The aim of the work. To investigate platelet aggregation, polymorphism in the genes that ensure its implementation, and the association between these indicators in patients with COVID-19-associated lung damage, depending on the severity of the clinical course.

Methodology. The study involved 75  patients with COVID-19, which, depending on  the severity of lung involvement, were divided into two groups: patients with  damage of up to 50  % of the lung parenchyma (n  =  48) and with damage of more than 50 % (n = 27) respectively. The control group consisted of healthy people (n = 24), comparable in sex and age. In all individuals, the number of platelets, platelet aggregation induced by ADP, collagen and ristomycin were studied; polymorphisms rs6065 in the GP1BA gene, rs1126643 in the ITGA2 gene, and rs5918 in the ITGB3 gene were determined by polymerase chain reaction. The analysis of the obtained data was executed using the IBM SPSS Statistics v. 23 (IMB Corp., USA).

Results and discussion. In patients with moderate and severe COVID-19-associated lung damage, platelet aggregation induced by ADP, collagen, and ristomycin accelerated; in severe cases, the number of  platelets decreased. The frequency of variants of the rs6065 polymorphism did not change, the frequency of occurrence of the T/C genotype of the rs5918 polymorphism increased; with moderate severity, the frequency of occurrence of the C/T and T/T genotypes of the rs1126643 polymorphism increased; with severe lung damage, the frequency of occurrence of the mutant C/C genotype polymorphism rs5918 increased. In moderate lung damage, the presence of the  mutant T/T polymorphism rs1126643 accelerated collagen-induced platelet aggregation; in severe cases, the presence of mutant C/C and heterozygous variant C/T polymorphism rs5918 accelerated ADP-induced platelet aggregation. There was no effect of the rs6065 polymorphism on platelet aggregation. The data obtained indicate the possible role of genetic predisposition in the activation of platelet aggregation in patients with COVID-19-associated lung damage.

Background. There is a mounting evidence in the scientific literature that susceptibility to SARS-CoV-2 infection could vary. The severity of COVID-19 symptoms can  range from asymptomatic to severe respiratory failure, requiring prolonged artificial ventilation. The underlying causes of this range of clinical manifestations remain unclear. Identification of the risk factors that may cause this variation in clinical symptoms is important for identifying the most susceptible populations at highest risk. This should help improve prevention measures, reduce hospitalizations, and decrease the mortality rate of the disease. Previously, an association has been found between the severity of COVID-19 and the genetic markers rs11385942 G>GA and rs657152 A>C.

The aim. To assess the impact of carrying polymorphic markers rs11385942 G>GA and rs657152 A>C on the severity of COVID-19 in patients undergoing specific therapy. Materials and methods. A total of 240 patients hospitalized with a coronavirus infection were included in the study. All patients received therapy with favipiravir or remdesivir. The presence of the rs11385942 G>GA and rs657152 A>C variants was determined in all patients. The study compared the length of hospital stays, frequency of patient transfers to the intensive care unit (ICU), and frequency of clinical outcomes (recovery or death) among carriers of allelic variants of the markers under investigation.

Results. There were no significant associations between the carriage of variants rs11385942 G>GA and rs657152 A>C and the duration of patients’ hospitalization, frequency of patient transfers to the ICU, and patient outcomes.

Conclusion. The carriage of rs11385942 G>GA and rs657152 A>C variants did not affect the severity or type of clinical outcomes in patients with COVID-19.

Background. During the ongoing COVID-19 pandemic and in the season of rising incidence of other respiratory infections, it is relevant to use preventive measures of  non-specific prophylaxis. Synthetic peptides are widely considered as a tool. The representative of this group is the synthetic analogue of thymus regulatory peptides Thymogen, which has been used in Russia for more than 20 years in the treatment of acute and chronic infection diseases.

The aim of the study. To evaluate the effect of Thymogen, a dosed nasal spray, on induced parameters of the immune system during prophylactic use in healthy volunteers.

Materials and methods. Twenty healthy volunteers received Thymogen nasal dosed spray (JSC  “Cytomed”, Russia) at a dose of 25  μg twice a day for 10  days. A  comparative assessment of  immunological parameters was carried out in dynamics: before the start of therapy, on days 6 and 11 of taking the drug and 14 days after the end of the course. Clinical observation was carried out from day 1 to day 11, registration of adverse events – the entire period of the study for 24 days. The first day was considered the day the drug was started.

Results. In the course of the work, according to the data of immunological examination, a statistically significant increase in the virus-induced production of interferon alpha (INF-α) by a culture of peripheral blood cells was revealed. The growth rate was recorded on day  11 of taking Thymogen and persisted for 14  days after  the  end  of  the  course. Significant differences in the dynamics of bactericidal and phagocytic activity of neutrophils, serum α- and γ-interferon were not obtained.

