocytes number was shown. In the phylogenetic analysis, the HCV subtypes are distributed as follows: HCV 1b – 47.2 %, HCV 3a – 30.6 %, HCV 1a – 13.9 %, HCV 2a – 5.5 % and only one sample was defined as HCV 2k – 2.8 %, respectively. Nine samples (25 %) presented NS5b mutations in the positions related to the development of drug resistance of HCV, including two samples among HCV genotypes 1a and 3a (i.e., 5.6 % of the total HIV + HCV group), as well as five samples among HCV 1b (13.9 % of the total group). Mutations among HCV 1a were C316Y and N444D substitutions. Among HCV 1b, C316N, C451S, S556N/G substitutions were identified. Among patients with HCV 3a, 2 samples (5.6 %) with a D310N mutation associated with an unfavorable disease prognosis were found. The introduction of direct sequencing of HCV nucleotide sequences into the routine laboratory diagnostics will allow us to estimate the primary drug resistance mutations prevalence in risk groups to predict the HCV life-threatening complications development – fibrosis, cirrhosis, hepatocellular carcinoma, as well as the outcome of antiviral therapy prognosis. The data obtained can be rationally used to assess the dynamics of the HCV primary pharmacoresistance prevalence among HIV-infected individuals.

Here we provide the assessment of COVID-19 epidemic in Italy, which scale has led to serious challenges both for society and national health care system. Despite timely information regarding the pandemic spread of the novel coronavirus infection, the country’s health care was not prepared to dramatically increased rate of patients with viral pneumonia at the first stage of the epidemic, infection control measures were not fully implemented that also led to spread of infection among health care workers. Socially vulnerable population groups did not seek timely medical care due to the lack of hospital facilities as well as well-trained medical personnel. At the second stage of developing epidemic, were also delayed and executed at varying timepoints in neighbor regions, with sustained insufficient management after implementing them that was reflected as ongoing rise of epidemic curve over long time. Delayed execution of anti-epidemic restrictive measures aimed at fighting against ongoing epidemic resulted in substantially increased morbidity and mortality among vulnerable population groups and retarded rate of decreasing COVID-19 epidemic curve. Analyzing response measures taken in Italy against COVID-19 epidemic should be appreciated by other countries while dealing with the current pandemic and preparing to react to novel biological threats in the future.

The cytokine system is a large group of humoral factors produced by immune cells and involved in the pathogenesis of most human diseases. To assess the significance of changes in cytokines/chemokines under pathological conditions, appropriate reference values are required for healthy people. As known from existing literature, most studies of various cytokine/chemokine concentrations in blood plasma were performed in healthy subjects from Western Europe and North America. Certain inter-population differences are known, with respect to production of distinct cytokines in different racial and national groups. Only single studies concern normal levels of distinct cytokines in blood plasma of healthy African residents. The purpose of this study was to determine the blood plasma cytokine profile in healthy residents of the Republic of Guinea (RG), and to establish normal cytokine values.We have examined 24 healthy RG residents and 23 residents of St. Petersburg. Concentrations of 40 cytokines/chemokines were determined in blood plasma. The study was performed using multiplex analysis by xMAP technology.The following cytokine/chemokine levels were significantly increased in the blood plasma of the RG residents: IFNγ, IL-2, IL-4, IL-6, IL-10, TNFα, CCL1/I-309, CCL3/MIP-1α, CCL7/MCP-3, CCL17/ TARC, CCL19/MIP-3β, CCL20/MIP-3α, CCL21/6Ckine, CXCL2/Gro-β, CXCL5/ENA-78, CXCL6/ GCP-2, CXCL9/MiG, CX3CL1/Fractalkine (р < 0.001). For the CCL8/MCP-2, CCL22/MDC, CXCL1/ Gro-α and CXCL12/SDF-1α+β chemokines a trend for increased concentration was revealed, in comparison with residents of St. Petersburg (р < 0.05). Moreover, the levels of CCL23/MPIF-1 and MIF were significantly lower (р < 0.0001) in the RG residents. There was a tendency for decreased levels (р < 0.05) for CCL2/MCP-1 and CCL24/Eotaxin-2 chemokines in blood plasma taken from RG residents. There were no differences in levels of cytokines/chemokines for the studied groups: GM-CSF, IL-1β, IL-16, CCL11/Eotaxin, CCL13/MCP-4, CCL15/Leukotactin-1, CCL25/TECK, CCL26/Eotaxin-3, CCL27/CTACK, CXCL8/IL-8, CXCL10/IP-10, CXCL11/I-TAC, CXCL13/BCA, and CXCL16/SCYB16. Hence, this study has presented for the first time the normal limits for a wide range of cytokines/chemokines in blood plasma of the African inhabitants. Interpopulation differences were found, including those for constitutive chemokines. Different levels of CCL19/ MIP-3β and CCL21/6Ckine chemokines (the CCR7 receptor ligands) for the two populations may indirectly indicate the physiological features of T-cell maturation. Increased levels of CXCR2 receptor ligands in the blood plasma of Guineans, i.e., CXCL2/Gro-β, CXCL5/ENA-78 and CXCL6/GCP-2, may be due to additional function of these chemokines as ligands for atypical DARC chemokine receptor, which neutralizes chemokines from the blood flow, whereas 95% of West Africans have mutations in the DARC gene and do not express this receptor. Increased levels of proinflammatory IL-6 and TNFα cytokines, and chemokine CCL20/MIP-3α in blood plasma from RG residents may suggest inflammatory processes in the liver, since 100% of the examined Guineans had antibodies against the hepatitis A virus, 48% had antibodies to hepatitis B virus (anti-HBs), and 12% had antibodies against hepatitis C virus. In summary, the differences in cytokine/chemokine level may be related to specific environment, circulation of infectious diseases, composition of intestinal, skin and mucosal microbiota, as well as distinct genetic features.

