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Abstract The excitation of terahertz plasmon modes in a graphene rectangle by normally incident linearly polarized electromagnetic wave has been theoretically studied. The complete electromagnetic approach based on formulation of the integral equations for sought-for electromagnetic quantities has been developed. The influence of edge-field effects on excitation of plasmon modes for different polarization of the incident wave and different shapes of graphene rectangle has been studied. The absorption cross-section spectra and the charge density distributions in graphene rectangle for different plasmon modes have been studied. It has been found that the edge-field effect, which results in spreading the plasmon field beyond the geometric boundaries of graphene rectangle, leads to considerable red shifts of the plasmon mode frequencies and modifies the plasmon mode dispersion.

Current research in the field of neuroimaging is focused on the possibilities of using data from various diffusion MR models: diffusion tensor visualization (DTI), diffusion-curtosis visualization (DKI), diffusion-spectral visualization (DSI), generalized q-sample visualization (GQI), Q-ball visualization (QBI) in the assessment reorganization of the brain. The purpose of this study is to compare the results of dynamic observation of post–stroke brain reorganization by diffusion MR models (DTI, DKI). Material and methods. Dynamic MR examination of the brain of 129 patients was performed on a Ingenia 3.0 T (Philips, Netherlands) on 1–3 days, 7–10 days, 3–4 months after the manifestation of stroke according to a routine protocol (DWI-EPI, FLAIR-SPIR, T2-WI, T1W-TFE) with DTI method. The stroke was verified and DTI, GQI, and DKI maps were built. Results and discussion It was showed that the fractional anisotropy (FA) of DTI significantly changed from 1–3 days to 7–10 days in the stroke area; the mean, axial and radial diffusions increased in the affected area over the three studies. For DKI model – the curtosis FA significantly changed in the lesion area by 3–4 months; the mean curtosis decreased by the second observation in the stroke area, axial curtosis decreased in the same area throughout all studies; radial kurtosis significantly increased in the affected area throughout the study. The results confirm the world data and also indicate that diffusion metrics can interpret the neuroplasticity of the brain in various diseases, however, this requires further study. The applied diffusion models indicated the reorganization of the ischemic area and the intact contralateral area. The use of diffusion models for the dynamic assessment is a promising direction in the study of the neuroplasticity mechanisms.

Objective. To study the possibilities of the «labyrinth» procedure in combination with the left atrium reduction. Materials and methods. Into the investigation 261 patients, suffering isolated failure of a mitral valve Stage IV, operated in the National Institute of Cardio-Vascular Surgery n. a. M. M. Amosov, were included. The left atrium plasty with objective to reduce and prevent the waves spread re-entry was performed in 139 (53.2%) patients. Fragmentation in the left atrium was made in regime of low radiofrequencies (25 - 35 Вт) in accordance to schemes of Maze ІІІ, ІV. Results. In the hospital period 5 patients died (the hospital lethality have constituted 1.9%). While discharge from the hospital the sinus rhythm was noted in majority of the patients after the left atrium plasty, than in the alternative group - in 119 (85.6%) of 139 and in 79 (64.8%) of 122 patients, accordingly. Conclusion. The «labyrinth» procedure in combination with the left atrium plasty owes significant clinical advantages, including restoration and persistence of the sinus rhythm in patients, suffering pathology of a mitral valve.

The COVID-19 mortality is associated with an increase in interleukin-6 (IL-6) levels. Levilimab is an anti–IL-6 receptor antibody with proven clinical efficacy in patients with severe COVID-19.The aim of the study was to assess the association of COVID-19 severity and levilimab effectiveness with IL-6 levels and to explore the potential for using levilimab in other conditions accompanied by cytokine release syndrome.Materials and methods: the subgroup analysis was based on the data of COVID patients with known baseline IL-6 levels from the CORONA clinical study. Subgroups were formed according to baseline IL-6 levels: ≤5 pg/mL (normal) and >5 pg/mL (elevated). The subgroup analysis included descriptive statistics of the patients and time courses of their clinical and laboratory findings (at screening, on the day of investigational product administration, and further until day 14). In order to compare the percentages of patients who had required rescue therapy, the authors used Fisher's exact test.Results: the subgroup analysis included 91 patients (47 from the levilimab group and 44 from the placebo group). At baseline, the authors observed elevated levels of IL-6 in 31/47 (66%) subjects in the levilimab group and 29/44 (48.4%) subjects in the placebo group. The subjects with elevated IL-6 demonstrated more pronounced clinical signs of pneumonia and abnormalities in inflammatory markers. Elevated baseline IL-6 levels were associated with the need for rescue therapy (OR=3.714; 95% CI: 1.317–9.747; p=0.0183); this association was stronger in the placebo group (OR=8.889; 95% CI: 2.098–33.31; p=0.0036). Also, the placebo group showed long-term abnormalities in the clinical and laboratory findings.Conclusions: IL-6 is one of the key elements in the pathogenesis of cytokine release syndrome related to COVID-19 and other conditions. Elevated IL-6 levels are associated with the severity of COVID-19. Inhibition of IL-6 receptors by levilimab leads to clinical improvement in patients with severe COVID-19, suggesting the effectiveness of levilimab in pathogenesis-oriented therapy for cytokine release syndrome of other aetiologies.

The article presents a clinical observation of a patient with primary infertility on the background of morbid obesity (BMI – 64.6 kg/sq.m.) and large cystic teratoma of the right ovary, who underwent bariatric surgery – laparoscopic minigastric bypass and simultaneous laparoscopic right-sided oophorectomy. Along with the true gynecological causes of female infertility, which include, among others, benign formations of the uterine appendages, obesity is a proven significant factor in its development. The use of various infertility treatment options in obese women is ineffective, and pregnancy outcomes are often disappointing. The only proven effective treatment for morbid obesity is bariatric surgery. The implementation of bariatric intervention, and, as a result, a significant decrease in body weight, directly positively affects fertility rates. However, the polyetiological nature of primary infertility in women dictates the need for an integrated approach to treatment. A feature of the presented case is the simultaneous elimination of both etiological factors of infertility – gynecological and endocrine after one surgical intervention. The goal was achieved – after 10 months, the patient was diagnosed with a progressive uterine pregnancy for a period of 11 weeks, with a decrease in body weight by 49.9% of overweight. The course of pregnancy was uneventful. Childbirth independent, newborn full-term boy without deviations. After the birth of the child, the patient continued to reduce body weight and, 29 months after surgery, she achieved a loss of 67% of her excess weight. The presented case clearly demonstrates the advantages of simultaneous elimination of the most likely causes of primary infertility. However, the implementation of such interventions by laparoscopic access requires extensive surgical experience, technical equipment and comprehensive readiness of the medical institution.

Objective. To study the possibilities of pharmaco–cold cardioplegia, while doing isolated prosthesis of the aortal valve. Materials and methods. Into the investigation were included 279 patients with aortal failures, operated in Department of Surgical Treatment of the Acquired Failures of the Heart of National Institute of Cardio–Vascular Surgery named after М. М. Аmosov in 2015–2021 yrs. The average age of the patients have constituted (62,5 ± 6,4) yrs old. In all the patients the isolated аоrtal valve correction for aortal failures was performed, using mechanical and biological prostheses. Infusion of “Kustodiol” solution for defense of the myocardium was applied. Results. On the hospital stage 9 patients died (hospital lethality have constituted 3,2%). Іnotropic support (dobutamin) in early postoperative period was applied in dosage of 3 – 4 mcg/kg/min during first 48 h. The levels of cardiac creatine phosphokinase enzyme on the second postoperative day, while exploiting antegrade, аnteretrograde, retroantegrade and retrograde methods of the cardioplegic solution delivery, have hade differences. Conclusion. Retrograde pathway of injection of cardioplegic solution permits to defense the myocardium effectively while correcting of aortal failure.

