Endocrinologic and metabolic abnormalities in polycystic ovary syndrome (PCOS) may have complex effects on the endometrium, contributing to the infertility and endometrial disorders observed in women with this  syndrome. The consequences of PCOS on endometrial homeostasis and pathophysiology have not been comprehensively understood. This review provides an overview of the molecular mechanisms of endometrial  function in women with this pathology. Analysis of the literature data found that women with PCOS have changes in the effects of estrogen and progesterone in the endometrium, violation of the spatial and temporal expression of steroid receptors. In PCOS impaired follicle maturation and consequent anovulation cause a chronic progesterone-deficient state that affects the endometrial milieu. Furthermore, even with ovulation (and thus progesterone acting on endometrium), the PCOS endometrium has several abnormalities including altered expression pattern of receptivity markers during the period of implantation and glucose transporter 4 (GLUT4) expression as well as progesterone-resistance. These pathological phenomena explain the possible mechanisms of increasing endometrial cell proliferation. An imbalance in adipose tissue worsens the increase in estrogen levels and its pathological effects. Hyperandrogenia and hyperinsulinemia lead to disruption of cellular proliferation and apoptosis, affect insulin signaling and glucose metabolism, disrupting endometrial energy homeostasis. Inflammation and oxidative stress in the endometrium are closely related, and lead to increased pathological changes in the endometrium. Inflammation can induce production of inflammatory cytokines in this syndrome and directly stimulates excess  ovarian androgen production. The potential mechanisms underlying these disorders, specifically in women with PCOS, are complex and await additional transdisciplinary research for their complete elucidation.

Background. Women with polycystic ovary syndrome in the early reproductive period have hormonal and metabolic dysfunction and an increased risk of long-term health consequences. The article presents the results of the study of hormonal indicators and the parameters of lipid peroxidation – antioxidant protection in women  with polycystic ovary syndrome in early period of reproductive age (from 18 to 35 years old).

Aim: evaluation of the functional state of the pituitary-ovarian-adrenal system and the lipid peroxidation – antioxidant protection system and the establishment of intersystemic relationships in women of the early reproductive period with polycystic ovary syndrome.

Materials and methods. Study included 33 women with ovarian hyperandrogenism and 17 healthy women of early reproductive age. A questionnaire survey, general medical and gynecological examinations, and ultrasound examination of the pelvic organs were conducted. Immunoenzyme method for detection the concentration of hormones, spectrophotometric and spectrofluorometric (determination of the concentration of  lipoperoxidation products, parameters of antioxidant protection), statistical methods were used.

Results. Women of early reproductive age (from 18 to 35 years old) with polycystic ovary syndrome characterized by an increase of 17-OH-progesterone by 2.2 times (p = 0.0005), and dehydroepiandrosterone sulfate by 1.3 times (p = 0.0001). A decrease in the total antioxidant activity of the blood by 25 % (p = 0.0005), an increase in the content of oxidized glutathione by 14 % (p = 0.0001) and a decrease in the concentration of retinol by 26 % (p = 0.0012) compared to the control values were shown. The increase in the  degree of oxidative stress was indicated by the value of the coefficient of oxidative stress equal to 2.8.

Conclusion. The obtained data indicate the features of the functional state of the pituitary-ovarian-adrenal system and the processes of LPO–AOP, as well as the need for timely diagnosis and effective correction of hormonal and metabolic disorders in women with polycystic ovary syndrome in the early reproductive period.

Background. The prevalence of chronic endometritis among women of reproductive age reaches 68 %. Polycystic ovary syndrome (PCOS) is a common cause of reproductive disorders. Data on the characteristics of the manifestation of chronic endometritis in patients with PCOS are incredibly insufficient. PCOS is known as closely associated with metabolic syndrome and chronic systemic inflammation. However, there is no information on the role of chronic systemic inflammation in the pathogenesis of chronic endometritis in women with PCOS.

The objective. Determination of the clinical and morphological features of chronic endometritis in women  with polycystic ovary syndrome and to establish the role of systemic inflammation and hormones of the  hypothalamic-pituitaryovarian axis in chronic endometritis associated with PCOS. 

Materials and methods. We performed a cross-sectional study from May 2017 to December 2019 and examined 198 women of reproductive age (33.71 ± 5.93 years) during annual preventive examinations. We used clinical, instrumental, and laboratory research methods, including hormonal, biochemical,  immunohistochemical techniques, and statistical analysis.

Results. Of the 198 women examined chronic endometritis was diagnosed in 76 patients, including 15 patients with PCOS. Chronic endometritis in PCOS is characterized by a relative decrease in the duration of the menstrual cycle and less pronounced lymphoid infiltration of endometrial tissue. The risk of chronic endometritis in women of reproductive age is not associated with changes in gonadotropins, prolactin, and  manifestations of clinical and biochemical hyperandrogenism. Chronic endometritis is not accompanied by an increase in the concentration of C-reactive protein. At the same time, BMI, waist circumference, and leptin are considered «anti-risk» factors for chronic endometritis.

Conclusion. The specific clinical manifestations of chronic endometritis in PCOS allows us to consider them as diagnostically significant. The revealed negative associations of chronic endometritis with BMI, waist  circumference, and leptin require further investigation of the role of adipose tissue products in the control of local and systemic inflammation. 

Premature ovarian insufficiency (POI) is a life-changing diagnosis, with profound physical and psychological consequences.

Objective. To determine the prevalence, clinical features and hormone characteristics of women with premature ovarian failure of different age group.

Materials and methods. During the study we examined 1200 women, aged 18–45 years. Of all examined women, 17 patients with clinical and hormonal signs of POI under the age of 40 were identified. All participants signed an informed consent and underwent general clinical, instrumental and hormonal examination. Statistical analysis was performed using the Statistica 10.0.

Results. The prevalence of POI among women of reproductive age was 1.4 % (1200/17). The most common clinical signs: a feeling of «heat», increased sweating and dryness in the vagina. Hot flashes were more often during the manifestation of the disease (50 %). An increase in FSH concentration was noted (26.14 ± 33.4  mIU/mL). The concentrations of thyroid hormone and prolactin were slightly higher in women aged 30–35 years, compared with older patients in the group of women at the onset of the disease in women from 35 to 40. Prolactin levels in women under 35 years old were 431.86 ± 357.82 and 387.13 ± 207.54 mU/L in the patients aged 35–40 years, accordingly (p > 0.05)

Conclusion. It was established that the frequency of POF in Eastern Siberia does not differ from the frequency of occurrence of this disease in the world. The progression of clinical manifestations of hypoestrogenism occurs  gradually.
Hot flashes were the earliest menopausal complaints. In women aged 30–35 years, POI is accompanied by a relatively higher activity of prolactinergic and thyrotropic pituitary functions.

