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The paper highlights modern views on the metabolism of vitamin D in the human body. The analysis of the literature data on the mechanisms of the effect of vitamin D deficiency on the pathological processes occurring in the skin with psoriasis is carried out. It is known that psoriasis is associated with a high prevalence of metabolic syndrome, diabetes mellitus, and cardiovascular diseases. There is a direct correlation between a decrease in vitamin D levels and an increased risk of developing metabolic syndrome and cardiovascular mortality, including in patients with psoriasis. Data on the possibility of using vitamin D in dermatology are presented. Based on international and Russian clinical recommendations, the place of oral colecalciferol preparations in the prevention and correction of vitamin D deficiency and deficiency has been determined. The use of oral vitamin D for the simultaneous treatment of psoriasis and metabolic syndrome reduces the risk of cardiovascular diseases and type 2 diabetes mellitus. We analysed the international and domestic recommendations for the treatment of vitamin D deficiency and insufficiency, the use of which makes the oral administration of vitamin D3 (cholecalciferol) optimal for the treatment and prevention of vitamin D deficiency, as the results of several studies showed a higher efficacy of vitamin D3 vs vitamin D2. Vitamin D3 is found in vitamin D-fortified foods and is available as dietary supplements and drugs. The bioavailability of vitamin D in dietary supplements may differ depending on the used vehicle substance.

The article presents the data concerning the efficacy and safety of topical corticosteroids (TCS) in psoriasis treatment in the practice of dermatovenerologist. The questions of etiology and pathogenesis of psoriasis are considered; violation of activation of innate and adaptive immunity plays the key role in its development. The basic approaches in psoriasis treatment, based on the international and Russian clinical guidelines, are distinguished. The place of TCS in psoriasis therapy is determined. The authors give the recommendations for the management of patients with psoriasis and the choice of therapy depending on the form and severity of the pathological process with the use of TCS as the first-line therapy of mild and moderate psoriasis on the basis of the modern Russian and foreign recommendations. The article presents the data of own clinical observations of Akriderm SK micronized drug application for treatment of different forms of psoriasis. A detailed description of management tactics and results of therapy in two patients with psoriasis is presented. The high efficacy of topical Akriderm SK drug in mono- and combined therapy in combination with phototherapy in patients with moderate to severe psoriasis has been shown. Based on the analyzed data of foreign and domestic studies, as well as the authors’ own experience, it is shown that the use of Acriderm SK in psoriasis therapy is effective and safe and meets the requirements of modern treatment principles and standards. The experience of its use for treatment of psoriasis patients demonstrated high therapeutic efficacy and low risk of adverse events.

Silver nanoparticles (AgNPs) and antimicrobial peptides or proteins (AMPs/APs) are both considered as promising platforms for the development of novel therapeutic agents effective against the growing number of drug-resistant pathogens. The observed synergy of their antibacterial activity suggested the prospect of introducing antimicrobial peptides or small antimicrobial proteins into the gelatinized coating of AgNPs. Conjugates with protegrin-1, indolicidin, protamine, histones, and lysozyme were comparatively tested for their antibacterial properties and compared with unconjugated nanoparticles and antimicrobial polypeptides alone. Their toxic effects were similarly tested against both normal eukaryotic cells (human erythrocytes, peripheral blood mononuclear cells, neutrophils, and dermal fibroblasts) and tumor cells (human erythromyeloid leukemia K562 and human histiocytic lymphoma U937 cell lines). The AMPs/APs retained their ability to enhance the antibacterial activity of AgNPs against both Gram-positive and Gram-negative bacteria, including drug-resistant strains, when conjugated to the AgNP surface. The small, membranolytic protegrin-1 was the most efficient, suggesting that a short, rigid structure is not a limiting factor despite the constraints imposed by binding to the nanoparticle. Some of the conjugated AMPs/APs clearly affected the ability of nanoparticle to permeabilize the outer membrane of Escherichia coli, but none of the conjugated AgNPs acquired the capacity to permeabilize its cytoplasmic membrane, regardless of the membranolytic potency of the bound polypeptide. Low hemolytic activity was also found for all AgNP-AMP/AP conjugates, regardless of the hemolytic activity of the free polypeptides, making conjugation a promising strategy not only to enhance their antimicrobial potential but also to effectively reduce the toxicity of membranolytic AMPs. The observation that metabolic processes and O2 consumption in bacteria were efficiently inhibited by all forms of AgNPs is the most likely explanation for their rapid and bactericidal action. AMP-dependent properties in the activity pattern of various conjugates toward eukaryotic cells suggest that immunomodulatory, wound-healing, and other effects of the polypeptides are at least partially transferred to the nanoparticles, so that functionalization of AgNPs may have effects beyond just modulation of direct antibacterial activity. In addition, some conjugated nanoparticles are selectively toxic to tumor cells. However, caution is required as not all modulatory effects are necessarily beneficial to normal host cells.