The COVID-19 epidemic curve in China can be divided into several stages. Despite transparency in informing the world public about clusters of undiagnosed viral pneumonia, the country’s health care at the first stage of the epidemic was not ready to provide adequate and rapid response for a fast increase in the number of patients with COVID-19, infection control measures were not fully implemented, which also led to a large number of nosocomial cases of infection among medical workers and patients. Socially vulnerable groups of the population did not refer for medical assistance in a timely manner due to the lack of the disease danger understanding and also in connection with the high cost for them of medical aid. At the second stage, simultaneously with the restrictive measures introduced by the government, the entire health care system was rebooted: free medical care for patients with COVID-19 was provided and the strictest infection control measures were implemented, multi-level contact tracking system using IT technologies was organized, and the capacity of hospitals was increased many times. Through the joint efforts of ministries, mass media, social networks and volunteer movements, an unprecedented social mobilization of the population was achieved. Strict implementation of the entire set of measures aimed at fighting the epidemic allowed to take it under strict control at the third stage and practically eliminate the epidemic after 2,5 months. China’s response to the COVID-19 epidemic can be useful to other countries, in fighting the current pandemic and in preparing for a response to biological threats in the future.

Low-affinity Fcγ-receptors that recognize the Fc portion of immunoglobulin (Ig) molecules, usually being in antigen-bound state, thus representing a link between innate and adaptive immunity. They play a significant role in inflammatory and infectious diseases. Among them, a separate FcγRII family (CD32) is discerned, which is characterized by transmission of intracellular signal independently of the common γ-chain, they have one α-chain containing two extracellular immunoglobulin-like domains. FcγRII receptors are present in almost all cells of the innate immune system: monocytes and macrophages, neutrophils, eosinophils, dendritic cells, as well as on B-lymphocytes and platelets. They perform two main functions: target recognition, facilitation of phagocytosis and destruction of antibody-opsonized cells by monocytes/ macrophages (including pathogenic cells). In parallel, the phagocytes are activated via the cytokine synthesis stimulation. The FcγRIIA (CD32a) and FcγRIIC (CD32c) activating receptors, like as FcγRIIB (CD32b) inhibiting receptors are present among the members of the FcγRII family. The low-affinity FcγRII receptors bind to IgG, with immune complexes being their natural ligands. High levels of immune complexes are usually found in both chronic viral infections and autoimmune diseases. There are shown polymorphic variants of the CD32a gene, which can affect the receptor function, and, thereby, causing susceptibility for different infections, influence the development of autoimmune diseases and primary immunodeficiencies. Activation of the CD32a receptor induces the production of pro-inflammatory cytokines, including TNFα and interferons, that are involved into inflammation in systemic lupus erythematosus, Kawasaki disease, Graves’ disease and rheumatoid arthritis. It has been shown that antibacterial activity of platelets is carried out via the CD32a receptor. The study of CD32a expression in people The CD32a receptor is considered a biomarker of cells that are a reservoir of HIV infection. At the present time, however, many questions remain regarding the mechanisms of CD32a expression of on HIV-infected cells and the role of CD32a in the formation of an HIV reservoir and/or development of appropriate resistance. In addition to HIV infection, the significance of FcγR receptors is shown in other infectious diseases, for example, with influenza and dengue virus infections. Better understanding of the CD32a structure and function will help to assess its role in immunopathogenesis of different conditions. This review focuses on the role of CD32a in development of the normal immune response in normal state and various diseases.

Objective. The purpose of our work was molecular genetic characterization of the hepatitis D virus isolates, circulating in the region with high prevalence of HBV + HDV super-infection. Materials and methods. The study material was 64 blood serum samples obtained from Kyrgyz Republic residents - patients with chronic viral hepatitis B+D. The hepatitis D virus complete genomes were sequenced, followed by phylogenetic analysis. Results and discussion. Based on the phylogenetic analysis of 64 HDV samples, it was shown that HDV genotype 1 (96.9 %) predominates in the examined group compared with HDV genotype 2 (3.1 %). Sequences were submitted to GenBank under access No MN984407 through MN984470. When assessing the genetic variability over the examined HDV genotype 1 samples, the maximum genetic distance was 12,49 %, and the minimum – 7,41 %. Within individual clusters, the genetic distance averaged from 2.6 % to 8.5 %. Among the sequences in GenBank, the closest resemblance to the HDV-2 Kyr41 and Kyr43 samples (nucleotide identity was 92.31 % and 89.57 %, respectively) was shown for the virus described earlier in Yakutia (AJ309880). To study the genetic relationships between the analyzed HDV genotype 1 strains in comparison with the HDV reference sequences, the predicted amino acid sequence was studied (111–214). Although hepatitis B preventive measures, including vaccination, have reduced the hepatitis D incidence, there is no effective way to prevent HDV infection in HBV carriers in endemic areas. The HDV sequence molecular-genetic characterization in this study, as well as the viral genomic sequence phylogenetic analysis, will help identify pathogen transmission pathways to control and / or prevent the spread of infection.

