Background. The study of the lower respiratory tract microbiome has been actively developed inrecent years with the help of whole genome sequencing (WGS) methods. Due to this, it became clear that the nature of the lungs microbiota is very different from other microbial communities inhabiting the human body. One of the important directions in the study of pathological lungs biocenosis is the study of the role of the satellite microbiota of the tuberculosis focus.

The aim of the work. To isolate and characterize oxygen-tolerant anaerobes from the necrotic contents of tuberculomas.

Materials and methods. Biopsy material from 5 patients with pulmonary tuberculosis was obtained during a planned surgical treatment of tuberculoma. A pure culture was isolated from one sample during anaerobic cultivation. Lipase activity of strain was determined by plating on brain heart infusion agar (HIMEDIA, India) supplemented with 0.1 % Tween-80 and 10 mM of CaCl₂. Antibiotic susceptibility was determined by RAPMYCO and SLOWMYCO of TREK Diagnostic Systems (Thermo Fisher Scientific, USA). DNA from the sediment of the broth culture was isolated by the CTAB chloroform method. Whole genome sequencing was performed on a DNBSeq-G400 NGS sequencer by Genomed (Russia).

Results. Based on WGS results and phylogenetic analysis, the strain was identified as Corynebacterium kefirresidentii. The strain was characterized by high lipase activity and resistance only to Isoniazid, Ethionamide and Trimethoprim/Sulfamethoxazolin.

Conclusion. The isolation of a lipophilic anaerobic representative of the Corynebacterium tuberculostearicum species complex from a tuberculous focus indicates a  possible role of the non-tuberculous microbiota in the liquefaction of caseous necrosis. We assumed that in some cases, favorable conditions are created inside the tuberculous focus for the development of satellite anaerobic lipophilic microbiota.

Background. Using probiotic preparations based on consortia of microorganisms not only helps to restore the balance of the intestinal microbiota, but also increases the therapeutic effect of probiotics. Promising sources for obtaining probiotic consortia are milk products that have undergone natural fermentation with the help of spontaneously formed microbial consortia.

The aim. To study the structure of five microbial consortia with probiotic properties from naturally fermented milk products and to assess in vitro their antagonistic activity against opportunistic bacteria and a representative of the human normobiota – Escherichia coli.

Materials and methods. The structure of bacterial consortia was analyzed by sequencing methods. The antagonistic activity of the consortia was assessed by the disk diffusion method.

Results. It has been established that the studied microbial consortiums are represented by Enterococcus spp. and Streptococcus spp. bacteria. In consortiums No. 1, No.  2, and No.  3, Enterococcus bacteria dominated, while in consortiums No.  4 and No. 5, Streptococcus dominated. Antagonistic activity was shown against four isolates of opportunistic bacteria: Klebsiella pneumoniae No.  493, Enterobacter hormaechei No. 372, Staphylococcus aureus No. 4 and Pseudomonas aeruginosa No. 25 IMB, as well as against one representative of the human normobiota – Escherichia coli No. 495. The highest growth delay zone is found in E. coli No. 495 isolate. Three test cultures (K. pneumoniae No. 509, E. coli ATCC25922 and P. aeruginosa No. 3 IMB) exhibited more dense growth around probiotic consortia.

Conclusion. The results of the study showed that the effect of probiotic consortia differing in the composition of microorganisms can be neutral and bactericidal. The presence of antagonistic activity in the studied microbial consortia against multiresistant isolates of opportunistic bacteria is a prospect for creating probiotics with antibacterial properties.

Background. Existing methods for studying intrauterine distress, despite their prevalence, still have their limitations, so studying and assessment of fetal movements during ultrasound diagnostics can become a convenient and affordable additional tool for diagnosing this pathological condition.

The aim of the study. To assess the prevalence and diagnostic significance of a known set of fetal facial movements for the timely determination of intrauterine distress.

Methods. This prospective single-center study included 225 fetuses of a gestational age from 32 to 40 weeks. The FIGO chart was used as fitting criteria of intrauterine distress. The assessment of facial movements in all fetuses was carried out using the BabyFACS technique, where the action unit (AU) used for the assessment; its coding is carried out in strict accordance with the chart of  motor descriptors (MD). Statistical data processing was carried out using SPSS Statistics 20 (IBM Corp., USA). The Mann – Whitney test was used as the main statistical parameter, where a threshold level of 0.05 was chosen to interpret the p-tests value.

Results. Despite the occurrence of AU1, AU2, AU3, AU4 in both groups, these MDs were recorded in the group with confirmed distress (p  =  0.00001). Facial units such as AU9 and AU20 were found only in children with intrauterine distress, which, in the total amount of the MD assessment, can be considered one of the main search signs that specialists should first of all pay attention to. All motor descriptors showed high positive predictive value and diagnostic sensitivity, with the highest results registered for AU9 and AU20.

Conclusion. Assessment of facial units during ultrasound diagnostics can be a convenient tool as an additional diagnosis of the development of intrauterine distress and requires further study.

The aim of the study. To determine the age limit of the initial manifestations of the metabolic syndrome in women of reproductive age of the Caucasian and Asian ethnic groups.

