The review presents evidence of the participation of low-density lipoproteins (LDL) modified by low molecular weight dicarbonyl compounds formed during freeradical oxidation of lipids (malondialdehyde) and carbohydrates in the development of endothelial dysfunction and atherosclerotic vascular lesions. The authors believe that it is they, and not oxidized (hydroperoxide-containing) LDL, that are the main factors of pathogenesis. The role of dicarbonyl-modified LDL in LOX-1 dependent induction of processes leading to the development of endothelial dysfunction is discussed. The results of studies proving that damage to the glycocalyx (a layer of macromolecules that prevent the development of endothelial dysfunction) covering the luminal surface of the endothelium is caused by hyperproduction of reactive oxygen species. Ways of pharmacological correction of free-radical oxidation processes are discussed, due to which inhibition of atherogenesis and diabetogenesis can be achieved.

Background. When developing methods for personalized diet therapy of obesity, an urgent task is to study the molecular genetics features of the obesity pathogenesis using in vivo experimental models in laboratory animals.

The aim. To determine metabolism effector links in obesity based on a comparative analysis of full-transcriptome profiles of the liver tissue of mice and rats of various strains.

Materials and methods. We carried out a comparative analysis of the changes in liver transcriptome in rats and mice fed with diets of excessive energy value and exerting lipogenic effect. Data of full-transcriptome profiling using DNA microarray technology have been presented previously in 8 publications.

Results. In three strains of mice treated with a high-carbohydrate high-fat diet (HCHFD), a significant differential expression (DE) of 1849 genes was revealed, of which 74 genes responded jointly in at least two groups of animals. In Wistar and Zuckerfa rats, 2109 genes responded to the consumption of HCHFD, of which 242 genes responded jointly in two groups of animals. For rodents different in genetic predisposition to the development of diet-induced obesity, the groups of genes that responded with the opposite sign of DE (depending on the genotype) in reaction to the consumption of HCHFD were identified. Bioinformatical analysis allowed establishing the presence of 43 metabolic pathways, which are targeted for the applied experimental diets exposure, in rats and 77 pathways – in mice. Four of these pathways – the pathway of retinoid metabolism, PPAR signaling pathway associated with it the previous one, xenobiotics metabolism and drugs metabolism mediated by cytochrome P450 system – responded in all groups of animals (except for female mice). The importance of the expression of Tat gene encoding tyrosine aminotransferase in the modulation of biogenic amines synthesis in diet-induced obesity was shown, which may represent a new neurometabolic regulatory function of the liver in response to the consumption of high-calorie diets.

Conclusion. The analysis of the results of full-transcriptome studies showed that within each studied species (Rattus rattus and Mus domesticus) and animal sex, a number of genetic variants with a greater or lesser predisposition to the development of diet-induced obesity phenotype can be identified; and at the same time, within these variants, there is a largely similar pattern in the response of metabolism effector links to hypercaloric dietary intake. This pattern creates new prospects for translating the results of transcriptomic and metabolomic studies of laboratory animals into clinical practice in order to substantiate new approaches to personalized diet therapy of alimentary dependent diseases in patients with different genetic predisposition to obesity.

Every year, 570,000 new cases of cervical cancer (CC) are diagnosed in the world, and 311,000 people die from this disease. CC is the fourth most common type of cancer and therefore the fourth leading cause of cancer death in women worldwide. Numerous data on the occurrence and development of cervical cancer indicate an association in most cases (up to 90 %) with human papillomaviruses (HPV) of high carcinogenic risk (HCR).

CC prevention strategies are based on screening, and deaths from this oncopathology can be prevented through vaccination and treatment with early detection of the disease.

In this review, much attention is paid to current issues of detection and prevention of HPV-associated pathologies, and cervical cancer in particular, aiming to summarize and analyze the latest international literature data on this issue. As a result of this study, it was shown that for countries implementing the National program of vaccination against HPV of high carcinogenic risk, a decrease in the incidence of both cervical pathologies of varying severity and other cancers associated with the HPV carriage was registered.

While effective implementation of actual experience and future advances in human papillomavirus vaccine prophylaxis may make it possible for all countries to move to the high levels of vaccination coverage required to eliminate HPV-associated pathologies, the results also suggest that the path to complete cervical cancer elimination as a global public health problem can be extremely difficult due to a number of existing limitations.