Objective. Elaboration of the correction methodology of mitral stenosis, complicated by massive thrombosis of left atrium, for improvement of immediate and late results of surgical treatment of this pathology. Materials and methods. Into the group analyzed 344 patients with mitral stenosis, complicated by massive thrombosis of left atrium, operated in Amosov National Institute of Cardiovascular Surgery in a period from 1 January 1984 yr to 1 January 2019 yr, were incorporated. In all the patients surgical correction of mitral stenosis and thrombectomy from left atrium was performed. In 161 (46.8%) patients a radical removal of thrombotic mass together with their base–lining was performed, while in 183 (53.2%) – without it. In 256 (74.4%) patients the left atrium auricle was ligated or resected, while in 88 (25.6%) – left intact. Results. The hospital lethality index have had directly proportionally raised with enhancement of degree of the left ventricle auricle: I – 0%, II – 3.9%, III – 5.1% (p

The article deals with the activities of a psychologist-educator and his role in relation to the problem of student deviation in the digitalisation context and the widespread use of the Internet. A comprehensive analysis of adolescent deviations and various aspects of dealing with students’ destructive behavior and with their parents using knowledge from different subject areas – law, sociology, psychology, medicine, pedagogy, has been conducted. The features and characteristics of adolescence are considered, and the factors influencing the formation of deviant behavior, including medical ones, are identified. The role of the educational organisation’s psychologist in identifying and correcting learners behavior destructive forms is outlined. The necessary ratio between the staff of psychologists and medical specialists and the students number in educational organisations is given. As a result of the analysis of the current legislation, the shortcomings of certain legal provisions and the need to change them in destructive behavior prevention part were noted. Recommendations for professionals in the helping professions have been developed and projected positive results of the outlined activities have been given. The authors’ conceptual findings are applicable to creating a safe and supportive environment for learners, reducing juvenile delinquency and amending legislation.

This work analyzes the right to a favorable social environment on the Internet. The main purpose of the article is to consider the right to access the Internet and a favorable social environment. The authors consider the influence of a favorable social environment on the human psyche. The object of the study is the rights of citizens of the Russian Federation to a favorable social environment and comfortable use of the Internet. The subject of the article is the consideration of the rights to a favorable social environment as an inalienable right of every citizen of the Russian Federation. The authors write about the role of a favorable social environment and the Internet for minors, describe the main factors of restrictions on Internet access for adolescents. The methodological and theoretical basis of the research is based on private and general scientific approaches to the study of this topic. Formal logical and comparative methods, as well as methods of structural analysis were used. In the course of the study, the researchers draw conclusions about the reasons why the right to a favorable environment cannot be considered exclusively in the context of ecology.

This work is devoted to the analysis of the right to access the Internet and its safe use. The main purpose of the article is to consider the right to access the Internet and to a favorable social environment, as well as the introduction of these rights into the legislation of the Russian Federation. The authors analyzed the legislation of various states and international organizations in the field of free Internet access, considered the impact of a favorable Internet environment on the human psyche. The object of the study is the subjective human rights to access the Internet and to use the Internet safely. The subject of the study is the legal norms of the Russian Federation and foreign states, the norms of international law. The authors consider the role of a favorable environment on the Internet for minors, describe the main factors of restrictions on access to the Internet for teenagers. The methodological and theoretical basis of the research are private and general scientific approaches to the study of this topic. Formal logical and comparative methods were used, as well as methods of structural analysis. During the study, conclusions about the main differences in approaches to digital rights in the Russian Federation, foreign legal systems, and international law were drawn.

This work is devoted to the analysis of the sociological and legal aspects of the implementation of authentication in social networks through passport data. In the article, along with authentication, the uses of biometric data, as well as the features of Russian legislation in the sphere of personal data, are considered. The positive and negative aspects of introducing authentication by passport data in social networks are shown and the psychological and legal aspectsare reveled. The authors analyzed all the features of authentication, the complexity of application and the impact of this innovation on the prevention of deviant behavior among the adolescent age group. The object of the research is authentication by passport data in social networks. The subject of the research is psychological and legal aspects of establishing authentication based on passport data. The methodological and theoretical basis of the research is made up of particular and general scientific approaches to the study of this topic, formal logical and comparative methods, as well as methods of structural analysis were used. In the course of the study, conclusions about the main features of storing citizens’ data, the complexity of storing data of Russians on foreign Internet platforms, conclusions on the need to filter information for minors were drawn, and also considered the phenomenon of deviant behavior among adolescents and the influence of information in social networks on their consciousness.

Purpose: to identify the features of the pathology of the eye in elderly and senile people in the Arkhangelsk region. Material and methods. Annual reports of medical eye care facilities for the 2009 to 2019 who offered ophthalmological assistance to individuals aged 60 or older were analyzed. To estimate the differences infrequency of occurrence Pearson's Chi-square was used. Results. The incidence of eye pathologies in elderly and senile people amounts to 20.74% (17.83 % male and 22.29 % female). The most common conditions included the pathology of the lens that occurred in almost 50 % of the old people, glaucoma was diagnosed in about 20 % and retinal conditions in one out of seven people. In the age group of 60 to 74 years, the most common pathologies included glaucoma, diabetic angioretinopathy, retinal conditions and refractive errors; in the people of advanced age (75—89 years), lens pathologies and age-related macular degeneration occurred more frequently than in the younger age group while glaucoma, diabetic angioretinopathy, retinal conditions and refractive errors occurred less frequently. The oldest age group (90 years and older) showed a different pathology distribution than people of the younger age groups: they have higher occurrence of lens pathologies, age-related macular degeneration, optic disc pathology. In contrast, they have a rarer occurrence of retinal diseases, whilst diabetic angioretinopathy or refractive errors were not diagnosed at all. Gender differences of eye pathology distribution are revealed in the fact that, among people aged 60 to 89, women have a higher occurrence of age-related macular degeneration, retinal diseases and refractive errors, while men are more often diagnosed with glaucoma. Conclusion. The identified features of eye pathology in elderly and senile people living in the Arkhangelsk region should be taken into account when medical care for advanced age groups is developed and improved.

Intrauterine infections are one of the most pressing health problems. A feature of listeria infection is the possibility of penetration of the pathogen through the placental barrier with the development of severe systemic lesions and negative perinatal outcomes.Purpose: To describe the nonspecific morphological manifestations of listeria infection in the early stages of the disease in postnatal fetal death.Morphological confirmation of listeriosis is multiple productive-necrotic granulomas (listeriomas) with the presence of listeria in them in the form of straight, short, sometimes ovoid rods, located singly or in groups, identified by Gram-Weigert staining.

The article discusses the development of a set of targets for the economic analysis of customs payments. The relevance of the topic of scientific work lies in the fact that customs payments are the result of joint economic activities of economic entities participating in foreign economic activity and customs authorities, which makes it possible to interpret them as an independent economic category and an object of a separate economic analysis, as well as to identify a multi-level scientific problem, which can be solved in a complex possibly through a developed methodology of appropriate economic analysis based on a set of targets. Economic activity as its ultimate goal is the production or exchange of material goods or services, which can be carried out both within the country and abroad. If the first aspect is closely related to the production and economic activities of economic entities and the analysis of the relevant indicators reflecting this specificity through the use of the formed system of indicators (cost, profit, etc.), then in the second case the values that determine the very process of moving objects should come to the fore economic activity between the countries participating in the foreign trade transaction. The monographic method, as well as the methods of scientific philosophy (deduction and induction), should be singled out as the methodological approaches of the study, since taking into account the opinions of specialists in specialized areas will make it possible to most qualitatively develop the main strategic directions for the development of this type of sectoral economic analysis. As a scientific novelty, the developed target settings of economic analysis can be considered, which form the desired image of the result of the economic analysis of customs payments in the researcher. The practical significance lies in the fact that the results and proposals of the work can be used both in the development of strategies for the development of the country’s foreign economic activity in the context of the intensification of international cooperation, as well as individual economic entities in the field of foreign economic activity, as well as the developed methodological approaches and scientific -practical recommendations for conducting sectoral economic analysis. The focus for further research is due to the high role of customs payments as an instrument of protectionist policy, as well as an integral part of the economic issues of international integration within the EAEU, as well as their stable component in the federal budget revenues (about 35% in 2020). The collection of customs duties at four levels made it possible to propose the author’s target setting of economic analysis corresponding to each of its levels; As a result, the research prerequisites were grouped according to the scientifically grounded four levels of structuring.