Materials and methods. The study included women of reproductive age of the Russian and Buryat ethnic groups (n = 1231). We carried out general clinical examination, studied glycemia levels and lipid metabolism indicators. The analysis of the components of the metabolic syndrome was performed taking into account age characteristics and ethnicity. Threshold values for the age of metabolic disorders manifestation were determined.

Results. It was found that the main components of the metabolic syndrome in women of reproductive age of the Russian and Buryat ethnic groups were a decrease in  high-density lipoprotein (HDL), an increase in waist circumference, and an increase in blood pressure. The age-related determinants of the metabolic syndrome in the  population of women of reproductive age in the Baikal region were determined. It was shown that the age-related determinants of the metabolic syndrome in Caucasian and Asian women do not differ significantly and amount to 33.5 years (95% confidence interval (95% CI): 32.5; 38.5) and 36.5 years (95% CI: 27.5; 52.5), respectively. A universal critical age value was determined as 34.5 years (95% CI: 32.5; 38.5), which is associated with a significant increase in the prevalence of the metabolic syndrome in accordance with the ATP  III criteria. The ranking of metabolic syndrome criteria in the studied groups revealed the following order of their occurrence: the decrease in HDL index prevailed, followed by the increase in waist circumference, blood pressure, glucose and triglycerides; no dependence on the ethnicity was found.

Conclusion. When assessing the age-related determinants of the metabolic syndrome in the mixed Caucasoid-Asian group, it is advisable to use universal approaches, taking into account the cut-off point of age, which is 34.5 years. The determination of age criteria for the correct classification of patients with respect to the manifestations of the metabolic syndrome is necessary to analyze the contribution of the age factor to the implementation of various metabolic syndrome predictors, to  develop prognostic models, and to  use effective age-determined markers of metabolic disorders.

Background. Studying the problem of alcohol consumption by pregnant women using modern laboratory research methods has valuable theoretical and practical significance.

The aim of the study. To determine the characteristics of the pregnancy course in women consuming alcohol in the prenatal period confirmed by survey and laboratory tests, depending on the phosphatidylethanol levels.

Materials and methods. We examined 863 women under observation at the Irkutsk Regional Perinatal Center for the period from 2014 to 2021. To confirm the fact of alcohol consumption in the prenatal period, 545 women were surveyed, 318  women were examined using laboratory analysis. The diagnostic biomarker for  alcohol was  PEth:16:0/18:1. To assign pregnant women to  the control group, a PEth concentration of ≤ 8 ng/ml was taken. If the PEth concentration was > 8 ng/ml, pregnant women were classified as heavy drinkers. Clinical and laboratory indicators of the course of pregnancy and childbirth were carried out in comparative groups.

Results. It has been established that every second woman of reproductive age took alcohol before pregnancy. 24.2 % of women did not stop consuming alcohol in  the  prenatal period. At the same time, the risk of congenital malformations was high, since 20.4 % of women consumed alcohol in the first trimester of pregnancy. Based on the results of the survey, it was revealed that in women who consumed alcohol in the prenatal period, the following pathological conditions are statistically significantly more common: anemia, congenital heart defects in fetuses, prematurity of gestational age, labor anomalies, uterus subinvolution. Based on the results of laboratory confirmation of alcohol consumption, it was established that parity of birth, intrauterine growth retardation, and  premature birth were statistically significantly more often in pregnant women who drink.

Conclusion. Thus, in order to obtain the most meaningful and high-quality results, it is necessary to  conduct larger studies. In addition, maternal blood biomarkers should be used to confirm levels of alcohol consumption throughout all trimesters of pregnancy.

Polycystic ovary syndrome (PCOS) is considered a common endocrine disorder among women of reproductive age, and the associated health risks persist throughout life. At the same time, there is a wide range of variations in the incidence of the syndrome (4–21 %), which in turn is explained by the influence of the study population characteristics, including ethnicity and race, as well as the applied diagnostic criteria.

The aim of the study. To systematize the available data on the prevalence of polycystic ovary syndrome using the Rotterdam 2003 criteria in a population of women of reproductive age.

Materials and methods. The search for information was carried out using Internet resources (PubMed, EMBASE, Google Scholar, eLibrary). Literature sources for  the  period 1990–2023 were analyzed. As a result, the article presents current data on the prevalence of PCOS using the Rotterdam 2003 definitions, the features of the PCOS incidence in hospital and non-selective (medically unbiased) populations, as well as in various ethnic groups. The review also discusses current guidelines for conducting studies on the PCOS prevalence.

Conclusion. The latest guidelines on the diagnosis and management of patients with PCOS, published in 2018, propose to consider the provisions adopted in Rotterdam as the basis for the diagnosis of the syndrome; at the same time, the need to take into account racial and age characteristics is noted.

The aim. To carry out a comparative morphological characteristic of the uteroplacental area with abnormal placentation – pl. accreta, pl. increta, pl. percreta.

Materials and methods. The study included 47 patients with atypical placentation; the comparison group included 10 healthy pregnant women with uterine scar after a previous caesarean section. A histological study of uteroplacental area samples was performed with hematoxylin and eosin, methylene blue staining. An immunohistochemical study with primary antibodies to cytokeratin 7 (CK7), Hif2a, vascular endothelial growth factor, α-SMA was carried out. The differences between the compared values were considered to be statistically significant at p < 0.05.

