In recent years, studies of the human microbiome have led to the development of the gut-brain axis theory, which proposes a relationship between the gut bacterial community and its metabolites and chemical compounds, as well as physiological and pathological processes in the brain. Melatonin is considered one of the potential links in this relationship.

The review provides brief information about the synthesis, metabolism and effects of melatonin in the body. General patterns of the effect of melatonin on the intestinal microbiota under various conditions, such as oral and intraperitoneal melatonin administration, sleep deprivation, as well as the results of studying the microbial community with measurement of hormone levels are considered.

Results are presented for families and individual genera of microorganisms and are obtained from studies in animal models or in the research of diseases. The article also notes some additional parameters which are supposed to be relevant to the interaction of melatonin with gut microbiome. Special attention is paid to butyrate as one of the most studied possible parts in this interaction. Studying the relationship between melatonin and microbiome is of interest for basic science and practical medicine.

Literature search was carried out using electronic information resources PubMed and eLibrary.

As of the beginning of 2023, there are more than 660 million convalescents of a new coronavirus infection in the world, however, even despite successful treatment of the acute period of the disease, such patients have a high risk of developing long-term complications in the post-COVID period, primarily cardiovascular events. One factor that seriously increases the risk of these complications is the state of lowgrade systemic inflammation (LGSI). LGSI is not a clinical diagnosis, it is characterized by a level of C-reactive protein in peripheral blood in the range of 3–10 mg/l and is most often detected during routine examination of patients, who in most cases have no clinical symptoms. In this regard, the condition of LGSI most often remains unnoticed and unreasonably ignored, despite quite extensive literature data on the effect of LGSI on the pathogenesis of many cardiovascular diseases. The development of drug therapy for LGSI is complicated by the multifactorial etiology of this condition. The causes of LGSI can be both genetic factors, which are practically impossible to correct, and conditions that are amenable to drug and non-drug treatment, such as, for example, increased intestinal permeability to pro-inflammatory agents, including lipopolysaccharide of gram-negative flora, the presence of a chronic untreated infection site and endocrine pathology (obesity and type 2 diabetes). This review presents the main information to date on the state of LGSI in patients who had a new coronavirus infection, including the results of our own observations of patients who have undergone a course of rehabilitation measures, as well as the most significant, in our opinion, factors predisposing to the development of LGSI in such patients.

Background. Glaucoma as one of the most common eye diseases can be a comorbid condition of an epithelial corneal defect of various etiologies. Maintaining an optimal level of ophthalmotonus includes the prescription of antiglaucoma drugs, including benzalkonium chloride-preserved drugs.

The aim of the study. To compare the effect of antiglaucoma drugs, as well as benzalkonium chloride (BC), on a primary culture of human corneal epithelium and A549 immortalized cell line.

Methods. The effect of brimonidine, dorzolamide and timolol (1/100, 1/50, 1/20 and 1/10 dilutions; exposure 24 hours) on a monolayer of a human corneal epithelial primary culture and A549 immortalized cell line was assessed by structural changes in cells (phase-contrast microscopy) and MTT assay data. The cytotoxic effect of BC was studied in concentrations corresponding to its content in these dilutions of the antiglaucoma drug. Using a model of a linear defect in the monolayer of a corneal epithelial primary culture and A549 immortalized cell line, the effects of brimonidine, dorzolamide and timolol (1/100 and 1/20 dilutions; exposure 48 hours) were assessed by cell migration activity.

Results. Among drugs (BC-free), dorzolamide (1/50, 1/20 and 1/10 dilutions) causes minor structural changes in human corneal epithelium and A549 immortalized cell line; timolol (1/100, 1/50, 1/20 and 1/10 dilutions) causes minor structural changes in A549 immortalized cell line. Structural changes in both types of cells, a decrease in their metabolic and migration activity occur under the influence of dorzolamide, brimonidine and timolol (BC-preserved) in 1/100, 1/50, 1/20 and 1/10 dilutions. BC at the studied concentrations exhibits a similar effect.

Conclusion. The cytotoxic effect of antiglaucoma drugs is caused by the presence of BC in their composition. Despite similar morphofunctional changes in cells, A549 immortalized cell line is more resistant to the effects of drugs than the human corneal epithelial primary culture. When using it as a cellular model, it is advisable to change the experimental conditions (duration of exposure and concentration of the studied drug).