T helpers (Th) producing IL-17 (Th17) have high plasticity and under the influence of external conditions are able to redifferentiate into cells with a different phenotype, primarily in Th1-lymphocytes, forming a population that combines the characteristics of both Th17 and Th1 and has a high pro-inflammatory potential, as well as a unique ability to overcome histohematic barriers. These cells are currently assigned a key role in the pathogenesis of many inflammatory diseases, including autoimmune ones: they account for up to half of the lymphocytes present in infiltrates of inflamed tissues. The paper discusses the reasons for the increased plasticity of Th17 cells in comparison with the main T helper populations (Th1 and Th2) and considers in detail the mechanisms of formation of IFNγ producing Th17, taking into account not only the redifferentiation of mature Th17, but also possible alternative pathways, in particular, Th1 cell redifferentiation or naive CD4+T lymphocytes direct differentiation into cells with an intermediate Th1/Th17 phenotype. The main inducers of differentiation of IFNγ producing Th17 cells and the reversibility of this process are also discussed. Particular attention is paid to the methods for identifying Th1 polarized Th17 cells: this population is heterogeneous, and its size significantly depends on the type of markers used to characterize these cells – Th1/Th17-associated transcription factors, key cytokines, as well as chemokine receptors and other membrane molecules. As a result, the data in the works on this problem are poorly comparable with each other. The unification of approaches to identifying a population of Th1 like Th17 cells will solve this problem and make it possible to use an assessment of the size and activity of such a population as diagnostic or prognostic markers.

Background. Low-grade inflammation is currently one of the main risk factors for the development of adverse events in the cardiovascular system, including death from cardiovascular diseases or their complications that cause mortality in the postCOVID period.

The aim of the study. To assess the impact of health resort treatment in the conditions of the Southern Coast of Crimea on clinical and functional parameters, as well as on the level of systemic inflammation in patients after a new coronavirus infection.

Materials and methods. The study included 67 patients (54.9 ± 9.05 years) in the post-COVID period who underwent health resort treatment at the I.M. Sechenov Academic Research Institute of Physical Treatment Methods, Medical Climatology and Rehabilitation. Methods of health resort treatment included climatic treatment on the Southern Coast of Crimea, therapeutic breathing exercises, terrainkur, and various methods of respiratory therapy. In all patients, the study of the C-reactive protein (CRP) in peripheral blood upon admission and at discharge was carried out.

Results. Despite a statistically significant improvement in most clinical and functional parameters, the level of CRP and the number of leukocytes and their subpopulations in peripheral blood in patients who underwent health resort treatment did not differ significantly (p > 0.05) from the baseline values obtained upon admission at the I.M. Sechenov Academic Research Institute of Physical Treatment Methods, Medical Climatology and Rehabilitation. The CRP index upon admission and at discharge corresponded to the lower limit of the interval specific for low-grade inflammation (from 3 to 10 mg/l).

Conclusion. Our results indicate the lack of effectiveness of the presented plan of health resort treatment in the correction of low-intensity inflammation, as well as the necessity for deeper scientific research in the direction of studying the mechanisms of low-grade inflammation development and the methods of its management.

Background. There are many differences in chest pain symptoms between men and women in terms of location, nature, and additional symptoms. The issue of describing the differences in chest pain in men and women with acute coronary syndrome (ACS), as well as their correlation with changes in the electrocardiogram (ECG) and coronary angiography (CAG) remains relevant.

Methods. The study included 588 patients of the cardiology department of the Novokuznetsk City Clinical Hospital No. 1 from 2013 to 2017 with a diagnosis of ACS. Depending on the gender, the subjects were divided into two groups: Group I – 330 men; Group II – 258 women.

Results. ACS with ST elevation was more common in men (45.8 %) than in women (33.3 %; p = 0.002). There were no pathological ECG changes in women in 58.1 % of cases, in men – in 45.5 % (p < 0.001). ECG type Q/ST elevation was detected more often in men (45.8 %) than in women (33.3 %; p = 0.002). The absence of coronary artery lesions was observed in 27.9 % of men and 44.2 % of women (p < 0.001). Hemodynamically significant coronary artery stenosis was more common in men (57.6 %) than in women (38.7 %; p < 0.001). In a typical angina clinic, hemodynamically significant coronary artery disease in patients with Q/without ST elevation ACS was detected in 40.2 % of men and in 58.5 % of women (p = 0.002). In the atypical angina clinic, hemodynamically significant lesions of coronary artery were more common in men (40.6 %) than in women (34.1 %; p = 0.02).

Conclusion. In women atypical chest pains and intact coronary arteries were detected more often than in men, and hemodynamically significant coronary artery stenosis were found less often than in men. In men, a more pronounced pathology of the coronary arteries in ACS was revealed, in women – great difficulties in diagnosing ACS.

Background. High levels of cardiac troponin in the blood indicates myocardial injury, including those caused by intense exercises. Recent studies have shown that an elevation in the troponin concentration in the patients can be caused by the macrotroponin circulation. There is no data in the scientific literature describing this problem in athletes.

The aim. To identify the cases and possible causes of high blood levels of cardiac markers in athletes before and after endurance exercises.