Objective. Studying of possibilities of the left atrium triangular plasty procedure in correction of combined mitral-aortal failure, complicated by the left-sided atriomegaly. Materials and methods. Into the analysis the results of surgical treatment in 360 patients, suffering combined mitral-aortal failure, combined with left-sided atriomegaly, who were operated in Amosov National Institute of Cardiovascular Surgery through period from 01.01.2006 to 01.01.2021 yr, were included. In the main group, consisting of 73 patients, original procedure of the left atrium triangular plasty was performed while correcting a combined mitral-aortal failure. In the control group, consisting of 287 patients, correction of combined mitral-aortal failure in presence of concomitant left-sided atriomegaly was performed only. Results. Of 73 operated patients of the main group 3 died (lethality have constituted 4.1%). Dynamics of echocardiographic indices in the main group of patients in accordance to stagesof treatment was following: definitely-systolic index of the left ventricle – (69.1 ± 12.1) ml/m2 preoperatively, (59.3 ± 8.5) ml/m2 postoperatively, (48.4 ± 9.5) ml/m2 in late period; the ejection fraction of the left ventricle – 0.51 ± 0.05 preoperatively, 0.54 ± 0.05 postoperatively, 0.56 ± 0.04 in late period. Diameter of the left atrium – (65.8 ± 4.1) mm preoperatively, (52.3 ± 2.1) mm postoperatively, (53.5 ± 2.2) mm in late period. Of 287 operated patients of control group 9 died (lethality have constituted 3.1%). Dynamics of echocardiographic indices in the main group patients on the treatment stages was following: definitely-systolic index of the left ventricle – (68.3 ± 11.3) ml/m2 preoperatively, (60.4 ± 9.3) ml/m2 postoperatively, (52.7 ± 7.2) ml/m2 in late period; the ejection fraction of the left ventricle – 0.52 ± 0.05 preoperatively, 0.53 ± 0.05 postoperatively, 0.5 ± 0.04 in late period. Diameter of the left atrium – (66.5 ± 3.7) mm preoperatively, (64.5 ±3.3) mm postoperatively, (73.5 ± 2.8) in late follow-up period. Conclusion. While performing operation for the left-sided atriomegaly the correction of triangular plasty of the left atrium constitutes a mini-invasive and effective procedure, leading to significant improvement in the left atrium morphometry and accompanied by low risk of lethality as well as thromboembolic complications.

Objective. Studying the possibilities of the method of the left atrium arch-like plasty while correcting of a mitral failure in combination with the left atrium dilatation. Materials and methods. Into the analysis of the surgical treatment results in 190 patients, suffering mitral failure in combination with the left atrium dilatation, who were operated in the National Institute of Cardio-Vascular Surgery named after N. M. Amosov NAMS of Ukraine in a period from 01.01.2012 to 01.01.2021 yr, were included. The main group consisted of 103 patients, to whom correction of a mitral failure in combination with original procedure of the arch-like plasty of left atrium was performed. Into a control group 87 patients were included, to whom the correction of a mitral valve failure was done without concomitant plasty of left atrium. Results. Of 103 operated patients of the main group on the hospital stage 1 have died (0.9% lethality). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of the left ventricle - (63.1 ± 11.3) ml/m2 (preoperatively), (58.3 ± 8.4) ml/m2 (postoperatively), (49.4 ± 9.2) ml/m2 (remote period); the left ventricle ejection fraction: 0.52 ± 0.04 (preoperatively), 0.55 ± 0.04 (postoperatively), 0.57 ± 0.03 (remote period). Diameter of left atrium: (58.8 ± 6.4) mm (preoperatively), (41.4 ± 5.3) mm (postoperatively), (43.9 ± 2.3) mm (remote period). Sinus rhythm in a remote period was stable in 75 (78.9%) of 95 patients. Of 87 operated patients of a control group 2 died (lethality 2.3%). Dynamics of the echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle- (67.3 ± 11.3) ml/m2 (preoperatively), (60.4 ± 9.3) ml/m2 (postoperatively), (52.7 ± 7.2) ml/m2 (remote period); the left ventricle ejection fraction: 0.52 ± 0.05 (preoperatively), 0.54 ± 0.05 (postoperatively), 0.54 ± 0.03 (remote period). Diameter of left atrium: (59.5 ± 2.3) mm (preoperatively), (57.5 ± 3.7) mm (postoperatively), (68.5 ± 3.4) mm (in remote period). Sinus rhythm was stable in 18 (22.5%) of 80 patients, followed in the remote period. Conclusion. The arch-like plasty of left atrium is a low-traumatic and effective procedure, leading to significant improvement of the left atrium morphometry and accompanied by low risk for postoperative lethality.

Objective. Studying of possibilities of procedure of the left atrium triangular plasty while doing correction of mitral failure, coexisted with left atriomegaly. Materials and methods. There were analyzed results of surgical treatment of 330 patients, suffering mitral failure in combination with left atriomegaly, who were operated in Amosov National Institute of Cardiovascular Surgery in period from 1 Jan 2005 to 1 Jan 2021 yr. The main group have consisted of 143 patients, to whom correction of mitral failure together with original procedure of triangular plasty of left atrium was performed. The control group have consisted of 187 patients, to whom correction of mitral failure was done only, although they suffered concurrent left atriomegaly. Results. Of 143 patients operated in the main group 3 died (lethality have constituted 2.1%). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle – (69.1 ± 12.1) ml/m2 before the operation, (59.3 ± 8.5) ml/m2 postoperatively, (48.4 ± 9.5) ml/m2 in late period; the left ventricle ejection fraction – 0.51 ± 0.05 preoperatively, 0.54 ± 0.05 postoperatively 0.56 ± 0.04 in late period. The left atrium diameter dynamics was following: (65.8 ± 4.1) mm preoperatively, (52.3 ± 2.1) mm postoperatively, and (53.5 ± 2.2) mm in late period. Of 187 оperated patients of control group 6 have died, (lethality have constituted 3.2%). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle – (68.3 ± 11.3) ml/m2 before the operation, (60.4 ± 9.3) ml/m2 postoperatively, (52.7 ± 7.2) ml/m2 in late period; the left ventricle ejection fraction – 0.52 ± 0.05 preoperatively, 0.53 ± 0.05 postoperatively, 0.5 ± 0.04 in late period. Diameter of left atrium: (66.5 ± 3.7) mm preoperatively, (63.5 ± 2.3) mm postoperatively, (71.5 ± 2.4) mm in late period. Conclusion. Triangular plasty of left atrium is a low-traumatic and effective procedure, leading to significant improvement in its morphometry and accompanied by low risk of hospital lethality.