Hepatitis B is an infectious viral disease in which damage or destruction of liver tissue occurs, and which can turn into a chronic form. In chronic hepatitis B (CHB), hepatocytes are replaced by connective tissue as they die, resulting in fibrosis, and then cirrhosis of the liver. Early diagnosis of liver fibrosis is an urgent task in the development of CHB. Already at this stage of the disease, the immune system is activated, which plays a leading role in liver damage in CHB. The main regulators of immune processes are cytokines, which mediate intercellular interactions. A separate group of cytokines are chemokines — proteins of cell migration. In CHB, they are responsible for infiltration of liver tissue by activated white blood cells. Cytokines and chemokines are active participants in fibrogenesis, so they can serve as biomarkers for the development of liver fibrosis, including in the early stages. The purpose of this study was to analyze the content of certain cytokines/chemokines in the peripheral blood of patients with CHB in order to search for potential biomarkers of the initial stages of liver fibrosis. The study included 30 patients with a confirmed diagnosis of CHB with stages of liver fibrosis F0-F1 on the Metavir scale, 36 patients with a diagnosis of chronic hepatitis C (F0-F1) and 37 conditionally healthy individuals as a control group. Concentrations of the following cytokines/chemokines were determined: IFNγ, TNFα, CCL2/MCP-1, CCL8/MCP-2, CCL20/MIP-3α, CXCL9/MIG, CXCL10/IP-10, CXCL11/I-TAC by multiplex analysis using xMAP technology (Luminex, USA). As a result of the study, it was found that in patients with CHB, the plasma content of cytokine TNFα and chemokines CCL2/MCP-1, CXCL9/MIG and CXCL10/IP-10 was increased, and the chemokine CCL8/MCP-2 was reduced, which indicates the possibility of using these cytokines/chemokines as biomarkers of liver damage in CHB. In the examined group of patients with CHB, there was no dependence of the concentrations of cytokines and chemokines in the blood plasma on the viral load, which may be explained by its low level. For plasma cytokines in patients with CHB, correlations were found between TNFα and CCL2/MCP-1 and CCL8/MCP-2 chemokines , which was not observed in the control group. At the same time, in the control group, a correlation was found between the content of TNFα and the chemokine CXCL9/MIG, which was not detected in the group of patients. For both groups, a correlation was found between the content of CXCL9/MIG and CXCL10/IP-10 chemokines. Based on the study data, an algorithm has been developed that allows us to establish chronic hepatitis B or chronic hepatitis C as the cause of the initial form of fibrosis F0-F1 in terms of the content of cytokines IFNγ, CCL2/MCP-1 and CCL8/MCP-2 in blood plasma with a diagnostic efficiency of 89.4%.

Abstract The cross section of the process e + e − → ηπ + π − is measured using the data collected with the CMD-3 detector at the VEPP-2000 collider in the center-of-mass energy range from 1.1 to 2.0 GeV. The decay mode η → γγ is used for η meson reconstruction in the data sample corresponding to an integrated luminosity of 78.3 pb −1. The energy dependence of the e + e − → ηπ + π − cross section is fitted within the framework of vector meson dominance in order to extract the Γ(ρ(1450) → e + e − ) B $$ \mathcal{B} $$ (ρ(1450) → ηπ + π − ) and the Γ(ρ(1700) → e + e − ) B $$ \mathcal{B} $$ (ρ(1700) → ηπ + π − ) products. Based on conservation of vector current, the analyzed data are used to test the relationship between the e + e − → ηπ + π − cross section and the spectral function in τ − → ηπ − π 0 ντ decay. The e + e − → ηπ + π − cross section obtained with the CMD-3 detector is in good agreement with the previous measurements.

Aim. To estimate the distribution of genotypes and subgenotypes of the hepatitis B virus among military personnel with chronic viral hepatitis B. Materials and methods. The work used samples of blood plasma and biopsy material obtained from 90 active or retired military personnel with chronic viral hepatitis B with various degrees of fibrosis undergoing treatment in St. Petersburg. Primary detection of HBV was carried out by isolating nucleic acids (NK) from the blood plasma using the «AmplePrime Ribo-prep» commercial kit (FBIS CRIE, Moscow). Specific primers were used for the amplification and sequencing reaction. Overlapping primer pairs were used, jointly flanking 1475 base pairs (bp) fragment, including the recommended for HBV genotyping the 1169 bp Pre-S1/Pre-S2/S. Results. Among 90 samples from patients with chronic viral hepatitis B from different regions of the Russian Federation, HBV subgenotypes are represented in the following ratios: D2 = 45.6% (n=41), D1 = 32.2% (n=29), D3 = 13.3% (n=12), A2 = 6.7% (n=6), D4 and A1 by 1.1%, respectively. The distribution of HBV subgenotypes from the North Caucasian federal district (D1 – 63.6%, D2, D3, D4, A2 – by 9.1%) was significantly different from the distribution among patients from the Central and North-Western federal districts (D1-20, 9%, D2 – 58%, D3 – 16.3%, A2 – 4.8%) (χ2=11,9 при p=0,0076, df=3). Uncharacteristic for the Russian Federation subgenotypes D4 and A1, representing single imported cases. The tendency to shift the distribution of genovariants due to imports of the corresponding HBV subgenotypes from other countries, including the Central Asian countries, is discussed. Conclusion. A systematic study of the HBV isolates phylogeny provides new information about the HBV subgenotypes distribution among certain population groups, including military personnel.