Conclusion. The use of Thymogen spray at a dose of 25 μg for 10 days was safe and contributed to a significant induction of interferon-alpha in response to exposure to a viral pathogen, which allows us to recommend the drug for prophylactic use during the period of rising incidence of acute respiratory diseases.

Introduction. Respiratory diseases occupy a leading place in the structure of pathology of childhood. The proportion of influenza and acute respiratory viral infections among all infectious diseases is 90 %. The literature describes gender differences in the immune response to respiratory infections in children, but there is a gap in  the  description of the cytokine profile in  children with influenza depending on gender and age.

The aim. To analyze clinical and laboratory parameters as well as cytokine profile parameters in children with influenza.

Materials and methods. A single-stage descriptive study was conducted with the participation of 50 children from 1 to 11 years of age with a diagnosis of influenza who were on inpatient treatment at the Irkutsk Regional Infectious Diseases Clinical Hospital from December 2018 to January 2019. The clinical and laboratory features of the course of influenza in children, the duration of treatment were determined. The concentration of cytokines interleukin (IL)  1β, IL-4, IL-6, IL-8, tumor necrosis factor alpha (TNF-α), interferon alpha and gamma (INF-α, INF-γ) in blood plasma was determined by enzyme-linked immunosorbent assay (ELISA) using diagnostic test systems manufactured by Vector-Best (Novosibirsk, Russian Federation) on the analyzer Multiscan EX (Thermo Electron, Germany).The control group consisted of practically healthy children without signs of acute respiratory viral infection (n = 50; mean age 5.3 ± 2.6 years).

Results. When comparing clinical and laboratory data and cytokine profile parameters in children with influenza, no gender differences were found. There was a statistically significant increase in the level of pro-inflammatory cytokines IL-1β, IL-6, IL-8, TNF-α, INF-α, as well as CRP, anti-inflammatory cytokine IL-4 in influenza in all age categories, in contrast to the control group (p < 0.05).

Conclusion. Influenza in children of different sexes proceeds classically without a statistical difference in clinical and laboratory parameters and in the level of cytokines.

Background. The use of P-glycoprotein (P-gp) inhibitors and carriage of certain ABCB1 polymorphisms can lead to increased concentrations of rivaroxaban and the development of bleeding.

The aim of the study. To study the features of drug-drug interactions (DDI) of rivaroxaban in patients over 80 years of age with non-valvular atrial fibrillation depending on the ABCB1 genotype (rs1045642 and rs4148738) using the example of verapamil (P-gp inhibitor) and amlodipine.

Materials and methods. One hundred and twenty-eight patients were examined (median age – 87.5 [83–90] years). Genotyping, determination of the minimum equilibrium concentration of rivaroxaban (C_{min, ss}), with standardization for the daily dose (C_{min, ss}/D), coagulogram and analysis of medical documentation for the presence of clinically relevant non-major bleeding (CRNM) were carried out. Analysis of CRNM was performed depending on the ABCB1 genotype.

Results. The use of rivaroxaban with verapamil in comparison with patients not taking calcium channel blockers (CCBs) leads to high C_{min, ss} values in the CC genotype (rs1045642, rs4148738); С_{min, ss} and С_{min, ss}/D in the CT genotype (rs1045642); prothrombin time in the CC genotype (rs1045642), more frequent occurrence of CRNM in the TT  genotype (rs1045642, rs4148738). In  comparison with patients taking amlodipine, it leads to high C_{min, ss} values in the CT genotype (rs1045642), a more frequent occurrence of CRNM in the TT genotype (rs1045642, rs4148738). The use of rivaroxaban with amlodipine in comparison with patients not taking CCBs leads to high C_{min, ss} and C_{min, ss}/D values in the CC genotype (rs1045642) (p < 0.017).

Conclusion. The use of verapamil with rivaroxaban in ABCB1 TT carriers (rs4148738 and rs4148738) leads to the development of CRNM in 75 and 78 % of cases, respectively. In  patients taking rivaroxaban, it is advisable to test the ABCB1 genotype (rs4148738 and rs4148738) before adding a P-gp inhibitor to therapy.

Background. In the pathogenesis of ischemic cardiomyopathy (ICMP), angiopoiesis remains unexplored.

The aim. To describe the vasculature of the heart and the imbalance of angiogenesis mediators in the coronary circulation in association with the number of endothelial progenitor cells (EPC) and desquamated endothelial cells (DEC) in the blood of patients with coronary heart disease (CHD), suffering and not suffering from ICMP.

Methods. Fifty-two patients with CHD (30  patients with ICMP, 22  patients without  ICMP), 15  healthy donors were examined. The content of EPC (CD14⁺CD34⁺VEGFR2⁺) in the blood from the cubital vein and DEC (CD45^–CD146⁺) in the blood from the coronary sinus and the cubital vein was determined by flow cytometry. The concentrations of VEGF-A (vascular endothelial growth factor A), PDGF (platelet-derived growth factor), and SDF-1 (stromal cell-derived factor 1) in blood plasma were recorded using immunofluorescence assay; the angiopoietin-2, MMP-9 (matrix metallopeptidase 9) were recorded using enzyme immunoassay. In myocardial biopsies the specific area of vessels and the expression of αSMA (smooth muscle alpha-actin) were determined by morphometric and immunohistochemical methods.