The results of the study. Pl. accreta was determined in 12 (25.5 %), pl. increta – in 30 (63.9 %), pl. percreta – in 5 (10.6 %) patients. In all patients of the main group, the decidua was completely or partially absent in the area of abnormal placentation or was replaced by an uneven layer of fetal fibrinoid. Cases when placental villi unevenly penetrated into the thickness of myometrium in the form of “tongues” or “coves” bordered by fetal fibrinoid and often located intermuscularly were defined as pl. increta (n = 26). Cases with the placental villi ingrowth to the serous membrane were considered as pl.  percreta (n  =  5). In cases with deep variants of  ingrowth (pl. increta and pl. percreta) (n = 31), the villi were visualized in the lumen of the vessels and the thinning of the lower uterine segment with the presence of stretched muscle bundles was revealed. Aseptic necrosis of  the myometrium was  found: in 2 (16.7 %) of 12 women with pl. accreta, in 26 (86.7 %) of 30 women with pl. increta and in 5 (100 %) women with pl. percreta. There were no areas of necrosis in the myometrium of the women of comparison group.

Conclusion. The appearance and increase of myometrial necrosis zones in response to an increase in the depth of placental villus ingrowth were detected. Myometrial necrosis zones could be the cause of activation of angiogenic factors and an important stimulus for the development of abnormal vascularization in placenta accreta spectrum.

The ixodid tick Haemaphysalis concinna (Koch, 1844) is a carrier of pathogens of vector-borne diseases of viral, bacterial and protozoal etiology. This tick was previously considered an adventive relict species in the Baikal region, but has recently shown a tendency to increase its numbers and expand its habitat.

The aim of the study. To generalize the available and newly received information on the distribution of the H. concinna tick in the Irkutsk region and the Republic of Buryatia; to carry out the comparative analysis of the results in order to identify the dynamics of the development of populations of this species of ixodid ticks in the Baikal region.

Materials and methods. The coordinates of H. concinna detection points in our studies were obtained using a GPS navigator directly in the field. Ticks were caught during the period of their maximum activity from plants using a flannel flag. Approximate geographic coordinates of H. concinna tick detection points were established when analyzing the maps published by other researchers.

Results. As a result of the generalization of our own data and data from literary sources, 52 georeferenced detection points of H. concinna were obtained on the territory of the Baikal region. A map showing the distribution of H. concinna in the territory of the Irkutsk region and the Republic of Buryatia is presented. It is shown that in a number of surveyed areas there are stable populations of this species of tick, which tend to increase in their numbers and expand their range.

Conclusions. Considering these data, as well as the fact that H. concinna ticks are actively involved in the circulation of pathogens of natural focal diseases in humans and animals, we can conclude that it is necessary to systematically monitor the populations of this vector species in the Baikal region.

Background. Obesity is a significant social problem among the population of the world. The leptin gene (LEP) is currently considered as a potential candidate gene influencing metabolic disorders associated with predisposition to overweight and obesity. Leptin plays an important role in body weight homeostasis by influencing food intake and energy expenditure and maintaining constant energy stores. A defect in the leptin gene may be one of the causes of obesity and, as a result, of various obesity-associated pathologies.

The aim of the study. To search for single-nucleotide polymorphisms (SNP) of the leptin gene in adolescents with different weight status.

Methods. The study involved 20  adolescents aged 11–17  years with normal body weight and  overweight/obesity. Research methods: assessment of clinical status with  anthropometry; Sanger sequencing of the leptin gene fragment localized in the  intron of this gene – (5’-AGCCTTGTTTTCATCATCTGGA, 3’-TGGGAGGAATCGCTCTCAGA). We also carried out bioinformatic processing of sequencing results.

Results. As a result of the study, the optimal conditions for amplification of the 891 bps leptin gene region were selected for the above mentioned primer pair of the LEP gene (s16_L891, s16_R891). Based on the results of sequencing, 45 single nucleotide substitutions of the LEP gene were identified, including 23 single nucleotide substitutions which were not previously registered in GenBank. In the group of adolescents with overweight and obesity, 14 unregistered single nucleotide substitutions of the LEP gene and 13 registered SNPs were identified in the GenBank database. In the group of adolescents with normal body weight, these SNPs were not found.

Background. The stability of human organism for different kind of infection, including SARS-CoV-2 is significantly defined by the immune system. The mechanisms of the cellular immunity to the SARS-CoV-2 are not exactly defined and are under study.

The aim. To study the features of cell immunity parameters in patients with lung damage up to 30 % in COVID-19.

Material and methods. 73 people were examined during the 2020–2021 pandemic. The study group consisted of 31 patients with lung damage up to 30 % with COVID-19, the comparison group consisted of 42 people not infected with SARS-CoV-2. A complete clinical blood count was carried out using a Medonic M20 hematological analyzer (Boule Medical, Sweden), the level of lymphocyte subpopulations was determined using a FACS Calibur cytometer (BD, USA) and FITC- and phycoerythrin-labeled monoclonal antibodies (Sorbent, Russia). Differences were considered statistically significant at p < 0.05.