Materials and methods. The study was conducted on 11 male cross-country skiers aged 15–21 years. The study included two stages: the first was conducted at the end of the preparatory period (November, 2020–2021), the second – in the middle (March) of the 2020–2021 competitive period. At each stage, two blood samples were taken from a vein: the first – in the morning on an empty stomach after a day of rest, the second – 12–14 hours after a high-intensity exercise. In the blood serum, the activity of total creatine kinase (CK), weight concentration of the cardiac isoenzyme of creatine kinase (CK-MB), and concentration of high sensitive troponin I (Tn) were measured.

Results. The activity of CK in athletes exceeded the upper limit threshold, and decreased from the preparatory (November) to the competitive (March) period. The concentration of CK-MB in response to exercise increased by 2 times and was not accompanied by the signs of myocardial injury. The most sensitive indicator, responsive to physical activity, was troponin I. However, the highest elevation of Tn in blood of one athlete, both before and after the exercise, was associated with the presence of macrotroponin without signs of myocardial injury.

Conclusions. An increase of muscle tissue injury biomarkers in blood, including the heart muscle (CK, CK-MB, and Tn), by 2–4 times is a typical reaction for the body of a cross-country skier to an intense exercise. High levels of troponin in the blood, both before and after training or competition, may be associated with the presence of macrotroponin.

Background. Neisseria gonorrhoeae is a facultatively anaerobic microorganism which is extremely demanding to the composition of a nutrient media and cultivation conditions. In a situation of the increasing shortage and cost of foreign components for the preparation of solid nutrient media, it is important to study the possibility of growing hard-to-cultivate microorganisms on domestically produced nutrient media.

The aim of the study. To evaluate the growth of gonococcus colonies on two types of solid nutrient media – chocolate agar with growth and selective additives prepared using imported reagents and chocolate agar with growth additives manufactured by “Gem LTD” (Moscow, Russian Federation).

Materials and methods. А reference strain of N. gonorrhoeae NCTC 12700/ ATCC 49226 and two types of chocolate agar (the first one – prepared in the State Scientific Center of Dermatovenerology and Cosmetology using imported components and the other one – from the domestic manufacturer “Gem LTD”) were used in the research.

Results. The equivalence of the growth properties of both studied types of nutrient media when cultivating pure gonococcus was revealed.

Conclusions. Ready-to-use chocolate agar with growth additives produced by “Gem LTD” can be successfully used in the laboratory for the cultivation of N. gonorrhoeae pure culture. Primary isolation of N. gonorrhoeae strains from clinical material is more appropriate to carry out on a medium that suppresses the growth of foreign microflora due to the inclusion of antibiotic additive. The organization of production of domestic bacteriological media for microorganisms with high nutrient requirements reduces the dependence of domestic microbiology on import and ensures their rapid delivery to laboratories.

Obesity is currently a major global public health problem. As a result, in recent decades there has been a growing interest in studying the impact of this disease on the functioning of the central nervous system. One of the least understood aspects is the impact that obesity has on sensory systems.

The olfactory and gustatory systems are closely related to various vital functions, such as the nocifensors activation, the stimulation of digestive reflexes. In addition, these sensory systems are known to play an important role in the mechanisms of food consumption through the regulation of appetite and satiety, influencing food choice and, therefore, they are involved in the development of obesity. A number of clinical studies have shown that obese patients are more likely to suffer from hyposmia compared to lean people of the same age.

The reasons why this relationship exists remain largely unclear. The aim of this review is to assess the available data on this topic and to identify new promising areas for further research. The review was conducted in the PubMed databases for 2017–2023.

Due to the high prevalence of sarcopenia among elderly and old patients, early prevention and treatment of sarcopenia and its complications are relevant. Protein supplements can be used to maintain muscle strength and mass during aging. The possibility of using branched-chain amino acids (BCAAs) in the treatment and prevention of sarcopenia in geriatric patients is of scientific interest. BCAAs promote the synthesis and inhibit the degradation of muscle tissue proteins, are involved in the regulation of tissue sensitivity to insulin, ammonia utilization, the tricarboxylic acid cycle, etc.

Search strategy. The search for scientific articles for literature review was carried out in the PubMed and PubMed Central databases. The selection criterion was scientific articles published up to December 2022. We used the following search keywords: “branched-chain amino acids”, “BCAA”, “body composition”, “sarcopenia”, “aging”. The 2019 European Working Group on Sarcopenia in Older People 2 (EWGSOP2) Consensus was included in the list of articles.

Conclusions. The possibility of using BCAAs in elderly and old patients for the prevention and treatment of sarcopenia is a relevant topic that continues to be actively studied. The effectiveness of BCAA supplementation in the diet is debatable as long as sufficient protein is consumed daily. On the other hand, BCAA supplementation may be justified in cases where it is not possible to consume enough high-quality protein in the diet. More research is needed on this topic.

