In recent years, the understanding of the mechanisms involved in the regulation of lipoapoptosis signaling pathways has expanded considerably. However, many mechanisms of apoptosis induction by lipids as well as molecules mediating intracellular and systemic signals belonging to AOS/enzyme-dependent phospholipid metabolites are not completely clear.

This review summarizes the current understanding of the mechanisms of apoptotic cell death induction by some lipid molecules. Literature search was performed in the database “PubMed”, “eLIBRARY” using key words: “apoptosis”, “lipids”, “fatty acids”, “eicosanoids”, “reactive oxygen species”.

A brief characterization of the signaling pathways of apoptosis is given. The role of reactive oxygen species and their dependent products of lipid peroxidation in the regulation of the main signaling pathways of apoptosis are shown. Particular attention is paid to the product of phospholipid metabolism – 4-hydroxynonenal.

Pro- and anti-apoptotic effects of some prostaglandins are demonstrated. Arguments are presented that prostaglandins of series J and D are pro-apoptotic in most cells, and this effect depends on activation of the prostanoid receptor DP2 and on reduction of AKT kinase activity. In contrast, the E-series prostaglandins and hydroxyecosatetraenoic acid act opposite to the J-series and D-series prostaglandins, reducing apoptosis by activating AKT and increasing Bcl-2 protein expression.

The role of individual fatty acids involved in the initiation and transduction of pro-apoptotic and anti-apoptotic signals is assessed. It was shown that saturated fatty acids have the maximum damaging potential than their unsaturated counterparts. An in-depth understanding and deciphering of the mechanisms by which lipids and their metabolites modulate the activation of signaling pathways of programmed cell death can help to develop therapeutic strategies to prevent a number of diseases associated with impaired regulation of apoptosis.

The aim. To study the dynamics of primary disability due to diseases of the digestive system (DDS) in the Irkutsk region for 2009–2020 in adults, its possible causes in comparison with the dynamics of morbidity and mortality of the population.

Materials and methods. The database of persons recognized as disabled for the first time due to the DDS in the Irkutsk region were analyzed by the solid method. The share in percent and the level of primary disability per 10,000 of the adult population were calculated. DDS morbidity and mortality were analyzed according to the forms of state statistics, the indicators were calculated per 100,000 population. In addition, data on the analysis of the causes of death provided by medical organizations for each person who died from DDS was studied.

Results. The number of people recognized as disabled for the first time due to DDS decreased by 2.2 times for the analyzed years, the level of primary disability for 2014–2020 – by 1.9 times. The main contribution to the primary disability due to DDS all the years was made by cirrhosis of the liver. Primary incidence of DDS in the Irkutsk region in the adult population for 2009–2019 increased by 1.5 times (the decline in 2020 was caused by the cessation of dispensary examinations due to the epidemic of a new coronavirus infection). Mortality due DDS increased from 2017 to 2020 by 1.3 times. The main contribution to mortality is made by alcoholic causes – primarily liver cirrhosis, acute pancreatitis.

An analysis was made of changes in regulatory documents according to the criteria for establishing disability to clarify the reason for the decrease in disability rates due DDS at the same time with an increase in morbidity and mortality.

Conclusion. It is not possible to explain the decrease in the proportion and level of primary disability due to DDS only by improving the quality of medical care with an increase in morbidity and mortality. A certain contribution to the reduction of disability rates was made by changes in the normative documents on the establishment of disability, starting from 2014.

Chronic scrotal pain (CSP) is a general term, which defines variety of problems causing discomfort or pain in the scrotum, which can be caused by the problems with testicles and other structures of the scrotum: epididymis, vas deferens, paratesticular structures. For a practicing urologist, the diagnosis and treatment of chronic scrotal pain is always a difficult task due to the many reasons for its appearance and the variety of clinical symptoms. CSP is a widespread but poorly understood condition, the etiology of which often can not be identified. Pain localized in the scrotum makes up 38.8 % of all cases of chronic men’s pelvic pain. From 2.5 to 4.8 % of all visits to the urologist relate to CSP syndrome. Primary scrotal pain syndrome is not associated with infection or other local pathological processes that could cause pain. The treatment of chronic scrotal pain is challenging because the pain often does not react to the traditional treatments.

The purpose of this lecture is to draw the attention of urologists, general practitioners, and everyone who is interested in the problem of treating chronic scrotal pain to the possibilities of modern medicine in solving this multidisciplinary problem.