Results. In the peripheral blood of patients with CHD, regardless of the presence of ICMP, the DEC content exceeded the physiological level, and the VEGF-A, PDGF, angiopoietin-2, and MMP-9 corresponded to the norm. In CHD patients without cardiomyopathy, there was an excess of SDF-1 and EPC in the blood from the cubital vein, and in ICMP, their physiological significance was noted. In the coronary blood flow in patients with CHD without cardiomyopathy, an increase in the concentration of PDGF was found, which was not determined in patients with ICMP, who had an increased content of DEC, angiopoietin-2 and MMP-9. The specific area of the vessels in the patients of the two groups was comparable; the expression of αSMA in ICMP was 6.2 times lower than in patients with CHD without cardiomyopathy.

Conclusion. The development of ICMP is accompanied by impaired maturation of vessels in the myocardium, associated with the absence of a compensatory reaction of activation of cellular and humoral factors of angiogenesis.

Background. To date, the genetic variability of Rickettsia helvetica has not been sufficiently studied.

The aim. To study the prevalence and genetic variability of R. helvetica in Ixodes spp. collected in Western Siberia and the Russian Far East.

Materials and methods. Ixodes  spp. collected from rodents in the Omsk province, Western Siberia (n = 280) and collected by flagging on Putyatin and Russky Islands in Primorsky Krai, Russian Far East (n = 482) were analyzed for the presence of Rickettsia spp. All positive samples were genotyped for the gltA gene fragment. For a number of R. helvetica samples, fragments of the 16S rRNA, ompA, ompB, sca4, htrA, and groEL genes and 23S–5S intergenic spacer were additionally sequenced.

Results. Four Rickettsia species (R. helvetica, “Candidatus Rickettsia tarasevichiae”, “Candidatus Rickettsia uralica”, and “Candidatus Rickettsia mendelii”) were found. Of them, R. helvetica was identified in 72.2 % of Ixodes apronophorus and 18.8 % of  Ixodes trianguliceps from the Omsk province and in single Ixodes persulcatus from the Omsk province and Putyatin Island. This is the first finding of Rickettsia spp. in I. apronophorus. All known R. helvetica sequences from this study and the GenBank database belonged to four well supported monopheletic groups forming genetic lineages I–IV. Lineage I included European isolates from Ixodes ricinus, Western Siberian isolates from I. persulcatus, and some sequences from I. apronophorus. All R. helvetica sequences from I. trianguliceps from the Omsk province and I. persulcatus from  the  Komi Republic and one sequence from I.  apronophorus were assigned to  lineage  II. Most sequences from I.  apronophorus formed lineage  III; all known R. helvetica sequences from I. persulcatus from the Far East formed genetic lineage IV.

Conclusion. The genetic heterogeneity of R. helvetica population was first demonstrated. Known isolates of R. helvetica are reliably assigned to four genetic lineages, but not in all cases the association of different lineages with a specific tick species or specific territory was observed.

Background. Klebsiella pneumoniae belongs to a group of opportunistic bacteria that can form multiple resistance to antibiotics and transmit it to various types of bacteria through horizontal gene transfer. These studies examine the structural and functional diversity of CRISPR/Cas systems that protect bacteria from foreign DNA. Their analysis using the example of antibiotic-resistant strains of Klebsiella pneumoniae will demonstrate their resistance to certain bacteriophages, which will make it possible to develop approaches to the treatment of complex infectious diseases caused by these microorganisms by creating targeted phage therapy.

The aim. To perform a bioinformatics analysis of the identified structural components of CRISPR/Cas systems for screening bacteriophages through CRISPR cassette spacers using the example of antibiotic-resistant strains of Klebsiella pneumoniae.

Materials and methods. The article analyzed 29 full-genome sequences of Klebsiella pneumoniae, in the genome of which the structures of CRISPR/Cas systems and  antibiotic resistance genes were determined (according to NCBI). To achieve this  goal, using software modeling methods, a search was made for Cas genes and CRISPR cassettes, and their structural and functional characteristics were given.

Results. Using bioinformatic search algorithms in the genome of antibiotic-resistant strains, functionally active CRISPR/Cas systems with the presence of one or two CRISPR cassettes and belonging to Type  I Subtype  IE were identified. Groups of resistant strains with identical spacer composition of CRISPR cassettes have been identified. A phylogenetic analysis was carried out confirming their common origin. By analyzing the spacer sequences of CRISPR cassettes, the spectrum of diversity of phages of bacteria of the genus Klebsiella, Salmonella, belonging to the same family Enterobacteriaceae, was determined. Thus, information was obtained about the bacteriophages that are targeted by the action of CRISPR systems of Klebsiella pneumoniae strains that have antibiotic resistance.