Antimicrobial peptides (AMPs) are acknowledged as a promising template for designing new antimicrobials. At the same time, existing toxicity issues and limitations in their pharmacokinetics make topical application one of the less complicated routes to put AMPs-based therapeutics into actual medical practice. Antiseptics are one of the common components for topical treatment potent against antibiotic-resistant pathogens but often with toxicity limitations of their own. Thus, the interaction of AMPs and antiseptics is an interesting topic that is also less explored than combined action of AMPs and antibiotics. Herein, we analyzed antibacterial, antibiofilm, and cytotoxic activity of combinations of both membranolytic and non-membranolytic AMPs with a number of antiseptic agents. Fractional concentration indices were used as a measure of possible effective concentration reduction achievable due to combined application. Cases of both synergistic and antagonistic interaction with certain antiseptics and surfactants were identified, and trends in the occurrence of these types of interaction were discussed. The data may be of use for AMP-based drug development and suggest that the topic requires further attention for successfully integrating AMPs-based products in the context of complex treatment. AMP/antiseptic combinations show promise for creating topical formulations with improved activity, lowered toxicity, and, presumably, decreased chances of inducing bacterial resistance. However, careful assessment is required to avoid AMP neutralization by certain antiseptic classes in either complex drug design or AMP application alongside other therapeutics/care products.

Background. The incidence rate of sexually transmitted infections (STIs) in different countries has attracted the attention of specialists from all over the world. The official rates of STI incidence in Russia are significantly lower than those in the United States. Objective. To assess the prevalence of STIs among patients in a network of federal laboratories. Methods. The prevalence analysis of Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis, Neisseria gonorrhoeae, human papillomavirus (HPV) types 16, 18 and herpes simplex virus (HSV) types 1, 2 was performed on the basis of anonymous data from 40 521 patients examined for sexually transmitted pathogens by real-time polymerase chain reaction (PCR). The studied biomaterial was delivered from 656 laboratory departments located in 284 settlements of all federal districts of the Russian Federation from January 2017 to June 2019. Results. One and more of the eight pathogens were detected in 13.8% of patients, two or more pathogens simultaneously were detected in 1.4% of patients. The prevalence of viral infections was: 5.6% in HPV type 16, 1.8% in HPV type 18, 0.5% in HSV-1, and 1.6% in HSV-2. The highest percentage of patients in whom at least one infection was detected was in the age groups under 17 years (27.9%) and 1825 years (19.8%). The distribution by gender in the groups varied, inversely: women predominated in the group under 17 years old (69%), men predominated in the group over 46 years old (71%). The prevalence of pathogenic bacteria was: C. trachomatis 3.8%, M. genitalium 1.5%, N. gonorrhoeae 0.5%, T. vaginalis 0.3%. Discussion. The official incidence of STIs in Russia is significantly lower than that in the United States, which, in our opinion, may indicate not the stable situation in our country infection-wise, but inefficiency of registering STIs in Russia. Conclusion. The data from the federal network of laboratories indicate a high prevalence of STIs in the Russian Federation. The existing STIs accounting system requires modernization. Introduction of the state national program for the Diagnosis, Treatment, and Prevention of STIs can be useful to reduce the spread of infections, improve the reproductive health of the population, and reduce the incidence of reproductive cancer.