Premature ovarian insufficiency (POI) is a life-changing diagnosis with profound physical and psychological consequences. POI, defined as amenorrhea due to the loss of ovarian function before 40 years of age, can occur spontaneously or be secondary to medical therapies. POI is associated with cardiovascular morbidity, osteoporosis and premature mortality. General practitioners play an important role in the evaluation and long-term management of women with POI. Before getting to the gynecologist, more than 50 % of women, on average, turn to three different specialists. Success of early diagnosis, possibility of timely prescription of hormone therapy, and monitoring of the long-term effects of hypoestrogenism depend on the general practitioner’s knowledge of this pathology. The purpose of this review was to systematize the available data on modern clinical diagnostic criteria for POI, for the early detection and prevention of reproductive losses, as well as improving the quality of life of women. An information search was carried out using Internet resources (PubMed, Web of Science, eLibrary.Ru), literary sources for the period 2015–2019 were analyzed. As a result of the analysis of the literature data, a step-by-step diagnosis of pathology was described, the main shortcomings of the main marker for assessing ovarian function – folliclestimulating hormone – were identified and listed. And also the advantages of  anti-Müllerian hormone in the early diagnosis of ovarian insufficiency are considered.

Diabetes Mellitus (DM) is one of the most common non-communicable diseases in the world. Despite the long struggle with this nosology, the medical community still does not have a clear answer to all the pathogenetic links of this disease. Every year, the number of sugar-lowering medications increases, but most patients develop complications of diabetes. This is probably because not all aspects of the pathogenesis of DM have yet been studied, and therefore it is impossible to fully influence the course of this disease. One of the promising directions in the study of additional aspects of the pathogenesis of DM is the study of the gut microbiota of patients. Science knows the influence of microflora on the formation of eating behavior, various pathological processes, including inflammation, but this knowledge is limited. What influences the microflora itself and whether it is possible to change its composition with the help of changes in external factors? Additional research is required on the mutual influence of microflora and host organism, as well as the possibility of correcting these interactions. Several studies have confirmed the positive effect of lactobacilli on the physiological processes of the body. However, the human gut microbiota is very diverse, and the question of identifying bacteria that can participate and correct pathological processes requires additional research. Probably, if it is possible to influence the composition of the gut microbiota, the medical community can get a powerful tool for correcting many pathological conditions. It may be that this  component is the missing component necessary for a more accurate impact in the treatment of many diseases, including diabetes.

This literature review is devoted to the study of the role of polymorphic variants of the anti-inflammatory interleukin-10 gene (Interleukin-10, IL10) in the etiology and pathogenesis of ulcerative colitis in patients of various ethnic groups.

Aim. To generalize the results obtained from electronic databases on the study of the characteristics of the course of ulcerative colitis in patients of different ethnic groups, taking into account the carriage of IL10 gene polymorphisms.

Materials and methods. Twenty-five studies were selected, including four meta-analyzes devoted to the  study of associative relationships of single nucleotide polymorphisms (SNPs) of the IL10 gene isolated from  blood samples at positions -592AA/CA, -819CT, -1082АА/GA, and rs3024505 in the development and course of ulcerative colitis.

Results. A number of researchers from Europe, Saudi Arabia report an increased incidence of ulcerative colitis among carriers of the IL10-1082AA SNP and a low incidence among carriers of -592AA. Positive associations of IL10-819CT with the prevalence of ulcerative colitis are presented in single reports from Europe, the Middle East and in a number of studies from Asian countries. However, the identified associations, even within the  same population, are often contradictory. Perhaps the discrepancies are due to the ethnic heterogeneity of the groups in the considered cohorts, and therefore it is necessary to continue epidemiological studies with a large sample size in specific geographic areas.

Severe injuries of the musculoskeletal system with damage of bone and cartilaginous tissue are associated with the necessity to find ways for replacement of defects. Current methods of treatment including the usage of autografts and modern synthetic materials are often not effective enough. The article deals with the prospects for developing the new areas in the traumatological pathology treatment based on the cell technologies application. Both medical and ethical aspects of the cell technology usage and the utilizing various sources of cell material for transplantation are discussed in detail. Special attention is devoted to application of the mesenchymal stem cells as  the most suitable material for bone and cartilage repair. These cells possess the properties of multipotent stem cells that can adhere to plastic surfaces, differentiate into various cells, including chondroblasts, osteoblasts, and migrate to the damaged area. It is shown that the number and biological characteristics of the isolated cells depend on the tissue, the cell isolation method, and the culture medium. During the cultivation of mesenchymal  stem cells, the true marker of which is Stro-1, it is necessary to monitor the duration and number of passages, because these values are inversely correlated with the differentiating potential of cells, and spontaneous transformation according to oncogenic pathway may occur.
Thus, mesenchymal stem cells represent a current material for the reconstruction of hard tissues. Despite ethical and technological problems, cell technologies are a promising approach in regenerative medicine.

Lysosomes are multifunctional cell organelles that not only provide degradation of macromolecules by lumenal acid hydrolases, but also contribute in the regulation of cell metabolism, ion homeostasis maintenance, and programmed cell death induction. The study of this compartment in various pathological conditions, including the oncological diseases by different origins is of particular interest. This article discusses the lysosome involvement in the process of malignant cell transformation, as well as the role of these organelles in the tumor cell metastasis mediated by proteolytic cleavage of the extracellular matrix components. Metabolic and morphological changes of cells during oncogenesis lead to pHdependent redistribution of lysosomes within the  cell, accompanied by the secretion of lysosomal proteases cathepsins into the extracellular space. Cysteine, serine, and arginine cathepsins released by both tumor cells and tumor-associated cells catalyze the cleavage of various components of the extracellular matrix and basement membrane, or proteolytically activate other enzymes also involved in this  process. In this instance, lysosomal proteases directly affect the ability of cells to invade and the metastatic potential of tumor formation. In addition, it was demonstrated the prognostic importance of some cathepsins (especially cathepsins B, K, and D) the number and activity of which in the tumor tissue and its microenvironment are associated with malignancy of the formation, as well as with a poor prognosis for patient survival and with the possibility of recurrences.

In multidisciplinary hospitals, there are conditions conducive to the emergence of healthcare-associated infections: high concentration of people with reduced immunity in a limited area, the presence of a significant number of sources of contagion (patients and carriers), a change in the biocenosis of the mucous membranes and skin of patients and medical personnel under the influence of widespread use of antibiotics and cytostatics.

The aim of the research was in the intercomparison of the standardized bacteriological algorithms and the MALDI Biotyper system in the microbiological diagnosis of pathogens as illustrated by the healthcare-associated diseases.

Materials and methods. Seventy-eight patients of a multidisciplinary hospital of a regional level (Irkutsk) in 2018–2019 were examined. The age of patients ranged from 1 to 15 years. The material for the study was blood, sputum, swabs from the tracheobronchial tree, throat, nose, wound, abdominal fluid, cerebrospinal fluid, and swabs from environmental objects. Identification of the isolated cultures (78 bacterial strains) was  carried out using generally accepted bacteriological methods, as well as using the MALDI Biotyper system.

Results and discussions. In the structure of healthcare-associated infections, Pseudomonas aeruginosa occupied a leading position. Not all isolates of microorganisms were identified by standardized bacteriological methods. The identification of strains with characteristic manifestations of physiological and biochemical characteristics was more reliable. Identification difficulties arose in the presence of atypical properties of microorganisms when the use of MALDI Biotyper would be crucial.