Objective. The studying of possibilities of procedures, directed on preservation of left ventricle while doing a mitral valve prosthesis in operative correction of combined mitral-aortal failure. Materials and methods. In the analysis the results of surgical treatment of 340 patients, suffering combined mitral-aortal failure and a left-sided ventriculomegaly, who were operated in N. M. Amosov National Institute of Cardio-Vascular Surgery NAMS of Ukraine, were included. In all the patients a mitral valve prosthesis in combination with the aortal failure correction (prosthesis) was performed. In 83 patients the mitral valve prosthesis with complete preservation of posterior flap (Group A) was conducted, in 97 - with translocation of chords with papillar muscles of anterior flap in combination with posterior flap (Group B), in 160 - without preservation of the undervalvular apparatus (Group C). Definitely-systolic index of left ventricle in Groups A, B and C have constituted (87.4 ± 10.5), (88.4 ± 11.1) and (89.4 ± 11.5) ml/m2 accordingly; left ventricular ejection fraction have constituted 0.51 ± 0.03, 0.5 ± 0.03 and 0.51 ± 0.03 accordingly. Results. In Group A on a hospital stage 2 (2.5%) patients died, in Group B - 2 (2.1%) patients, and in Group C - 5 (3.1%). Definitely-systolic index of left ventricle on the tenth-eleventh postoperative day in Groups A, B and C have constituted (74.3 ± 9.8), (69.4 ± 8.2) and (76.4 ± 9.2) ml/m2 accordingly, while in late follow-up period - (55.4 ± 8.4), (49.4 ± 7.2) and (62.4 ± 7.2) ml/m2 accordingly. The left ventricle ejection fraction on the tenth-eleventh postoperative day in Groups A, B and C have constituted 0.54 ± 0.03, 0.55 ± 0.03 and 0.53 ± 0.03 accordingly, and in late follow-up period - 0.55 ± 0.03, 0.57 ± 0.03 and 0.54 ± 0.03 accordingly. Conclusion. In the left-sided ventriculomegaly and combined mitral-aortal failure the a maximal preservation of undervalvular structures of mitral valve, while its prosthesis performance, constitutes a serious component, which leads to improvement of morphometric indices of left ventricle on hospital stage and in follow-up period as well.

The aim. To study the possibilities of techniques for preserving left ventricular (LV) contractility during mitral valve replacement (MVR) and correction of combined mitral-aortic valve disease (CMAVD). The analyzed group included 257 patients with CMAVD who were undergoing surgical treatment at the Institute. In 97 patients, MVR was performed with translocation of the chordae of the anterior leaflet muscles in combination with complete preservation of the posterior leaflet. Of the 97 operated patients, 2 (2.1%) died at the hospital stage (within 30 days after the operation). Inotropic support (dobutamine) ranged from 3 to 4 ¤g/min/kg during the first 48 hours. The patients were discharged on average 9-12 days after surgery without clinically significant complications. There were no complications at the hospital stage associated with the operative technique. In significant dilation of the left ventricle, MVR with an option of maximizing the preservation of the chordo-papillary continuum is an essential procedure. Materials and methods. The analyzed group included 257 patients with CMAVD who were undergoing surgical treatment at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine from January 01, 2006 to January 01, 2020. In addition to MVR, all the patients underwent aortic valve replacement with a mechanical prosthesis. The patients had left ventriculomegaly with an end-diastolic volume exceeding 300.0 ml. In 97 patients, MVR was performed with translocation of the chordae of the anterior leaflet with simultaneous complete preservation of the posterior leaflet of the mitral valve (main group A). The remaining 160 patients underwent MVR without preserving the subvalvular chordopapillary continuum (comparison group B). Results. Among 97 operated patients of the group A, 2 died (2.1%) at the hospital stage (within 30 days after the operation). The dynamics of echocardiographic indicators within 10-11 days of the postoperative period was as follows: LV end-systolic index (ml/sq.m) was 88.4 ± 11.1 (before surgery), 69.4 ± 8.2 (after surgery) and 49.4 ± 7.2 (long-term period); left ventricular ejection fraction (LVEF) was 0.52 ± 0.03 (before surgery), 0.55 ± 0.03 (after surgery) and 0.57 ± 0.03 (long-term period); left atrium (LA) diameter was 62.2 ± 4.5 mm (before surgery), 49.5 ± 1.7 mm (after surgery) and 50.5 ± 1.5 mm (long-term period). Diastolic gradient of a mitral prosthesis was 13.2 ± 2.4 mm Hg. In the long-term period, the mean follow-up of the patients was 8.2 ± 2.4 years. In group B, among 160 operated patients, 5 (3.1%) died at the hospital stage. The dynamics of echocardiographic indicators within 10-11 days of the postoperative period was as follows: LV end-systolic index ( ml/sq.m) was 89.4 ± 11.5 (before surgery), 76.4 ± 9.2 (after surgery) and 62.4 ± 7.2 (long-term period); LVEF was 0.52 ± 0.03 (before surgery), 0.54 ± 0.03 (after surgery) and 0.55 ± 0.03 (long-term period ); LA diameter (uncorrected) was 63.2 ± 3.5 mm (before surgery), 60.5 ± 1.7 mm (after surgery) and 64.5 ± 2.7 mm (long-term period). Diastolic gradient of a mitral prosthesis was 12.7 ± 2.4 mm Hg. Conclusions. Based on the obtained clinical experience, it seems appropriate to recommend the original operation of translocation of the anterior mitral valve leaflet for the correction of combined mitral-aortic defects.

The search for reserves for stabilization of Russian economy is coming to the fore in the context of the ongoing crisis. Given its raw material orientation, a significant share of which is accounted for by exports, and the high share of customs payments (in particular, export customs duties on oil and gas) in the structure of the Federal budget, it is extremely important to assess the estimated losses of customs payments as a result of shadow exports, which determines the relevance of this study. The paper discribes assessing the volume of customs payments in the conditions of the country’s shadow economy development as well as searching for sources of their increase in the structure of Federal budget revenues due to organizational measures. A review of positions of the Russian scientists in the field of economic categories including taking into account the normative and reference documentation. In this study it is proved that the activities of customs authorities belong to the type of organizational and economic relations and customs payments are an economic category. A methodological tool for economic analysis has been developed to identify the significance of losses from shadow exports for the state budget as well as to assess the correctness of the distribution of import customs duties to the budgets of the EAEU member States. The theoretical and practical significance of the study is determined by the prospects for increasing the volume of the Federal budget revenue due to the collection of customs duties. The study may be interesting for government agencies of foreign trade policy and Federal budget formation.

Objective. To study clinical possibilities of original procedure of the ascending aorta braid-like bandage for her poststenotic dilation while performance of the aortal stenosis surgical correction. Materials and methods. To the main Group 196 patients were included those, who were operated on for prevailing aortal stenosis, conjoined with poststenotic dilation of ascending aorta. In accordance to the echocardiographic investigation data the ascending aorta diameter preoperatively have constituted (47.7 ± 1.7) mm. In all the patients the aortal valve prosthesis was performed together with complex braided wrapping of ascending aorta. Into the control group 121 patients were included, in whom Bentall intervention was accomplished with vascular prosthesis of ascending aorta. Results. Hospital lethality in the main group have constituted 0.5%. Diameter of ascending aorta in the moment of hospital discharge have constituted (39.1 ± 1.5) mm, and in late follow-up period - (40.3 ± 1.1) mm. Conclusion. Basing on clinical experience gained, it is expedient to recommend the original procedure of braided wrapping of ascending aorta in presence of her poststenotic dilation while performing surgical correction of prevailing aortal stenosis.

