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Background. There is reason suppose that the concentration of photosynthetic pigments in sphagnum mosses, as in vascular plants, changes throughout the year and varies from species to species. Moreover, hollow sphagnum species have a higher growth and photosynthesis rate than ridge sphagnum species, which suggests the presence of differences in the pigment complex of species from different habitats. Purpose. Evaluation of quantitative changes in the pigment complex of the sphagnum mosses growing in different microclimatic conditions within oligotrophic bogs during the growing season at high latitudes. Materials and methods. The content of photosynthetic pigments in the three Sphagnum species growing in oligotrophic conditions was determined using the photometric method in an acetone extract once a month from May to October. The study was carried out for S. fuscum and S. lindbergii in 2021-2022, and for S. angustifolium only in 2022. Statistical data processing was carried out in Microsoft Excel 2010 and SPSS Statistics 11. Results. Seasonal and interannual variability in the content of chlorophylls, carotenoids, and their ratios was revealed for the studied sphagnum species. The pigment complex of S. lindbergii and S. angustifolium during the growing season is influenced by the bog water level and air temperature. Changes in the pigment complex of S. fuscum are associated with the amount of precipitation. Conclusion. Apparently, the seasonal and interannual dynamics of the pigment complex of sphagnum mosses is species-specific, but to further verify this statement it is necessary to study other species of sphagnum mosses from the same habitats, since the dynamics may be associated not so much with a peculiar species, but with the ecological conditions of the habitat.

Introduction: Cerebral arterial air embolism (CAE) is a serious and potentially dangerous condition that can interrupt the blood supply to the brain and cause stroke. One of the promising gas mixtures for emergency treatment of air embolism is an oxygen-helium mixture.Methods: We modeled CAE in awake rats by injecting air into the common carotid artery. Immediately after CAE, animals were either untreated or underwent hyperbaria, oxygen inhalation, heated air inhalation, or helium-oxygen mixture inhalation. Body temperature, locomotor activity, respiratory and cardiovascular parameters were monitored in the animals before CAE modeling, and 3 and 24 h after CAE modeling.Results: After 3 hours of CAE modeling in awake rats, depression of the nervous, cardiovascular and respiratory systems, as well as decreased body temperature were observed. 24 h after CAE modeling multifocal cerebral ischemia was observed. Normobaric helium-oxygen mixture inhalation, on par with hyperbaric treatment, restored body temperature, locomotor activity, respiratory volume, respiratory rate, and blood pressure 3 hours after CAE, and prevented the formation of ischemic brain damage lesions 24 h after CAE.Discussion: Thus, inhalation of a heated oxygen-helium gas mixture (O2 30% and He 70%) immediately after CAE improves the physiological condition of the animals and prevents the foci of ischemic brain damage formation.

Проанализирована значимость прогностических факторов эффективности терапии у детей с острым лимфобластным лейкозом (ОЛЛ), получающих терапию по протоколу ALL-MB-2002, в зависимости от группы риска. В исследование были включены 1544 первичных больных ОЛЛ в возрасте от 1 года до 18 лет, получавших лечение в 36 клиниках России и Беларуси в период с 15 апреля 2002 г. до 1 января 2008 г. Из 1544 больных, включенных в анализ, пациенты группы стандартного риска (SRG) составили 69,2 %, промежуточного риска (ImRG) — 24,5 % и 6,3 % пациентов были отнесены к группе высокого риска. Анализ, проведенный у пациентов SRG, продемонстрировал резкие различия в выживаемости между отдельными подгруппами больных. Выявлены достоверные различия в показателях выживаемости пациентов в зависимости от возраста (старше и младше 10 лет), инициального лейкоцитоза (более и менее 30 × 10 9 /л), инициального пальпаторного увеличения селезенки (более и менее 4 см из-под края реберной дуги) и параметров раннего ответа на терапию (8-й и 15-й день). При ретроспективном определении больных, относящихся к SRG, с использованием новых критериев (инициальный лейкоцитоз

In present article comparative efficacy analysis of two conceptually various acute lymphoblastic leukemia (ALL) chemotherapy programs from 18. 04. 2002 till 01. 01. 2007 aimed at definition of optimum ALL chemotherapy strategy in children is presented. To obtain an ultimate correct analysis patients data bases from Moscow and St.-Petersburg oncohematology departments have been united to the subsequent carrying out of meta-analysis. 292 primary patients are included in this analysis from ALL-MB-2002 group and 126 patients from COALL-St.Petersburg-92 group aged from 4 months to 18 years. Analysis of treatment results dynamics in ALL patients received COALL-St.Petersburg-92 protocol for 2 periods: from 01. 01. 1999 till 18. 04. 2002 and from 18. 04. 2002 till 01. 01. 2007 is also presented. Detailed comparison of two chemotherapy programs efficacy has not found any statistically significant differences concerning such factors, as complete remission rate, early death rate and relapse rate, and as number of children who are in continuous complete remission. Event-free survival (EFS) in both groups was 78 ± 3 and 78 ± 4 %, respectively (р = 0.85). The overall survival (OS) was 80 ± 5 % for patients treated according to ALL-MB-2002 protocol, and 83 ± 4 % for patients receiving COALL-St.Petersburg-92 protocol (р = 0.65). Though comparison of ALL-MB-2002 and COALL-St.Petersburg-92 protocols has shown, that efficacy of both chemotherapy regimens is identical, however such advantages of ALL-MB-2002 protocol as reduced toxicity and greater simplicity in implementation could be crucial for the choice of optimal chemotherapy strategy for childhood ALL in Russia.