Aim. Molecular genetic characterization of hepatitis B virus and human immunodeficiency virus in patients with HIV / HBV co-infection living in the Republic of Guinea. Materials and methods. 2168 blood serum samples obtained from the Republic of Guinea residents – blood donors and conditionally healthy people, without suspicion of Ebola virus disease, UK RUSAL employees and their families, as part of their routine medical examination. The presence of serological and molecular biological markers of HIV and HBV was examined. When HIV/HBV co-infection was detected, the nucleotide sequences of the complete HBV genomes and the HIV pol gene fragment were sequenced. Results and discussion. HIVserological markers were detected in 239 people (11.02 %). HIV RNA was detected in 31 people, which accounted for 12.9 % of patients in the seropositive group (1.43 % of the total group). HBV serological markers among HIV RNAs-positive individuals were detected in 29.03 % of patients, including 16.12 % HBsAg and 12.9 % anti-HBcore IgG. HBV DNA was detected in all HBsAg-positive and in two anti-HBcore IgG-positive patients, as well as in 12 people negative for all HBV serological markers analyzed in the work. Thus, HBV DNA was found in 61.29 % of HIV RNA-positive individuals. Based on the pol gene fragment nucleotide sequences analysis of 19 HIV samples, it was shown that the HIV circulating recombinant form CRF02_AG prevails in the examined group (52.63 %) compared with HIV A1 (42.1 %), one sample was an independent recombinant of genotypes A1 and G. HBV phylogenetic analysis of the studied samples showed that genotype E prevails – 47.36 %, compared with HBV D1 – 21.05 %, D2 – 15.78 %, D3 – 10.52 % and A2 – 5.26 %. HIV and HBV samples have been detected that carry drug resistance mutations despite the antiretroviral therapy absence. HIV and HBV drug resistance mutations identification in ART-naive patients emphasizes the need for HIV surveillance programs as well as routine testing for HBV and HIV and HBV drug resistance before starting antiretroviral therapy in the clinical management of patients in the country.

Chemokines are a special family of cytokines whose main function is to control cell migration; they are key players in the innate and adaptive immune responses. Directed chemotaxis of specific leukocyte subpopulations is necessary not only to maintain homeostasis, but also in development of some immunopathological conditions such as cancer, inflammation, infection, allergies and autoimmune disorders. Chemokines are pleiotropic molecules that are involved in physiological and pathophysiological processes. For example, the CXCR3 chemokine receptor is expressed on various cells: activated T and B lymphocytes, natural killers, eosinophils and neutrophils, dendritic cells, fibroblasts, endothelial and epithelial cells. Hence, CXCR3 and its ligands have a wide range of functional activity. CXCR3 ligands are the IFNγ-induced chemokines: CXCL9, CXCL10, CXCL11, and platelet-derived chemokines: CXCL4, CXCL4L1. All the CXCR3 ligands share common angiostatic properties due to lack of the Glu-Leu-Arg (ELR) motif. IFNγ-induced ligands of the CXCR3 are proinflammatory chemokines, they mainly recruit activated T cells and exert an effect on T cell polarization. Due to wide spectrum of biological activity, the ligands of CXCR3 receptor are involved in pathogenesis of various disorders, such as inflammation, infection, cancer, allergies and autoimmune disorders. In this review, we discuss the role of CXCR3 ligands in immunopathogenesis of various diseases, including the results of our studies in chronic hepatitis C, rheumatoid arthritis and pulmonary tuberculosis. Moreover, we have also discussed the potential laboratory diagnostic applicability of the chemokines in various diseases. This review illustrates a universal role of IFNγ-induced chemokines as mediators of immune responses in various diseases. The studies of CXCR3 ligands, their isoforms and receptors, interactions between themselves and with their receptors can provide a significant contribution to our understanding of the chemokine network. Understanding the system of IFNγ-dependent chemokines may have clinical implications, both for diagnostic tasks, and for therapeutic purposes.

Aim. To estimate the prevalence and characterize the hepatitis B virus among HIV-infected patients with virological failure of antiretroviral therapy in Arkhangelsk. Material and methods. HBV markers determinations (HBsAg, anti-HBs IgG, anti-HBcor IgG, DNA HBV) were performed in isolates from blood plasma samples 64 HIV-infected patients with virological failure of antiretroviral therapy (viral load >50 IU / ml after 6 months of antiretroviral therapy or an increase in viral load after primary suppression of viral replication). For the detection of the hepatitis B virus, nucleic acids were isolated using the commercial kit «AmplePrime Ribo-prep». The virus presence analysis was performing by the polymerase chain reaction (PCR) method with hybridization-fluorescence detection in “real time” using the commercial set of «AmpliSens® HBV-FL». In the future, we used the method developed by the Saint-Petersburg Pasteur Institute, which allows detecting HBV in biological material with a low viral load. Results. HBsAg-negative (occult) HBV was detect in 28 (43.8%) HIV-infected patients. Only HBV genotype D was detected, and the HBV subgenotype D1 prevailed (39.3%) compared with the HBV subgenotype D2 (32.1%) and D3 (28.6%). Serological markers in 42.8% of patients with HBV DNA were founding. Two HBV isolates with drug resistance mutations in the polymerase gene, leaded to amino acid substitutions (L180M, M204V) associated with the resistance development to lamivudine, entecavir, telbivudine and tenofovir were identifying. Conclusion. The occult (HBsAg-negative) HBV high prevalence among HIV-infected patients suggests the need to use molecular-biological diagnostic methods to identify HBV, as well as to analyze the HBV drug resistance mutation before starting antiretroviral therapy for HIV.