Introduction. At present, considering active participation of people in the elimination of wildfires, the study of the effects of smoke on the reproductive system is an urgent scientific problem.

Materials and methods. Sexually mature outbred male rats were exposed to a daily four-hour inhalation exposure to smoke for one month. Immediately after the end of the exposure, some of the animals were removed from the experiment, and some were left to survive for two months. The study on testicular samples included counting the total number of spermatogonia, the number of tubules with desquamated epithelium, as well as determining the spermatogenesis index and the number of Leydig cells.

Results. The effect of forest fire smoke on the reproductive system of model animals (outbred laboratory rats, males) was characterized by a decrease in the spermatogenesis index with a simultaneous decrease in the percentage of spermatogonia and the number of Leydig interstitial cells. The indices of the reproductive system of animals left for survival did not differ from the control values.

Discussion. The results of this study suggest that prolonged exposure to combustion products released during a forest fire negatively affects the reproductive function of male laboratory rats examined immediately after the end of the exposure. After the course of the standard cycle of spertatogenesis, the indicators characterizing the development of sperm and the generation of male sex hormones are restored to normal, which indicates a high plasticity of the male reproductive system in response to the adverse environmental factor – smoke of forest fires.

Background. According to the literature data, long-term and poorly controlled hypertension (HTN) leads to target organs damage, and in some cases, to the development of associated diseases, the severity of which in men may be partly due to the characteristics of the androgenic status.

The aim: to reveal the features of hormonal indicators of androgen status and their relationship with the anthropometric and metabolic characteristics of the therapeutic clinic male patients, depending on the severity of HTN.

Materials and methods. 296 men aged 59,0 [54,0; 65,0] years with confirmed HTN were examined. All study participants in the morning on an empty stomach underwent anthropometry, determination of metabolic and androgenic status, and assessment of comorbid burden. Depending on the severity of hypertension, all patients were divided into two groups (G): G1 (n = 134) – patients with hypertension without a history of coronary artery disease or stroke; G2 (n = 162) – patients with hypertension with a history of ischemic heart disease (IHD) and/or stroke.

Results. In male patients of G2 with severe HTN, a decrease in the levels of free testosterone (FT) and, to a greater extent, dehydroepiandrosterone sulfate (DHEA-S), as well as total cholesterol, high and low density lipoproteins, was revealed. The correlation analysis performed revealed statistically significant negative correlations between the levels of total testosterone (TT) and FT with body mass index, the value of the ratio of waist circumference to hips, only the level of FT – with the presence of IHD, chronic heart failure (CHF), disorders of carbohydrate metabolism and abdominal type of fat distribution, and the level of DHEA-S – with the presence of IHD and CHF.

Conclusion. A decrease in FT and DHEA-S is associated with early progression of atherosclerosis and the risk of developing HTN-associated cardiovascular events, which can aggravate the course of HTN.

Introduction. Important links in the pathogenesis of cold alterations are vascular damage and powerful systemic alterations. The presence of premorbid pathology and the duration of the wound process negatively affects to the function of most organs and systems, including the kidneys. Renal insufficiency in patients with frostbite develops in the acute period of cold damage. This is indicated by a decrease in the amount of urine and an increase in creatinine levels in victims with frostbite. In this regard, the identification and analysis of the dynamics of new markers of renal dysfunction in patients with frostbite is promising both from a scientific and practical point of view.

The aim. To investigate the dynamics of changes in serum creatinine, NGAL and cystatin C levels in patients with local cold trauma.

Materials and methods. The study included 60 patients with frostbite of the III–IV degree of distal limb segments. The study was carried out depending on the volume of the lesion and the timing from the moment of cryoalteration.

The results of the study. In patients with grade III–IV frostbite, an increase in the level of lipocalin and serum creatinine was detected in the blood. The concentration of lipocalin and serum creatinine is directly proportional to the volume of cold-affected tissues. Indicators of lipocalin and serum creatinine decrease in the late stages of cryopreservation. The level of cystatin C significantly decreases during all periods of frostbite; the concentration of the latter does not depend on the severity of cryopreservation.

Introduction. According to the literature, the development of adjacent-level syndrome 10 years after posterior rigid stabilization is noted in 6.7–80 % of patients, of which 24 % require revision surgery.