Comparative retrospective analysis of treatment results of three different chemotherapy protocols - ALL BFM 90m, ALL MB 91 and PECO 92 — in primary ALL patients aged before 18 years, registered in Moscow and St-Petersburg clinics from 01.01.1993 to 01.01.1999 is presented. It has been shown, that treatment results of PECO 92 protocol have appeared much worse, thus, any differences in treatment results for children with ALL between ALL BFM 90m and ALL MB 91 protocols were not revealed. Event-free survival (pEFS) of St-Petersburg' patients, received PECO 92 protocol (60±3%), was significantly worse, in comparison with patients treated according to ALL BFM 90m protocol (74±4%; р=0,0056) and ALL MB 91 protocol (73±4%; р=0,0239). The high incidence of relapses became a main cause of efficacy decreasing. Differences of induction and remission death incidences between three chemotherapy protocols were not revealed. Significant and most expressive EFS differences between PECO-92 and two other protocols were obtained in boys, in a 1—10 age group, and in patients with leukocytes count > 100 000/mm3, in patients with non-T-ALL and in patients with spleen size >4 cm.

Redox potential and acidity are widely used to describe soil processes and to assess the state of soils, including peat soils. This study aimed to identify the main trends in the change of peat physicochemical properties with depth below the surface of a peat deposit. The research was carried out on the Ilas bog complex, Russia, which is typical for the South White Sea bog province. Changes in peat indicators (Eh, pH, botanical and elemental composition, the number of viable cells of the main groups of aerobic and facultative anaerobic microorganisms) with depth demonstrated that the redox regime of the studied peat deposit corresponded to the moderately reduced class of organogenic soils with Eh range 100–400 mV. There was an increase in pH (from 3.3 to 4.3) and a non-monotonic decrease in Eh (from 340 to 220 mV) with increasing depth within the deposit (up to 360 cm). These results were consistent with data on the elemental composition of peat and the number of viable cells of the main groups of aerobic and facultative anaerobic microorganisms. The stratigraphic zoning of the peat deposit of a typical boreal raised bog will serve as a theoretical basis for assessing the transformation of wetland ecosystems resulting from anthropogenic pressure or climatic changes within this geographical region.

The study objective – to analyze the treatment results and prognostic factors of survival in patients with locally advanced laryngeal cancer who received surgical treatment and chemoradiotherapy.Materials and methods. The retrospective study included patients with locally advanced laryngeal cancer treated at the N. N. Petrov National medical Research Center of Oncology, Ministry of Health of Russia in the period from 2009 to 2018. The patients included in the study were divided into 2 equal groups (74 patients were included in each group) depending of treatment: surgery with postoperative radiation therapy combined with chemotherapy (group 1) and concurrent chemoradiation therapy and subsequent surgical treatment in case of incomplete response to treatment or disease progression (group 2). The endpoints of the study were general and relapse-free survival.Results. One hundred and forty-eight patients were included in the study: 74 patients in group 1 and 74 patients in the group 2. The median overall survival in the surgical treatment group was 45 months, in the chemoradiotherapy group – 44.6 months, and the overall 5-year survival for the group 1 and the group 2 were 39.3 (95 % confidence interval (CI) 26.1–59.2), and 59.2 % (95 % CI 45.3–77.2), respectively. The relapse-free 5-year survival rate for the surgical treatment group and the chemoradiotherapy group was 36.8 (95 % CI 25.1–53.8), and 53.9 % (95 % CI 40.7–71.4), respectively.Conclusion. There were no significant differences in overall and relapse-free survival. Metastatic lesion of the neck lymph nodes (N2–3), invasion of laryngeal cartilage, invasion of the thyroid gland and the spread of the tumor to the larynx are statistically significantly associated with lower overall and relapse-free survival.

Aim. To analyze the results of treatment and prognostic factors of survival in patients with cervical esophageal cancer (CEC) who received surgical treatment, chemoradiation therapy and chemotherapy. Materials and methods. The retrospective study included patients with a verified diagnosis of CEC treated at the Petrov National Medicine Research Center of Oncology from 2009 to 2018 and divided into three treatment groups: surgical treatment, chemoradiotherapy and chemotherapy. The endpoints of the study were overall survival (OS) and relapse-free survival (RFS). Results. Ninety-seven patients were included in the study: 48 in the surgical group, 30 in the chemoradiotherapy group and 17 patients in the chemotherapeutic treatment group. The average age of patients was 59.210.4 years. The median OS in the surgical group was 39.1 months, in the chemoradiotherapy group 23.9 months and 8.9 months in the chemotherapy group; the overall 3-year survival rate was 51.0% (95% CI 36.471.7), 44.9% (95% CI 26.974.9) and 26.0% (95% CI 9.968.2), respectively. The overall 5-year survival rate for the surgical group and the chemoradiotherapy group was 40.0% (95% CI 25.862.0), and 44.9% (95% CI 26.974.9), respectively. The presence of coronary heart disease is associated with a significant decrease in OS. The median disease-free survival in the surgical group was 19 months, in the chemoradiotherapy group 11.5 months and 3.4 months in the chemotherapy group; the relapse-free 3-year survival rates were 44.1% (95% CI 30.264.4), 25.0% (95% CI 11.753.4) and 14.3% (95% CI 4.051.5), respectively. The relapse-free 5-year survival rate for the surgical treatment group and the chemoradiotherapy group was 34.6% (95% CI 21.655.3), and 25.0% (95% CI 11.753.4). The presence of peptic ulcer disease was statistically significantly associated with higher overall and RFS regardless of the treatment received. Conclusion. In our study, surgical treatment of the CEC showed better overall and RFS rates compared with chemoradiotherapy. The presence of coronary heart disease and peptic ulcer disease are prognostic factors for overall and RFS.