Background. Thrombotic thrombocytopenic purpura is a rare blood disease characterized by increased thrombogenesis in the microcirculation. One of the most common triggers for the development of this disease is pregnancy. The article describes a case of pregnancy complicated by thrombotic thrombocytopenic purpura.

Materials and methods. To assess the clinical case, we used a retrospective analysis of medical documentation: maternity case record, birth history, results of laboratory and instrumental research methods.

Results. A 32-year-old patient was admitted to hospital at week 32 of gestation with manifestations of moderate preeclampsia, thrombocytopenia, and moderate anemia. Due to worsening of the condition, the delivery was performed by cesarean section. Subsequently, the mother’s condition did not improve: thrombocytopenia and hyperbilirubinemia progressed; the level of transaminases increased; ADAMTS13 activity was 8 %. Teleconferences were repeatedly held with experts from the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov (Moscow). Complex therapy including extracorporeal methods led to a positive result; the patient was discharged in satisfactory condition under the supervision of a hematologist and obstetrician-gynecologist.

Conclusion. Thrombotic thrombocytopenic purpura treatment tactics have its own characteristics; it is necessary to diagnose this pathology in a timely manner to provide qualified medical care and to prevent maternal and perinatal losses.

Background. The impact of natural and climatic factors on human health may change under the influence of other factors related to his socio-economic well-being. The aim of the study. To determine the correlation between indicators of heart rate variability and parameters of socio-economic well-being, quality of life of young people living in the Arctic zone of the Russian Federation (Arkhangelsk).

Materials and methods. Parameters of Heart rate variability in 36 young men (16–18 years old) were determined at entry (5 minutes) and at a fixed breath rate (5 minutes). We used the World Health Organization Quality of Life Brief Version of questionnaire, Family Affluence Scale (FAS II) and a questionnaire reflecting the financial situation, composition, and large number of children in the participants’ families.

Results. According to correlation analysis, a decrease in the number of family vacations per year and FAS-II scores is accompanied by an increase in sympathetic activity. Indicators of self-perceived health status, number of cars in the family, FAS-II score and family financial status are positively correlated with indicators of vagal activity. Parameters of the psychological sphere of life quality and family composition were negatively correlated with sympathetic activity; parameters of the physical sphere of life quality and the number of family vacations per year were negatively correlated with vagal activity (fixed breath rate).

Conclusion. We identified specific indicators of socio-economic well-being that are most closely related to both the tension of the cardiac activity mechanisms and the decrease in vagal reserves of autonomic regulation in young men living in the Russian Arctic.

Background. In demographic processes, a significant place is occupied by such a type of immigration as the return of representatives of the indigenous population to the mother state. Many states, including Kazakhstan, adopt special programs aimed at adapting immigrants to the host society. However, the integration of kandas (fellow countrymen) into Kazakh society is not always painless for both the repatriates themselves and the local population.

The aim of the study. To justify the need for a pragmatic approach to immigration in modern Kazakhstan, taking into account new risks and challenges.

Materials and methods. The methodology for studying social phenomena and interactions in concept is based on classical approaches: the theory of structural functionalism, symbolic interactionism, conflict theory, the theory of communicative action. To collect primary social information, qualitative and quantitative methods of sociology were used: statistical information analysis, focus groups, interviews, questionnaires.

Results. The resettlement of ethnic Kazakhs from farand near-abroad countries and their settlement in Kazakhstan affect the change in the demographic structure of the regional population. On the one hand, mostly young people of active, working age arrive, who can contribute to the economic development of the country. On the other hand, not all immigrants have the working qualifications necessary for a particular region. The conditions of turbulent social processes and complicated geopolitical situation require a pragmatic approach to immigration, which takes into account education, profession and other characteristics of immigrants.

Conclusion. Resettlement processes in manpower-surplus areas require special attention from the authorities. It is necessary to look at resettlement processes as a tool for solving socio-economic problems. First of all, these objectives include improving the well-being of the local population living in these regions and reducing risks and challenges for the state.