The aim: to conduct a comprehensive analysis of the results of surgical treatment of patients with degenerative diseases of the lumbar spine using rigid fixation systems.

Materials and methods. A multicenter retrospective study of the results of surgical treatment of 268 patients with degenerative-dystrophic diseases of the lumbar spine, who underwent mono- or bisegmental decompression-stabilizing intervention with the implementation of the TLIF (Transforaminal Lumbar Interbody Fusion) technique and open transpedicular rigid fixation, was conducted. The study included radiography, MRI and CT (in 2-energy mode) of intervertebral discs and isolated facet degeneration of the upper adjacent level.

Results and discussion. The combination of the initial degeneration of the adjacent spinal motion segment in the form of disc degeneration of grade III and higher according to Pfirrmann with threshold values of the density of the outer cartilaginous plate from 161.7 ± 18.8 to 164.8 ± 14.2 HU, the density of the outer facet – from 702.43 ± 12.3 to 713.65 ± 13.6 HU and the density of the inner facet – from 580.5 ± 11.6 to 582.1 ± 15.1 HU, as well as with signs of segmental instability of the adjacent segment can be considered as risk factors for the development of its degeneration. With the progression of degeneration of the upper intervertebral disc, revision interventions were performed within 12–60 months after surgery.

Conclusion. Bisegmental stabilization with signs of initial degeneration in the intervertebral disc and facet joints in the upper segment has proven its clinical and instrumental effectiveness in the period of 36 months and reduces the risks of developing degenerative disease of the adjacent disc.

A clinical case of successful treatment of hemicrania continua with ophthalmic symptoms using acupuncture is presented.

Chronic headache (CH) is an important medical and social problem. The fact is that CH is treated mainly medication-based. About 63 % of patients have to take analgesic and nonsteroidal anti-inflammatory drugs for a long time, while in most cases there are signs of drug overdose, which increases the risk of complications and side effects.

The presented clinical case showed the acupuncture effectiveness in hemicrania continua with ophthalmic symptoms in a 23-year-old patient.

Since the age of 13, the patient has been observed and repeatedly treated with complaints of persistent headaches on the left, pain in the left eye and decreased vision, accompanied by nausea, dizziness, weakness, fatigue, sleep disturbance. In 2019, against the background of constant daily intake of indomethacin, at a dosage of 9 tablets (225 mg) and a short course of glucocorticosteroids, positive dynamics of the left eye side and relative remission on the part of the pain syndrome were achieved. At the same time, choroidal ischemia with retinal edema persisted, headaches periodically occurred. Acupuncture had been performed during 6 months, 1–2 times every 14–28 days, depending on the patient’s condition, against the background of a gradual reduction in the dose of indomethacin. Complete remission has been achieved. After the end of treatment and complete withdrawal of the drug the patient has been under control for more than 3 months. The patient’s condition is satisfactory, no complaints.

Background. Keratitis, characterized by superficial inflammation, cellular infiltration and vascularization of the stroma with minimal involvement of the corneal epithelium and endothelium, is an extremely rare specific condition, that has been isolated, as a separate nosology – linear interstitial keratitis.

The aim. Clinical case demonstration of linear stromal keratitis, using modern methods of corneal examination and world literature analysis, devoted to this problem, from the point of view of determining disease etiology.

Materials and methods. Case demonstration of linear keratitis in a young patient with a recurrent course of the disease is presented.

Results. Рresented clinical case confirms course features and lesion morphology of linear interstitial keratitis.

Conclusion. Linear interstitial keratitis is a rare clinical phenomenon, and its etiology remains uncertain. Confocal microscopy is a promising method of studying linear interstitial keratitis in view of best resolution. Coherent tomography of anterior segment of the eye, is uninformative and does not reflect true depth of the pathological process. Mirror microscopy of endothelial cells confirms confocal microscopy data of panstromic process. Herpes simplex virus and pale treponema roles in the development of linear interstitial keratitis has not been confirmed by existing standard laboratory methods.

Central serous chorioretinopathy is a disease that occurs in young people and causes a significant decrease in visual functions. In some cases, the pathological process acquires a chronic course, the treatment of which remains an urgent problem. Unfortunately, the available methods of conservative treatment of this problem do not have proven effectiveness, and laser treatment methods do not always lead to rapid and persistent remission and do not guarantee the absence of relapses of the disease.