Introduction. Soft gelatin capsules are a promising dosage form comprising essential oils as active agents. Joint research of the staff of the Perm State Pharmaceutical Academy, the Research Institute of Nutrition of the Ministry of Energy and Industry of the Republic of Tajikistan have proposed the composition of gelatin mass for encapsulation by the rotary matrix method. The mechanical and physical-technological parameters required to preserve the strength and elasticity of the capsule shell during the production process and storage are determined.Aim. Study of the rheological properties of gelatin masses based on gelatin of different grades, as well as the migration of essential oils through capsule shells.Materials and methods. Pharmaceutical active substances "Lipovitol" and "Limoneol" obtained in the Republic of Tajikistan were used as active substances introduced into the composition of soft gelatin capsules. Sunflower oil was used as the solvent. Gelatin samples were used to obtain gelatin masses: 1 – Foodchem (China), 2 – Brodnickie Zaklady Zelatyny Sp. zo.o. (Poland), 3 - Italgelatine s.p.a. (Italy), 4 – Ewald-Gelatine GmbH (Germany), 5 – Weishardt International (France); glycerol; sunflower oil. Gelatin mass for manufacturing soft capsules was prepared in a closed reactor. Capsules were prepared on an automatic encapsulation line RJWJ – 115 Soft Gelatin Encapsulator Machine (China). The structural and mechanical properties of soft gelatin masses were determined on a rotary viscometer RV type "Reotest 2" (Germany). The dynamics of the process of migration of essential oils and its components were studied by changing their amount in a capsule by chromato-mass spectrometry method on a chromatograph Varian CP 3800 with a quadrupole mass spectrometer 4000 MS as a detector (USA).Results and discussion. When studying the rheological properties of model compositions, it was found that for all samples of gelatin masses there is a decrease in values of effective viscosity when the shear rate increases, which characterizes the tested samples as a structured dispersion system. Additional studies have shown that the gelatin masses have thixotropic properties. Samples of gelatin masses 3–5 had narrower hysteresis loops, while sample 5 the narrowest, restoration of the structure took place quite quickly. Capsules obtained from gelatin mass 3 and 4 samples had a strong seam and were well cut out of the tape. From the mass of sample 5, high strength ribbons were obtained, a high temperature was required to seal the capsules, in some capsules the seam was not glued on one side, as a result, the capsules were rigid and brittle. As a result of the study, the rheological optimum of the gelatin mass suitable for preparing capsules by a rotary matrix method was determined, which has boundaries in the ranges of shear rates of 0.556–243 s-1 and viscosity ranges of 11.46-5028.76 Pa ⋅ s and shear stress of 2788–2808 Pa developing at these rates. When studying the migration of active substances through the capsule shell, it was found that over three years of storage of capsules in a closed polymer can, the content of essential oil in Lipovitol capsules decreased by 4.88 %, in Limoneol capsules by 5 %, which indicates partial migration of oil through the gelatin shell. The content remained within the permissible deviations (±10 %). The content of essential essential oil components also remained within acceptable deviations throughout the shelf life.Conclusion. The optimal composition of the shell for producing soft capsules by a rotary matrix method is justified. It was found that the rheological optimum of gelatin mass is characterized by viscosity ranges of 11.46-5028.76 Pa ⋅ s and shear stress of 2788–2808 Pa. According to the results of the study of the migration of essential oils through the shell, has been established the shelf life of soft gelatin capsules in glass jars made of dark glass and a temperature of 15 to 25 °C – 3 years.

The study objective – present a clinical case of radical surgical treatment of a laryngeal granular cell tumor with invasion of cricoid cartilage and thyroid gland and show the importance of pathomorphological diagnosis.Case report. A 47‑year-old woman of European origin complained of progressive hoarseness that lasted for 8 months. We analyzed her clinical, laboratory, radiological, and pathomorphological data. At the preoperative stage, the tumor was classified as well differentiated squamous cell carcinoma (stage cT4aN0M0). Endoscopic examination revealed the exophytic part of the tumor with an infiltrative base and tuberous surface, pinkish, with signs of dyskeratosis and tumor invasion to the cartilage. Pathomorphological examination of biopsy specimens demonstrated well differentiated keratinizing squamous cell carcinoma. The patient has undergone laryngectomy, thyroidectomy, and selective cervical lymph node dissection. Pathomorphological and immunohistochemical examinations of surgical material verified granular cell tumor of the larynx (Abrikosov’s tumor) that was excised within healthy tissues (R0). Conclusion. The presented clinical case of such a rare pathology as a granular cell tumor of the larynx shows the importance of pathomorphological diagnosis and the use of additional immunohistochemical research methods for making an accurate diagnosis and differential diagnosis of squamous cell carcinoma and Abrikossoff tumor.

Background. Pseudosarcomas of soft tissues can cause diagnostic and treatment challenges. On the one hand, it is difficult to make a nosological diagnosis based on a biopsy specimen of a tumor; on the other hand, it is difficult to determine the most appropriate treatment strategy based on a histological pattern.The purpose of the study was to analyze available literature data and systematize the histological characteristics of the chondroid lipoma and pseudosarcoma.Case description. We present the case of chondroid lipoma in a 57-year-old female patient with atypical clinical symptoms. This case shows the difficulties of differential diagnosis of soft tissue sarcomas. Using a clinical example of chondroid lipoma, a rare soft tissue tumor, and an analysis of literature data, the authors showed the importance of a detailed study of the obtained material, a qualified description of the morphological picture, in those cases when the diagnostic conclusion cannot be unambiguous about the malignancy of the tumor process. Additional biopsy is not always possible to clarify the histotype of the tumor. The presented observation shows the difficulties of differential diagnosis of soft tissue sarcomas. Minimally invasive biopsy provides no a full appreciation of histological structure; therefore, if there is a suspicion for chondroid lipoma, it is necessary to perform total surgical biopsy followed by a morphological study using the immunohistochemical method.