Background. The high incidence rate, the severity and the occurrence of complications determine the relevance of intestinal infections today. The individual’s immune response, which is controlled by the polymorphism of inflammatory protein genes is significant in the development and course of the disease. This issue in relation to intestinal infections has been understudied and is of interest in researching the influence of gene polymorphism on the development of intestinal infections.

The aim. To establish the presence of an associative relationship between the set of IL-2 T330G and TLR-4 ASP299GLY polymorphic genes and the likelihood of developing an acute intestinal infection, as well as the role of a combination of genes in induction of inflammatory proteins.

Materials and methods. The study included 108 people with acute intestinal infection and 94 apparently healthy volunteers. To determine the concentration of cytokines, immunoglobulins, we used blood serum and Vector-Best (Koltsovo, Russian Federation) test systems. The polymorphism of the IL-2 T330G and TLR-4 ASP299GLY genes was determined by PCR using Litekh LLC (Moscow, Russian Federation) primers. Statistical analysis was carried out using the ICMJE (International Committee of Medical Journal Editors) principle and SAMPL (Statistical Analyses and Methods in Published Literature) recommendations by MS Excel 2010 (Microsoft Corp., USA) and Statistica 6.0 (StatSoft Inc., USA) software.

Results. When constructing the ROC curve, the area under the curve was within 0.77, sensitivity – 0.9, specificity – 0.5 (95% confidence interval: 0.7–0.84; p < 0.001). These results are at a good prognostic level with a high risk of the disease development. Comparing the level of pro-inflammatory and anti-inflammatory cytokines, immunoglobulins between the patients with -299А/А+-330GG haplotype of TLR4 ASP299GLY and IL-2 T330G genes and the carriers of only the dominant allele A of the TLR4 A/A299 genotype or only the minor allele G of IL-2 G/G330 we found no significant differences (p ≥ 0.05).

Conclusion. Among carriers of the -299А/А+-330GG haplotype of the TLR4 ASP299GLY and IL-2 T330G genes, the risk of the intestinal infection development increases, but this haplotype does not affect the production of inflammatory molecules.

Background. Early diagnosis of the mixed infection of ixodic tick-borne borreliosis and tick-borne encephalitis can be difficult without laboratory confirmation of the diagnosis.

The aim. To assess clinical and laboratory predictors in patients for building the models of early differential diagnosis between mixed infection of erythema form of ixodic tick-borne borreliosis and febrile form of tick-borne encephalitis and monoinfection of erythema form of ixodic tick-borne borreliosis.

Materials and methods. The clinical study included 26 patients with mixed infection of the erythema form of ixodic tick-borne borreliosis with tick-borne encephalitis (mean age – 46.7 years) and 30 patients with monoinfection of the erythema form of ixodic tick-borne borreliosis (mean age – 48.5 years). 59 clinical, epidemiological and laboratory parameters, including 6 leukocyte blood indices, standard and extended hemogram profiles were studied in these patients the first week of the disease. For statistical analysis, we used Pearson and Mann – Whitney goodness-of-fit tests, ROC analysis with calculation of the area under curve (AUC) and logistic regression. Results. Patients with mixed infection, compared to the patients with monoinfection, had increased odds of having febrile fever, weakness, headache and orbital pain; meningism symptoms occurred only in patients with mixed infection. Early predictors of a preliminary diagnosis of mixed infection were elevated values of fever (AUC = 0.87), intoxication syndrome score (AUC = 0.71), leukocyte count (AUC = 0.64) and neutrophils (AUC = 0.71) in the hemogram, levels of leukocyte intoxication index according to V.K. Ostrovsky (AUC = 0.67) and neutrophil-leukocyte index (AUC = 0.65), as well as a decrease in the number of platelets (AUC = 0.77), eosinophils (AUC = 0.72) and basophils (AUC = 0.79) in peripheral blood. Two prognostic models which included clinical and laboratory parameters demonstrated excellent prediction of mixed infection (AUC = 0.90 and AUC = 0.91).

Conclusion. Early clinical and laboratory predictors have been established and models have been developed that make it possible, with excellent prognosis quality, to calculate in patients the probability of a preliminary diagnosis of mixed infection of the erythema form of ixodic tick-borne borreliosis with tick-borne encephalitis in comparison with borreliosis monoinfection.