The aim of this study. To evaluate the effectiveness of the treatment of this pathology using a combined treatment method: a combination of transpupillary thermotherapy of the optic nerve disc with micropulse laser exposure to the retinal neuroepithelial detachment zone in the treatment of patients with chronic central serous chorioretinopathy.

Patients with chronic central serous chorioretinopathy were divided into two groups: patients who were treated with simultaneous application of laser exposure in micropulse mode (wavelength – 577 nm) with a single session of transpupillary thermotherapy on the optic nerve disc area (wavelength – 810 nm); and patients whose treatment consisted in laser exposure in micropulse mode (wavelength – 577 nm). In patients of the combined laser treatment group, there was an improvement in visual acuity after a month and a half from the start of therapy in 84 % of cases, whereas in patients who received only micropulse laser exposure it happened in 57 % of cases. A noticeable improvement in the linear blood flow rate in the posterior short ciliary arteries according to the ultrasound triplex examination of the eye vessels was also observed in the combined treatment group: the blood flow rate increased by 36 %, in the other group the blood flow rate did not significantly change. Also, in the combination therapy group, only 1 relapse of the disease was detected within 24 months, while in the second group, relapses were observed in 8.7 % of cases. Subjectively, patients from the combined treatment group noted a faster disappearance of complaints of visual discomfort.

Background. Targeted therapy in patients with cystic fibrosis, which aims to restore the function of the cystic fibrosis transmembrane conductance regulator protein, is currently revolutionary in the treatment of the disease. The first drug available in Russia for the treatment of patients with this genetic disease is lumacaftor/ivacaftor (Orkambi®), which was registered on December 2, 2020.

The aim. To study the efficacy of lumacaftor/ivacaftor during 12 weeks of administration in children in Astrakhan region.

Materials and methods. This article presents the clinical experience of Orkambi medicine use in 3 children with F508del/F508del genotype and a severe course of cystic fibrosis for 12 weeks. According to the study design, such indices as body mass index, indexes of external respiratory function, character of respiratory tract microbiota, level of chloride in sweat fluid and pancreatic elastase in feces, dynamics of biochemical blood indexes were evaluated. The study was performed within the time periods specified in the study protocol, namely, before the start of therapy, 2, 4, and 12 weeks of treatment.

Results. Two patients had a decrease in sweat test values by 11 and 19 mmol/l from the baseline, a significant increase in forced vital capacity of lungs. One patient had an adverse event in the form of hepatobiliary disorders manifested by increased liver transaminase activity, which was the reason for discontinuing the drug.

Conclusions. The short-term experience of using pathogenetic therapy with lumacaftor/ ivacaftor in children in the Astrakhan region demonstrated both the expected effect on chlorine channel function and the possibility of side effects, including severe ones, that can lead to withdrawal of the drug.

Relevance. Thyroid diseases in children and adolescents rank first in the structure of endocrine pathology. An issue related to comparability of data on prevalence obtained with different procedures is vital given the necessity to intensify activities aimed at optimizing prevention of thyroid pathology.

The aim. Comparative analysis of pathological lesions of thyropathies and the prevalence of thyroid gland diseases in children and adolescents living in the territory of the Perm region.

Materials and methods. Prevalence of thyroid diseases was analyzed based on data taken from Statistic Form No. 12. Pathological damage caused by thyroid diseases was calculated based on results produced by medical examinations that included laboratory tests, ultrasound scanning of the thyroid gland, and a check-up by an endocrinologist. Calculation results were then compared with data taken from statistic reports. Influence exerted by sex and age on the growth in thyrotrophic hormone contents and thyroid gland volume was assessed by analyzing values in one-factor logistic regression models.

Results. Prevalence of thyroid diseases, endemic goiter and subclinical hypothyroidism tends to decrease among children living in Perm region (р = 0.003–0.015) but prevalence of thyroiditis remains stable (р = 0.794). Having assessed prevalence among teenagers, we did not reveal any dynamics in prevalence of thyroid diseases and thyroiditis (р = 0.129–0.248); prevalence of endemic goiter went down in this age group (р = 0.008) whereas prevalence of subclinical hypothyroidism grew due to iodine deficiency (р = 0.012). The difference between pathological damage and prevalence of thyroid diseases reached 4.8–38.6 times. Having analyzed created logistic models, we were not able to identify sex or age as predictors of thyroid pathology occurrence.