Thermal injuries are now ranked number one among injuries, and incidence of injury-related complications, especially infectious and purulent, does not decrease in surgical practice, despite the modern methods for treatment and prevention. Purulent complications depress the speed and quality of wound healing and increase the number of bed-days and treatment costs. Moreover, infection spreading complicates treatment and increases mortality and disability of patients with burn injuries. Choosing the most effective antiseptic agent for burn injuries is crutial both from the perspective of effective local treatment of wounds and wound complications and from the perspective of pharmacoeconomic aspects. At the current time, povidone iodine solution and ointment are one of the leading antiseptics used at all stages of care for burn patients. Its efficacy has been proven by clinical trials and many years’ experience of use by specialists and patients. We have also gained extensive positive experience in using this drug to treat 269 patients with burns of 5 to 35% total body surface area (TBSA) and various thickness without development of resistance and pain in patients and with a pronounced antiseptic effect during its use on the basis of City Clinical Hospital No. 2 of Stavropol, which once again proved high efficacy and feasibility of the widespread use of povidone-iodine in practice due to antimicrobial activity, high bioavailability, ease of use and economic benefits.

The clinical significance of Ureaplasmas in urogenital pathology is reviewed. Ureaplasmas belong to the class Mollicutes. Asymptomatic carriage of these bacteria is common, and most individuals do not develop disease. Ureaplasma urealyticum and Ureaplasma parvum are sexually transmitted bacteria among humans implicated in a variety of disease states including but not limited to: nongonococcal urethritis, adverse pregnancy outcomes, chorioamnionitis, and bronchopulmonary dysplasia in neonates. U. urealyticum has been associated with urethritis in men and is revealed in a high concentration that confirms its etiological role in the disease. Men with a high U. urealyticum load are considered for treatment, however, the data on the therapy efficiency have been insufficient so far. In symptomatic women, bacterial vaginosis should always be tested for, and the corresponding therapy should be prescribed in case of positive results.

The article describes the experience of application of the combined antiscar agent containing boswellic acid, cepalin, hyaluronic acid and allantoin with the subsequent application of the prolonged action pressing patch with the matrix of active release of cepalin and allantoin at the early stages of formation and maturation of scars in the patients with postoperative, post-burn scars and traces after cosmetic manipulations in the form of persistent skin redness. A comparison of the efficacy of two therapy schemes for 43 patients aged 18 to 45 in two groups was shown. When evaluating the effectiveness of the therapy by analyzing the data of evaluation scales, ultrasound, dermatoscopy, a greater effectiveness of the combined antiscar agent and pressure patch in comparison with the use of hydrating agents and silicone patches was noted.

Background and Aims: The macrophage “don’t eat me” pathway CD47/SIRPα is a target for promising new immunotherapy. We hypothesized that a soluble variant of SIRPα is present in the blood and may function as a biomarker. Methods: Monocyte derived macrophages (MDMs) from human buffy-coats were stimulated into macrophage subtypes by LPS and IFN-γ (M1), IL-4 and IL-13 (M2a), IL-10 (M2c) and investigated using flow cytometry. Soluble SIRPα (sSIRPα) was measured in cell cultures and serum by Western blotting and an optimized ELISA. Serum samples were obtained from 120 healthy individuals and from 8 individuals challenged by an LPS injection. Results: All macrophage phenotypes expressed SIRPα by flowcytometry, and sSIRPα was present in all culture supernatants including unstimulated cells. M1 macrophages expressed the lowest level of SIRPαand released the highest level of sSIRPα (p < 0.05). In vivo, the serum level of sSIRPα increased significantly (p < 0.0001) after an LPS challenge in humans. The median concentration in healthy individuals was 28.7 µg/L (19.8–41.1, 95% reference interval), and 20.5 µg/L in an IFCC certified serum reference material. The protein was stable in serum for prolonged storage and repeated freeze/thawing. Conclusions: We demonstrate that sSIRPα is produced constitutively and the concentration increases upon macrophage activation both in vitro and in vivo. It is present in human serum where it may function as a biomarker for the activity of tumor-associated macrophages (TAMs), and for monitoring the effect of immunotherapy.