Introduction. Various formulations of sprouted grain breads, including those with amaranth flour, were developed to combat food-related diseases. Healthy food industry requires thorough assessment procedures and hygienic practices. The research objective was to assess the functional properties and safety indicators of amaranth bread made from sprouted wheat grain. Study objects and methods. One day old grain bread was tested for antioxidant activity using amperometric method. Its glycemic index was determined according to the ratio of the area under the glycemic curve per bread sample to the area under the glycemic curve for pure glucose, expressed as a percentage. Crumb proteins digestibility was measured in vivo using ciliates Paramecium caudatum. Phytin content was measured by the colorimetric method, while safety indicators were compared to the Technical Regulations of the Customs Union No. 021/2011. Bound moisture content was determined with a refractometer after three days of storage according to the change in sucrose concentration. The number of mesophilic aerobic and facultative anaerobic microorganisms (NMAFAnM) was described based on State Standard 10444.15-94. Results and discussion. The amaranth flour slightly affected the antioxidant activity of the grain bread. It decreased the glycemic index by 8.3% and increased the microbiological purity by 1.4 times, raised the crumb proteins digestibility by 3.0%, reduced the phytin content by 7.0%, and slowed down the staleness process by 12 h. In terms of safety indicators, the obtained sample of amaranth grain bread met the TR CU 021/2011 requirements «On food safety». The decrease in the glycemic index values could be explained by the lower activity of amylolytic enzymes in amaranth flour compared to sprouted wheat. The low digestibility of carbohydrates resulted from their effect on starch. The increase in digestibility and the decrease in phytin content were caused by the lower amount of dietary fiber. The high content of bound moisture explains the longer shelf life. Amaranth flour had lower microbiological contamination compared to wheat, which decreased the NMAFAnM. Conclusion. Amaranth flour had a positive effect on the functional properties of grain bread safety indicators, which makes it possible to include it into sprouted wheat grain products.

Economic growth and its financial component is one of the thorniest problems of economic theory and practice. The paper studies the evolution of views on the relationship between economic growth and financial development. Methodologically, the research relies on the theories of economic growth; applies general scientific methods of synthesis and analysis, in particular, methods of structural and time series analysis. Theoretical insight into the research findings on the problem confirms the reasonableness of the conclusion about the formation of the new paradigm of the scientific knowledge, which changes approaches to exploring the content and orientation of the interrelation between financial development and economic growth. The authors review the discussion about non-trivial impact of finance on macroeconomic parameters, which implies nonlinear relationship between financial depth and economic growth. The paper identifies and examines the most important lines of further research in this field: the impact of financial development on economic growth; assessment and identification of indicators of the level of financial development; financial inclusion as a possible avenue towards overcoming a deficit in financial development under excessive financial depth and simultaneously, as an element of the model of inclusive economic growth (the model of growth for all). The paper concludes that with other conditions equal, the economic growth directly depends on economy saturation with financial resources differentiated by the form and content. The paper proves that developing a theory of the impact of financial development on economic growth allows picking the tools of economic policy aimed at redressing imbalances in the Russian financial system.

Attracting applicants in modern conditions is quite an important and difficult task for higher education institutions. Non-core graduate departments of the University face the greatest difficulties in this process.The article discusses the main directions of career guidance work of the Department of “Sociology, psychology and social management” of the Moscow Aviation Institute (NationalResearchUniversity) in the course of implementing cooperation agreements with educational institutions inMoscowand theMoscowregion. The authors present an experience of organizing and conducting research circles in sociology and social psychology for students of grades 8-11.The activity of the sociological research circle “First steps in science” was aimed at forming students’ ideas about research, its methods and stages; developing skills of independent work with the received social information; obtaining skills for developing, conducting and presenting research results. The program of the circle “Social psychology” adapted for classes of humanitarian and socioeconomic orientation, included personal growth trainings and career guidance games aimed at developing professional self-determination in career planning.Research circles allowed school students to develop their special skills, arouse interest in sociology and psychology, improve their understanding of the criteria for their own professional choice, as well as form students’ understanding of the Department’s profile.During the implementation of career guidance measures in modern conditions, along with positive results, the authors have identified the factors that hinder the successful interaction of schools and universities such as the lack of involvement in this process of all subjects of the educational space, insufficient attention of the school administration to the social needs of graduating departments. To solve these problems, the authors have developed and proposed a model for organizing research circles based on schools, which can qualitatively improve the social partnership of all interested participants. The basic ideas and theses of the article may be of interest both for teachers of higher educational institutions and for pedagogical staff of secondary schools.

Thymolipoma is a rare benign pathological tumor of the anterior mediastinum and accounts for about 2–9 % of thymus tumors. Tumor is usually represented as soft tissue consisting of adipose and thymic tissues. Because of the asymptomatic presentation, patients are often diagnosed with a large tumor. Gigantism of the tumor due to long-term and progressive compression of adjacent organs and anatomical structures of this region can lead to dysfunction, and in some cases, to a complete block of their activity, which is fraught with a fatal outcome. Preoperative diagnosis is always a difficult task due to the lower sensitivity of CT scans and biopsies. The main method of treatment is radical surgical excision. The article presents a clinical case of a 51-year-old patient with a giant tumor of the left hemithorax with a long-term asymptomatic presentation, who was diagnosed with thymolipoma after surgical excision and final histopathological examination.