Conclusions. Analysis of the functional and structural features of the CRISPR/Cas systems of antibiotic resistant Klebsiella pneumoniae strains made it possible to obtain information about their evolutionary history and about the bacteriophages against which their action is directed, that is, about their phage resistance. The approach used in this study may further serve as the basis for the creation of personalized phage therapy

Coronaviruses (family Coronaviridae, genera Alphacoronavirus, Betacoronavirus) are dangerous viral pathogens that have caused three outbreaks of severe respiratory diseases, SARS, MERS, COVID-19. In Russia, data on coronaviruses in natural reservoirs are limited, as investigations began only during the COVID-19 pandemic.

The aim. To study the diversity of coronaviruses among rodents and insectivores in the Republic of Altai.

Materials and methods. Rodents (n  =  67) and shrews (n  =  52) were captured in 2022. Samples were analyzed by reverse transcription-polymerase chain reaction followed by sequencing.

Results and conclusions. Four samples from rodents (Myodes rutilus, M. glareolus, Apodemus peninsulae, A. agrarius) and two samples from an insectivore (Crocidura sibirica) were positive for coronaviruses, among which three different coronaviruses were detected. Rodent-borne coronaviruses are classified in the genus Betacoronavirus, subgenera Embecovirus, and have shown host associated clustering. The nucleotide sequences of Siberian coronaviruses from rodents were identical for closely related species (M. rutilus and M. glareolus, A. agrarius and A. peninsulae) and close (> 94 % homology) to previously published sequences in each of the groups of carriers found in the territory Novosibirsk region, Europe and China. The coronavirus identified from the insectivore, possibly belonging to a new subgenera of the family Coronaviridae, has also been assigned to the genus Betacoronavirus.

Conclusion. Five species of natural carriers of three different coronaviruses were detected in the Altai Republic. A high level of identity of coronaviruses genomes from rodents has been revealed, indicating a relatively low rate of their evolution.

Background. Bedaquiline is a new and promising anti-tuberculosis drug, but longterm use requires resistance. This is due to mutations in the atpE and mmpR genes in M. tuberculosis (MBT).

The aim of the research was to test a system for automated interpretation of results for predicting resistance to bedaquiline by the molecular data.

Materials and methods. DNA was isolated from strains of M. tuberculosis in the Irkutsk region and Yakutia. The total quantity of DNA samples was 27 strains from Yakutia and 21 strains from the Irkutsk region. The study of MBT genomes was carried out on the DNA previously obtained by the authors in the territories of the Irkutsk region (n = 5), Yakutia (n = 4), Buryatia (n = 3), Zabaykalskiy kray (n = 4) and the Far East (n = 8). We used the BSATool program to detect bedaquiline resistance based on  Sanger and genomic data. Sanger sequencing analyzed the atpE and  mmpR genes, and whole genome sequencing examined mutations in the same sequences, as well as additionally in mmpL5, mmpS5, Rv0678, Rv1979c, and pepQ.

Results. Complete agreement between the phenotypic and genotypic analysis of resistance to bedaquiline was found for three strains from Yakutia. One genome with significant mutations to bedaquiline was identified. A conclusion was made about the importance of molecular analysis of target genes with subsequent detection of resistance to bedaquiline in silico.

Background. Infections transmitted to humans by the bites of ixodid ticks remain an urgent public health problem. In this work we explored the natural foci of tickborne infections located in the valley of the Chikoy River, which is a part of the buffer zone of the Baikal natural territory.

The aim. To characterize the modern diversity and prevalence of tick-borne pathogens in the ecosystems of the valley of the Chikoy River (Trans-Baikal Territory, Russian Federation).

Materials and methods. Thirteen sampling sites were located in typical biotopes throughout the Chikoy valley. In total 48  adult Ixodes persulcatus ticks, 1  female Haemaphysalis concinna tick and 38 specimens of small mammals were studied. All samples were tested for infection with seven tick-borne pathogens using multiplex real-time PCR.

Results. No pathogens were detected in the H. concinna specimen. No R. sibirica and R. heilongjiangensis were detected both in ticks and in rodents. Among I. persulcatus, tick-borne encephalitis virus (TBEV), and the prevalence of Borrelia burgdorferi s. l. comprised 39.5 %, A. phagocytophilum – 16.7 %, B. miyamotoi – 8.3 % and Ehrlichia sp. – 2.1 %. Among infected ticks 6.2 % were co-infected with B. burgdorferi s. l. and A. phagocytophilum. Four rodent hosts of ticks and infections were identified: Myodes rufocanus (44.7  %), Apodemus peninsulae (39  %), Microtus oeconomus (13.2  %) and M.  rutilus (2.6  %). Mean prevalence of B.  burgdorferi  s.  l. in  rodents comprised 39.5 %, B. miyamotoi – 28.9 %, Ehrlichia sp. – 21.1 % and A. phagocytophilum – 18.4 %. TBEV was detected in 5.3 % of rodents.