Conclusion. It is necessary to apply an integrated approach to conduct reliable diagnostics of pathogens. It includes standardized bacteriological methods and methods for identifying microorganisms using mass spectrometry in the subsequent stages.

Antibiotic drugs are used to treat and prevent bacterial infections around the world. The emergence and spread of  bacterial resistance to carbapenems is currently a real threat that determines the need for its timely detection and  suppression. Carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii are ranked as the highest priority in the 2017 WHO Global Priority Pathogens List. The number of known carbapenemases is constantly increasing, but the most common are IMP-type, VIM-type, NDM-type, KPC-type, and OXA-type. Carbapenemases belong to molecular class B (metallo-β-lactamases) or molecular classes A and D (serine carbapenemases). The genes encoding carbapenemases are part of the mobile genetic elements, which contributes to their rapid intra- and interspecific transfer. In this regard, the purpose of this review is to get acquainted with the current information on the classification and characteristics of carbapenemases, ways to overcome the spread of resistance to carbapenems. At the same time, the article pays attention not only to infectious agents, but also to those carriers of carbapenemases that have not been seen as infectious agents, since they can also influence the evolution of resistance genes.

Background. The development of functional gastrointestinal disorders (FGID) in children, especially in the first year of life, is a key factor in the formation of an altered colon microbiota and its formation in older age. The article presents both clinical-detailed anamnesis, symptoms of FGID, and bacteriological characteristics – qualitative and quantitative composition of the colon microbiota in children of the first year of life.

Aim: to determine the features of the colon microbiota in children of the first year of life with FGID.

Materials and methods. The objects of the study were children of the first year of life (n = 28) with a diagnosis of FGID established by a gastroenterologist. The material was divided into two comparison groups, depending on the age of the subjects: the first group included stool sample cultures of children aged from birth to 6 months (n = 17), the second – from 6 to 12 months (n = 11). The bacteriological study of the quantitative and qualitative composition of the contents of the colon was performed using standard methods.

Results. According to the anamnesis, colic and flatulence were the key symptoms of FGID (p < 0.05). The results show that the formation of FGID in children from birth to 6 months and from 6 to 12 months may be associated with altered colon microbiota. There was a decrease in the quantitative indicators of the indigenous microbiota: bifidobacteria, E. coli with normal sensitivity and Enterococcus spp., and an increase in the degree of contamination of Klebsiella spp., S. aureus, Clostridium spp.

Conclusion. It is shown that the determining factor in reducing the risk of developing FGID in children of the first year of life is a high concentration and diversity of indigenous microbiota. 

Parathyroid hormone receptors PTH1R and PTH2R are poorly studied in the pathology of the vertebral column and may be involved in both ectopic ossification of the vertebral ligaments and fibrous growth of the extracellular matrix, as well as in other unknown processes occurring in the pathological focus.

Aim. To study the expression of genes encoding parathyroid hormone receptors in intraoperative Ligamentum flavum samples of patients with stenosis of the spinal canal and the lumbar dural sac of the spine and to assess the correlation with the expression of other genes active in connective tissue in conditions of developing pathology.

Materials and methods. Studies of the Ligamentum flavum were performed in 33 patients (17 women, 16 men) with stenotic processes of the spinal canal and dural sac of the lumbar spine. RNA was isolated from the biopsies using Qiagen reagents (Germany). Then reverse transcription was performed. cDNA was used for setting up a polymerase chain reaction (Promega Reagents, USA) using a CFX96 thermal cycler (Biorad, USA) with specially selected specific primers.

Results. The expression of genes encoding parathyroid hormone receptors PTH1R and PTH2R was detected and evaluated for the first time in intraoperative Ligamentum flavum samples of patients with spinal canal and dural sac stenosis, and their relationship with the activity of genes encoding estradiol receptors (ESR1 and ESR2) and FGFR3 was revealed. For the first time, common features of PTH1R and PTH2R gene expression, as well as their differences, were revealed. It is proved that the intensity of expression of parathyroid hormone receptors in intraoperative Ligamentum flavum biopsies does not depend on age, gender, or the presence of bone and cartilage nodes according to MRI results. The interdependence of differential changes in the expression of genes of the receptor apparatus involved in the metabolism of Ligamentum flavum tissues was  revealed.

Changes in the activity of the lipid peroxidation – the antioxidant defense system is an important metabolic  characteristic in various diseases, including infection with the human immunodeficiency virus. The high  medical, social and economic significance of HIV infection is determined by the widespread and severe course of the disease. Up to 2.7 million new infections are registered in the world every year. The increase in the  prevalence of HIV infection in the Russian Federation is largely due to the prevalence of sexual transmission (50.3 %). In recent years, the proportion of women of reproductive age who are infected with HIV has significantly increased, which entails the problem of an increase in the number of cases of HIV transmission from mother to child during pregnancy and childbirth.
According to a number of authors, it was found that in patients with HIV infection there is an intensification of the processes of lipid peroxidation, against the background of depletion of the activity of the antioxidant defense system. The presence of co-infections in the human immunodeficiency virus, concomitant diseases and other negative factors can aggravate the course of this kind of reactions.
The article presents a review and analysis of recent literature data on studies of the features of changes in free radical oxidation indicators in HIV infection. The study of LPO–AOD processes in HIV infection is necessary and can act as a new approach in the prevention of complications and treatment of this disease.
When writing the review, the database of the scientific electronic library (eLibrary.Ru) was used, the keywords were HIV, lipid peroxidation, lipid peroxidation, free radical oxidation, antioxidant protection; filters: publication years 2010–2020, publications with full text, publications available for viewing; An English-language database of medical and biological publications created by the NCBI, keywords: HIV, lipid  peroxidation, antioxidant protection, antioxidants, oxidative stress, human immunodeficiency virus.

This review examines the variability of the glutathione system in sleep pathologies. Modern sleep theory assumes a restorative sleep function, including active utilization of oxidants and protection from excessive oxidation. In this review article, we conducted an analysis of domestic and foreign literature and summarized  data relating aspects of the functioning of the glutathione system in somnological disorders. Various authors have established systemic oxidative stress in insomnia due to reduced activity of glutathione peroxidase. Also, oxidative stress in insomnia is observed in certain areas of the brain due to a decrease in glutathione levels in them. Studies of the functioning of the glutathione system genes in insomnia, whose polymorphisms may include alleles that inhibit oxidation, are arousing interest. An alternative pattern of changes is observed in obstructive sleep apnea syndrome. The apnea stage affects the indicators of the glutathione system. The values of the glutathione system indicators increase with mild to moderate apnea. This is an adaptive response mechanism. Also, the development of oxidative stress in apnea, which leads to disorders in the glutathione system, is cyclical. As a result, people with apnea do not have sufficient replenishment of the components of the glutathione system during sleep. The existing modification does not allow to fully respond to the intensification of peroxide processes and to restrain the activation of excessive oxidation.

Background. Ligamentum flavum is involved in the development of stenosis of the spinal canal and dural sac, but the mechanisms underlying degenerative-dystrophic changes have not yet been sufficiently studied.