The study objective is to evaluate the informativeness of the biopsy technique of the signal lymph node (LN) in squamous cell carcinoma of the tongue cT1–2N0.Materials and methods. A prospective, single-center study included 26 patients with morphologically verified squamous cell carcinoma of the tongue cT1–2 and the lack of clinical and radiological data for metastatic damage to the LNs of the neck. All patients underwent a radioisotope study of the lymphatic flow from the primary tumor and the topography of the signal LNs. The informativeness of the biopsy of the signal LNs was evaluated in accordance with 2 diagnostic models. When using the first diagnostic model, all LNs accumulating colloids labeled with the 99mTc isotope were considered signal LNs. In the second model, only nodes accumulating radiocolloids and located in the immediate vicinity of the primary tumor of the tongue and / or connected with the primary tumor by the “pathway” of the lymphatic vessels were considered as signal LNs. Results. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy, according to the 1st diagnostic model, were 66.6 % (95 % confidence interval (CI) 9.43–99.16), 100 % (95 % CI 85.18–100 %), 100 %, 95.83 % (95 % CI 82.28–99.13 %), 96.15 % (95 % CI 80.36–99.90 %), and when all LNs located along with the signal LNs were removed at the same levels as regional LNs, the sensitivity increased to 100 %. In the second model, the diagnostic values were: 33.3 % (95 % CI 0.84–90.57), 100 % (95 % CI 85.18– 100.00), 100 %, 92 % (95 % CI 83.78–96.24), 92.31 % (95 % CI 74.87–99.05 %). Conclusion. Evaluation of lymphatic outflow from the primary tumor and assessment of sentinel lymph node location in patients with stage cT1–2N0M0 squamous cell carcinoma of the tongue allow a doctor to determine the volume of lymph node dissection for each patient individually. Unilateral lymph node dissection is acceptable in patients with unilateral lymphatic outflow, whereas in patients with bilateral lymphatic outflow, it is associated with a quite high (up to 10 %) risk of metastatic lesions in the lymph nodes on the opposite side of the neck. It is necessary to excise all lymph nodes accumulating radiocontrast agent and regional lymph nodes located at the same levels.

The paper presents the analysis of the system of adaptation of labor migrants in the host country on the basis of the organization of vocational training. Identifies the key organizational, legal, personnel, financial and other conditions of the organization of vocational training of migrant workers.

The objective is to present a clinical case of combined treatment of cancer of the tongue and its progression to the contralateral lymph nodes of the neck using data on individual lymphatic outflow from the primary tumor of the tongue.Clinical case. Clinical, laboratory, radiological and pathomorphological data of a 50-year-old patient with a diagnosis of squamous human papillomavirus-negative cancer of the free part of the tongue and clinically negative lymph nodes of the neck with cT2N0M0. The patient underwent radical surgical treatment in the amount of hemiglossectomy and ipsilateral selective cervical lymphadenectomy after two courses of polychemotherapy according to the cisplatin + 5-fluorocracil regimen with partial regression and adjuvant treatment in the amount of conformal remote radiation therapy combined with chemotherapy. 9 months after the end of treatment, progression to the lymph nodes of the neck of the contralateral side was revealed, which accumulated a radiopharmaceutical before treatment.Conclusion. The described clinical case shows the importance of studying the lymphatic outflow from the primary tumor of the tongue to the regional lymph nodes in order to plan surgical treatment on the regional lymphatic collector in patients with squamous cell carcinoma of the free part of the tongue.

The study objective is to report a case of tracheal chondrosarcoma, which is a very rare malignant tumor. Only 18 cases have been described so far in English medical literature.Materials and methods. A 74-year-old male patient visited an otorhinolaryngologist in August 2011 with complaints of hoarseness of voice, which have been gradually increasing during the last 3 years. The patient was diagnosed with myxoid chondrosarcoma.Results. In September 2011, the patient underwent thyroidectomy and circular resection of the trachea at the level of its second ring with the creation of a tracheal anastomosis. This volume of surgery was determined by the presence a thyroid nodule in the right thyroid lobe, which invaded the cricoid cartilage and the first ring of the trachea. In November-December 2011, the patient underwent a course of adjuvant external beam radiotherapy with a total dose of 50 Gy delivered in 2.0 Gy fractions, 5 days per week. No cancer recurrence had been observed during 3 years and 9 months of follow up. In September 2015, the patients was found to have a 24-mm thyroid nodule with an exophytic component in the right thyroid cartilage plate. This finding was considered as recurrent chondrosarcoma. In May 2016, the patient had laryngectomy. We performed margin-negative (R0) resection. The patient has now been in remission for 2 years and 9 months.Conclusion. We demonstrate successful treatment of a patient with tracheal chondrosarcoma with a long-term remission after surgery for recurrent tumor.

Aim. The study was conducted to estimate the clinical and pharmacoeconomic efficiency of proton pump inhibitors (PPIs) omeprazole and esomeprazole when GERD patients undergo a course of medical treatment.Materials and methods. 25 GERD patients with a history of the disease for more than 5 years were under observation in Krasnodar regional clinical hospital № 2 from 2017 till 2018. All the patients have been thoroughly examined. Conservative therapy included the «gold standard» of proton pump inhibitors. Evaluation of the efficiency included the number of disease relapses in the period of dynamic observation and the calculation of the cost-effectiveness ratio.Results. When patients were taking esomeprazole, the relapses of the GERD disease were rare. The cost-effectiveness ratio was lower.Conclusion. The use of esomeprazole during the treatment of GERD patients has lower economic expenditures. The relapses of the disease are also less frequent.