Background. Acute cerebrovascular disorders are one of the main causes of severe disability in modern society. Russian and foreign researchers register the emerging trend towards rejuvenation of the patients with stroke, which, in turn, significantly increases the relevance of the treatment and rehabilitation of these patients at various stages.

The aim. To study the social and hygienic characteristics of the stroke patients and to determine their need for medical rehabilitation in the early recovery period.

Materials and methods. We studied the social and hygienic characteristics of 109 patients who had stroke in 2020 and 2021 and underwent rehabilitation in the specialized rehabilitation department of the Southern District Medical Center of the Federal Medical and Biological Agency, and determined their need for medical rehabilitation using the analytical method, the method of expert assessments and questionnaires.

Results. The average portrait of a patient with a stroke in the early recovery period is as follows: this is a man aged 61 to 70 years with a higher or secondary specialized education, unemployed, living in the city. Up to 30 % of stroke survivors were recognized as disabled; among which, the persons with more severe disability (groups I and II) predominate – up to 90 %. Implementation of rehabilitation measures in the acute period in the hospital and in the early recovery period in the outpatient clinic is carried out at a fairly low level. The percentage of patients being examined by a multidisciplinary rehabilitation team ranges from 17.4 to 10.1 %.

Conclusion. The availability of medical rehabilitation measures in a specialized rehabilitation center is quite limited; more than half of the surveyed contingent (52.3 %) experienced problems in obtaining a referral to treatment, about half of the respondents (46.8 %) waited up to 6 months for a referral, which indicates the need to expand the network of such institutions at the regional level.

Background. An increase in the number of older people with cognitive disorders, including dementia, is expected.

The aim. To study the risk factors for vascular dementia.

Material and methods. 39 patients with vascular dementia (ICD-10 diagnosis code F01) were examined. The comparison group consisted of 167 people. According to the MMSE (Mini Mental State Examination) scale, moderate dementia was detected in 56.4 % of cases, severe – in 43.6 %; in the comparison group, 94 % had mild and 6 % – moderate cognitive impairment.

Results. In the vascular dementia group, the following risk factors were registered significantly more often: ischemic heart disease – at the age of 70–79 years (57.1 %; p = 0.000) and in the group as a whole (56.4 %; p = 0.000); diabetes mellitus – at the age of 60–69 years (100 %; p = 0.005); arterial hypertension – at the age of 70–79 years (100 %; p = 0.000) and in the group as a whole (87.2 %; p = 0.000). In the comparison group, the frequency of body mass index over 25 was significantly higher at the age of 70–79 years (60 %; p = 0.000), 80 years and older (64.3 %; p = 0.037) and in the group as a whole (68.9 %; p = 0.000). Among people with moderate cognitive impairment, the following risk factors were significantly more common: coronary heart disease – at the age of 60–69 years (10 %; p = 0.001); diabetes mellitus – at the age of 70–79 years (40 %; p = 0.025) and in the group as a whole (50 %; p = 0.033), the frequency of body mass index over 25 – at the age of 80 years and older (70 %; p = 0.000) and in the group as a whole (100 %; p = 0.000).

Conclusion. Risk factors for the development of cognitive disorders (coronary heart disease, hypertension, diabetes mellitus, overweight) are potentially reversible; their timely detection can reduce the development of cognitive disorders and dementia.

Castleman disease is an extremely rare benign disease of the lymphatic system with an estimated incidence of 1–9 cases per 1,000,000. Its etiology remains unknown; interleukin 6 (IL-6) plays an important role in pathogenesis. Castleman disease has two clinical forms: localized (up to 90 % of cases) with a favorable prognosis, treated predominantly by surgical method; generalized (up to 10 % of cases) with less favorable prognosis, treated by pharmacological therapy. The diagnosis is rarely established at the preoperative stage.

The aim. To present a clinical case of diagnosis and treatment of Castleman tumor of a rare topical localization.

Results. A 66-year-old patient was admitted at the Abdominal Oncology Department of the G.E. Ostroverkhov Kursk Oncology Scientific and Clinical Center. Diagnosis: Retroperitoneal mass on the right found at the preventive examination; no peripheral lymphadenopathy was detected on ultrasound and computed tomography (CT). After the examination, a preliminary diagnosis was made: Gastrointestinal stromal tumor (GIST) of the small intestine mesentery.  Based on the results of the case conference, the decision was taken to perform a surgery – laparoscopic removal of the tumor under endotracheal anesthesia. For surgical approach, a fan-shaped arrangement of ports was chosen. The surgery had no complications. Intraoperative blood loss was 50.0 ml. The total operating time was 98 minutes.

According to the results of the histological study, the following diagnosis was made: Castleman disease, unicentric form, hyaline-vascular variant. En bloc surgery is the standard method for the treatment of localized forms of the Castleman disease. In all cases, long-term follow-up shows a long relapse-free period in almost all patients.