Conclusion. Prevalence of thyroid pathology was established to be by 4.8–38.6 times lower than pathological damage. Iodine deficiency on a given territory calls for developing regional medical and prevention programs aimed at diagnosing and preventing thyroid diseases caused by it.

The article presents a discussion of the study results of the effectiveness of treatment of newborns infants with hypoxic ischemic encephalopathy using device-induced therapeutic hypothermia which were obtained by a group of researchers (Zarubin A.A. et al.) in comparison with the results of Russian and foreign researchers.

Rationale. The article provides an analysis of the features of the organization of coloproctological care for the population of the Perm Territory, taking into account regional morbidity rates, which made it possible to identify a number of significant shortcomings. There is no connection between the volume of specialized coloproctological care provided and the real need of the population. It was revealed that 32.0 % of coloproctological patients are being treated by doctors of other specialties. In 2018, 47,172 cases of coloproctological diseases were registered, and only 30,900 specialized outpatient appointments were made in the region (11.7 appointments per 1,000 population). More than half of them (57.4 %) were held in Perm.

The aim of the study. Determination of the features of the organization of coloproctological care for the population of the Perm Territory, considering the incidence rates.

Materials and methods. An analysis was made of the distribution among the adult population of the Perm Territory of pathologies related to the profile of coloproctology according to official statistical reports and the report of the chief specialist of the region for 2018.

Results. In 2018, 3.9 sigmoidoscopies per 1,000 population were performed and 1.7 fibrocolonoscopies per 1,000 population, which led to an insufficient level of diagnosis of coloproctological pathologies. At the same time, identified for the period 2004–2018, a significant increase in the incidence of colorectal cancer (by 48.1 %), with an average annual growth rate over 15 years of 7.8 %, which is 3 times higher than the national figure, requires a change in approaches to the organization of coloproctological care, incl. for early diagnosis.

Conclusion. Thus, in order to improve the quality of early diagnosis of coloproctological, and especially onco-coloproctological diseases, it is required to optimize the outpatient specialized coloproctological care in the Perm region. It is proposed to reorganize the service with the aim of organizing a primary link on the basis of an outpatient coloproctology center with a daily stay hospital, separate or at the coloproctology department of the City Clinical Hospital.

Osteoporosis is the most common metabolic bone disease. However, because it is asymptomatic, it cannot be diagnosed until a clinical event such as a fracture occurs. It is osteoporotic fractures, not osteoporosis itself, that lead to noticeable clinical and economic consequences.

The aim. To study the frequency of osteopenia and osteoporosis in the older age group of the population of Kyrgyzstan using ultrasound bone densitometry.

Materials and methods. A total of 1988 people were examined – 1105 women, 883 men. By age, the patients were divided into three age groups: 40–59, 60–74 and 75–90 years old. A portable ultrasonic bone densitometer SONOST-3000 (South Korea) was used to measure bone mineral density.

Results. The prevalence of osteoporosis, osteopenia, and normal bone mineral density in the first age group was 20.9 %, 40.0 % and 39.1 %; in the second group – 30.2 %, 38.9 % and 30.9 %, and in the third group – 39.9 %, 34.9 % and 25.2 %, respectively. The incidence of osteoporosis increased with age and was gender-dependent – more common in women (p < 0.05 and p < 0.041, respectively). The probability of developing osteoporosis was lower in patients with a higher body weight (p < 0.002). Smoking had a bad effect on bone density (p < 0.001), physical exercise, on the contrary, inhibited the development of osteoporosis (p < 0.001). The use of alcohol and tea had no effect on the development of osteoporosis in our study (p = 0.421, p = 0.387, respectively).

Conclusions. The study of osteoporosis from an epidemiological point of view in Kyrgyz residents revealed a higher-than-expected incidence of osteoporosis according to densitometry. Further large-scale studies are needed throughout the country, which will help to understand the outcome of low bone mineral density in the population of Kyrgyz residents.

All over the world, the timber industry is one of the most physically hazardous industries. Working in such conditions is accompanied by an increase in the risk of unfavorable functional states and a critical decrease in professional reliability. Monitoring the workers’ state during the shift period will allow to determine the adaptation degree of personnel to work, as well as to identify the days of the shift arrival with a high risk of injury caused by the unfavorable state of workers.

The aim. To identify and describe the functional states dynamics of loggers during the entire shift period in the Far North as their adaptation degree to work.