Aim. The analysis of experience of nelarabine use in refractory/relapsed T-cell acute lymphoblastic leukemia (T-ALL) depending on the immunophenotype and the line of therapy. Materials and methods. All the patients with relapsed or refractory T-ALL aged from 0 to 18 years who received treatment with nelarabine as a part of the therapeutic element R6 were included in the study. For all patients a detailed immunological analysis of leukemia cells with discrimination of immunological variants TI, TII, TIII or TIV was performed. Patients administered with nelarabine as a first therapeutic element were referred to the first-line therapy group, other patients were referred to the second-line therapy group. Nelarabine was administered as intravenous infusion at a dose of 650 mg/m2, on days 1-5. Allogeneic hematopoietic stem cells transplantation (allo-HSCT) was considered for all patients. Results. From 2009 to 2017, 54 patients with refractory/relapsed T-ALL were treated with nelarabine. Five-year event-free survival (EFS) and overall survival (OS) was 28% for all patients, cumulative risk of relapse (CIR) was 27%. EFS was significantly higher in nelarabine first-line therapy group in comparison with second-line therapy group (34±8% vs 8±8%, p=0,05). In patients after allo-HSCT EFS, OS and CIR were 51±10%, 50±10% and 39,1±9,5% accordingly. The best results were achieved in patients with TI immunophenotype. No toxicity-related mortality as well as severe neurologic complications or discontinuation of therapy associated with use of nelarabine were reported. Conclusion. The use of nelarabine is an effective strategy for the treatment of relapsed and refractory T-ALL. The best treatment outcomes were obtained in patients with TI immunophenotype and in the first-line therapy group. Optimal dosage regimens can be established during controlled clinical trials.

The article discusses the problem of using ACE inhibitors and diuretics in arterial hypertension. Analysis of the position of doctors when prescribing ACE inhibitors and diuretics showed its compliance with current national guidelines for the treatment of hypertension. Physicians use more adequate criteria for antihypertensive drugs usage. There were no non-rational use of diuretics in combination, regardless of indications and contraindications. If there are indications for the use of a diuretic and a preparation of ACE inhibitors, you have to make greater use of fixed combinations of drugs. The article discusses the results of clinical efficacy studies of perindopril and indapamide in clinical practice. Noliprel® forte is an effective antihypertensive medication, not only reducing BP, but also organoprotective aim and good tolerability in wide range of patients with arterial hypertension.

Clinical and social efficiency of three different treatments of supporting therapy of Asthma of 102 patients at the age of 18–22 with moderately severe disease without concomitant pathology has been correlated in a prospective way. Observation over the patients has been carried out during a year. Minimal clinical efficiency was obvious when inhalation corticosteroids were selectively used. The patients receiving the combination of inhalation corticosteroids and beta – 2-adrenoagonists have completely comparable clinical effectiveness. Expenses on the taking of fixed combinations of mentioned medicines exceed expenditures on their wandering combinations.

Aim. To compare the influence of the simple and combined with anxiolytic drug tofisopam (AT) antihypertesion therapy (AHT) on the 24-hour blood pressure (BP) profile, anxiety level and life quality of patients with uncontrolled arterial hypertension and anxiety spectrum disorder.Material and methods. Sixty-nine patients (mean age 48,5±5,3 y. o., 35 women) were randomized to 2 groups. Each group consequently during 1 year study received two types of medicines for 6 months each with cross-replacement: isolated AHT and combination AHT with AT (AHT+A). Group 1 (35 persons) for the 1st half year took AHT, and then following half year AHT+A; group 2 (34 persons) — in back order. At the end of every period the following parameters were controlled: ambulatory blood pressure monitoring, prominence of trait and reactive anxiety, and life quality. Also, the same comparisons were done for every group separately at the end of the first and second stages of treatment.Results. The initiation of combination AHT+A led to faster decrease of BP, achievement of lower mean daily and mean nocturnal systolic and diastolic BP, lower BP variability parameters. Only combination AHT+A showed adequate reducement of reactive anxiety. Combination and simple AHT in 6 months led to significant improvement of life quality, however combination AHT showed more significant values.Conclusion. Efficacy of combination AHT+A in hypertensive persons with anxiety disorder is higher comparing to simple AHT.

In the treatment of many unresolved issues, indicating the need for research aimed at finding more effective treatment approaches. The aim of the study is to analyze the results of combined treatment of patients with widespread forms of cancer of the cervical esophagus and hypopharynx with the application of surgical treatment in the amount of pharyngolaryngitis with single-step plastic of the defect. A retrospective analysis of results of combined treatment of 28 patients with a verified diagnosis of cancer of the cervical esophagus and hypopharynx. Combined treatment of patients with cancer of the cervical esophagus and hypopharynx included the following treatments: induction chemoradiotherapy according to the scheme cisplatin/5-fluorouracil, external beam radiation therapy 65 Gy, brachytherapy (7 Gy 1 time per week, 3 sessions), surgical treatment with one-stage plastic of the esophagus. In 7 patients (25 %) was achieved complete regression on the background of induction chemotherapy, 21 patients (75 %) received the treatment in full. Postoperative mortality rate was of 9.52 %, post-operative complications such as anastomosis dehiscence – 19 %.