Objective. To research of possibilities of reconstruction of aorta`s ostium and ascending aorta during aortic valve replacement and simultaneous correction of mitral valve defects at patients with narrow aorta`s ostium. Materials and methods. The study group consisted of 46 patients with mitral-aortic heart diseases and combination with a narrow aortic mouth, who were operated on at the A Amosov National Institute of Cardiovascular surgery for the period from January 1, 2006 to January 1, 2020. All patients underwent reconstruction of the aortic root and ascending aorta according to the original method of posterior aortoplasty. There were 26 men (56.5%) and 20 women (43.5%). The age of patients ranged from 23 to 72 years (average - 58.4±7.3 years). 8 (17.4%) patients belonged to class III NYHA, 38 (82.6%) - to class IV. Results. Of the 46 operated patients at the hospital stage (30 days after surgery), 4 died (hospital mortality 8.7%). No fatalities were associated with surgical technique. The dynamics of echocardiographic parameters at the hospital stage was as follows: the systolic gradient on the aortic valve was before surgery 112.1 ± 15.2 mm Hg, on the aortic prosthesis at discharge - 23.2 ± 6.4 mm Hg; end-systolic index (ESI) of the left ventricle (ml/m²) - 59.1 ± 7.6 (before surgery) and 48.3 ± 5.9 (after surgery); left ventricle ejection fraction (EF) - 0.45 ± 0.04 (before surgery) and 0.53 ± 0.04 (after surgery). Conclusions. The proposed original technique of posterior aortoplasty allows to effectively expand the mouth of the aorta for further implantation of an artificial heart valve of larger diameter. The technique is quite safe. At the hospital stage there are no complications directly related to the technique of operations. At the early postoperative period, the morphometric parameters of the left ventricle (EF and ESI) improved. The technique can be successfully used for the correction of combined mitral-aortic valve defects.

Objective. Studying possibilities concerning the proposed procedure of intraoperative restoration of the sinus rhythm in surgical treatment of combined mitral-аоrtic failures. Маterials and methods. Results of treatment of 42 patients, suffering combined mitral-aortic failures and constant forms of the atria fibrillation, who were operated in Аmosov National Institute of Cardiovascular Surgery in period from 01.01.2006 tо 01.01.2013 yr. Median presence of the atria fibrillation have constituted (3.7 ± 0.4) yrs. Besides correction of the valve pathology, in the patients a simultant operation «labyrinth» was performed. Fragmentation in left atrium was performed, using a low-frequency (25 - 35 W in regime of diathermocoagulation) аblation of the left atrium wall in the operation variant «left labyrinth-III». Оbligatory condition of fragmentation have served the external ligation and resection of the left atrium auricle. Plasty of left atrium with re-entry was performed in 29 (69.0%) patients with the objective of its diameter reduction and exclusion of the waves expansion. Аtrioplasty was performed, using method of paraannular plication of the left atrium posterior wall (16 patients) and of triangular plasty (13 patients). In late period, in (9.1 ± 2.1) yr at average, the treatment results in 37 (94.9%) patients were studied. Results. Of 42 оperated patients 3 died (hospital mortality have constituted 7.1%) during the hospital stage. The sinus rhythm have had restored after the operation immediately in 34 (80.9%) patients, аnd in discharge from the hospital (11 - 13th postoperative day) persisted in 31 (73.8%) patient. Rate of restoration and preservation of the sinus rhythm in group of patients, in whom plasty of left atrium was performed, was higher, than in group of patients without plasty of left atrium: 86.2 and 46.2%, accordingly (р < 0.05). In late period good and satisfactory results of the operation were noted in 83.8% patients. During first 5 postoperative years the sinus rhythm have been preserved in 67.8% patients. Conclusion. After correction of combined mitral-aortic failures with the simultant fragmentation operation on left atrium («labyrinth») in our modification in concomitant fibrillation of the heart atria a successful restoration of the sinus rhythm was noted in 73.8% patients on the hospital stage and its preservation during 5 postoperative years in 67.8% of the patients. Reduction of left atrium in its dilatation enhances possibility of the sinus rhythm restoration. Immediate and late results of operations permits to estimate the proposed procedure gains positively.

The aim. To study the clinical possibilities of the original technique of the wrapping tape operation (WTO) of the dilated post-stenotic ascending aorta (AA) during surgical correction of aortic stenosis (AS). Materials and methods. The study group included 196 patients who were operated on for the prevailing AS combined with poststenotic dilation of the ascending aorta (PDAA) for the period from 01.01.2006 until 01.01.2020 at the National Amosov Institute of cardiovascular surgery of the National Academy of Medical Sciences of Ukraine. All the patients underwent aortic valve replacement (AVR) combined with the original technique of WTO. During echocardiographic examination, the diameter of the AA before surgery was 47.7±1.7 mm, and the diameter of the Valsalva sinuses was 37.4±1.8 mm. The original technique of the correction of PDAA included plication of the non-coronary Valsalva sinus, as the most vulnerable zone, reduction of the AA diameter, creation of its reliable framework in order to prevent further AA dilation in the long term. Results. Hospital mortality was 0.5%. In the long term, the outcomes in 185 patients (94.4% of the number of discharged patients) were studied. The follow-up period was 8.1±0.8 years. In the long-term period, 8 (4.1%) patients died. The AA diameter at the time of discharge was 39.1±1.5 mm and 40.3±1.1 mm in the long term, and the diameter of the Valsalva sinuses was 34.5±1.5 mm and 34.8±1.3 mm, respectively. Complications or deaths associated with the technique of the intervention on the aortic root and AA were not observed both at the hospital stage and in the long term. None of the patients was reoperated due to further AA dilation. Conclusions. The proposed technique has established itself as a fairly reliable, safe procedure. In addition, it is costeffective since it does not require the use of a vascular prosthesis. The technique is useful for the correction of AS and PDAA from 4.0 to 5.2 cm.

Objective. Studying possibilities of the triangular plasty of left atrium procedure, performed while prosthesis of a mitral valve. Materials and metods. Into the main group 137 patients, suffering isolated mitral failure, complicated by left atriomegaly (diameter of left atrium ≥ 6.0 cм), to whom surgical treatment was performed in Amosov National Institute of Cardiovascular Surgery from 01.10.2010 to 01.01.2019 yr, were included. In all the patients a prosthesis of a mitral valve, preserving native structures of a mitral valve with reduction of the left atrium cavity, using procedure of the left atrium triangular plasty, was performed. Into a control group were included 57 patients, in whom a mitral valve correction without a left atrium reduction was performed only for a mitral valve failure and a left-sided atriomegaly (diameter of left atrium was ≥ 6.0 cm). Results. Of 137 patients of the main group on the hospital stage 3 (2.2%) have died. Dynamics of echocardiographic indices of the left atrium diameter on different stages was following: (65.5 ± 3.8) mm preoperatively, (51.5 ± 2.1) mm postoperatively, (52.5 ± 2.2) mm in a remote follow-up period, in a remote follow-up period in (5.1 ± 0.4) years at average, thromboembolic complications (the transient disorders of the brain blood circulation) were noted in (1.6%) of 125 patients. Of 57 patients of a control group on the hospital stage 2 (3.5%) have died. Dynamics of echocardiographic indices, concerning diameter of the left atrium on various stages was following: (66.7 ± 2.7) mm preoperatively, (63.5 ± 2.3) mm postoperatively, (71.5 ± 2.4) mm in the remote follow-up period. In the remote follow-up period in (7.1 ± 0.4) years, thromboembolic complications were noted in 7 (14.6%) of 48 patients. Conclusion. The procedure of triangular plasty of left atrium constitutes an obligatory stage while performing correction of a mitral failure in presence of a left-sided atriomegaly (diameter of left atrium ≥ 6.0 cm). The procedure is miniinvasive and effective, leads to significant improvement of the left atrium morphometry and is accompanied by low risk of the complications occurrence and hospital mortality. The data accumulated and estimation of remote results of the procedure permits her to occupy a significant place among other methods of atrioplasty.