Methods. Objective: collection of saliva for the determination of cortisol, psychophysiological instrumental methods; projective: M. Luscher’s color test; subjective – questionnaire “Well-being. Activity. Mood” by V.А. Doskin et al.; statistical methods: descriptive statistics. The study involved 24 shift workers of a logging enterprise, with whom we conducted daily monitoring of objective, projective and subjective characteristics of their functional state in the morning and evening during a fourteenday shift visit.

Results. According to the objective, projective and subjective indicators of functional states, their consistently favorable level is observed with multidirectional peaks during the shift change period and a slight decrease at the end of the shift, which demonstrates the staff’ adaptability to work. The operator performance is somewhat higher in the second half of the shift period, but in general it is below average due to the reduced quality of task performance. An increased free cortisol level was revealed in employees during the entire shift period with a high functional reserves level of the body. During the shift change period, the risks associated with the efficiency and safety of labor increase, which undoubtedly requires consideration by the management of enterprises.

The desire to realize oneself is characteristic of people, regardless of the state of health.

The scientific problem is based on the need to study the conditions, resources and psychological consequences that ensure self-realization of persons with atypical development in comparison with typically developing people.

The aim of the study. To analyze the specifics of self-realization of people with typical and atypical development, its resources and consequences.

Methods. The sample included 93 people with normative and impaired development (impaired vision, hearing, musculoskeletal system, somatic diseases). Questionnaire methods were used: the test of judgments of self-realization of the personality by S.I. Kudinov; hardiness test of S. Maddi, D.A. Leontiev and E.I. Rasskazova; scale of subjective happiness by S. Lubomirsky and H. Lepper (adapted by D.A. Leontiev and E.N. Osin); scale of subjective well-being A. Perrudet-Badoux (adapted by M.V. Sokolova); self-compassion scale by K. Neff (adapted by K.A. Chistopolskaya et al.); scale of subjective vitality R.M. Ryan and S. Frederick (adapted by L.A. Alexandrova); coping strategies evaluation questionnaire COPE by C. Carver et al. (adapted by T.O. Gordeeva et al.); as well as an author’s interview.

Results. Characteristics of self-realization of persons with typical and atypical development do not have significant differences. Subjects with developmental disorders are more likely to be pessimistic in the context of self-realization. The most successful areas of self-realization for people with atypical development are personal growth and family relationships. In areas related to contacts with the external environment (study, leisure, interpersonal interaction), people with typical development are more realized. The specifics in the aspects of self-realization, components of resilience, subjective well-being, sympathetic attitude towards oneself and preferred coping strategies are revealed.

Conclusion. There is specificity in the aspects of self-realization, its resources and consequences in people with typical and atypical development.

A case of successful treatment of a patient with a periprosthetic fracture of the femur is described. The fracture occurred one day after total hip replacement as a result of a fall, possibly associated with postoperative conduction analgesia. Lower limb large joints total replacement may become the most frequently performed type of elective surgery already in the current decade. The increasing prevalence of osteoporosis, osteoarthritis, rheumatic diseases and hip fractures is an objective prerequisite for it. Despite of all efforts, the problem of postoperative pain control during these surgical interventions currently remains unresolved. There is currently no “gold standard” for pain relief after total hip and knee replacement surgeries. An excellent ratio of effectiveness and safety is demonstrated by multimodal pain relief programs based on peripheral nerve blocks. However, while having undeniable advantages, conduction anesthesia/analgesia has a critically important drawback. The cornerstone of postoperative rehabilitation for patients undergoing total hip or knee replacement is their early activation. All methods of conduction anesthesia are associated with motor blockade. In particular, femoral nerve block causes weakness of quadriceps muscle of thigh, inducing patients’ inadvertent falling when attempting to stand or walk. The situation with the choice of the method of anesthesia after total replacement of the lower limb large joints can be described as “a long way to go”.