Background and aims: to estimate concentration of sMadCAM-1 in peripheral blood at patients with chronic hepatitis C with excess body weight.Materials and methods: The research included 88 patients (67 men, 21 women 41.4±3.2 years of age) with chronic hepatitis C (CHC) and excess body weight (the index of body mass is ³25 kg/m2, and abdominal circumference more than 94 cm in men, and 80 cm in women) with various morfofunktsionalny changes in a liver and a small bowel. From them men there were 67 people, women – 21, middle age was 41.4±3.2 years.To all the patients complex clinical, biochemical, virologic, morphological trial was carried out. The functional condition of intestines was estimated by identification of a small intestinal bacterial overgrowth (SIBO) when carrying out the hydrogen respiratory test (HRT) with lactulose and existence of endoscopic signs of inflammation of a mucous membrane of intestines at a fibroezofagogastroduodenoskopiya. The quantitative assessment of a mucosal addressin cell adhesion molecule -1 was carried out by the definition concentration of its soluble form (sMadCAM-1) in a blood plasma by enzyme immunoassay method.Results: the sMadCAM-1 level of peripheral blood at the patients with excess body weight increased in process of progressing of a stage of chronic hepatitis C (F0 – 349.10 (324.27-373.92) ng/ml; F1/2 – 439.69 (406.43-472.94) ng/ml; F3/4 – 1057.82 (593.38-1522.26) ng/ml; p˂0.05), existence of a syndrome of excess bacterial growth and endoscopic signsof a duodenitis. Besides, patients had its concentration more with the biochemical signs characterizing cytolytic (at ALT˃N: 502.54 (432.04-573.03) ng/ml against 381.04(345.49-416.58) at the ALT normal values), cholestatic (at GGTP˃N: 550.59 (453.31-647.88) ng/ml against 400.86(365.13-436.59) atnormal GGTP, p values 0.05; at ALP N: 572.2 (353.7-790.8) ng/ml against 468.7 (408.5-528.9) ng/ml at normal ALP, p values 0.05) and metabolic syndromes (at glucose of blood, TG, VLDL N: 562.93 (369.59-756.27) ng/ml, 681.15 (387.81-974.49) ng/ml, 809.65(124.04-1495.28) against (438.34(391.36-485.31) ng/ml), (421.69(379.41-463.97) ng/ml), 434.47(389.45-479.48), p values 0.05 at normal values of these indicators respectively). Conclusion: Progressing of fibrosis and functional disturbances in intestines are interconnected with increase in concentration of MadCAM-1 in blood that allows to consider pathological changes in intestines of various genesis as the accessory factor promoting progressing of СHC at patients with excess body weight. Besides, definition of concentration of sMadCAM-1 in peripheral blood can be used as one of markers of noninvasive diagnostics of a stage of fibrosis at the patients with СHC and excess body weight.

The work presents data on forty-one patients with chronic hepatitis C (HCV, genotype 1), at different liver fibrosis stages. The studies were performed in the course of interferon-containing treatment regimens, i.e., pegylated interferon combined with ribavirin and pegylated interferon; ribavirin together with NS3/4A inhibitor of HCV serine protease. Concentrations of cytokines/chemokines (TNFα, CCL2/MCP-1, CCL20/MIP-3α, CXCL9/MIG, CXCL10/IP-10, CXCL11/ITAC) were measured in blood plasma samples, using xMAP multiplex analysis. Flow cytometry studies were also performed in order to reveal cells with CCR6 and CXCR3 receptors in lymphocyte populations. The obtained results were analyzed using a statistical program package R. Results: 36 out of 41 patients achieved virological response, while 5 patients did not respond to the therapy. The responders were split into two groups, as follows: (1) liver fibrosis-free; (2) patients with fibrosis stages 1, 2 and 3. In the group of fibrosis-free patients, the decrease of CXCL11/ITAC concentration and the increase of TNFαwere observed, as well as increase of CTL CXCR3+ content by the 12th week of therapy and an increase of NK CXCR3+ by the end of treatment. In addition, this group exhibited a decrease in the CXCR3+ B lymphocyte contents at this timepoint. Concentrations of CCL2/MCP-1 during treatment were increased in the patients with different stages of liver fibrosis, as compared to baseline. By the end of therapy, an increase in the relative content of NK CXCR3+and TNK CCR6+ was also detected. The study confirmed a potential role of cytokines/chemokines TNFα, CCL2/MCP-1 and CXCL11/ITAC in activation of the cell-mediated immunity and elimination of the hepatitis C virus from the body. The results indicate that activation of T cellmediated immunity in both groups of the patients and reduction of B cells with CXCR3 receptor in the patients of first group is a positive prognostic factor showing efficiency of interferon therapy. Two of studied cytokines/ chemokines (TNFαand CCL20/MIP3α) differed in the groups of responders and non-responders at the start of therapy. Statistical evaluation of pre-treatment results has shown a tendency for differing concentration of TNFα, and CCL20/MIP3αamounts were significantly different for the patients of these groups. The plasma concentrations of CCL20/MIP3αin non-responders were > 4-fold higher than in responders to the therapy. Hence, the present study allowed us to propose the chemokine CCL20/MIP3α as a potential predictor of treatment outcomes in HCV infection.