The aim of the study was to determine the bioavailability of minerals and oxidation-antioxidant status in the laboratory animals fed with bread from regular and bioactivated wheat grain. Material and Methods ― Studies were conducted for 21 days on white inbred BALB/с mice. The animals were organized in three groups with 30 mice in each one. Group 1 (control group) was given the complete compound feed; Group 2 was fed with regular whole wheat bread; and Group 3 was given the bread from the bioactivated wheat grain. Their blood plasma was tested for total protein, cholesterol, glucose, low and high density lipoproteins, phosphorus, calcium, magnesium, iron, zinc, malondialdehyde (MDA) levels, and the activity of superoxide dismutase (SOD). Calcium was detected histochemically using McGee-Russell’s method with Alizarin red S. Results ― It was established that the levels of glucose, total protein, cholesterol, and lipids in the blood plasma of animals in all groups were within the physiological norms. There were no significant reliable deviations in the levels of mineral substances in the blood plasma of the animals in the study groups. However, the histochemical response of the bone tissue calcium to the Alizarin red S revealed significant differences in its content in the tissues between the animals of the three groups. At the 21st day of the experiment, the maximum light absorption of the colored specimen was observed in Group 3 which indicated higher calcium content in the bone tissue of the animals fed with the bread from the bioactivated wheat grain. The oxidation-antioxidant status of the animals in Groups 2 and 3 was higher than that of the control group. On the 21st day of the experiment, MDA content in the blood plasma of the animals in Group 3 was 0.04±0.017 mmol/L which is 2.0 and 1.5 times less as compared to Groups 1 and 2 respectively. The activity of SOD in the blood plasma on the 21st day of the experiment was the highest in Group 3 animals. Conclusion ― The experiment on the laboratory mice has shown that the use of the bread from the bioactivated wheat grain makes it possible to improve the bioavailability of minerals and increase the antioxidant activity of blood plasma.

Aim. Characteristics of clonal composition of Corynebacterium diphtheriae strain populatior in Russia using MLST, as well as evaluation of a possibility of using of this method during execution of monitoring of diphtheria infection causative agent strains. Materials and methods. C. diphtheriae strains, isolated in Russia in 1957 - 2015 and sent to Gabrichevsky MRIEM reference centre for diphtheria and pertussis, were studied. Genotyping of C. diphtheriae using MLST wa: carried out based on sequencing of «housekeeping» gene fragments. ST identification was carriec out according to PubMLST. Results. C. diphtheriae strains of 36 sequence-types (ST) were identified on the territory of Russia - 27 previously known and 9 novel, detected for the first time. 2 sequence types ST25 and ST8 (22% and 18%) dominated. Inter-relation between phenotype properties (toxigenicity and biovar) and membership of C. diphtheriae strains in certain sequence-types was shown - toxigenic and non-toxigenic C. diphtheriae strains of various biovars were characterized by certain sequence-types. Changes of clonal composition of C. diphtheriae population in dynamics of epidemic process of diphtheria infection were shown. Conclusion. Use of MLST allowed to characterized clonal composition of C. diphtheriae strains’ population in Russia and has shown perspectives of use of this method to characterize population of diphtheria causative agent, detect epidemically significant strains and decipher foci of diphtheria infection.

Lineage switch is a rare phenomenon in which a transition from lymphoid to myeloid was observed in relapse of acute leukemia, or vice versa. This paper presents the four clinical case reports of acute lymphoblastic leukemia with MLL gene rearrangement (KMT2A) with myeloid phenotype in relapse.

Aim. To compare the influence of monoand combined with antidepressant antihypertension therapy (AHT) on the parameters of 24-hour blood pressure (BP) profile, severity of depression and life quality of patients with non-controlled arterial hypertension (AH) and depression.Material and methods. 71 patients, aged 48,7±5,2 y.o., 37 females, were randomized to two groups. Each group during a year consequently received two types of pharmacotherapy for 6 months twice: mono AHT and AHT with antidepressant fluvoxamine (AHT+A). Group 1 (n=35) for the first half-year received AHT, then AHT+A; group 2 (n=36) in reversed order. At the end of each half-year, we compared 24-hour blood pressure, and severity of depression by Beck score, with life quality. Same comparisons were done in the group by endings of two periods.Results. Starting with combination AHT led to faster achievement of relatively low values of mean day and mean night systolic and diastolic BP, lower BP variability. Combination AHT made to reach significantly higher level of the value and velocity of morning BP raise. Only combination therapy showed adequate reduction of depression symptomathics. Combination, as monotherapy in 6 month led to significant improvement of life quality; however, combination therapy was significantly better.Conclusion. Efficacy of antidepressant-combined AHT with fluvoxamine in AH patients with depression better than mono AHT.

The purpose of the study is to determine the spectrum used drugsslows the heart rate in patients with arterial hypertension and chronic heart failure in clinical practice and compliance of prescribing with clinical guidelines.Materials and methods. Consistently formed a retrospective sample of medical records of patients with arterial hypertension and chronic heart failure. Used sources of primary medical documentation for 2012-2015 (320 patients). Estimated the amount and quality therapyslows the heart ratein patients with arterial hypertension and chronic heart failure.Results and discussion. b-blockers prescribed for 72.5% of patients. Calcium antagonists range recommended by 13.1%. On the background of optimal doses of b-blockers in patients with arterial hypertension and chronic heart failure with the exile faction of less than 40 and heart rate more than 70 BPM, ivabradine is not assigned in 81.3% of patients, although it is in these situations of particular urgency is the drug given its bright positive effect on hard end points, proved in international multicenter trials.