Aim. To study the expression of candidate genes potentially involved in connective tissue metabolism in intraoperative samples of Ligamentum flavum of patients with stenosis processes of spinal canal and duralsac on the lumbar spine.

Materials and methods. During the surgical treatment, Ligamentum flavum biopsies were collected from 33 people with stenosis processes of spinal canal and dural sac on the lumbar spine (16 men, 17 women). RNA was isolated, then reverse transcription was performed. After that, real time PCR was performed (CFX96, Biorad) with the specific primers (RealTimePrimers.com).

Results. The characteristics of the expression of candidate genes that are active in the Ligamentum flavum of  the examined patient population are given: NAT1 and NAT2 acetyltransferase genes; genes that determine the intensity of local metabolism (Dio1, Dio2 and Dio3); estradiol receptor genes ESR1 and ESR2; genes encoding receptors for growth factors and parathyroid hormone. All Ligamentum flavum samples showed activity of the NAT, ESR 2, FGFR1, FGFR3, NA20, PTH1R, and PTH2R genes. In the vast majority of samples (93.9–97.0 %), the following genes were active: PDGFA, ESR1, CALCR, and PDGFB. In 21.2–39.4 % of samples, “silence” of the Dio1, Dio2, Dio3, NAT2 and GDF5 genes was detected, and only 39.4 % of samples revealed NAT1 transcripts. The highest heterogeneity of transcript content was observed for Dio1, NAT2, and Dio2. The most stable expression in Ligamentum flavum tissue and a narrow range of fluctuations were characterized by genes with a high level of activity AANAT, ESR2, NAA20 and genes with an average level of activity FGFR1, FGFR3, PTH1R and PTH2R.

Conclusions. Ligamentum flavum is a promising little-studied substrate for molecular genetic research. The revealed features of gene expression provide new information about pathogenesis, and the new fundamental knowledge obtained can provide a basis for developing methods for preventing the development of epidural fibrosis.

Background. Exact notion about the timing of acute traumatic intracranial hematomas (ATIH) generation is very important to gain a better understanding of the primary and secondary traumatic brain injury (TBI) pathophysiology. The variety of TBI and individual anatomical features of the victims determine the complexity of the issue, as well as the relevance of studies that bring it closer to its solution.

Aim of the study was to assess the possibility of using multispiral computed tomography (MSCT) to determine the average timing of the formation of epidural and subdural ATIH.

Materials and methods. It is a retrospective study of 84 MSCT investigations of 55 patients with ATIH (epidural – 15, subdural – 40) in Irkutsk City Clinical Hospital N 3 (2018–2019). The ATIH volume calculated by the MSCT. The correlation of ATIH volumes with the period of trauma was studied, as well as a comparison  of average volumes of ATIH among patients distributed in groups in line with the hour of primary MSCT after injury. The dynamics of ATIH of small volumes (up to 40 ml) were assessed in 21 patients left under observation.

Results. The volume of epidural ATIH and the time of their detection had no a direct correlation in the period 1 to 4 hours after the injury (p = 0.05). There was no reliable difference in their average volumes per hour of diagnosis, amounting to a total of 54.1 ± 19.7 ml. A direct correlation between the volume of subdural ATIH and the duration of trauma was identified during periods of 1–2 hours (p = 0.02) and 1–3 hours (p = 0.002; t = 3.77) after injury; a true difference in their average volume of 1 and 2 hours after the injury (52 ± 20.2 ml and 106.4 ± 14 ml, respectively). Increase in small ATIH found in 14.3 % of patients left under observation.

Conclusions. The MSCT allows us to estimate the average timing of the formation of the main volume of ATIH when hospitalized victims with TBI. The average rate of accumulation of ATIH is about 50 ml per hour, and the direct correlation of their volume and time of diagnosis is reliable the first 2–3 hours after the injury  for subdural ATIH only.  

The article describes the treatment of a 20-year-old patient with a spinal hourglass schwannoma (neurinoma) in the thoracic spine, growing from the right Th3 spinal root, spreading into the thoracic cavity and compressing the apex of the right lung. The introduction presents the frequency of occurrence of such neoplasms among all spinal cord tumors. Complaints, neurological symptoms, neoplasm diagnosis methods and its clinical and radiological manifestations are presented. The article describes stages and techniques of total surgical removal of the spinal hourglass schwannoma through the posterior paravertebral minimally invasive approach without opening the pleural cavity and with using neurophysiological monitoring of spinal cord function performed at the Neurosurgical Clinic of the Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan. The data  of histological examination and MRI control in the early postoperative period are presented. The follow-up was carried out at 6 and 12 months after surgical treatment. The publications describing the surgical treatment of paravertebral tumors through different approaches, the technique of their removal, possible complications and methods of their prevention are analyzed, and the classification according to Eden (1941), which characterizes the type of tumor growth, is presented.

Using a clinical example, the authors set the goal of elucidating the result of a two-stage surgical treatment of Anderson’s lesion, carried out in the long-term period after a one-stage correction of flexion deformity of the  ankylosed spine without fixation.

Results. The analysis of the results of treatment three years after decompression-corrective stabilizing surgery performed for Anderson’s lesion at the ThX–ThXI level, which developed 10 years after the correction of flexion deformity of the ankylosed spine by “open” vertebrotomy LIV–LV. No progression of Anderson’s lesion in all previously identified vertebral segments was noted. The existing neurological deficit regressed from ASIA C to ASIA E. Normalization of the SVA sagittal balance parameter was revealed, with preserved local kyphosis at the ThX–ThXI level of 15° (initial – 30°). The indicator ODI (Oswestry Disability Index), VAS and FIM (Functional Independence Measure) were, respectively, before surgery 67, 6 and 82, 3 years after surgery – 10, 0 and 126.

Conclusion. In the presented case, the surgical correction of the deformity, carried out taking into account the parameters of the sagittal balance, with the stabilization of the ventral and dorsal columns, and decompression, made it possible to prevent the progression of Andersson’s lesion, achieve regression of neurological symptoms, and improve the patient’s quality of life.

Background. The key link in the pathogenesis of angle-closure glaucoma is the formation of structural blocks that initiate a violation of hydrostatic balance. However, if the parameters of the eyeball are equal, the state of the outflow pathways, the level of intraocular pressure and the eye hydrodynamics may be different. It was suggested that the formation of hydrodynamic blocks in patients with hypermetropia may be initiated at a young age by the processes of excessive accommodation, which are aggravated by physiological aging, accompanied by the formation of presbyopia.

Aim. To find out the factors that provoke and aggravate the processes of formation of pathological changes in the eye hydrodynamics in patients with older hypermetropia.

Materials and methods. A comprehensive study of the anterior segment of the eye was performed in 80 patients aged 45–60 years with hypermetropic refraction. Structural deviations were evaluated using ultrasound biomicroscopy and interactive Scheimpflug registration of the anterior segment of the eye (“Pentacam HR”, Oculus, USA) with the calculation of the parameters of the anterior and posterior chambers of the eye and the Lowe coefficient. Tonometry and tonography were performed on an electronic tonograph “Mentor” (Tecnar Ophthalmic, USA).