A clinical case of successful radical multi-stage surgical treatment of a patient with bilobar parasitic lesion of the liver with echinococcosis complicated by infection of one of the cysts is presented. The patient was admitted to the clinic with volumetric lesions in both lobes of the liver. At the stage of differential diagnosis, on the basis of process verification by puncture biopsy under ultrasound control, the ethiology of mass lesions was reliably established. At the primary stationary stage, infection of one of the echinococcal cysts was diagnosed, for which the cyst was drained under ultrasound control. After that, the patient was discharged to the outpatient care for compensation, correction of the general level of health and nutritional status. At the next stage of the inpatient examination, the patient was determined to have an insufficient level of functional reserves of the liver to perform a radical operation. For this reason, laparoscopic ligation of the right branch of the portal vein was performed in order to develop vicarious hypertrophy of the contralateral lobe. After 30 days, the increased level of functional reserves of the liver made it possible to plan radical surgical treatment with an acceptable risk for the patient. The operation was performed in the amount of right-sided extended hemihepatectomy with marginal resection of the 3rd segment of the liver. The symptoms of liver failure in the postoperative period according to the ISGLS scale were regarded as Grade A. The patient was discharged from the hospital in a satisfactory condition on day 10 after the operation. In the postoperative period, courses of therapy with albendazole were prescribed according to the standard scheme. The patient is under observation for more than a year after treatment. The condition is satisfactory. No recurrence of the disease was noted.

The current approach in the surgical treatment of ureteral calculi involves the use of endourological procedures such as retrograde ureteroscopy with lithotripsy or percutaneous antegrade lithotripsy in the proximal ureter. Ureterolithotomy as a treatment method is of an auxiliary nature and is used when endourological intervention is impossible or in case of intraoperative collisions during access conversion. However, there are several comparative studies on lithotripsy and lithotomy.

The aim. Comparative analysis of the outcomes of laparoscopic lithotomy and retrograde lithotripsy in the surgical treatment of proximal ureteral calculi, as well as the search for predictors of prolonged disability.

Materials and methods. A prospective randomized multicenter study included 53 patients with an established diagnosis of ureterolithiasis who were treated in the period 2018–2021 in urological hospitals in Irkutsk. All patients were divided into two comparison groups: Lithotomy group (group 1; n = 30) and Lithotripsy group (group 2; n = 23).

Results. When analyzing the results of the study, it was found that the level of complications of class II–III according to Clavien – Dindo was statistically comparable in both groups (p > 0.05). However, in absolute and relative terms, the prevalence of this indicator was noted during retrograde ureterolithotripsy. According to hard endpoints (reoperation, presence of residual stones or migration during the operation), 29 (96.6 %) patients of group 1 and 17 (73.4 %) patients of group 2 (p = 0.514) were successfully operated on.

Conclusion. Laparoscopic ureterolithotomy may be offered to patients with large proximal ureteral stones as an alternative treatment option with better residual stone freedom but generally similar overall outcomes and complication rates.

Background. Cerebral ischemia induced by transient middle cerebral artery occlusion is one of the most popular ischemic stroke models used to evaluate drug candidates with neuroprotective properties. The possibilities of combining this model with neurophysiological techniques (e.g., electroencephalography, electrocorticography, evoked potential registration, etc.) to assess the effectiveness of novel pharmacotherapeutic strategies appear to be of great interest to current biomedical research.

The aim. Identifying specific changes in somatosensory evoked potentials occurring after cerebral ischemia induced by middle cerebral artery occlusion in rats.

Materials and methods. A total number of 18 white outbred male rats were randomized into 3 groups by 6 animals in each: 1) control (presumably healthy animals); 2) ischemia-30 (30-minute middle cerebral artery occlusion); 3) ischemia-45 (45-minute occlusion). At post-surgery day 7, cortical responses to sequential electrical stimulation of left and right n. ischiadicus were registered. N1, P2, N2, P3, and N3 peak latencies and amplitudes, peak-to-peak interval durations and amplitudes were calculated. Spearman’s rank correlation coefficients were used to assess the relationship between ischemia duration and evoked potential parameters, and the Chaddock scale was used to qualitatively evaluate the strength of correlations.

Results. The rats subjected to cerebral ischemia demonstrated a decrease in some of the peak amplitudes of the ipsi- and contralateral somatosensory potentials evoked by n. ischiadicus stimulation. In the injured hemisphere, decreased P2 and N3 peak and P3–N3 interval amplitudes were registered ipsilaterally, and decreased P3 peak amplitudes and N2–P3 interval durations were observed contralaterally.

Conclusions. The obtained data suggest that somatosensory evoked potential registration and analysis can be used to evaluate the functional state of central nerve tracts in rats subjected to cerebral ischemia.