Results. Patients with COVID-19 with lung damage according to computed tomography (CT) ≤ 30 % before the treatment had a restructuring in the ratio of lymphocyte subpopulations in 67.7 % of cases. Lymphopenia (< 1.1 × 10⁹ cells/l) was detected in 34.4 % of patients: a decrease in the absolute count of CD3⁺ lymphocytes by 30.8 %, CD3⁺CD4⁺ – by 35 %, CD3⁺CD8⁺ – by 6.7 % (p < 0.05), CD16⁺CD56⁺ natural killer (NK) cells – by 29.4 % (p = 0.009). The level of CD95⁺ lymphocytes in COVID-19 is 3.2 times higher than in healthy individuals. Elevated levels of HLA-DR⁺- (> 20 %) and CD3⁺ HLADR⁺ lymphocytes (> 6 %) are recorded in 60 % and 86.7 % of patients, respectively. Elevated levels of CD19⁺ B lymphocytes (> 17 %) in COVID-19 are 2.6 times more common than in healthy individuals. Correlation dependences of the count of NK cells with a wide range of T lymphocyte subpopulations were revealed.

Conclusion. Cellular immunity indicators in COVID-19 have a number of features that can serve as predictors of the progression of the severity of the disease.

Background. Identification of the characteristics of the pulmonary tuberculosis process using multi-layer spiral computed tomography (MSCT) in patients with tuberculosis and HIV infection is important in the diagnosis of tuberculosis, determining the dissemination of the process and its dynamics during treatment.

The aim. To determine the initial characteristics and dynamics of infiltrative tuberculosis according to MSCT in patients with and without HIV infection, with and without multidrug resistance (MDR) of Mycobacterium tuberculosis who were treated in a hospital.

Materials and methods. 126 patients aged 19–59 years with tuberculosis, combined with HIV infection and without HIV infection were examined. For statistical processing, we used MS Excel (Microsoft Corp., USA) software package.

Results. Patients with tuberculosis and HIV infection in comparison with patients with tuberculosis and without HIV had more expressed intoxication syndrome and respiratory impairement in the clinical picture (p < 0.00001). Patients with coinfection were more likely to suffer from alcohol (p  <  0.05) and drug addiction (p < 0.001). According to MSCT, the pathological process in HIV-positive patients with pulmonary tuberculosis was more disseminated (p < 0.05), included severe intrathoracic lymphadenopathy (p < 0.0001), more common pleural lesions (p < 0.005), less common destructive changes (cavities) (p < 0.001) and outcomes in form of fibro-cavernous tuberculosis (p < 0.01). Process regression was slower in patients with tuberculosis and HIV (p < 0.005). According to MSCT, extensive lung damage, intrathoracic lymphadenopathy were  more often found in patients with MDR in coinfection (p  <  0.05). Cavities and fibro-cavernous tuberculosis outcomes were more common in patients with tuberculosis without HIV infection and with MDR (p < 0.05).

Conclusion. MSCT provides detailed information about the pathological process in the lungs and its dynamics under the treatment of tuberculosis and HIV infection.

Background. People who previously had COVID-19 infection have an increased risk of developing cardiovascular diseases. Left ventricular diastolic dysfunction is an early marker of the development of cardiac pathology. Its early detection is important for the adequate therapy order and dynamic monitoring of patients. In this regard, it seems relevant to study the effect of a recent COVID-19 infection on the left ventricular diastolic function and transmitral blood flow parameters in apparently healthy individuals without clinical and instrumental signs of cardiovascular pathology.

The aim of the study. To assess the changes in the diastolic and systolic function of  the left ventricle, its anatomical parameters and transmitral blood flow parameters in two groups of  apparently healthy individuals: those who had and those who had not COVID-19 infection.

Materials and methods. Transthoracic echocardiography was performed according to the standard technique and its results were analyzed in 66 examined patients who were recognized as apparently healthy according to the results of  regular comprehensive clinical and instrumental studies. The first group included 30 individuals who underwent an echocardiographic study before or during the COVID-19 pandemic, but did not have a coronavirus infection; the second group consisted of 36 people who recovered from COVID-19. The indicators of the presence of left ventricular diastolic dysfunction and the transmitral blood flow parameters were assessed. The study was approved at a meeting of the Medical Ethics Committee under the Ministry of Health of the Republic of Karelia and of Petrozavodsk State University (Minutes No. 47 of 01.11.2023).

Results. The frequency of the left ventricular diastolic dysfunction did not differ in  the  first and second groups of patients. Statistically significant differences were recorded in the average flow deceleration time for both early and late filling of the left ventricle in people who had and did not have COVID-19 infection. A change in the phase structure of the transmitral blood flow may be an early manifestation of intracardiac hemodynamic disorders in people who have recovered from COVID-19.

Recently, it has become common to identify type D personality, which is predisposed to the development of psychological distress. Negative behavioral characteristics of individuals with type D personality contribute not only to the development of cardiovascular diseases, but also to  other comorbid pathologies that can influence the progression and prognosis of coronary heart disease.

The aim of the study. To identify clinical and psychological correlations with type D personality in patients with chronic coronary syndrome.

Methods. The study included 113 patients (68 men and 45 women; median age – 64 years) admitted for planned percutaneous coronary intervention at the Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo, Russian Federation). Based on the results of the DS-14 test, patients were divided into two groups: patients with type D personality (n = 40) and patients without this type (n = 73).