Conclusion. At least five tick-borne pathogens circulate in the Chikoi River valley, i. e. TBEV, B. burgdorferi sensu lato, A. phagocytophilum, B. miyamotoi and Ehrlichia sp. The wide spread of I. persulcatus and abundance of competent rodent hosts of infections and ticks indicates that natural foci of tick-borne diseases are widely distributed in the Chikoi River valley.

Objective. To evaluate the anti-nociceptive and reparative effects of adipose-derived mesenchymal stem cells (ADMSCs) under the pharmacological blockade of cannabinoid CB₂ receptors in a model of peripheral neuropathic pain.

Material and methods. In 40 male Wistar rats, modeling of peripheral neuropathy (NP) was performed by excising a sciatic nerve. On day 7 of the study, ADMSCs (1 × 10⁶ cells/kg) were transplanted into the area of sciatic nerve injury without additional influences or after administration of the CB₂ receptor antagonist AM630, as well as after incubation with AM630. Within 90  days, nociceptive sensitivity was studied, as well as a detailed analysis of gait using CatWalk XT (Noldus, Netherlands). On day 21 and day 90, histostructure of the distal segment of the sciatic nerve was assessed.

Results. Pharmacological blockade of CB₂ receptors both on the ADMSCs and in the soft tissues surrounding the site of sciatic nerve injury led to a decrease in withdrawal threshold and withdrawal latency from day 28 of the study compared with the group of rats with NP and transplantation of ADMSCs only. Local injection of AM630 before transplantation of ADMSCs contributed to the development of  NP-induced gait disturbances and increase of the number of damaged nerve fibers in the distal segment of sciatic nerve. Transplantation of ADMSCs pretreated with  AM630 did not significantly affect the rate of recovery of gait parameters, and decreased the number of damaged nerve fibers by day 90 of study.

Conclusion. Blockade of CB₂ receptors, both on the membranes of MSCs and in the area of damage to the peripheral nerve, has a negative effect on the development of the anti-nociceptive and reparative effects of MSCs.

A critical analysis of the literature on the structure and properties of alpha-synuclein under physiological and pathological conditions is presented, when the conformation of this protein changes, which contributes to its aggregation and changes in localization features in brain structures in such neurodegenerative diseases as Parkinson’s disease, dementia with Lewy bodies, multiple systemic atrophy and Alzheimer’s disease.

It has been shown that the toxic effect of conformationally altered alpha-synuclein can indirectly affect the functions of neurons due to its interaction with neuroglial cells, primarily microglia and astrocytes, and can also modulate the aggregation and expression of other proteins that are functionally important for the development of neurodegeneration.

Further study of the mechanisms of interaction of conformationally altered alphasynuclein with other proteins and clarification of the relationship between its accumulation in brain structures and neuronal dysfunction remains relevant for modern neurology.

Literature search was carried out in the “PubMed” and “eLIBRARY” databases.

Background. One of the promising methods of treating tumors is virotherapy, which is based on direct lysis of cancer cells by a virus and a virus-mediated antitumor immune response of the body. For the recombinant vaccinia virus strain VVGMCSF-Lact, producing human GMCSF and the oncotoxic protein lactaptin, cytotoxic and antitumor effects were shown in experiments in vitro and in vivo, respectively, when using adhesive cultures of U-87 MG human glioblastoma cells. 3D cultures are a more relevant tumor model than adhesive models, as they more fully reflect the realistic scenario of cancer development, as well as the response of the tumor to anticancer therapy.

The aim. To evaluate the cytotoxic effect of the oncolytic virus VV-GMCSF-Lact against 3D cultures of human glioblastoma U-87 MG.

Materials and methods. The following methods were used in the work: cultivation of 3D cell cultures, cytofluorometry, microscopic analysis, virus titration, statistical analysis.

Results. U-87 MG cells were transduced with a lentiviral vector carrying the GFP reporter gene. The cytotoxicity of the VV-GMCSF-Lact virus (IC50) against the studied cells was 0.024 PFU/cell. U-87 MG cells were cultured under conditions for the formation of 3D structures. Microscopic analysis showed the oncolytic effect of the virus on the cells of 3D cultures as early as 24 hours after the start of incubation. Flow cytometry showed an increase in the granularity of glioblastoma cells under the action of the virus, which indicates active replication of the virus in the cells. The virus titer was 0.44 PFU/cell.

Conclusions. The recombinant VV-GMCSF-Lact virus has a cytotoxic effect on 3D human glioblastoma U-87 MG cell cultures and actively replicates in them. In the future, to test the oncolytic effect of VV-GMCSF-Lact, it is planned to use not only 3D human glioblastoma cultures, but also cerebral organelles obtained in the process of cocultivation of glioblastoma cells and induced human pluripotent cells.