Aim. The aim was to determine the possibilities of left atrium (LA) reduction by triangular plasty of LA (TPLA) during mitral valve replacement (MVR). Isolated surgical correction of mitral defect (mitral valve replacement or plasty [MVP]) in the presence of uncorrected left atriomegaly is associated with the long-term manifestation of heart failure with the risk of thromboembolic complications and the absence of reversion to sinus rhythm. The treatment outcomes in patients with isolated mitral defect and left atriomegaly, who were undergoing surgical treatment at the Department of Surgery of Acquired Heart Defects of the Institute were analyzed. The analyzed group included 137 patients. All the patients underwent MVP combined with the original technique of triangular plasty of LA. Among 137 operated patients, 3 (2.2%) died. The changes in echocardiographic parameters at the treatment stages were as follows: LV ejection fraction 0.51 ± 0.05 (preoperative), 0.54 ± 0.05 (postoperative), and 0.56 ± 0.05 (remote). The LA diameter (mm) was 65.5 ± 3.8 (preoperative), 51.5 ± 2.1 (postoperative), and 52.5 ± 2.2 (remote). The technique is less traumatic and outlines an effective procedure which leads to a significant improvement in the LA morphometry and is accompanied by a low risk of hospital mortality. Materials and methods. From 1.10.2010 to 1.01.2019, 137 adult patients (pts) with mitral valve disease (MVD) and giant LA (¤60 mm in diameter) underwent surgical intervention at the Institute. MVR was performed in all the pts. TPLA including ligation of LA auriculum was performed in all the pts. All operations were performed with cardiopulmonary bypass and moderate hypothermia with crystalloid cardioplegia. Results. There were 3 hospital deaths. Echocardiography showed that LA diameter (mm) was 65.5 ± 3.8 (preoperative), 51.5 ± 2.1 (postoperative), and 52.5 ± 2.2 (remote). Conclusions. TPLA during isolated MVR to improve LA morphometry during the postoperative period.

In patients undergoing surgical treatment of aortic heart defects under artificial circulation, pre-operative correction of serum iron levels, and application of blood-saving techniques during surgery reduce the level of postoperative anemia. The aim. To investigate the combined influence of preoperative correction of serum iron levels and blood-saving techniques in the early postoperative anemia in the surgical treatment of aortic heart defects under artificial circulation. Material and methods. This study involves 133 patients with acquired aortic heart diseases undergoing surgical treatment under artificial circulation and aims at identifying the combined effect of preoperative correction of serum iron (III) hydroxide levels and blood-saving techniques on the level of postoperative anemia. The levels of iron, transport enzymes, blood corpuscles, Hb and Ht were investigated. All the patients were divided into 3 groups. Group A (control group) included 52 patients in whom iron levels were within the normal range and donated blood components were used during the intervention. Group B (study group) included 43 patients in whom iron levels were within the normal range and blood-saving techniques were used during the intervention. Group C (adjustment group) included 38 patients with low iron levels and anemia, which was interpreted as anemia of chronic disease (ACD). Preoperative correction of serum iron levels and intraoperative blood-saving techniques were applied in this group. Results. For the purpose of perioperative anemia correction, transfusion of 539.8 ± 9.1 ml (p¤0.05) of packed red blood cells and 582.4 ± 77.2 ml (p¤0.05) of fresh frozen plasma was given in Group A patients. In the Group B, the use of blood-saving techniques during the intervention allowed us to obtain good clinical effect without perioperative transfusion of blood products. It was established that in Group C preoperative correction of serum iron enabled to achieve 5.6 times higher level of serum iron (p¤0.05), 2 times higher transferrin saturation, and 7.3 times higher ferritin activity (p¤0.05), as well as increase preoperative Hb level by 9.5 % and decrease postoperative anemia by 8.7 %. Conclusions. Correction of low baseline serum iron in patients with chronic anemia (ACD) provides 5.6 times increase in preoperative serum iron (SI) (p¤0.05), increases hemoglobin by 9.5% (p¤0.05), and reduces the level of postoperative anemia in patients undergoing surgical treatment of aortic heart defects under artificial circulation with the use of blood-saving techniques and without the use of donor blood and Cell Saver.

The purpose of the study was to evaluate a combined approach to surgical treatment of patients with morbid obesity.Material and methods. Between January 2017 and December 2018, 26 women with stage I endometrial cancer underwent laparoscopic gysterectomy in combination with panniculectomy. Results. No episodes of intraoperative hemodynamic instability, significant hypoxemia or hypercapnia were reported. The average blood loss was 236.4 ± 114.8 ml; surgery time: 264.2 ± 57.3 min; mass of the removed flap: 10.52 ± 6.5 kg; length of hospital stay: 11.2 ± 3.7 days. There was no delay in the start of adjuvant radiation therapy. Conclusion. Surgical treatment of endometrial cancer patients with morbid obesity presents significant technical challenges. The choice of surgical access in such cases may depend not on the stage and prevalence of the tumor, but on the constitutional characteristics of the patients. Sometimes surgeons can refuse to perform surgery for such patients and offer them an alternative treatment. Classical laparotomic access is associated with the maximum risk of perioperative complications. Laparoscopic techniques have technical limitations associated, for example, with the length of trocars and surgical instruments. Robotic surgery is considered generally safe, but due to its low availability, it is limited only to large clinical centers. The combined approach to surgical treatment of endometrial cancer patients with morbid obesity is the most effective surgical modality for these patients.

Traditional mitral and aortic valve replacement in conditions of artificial blood circulation (ABC) involves the use of blood products. Given various complications arising in perioperative period, the authors propose a technique for “bloodless operations” without the use of donor blood, without the use of columns, and the “sell-saver” method. From January 1, 2011 to December 31, 2018, mitral-aortic valve replacement was performed in 79 patients; in 42 of them blood products were used during surgery, and in 37 patients donor blood components were not used. The method of anaesthetic and infusion-perfusion measures for mitral-aortic valve replacement in conditions of ABC is given. The use of the blood-saving method has allowed to obtain good clinical effect without transfusion complications in perioperative period, which facilitated the use of bloodless methods for mitral-aortic valve replacement in the main group in conditions of ABC and reduce blood transfusions in perioperative period from 27.4 % to 10.3 % of the circulating blood volume (CBV), compared to the control group. In the variant of reservation of autoblood “A+B+C” and exfusion of 27.2% of the CBV, the most effective variants of the blood-saving) technology were observed during mitral-aortic valve repair in conditions of ABC.

Aim. To reveal the features of multimorbidity in elderly and senile people with hypertension (HTN).Material and methods. A total of 70 elderly and senile hypertensive patients were examined at one of the Arkhangelsk outpatient clinics (from 60 to 90 years old; mean age — 69,14±1,34 years), including those aged 60-74 years (n=56; (80,0%) and 75 years and older (n=14; 20,0%). We assessed the questionnaire survey data, the outpatient medical records, the clinical status, and the cumulative illness rating scale for geriatrics (CIRS-G).Results. The analysis showed a high prevalence of multimorbidity in elderly and senile people with HTN, which was found in all patients. On average, an elderly patient with HTN has 6 diseases that are pathogenetically interrelated and unrelated, while a senile patient has 8 diseases. The most common comorbidities were gastrointestinal (81,43%), musculoskeletal (77,14%) and endocrine (77,14%) diseases. Among the cardiovascular comorbidities in the elderly with HTN, the following were more common: heart failure (54,29%), coronary artery disease (angina pectoris — 41,43%) and cerebrovascular diseases (28,57%) (stroke/transient ischemic attack, vascular encephalopathy). Patients with HTN took an average of 6 different drugs at the same time. There was moderate comorbidity level in the elderly patients and a high one in those of senile age.Conclusion. In elderly and senile patients with HTN, there is a high prevalence of multimorbidity, which must be taken into account when preventing polypharmacy.