During follow-up examinations (ultrasound of the abdominal cavity and retroperitoneal space, CT of the abdominal cavity with contrast enhancement, CT of the chest), no disease recurrence was detected during the year of observation.

Castleman disease is a rare non-clonal lymphoproliferative disease of unknown etiology. A rare case of its retroperitoneal localization indicates that in cases with an uncertain nature of the peritoneal mass, Castleman disease should be included in the differential diagnostic search.

Background. The relevance of the treatment of hepatocellular cancer (HCC) is determined by a significant increase in the incidence rate and its high prevalence among primary malignant hepatic tumors.

The aim of the study. To summarize the experience of providing specialized medical care to patients with hepatocellular cancer.

Methods. We studied the direct results of treatment of patients with primary hepatic cancer treated at the Kuzbass Regional Hepatological Center for the period from January 2015 to August 2022. The materials for the study were medical records of patients with an established diagnosis of primary hepatic cancer, surgical records, results of pathohistologic examination. The exclusion criterion was diagnosed cholangiocellular carcinoma.

Results. During the period from 2015 to 2022, 59 patients with primary hepatic cancer were treated at the Kuzbass Regional Hepatological Center. Among them, hepatocellular cancer was diagnosed in 48 cases, cholangiocellular cancer – in 11 cases; radical surgery was performed in 12 patients with hepatocellular cancer; fatal outcome was noted in 1 (2.1 %) patient, complications in the postoperative period developed in 5 (41.7 %) cases and were ranked as I-3, IIIb-1 and IVb-1 according to Clavien – Dindo classification.

Conclusion. The degree of risk of severe post-resection hepatic failure should be considered one of the main criteria in choosing a strategy for radical surgical treatment. New surgical approaches (laparoscopic vascular isolation of the portal blood flow, using temporary hemostasis in laparoscopic hepatic resections and the device for its implementation) in resection surgery of primary hepatic cancer can improve the immediate results of treatment.

Background. Sclerochoroidal calcification is an idiopathic rare benign lesion of the sclera or choroid characterized by histological deposition of calcium pyrophosphate. Taking into consideration its similar clinical manifestations with other diseases of the sclera, the most dangerous of which are malignant, timely verification of the diagnosis with the appointment of a further observation period is important.

The aim. The description of a clinical case of sclerochoroidal calcification to improve the efficiency of disease detection through the use of multimodal diagnostics.

Material and methods. A 62-year-old patient with complaints of “bright flashes” in her left eye for the past few months, who underwent a standard complex of ophthalmological examinations, supplemented according to indications by optical coherence tomography of peripapillary nerve fibers, macular zone, B-scan, Dopplerography in color Doppler mapping mode. Auxiliary diagnostic methods were magnetic resonance imaging of the orbits and extraocular muscles, computed tomography of the orbits and a biochemical blood test.

Results. Considering the anamnesis, the absence of progression of complaints, the data of instrumental diagnostic methods, the absence of pathological blood flow in the area of both eyes formations, the correct diagnosis is most likely to be sclerochoroidal calcification of both eyes, despite the difficulties of the diagnostic process, which consisted in the absence of visualization of foci during ophthalmoscopy.

Conclusion. Sclerochoroidal calcification is of interest to practicing ophthalmologists due to the difficulties of diagnostic search and differential diagnosis with malignant neoplasms. Modern medicine has a sufficient set of instrumental and laboratory research methods for making an accurate diagnosis.

Chronic periodontitis as an osteoimmune disease of the oral cavity is accompanied by a change in the functional activity of endotheliocytes. Moreover, abnormal vascularization exacerbates periodontal inflammation, as it promotes the transmigration of a larger number of immunocompetent cells, the influx of inflammatory mediators and cytokines.

The aim of our work was to study the functional activity of the endothelium of the vessels of the oral cavity in persons suffering from chronic periodontitis in the treatment of plasmolifting.

Materials and methods. Under observation were 30 patients diagnosed with chronic generalized periodontitis of moderate severity at the age of 35 (32.50; 40.00) years, with no severe somatic pathology (main group). The comparison group included 20 people aged 38 (34.00; 45.00) years with no inflammatory diseases in the oral cavity. All patients underwent local anti-inflammatory therapy and sanitation of periodontal pockets, correction of occlusal contacts, curettage, plasma lifting. Oral fluid concentration of soluble adhesion molecules ICAM-1 and VCAM-1, endothelin-1, qualitative and quantitative composition of microflora were determined.