Objective: to improve the results of treatment of patients with acute appendicitis. Te results of surgical treatment of 360 patients with acute appendicitis were presented.Materials and methods: in predicting of development of intra-abdominal adhesions in patients afer appendectomy and of effectiveness of anti-adhesion therapy in postoperative period was used clinical, laboratorial (phenotype signs of connective tissue dysplasia syndrome, activity of the enzyme N-acetyltransferase, a test system based on sorbents with magnetic properties with immobilized granular antigen from adhesive tissue), instrumental methods of research. Te frst group included 120 (50%) patients who underwent standard appendectomy. In 120 patients with acute appendicitis (the second group) the elements of “Fast-Track” surgery was used in performing classical laparotomy appendectomy. Te third group consisted of 120 patients who underwent laparoscopic appendectomy.Results: all patients with diagnosed adhesive process in the early stages of its development in postoperative period were provided with anti-adhesion therapy. Te least number of postoperative complications was observed in cases of multimodal approach to treatment of acute appendicitis.Conclusions: application of “Fast-Track” surgery principles allowed to reduce development of intra-abdominal adhesion afer surgery compared with traditional appendectomy on 6.6 %, and with laparoscopic — on 2.8 %.

Domesticated species exhibit a suite of behavioral, endocrinological, and morphological changes referred to as “domestication syndrome.” These changes may include a reduction in reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and specifically reduced adrenocorticotropic hormone release from the anterior pituitary. To investigate the biological mechanisms targeted during domestication, we investigated gene expression in the pituitaries of experimentally domesticated foxes (Vulpes vulpes). RNA was sequenced from the anterior pituitary of six foxes selectively bred for tameness (“tame foxes”) and six foxes selectively bred for aggression (“aggressive foxes”). Expression, splicing, and network differences identified between the two lines indicated the importance of genes related to regulation of exocytosis, specifically mediated by cAMP, organization of pseudopodia, and cell motility. These findings provide new insights into biological mechanisms that may have been targeted when these lines of foxes were selected for behavior and suggest new directions for research into HPA axis regulation and the biological underpinnings of domestication.

The results of a 35-year selection of foxes for aggressive response to humans are reported. Averaged estimates of the phenotypic manifestation of aggressiveness in all selection generations are presented. The dynamics of these estimates shows that the phenotypic response to the selection was obvious only in the first 12 generations. Subsequent selection did not alter the mean aggressiveness score. Analysis of variance was performed for the intergroup variability (among descendants of different mothers) and intragroup variability (among the offspring within a family). The intragroup variability was constantly low. Most likely, the trait is stabilized by maternal prenatal and early neonatal factors. The general tendency in the dynamics of intergroup variability is that it does not decrease over time during selection, no matter how long the population has been under it. It follows from the statistical indices of the phenotypic similarity between parents and offspring that additive interactions are insufficient for the explanation of the persisting variability. The contribution of epistatic interactions is not ruled out, though. Emphasis is laid on the correlated consequences of the selection for aggressiveness and their coordination with the consequences of the selection in the opposite direction, for elimination of aggressive response to humans, or for tameness. The parallelism of correlated changes in the selection in contrasting directions is illustrated by the examples of some physiological and morphological traits. The phenomenon is discussed in the light of classical notions of the resource of cryptic genetic variation and the role of selection in its phenotypic manifestation. Its interpretation also invokes molecular data pointing that some genetic pathways may regulate parameters of both aggression and tameness and that the selection processes in both directions may have some genetic targets in common.

This review is devoted to the study of effects of quantum optics in nanostructures. The mechanisms by which the rates of radiative and nonradiative decay are modified are considered in the model of a two-level quantum emitter (QE) near a plasmonic nanoparticle (NP). The distributions of the intensity and polarization of the near field around an NP are analyzed, which substantially depend on the polarization of the external field and parameters of plasmon resonances of the NP. The effects of quantum optics in the system NP + QE plus external laser field are analyzed—modification of the resonance fluorescence spectrum of a QE in the near field, bunching/antibunching phenomena, quantum statistics of photons in the spectrum, formation of squeezed states of light, and quantum entangled states in these systems.