The use of donated blood components in patients with acquired heart defects in the operative period is often associated with a variety of possible complications requiring the search for alternative measures to reduce their use. In the pe-riod from 01/01/2011 to 01/01/2019 at the Department of Surgery of Acquired Heart Defects of National Amosov Institute of Cardiovascular Surgery, isolated aortic valve replacement was performed in 680 patients divided into 2 groups. The main group included 452 patients in whom no donated blood components were used at the operative stage, and the comparison group included 228 patients who obtained blood products during the operative period. The technique of anesthesiological and perfusiological measures at the “bloodless” aortic valve replacement under cardiopulmonary bypass is described. In the main group, autologous blood collection in pre-perfusion period was not marked by sharp hemodynamic changes. Acute normovolemic hemodilution was performed with a 6% hydroxyethyl starch solution in a 1:1 ratio. The levels of Hb, Hct and protein during the surgical intervention were at the stage of compensation. At Hct ≥39, autologous blood was collected (variant A) before heparin administration. Under the central venous pressure control, water balance was evaluated during stimulation of diuresis. Variant A was perdominantly used. For variant A, Hb decrease from 13.6 g/L to 11.9 g/L, and blood protein decrease from 67.4 ± 4.1 g/L to 61.5 ± 5.2 g/L were observed. The retrograde antological priming (RAP) variant B (displacement from the perfusate tank) was used in 11.4% of the total. In the comparison group, 511.8 ± 117.7 ml of packed RBC and 564.9 ± 63.3 ml of fresh frozen plasma per patient were transfused in the operating period. The length of stay in the ICU was 64.7 ± 16.8 hours in the main group, 87.2 ± 24.6 hours in the comparison group. The time spent in the surgical hospital was 9.2 ± 1.1 days in the main group and 11.8 ± 3.3 days in the comparison group. Implementation of the procedure described enabled to obtain good clinical effect without transfusion complications at the hospital stage.

The relevance of the work is determined by the interest in the study of discursive practices by corpus linguistics methods. The subject of the analysis is the axiological dominants of a genre that are objectified by key words, extracted from the corpus by statistical methods. The authors aim to show the specificity of the value dominants of the Russian-language genre of press release based on the use of the keyword method of the corpus methodology and an algorithm developed using the programming language Python, based on the measure tf-idf, which allows to objectively identify lexical and semantic dominants that represent value meanings. The study was conducted on the material of a representative specialized corpus, that combine texts of press releases posted on the official websites of major Russian companies between 2017 and 2019. Based on the analysis of lexical choices, it is established that the texts of press releases of the companies are addressed to professional investors, as well as to a wide discursive community. It is shown that the discursive practices of energy sector companies emphasize the prospects of development, care for the environment, the importance of their activities for society in general. Companies in the manufacturing sector emphasize the achievements and highlight quality and domestic origin of products. Retail network companies are focused on utilitarian values of choice, convenience and economy.

The operation reliability and service life of various heat engineering equipment: turbines, steam generators, heat exchangers, valves and control valves, pumps, etc. largely depends on the degree of wear of the working surfaces of highly loaded machine elements, particularly working blades of steam turbines and compressors of gas turbine engines (GTE) and gas turbine units (GTU).

Objective. To analyze the peculiarities of surgical treatment of a mitral stenosis, complicated by massive thrombosis of left atrium. Маterials and methods. The group analyzed, operated in the Institute, consisted of 344 patients. Thrombosis of left atrium was considered a massive, when thrombotic masses have occupied no less than one third of its volume, not mentioning an auricle of atrium. Results. Hospital lethality after change of a mitral valve have constituted 4.2% and directly depended on from a degree of the left atrium thrombosis (р < 0.05). After open mitral comissurotomy hospital lethality was not observed, witnessing the expediency of the thrombosis matrix extraction. Conclusion. During the operation for a massive thrombosis of left atrium it is important to remove a maternal base of thrombotic bed and to eliminate the left atrium auricle, what lowers essentially the risk for lethality and thromboembolic complications on a hospital stage. Doing preoperative computed tomography of head and abdominal organs constitutes obligatory condition for exclusion of a hidden thromboembolism occurrence.

Objective. Investigation of modern possibilities of the bloodless technique of surgical treatment of the mitral valve failure (МVF) in environment of artificial blood circulation (ABC). Маterials and methods. There were examined 727 patients, suffering MVF. All the patients were divided into two groups: the main and a comparative one. The main group have consisted of 637 patients, in whom various variants of the blood preservation without its transfusion were applied, without application of a cell-saver, hemoconcentrating columns and the blood ultrafiltration; and a comparative one group have consisted of 90 patients, to whom the blood preparations were transfused. The procedure depicted have provided the anesthesia and the perfusion measures during operation of the mitral valve change, including аs well the peculiarities of the intraoperative infusion therapy management in the ABC conditions. Results. In the main group of patients the rate of postoperative infectious complications have constituted 1.2%, while in a comparative one - 9.9%. Median duration of stay on the artificial pulmonary ventilation have constituted (6.7 ± 2.3) and (12.3 ± 8.4) hours accordingly. The average duration of stay in reanimation department was (58.4 ± 12.4) and (116.3 ± 45.2) hours, accordingly (р < 0.05). The intraoperative blood loss volume in the main group was significantly lesser, than in a comparative one: (261.2 ± 33.8) and (533.1 ± 131.6) ml, accordingly (р < 0.05). On all stages of the operation and in postoperative period the level of hemoglobin have persisted in a compensation period range, what constitutes a safe level of the blood oxygen capacity. Conclusion. Introduction of intraoperative variants of the autologous blood reservation without application of the donor’s blood, сеll-saver and hemoconcentration columns is not accompanied with lowering of the oxygen delivery and consumption, as well as development of lactate-acidosis. The improved procedure of anesthesiological support consisted of the infusion-transfusion therapy conduction with stimulation of diuresis, the water balance control, applying combination of an acute normovolemic hemodilution with ABC, and lowering of hemodilution due to retrograde filling of oxygenator by autologous blood. As well there were applied various methods of the autologous blood exfusion and its components combinations, change of tactics in the infusion hemostatic therapy; a central venous pressure control and support of median arterial pressure. Introduction of the procedure depicted have guaranteed a good clinical effect without complications of transfusion on a hospital stage of the patients’ management.

The article investigates prospects for the settlement of the Arab-Israeli conflict. In the detailed consideration of the actual state of affairs, the author refers to the history, showing how certain decisions influenced the development of the situation. Special attention is paid to the US policy in the region. The chances of a peaceful settlement are also analyzed.

132 patients with isolated aortic valve disease with narrow aortic ostium who underwent surgery in the Institute from 1 May 2009 to 01 Jan 2019 are included in the study group. Among 132 patients, 6 died at the hospital stage (hospital mortality – 4.5%). There were no negative remarks to the surgical technique in any case. Changes in echo data during the hospital stay: systolic pressure gradient across the left ventricular outflow tract (LVOT) before operation was 105.1±11.5 mmHg, with 25.9±4.1 mmHg on the aortic prosthesis upon discharge. Reconstruction of the root and ascending aorta according to the proposed method in cases of aortic hypoplasia and aortic valve replacement (AVR) is highly effective intervention. The purpose of this research is to study possibilities of a new approach to the reconstruction of the root and ascending aorta in AVR.