Results. In patients with chronic coronary syndrome with type D personality, compared with patients without this type, concomitant diabetes mellitus (35 % and 15 %, respectively; p = 0.018), signs of diastolic dysfunction of left (Е/е’ ratio 7.1 [6.48; 8.0] and 5.0 [4.55; 5.74], respectively; p = 0.0038) and right (Et/At ratio – 0.8 [0.66; 1.35] and 1.38 [1.28; 1.63], respectively; p = 0.014) ventricles were more often diagnosed. Correlation analysis revealed associations of diabetes mellitus with type D personality (r = 0.243; p = 0.011), severity of negative excitability (r = 0.253; p = 0.008) and social suppression (r = 0.224; p = 0.020), as well as association of ankle-brachial index (ABI) with the severity of negative excitability (r = 0.393; p = 0.004) and social suppression (r = 0.414; p = 0.002).

Conclusion. In patients having chronic coronary syndrome with type D personality, concomitant diabetes mellitus, as well as left and right ventricular filling disorders are  more often detected. Correlation analysis revealed associations of diabetes mellitus with type  D personality and its subscales; the ABI level was associated with subscales of type D personality, but not with the level of anxiety and depression.

The article is presented in the format of a lecture. Peyronie’s disease (induratio penis plastica) is a progressive fibrotic disorder of the penile tunica albuginea that results in fibrotic penile plaques and  can cause penile deformity. The issues of  etiology, pathogenesis, clinical picture and diagnosis of Peyronie’s disease (PD) are reviewed in the lecture from the modern points of view. PD is frequently associated with penile pain, erectile dysfunction, and a secondary anxiety-depressive state. Despite the existence of this problem for several centuries, no unified concept of the Peyronie’s disease pathogenesis can be found in literature. A growing amount of research has shown that PD is a chronical disorder of local wound healing process within the tunica albuginea and the Smith’s space. Over the past 40 years, multiple lines of evidence have pointed to a genetic factor that predisposes some men to the development of Peyronie’s disease. Treating men with PD remains a challenging problem for clinicians working in urology. Given the high prevalence of PD and its significant impact on affected men, its better understanding is essential. Treatment methods for PD are varied and include oral, local, intralesional and traction therapy, and surgical treatment. Current clinical care standards for PD are aimed at the symptom suppression, as there are currently no treatment for PD that can eliminate its causes or progression. Clostridium histolyticum collagenase has shown its effectiveness in  treating PD, but its efficacy and safety remain controversial. Surgery remains the most effective method for PD treatment and is considered to be “gold standard”. The choice of the  surgical technique depends on the length of the penis, degree of deformity, erectile function, patients’ expectations and surgeon’s preferences. Various surgical techniques and grafting materials (autologous and non-autologous) can  be used for  the coverage of  the tunica albuginea defect after partial plaque excision or incision. 

Background. Cold injury is one of the most significant problems for the northern regions of the Russian Federation. Frostbite is defined as a complex of changes caused by the action of low temperatures, which lead to morphological changes in damaged tissue structures. As a result, the skin with underlying tissues and the intercellular matrix, the components of which are collagen fibers, are damaged, which eventually leads to remodeling and a protracted course of the wound process. Morphometric studies in combination with quantitative analysis of microphotographs (histological specimens) using GIS technologies make it possible to distinguish altered collagen fibers under the influence of low temperatures from relatively healthy tissues.

The aim of the study. To assess the possibility of using computer analysis of microphotographs in  a  complex of morphometric studies of collagen fibers in local cold injury.

Materials and methods. The study included 84 patients with III and IV degree frostbite of the lower extremities. Morphological study of tissues and microphotography were performed using Leica DM2500 microscope (Leica, Germany). The thickness of  collagen fibers was measured based on  visual measurements of characteristic areas of the microphotograph. Computer analysis of tissue microphotographs of  the  zone of cryoinjury was performed using the ArcINFO software (Esri, USA). Statistical processing of the study results was carried out using the SPSS Statistics software package (IBM Corp., USA). Graphs and diagrams were constructed using MS Office Excel (Microsoft Corp., USA).

Results. With frostbite, severe tissue damage occurs, accompanied by the destructive processes of the extracellular matrix components. Low temperatures contribute to  changes in the width and orientation of collagen fibers in the damaged area. In  this  regard, a change in the texture of the histological specimen image leads to achange in the numerical characteristics of the standard deviation of the curvature coefficient in the studied area of the microphotograph. Thus, in the late reactive period, the described complex of morphometric studies makes it possible to classify particular microphotograph as having pathological signs or as a sample of healthy tissue.

Background. In our previously published studies, we demonstrated a high hemostatic activity of a low dose of exogenous fibrin monomer during its systemic administration in a model of dosed liver injury with preliminary inhibition of platelet aggregation. However, the analysis of platelet involvement in the mechanisms of local fibrin formation has not been analyzed.

The aim of the study. To conduct a comparative analysis of the cellular composition of venous and wound blood, as well as blood in the wound vessels to assess the contribution of platelets to the hemostatic effect of exogenously administered fibrin monomers in dosed liver injury under conditions of pharmacologically determined thrombocytopathy.

Methods. In a model of dosed liver injury in rabbits after inhibition of platelet aggregation by  acetylsalicylic acid in combination with clopidogrel, the effect of the administration of fibrin monomer was evaluated in comparison with the use of tranexamic acid. We studied the number of platelets in venous and wound blood smears, as well as in the contents of wound vessels.