Results. After the treatment with plasmolifting, a noticeable relief of the activity of the inflammatory process was observed. In patients with chronic periodontitis, Porphyromonas gingivalis was found in 100 % of cases in a titer of 5.73 (4.9; 6.7) lg (gEq/sample), in 62.5 % – Prevotella intermedia in a titer of 4.5 (3.0; 5.5) lg (gEq/sample). Against the background of therapy, decrease of the occurrence of the microorganism and of the number of microorganisms was observed. The concentration of the soluble form of VCAM-1 in the oral fluid of patients with chronic periodontitis exceeded the values of the control group by 38.3 times (p = 0.000001), and ICAM-1 – by 18.1 times (p = 0.00001). Against the background of plasmolifting therapy, the level of the studied substances decreased, but exceeded the control values by 25.2 and 6.4 times, respectively. The content of endothelin in the oral fluid in patients with periodontitis exceeded the values of healthy individuals by 40.7 % (p = 0.003), during therapy its values decreased, but did not reach the level of healthy volunteers (p = 0.04).

Background. Furanocoumarin-based drugs are used for photochemotherapy of various diseases. Sosnovsky’s hogweed can be an available source of furanocoumarins for the development of drugs.

The aim of the study. To obtain stable emulsions containing furanocoumarins from Sosnowski’s hogweed and to evaluate their photocytotoxicity.

Materials and methods. To obtain the emulsions, furanocoumarins were extracted with chloroform from the sap of the aerial part of the Sosnowski’s hogweed. The chloroform extract was clarified by silica gel gradient column chromatography. The extractive fraction containing furanocoumarins was analyzed by high performance liquid chromatography with ultraviolet (UV) detection. An extract with a high content of 8-methoxypsoralen was used to prepare two types of emulsions. The extract was dissolved in peach oil and emulsified in water with tween-80 (emulsion No. 1) and in an aqueous glycerin solution with lecithin (emulsion No. 2).

The emulsions were tested for dark and photo-induced toxicity for human lung fibroblasts. The dose of UV radiation for the photoactivation of furanocoumarins was 9 J/cm2. A solution of chlorine e6 was used as a comparison photosensitizer.

Results. The obtained emulsions contained 1 mg/ml 8-methoxypsoralen. Both emulsions were homogeneous at macro- and microscopic visualization, remained stable when stored under various temperature conditions for 14 days. Emulsion No. 2 did not show dark toxicity and caused a statistically significant inhibition of cell viability under UV irradiation at a concentration of 12.5–31.3 µg/mL. Emulsion No. 1 had a toxic effect on cells regardless of UV irradiation due to the content of tween-80. According to fluorescent microscopy, the phototoxic effect of emulsion No. 2 was manifested mainly due to apoptosis, in contrast to the effect of chlorine e6, in which there were more pronounced signs of cell necrosis.

Conclusion. The developed experimental emulsions of furanocoumarins from Sosnovski’s hogweed are an example of promising medicinal photosensitizers of plant origin for phototherapy of various dermatological and oncological diseases.

The article presents data on variant X-ray anatomy of the superior rectal artery and types of arterial architectonics of the rectum. The causes of recurrent hemorrhoidal disease after traditional transanal surgical interventions are highlighted. The possibilities of endovascular occlusion of rectal arteries in the treatment of relapses of chronic hemorrhoids are shown. Its technical variants are given depending on the number of hemorrhoidal arteries and types of arterial architectonics of the rectum.

Over a 2-year period, clinical results of endovascular occlusion of hemorrhoidal arteries were evaluated in 11 patients with relapse of the disease after various transanal interventions: after latex ligation of internal hemorrhoids – in 5, transanal desarterization of internal hemorrhoids with mucopexia – in 4, hemorrhoidectomy – in 2. The average age of patients was 44.2 ± 12.5 years. Men – 5, women – 6. Superselective occlusion of the target hemorrhoidal branches of the upper rectal artery was performed with EmboGold (Merit Medical) microparticles, 500–700/300–500 mkm in size. Immediate results: cessation of bleeding on the first day – in 4 patients, after 3 days – in 5, after 7 days – in 2. Terms of hospitalization – 1 day, disability – 4.3 ± 0.7 days. Long-term results (from 1 to 2 years) were observed in all 11 patients. The course is relapse-free.

As an illustration, a clinical case is presented – successful treatment of a patient with recurrent hemorrhoidal disease by endovascular occlusion of hemorrhoidal arteries after five traditional transanal surgical interventions: sclerosing, ligation, dearterization of internal hemorrhoids, dearterization of internal hemorrhoids with mucopexia, removal of external hemorrhoids. Within 3 months after endovascular occlusion – complete regression of all symptoms of hemorrhoidal disease. According to the questionnaire (after 1 and 2 years) there is no relapse of the disease, the patient is subjectively satisfied with the endovascular treatment.

Cardiac complications of non-cardiac surgeries are an actual and unresolved interdisciplinary problem of clinical medicine today. The incidence of cardiovascular events after non-cardiac surgery is higher than in the general population and does not tend to decrease. The risk of cardiac complications in cancer surgery is the highest. Evidence-based approaches to risk assessment and prevention of cardiovascular events in surgical patients with malignant neoplasms have not been developed. In current clinical guidelines on the prevention, prognosis and treatment of cardiac complications of non-cardiac surgeries, the aspects of this problem in surgical oncology are not considered separately.