One of the possible measures that can enhance the quality of medical care, reduce the number of adverse outcomes, and also achieve target values for the use of reperfusion methods of treatment for acute ischemic stroke is to improve the system of care for patients with in-hospital ischemic stroke. One type of in-hospital stroke is perioperative stroke that develops during or 30 days after surgery. Since the publication in 2014 of the last fundamental work on the prevention of perioperative stroke, the approaches to primary and secondary prevention, diagnosis, conservative and reperfusion treatment of ischemic stroke have been seriously modified. The numerous changes have created the preconditions for a revision of existing approaches to providing care for patients with perioperative ischemic stroke. In 2021, updated documents from foreign researchers/associations on the perioperative ischemic stroke in non-cardiac and non-neurosurgical patients were published. The second part of our review presents current data on the perioperative antithrombotic prophylaxis, clinical and instrumental diagnosis, treatment and organization of care for perioperative ischemic stroke in this category of patients. The issues of using reperfusion treatment methods in non-cardiac and non-neurosurgical patients with perioperative stroke, such as systemic thrombolytic therapy and endovascular interventions, are discussed in detail, including the world experience of their “offlabel” use.

The aim. The research was conducted to assess the total antioxidant and glutathione status, superoxide dismutase activity in menopausal women with moderate and asymptomatic COVID-19.

Materials and methods. Ninety two women 45 to 69 years old were divided into groups: women without COVID-19, not vaccinated, with no antibodies to SARS-CoV-2 (IgG) – control; women with moderate COVID-19 – main group; women with anti-SARS-CoV-2 IgG in blood but who deny any symptoms of COVID-19 in the last 12 months – asymptomatic COVID-19.

Results. A lower glutathione peroxidase (GPx), superoxide dismutase (SOD) activities and a higher glutathione reductase (GR) activity, glutathione S-transferase pi (GSTpi) concentrations were detected in the patients with moderate COVID-19 as compared to control. There were statistically lower oxidized glutathione (GSSG) levels, total antioxidant status (TAS) and higher reduced glutathione (GSH) levels, as well as GSH/GSSG ratio in the group with asymptomatic COVID-19 as compared to control. Significantly a lower GPx, SOD activities and a higher TAS, GR activity, GSTpi concentrations were detected in the patients with symptomatic COVID-19 as compared to group without clinical symptoms. ROC analysis shows the diagnostic significance of TAS (AUC = 0.714; p = 0.048), GSH (AUC = 0.714; p = 0.030), GSSG (AUC = 0.712; p = 0.031), GSH/GSSG (AUC = 0.837; p < 0.001) for group with asymptomatic COVID-19 compared with controls; TAS (AUC = 0.709; p = 0.020), SOD (AUC = 0.760; p < 0.001), GSH/GSSG (AUC = 0.658; p = 0.039), GPx (AUC = 0.774; p < 0.001), GSTpi (AUC = 0.864; p < 0.001) and GR (AUC = 0.871; p < 0.001) for group with moderate COVID-19 compared asympotmatic COVID-19.

Conclusions. Antioxidant defense system activity in menopausal women depends on the COVID-19 course.

The aim. To identify phenotypic features of adaptive cellular immune responses in young women living in different climatic and geographic regions.

Materials and methods. We examined 63 apparently healthy women, including 25 residents of Sovpolye settlement, Arkhangelsk region (Arctic region) and 38 residents of Tskhinvali (Republic of South Ossetia) aged 20–40. The content of lymphocytes, their phenotypes CD4+, CD8+, CD3+, CD5+, CD16+, CD10+, CD71+, CD25+, HLA-DR+ and CD95+, CEA (carcinoembryonic antigen) glycoprotein, and interleukin (IL) 6 and IL-10 cytokines was studied. Lymphocytes phenotyping was performed by indirect immunoperoxidase reaction using monoclonal antibodies (MedBioSpektr, Moscow) on “dried drop” lymphocyte sample with peroxidase conjugate and chromogen solution staining for immersion microscopy analysis (Nicon 50i, Japan). The content of CEA glycoprotein and cytokines was determined using ELISA.

Results. In women living in Arctic region, a deficiency of CD5+, CD3+, CD10+, CD95+, CD71+, CD25+, HLA-DR+ cells, CEA and IL-6 concentrations is associated with high concentrations of CD8+ and IL-10. In women living in Southern region, a slight deficiency of CD5+, CD8+ and CD95+ cells is associated with high concentrations of CEA, IL-6, IL-10 and CD10+, CD16+ and HLA-DR+ cells.