Background. There are unresolved issues in bone defect management associated with complications, invasiveness and long duration of treatment. The use of elastic implants made of bioactive biodegradable materials that take any form of defect could close many of them.

The aim. To investigate features of reparative regeneration in filling bone defects with an elastic degradable implant made of polycaprolactone (PCL) with and without hydroxyapatite (HA).

Materials and methods. The study was carried out on 10 adult mongrel dogs. A non-through cylindrical hole, 4 mm in diameter and 10 mm deep, was modeled in the upper third of the diaphysis of the tibia. The defects thus formed were filled with an elastic degradable implant made of polycaprolactone. In Group 1, HA was not added to polycaprolactone, while HA was added in dogs of Group 2. Radiographic and histological methods were used to study the results.

Results. It was found that the tested materials did not cause toxic and allergic reactions, both local and general, during intravital observations and in post-mortem anatomical preparations. After 28 days in both series, the implant biodegraded and was replaced by bone tissue. The proportion of the bone component and the numerical density of microvessels in the defect zone in Group 2 were significantly higher than in Group 1.

Conclusion. Elastic implants produced of polycaprolactone by electrospinning are biologically compatible, biodegradable and can be used to heal bone defects. Hydroxyapatite that was added stimulates the activity of osteogenesis.

Background. Due to the high prevalence of chronic venous insufficiency among the population, with a decrease in the quality of life of patients and their early disability, there is a need to develop modern effective and safe means for the prevention and treatment of this pathology. We have developed the optimal composition and technology of a gel for external use based on a nanobiocomposite of dihydroquercetin and arabinogalactan, which has a venoprotective effect. The article presents data on the results of a preclinical study of the safety and specific activity of the gel.

The aim. To study the specific activity (decongestant, antitranssudative action) and safety of a gel for external use based on nanobiocomposite of dihydroquercetin and arabinogalactan used for the treatment of chronic venous insufficiency in the framework of preclinical studies.

Materials and methods. The object of the study was a gel for external use based on dihydroquercetin and arabinogalactan nanobiocomposite. The study was conducted on 32 white male rats of the same age, for 15 days. The study of the pharmacological activity of a gel based on a nanobiocomposite of dihydroquercetin and arabinogalactan, was carried out on a model of acute venous stagnation in the tail of a rat (edema of non-inflammatory genesis), the dynamics of tail volume growth in the experimental and control group of animals was evaluated. The irritant effect of the gel on the skin of animals was also determined, the permeability of the capillaries of the skin was determined.

Results. When studying the pharmacological activity of the gel on a model of acute venous stagnation in the tail, it was shown that a soft dosage form for external use developed on the basis of nanobiocomposite of dihydroquercetin and arabinogalactan has decongestant and antitranssudative activity. The presence of a locally irritating effect in the gel under study has not been established in the framework of the experiment.

Conclusion. In the course of preclinical study of the gel of the nanobiocomposite dihydroquercetin and arabinogalactan on laboratory animals, its antitranssudative activity and safety have been proven.

Background. The spread of community-acquired pneumonia (CAP) in children and adults is interconnected and conditioned by natural, climatic and social factors.

The aim. To assess the relationship between the incidences of CAP in different seasons of the year with the location of educational institutions in the urban settlement.

Materials and methods. A cross-sectional study of the spatial distribution and seasonal dynamics of CAP cases in 2015 in a Siberian city with a population of more than 600 thousand people was carried out. Using GIS, 787 cases of CAP were analyzed among children of preschool and school age and adults. For statistical processing, 111 analyzed territorial units (ATUs) with an area of 250 m2 each were allocated on the maps. The dynamics of morbidity was assessed by weeks and seasons of the year among different age groups.

Results. There was a direct moderate correlation between the number of CAP cases registered during the year with the number of schools and preschool educational institutions in ATU (r = 0.59; p < 0.001). ATUs with the presence and absence of educational institutions differed in the number of epidemic foci of CAP among the total population in winter and spring. The maximum number of cases of CAP among children and adults was registered in the second half of winter (weeks 3–13), the minimum – in the summer months (weeks 25–34).

Conclusions. GIS analysis confirms the more frequent registration of CAP diseases among the total population in urban areas with educational institutions. There was established a direct moderate correlation between the incidence of CAP in children and adults by weeks of the year. Statistically significant differences in the number of cases in areas with and without educational institutions were noted in seasons with a higher incidence (autumn and winter).