Results. It has been established that with the systemic administration of exogenous fibrin monomer, the number of platelets in wound blood smears decreases by 17.2 % in comparison with free circulating venous blood. Platelets in wound blood form aggregates and are in an activated state. In the wound vessels, the number of these cells was maximum (150 per lower field) compared with the number of platelets in the placebo and tranexamic acid groups (55 and 84 per lower field, respectively). Also in the wound blood, erythrocytes with altered forms (echinocytes, schistocytes, stomatocytes and ovalocytes) were found.

Conclusion. Systemic administration of exogenous fibrin monomer affects the redistribution of platelets between the systemic circulation, wound vessels and wound blood, determining its hemostatic effect and local wound fibrin formation in dosed liver injury. The presence of receptor-mediated platelets recruitment due to fibrin monomer in the wound vessels with the  participation of damaged erythrocytes is assumed.

The aim. To present a clinical case of a patient with corneal edema caused by undiagnosed iridocorneal endothelial syndrome after SMILE surgery.

Iridocorneal endothelial syndrome is characterized by abnormal proliferation of the corneal endothelium beyond the Schwalbe line, blockade of the iridocorneal angle, specific changes in the shape of the pupil and the formation of synechiae between adjacent structures of the anterior chamber angle of the eye, which is accompanied by the development of pretrabecular retention of intraocular aqueous humour, increased intraocular pressure (IOP) and subsequent development of glaucoma in 46–82 % of patients. One of the forms of the disease is Chandler’s syndrome, which clinically in the initial stages may be accompanied by the formation of only moderate ectropion. At the same time, endothelial dysfunction is characterized by a significant decrease in the number of cells, a change in their shape and the appearance of epithelioid cells with a hyper-reflective nucleus (the so-called “ICE (iridocorneal endothelial) cells”), with a violation of their natural pumping function.

The article presents a clinical case of a patient who underwent a standard examination and symptomatic treatment after laser keratorefractive surgery for myopia correction. Low visual acuity, diffuse corneal edema, IOP decompensation of unclear genesis were observed in one operated eye.

Conclusion. Keratorefractive operations can act as a trigger that stimulates the transition of the latent form into a clinically developed pathological process, which causes a decrease in corrected visual acuity due to the formation of corneal edema and glaucoma optic neuropathy.

Background. The development of diabetic retinopathy is favoured by immunological factors such as interleukins (IL) and chemokines. However, analysis of blood interleukins in patients aged 45–59 years with diabetic retinopathy in type 2 diabetes mellitus, who have biological age acceleration, has not yet been presented in publications.

The aim of the research. To study the content of blood interleukins in patients aged 45–59 years with diabetic retinopathy in type 2 diabetes mellitus, who have an excess of biological age over chronological age.

Materials and methods. 241 patients aged 45–59 years with diabetic retinopathy in type 2 diabetes mellitus were examined in a clinical setting. Biological age acceleration over chronological age was found in 148 patients, biological and chronological age concorded in 51 patients. The content of interleukins in the blood was studied in all patients using an enzyme-linked immunoassay.

Results. The concentration of blood interleukins in patients with biological age exceeding chronological, compared with patients aged 45–59 years with concordance of biological and  chronological age, was statistically significantly different for most blood interleukins and especially for IL-6, the concentration of which was  20.8  ±  1,2  pg/ml versus 3.9  ±  0.6  pg/ml, respectively (p  <  0.001). IL-13, IL-17 were significantly increased among patients with biological age acceleration over chronological; their concentrations were 2.1 ± 0.4 and 16.5 ± 0.6 pg/ml versus 0.5 ± 0.2 and 7.9 ± 0.7 pg/ml in the comparison group (p < 0.001). In contrast, IL-4 and IL-10 levels were higher in patients aged 45–59 years with diabetic retinopathy in type 2 diabetes mellitus and with concordance of biological and chronological age.

Conclusion. IL-6, IL-8, IL-13, IL-17, IL-4 and IL-10 may serve as markers of biological age dissociation in patients aged 45–59 years with diabetic retinopathy in type 2 diabetes mellitus.

The aim of the study. To develop a mathematical model of changes in corneal refraction during femtosecond laser-assisted lenticule extraction through a small surgical incision and, on this basis, to propose a technology for modified calculation of surgical parameters and to prove its effectiveness.

Material and methods. The study included 191 patients with high myopia. They were divided into two groups: group  1 consisted of 55  patients who  were  had  SMILE (SMall Incision Lenticule Extraction) surgery with standard calculations; group  2 included 136 patients who had SMILE surgery with a modified calculation of surgical parameters based on the developed mathematical model of the refractive effect of the surgery.

Results. When assessing the refractive effect of patients who were operated using standard technology, it was found that it was possible to achieve a refraction different from emmetropia for ± 0.5 D only in 51 % of cases; in the remaining patients, the planned residual refractive effect was obtained and averaged –1.96 ± 0.29 D. In patients operated using the modified technology, a statistically significantly better refractive result was achieved already on the first day. A refractive error of more than ± 1.0 D was obtained in only 1 % of cases; a deviation from the calculated refraction of ± 0.5 D was achieved in 82 % of cases, with the average values by 1 year –0.24 ± 0.57 D.