Conclusion. In inhabitants of different climatic regions, the features of formation of adaptive immune reactions are determined by different quantitative and qualitative composition of lymphocytes and cytokines phenotypes. Reduction of reserve capabilities of immune homeostasis is detected 3 times more often in inhabitants of the Arctic region.

Background. Benign prostatic hyperplasia (BPH) is a common disease in older men. Transurethral surgery in BPH is the gold standard for treatment, but the techniques differ in the energy used. Considering the different mechanisms of action of bipolar plasma and thulium fiber laser energy on prostate tissue, the study of structural changes under their influence is relevant.

The aim. To study the features of structural changes in the prostate during bipolar plasma and thulium fiber laser enucleation of benign prostatic hyperplasia.

Methods. Thirty one patients with BPH were divided into two groups. Group 1 (n = 17) underwent transurethral plasma enucleation of the prostate; Group 2 (n = 14) underwent transurethral thulium fiber laser enucleation. Fragments of the surgical prostate capsule were collected intraoperatively and were processed according to standard examination protocols using light and electron microscopy. The width of coagulation necrosis, the relief of the dissection line, the severity of cell and the prostate intercellular matrix destruction were taken into account.

Results. Studies have shown the clinical and functional perioperative homology of the compared methods of surgical treatment of BPH. Data from light and electron prostate microscopy showed a greater damaging effect of bipolar plasma energy, which is manifested by a larger width of the zone of coagulation necrosis, a torn and raised appearance of the dissection line, and pronounced integrity violations of cellular elements and intercellular matrix components. Laser exposure causes less pronounced changes, which indicates a more gentle effect of the thulium fiber laser on the prostate components.

Conclusion. The obtained microscopy results indicate that the intraoperative action of a thulium fiber laser is less traumatic for the cells and intercellular matrix of the surgical prostate capsule compared to bipolar plasma exposure.

The incidence of trigeminal neuralgia (TN) is 4–5 cases per 100,000 population per year, and the prevalence is about 20–50 cases per 100,000 population. According to the modern classification, the following types of TN are distinguished: classical, symptomatic and idiopathic. The cause of classical TN is a neurovascular conflict, of symptomatic TN – neoplasms in the petroclival area, vascular anomalies, multiple sclerosis, etc. In the absence of a reliable etiological factor, TN is considered idiopathic. TN pathogenesis remains one of the most challenging topics in neuroscience. Today, there are many theories and hypotheses regarding the peripheral and central mechanisms of trigeminal neuralgia. The most popular theory is the neurovascular conflict that occurs between the trigeminal nerve and the cerebral vessels, but this theory is not the only one. It is known that even after microvascular decompression, patients may continue to experience facial pain. Therefore, other pathogenetic mechanisms are discussed: short circuit theory, multineuronal mechanism, allergic and immune hypothesis, gate theory, bioresonance hypothesis, trigeminal convergence projection theory, “ignition” hypothesis and ion channel pathology. TN is a clinical diagnosis, and its establishing requires certain criteria proposed by the International Headache Society. Using instrumental research methods, namely magnetic resonance imaging of the brain, is necessary for the differential diagnosis of classical and symptomatic TN, and imaging results should always be interpreted in combination with clinical data to make correct decisions on further treatment tactics.

Background. The high prevalence of advanced forms of cancer currently requires new treatment approaches. Only modern high-tech surgical procedures can provide means for improving the results of treatment.

The aim. To study the results of treatment of patients with ovarian cancer with symptoms of peritoneal carcinomatosis using the HIPEC (Hyperthermic IntraPEritoneal Chemotherapy) method.

Materials and methods. The study was conducted in Irkutsk Regional Cancer Center and included 88 patients. They were divided into 2 groups: group 1 – primary cytoreductive surgery (CRS) with the HIPEC method (41 patients); group 2 – primary cytoreductive surgery (47 patients). The most important criterion was the peritoneal cancer index (PCI). If the PCI was ≤ 14, we chose cytoreductive surgery with or without HIPEC.