Background. Performing penetrating keratoplasty in 100 % of cases leads to the occurrence of induced postkeratoplasty astigmatism, which can be more than 12,0 D. If cataracts occur in this category of patients, performing cataract phacoemulsification with implantation of a toric intraocular lens (tIOL) does not completely solve the problem. The use of the method of implantation of intrastromal corneal segments at stage I before cataract phacoemulsification makes it possible to reduce the degree of postkeratoplasty astigmatism and create optimal conditions for additional correction of residual postkeratoplasty astigmatism due to the implantation of tIOL during cataract phacoemulsification.

The aim. To analyze the clinical and functional indicators of correction of regular high-grade postkeratoplasty astigmatism in a patient with cataracts using a combined method, including first implantation of intrastromal corneal segments and subsequent cataract phacoemulsification with implantation of toric intraocular lens using the example of a clinical case.

Material and methods. A 55-year-old patient with cataracts, who had a history of  undergoing penetrating keratoplasty, contacted us. According to the keratotopogram data, a regular postkeratoplasty astigmatism of 18.68 D was diagnosed. The patient underwent a combined method. At stage I, intrastromal corneal segments were implanted into the corneal graft, then after 6 months stage II was performed – cataract phacoemulsification with implantation of tIOL.

Results. Six months after intrastromal corneal segments implantation, the patient’s keratometric data stabilized, and corneal astigmatism decreased to 8.98 D. Then the patient underwent cataract phacoemulsification with tIOL implantation. After 1 month, the spherical component of refraction was 0.5 D, the cylindrical component of refraction was –0.5 D, visual acuity increased to 1.0.

Conclusions. A combined method for correcting regular high-grade postkeratoplasty astigmatism in a patient with cataracts showed high refractive results, stability and safety in the long-term postoperative period.

Background. Vaccination coverage of children in India is not sufficient since the COVID-19 pandemic (less than 90 %). This may lead to low adherence of parents to children’s vaccination.

The aim. To study parental attitudes and awareness towards children vaccination programs in India at the COVID-19 pandemic background.

Methods. Two hundred and fourteen participants from Kerala state (India) took part in the descriptive cross-sectional study via survey method. The survey was prepared with Google form according the principles of anonymity.

Results. Indian parents demonstrated good adherence towards children’s vaccination, 98.6 % (95% confidence interval (CI): 95.9–99.5) of them vaccinated their child, and if vaccination appointment had to be rescheduled 84.6 % (95% CI: 79.1–88.8) of  them vaccinated children after. Most of Indians (68.7  %; 95%  CI: 62.1–74.5) preferred to vaccinate children in state clinics, however, 28.5 % (95% CI: 22.8–34.8) chose private clinics. Information about diseases that vaccines can prevent, vaccine safety, and side effects 47.2 % (95% CI: 40.6–53.8) of parents got from public pediatricians, 50.9 % (95% CI: 44.2–57.5) – from private pediatricians, and 10.3 % (95% CI: 6.8–15.0) – from complementary and alternative medicine practitioners. Over 80 % of Indians were informed about vaccination through mass media (83.6%; 95% CI: 78.1–87.9). Indian parents showed low awareness about vaccination, because 63.1 % (95% CI: 56.4–69.2) of parents wanted to know more about vaccination. Moreover, before vaccination 21.5 % (95% CI: 16.5–27.4) of them were not informed by a doctor about health benefits and possible risks for their children.

Conclusion. In the COVID-19 pandemic Indian parents showed good attitude towards vaccination and low awareness in vaccination questions.

Background. Adequate sleep ensures a person’s physical and psycho-emotional well-being. Adolescence is one of the critical stages of life. The exclusive attention of specialists and leveling the impact of adverse factors on the body during this period is the key to the proper development and preservation of the health of adolescents. Meanwhile, sleep problems in teenage girls remain poorly understood.

The aim. To study the features of the sleep regime and quality of sleep of teenage girls in the city of Irkutsk.

Materials and methods. A survey of 422 teenage girls in the city of Irkutsk was conducted using a translated version of a questionnaire about adolescent sleep habits to subjectively assess their sleep and wakefulness. Two groups were formed: group I – girls with sleep problems (n = 171); group II – girls without sleep problems (n = 251).

Results. Sleep disorders among teenage girls in the city of Irkutsk occurred with a frequency of 40.52 %. In most cases, a complex effect of various unfavorable factors on the sleep process has been identified. The adolescents with sleep disorders we  examined were characterized by higher rates of sleep latency, later bedtime, earlier awakening, decreased time of night sleep, as well as changes in the sleep shift indicator towards its increase. These violations were noted both on weekdays and on weekends.

Conclusions. Sleep problems were reported in 40.52% of respondents. The complex impact of various unfavorable factors on sleep quality has been revealed. The features of sleep hygiene of teenage girls are reflected. The group of girls with sleep problems was characterized by increased sleep latency, later bedtime, earlier awakening, reduced sleep time, and an increase in sleep shift.