Conclusions. The developed technology of a modified calculation of the parameters of the SMILE surgery for high myopia correction makes it possible to obtain an optimal refractive effect in compliance with safety rules when the structural and functional parameters of the eye are initially unfavorable for refractive surgery.

The article presents a literature review of the modern concept of anatomical and physiological structure and functioning of the cornea. The strict morphological structure and corneal tissue homeostasis ensure its transparency. Studying the mechanisms that regulate the constancy of the corneal tissue internal environment allows us to get closer to understanding the prospects forregenerative therapy for the corneal stroma pathology. The article discusses in detail the role and functional potential of corneal stromal cells, which are capable of reverse cytologic differentiation, which primarily ensures the maintenance of tissue homeostasis and corneal transparency. The functional activity of corneal cells can change for a number of reasons, which may be exogenous, iatrogenic (trauma, infection, etc.) or endogenous. Endogenous causes include: cell autoregulation pathologies (for example, enzyme defects); defects in transport systems leading to tissue hypoxia; disorders of the neuro-humoral regulation of trophism. The physical reason forthe violation of the corneal transparency is an increase in the light scattering. The article presents five main causes of increased light scattering in the opaque cornea, and also provides an overview of the main substances – components and products of cellular synthesis of corneal stromal cells: cytokines and growth factors (complex of the signal molecule and the SDF1/CXCR4 receptor, insulin-like growth factor 1, tumor necrosis factor alpha, intercellular adhesion molecule 1, erythropoietin, neurotrophic factors, etc.). Thus, corneal opacity can be caused by a single pathogenic mechanism or be the result of a complex effect of several factors. The main processes of tissue homeostasis regulation are aimed at maintaining the unique morphological structure of the cornea.

Background. Many patients after penetrating keratoplasty (PK) experience induced postkeratoplastic astigmatism, which is often irregular and causes an increase in corneal aberrations that reduce visual acuity and quality.

The aim of the study. To conduct a comparative analysis of the effect of rigid gas permeable scleral lenses and the MyoRing implantation method on clinical and functional parameters in patients with IPA.

Material and methods. The clinical study included 60 patients (60 eyes). The age of patients with IPA was from 25 to 42 years. All patients underwent penetrating keratoplasty. All patients were divided into two groups depending on the method for irregular postkeratoplastic astigmatism correction. Group I included 30 patients (30 eyes) who were fitted with rigid gas permeable scleral lenses. Group II consisted of 30 patients (30 eyes) who underwent implantation of the MyoRing into a penetrating corneal graft. The observation period was 1 year.

Results. After 12 months of observation, there was a greater increase in uncorrected visual acuity by an average of 3 lines, in corrected visual acuity – by 2 lines; a greater decrease in corneal aberrations in photo- (root mean square (RMS) of total aberrations (RMS total) by 0.30 ± 0.08 µm, RMS of higher order aberrations (RMS HOA) – by 1.01 ± 0.24 μm) and mesopic conditions (RMS total – by 0.33 ± 0.09 μm, RMS HOA – by 0.08 ± 0.03 μm) in patients wearing rigid gas permeable scleral lenses compared with patients after MyoRing implantation into a penetrating corneal graft.

Conclusion. Patients of group  I, wearing rigid gas permeable scleral lenses, showed a greater improvement in visual acuity and a decrease in corneal aberrations in  photo- and mesopic conditions compared to the patients of group  II (after MyoRing implantation) at a follow-up period of 12 months.

Studying not only individual students indicators of students, but complex intersystem interactions that reflect the specifics of adaptive capabilities is of scientific interest.

The aim of the study. To reveal the features of intersystem interactions of indicators of the blood vessels functional state, morphological and neurodynamic characteristics of students with different types of autonomic regulation, living in the KhantyMansiysk Autonomous Okrug – Yugra.

Methods. 429 first–fourth-year students (348 girls, 80 boys) of the Surgut State Pedagogical University were examined. The initial type of autonomic regulation was determined by the average duration of electrocardiogram RR intervals. Anthropometry parameters (body length and weight) and body composition were assessed using Tanita BC-601 device (Tanita, Japan), vascular wall elasticity – using AngioScan-01 (AngioScan-Electronics Ltd, Russia), neurodynamic indicators – using NS-PsychoTest device (Neurosoft, Russia). Statistical analysis was carried out using Statistica 7.0 software (StatSoft Inc., USA). We used the nonparametric Mann – Whitney U-test to evaluate differences and the nonparametric Pearson R-test to analyze correlations.

Results. An increase in the stiffness of the vascular wall of large and small arteries in girls is  accompanied by an increase in parasympathetic activity. In young men, an  increase in the stiffness of large arteries raises with an increase in sympathoadrenal activity, while a  compensatory increase in the stiffness of small muscular arteries is noted with an increase in parasympathetic activity. In persons with the sympathicotonic type of autonomic regulation, an excess content of fat mass, an increased frequency of visceral obesity, and a deficiency in water content were registered. With the predominance of the parasympathetic component contribution to the regulation of cardiac rhythm, an increase in the processes of inhibition in the central nervous system was noted. In young men, reduced sensorimotor reactions are consistent with sympathetic activation in the regulation of heart rate. Correlation analysis made it possible to establish some features in the interaction of the vascular, morphological and central nervous systems.