The aim of this review was to analyze the current sources of literature on the prediction of cardiovascular complications in surgical treatment of cancer patients. The distinctive features of cancer surgery and additional factors causing an increased risk of adverse cardiac outcomes in patients with malignant neoplasms are described. The article presents the results of large cohort studies on the search for reliable predictors of cardiac complications in non-cardiac surgery and on the development of stratification scales and algorithms for preoperative risk assessment. Particular attention is paid to the possibilities and prospects of using these predictive tools in the surgical treatment of cancer. The surgical risks of interventions for malignant neoplasms are described, as well as methods for calculating cardiac risk and functional status assessment that have been validated in oncological patients cohorts. The data of recent studies on the role of serum biomarkers of myocardial damage and increased cardiovascular risk (cardiac troponins and brain natriuretic peptide) in predicting postoperative cardiac events in non-cardiac surgery are presented. Further prospects for the inclusion of biomarkers in risk stratification systems in patients with malignant neoplasms are discussed.

Background. Reliable data on the efficacy and safety of fistulectomy with primary sphincter repair for the treatment of high transsphincteric anal fistulas are deficient.

The aim. To compare the efficacy and safety of fistulectomy with advancement muco-muscular flap (F) and fistulectomy with primary sphincter reconstruction (SR) for the treatment of high anorectal fistulas.

Methods. A cohort of 92 consecutive patients with transsphincteric anal fistula involving 1/3 to 2/3 of the sphincteric complex were included in prospective randomized study. The primary endpoint was the recurrence rate. The duration of surgery, blood loss, pain intensity, postoperative complications, the duration of wound healing, incontinence, quality of life were registered.

Results. Forty-six patients were randomized in each group. A statistically significant difference was obtained for operative time (Group “F” – 45 (20–160) min, Group “SR” – 33 (10–55) min). The blood loss was 3 (1–20) and 2 (1–10) ml in Groups “F” and “SR”, respectively (p = 0.482). The return to work in Groups “SR” and “F” occurred after 7 (2–14) and 8 (4–20) days, respectively (p = 0.005). The pain syndrome was significantly greater in Group “F” (p < 0.05) on days 1 and 7. Recurrence rate was in 23.9 % (11 cases) in Group “F” and in 6.5 % (3 cases) in Group “SR” (p = 0.042). Incontinence was in 7 (15.2 %) people in Group “F”, in 10 patients (21.7 %) – in Group “SR” (p = 0.591). There was no statistically significant difference in postoperative complications.

Conclusion. Findings can expand the indications for the treatment of high transsphincteric anorectal fistulas involving from 1/3 to 2/3 of the sphincter complex without statistically significant risk for functional results.

Background. Overweight and obesity are key factors for the occurrence of many morphofunctional disorders in organs and tissues, including bronchopulmonary system.

The aim. To study the influence of metabolic disorders that occur against the background of obesity on the state of the airways tone in rats.

Materials and methods. Obesity in male Wistar rats was induced using a high-fat and high-carbohydrate diet. In animals, body weight and fat mass were measured, and the heart-lung complex was extracted. In blood serum, the levels of glucose, insulin, leptin, triglycerides, and cholesterol were assessed. Bronchoalveolar lavage fluid was obtained by an open method, in which the concentration of protein, interleukin (IL) 6 and IL-10 was determined. The contractile activity of the isolated bronchial smooth muscle segments was studied using mechanographic method. The effect of acetylcholine (10–7–10–4 M), indomethacin (10–5 M), and forskolin (10–7–10–5 M) on the changes in the tone of airway smooth muscles was assessed.

Results. High-fat and high-carbohydrate diet caused an increase in body weight, visceral obesity, hyperglycemia, insulin resistance, leptinemia, dyslipidemia in rats of the experimental group. In the bronchoalveolar lavage fluid of experimental animals, an increase in the content of protein and IL-6 was found, which positively correlated with the level of leptin and the fat mass. In obese rats, the contractile responses of bronchial smooth muscle segments increased in response to the effect of the cholinergic agent acetylcholine. The bronchoconstrictor effect of acetylcholine was reduced by the cyclooxygenase inhibitor indomethacin. In turn, the adenylate cyclase activator forskolin caused relaxation of the airway segments smooth muscles in rats of both groups, which was more pronounced in the experimental group.

Conclusion. The obtained results indicate that the change in the reactivity of the respiratory tract can be the cause of  bronchospastic conditions in obesity and of the inflammatory reaction in the respiratory system induced by obesity.