Results and conclusion. The total results of the study of 80 patients with hypermetropia were processed using cluster analysis, which revealed significant and significant heterogeneity for three clusters. Comparative and regression analysis found that the parameters transformation and intraocular structures position are  initial and under the conditions of the load test in subjects of the first and third clusters was accompanied by a violation of the eye hydrodynamics with the predominant inclusion of the lenticular or iridociliary component, respectively. The changes detected in patients of the second cluster were characterized by balanced moderate changes in structural relationships and the absence of a clinically significant intraocular pressure increase.

Background. Obesity and its complications continue to be a serious problem in children and adolescents in the 21st century. Clinical and psychological studies show that obesity may lead to changes in emotional status of adolescents. Today exposure to sociodemographic parameters is known to be a risk factor for the development of obesity in children. Thus, our research focuses on the relationship between sociodemographic  and psychological factors and obesity in adolescents, as this link has not been sufficiently studied.

Aim. To determine sociodemographic and psychological factors associated with adolescent obesity.

Materials and methods. Our cross-sectional study included 111 obese adolescents and 39 normal weight adolescents, aged 11–17 years. We used anthropometry and questionnaire methods to examine emotional state, eating habits and socio-demographic characteristics of teenagers.

Results. It is shown that adolescents with obesity are more likely than adolescents with normal weight to  have a stepparent (p = 0.002). All adolescents with normal weight were involved in extracurricular activities  and attended different courses (studying with tutors, going to language schools, exam preparation courses),  compared to adolescents with obesity (75 %) (p < 0.001). We did not find any differences between the groups in the domains of sports activities and screen time. When examining the emotional state of adolescents, we found that more people from the group with obesity suffered from lower self-esteem than from the control group (p = 0.041). Adolescents with obesity tend to have (15.3 %) severe depression, while no controls reported this issue.

Conclusions. We found that adolescents with obesity more often live in a step-family. They are less likely to be engaged in additional educational activities. We succeeded to describe the emotional status and eating habits of obese adolescents.

The article analyzes the problem of development of coping strategies as one of the factors of correction of psychoemotional disorders in women with hyperandrogenia. The nature of coping strategies is analyzed. Two approaches to the development of coping strategies – the concept of mindfulness, proposed by John Kabat-Zinn, and the concept of hardiness, proposed by S. Maddi. In conception of Kabat-Zinn mindfulness involves a feeling of full involvement in the events “here and now”, as well as the obligation to be curious about the flow of consciousness: all thoughts and feelings that arise in the person should be perceived by it without criticism, as relevant to the current state and therefore do not require condemnation. At the same time, by S. Muddy hardiness is a combination of inclusion in the surrounding reality (commitment), control, denoting the belief of the individual in their own abilities to influence the stressful situation, although without certain guarantees of the result, and the  challenge, representing the belief that any changes are fundamentally positive for the individual and contribute to its development.
It is shown that the content of the category of mindfulness – the management of attention and the adoption of the position “here and now” – as well as the methods of its development, are similar in each of the concepts. It is concluded that mindfulness, which is the core of productive coping strategies, is a set of concentration skills and a certain attitude.

Massive rotator cuff tears present a challenging problem for surgeons. According to various authors, from 10 to 40 % of ruptures are massive and more often affect patients over 60 years of age with low-intensity injuries. There is currently no consensus on the classification of rotator cuff injuries. The use of MRI is the gold standard in diagnostics and surgical tactics. Treatment of patients with severe fatty degeneration, muscular atrophy and retraction of the damaged tendon presents certain difficulties. Reinsertion of the damaged rotator cuff tendon is not possible in such patients. There are many different methods of surgical and conservative treatment. In our opinion, transposition of the latissimus dorsi is the method of choice for young and active patients. With the development of new technologies, transposition of the latissimus dorsi muscle began to be performed  arthroscopically. This article presents a clinical case: a woman with chronic total rupture of the supraspinatus tendon, Patte grade 3 and fatty degeneration of grade 3 by Thomazeau. The patient was also diagnosed with a secondary superior subluxation of the humeral head. The patient underwent surgical treatment: arthroscopic- associated transposition of the latissimus dorsi muscle to the greater tubercle of the humerus. There was a positive trend, an improvement in the functional result occurred already in the early postoperative period.  Considering the above, the method of choice in the treatment of patients with massive ruptures of the rotator cuff tendons can be considered as transposition of the latissimus dorsi muscle, performed by the arthroscopic-associated method.

Background. The known methods of choosing the surgical treatment of infectious complications of arthroplasty of large joints have their drawbacks.

Aim of the study. To assess the effectiveness of the proposed algorithm for choosing surgical tactics in patients with periprosthetic infection of the hip and knee joints.

Materials and methods. The analysis of the results of surgical treatment of 67 patients with deep periprosthetic infection of the hip and knee joints, who were in the clinic of the Irkutsk Scientific Centre of Surgery and Traumatology from 2014 to 2019. The average age of the patients was 67.8 ± 6.3 years (from 36  to 81 years). 50.7 % were men. In 42 patients, the infectious process developed in the area of the hip joint endoprosthesis, in 25 – in the knee joint. The patients were divided into two groups depending on the method of choosing surgical tactics. The first group consisted of 47 patients in whom the choice of surgical tactics was performed as standard. In 20 patients of the second group, the treatment tactics were determined using the proposed algorithm. The proposed algorithm for choosing surgical tactics for periprosthetic infection includes determining the degree of risk of maintaining the infectious process in the area of the prosthetic joint after the proposed surgical treatment and evaluating additional criteria.

Results. Analysis of the results of the treatment of patients with deep periprosthetic infection of the hip and knee joint showed that in patients of the first group, it was possible to arrest the infectious process in 61.7 % of cases, in the second group of patients, relief of periprosthetic infection was achieved in 90 % of cases.

Conclusion. The use of the proposed algorithm for choosing surgical tactics for periprosthetic infection, taking into account the risk factors for maintaining the infectious process and evaluating additional criteria, makes it possible to determine the type of surgical intervention that is optimal for each patient, and contributes to the relief of the infectious process in the area of the prosthetic joint. 

The frequency of unsatisfactory results of surgical treatment of patients with a fracture of the proximal humerus remains high and is up to 40 %. This is primarily due to the early instability of the metal structure against the background of osteoporosis and as a consequence of non-fusion of the fracture and the formation  of a false joint. The aim of the study was to evaluate the effectiveness and safety of a new surgical method for treating patients with a fracture of the proximal humerus against the background of critical osteoporosis. After the approval of the local ethics Committee, 2 groups of 10 patients were formed in the clinic: the patients of  main group were operated by the proposed method; the group of clinical comparison was operated by the standard method. In all clinical cases, fractures of the proximal humerus were consolidated on control radiographs. VAS assessment the pain syndrome in the early postoperative period showed that there were no  statistically significant differences in the shoulder joint area in the groups. Three months after surgery, when assessing the volume of movement in the shoulder joint (without the participation of the scapula), there was a statistically significant improvement in the main group: abduction – by 35° and external  rotation – by 25° (p<0.05). When assessing the range of motion of the operated shoulder joint using the ASES scale, a  statistically significant improvement was observed in the main group by 11.6 points after 3 months after  surgery. According to the assessment of the patient›s functional recovery according to the DASH scale, the indicators in the main group were statistically significantly better, which indicates a complete recovery of the shoulder joint function. Thus, the use of the proposed new method, in comparison with other known technologies for surgical treatment of fractures of the proximal humerus, allows achieving a more rigid and stable fixation of bone fragments in the aftermath of trauma and the presence of regional osteoporosis.