Aim. Genotyping and molecular genetic characteristics of parvovirus B19, circulating in the NorthWest Federal District. Material and Methods. The material of the study is based on serum samples from 821 patients with maculopapular rash negative for antibodies IgM-measles and IgM-rubella were received at the St. Petersburg Regional Center for Measles and Rubella Surveillance in 2009-2017. In the present study we used genotyping by direct sequencing of the NS1/VP1 region of Parvovirus B19 genome. Results. DNA of the virus was detected in 59 (42.4%) of seropositive patients. To assess the heterogeneity of isolates, 14 samples were selected from patients from geographically remote regions of the NWFO, of different ages, regardless of gender, with a high viral load (106-107 copies/ml). Based on the phylogenetic analysis of the isolates showed that only the genotype 1A was detected in all isolates. The nucleotide sequences can be divided into two subgroups: 13 isolates (92.8%) belong to the subgroup 1A2, one isolate to the subgroup 1A1. Conclusion. The introduction of B19 screening from patients with fever / rash can provide meaningful information on the prevalence of parvovirus infection in the Russian Federation. Identifying new mutations of the virus and further analysis of their possible relationships with the course of the mutation disease can help in the development of medicines, as well as in the development of an effective vaccine against the parvovirus B19.

Objective: to study changes in the cross sectional optic nerve diameter (OND), by using multislice computed tomography (MSCT), in patients with mild traumatic brain injury (TBI), as well as those with severe (including mixed) TBI before and after craniotomy; to assess whether this technique can be integrated with a whole-body MSCT protocol in severe mixed TBI (MTBI).Material and methods. OND was retrospectively studied in two selected groups of patients with injuries (a total of 51 patients): Group 1 (n = 40) included 2 subgroups (n = 20 in each) with mild TBI or severe MTBI; Group 2 (n = 11) comprised 2 subgroups with severe TBI who had undergone decompressive (n = 6) or osteoplastic (n = 5) craniotomy with subsequent OND measurement after 12–18 hours. Results. Primary brain MSCT showed that the average OND was 6.12±1,01 mm in severe MTBI and 4.4±0.19 mm in mild TBI (Student’s t = 5.707). After decompressive craniotomy, there was a decrease in OND from 6.26±0.27 to 5.38±0.22 mm (Student’s t = 2.486).Conclusion. Among the patients with severe MTBI, the OND at primary MSCT is significantly greater than that in patients with mild TBI, which may be due to elevated intracranial pressure, as shown by the literature data. There is a statistically significant decrease in OND after decompressive craniotomy and removal of the brain compressive factor. Whole-body MSCT revealed no technical obstacles to the application of an OND measurement technique.

Single-center randomized controlled partially blinded research aimed at the determination of functional results of surgical treatment of patients with Achilles tendon injury of different Myerson stages was carried out in the clinic of Irkutsk Scientific Centre of Surgery and Traumatology. Based on the analysis of surgical treatment of 20 patients with Achilles tendon divided into two groups (with Myerson stage 11 and stage 111 diastasis) we showed the effectiveness of surgical treatment using plantar muscle flexor tendon. We assessed the following criteria: 1) time from the moment of injury, diastasis length, duration of surgery; 2) pain syndrome after the surgery, omission of additional mobility aids and equipment; 3) AOFAS functional results. While the analysis we found statistically significant differences in studied groups by the criteria "time from the moment of injury" and "diastasis length". As the result of the research we found statistically significant differences by "duration of surgery» criterion. In consequence of using plantar muscle flexor tendon as a stabilizing factor at the restoration of Achilles tendon we didn't register the differences between the groups by the level and duration of pain syndrome after the surgery, terms of the omission of additional mobility aids and equipment after the surgery and also in AOFAS functional results.

The prevalence of HBV infection is estimated by the frequency of occurrence of HBsAg and varies depending on the geographic region. Chronic infection is characterized by a stable presence of HBsAg for 6 months, with the exception of the occult form of the disease, characterized by the absence of HBsAg, an extremely low level of HBV DNA in the blood serum. The problem of identifying occult HBV (ocHBV) is especially relevant because of the development of transplantology and transfusiology. However, serological screening of donor blood used in the Russian Federation and Central Asian countries does not reveal HBV seronegative donors. Since HBV infection is possible with the introduction of small doses of the virus, the importance of using complex molecular methods for detecting donor ocHBV is obvious, despite the low viral load, since donor blood is used predominantly in patients with severe course of various diseases characterized by increased susceptibility to HBV because of immunosuppression. The aim of our work was to study the characteristics of the genetic structure of the ocHBV in donors in Astana, Kazakhstan. A total of 500 blood plasma samples from HBsAg-negative donors were obtained in 2012 from residents of Kazakhstan, Astana. Using the method, we proposed to detect HBV DNA with a low viral load, HBV was detected in 9.4% of donors. Serological markers were found in 12.7% of patients with HBV DNA, 8.5% had HBcor IgG antibodies, 4.2% had HBcor IgG and HBe IgG antibodies at the same time. Thus, in 41 (87.3%) of the blood donor, ocHBV was seronegative. Based on the phylogenetic analysis of the 47 isolates showed that the HBV of genotype D (95.75%) prevails in the examined group in comparison with HBV of genotype A (4.25%). HBV subgenotypes are represented in the following ratios: D1 — 46.8%, D2 — 17.05%, D3 — 31.9%, A2 — 4.25%. In a comparative analysis, the distribution of HBV subgenotypes in the group with ocHBV and in the case of the manifest form in donors in the Republic of Kazakhstan significantly differed — χ2 = 14.027 at p = 0.0072, df = 4. The incidence of HBV D3 with ocHBV (31.9%) exceeded that of patients with a manifest form (7.4%). The relative risk of occult form of disease in patients with the subgenotype D3 is significantly higher (RR = 1.572, CI: 1.179–2.096, p = 0.0208). When assessing the picture of HBV diversity on the material of the group including HBsAg-negative and HBsAg-positive blood donors, it is evident that the genetic relationship of the manifestations of the manifest HBV and the ocHBV of genotype D is obvious. Among the isolates are both similar in nucleotide sequences with those previously described in various regions of Europe and Central Asia, and circulating in the territory of the Republic of Kazakhstan, which indicates an independent homologous evolution of HBV in the region. The high incidence of ocHBV among HBsAg-negative blood donors is indicative not only of the widespread prevalence of the occult form of the disease course in the population and the inadequacy for the detection of chronic HBV of conventional HBsAg and HBV DNA in the peripheral blood using commercial kits, but also the need to study the characteristics of the immune response with this form of the disease course.