The aim of the study. In recent years, non-alcoholic fatty liver disease (NAFLD) has been considered a hepatic manifestation of the metabolic syndrome. The main consequence of NAFLD is chronic hepatic inflammation, which leads to dyslipidemia, inflammation, increased oxidative stress, and endothelial dysfunction. Immune activation in response to interaction with agents of a metabolic nature induces the release of pro-inflammatory cytokines in the liver, which subsequently cause iron сhomeostasis disorder. This leads to a frequent association of NAFLD with anemia of various etiology. In this regard, we considered it important to assess the severity of the systemic inflammatory response in NAFLD in the experiment in order to -diagnose anemia of chronic inflammation.

Materials and methods. The study was carried out on 26 male Wistar rats, which were divided into control and experimental groups. In animals of the experimental group, NAFLD was modeled according to the generally accepted method. In order to assess metabolic disorders, we determined the main biochemical parameters, a complete blood count with the calculation of erythrocyte indices, the concentration of the main pro-inflammatory cytokines – interleukin (IL) 1, IL-6.

Results. In laboratory rats with NAFLD, a statistically significant increase of intrahepatic enzymes in blood serum was found. The state of the erythrocyte lineage of hematopoiesis in the experimental group progressively worsened and caused the development of anemic syndrome. Synchronously, a statistically significant increase in serum levels of IL-1, IL-6 was recorded, which confirms the correlation of NAFLD with anemia of chronic inflammation.

Conclusions. A high concentration of IL-1, IL-6 cytokines in NAFLD inhibits iron absorption in the duodenum, leads to the activation of macrophages, blocking the release of iron processed from aging erythrocytes into plasma. Further study of the mechanisms of anemia in NAFLD provides important therapeutic targets in the treatment of both NAFLD and its comorbidities.

Rationale. An important task is to monitor the incidence of tularemia among the population of Kazakhstan. Natural foci of this infection occupy large areas. In some regions with large numbers of rodents and ectoparasites and low vaccination coverage, human cases of tularemia have been reported.

The aim of the study. To carry out retrospective analysis and to study modern spatiotemporal characteristics of tularemia in the West Kazakhstan and North Kazakhstan regions in order to improve the effectiveness of preventive measures.

Materials and methods. In our work, we used public records, the results of an epizootological survey of tularemia natural foci and the official data from the Departments of Sanitary and Epidemiological Control of two regions on the human cases of tularemia in 2000–2021. We used descriptive statistics methods, relative and absolute indicators of the tularemia incidence in the population for the analysis. The phenotypic and genetic properties of the strains isolated in 2000–2021 were studied according to the guidelines.

Results. A retrospective analysis of the tularemia incidence among the population of the North Kazakhstan and West Kazakhstan regions showed an improvement in the epidemic situation. Over the past 20 years, 4 human cases of tularemia have been registered in the West Kazakhstan region, while the epizootic potential was quite high; more than 300 strains of the tularemia microbe were isolated during the studied period. In the North Kazakhstan region from 2000 to 2021, 11 human cases of tularemia were registered; when studying rodents, mammals and environmental objects, single positive samples for specific tularemia antibodies and antigens were detected; no strains of tularemia microbe were isolated.

Conclusion. An analysis of long-term data on the epizootic and epidemic activity of tularemia natural foci, processed using descriptive statistics and GIS technology, made it possible to identify places of long-term persistence of the tularemia agent in the natural focus of the North Kazakhstan and West Kazakhstan regions and to create an electronic map of the territories endemic for tularemia to determine the scope of preventive measures.

The article is dedicated to the 400th anniversary of the birth of the outstanding French anatomist, physician and philosopher Jean Pecquet (1622–1674). Pecquet’s biography is connected with the city of Dieppe, where the future scientist was born and got his primary education, and with Paris, where he made his main discoveries in anatomy. Throughout his life, Pecquet collaborated with many prominent scientists of that time (Jacques Mentel, Louis Gayant, Jean Riolan (the Younger)), including not only physicians and anatomists, but also physicists such as Blaise Pascal, Edme Mariotte, Marin Mersenne and Evangelista Torricelli. Pecquet’s most famous discovery is the chyle cictern, or cisterna chyli. The structure was named after of the scientist – “Pecquet’s reservoir (cistern)”. But more revolutionary discovery made by Pecquet is revealing and proving the fact that the lymphatic ducts flow into the superior vena cava indirectly through the venous angles and refuting the conventional opinion on the drainage of lymph into the liver. An important help in Pecquet’s anatomical research and experiments was his passion for the physical and mathematical sciences. In collaboration with Edme Marriott, Pecquet studied the structure of the eyeball and turned out to be more foresighted, because, unlike Marriott, he correctly understood the role of the retina in the functioning of the eye as an organ of vision. Pecquet was one of William Harvey’s supporters regarding his concept of blood circulation. He introduced cutting-edge at that moment technologies into the anatomy methodology, including animal experiments in vivo, and made a fateful contribution to the progress of anatomical science.