The treatment of the consequences of diaphyseal fractures of the humerus, despite the emergence of modern effective methods of internal osteosynthesis, has not lost its relevance. Transosseous osteosynthesis remains the method of choice in the treatment of pseudoarthrosis and delayed consolidating fractures of the humerus. The experience we have accumulated in the use of external fixation devices in the treatment of fractures, based on the use of the method of unified designation of transosseous osteosynthesis, made it possible to systematize and describe the surgical technique of combined transosseous osteosynthesis in the treatment of fractures of the humerus diaphysis with impaired reparative processes in combination with longitudinal corticotomy of the  pseudarthrosis zone, and evaluate its effectiveness. The article presents a case of successful surgical treatment of a patient with a pseudarthrosis of the humerus diaphysis by the method of combined transosseous osteosynthesis in combination with longitudinal corticotomy of the pseudarthrosis zone. A description of the technique of transosseous osteosynthesis is given. The presented clinical case shows that the use of combined transosseous osteosynthesis, taking into account the method of unified designation of transosseous osteosynthesis, makes it  possible not only to determine the optimal arrangement of the apparatus and the positions of the transosseous elements, but also to use this method to determine the optimal area for performing longitudinal corticotomy.

The proportion of injuries to the rotator cuff of the shoulder occupies one of the leading places in the structure of injuries to the musculoskeletal system. The history of the study of this pathology began about five centuries ago and continues to the present day. However, attempts to introduce a generally accepted classification of injuries have not been crowned with success. With the development of scientific and technological progress, many methods of conservative and surgical treatment have appeared. Among the conservative methods of treatment aimed at reducing pain and improving the quality of life, injections of corticosteroids, hyaluronic acid, and autoplasma therapy are used. But, unfortunately, these treatment methods are not aimed at restoring the function of the shoulder joint. Surgical treatments for rotator cuff injuries are varied. This includes both the classic reinsertion of the damaged tendon and arthroscopic treatments. In case of massive ruptures, reconstructive plastic surgery is performed with the transfer of the tendons of the infraspinatus, small round or latissimus dorsi muscle, and autografts or allografts are also used. However, despite the large number of treatment methods, there are no clear algorithms for managing patients with this pathology, and the percentage of unsatisfactory treatment outcomes remains high.

The article presents the experience of surgical treatment of a rare pathology of the upper limb – the pseudarthrosis of the middle third of the radial shaft with a bone defect in combination with the pseudarthrosis of the middle and lower third of the shaft of the ulna of the forearm. Determination of reasonable and well-considered treatment tactics is of great importance in the treatment of patients aimed at restoring the anatomy and function of the injured upper limb. A feature of this case is the formation of several false joints at different levels of the forearm bones, the presence of a bone defect of 2.5 cm, which required its replacement with an autograft, and a previously performed surgical intervention using transosseous osteosynthesis. The applied tactics of surgical treatment consisted of several stages: bone osteosynthesis of the ulna with opening of the medullary canals of the ulna; replacement of a bone defect in the area of the pseudarthrosis of the radius with an autograft from the iliac crest using combined stress osteosynthesis in combination with transosseous osteosynthesis. The results of surgical treatment of false joints and bone defects depend on the correct treatment tactics, according to the indications, and the correct implementation of the selected treatment tactics. The surgical tactics of treatment used in this clinical situation made it possible to create conditions for the fusion of fragments of the radius and ulna  bones, as well as to replace the defect of the radius, as a result of which the anatomy and function of the damaged segment were successfully restored.

Background. Currently, work continues to improve the methods of arthroscopic reconstruction of the anterior cruciate ligament with an autograft, aimed at reducing the risk of postoperative failure.

Aim of the study. To assess the immediate results of using a new method of preparing an autograft for anterior cruciate ligament plasty.

Materials and methods. The analysis of the results of surgical treatment of 28 patients with old complete traumatic rupture of the anterior cruciate ligament, who were treated in the Department of traumatology and orthopedics of the Irkutsk Scientific Center of Surgery and Traumatology, was carried out. The patients were men aged 18 to 40 years. The common thing for all patients was the All-inside arthroscopic plasty of the anterior cruciate ligament. Two groups of patients were formed depending on the method of preparation of the autograft. The first group consisted of 18 patients in whom a well-known technique was used, including the formation of a four-bundle autograft from one tendon of the semitendinosus muscle. In 10 patients of the second group, a new method of preparing an autograft was used, including the stage of preliminary determination of the required length and thickness of the autograft, and the stage of forming an autograft from the tendon of the semitendinosus and gracilis muscles on the common tendon pedicle.

Results. Comparative analysis of the immediate results of arthroscopic plasty of the anterior cruciate ligament with an autograft in case of its old complete traumatic injury revealed a significantly lower number of undesirable consequences when using a new method of preparing an autograft. In two cases, persistence of  the pain syndrome associated with arthritic changes in the joint was observed, in one patient there was a  restriction of movements in the knee joint, no synovitis, a sensation of instability of the knee joint, ruptures  and detachments of the autograft were found. All patients were satisfied with the achieved result.

Conclusion. A new method of preparing an autograft for plasty of the anterior cruciate ligament allows  achieving anatomical reconstruction of the anterior cruciate ligament, optimal function of the knee joint,  reducing pain, significantly reducing the risk of developing knee instability, ruptures and abruptions of the autograft in the postoperative period due to an individual approach, increasing the strength of the autograft and the strength of its fixation in the bone canals.

Introduction. The urgency of the problem of surgical treatment of hammer-like deformity of the toes is due to the incidence of pathology, the presence of unsatisfactory results and postoperative complications.

Objective. Analysis of scientific literature devoted to the problems of surgical treatment of hammer deformities of the toes.

Materials. Analyzed domestic and foreign scientific publications on the classification and surgical treatment of hammer toes.

Results. The article presents an analysis of the classifications of hammer-like deformity of the toes and instability of the metatarsophalangeal joints and an analysis of treatment methods aimed at eliminating various manifestations of deformity, with a description of the complications that have arisen. The systematization of methods for correcting hammer-like deformity of the toes was carried out.

Conclusion. Analysis of the literature data allowed us to determine that the problems of treating hammer-like deformity of the toes are associated with the lack of a classification that would reflect the condition of the forefoot of each individual patient and allow choosing the optimal effective methods of treatment, as well as an algorithm for choosing tactics for surgical treatment of hammer-like deformity, which systematizes the methods treatment depending on the manifestations of deformity of the entire forefoot.