Background. The rational nutrition of the child population is given great medical importance as a factor in preserving the health and development of the child. A complete and balanced diet in terms of the content of basic nutrients ensures the normal growth and development of the child’s body.

The aim. To analyze of the actual nutrition of adolescents living in rural areas of the Irkutsk region.

Materials and methods. The study involved 69 rural adolescents aged 11–17 years (34 boys, 35 girls). The actual nutrition was studied by the method of 24-hour nutrition reproduction. The energy value of the diet was determined, the nature of the provision of the diet with basic macro- and microelements was studied. The obtained values were compared with the norms of  physiological needs for energy and nutrients in 2008 and 2021.

Results. The analysis of actual nutrition revealed deviations from the principles of  healthy nutrition: insufficient energy value of the diet, deficiency of proteins and  fats. The diet of  adolescents was characterized by an insufficient content of the main groups of macro- and micronutrients – vitamins A, C and D, essential trace elements, and a deficiency of dietary fiber. The diet of adolescents was characterized by increased sodium intake. The calculated ratio of proteins, fats, carbohydrates indicated a carbohydrate type of diet.

Conclusion. Despite the great attention to the problem of balanced nutrition of adolescents, the question of the impact of nutrition on the health of a teenager, considering the regional factor, remains open. Recommendations for the development of a regional program for the organization of proper nutrition for school-age children are of great practical importance.

Background. Overweight and obesity significantly increase the risk of premature death and the development of chronic diseases. Many anthropometric indices have been developed to verify obesity, although the best among them still remains undetermined.

The aim. To determine the sex and age specificities of the dynamics of anthropometric indicators characterizing obesity.

Materials and methods. The program was implemented in the period from 2015 to 2020. It provided for the implementation of a sample research. The baseline research included 1,124 women and 476 men. The average age was 54.9 ± 9.75 years and 52.6 ± 10.0 years, respectively. To identify gender specificities, all participants were divided into three age groups: 35–49 years old, 50–59 years old, and 60–70 years old. The observation period was 3 years.
To determine the level of visceral fat, the VS-532 fat mass analyzer (Tanita Health Equipment HK Ltd., Hong Kong) was used. Body mass index (BMI), waist-hip index (WV/HV), visceral obesity index (VOI) were also calculated. Statistical processing of the results was carried out using the program Statistica 6.0 (StatSoft Inc., USA).

Results. New cases of obesity developed in 30.6 % of the surveyed. There was an increase in the prevalence of obesity according to the criteria of WV (by 8.9 %) and VFL (by  5.4  %) and a  decrease in the number of people who are obese according to WV/HV – by 4.2 %. Of all the indicators, only VOI showed a statistically significant decrease in the mean values over the observed period, while BMI, WV and VFL showed an increase.

Conclusions. It is necessary to apply various criteria for the diagnosis of obesity, since individual indices are not able to fully reflect the gender and age specificities of the distribution of fat in the body

The problem of human individual development requires not just the accumulation and generalization of data, but also clarification, a systematic understanding of the individual variability of higher mental functions in relation to environmental factors and taking into account the risks associated with their formation.

The aim: to identify systematic patterns of correlation between individual variability of higher mental functions of preschool children and the material prosperity of their families.

Methods. Traditional neuropsychological tests developed by A.R. Luria and adapted in the neuropsychology laboratory of the Faculty of Psychology at Lomonosov Moscow State University were used. We examined 180 preschool children from families with high, average, and low income.

Results. The greatest individual variability in the period of preschool age in relation to the level of material prosperity of the family, are the functions with a long period of formation, these are functions of block III of the brain, and the functions provided mainly by the left hemispheric parts of the brain. Children from the most affluent families have the highest indices of brain block  III functions (p  <  0.001) and left hemispheric functions (p < 0.001). Preschoolers from low-affluence families had indexes of both front brain function (p < 0.001) and left hemispheric function (p < 0.001) in the zone of negative values.

Conclusion. The empirical results of the study allow us to clarify that the factor of material prosperity of the family, both directly, factor-wise, and indirectly, cumulatively, through the system of proximal factors, can make its selective contribution to the variability of indicators of children’s higher mental functions.

Background. In Russia, of all detected cases of COVID-19, 18 % were in the pediatric population. According to a number of studies, adolescents develop long-term clinical and psychological consequences after an illness. Therefore, at present, the most relevant is a thorough study of the structure and severity of consequences of COVID-19 in adolescents.

The aim of the research was to assess the severity of consequences of COVID-19 in adolescents depending on the time period after diseases.