Relevance. Breast cancer is the most commonly diagnosed cancer in women. Tumor biopsy, a key diagnostic approach, is required to evaluate the nature of tumor and to determine the therapeutic strategy. In clinical practice methods are being applied: trepan-biopsy and fine needle aspiration biopsy (FNAB). The latter is less traumatic however is used less often because it provides with less information. Moreover, dependence from quality of biopsy and qualification of morphologist are attributes of both techniques. A possibility to use biopsy material for farther analysis of tumor-markers would open a perspective to obtain more information and to improve objectivity of traditional diagnostic approaches, including FNAB. MicroRNAs (miRNAs), regulatory molecules involved in control of virtually all physiologic and pathologic process, emerged as promising tumor markers. Malignant transformation of mammary gland epithelia is associated with specific alterations of cellular miRNAs profile. Analysis of these alterations is of great diagnostic potency.Objective. Development of method for miRNAs analysis in cytological smears material and evaluation of its practical applicability.Material and methods. Archived cytological material (smears on the glass slides) from patients with benign tumor and breast cancer was used. Analysis of miRNAs expression was performed by reverse transcription followed by quantitative PCR. Results of reverse transcription polymerase chain reaction were analyzed with use of relevant cytological and morphological data.Results. Method of miRNAs analysis in material of cytological smears was developed. Expression of 9 miRNAs in 80 samples was evaluated. Statistically significant expression difference between benign and malignant tumor samples was found for 5 miRNAs: miR-21, miR-205, miR-125b, miR-200a, miR-221. MiR-125b exhibited most prominent expression dysregulation: malignant transformation of mammary epithelium is associated with 500 fold decrease of miR-125b expression level. Expression alterations of several miRNAs were revealed to correlate with clinically relevant characteristics of tumors.Conclusions. Results of our study indicated the possibility of miRNAs expression analysis in the FNAB material and the applicability of this method as additive approach to the convention cytological examination. Application of this method will allow to specify diagnosis and to optimize choice of the therapeutic strategy.

The article highlights the problem of the role of professional identity in self-realization of psychologists- teachers. Within the frame of a system-defined approach the research identifies and describes the individual- typological features of the phenomena interesting to us. The works that focus on the study of self-realization are subjected to the analysis, as the result it is noted that in this field there are still gaps in the understanding of this issue. Thus, the study from the perspective of the influence of professional identity on the successful self-realization of the personality is recognized as relevant. In the framework of this study the following assumptions are put forward: there is a relationship between the professional identity and successful self- realization of the personality; the level of formation of professional identity has an impact on the success of personality self-realization; the professional identity not fully formed acts as a barrier for creativity, activity, internality and constructive self- realization; fully formed professional identity provides a high success rate of self-realization. The purpose of this study was to investigate the features of self- realization and professional identity of psychologists-teachers. For the study, we used “Multidimensional questionnaire of personality self-realization” (MQPS) by S.I. Kudinov, for the study of professional identity the following methods were used: “Professional identity-marginalism” questionnaire by E.P. Ermolaeva and Methods of measuring professional identity (MMPI) by L.B. Schneider. The results obtained were subjected to quantitative analysis. In the article the author relies on the data gathered as a result of a study conducted at the Institute of Education Development of the Republic of Bashkortostan (GAOU DPO IRO RB), city of Ufa. The sample consisted of 142 educational psychologists. As a result of the conducted research, the specific relationship between the professional identity and self-actualization of the educational psychologists was established

Modernization of Health Care in Russia formed new modern approaches in preparing future specialists in medicine. This article outlines new methods of three-stage preparation of students using simulation technics and involving the students in the role of a simulator for modeling different clinical situation cases. The developed method of preparation and improvement of professional skills of medical students allows to study algorithms of first aid in critical cases more deeply, to learn emergency medical manipulations, to be able to evaluate the results of performed manipulations. Elements of this method can be used in different stages of educational process: in development of practical skills in emergency care, in training to render the first aid in traumas and wounds, and in state attestation.