The article presents a case of successful surgical treatment of a patient with hammer-like deformity of the second toe associated with deformity of the first toe. During the preoperative examination of the patient, the length of the required shortening of the second metatarsal bone relative to the length of the third metatarsal bone was calculated on the X-ray in frontal projection and the length of the required shortening of the first metatarsal bone was calculated using a known method. To eliminate the deformity of the first toe, the author’s method of surgical treatment was used. To correct the deformation of the second toe, the proposed method was used, which includes the following steps: marking the lines of osteotomies during the operation; performing osteotomies along the outlined lines; removal of a free bone fragment; precise implementation of  the required shortening of the second metatarsal bone; fixation of the osteotomized fragments of the second metatarsal bone with a cannulated screw. As a result of the performed surgical treatment, correction of the hallux valgus and hammer-like deformity of the second toe was achieved.
The presented clinical case shows that in the surgical treatment of hammer deformity of the second toe, it is important to take into account the individual characteristics of the patient’s foot condition, namely, the ratio of the length of the second and adjacent third metatarsal bones. Preliminary calculation of the length of the required shortening of the second and first metatarsal bones on the roentgenogram, precise markings of the  osteotomy lines and the implementation of the necessary shortening contribute to achieving a balance in the ratio of the lengths of the metatarsal bones, restoring the optimal load distribution on the heads of the metatarsal bones, more accurate correction of the deformity of the second and first toes, and improving statodynamic function of the foot and reducing the risk of postoperative failures.

Introduction. At the present time there is increase the number of patients diagnosed with pseudomembranous colitis due to Clostridiodes difficile, respectively it significantly increases the frequency of hospitalizations, the length of hospital stay and the cost of treatment. Approved drug methods for correcting a  pathological condition are not always able to lead to recovery after the first use, repeated and prolonged courses of therapy are often required, especially with recurrent Clostridiodes difficile. An alternative way of treatment is fecal microbiota transplantation from a donor. Nowadays, fecal microbiota transplantation is included in national clinical guidelines in several countries in Europe, the USA and Australia. In Russia this method has not been registered, however, there are some publications about its successful application in gastrointestinal diseases, oncohematology, and some autoimmune diseases.

Aim. To show the result of successful treatment of severe pseudomembranous colitis after a single fecal microbiota transplantation.

Material and methods. Outpatient treatment of an acute respiratory infection with a broad-spectrum antibacterial drug caused the development of severe pseudomembranous colitis in a young patient. Standard courses of metronidazole and vancomycin were unsuccessful. Transplantation of fecal microbiota from a donor was performed via ileocolonoscopy.

Results. A single fecal microbiota transplantation contributed to the patient’s complete recovery, short term  rehabilitation and the absence of recurrence of Clostridiodes difficile within two years. Conclusions. Evidence-based medicine has shown the high efficiency of fecal microbiota transplantation. In Russia a legislative basis is needed for including fecal microbiota transplantation in clinical guidelines for the treatment of severe Clostridiodes difficile resistant to standard therapy.

Background. ERK1 and ERK2 (extracellular signal-regulated kinase) are related protein serine / threonine kinases that are involved in the regulation of the cell cycle, cell migration and survival, differentiation, metabolism, and proliferation. Evaluation of this cascade is promising to determine the possibility of influencing  pathological conditions through the regulation of ERK1/2.

Aim of the study. To assess the involvement of the ERK MAPK cascade in the development of adhesions in the abdominal cavity.

Methods. The experiments were carried out on male Wistar rats. The adhesion process in the abdominal cavity was simulated (n = 40). The research time is from 2 hours to 30 days. Tissue samples from 5 intact animals were examined as a control. Histological sections were prepared and stained histochemically for ERK1. The expression of ERK1 and ERK2 was assessed by PCR.

Results. Using the PCR method, the involvement of both the ERK1 and ERK2 cascades in the process was established, and, judging by the change in gene expression, the latter is more actively involved in the process. Histochemical study confirmed the role of ERK cascades in the management of repair in serous membrane injury. Histochemically revealed an increase in ERK1 expression with two peaks of activity – at 1 and 30 days.

Conclusion. Our data establish multichannel control of the reparative process in the area of damage to the serous membrane with the involvement of both the p38 and ERK MAPK cascades, which is important to consider when developing methods of influencing the wound healing process in the abdominal cavity. 

Epidural fibrosis is a dynamic pathological process that develops and progresses over time and is a polyetiological and multifactorial complication in the postoperative period during spinal surgery.

Aim of the study. To study the reparative process and the formation of epidural fibrosis and its effect on the shape of the dural sac in the area of laminectomy at different periods of wound healing.

Materials and methods. To assess the dynamics of the formation of epidural fibrosis and the involvement of the dura mater in this process, laminectomy was performed at the level of the LVI vertebra in 35 male Wistar rats at the age of 4–5 months. The animals were divided into 5 periods of withdrawal from the experiment on days 3, 7, 14, 21, and 28. The histological material was studied by staining with hematoxylin and eosin. To assess the deformation of the dural sac, the ratio of the diameter to the length of the canal was assessed on histological preparations in the laminectomy zone, and these measurements were carried out in a group of intact animals at the level of the LVI vertebra (n = 7).

Results. During the observation process, a change in the ratio of the sizes of the dural sac has been observed. In the period from days 3 to 14, the anterior-posterior size of the dural sac progressively decreases, in parallel, the transverse size increases, which leads to a change in its shape. On follow-up, some form correction occurs. It is possible that the change in the shape of the dural sac in terms of up to 14 days is due to edema, plasma saturation of tissues, as well as the growth of connective tissue. The subsequent decrease in edema and the restructuring of the newly formed connective tissue leads to a correction of the shape of the dural sac.

Conclusion. In the work, the dynamics of morphological changes in the zone of formation of epidural fibrosis during laminectomy in the experiment was assessed. The dynamics of changes in the lumen of the dural sac was established. The early involvement of the dura mater in the pathological process, its interest during the entire observation period was noted. Also, histological preparations show the involvement of the nerve fibers of the cauda equina in the pathological process from the early stages after surgery: vacuolization and destruction of nerve fibers, adhesion of fibers to each other and to the dura mater, as well as activation of endotheliocytes in the vasa nervorum.

The development of disturbances in energy processes and damaging free radical reactions in various pathological processes, including cardiovascular diseases, are interrelated and lead to a significant deterioration in the course of diseases.

Aim of the study. Research of the dynamics of malondialdehyde, creatine phosphate and lactate in the cardiac tissue of rats under experimental adrenaline stress and during its correction with neonatal, xenogenic, cardiac cells.

Methods. The experiment was carried out on outbred male rats. Adrenaline damage to the heart was simulated by a single subcutaneous injection of 0.1% adrenaline solution at a dose of 0.5 mg per 100 g of body weight. The first group (37 rats) was injected subcutaneously with adrenaline, the second group (41 rats) – adrenaline and isolated heart cells of a newborn rabbit at a dose of 500 000. The third group included 6 healthy rats.