Results. PCI analysis showed differences in its values between the study groups (CRS – 10.17 ± 0.952; CRS + HIPEC – 12.93 ± 0.744; p = 0.002). There was an increase in length of stay in patients who underwent major surgeries in combination with HIPEC (21.8 ± 0.9 days versus 14.5 ± 0.6 days in the CRS group; p = 0.001). The CRS + HIPEC group had a longer duration of surgery (394.88 ± 19.935 min vs. 172.98 ± 11.514 min in the CRS group; p = 0.001). There was an increase in the overall percentage of postoperative complications in the CRS + HIPEC group – up to 26.8 % without statistically significant differences with the CRS group – 8.5 % (p = 0.082). The median time of relapse onset in the CRS + HIPEC group was 26 ± 4.3 months, while in the CRS group it was 18 ± 2.6 months.

Conclusion. Using HIPEC method has proven its significance in increasing diseasefree survival.

The prevalence rate of dry eye syndrome varies from 6.5 to 95 %. Diagnostic criteria are based on different methods and/or their combinations and are characterized by heterogeneity.

The aim of the study. To identify the risk factors for the development of dry eye syndrome in order to create a technology for early diagnosis of the degree of the disease in young people without concomitant ocular and general somatic pathology.

Materials and methods. Fifty patients aged 24 [22; 27] years were examined. We carried out an ophthalmological examination, including autorefractometry, visometry, biomicroscopy, the Norn test, a survey using the author’s questionnaire, and an assessment of the degree of dry eye syndrome using the Ocular Surface Disease Index (OSDI). Three study groups were formed: control group (OSDI = 0–13 points); group 1 – patients with OSDI = 14–22 points; group 2 – patients with OSDI > 22 points.

Results. When examining presented independent variables, screen time had the highest normalized importance (100 %), followed by tear film breakup time (58.4 %), smoking (24.3 %), night shifts (22.5 %) and using soft contact lenses (11.1 %). The technology for early diagnosis of the degree of dry eye syndrome is implemented on the basis of a multilayer perceptron, the percentage of incorrect predictions during its training process was 8.0 %. The structure of the trained neural network included 8 input neurons (the value of screen time and tear film breakup time, the presence or absence of smoking, night shifts and/or the use of soft contact lenses), two hidden layers containing 3 and 2 units, respectively, and 3 output neurons.

Conclusion. The proposed neural network has no difficulties in assessing the early diagnosis of the severity of dry eye syndrome and can be used in clinical practice.

Granulomatosis with polyangiitis (GPA) is manifested as ocular pathology in almost a third of patients, which can either be detected at the onset of the disease or occur in the late stages. The pathological process involves the orbit, sclera, episclera, cornea, conjunctiva, eyelids, nasolacrimal system, optic nerve, retina and choroid. Lesion of eye and its surrounding structures determines the severity of the pathological process, the patient’s quality of life and prognosis. The article presents a clinical case of a 38-year-old man with an unfavorable course of GPA, lesion to upper and lower respiratory tract, kidneys, and musculoskeletal system. The authors consider ocular manifestations in the context of a systemic disease. An ophthalmological examination of the patient revealed changes in sclera and choroid, which had not previously been described in detail in the literature. The patient underwent cataract phacoemulsification in the right eye with implantation of a posterior chamber intraocular lens. The dynamics of clinical manifestations of eye lesion in the near future is positive, but in the long term it remains doubtful due to pronounced changes in the orbit and adnexa of the eye against the background of ongoing small vessels vasculitis. Early consultation with an ophthalmologist and optical coherence tomography in patients with GPA are necessary at any stage of the disease. The clinical case is presented with consideration to the CARE 2021 recommendations.

Background. In recent years, modern medicine has been paying increasing attention to the patient’s quality of life, both in an interdisciplinary approach and in individual diseases. Quality of life is not only an important component of overall health, but also allows the clinician to develop an individualized approach to the patient based on general criteria for the pathological condition.

The aim of the work. To assess the quality of life of a child with post-COVID syndrome.