Резюме. Неонатальний сепсис на сьогодні є однією з провідних причин захворюваності та смертності новонароджених у всьому світі. Метою роботи було визначити частоту позитивного стрептококового статусу матері та новонародженої дитини серед тих дітей, які отримували антибактеріальну терапію з метою лікування інфекції, специфічної для перинатального періоду, та попередження раннього неонатального сепсису за даними материнських факторів ризику на базі відділення постнатального догляду перинатального центру міста Києва. Матеріали і методи. Проведено аналіз історій розвитку новонароджених, які народилися у перинатальному центрі в період з 01.01.2016 р. по 31.12.2016 р. Ретроспективно селективно відібрано історії 199 дітей, яким проводилася антибіотикотерапія у зв’язку з наявністю ризику розвитку неонатального сепсису. Частина дітей отримувала антибіотикотерапію через наявність факторів ризику з боку матері, частина – через клінічні прояви інфекції. Стрептококовий статус новонароджених визначався шляхом бактеріологічного дослідження крові, матерів – бактеріологічним дослідженням мазків з перианальної ділянки. Результати дослідження. Проведено аналіз частоти колонізації новонародженого та породіллі стрептококом групи В як одного з основних етіологічних факторів ризику розвитку інфекції, специфічної для перинатального періоду, та визначено фактори ризику, які впливали на клінічну ситуацію. Зроблено акцент на менеджменті новонародженого з підозрою на сепсис та проведено аналіз тривалості призначення антибіотиків у новонароджених згідно факторів ризику та клінічних симптомів. Висновки. Вдосконалення методів діагностики, розробка клінічних протоколів та впровадження на базі них локальних протоколів дозволяє чітко визначити порядок дій медичних працівників щодо тактики ведення новонароджених з ризиками виникнення інфекційного процесу.

Variability in the subfertile patient population excludes the possibility of a single approach to controlled ovarian stimulation. Genetic screening may allow an individual patient’s response to stimulation during controlled ovarian stimulation to be predicted based on genotype. The objective of the study was to analyze the specific features of folliculogenesis, oogenesis, and embryogenesis in patients in relation to single nucleotide polymorphisms in assisted reproductive technology.

Purpose: to improve results of treatment of patients with postoperative ventral hernias using of different methods of abdominal wall repair, to study patients’ quality of life in postoperative period.Materials and Methods: the study presented results of treatment of 288 patients with postoperative ventral hernias. Based on the treatment type all patients divided on 2 groups. 144 patients (50,0%) (first group) were operated on using traditional surgical methods of abdominal wall repair (Meyo, Sapejko, Yanov). In surgical treatment of another 144 (50,0%) patients (Second group) were used tension-free surgical technics of hernioplasty (by methods of «оn lay», «sub lay», «in lay») as well as traditional methods of repair depending on individual features of patients. Basic clinical data, laboratory investigations, diagnostic of external phenotypical signs of the syndrome of connective tissue dysplasia, monitoring of intraabdominal pressure in dynamic were studied. Indicators of patients quality of life in both groups were searched.Results and summary: created complex of tactical and treatment measures lead to decrease frequency of early postoperative complications in 2,4 times , recurrence of diseases in 8,5 times, mortality – in 3 times.

Purpose: to improve results of treatment of patients with pilonidal sinus by developing and implementing of some modifications of operationsMatherials and methods: 267 patients with different clinical forms of pilonidal sinus were underwent surgical treatment. A new treatment strategy and some modification of operations are studied.Results and Summary: it’s necessary to identify risk groups of excessive (pathological) scarring and administer antiscarring treatment among the patients with pilonidal sinus. It is shown that such a treatment strategy has significantly improved the patients outcome with pilonidal sinus: the number of relapses reduced from 8,1% to 2,4%;discomfort phenomenon as a result of rough scar deformation in the sacrococcygeal region from 21,8% to 7,3%; number of patients with persistent recovery increased from 91,9% to 95,3%;time of hospital cure reduced in the main group in average:a stage without inflammation on 1,7 b/d(bad day), in remission stage – 2,1 b/d; in the stage of chronic inflammation – 2,6 b/d.