Results. It was found that a spike in the level of malondialdehyde and, accordingly, the activation of free  radical processes in adrenaline damage to the heart, occurred during the restructuring of the energy of the  heart cell from intense glycolysis to the restoration of active mitochondrial ATP synthesis (which corresponded to the end of the depletion of lactate and creatine phosphate, and the beginning of the restoration of their content in heart cells).  The dynamics of MDA sensitively reflected both the activity and the inhibition of oxidative processes in mitochondria, which manifested itself, respectively, both in the form of peaks and in a low level of MDA and corresponded to the interpretation of the dynamics of lactate and creatine phosphate.
In the cardiac tissue of rats with transplantation of neonatal, xenogenic cardiac cells, the accumulation of lactate in the early stages of the experiment decreased, the subsequent depletion of the cellular reserves of creatine phosphate and lactate was inhibited, the period of inhibition (non-increase) in MDA was shorter, the subsequent increase in MDA was more moderate than in control animals.

Conclusion. The data obtained indicate that neonatal cardiac cells are able to limit the disturbance of aerobic and of anaerobic processes in the heart tissue and promote the restoration of mitochondrial energy processes.  Moreover, they contribute to a more efficient restoration of mitochondrial ATP synthesis, accompanied by a smaller burst of damaging free radical processes.

Background. Tick-borne encephalitis virus (TBEV) in nature exists due to the constant circulation between vertebrate animals and tick viruses. To study the characteristics of reproduction of TBEV in the cells of vertebrate hosts of various species, it is necessary to simulate infection in the cell lines of both natural and accidental hosts of TBEV.

Aim. To study the possibility of reproduction of TBEV in the cell line of the kidney of Siberian bat Myotis sibiricus (Kastschenko, 1905) – an accidental host of the virus.

Materials and methods. The cell line of Siberian bat M. sibiricus was established by serial passages of primary culture of kidney cells. The SPEV line porcine kidney cells were used as reference. Cells were infected with a strain of TBEV of the Siberian subtype 92M and both cells and cell culture fluids were sampled every 2 hours during first 24 hours post infection. In addition, the samples were collected daily up to 5 days post infection. Evaluation of the amount of intracellular RNA of TBEV of positive polarity (+RNA) was performed  using quantitative real-time PCR. The concentration of infectious TBEV was evaluated using the method of titration TBEV on plaque forming units.

Results. The continuous cell line, designated as MdbK, was established from the kidney cell suspension of M. sibiricus and was used for experiments after 20 serial passages. MdbK cells were able to support the replication of TBEV RNA and production of infectious virus was also possible. The concentration of intracellular RNA had reached 9.1 lg copies/μl by day 3 post infection, whereas highest titer of infectious TBEV in cell culture fluid had comprised 5,5 PFU/ml and was detected by day 4. The concentration of intracellular RNA and the virus infectivity in MdbK cell line was significantly lower than in convenient SPEV line porcine kidney cell.

Conclusions. The results suggest the low fitness of TBEV to the intracellular environment of an accidental host. 

Background. Violation of the regeneration of the tracheal wall after undergoing reconstructive surgeries remains an urgent problem of modern surgery. One of the reasons for the violation of the regeneration processes is insufficient blood supply to the organ. Finding new ways to improve blood flow is a promising area of research.

Aim. To evaluate the effectiveness of VEGF effect on the regeneration of the anterior tracheal surface in the early postoperative period.

Materials and methods. The study included 60 male Wistar rats at the age of 10 months. All animals underwent tracheal reconstructive surgery; the animals were divided into three groups: group 1 – without medicinal film, group 2 – with prolonged-release medicinal film, group 3 – with prolonged-release medicinal film containing VEGF. The sampling of histological material was carried out on days 3, 7 and 21 of the study, using morphometry to determine the thickness of the tracheal wall, the thickness of the postoperative scar, the area of the surgical intervention zone, the area of the vessels, the ratio of the thickness of the postoperative scar to the wall thickness trachea and the ratio of the area of the vessels to the area of the surgical intervention zone.

Results. It was revealed that when exposed to a long-acting medicinal film containing VEGF, significant histological changes occurred on day 7 of the study. In groups 1 and 2, healing occurred by day 21 and was accompanied by defects of the mucous membrane and cartilage. On day 7 in group 3, there was a complete epithelialization of the tracheal wall, an increase in the number of newly formed vessels and glands in the area of surgical intervention. Healing was carried out with a thin postoperative scar without defects in all layers of the tracheal wall.

Conclusion. The results obtained indicate the stimulating effect of VEGF on the regeneration of the tracheal wall in the early postoperative period after undergoing reconstructive surgery. The use of VEGF reduces the time of postoperative wound healing and preserves the anatomical structure of the tracheal wall.

Background. The development of new methods for delivering biologically active substances to the surgical site is a promising area of modern surgery. One of the biologically active substances used to stimulate regeneration is the vascular endothelial growth factor (VEGF). The search for ways to gradually and over a long period of time deliver VEGF to the surgical site is a promising area of research.

Aim. To develop a method for delivering VEGF to the surgical site and to assess its elimination in the early postoperative period.

Materials and methods. The study included 78 male Wistar rats at the age of 10 months. All animals underwent reconstructive surgery on the trachea, the animals were divided into 3 groups: group 1 – without a medicinal film, group 2 – with a medicinal film of prolonged action, group 3 – with a medicinal film of prolonged action containing VEGF. Blood sampling was carried out on days 1, 3, and 21 of the study, using the method of enzyme-linked immunosorbent assay to determine the level of VEGF in blood plasma, the unit of measurement was pg/ml.

Results. A long-acting medicinal film containing VEGF has been developed. It was revealed that the use of a medicinal film containing VEGF significantly increases the VEGF index in blood plasma by 26 times starting from the first day of the study and remained high throughout the study.

Conclusion. The results obtained indicate the effectiveness of the developed medicinal film of prolonged  action. Elimination of VEGF starts from the first day of the study and lasts up to 21 days. High VEGF indices,  according to the authors, are associated with the exogenous introduction of VEGF into the animal organism in the form of a prolonged-action film and the induction of endogenous VEGF in rats.

Today in Irkutsk region, we face a noticeable increase in the number of cases of ixodid tick sucking to urban residents. Ticks, found in the territory of Irkutsk city, were detected to have all currently known pathogens causing such serious diseases as tick-borne encephalitis, tick-borne borreliosis, monocytic ehrlichiosis, granulocytic anaplasmosis, rickettsiosis and tick-borne recurrent fever. These diseases may develop to severe  forms, and lead to disability or even death.  

The aim of the study was to evaluate the opinion of parents and doctors on vaccination against tick-borne viral encephalitis in Irkutsk based on the data of an anonymous questionnaire survey.

Material and methods. The descriptive retrospective epidemiological study was conducted between November 2018 and January 2019. It included 1620 parents and 193 doctors of various specialties in Irkutsk. Statistical processing of the material was carried out using Excel tables (Windows 2010) and the Statistica 6.0 program.

Results and discussion. In general, the attitude towards vaccination looks positive – 98 % of the parents vaccinate their children. 11.3 % of parents vaccinate their children from tick-borne encephalitis, 23.3 % of doctors vaccinate themselves. Every fourth doctor vaccinates his child against this infection.

Conclusion. Insufficient vaccination coverage against tick-borne encephalitis is noted both among the population and among doctors of Irkutsk. It is important to introduce health education for the population and to adopt new ways for improving the qualifications of doctors in immunization issues.