Conclusion. Differences in indicators of functional systems (physical development, blood flow, neurodynamic characteristics) in the examined groups of students are  shown, taking into account gender and autonomic regulation type. Features of intersystem interactions of indicators of physiological systems of students’ bodies with different types of autonomic regulation were revealed.

Background. α-сyanothioacetamide derivatives are promising targets for the search for effective and safe antinociceptive agents with antipyretic and antiexudative activity.

The aim. To conduct in vivo experimental study of anti-inflammatory and analgesic effects of new thienopyridines and 1,4-dihydropyridines derivatives.

Materials and methods. The synthesized cyanothioacetamide derivatives were subjected to virtual bioscreening using Swiss Target Prediction online service. 140  laboratory rats were randomly distributed into intact and control (dextran edema) groups, reference groups (acetylsalicylic acid and  nimesulide) and ten experimental groups for the investigated derivatives of thieno[2,3-b]pyridine and 1,4-dihydropyridine. The anti-inflammatory activity of the compounds at a dose of 5 mg/kg was evaluated by modeling acute dextran edema of rat paw. Determination of analgesic activity was carried out in the hotplate analgesic assay on 130 rats in comparison with sodium metamizole.

Results. 1,4-dihydropyridines AZ331 and AZ420, as well as thienopyridine derivative AZ023 were determined to have strong anti-inflammatory activity (2.5 times more effective than nimesulide and 2.2 times more effective than acetylsalicylic acid). Compounds AZ023, AZ331 and AZ383 showed pronounced analgesic activity. The time of stay on the heated plate for rats of experimental groups that were fed with AZ331 and AZ383 for prophylactic purpose was respectively 9.56 and 9.93 times more than the same index in the reference group. The animals receiving AZ023 were characterized by an increase in the latent reaction time up to 241.2 seconds, which is 14.53 times higher than that in the rats received sodium metamizole.

Conclusion. New thienopyridine and 1,4-dihydropyridine derivatives with high antiinflammatory and analgesic activity were synthesized and studied; they were recognized as promising targets for further preclinical studies.

In recent years, information on the increase in the incidence of  infection associated with Clostridioides difficile (CDI) has appeared in the literature. It is known that C. difficile which causes pseudomembranous colitis (PMC) most often affects debilitated patients who receive treatment for the main pathology for a long time. That is why PMC is most common in cancer patients receiving long-term and aggressive anticancer treatment, which is often accompanied by the use of several courses of antibiotics. The result of the irrational use of antibiotics, incorrect PMC therapy may be the  formation of toxic megacolon, intestinal perforation, sepsis, which in turn is fraught with a fatal outcome. It is this state of affairs that aroused our interest in the study of this topic.

The steady increase in the incidence of Clostridioides difficile infection makes it particularly relevant to study CDI problem in relation to cancer patients, since they most often have a wide range of risk factors for developing clostridial infection.

The article presents an overview of domestic and foreign sources describing this pathology, discusses epidemiology, pathogenesis, clinical picture and current understanding of the CDI treatment. At the end of the review, we present a case of successful treatment of pseudomembranous colitis after stoma closure, which was complicated by the development of toxic megacolon. Colproctectomy was performed as part of the complex treatment of this pathology. The patient received respiratory, renal replacement, hepatoprotective, antibiotic and antifungal therapy and other treatments.

Metabolic syndrome, obesity, type 2 diabetes mellitus are characterized by the accumulation of toxic metabolic products in the internal environment of the organism. The development of innovative medicines based on a sorbent matrix modified with  biologically active molecules remains relevant. The sorbent composition from aluminum oxide and polydimethylsiloxane is considered promising.

The aim of the study. To investigate the effect of the sorbent composition from aluminum oxide and polydimethylsiloxane on the uterus and ovaries of db/db  mice with obesity and type 2 diabetes mellitus.

Materials and methods. The sorbent composition (0.665 g/kg in 200 μl of distilled water) was administered to 14-week-old animals through an intragastric tube once a day for 7 days. The comparison groups were female rats injected with placebo (daily intragastrical administration of 200 µl of water for 7 days) and intact animals. Digital images of light-optical preparations stained with hematoxylin and eosin were processed using Image-Pro Plus 4.1 software. In the ovaries, the numerical density of primordial, primary, secondary follicles and corpus luteum was determined. The width of the uterus layers, the diameters of the blood and lymphatic vessels, the width of the interstitial fissures in both organs were measured. The statistical significance of differences was determined using the Mann – Whitney test.

Results. In the myometrium and endometrium of the uterus of db/db mice, dilatation of arteries, veins, lymphatic vessels and edema were noted due to the accumulation of tissue fluid in the interstitium layers. There were no tertiary follicles in the ovaries. The introduction of the sorbent composition contributed to a decrease in the diameters of arteries, veins, lymphatic vessels of the uterus, a decrease in edema in both organs due to the narrowing of the prelymphatic slits, and stimulated an increase in the numerical density of secondary follicles.

Conclusion. A corrective effect of the sorbent composition of aluminum oxide and  polydimethylsiloxane on prelymphatic slits, blood and lymphatic vessels in the uterus and ovaries in db/db mice with obesity and type 2 diabetes mellitus was revealed.