The data of 1740 patients (during 20 years) with rectal cancer were analyzed. Planned operations were performed in 95.8% of patients. The adenocarcinoma was verified in all patients. Accompanying pathology was detected in 84.9% of patients and the pathology of cardiovascular system was more frequent (76.6%). Complicated course of tumourous process was revealed in 4.5% of patients (cases of bowel obstruction, the perifocal inflammation). The majority of patients had the II, III stage of the oncologic process. All operations were performed by conventional (open) way. The number of anterior resection of the rectum increased and the number of abdominoanal resection with bringing down reduced. The specific weight of sphincter preserving operations, which were completed by forming a colostomy decreased. The quantity of performed abdominoperineal extirpation was constant.

Objectives. The purpose of this study was to assess the tolerance and efficacy of accelerated hypofractionated chemoradiotherapy for oropharyngeal cancer. Material and methods. The study included 54 patients with morphologically confirmed primary stage II–IV oropharyngeal cancer. All the patients received neoadjuvant polychemotherapy with the PF regimen followed by radiation therapy alone. Radiation was delivered in daily 2.4 Gy fractions five days per week to high-risk areas up to a total dose of 62.4 Gy and to low-risk areas up to a total dose of 45.6–48 Gy. Results. A response to neoadjuvant chemotherapy was noted in 75.9 % of cases. Stable disease was seen in 24.1 % of patients. After accelerated hypofractionated radiation therapy, 50 (92.6 %) patients demonstrated tumor response and 4 (7.4 %) demonstrated stable disease. A complete response was achieved in 38 (76.0 %) and partial response was achieved in 12 (24.0 %) patients. The one-year overall survival rate was 83.8 %. Grade III and II oral mucositis was observed in 38 (70.4 %) and 16 (29.6 %) of cases, respectively. Therapy had to be interrupted in 33 (61.1 %) patients. On average, the treatment break lasted 14.2 ± 2.4 days. There was no statistically significant difference in survival rates between the patients treated with or without treatment break (p=0.418). The one-year overall survival rates were 88.9 and 70.0 %, respectively. Conclusion. Evaluation of short-term outcomes and our initial experience with accelerated hypofractionated irradiation at 2.4 Gy per fraction in the treatment of oropharyngeal cancer do not still allow us to draw any firm conclusions on these matters. Further follow-up is needed to make an assessment of long-term treatment outcomes and late toxicities.

We have studied the electronic band properties of 2H-SiC and 4H-SiC silicon carbide polytypes. The structures of the electronic bands and density of state (DOS) using ab initio Density Functional Theory (DFT) were calculated for the first Brillouin zone both in the generalized gradient approximation and taking into account quasiparticle effects according to the GW scheme. The calculated bandgaps obtained using the GW approximation E_{g2H-SiC} = 3.17 eV and E_{g4H-SiC} = 3.26 eV agree well with experimental values. The shape and values of total DOS are within agreement with calculations performed by other authors. The calculated total energy values for 2H-SiC and 4H-SiC were close, but they satisfy the condition E_2H > E_4H, which implies that the 4H-SiC structure is more stable than 2H-SiC. Our calculations of the band structure and DOS of 2H-SiC and 4H-SiC by the DFT method showed that the application of the GW approximation is an optimum approach to the study of the electronic structure of 2H-SiC and 4H-SiC polytypes.