Methods. The sample included 96  people aged 11–16  years: 48  adolescents who  have  undergone COVID-19 (main group); 48  adolescents who  did  not  have  COVID-19 (control group). The main group was divided into six subgroups, depending on the period after COVID-19. The following research methods were used: clinical history using a standardized interview method; “Correction test” method by B.  Bourdon; Beck’s Depression Inventory (BDI-1A); Adolescent’s Form of Manifest Anxiety Scale by A.M. Prikhozhan.

Results. Clinical symptoms of COVID-19 during the acute phase of the disease were considered in adolescents. It has been established that the most common symptoms include fever, runny nose, cough, sore throat, severe fatigue, impaired sense of smell, impaired taste, headache (most often localized in the frontal region). Clinical and psychological symptoms characteristic of post-COVID syndrome were considered as consequences of COVID-19 in adolescents. The majority of the  examined adolescents showed the following clinical symptoms of COVID-19 after discharge: asthenia, disturbances of smell and taste; lasting from 2 to  64 weeks. As psychological symptoms, adolescents were characterized by reduced attention span, reduced speed of information processing and concentration, as well as the presence of symptoms of severe depression and high anxiety. During the second month after COVID-19, the most unfavorable emotional state was revealed in adolescents.

Conclusions. The data obtained made it possible to determine that post-COVID syndrome in adolescents is characterized by the presence of an asthenic condition, impaired attention, high anxiety, severe depressive symptoms.

Background. The use of complexes of synthetic and herbal remedies as hepatoprotectors in the treatment of liver pathologies of various etiologies is an urgent task of pharmacology. A promising type of medicinal plant raw material is an extract of  Hippophaes rhamnoides leaves. The  hepatoprotective effect of extract of  Hippophaes rhamnoides leaves in combination with ademethionine has not been studied to date.

The aim of the research was to study changes in biochemical markers of hepatic function in the application of complex schemes of pharmacotherapy of experimental liver damage with paracetamol using Extractum foliorum Hippophaes rhamnoides.

Materials and methods. The experimental study was performed on Wistar rats, the  animals were divided into six groups. Group  1 (intact) – animals without a model of liver damage and without treatment; in Group 2 (control) paracetamol was used to create experimental hepatitis without treatment (positive control group); in  Group  3 (comparison) a combination of “silibinin  +  ademethionine” was used on a model of paracetamol hepatitis; in Group 4 (experimental) extract of Hippophaes rhamnoides leaves was used on the model of paracetamol hepatitis; in  Group  5 (experimental) ademethionine was used on a model of paracetamol hepatitis; in Group 6 (experimental) a combination of extract of Hippophaes rhamnoides leaves and ademethionine was used on a model of paracetamol hepatitis. The functional state of the liver of experimental animals was determined by biochemical parameters.

Results. When using a combination of extract of Hippophaes rhamnoides leaves with ademethionine, the studied biochemical parameters significantly (p  <  0.05) differed from the numerical values in the negative control group and were closest to those in the intact group than in other experimental groups.

Conclusions. A comparison of the effectiveness of the use of extract of Hippophaes rhamnoides leaves in combination with ademethionine by the total effect on blood biochemical parameters determines this complex as a promising drug for further research.

Background. Antiorthostatic hypokinesia (ANOH) reproduces some of the effects of weightlessness on the human body and is used to study adaptation to space flight conditions. It is known that ANOH affects nighttime sleep, but there is no information in the literature on the sequence of occurrence of sleep disorders in ANOH.

The aim of the research was to study the dynamics of subjective changes in assessing sleep quality under conditions of antiorthostatic hypokinesia.

Materials and methods. Six healthy male volunteers (age from 26 to 34  years) participated in the experiment with 21-day ANOH. They were on a medical bed with a body inclination angle relative to the horizon of –6° for 21 days. To assess sleep quality, a structured questionnaire was used that assessed sleep duration, rate of falling asleep, night awakenings, the presence of daytime sleepiness, and daytime falling asleep.

Results. Based on the assessment of the dynamics of the sleep efficiency index (SEI), three stages of adaptation were identified. At the stage of acute adaptation (the first 3 days), there is a decrease in SEI from 96.4 to 91.3 (p < 0.01), a statistically significant prolongation of falling asleep from 17.6 to 33.6  minutes (p  <  0.01), an increase duration of night awakenings up to 17.4 minutes, increase in daytime sleepiness by 11 %. In the next 3 days (the “recovery” stage), there is a statistically significant increase in SEI compared to the 1st stage to 94.7 (p < 0.01), but it remains statistically significantly lower than the background values (p < 0.004). The number of complaints about daytime sleepiness increases (up to 42  %), evening bedtime shifts later by 26 minutes. At the 3rd stage (the remaining nights) there is a relative stabilization of the sleep-wake cycle.

Conclusion. Under conditions of 21-day ANOH, a gradual change in the pattern of sleep disturbances occurs. The most negative changes in terms of subjective assessment were noted in the first three days. Then there is an improvement in falling asleep, a decrease in night awakenings, combined with an increase in daytime sleepiness and the formation of a schedule with a later bedtime.