Aim. To determine predictors for decision-making on a differential approach to choosing glucocorticosteroids (GCS) for children and adolescents with acute lymphoblastic leukemia (ALL). Subjects and methods. The analysis covered 1064 primary patients aged to 1 to 18 years with ALL who had been registered at the clinics of Russia and Belorussia in April 2002 to November 2006. Before induction therapy, the patients were randomized into a dexamethasone (DEXA) 6 mg/m2 group (n=539) and a methylprednisolone (MePRED) 60 mg/m2 one (n=525). Results. The entire group showed no statistically significant differences in survival rates between the patients receiving DEXA or MePRED. However, an analysis of age groups revealed the benefits of DEXA in children younger than 14 years (the event-free survival (EFS) was 76±2 and 71±2%, respectively (p=0.048); the overall survival (OS) was 81±2 and 77±2%, respectively (р=0.046); therapy-induced mortality was 6.4% (DEXA) and11.1% (MePRED) (р=0.014); the rate of isolated extramedullary relapses was 1.5% (DEXA) and 4.4% (MePRED) ( р=0.009). At the same time, EFS and OS in 14-to-18-year-old adolescents were statistically significantly higher than in those who used MePRED (EFS, 65±6 and 52±6%, respectively (р=0.087); OS, 72±6 and 61±6%, respectively; (р=0.17). Conclusion. The findings suggest that it is possible that the choice of a GCS for ALL therapy must be also based on a patient’s age. There is a need for further studies of this matter in prospective randomized multicenter trials in children and adolescents.

In the treatment of many unresolved issues, indicating the need for research aimed at finding more effective treatment approaches. The aim of the study is to analyze the results of combined treatment of patients with widespread forms of cancer of the cervical esophagus and hypopharynx with the application of surgical treatment in the amount of pharyngolaryngitis with single-step plastic of the defect. A retrospective analysis of results of combined treatment of 28 patients with a verified diagnosis of cancer of the cervical esophagus and hypopharynx. Combined treatment of patients with cancer of the cervical esophagus and hypopharynx included the following treatments: induction chemoradiotherapy according to the scheme cisplatin/5-fluorouracil, external beam radiation therapy 65 Gy, brachytherapy (7 Gy 1 time per week, 3 sessions), surgical treatment with one-stage plastic of the esophagus. In 7 patients (25 %) was achieved complete regression on the background of induction chemo-therapy, 21 patients (75 %) received the treatment in full. Postoperative mortality rate was of 9.52 %, post-operative complications such as anastomosis dehiscence – 19 %.

The aim of the study is pharmacoepidemiologicalanalysis of the structureandreasonability of diuretic therapy in patients with hypertensive disease (HD)in ‘real-life’ clinical practicesettings.Materialandmethods:we underwentthe retrospectivepharmacoepidemiologicalcomparative analysisof the structureofdiuretic therapyreviewingoutpatient cardsfrom 2011 to 2014.We extracted data from outpatientcardsin outpatient department of Krasnodar Territoryusingcontinuous sampling method(421 patients)with the subsequent assessmentin accordance withmodern guidance materials. Results. In comparison with the regional study historic resultsthe administrationoftorsemidehad significantly increasedin patients withHD andnoncomplicatedchronic cardiac failure(12%).The priority drugs for the administrationamong diuretics werehydrochlorothiazide (24%)and indapamide (20%),spironolactone (20%).The ACE inhibitoror sartanusing in fixed combination with diuretic was recommended in 20% of out- patient cards.Structure ofdiuretic distribution in group of patients with HD, associated withCHF(II-IVfunctional class)had showedthe efficiencyof spironolactonein26%,of hydrochlorothiazide - 15%,torsemide - 13%,indapamide - 7%;the combination of spironolactoneandtorsemidewas receivedby 14% of patients,the combination of spironolactoneandhydrochlorothiazide - 6%,spironolactoneand furosemide - 1%,in 4% of outpatient cardswe noticed the triple combination of monocomponentdiuretic.Conclusion. We did not find unreasonable administration of diuretic therapy combination out ofindication and in the presence of contradictions.The prescription of modern long-termdiuretics associated with lower risk of side-effects developing will improve efficiencyand safetyof pharmacotherapy.It is very important to use fixed drugs combinationin case of administration the diuretic and agentsofrenin angiotensin system inhibitors.The volume and prescription reasonability analysis ofdiuretic therapy in patients withHDin ‘real-life’ clinical practicesettingshas shown compliance with modernnational guidance materials for the HD and CHF treatment.

Introduction: Invasive fungal infections (IFI) remain an unresolved issue of hematology/oncology despite the introduction of methods of early diagnostic and invent of new highly active antimycotics. In etiologic structure of IFI the leading role belongs to candidiasis, the most frequent clinical form of which is candidemia. Candidemias in the pediatric hematology/oncology departments usually occur as sporadic cases, and epidemics are very rare. We describe an epidemic outbreak of candidemia caused by species of Candida non-albicans rarely reported in patients.Results: Ten cases of candidemia were registered in the hematology/oncology department within one month. Candidemia was caused by C. guilliermondi in 4 patients (in 1 concomitantly with C. calliculosa), by С. parapsilosis – in 3 patients and by C. pelliculosa in another 3 patients. Contaminated intravenous 4 % KCl solution has been found to be the source of candidemia. In four patients granulocytes count was < 0.5  109/l at the time of positive blood cultures. Clinical manifestation of candidemia included fever > 38.5 in all patients and lung involvement in 2 patients. All patients received systemic antifungal therapy: 5 — monotherapy, 3 — combinations of 2 drugs and 2 — of 3 drugs. Central venous catheter was removed in 4 patients. Clinical and microbiological cure was achieved in all patients; the mortality rate was 0 %. In 2 patients candidemia relapsed 22 and 60 days after the first episode.Conclusions: Outbreaks of systemic infections caused by unusual pathogens necessitate searching of a single infection source. Candidemia caused by a direct pathogen inoculation in the bloodstream, in the absence of multiple risk factors for invasive fungal infections follows a favorable course.