Objective. The aim of this study is to evaluate the experience with minimally invasive transanal operations and to improve treatment results in patients with early rectal cancer; to assess the accuracy of endorectal ultrasound (ERUS) in preoperative staging of rectal cancer. Materials and methods. The present clinical trial includes 38 selected patients who were underwent minimally invasive transanal procedures for early rectal cancers. 22 (58 %) patients were operated by transanal endoscopic microsurgery, 16 (42 %) were underwent transanal local excision. The study population consisted of 20 men and 18 women; average age was 64 (range 42–84) years. The main outcome measures included the operation time, the intra- and postoperative complication rate, negative microscopic margin rate, specimen fragmentation rate, oncological results (local recurrence and distant metastasis rate). Comparison of ERUS preoperative staging and pathological staging was performed to identify the accuracy of ERUS. The postoperative surveillance protocol was applied to all patients. Results. The median operative time was 56 (30–110) minutes. Postoperative complications occurred in 2 patients (5.2 %). There was no mortality. All pathological specimens were removed en block without fragmentation. Final histology revealed pTis – 10 (26 %), pT1sm1 – 9 (24 %), pT1sm2 – 12 (32 %), pT1sm3 – 5 (13 %) and pT2 – 2 (5 %) adenocarcinomas with negative resection margins (R0). The overall accuracy of ERUS for preoperative T stage was 78.9 %; for Tis was 80.0 % and for T1 – 85.0 %. All 7 patients in the pT1sm3 and pT2 groups were offered immediate radical surgery or adjuvant chemoradiotherapy. The follow-up period was from 5 to 60 (median 36) months. There was one local recurrence (2.6 %) in 6 months after local excision in a patient with pT1sm3. This patient underwent total mesorectumectomy. Conclusions. Selected patients with “low-risk” early rectal cancer and favorable features may be effectively treated with minimally invasive transanal operations without jeopardizing long-term oncological results. The lack of lymphadenectomy represents the main concern of this approach for the treatment of rectal cancer. Further follow-up is necessary. Preoperative ERUS has a good accuracy with pathologic T stage and can guide transanal procedure in early rectal cancer.

Aim. Epidemiologic examination of the case of group HIV-1 infection based on data obtained by general diagnostics methods for confirmation of the investigation hypothesis of deliberate HIV infection during heterosexual intercourse. Materials and methods. Sera samples from 8 HIV infected patients (5 female and 3 male) from Veliky Novgorod sent for epidemiologic investigation were used. Determination was carried out based on 1285 nt sequence analysis of polymerase gene segment (pol). Results. The study allowed to identify HIV in clinical samples sent to the expertise and establish phylogenetic connections between virus isolates obtained from both target and control group patients. Analysis of the results allowed to isolate samples grouped in a separate cluster that indicates tight cordial connections between the vims isolates from clinical material of these patients. Patients of the target group were infected with HIV-1 isolate ofthe circulating recombinant form CRF03_AB from the same origin that is confirmed by high homology ofthe nucleotide sequences. Conclusion. Epidemiologic investigation of a group case of HIV-1 infection has determined that the infection of the women of the target group occurred from the same source. Phylogenetic analysis results indicate the presence of an epidemiologic connection within the examined group that confirms the HIV infection transmission and conclusions ofthe investigation. Use of molecular-phylogenetic analysis of data obtained by laboratory diagnostics methods of HIV resistance to antiretroviral preparations allows with anamnestic and investigation information (in the context of available evidence) to investigate cases of HIV infection.

Objective: to analyze the clinical course of ventilator-associated pneumonia caused by Stenotrophomonas maltophilia in infants as a high-risk group for the development of hospital acquired infection, as well as a study of the sensitivity of the pathogen to antibiotics.Eighteen infants (14 premature and 4 mature infants) with ventilator -associated pneumonia due to (Stenotrophomonas maltophilia) were monitored. The disease occurred in the majority (72%) of infants as a monoinfection, more often in severe and acute form with severe toxicosis, trophic disorders, severe respiratory failure, bilateral lung and bronchial lesions. In 33% of children, mostly premature, there was a change in the pathogen, which increased the severity and duration of the disease. Pneumonia had complications in the form of sepsis (6%) and bronchopulmonary dysplasia (28%). Most Stenotrophomonas maltophilia retained sensitivity to ticarcillin + clavulanate, ciprofloxacin, chloramphenicol and co-trimoxazol.

Aim. Study cases virologic failure ART HIV-1 in children.Materials and methods. The blood plasma samples of 6 patients with HIV infection were used, identified under 1 year of life, from the North-West Federal District of the Russian Federation, received in 2014–2016. Presented in a group of patients were aimed at identifying drug resistance in the virus and correction of ART due to virological failure. In the present study we used genotyping by direct sequencing of the site of the polymerase gene (pol) length of 1285 nt., The gene encoding the protease (PR) length of 465 nt. and a portion of the reverse transcriptase (RT) gene length of 820 nt.Results. In all cases, I was diagnosed with HIV-1 subtype A1, the so-called IDU-A, which is the most common form of HIV-1 in the Russian Federation. Among the obtained isolates of HIV have been identified typical drug resistance mutations to NRTI and NNRTI. Detected multiple natural polymorphic variants from the land of the nucleotide sequences. Thus, all samples show protease mutation M36I, R41K, H69K, and L89M, five samples E35D, four samples I13V. Only one among the surveyed our children with combined variant protease gene mutations L63T + V77I + I93L and reverse transcriptase gene V35I + K166R, despite ongoing therapy and absence of significant drug resistance mutations, according to Stanford University-based data showed high viral load – 2.03×107 copies/ml. The importance of the influence of natural polymorphisms in the drug resistance of the virus is discussed.Conclusion. The high frequency of natural polymorphic variants of the protease and reverse transcriptase genes of the virus in clinical samples submitted. The number of such mutations, apparently does not depend on the number of treatment regimens, but found some correlation with adherence to treatment.

The article provides information on transboundary watercourses and international lakes of the Russian Federation. We discuss the goals and objectives of environmental monitoring. Particular attention is given to the possibilities of satellite monitoring of transboundary water bodies of the Russian Federation.