Проаналізовані віддалені результати пластичної корекції недостатності мітрального клапана (НМК) з порушенням цілісності хордально–папілярного апарату у 201 пацієнта. У 67,7% пацієнтів, крім пластики мітрального клапана (МК), виконані супутні хірургічні процедури. Віддалені результати вивчені у 95,5% хворих у строки спостереження у середньому (6,5 ± 2,8) року. У 79,2% пацієнтів відзначені хороші й задовільні результати, у 16,6% – незадовільні, 4,7% хворих померли у віддаленому періоді. Найбільш сприятливі віддалені результати спостерігали при вихідному ураженні тільки задньої стулки МК – у 81,5% пацієнтів, при ураженні тільки передньої стулки – у 61,1%. Пластика МК є надійним способом корекції НМК.

Узагальнений досвід хірургічного лікування 520 пацієнтів, яким здійснено хірургічну корекцію недостатності мітрального клапана (МК) внаслідок порушення цілісності хордально-папілярного апарату. Хворі послідовно оперовані в умовах штучного кровообігу (ШК) за період 2006 - 2015 рр. Пластика МК виконана у 201 пацієнта, протезування МК (ПМК) - у 319. Віддалені результати проаналізовані у 487 (93,8%) пацієнтів у строки спостереження у середньому (6,3 ± 2,6) року. Ключові слова: пластика мітрального клапана; протезування мітрального клапана; хордально-папілярний апарат; віддалені результати.

Elastic-damping supports are widely spread in the design of aviation gas-turbine engines. These supports include elastic elements of the squirrel cage type. A methodology of calculating the flexibility matrix for the squirrel cage with straight rod elements of rectangular cross-section with account for groove rounding is presented in the paper. Determining the flexibility matrix is essential for constructing mathematical models of aviation gas turbine engines when solving problems of rotor dynamics. The methodology is based on the application of Mohr integral for beam constructions. The results obtained with the help of the methodology are compared with the results of calculations in the finite-element complex and with the results of calculation without regard for the rounding, as well as with results obtained by other authors.

The article is devoted to 70-anniversary of the famous scientist, teacher, of the member of the Academy of Ukraine Sciences, of the rector of Dnipropetrovsk National University named O.Gonchara Professor Nikolai Viktorovich Polyakov which is the one of the founders of the Dierential equations Department of DNU.

Arterial hypertension (HT) takes leading position in the structure of morbidity and mortality among the cardiovascular diseases in the economically developed and developing countries of the world. Despite progress in treatment of this disease, a number of people with uncontrolled or resistant HT increases. There is a problem of inefficiency of therapy or lack of patients' adherence to treatment. Therefore, search for new approaches to treatment of HT continues. Current most effective agents for blood pressure control, and possible future antihypertensive agents, are related to groups of agents, which inhibit renin–angiotensin–aldosterone system (RAAS). Novel targets for antihypertensive therapy could include the angiotensin II type 2 and type 1 receptor , neutral endopeptidase, aldosterone synthase, renalase, endothelin receptors, (pro)renin receptors, vaccine against RAAS components. Development of novel agents and approaches to HT therapy is discussed.

Arterial hypertension (HT) takes leading position in the structure of morbidity and mortality among the cardiovascular diseases in the economically developed and developing countries of the world. Despite progress in treatment of this disease, a number of people with uncontrolled or resistant HT increases. There is a problem of inefficiency of therapy or lack of patients' adherence to treatment. Therefore, search for new approaches to treatment of HT continues. Current most effective agents for blood pressure control, and possible future antihypertensive agents, are related to groups of agents, which inhibit renin–angiotensin–aldosterone system (RAAS). Novel targets for antihypertensive therapy could include the angiotensin II type 2 and type 1 receptor , neutral endopeptidase, aldosterone synthase, renalase, endothelin receptors, (pro)renin receptors, vaccine against RAAS components. Development of novel agents and approaches to HT therapy is discussed.

The Upper Visean-Serpukhovian deep-water shelf succession is described in the Subpolar Urals. Turbidite model of the sequence forming and direction of the carbonate material transport are proposed. The bioherm and shoal facial belt of the shelf margin is supposed as a main source of the material.

The research objectives are lipid spectrum and endothelial function (EF) in women with metabolic syndrome (MS) associated with autoimmune thyroiditis (AIT) against the background of non-compensated with L-thyroxin subclinical hypothyroidism (SH). Groups of women with MS associated with AIT and euthyroidism, women with MS associated with SH and women with MS without any thyroid disorders were observed. Complex «intima media» and endothelial function of brachial artery were evaluated by ultrasound method. It was indicated that dyslipidemia was more significant in women with MS associated with AIT and SH. But there were no abnormalities in complex «intima media» and EF. The cause of it is that the diabetes mellitus occurred two times rarely in this group in comparison with the other groups as well as the high sensitivity to the L-thyroxin. The results of the study demonstrate the necessary prescription of adequate dose of L-thyroxin to compensate SH completely.

Розроблено метод оптимального вибору варіанта розподілу потужності пристроїв компенсації реактивної потужності за умови мінімальних зведених витрат, який дозволяє знизити втрати електроенергії у трансформаторах комплектних трансформаторних підстанцій (КТП) і розподільній внутрішньозаводській мережі електропостачання, а також забезпечує вибір оптимальної кількості і номінальної потужності трансформаторів КТП.

The article explains why two major international projects supported be UNO – Iranian idea of the dialogue of civilizations and Spanish-turkish conception of the alliance of civilizations did not lead to the desired results and didn’t give expected effects.

The influence of modulation of cytoskeleton by colchicine, vinblastine, cytochalasine B and docetaxel on contractile reactions of smooth muscle cells caused by electric stimulus, depolarization, phenylephrine has been investigated by the mechanographical method, by the methods of the double sucrose gup junction. It is established, that induced by a isoosmotic hyperpotassium solution of reduction of smooth muscle of the rat’s aorta, and also caused depolarization stimulus potentials of action and reductions smooth muscle cells from guinea pig urethra, depend more on the condition of microfilaments cytoskeleton than on microtubules. The reduction of smooth muscles cells of an aorta of the rat, caused by isoosmotic striction, is suppressed under the destruction microfilaments whereas the reduction in a hyperosmotic solution depends on a condition of both microfilaments, and microtubules. Cytoskeleton’s microfilaments of aorta’s smooth muscles and microtubules of smooth muscles of cells ureter are involved in mechanisms of action phenylephrine’s action on contractile activity of smooth muscle cells of an aorta and ureter.

The study included 25 men (mean age 29,24±0,76 years) with Stage I arterial hypertension (AH-I). The control group consisted of 25 healthy men (mean age 30,27±0,59 years). All groups underwent 24-hour blood pressure monitoring (BPM), echocardiography (EchoCG) with Doppler ultrasound, heart rate variability (HRV) assessment, and cholesterol fraction measurement. Analyzing the correlations between vegetative parameters, levels of cholesterol and its fractions, myocardial morphology and function, it has been demonstrated that in AH-I patients, the number and strength of correlations are higher than in healthy participants. This points to a possibility of more rigid neuro-humoral cardiovascular regulation in AH-I patients, comparing to healthy individuals.

Sudden cardiac death (SCD) remains the principal cause of coronary heart disease (CHD) deaths. Therefore, studying SCD mechanisms, implementing new prognostic and preventive approaches are the main aims of modern cardiology. The review analyzes modern approaches to myocardial electrical instability correction and prognosis improvement in CHD patients. It has been proved that among all antiarrhythmics, beta-adrenoblockers only, and perhaps amiodaron, can reduce SCD incidence. Total mortality and SCD rate reduction has been demonstrated for ACE inhibitors, aspirin, statins, aldosterone antagonists. Recent clinical trials have proved that implanted cardioverters-defibrillators are more effective than pharmaceutical treatment in SCD prevention among high-risk patients.