Material and methods. We studied the tonus of autonomic nervous system, the level of memorization, attention span and performance distribution, work efficiency, mental stability, and self-assessment of the anxiety level. The quality of life was assessed using our own method “Quality of life of children with post-COVID syndrome”. Results. A child with post-COVID syndrome developed vegetative, psycho-emotional, and cognitive disorders, which caused significant discomfort in everyday life and persisted for a long period. The neurovegetative changes described above were functional in nature, which allows us to hope for their reversibility. After the treatment, the teenager’s quality of life, based on assessment using our methodology, had a satisfactory score (43 points).

Conclusion. The clinical case was characterized by asthenoneurotic disorders, autonomic disorders, increased anxiety, emotional lability, and some cognitive impairments that negatively affected the patient’s quality of life. The above describes the growing need for further development of assessment of the quality of life of children with post-COVID syndrome in order to form clear personalized algorithms for medical correction and rehabilitation of such patients.

Background. The long head of biceps brachii tendon plays an important role in shoulder pain. Surgical tactics remain controversial. There are two approaches: tenotomy of the long head of biceps brachii tendon and tenodesis. Both have positive and negative sides. There is also no consensus on the effective position for performing tenodesis.

The aim. To assess the histological structure of various parts of the long head of biceps brachii tendon, which may be the causes for persistent pain syndrome.

Materials and methods. In this study, we examined the histological structure of the long head of biceps brachii tendon in 12 patients aged 18–59 years having chronic anterior shoulder pain with concomitant damage to the supraspinatus and subscapularis tendons. In all cases, magnetic resonance imaging (MRI) revealed changes that made it impossible to perform intraarticular tenodesis. Patients were divided into two groups according to the World Health Organization classification: young (18–44 years) and middle-aged (45–59 years). All patients underwent arthroscopy with subpectoral tenodesis and correction of concomitant pathology. The obtained macropreparations are divided into three zones: the proximal zone, the intertubercular zone and the zone below the intertubercular groove. All macropreparations were sent for histological examination.

It was revealed that the most common changes occur in the area of the intertubercular groove in all categories, however, in the middle-aged group, the signs of inflammation and degeneration are equally evident in this zone and in the proximal part of the tendon.

Conclusions. Young and middle-aged patients with damage to the tendons of the supraspinatus and subscapularis muscles and signs of chronic tendinitis of the long head of biceps brachii tendon tendon and pronounced structural changes according to MRI should undergo a subpectoral tenodesis procedure; it is also necessary to take into account the anatomical features of the tendon and possible surgical risks.

Background. Studying the characteristics of the course of coronavirus infection caused by SARS-CoV-2 remains relevant due to the high mutagenicity of the virus and the prevalence of the disease in the world. The search for new drugs to eliminate clinical manifestations of COVID-19, as well as against its agent, is essential. During the pandemic caused by SARS-CoV-2, dexamethasone was recognized as the only effective anti-inflammatory drug for the treatment of patients with severe form of the disease, but its use leads to a large number of side effects.

The aim. To study the therapeutic effect of the drug Molixan in the treatment of coronavirus infection in model animals – Syrian hamsters.

Methods. To assess the effectiveness of the drug Molixan, we carried out a visual assessment of the condition of the lungs using light microscopy and the morphometry of the lung tissue of experimentally infected Syrian hamsters on the day 6 after infection under different Molixan treatment regimens and during dexamethasone therapy. The test drug was administered using three different doses (22.2 mg/kg, 44.4 mg/kg and 88.8 mg/kg, which are equivalent to doses of 3 mg/kg, 6 mg/kg and 12 mg/kg of human body weight) once daily or dividing the dose into two within 12 h interval in case of multiple (5 days) intramuscular administration. Dexamethasone (comparison drug) was administered at a dose of 20 mg/kg once daily for 5 days.

Results. The studies showed statistically significant effectiveness of using Molixan at a dose of 44.4 mg/kg, divided into two doses, during 5 days. When compared with untreated hamsters, this treatment regimen reduces the degree of generalization and severity of the inflammatory process in the lungs; and the pathomorphological picture is similar to that observed during treatment with Dexamethasone.

Conclusion. The studied drug Molixan is effective as an anti-inflammatory drug in the treatment of the disease caused by SARS-CoV-2.

Background. In phthisiology, all recurrent respiratory tract infections are considered risk factors for tuberculosis (TB) in children. A differentiated assessment of the predictive value of recurrent upper and lower respiratory tract infections will improve the effectiveness of selective TB screening.

The aim. To carry out a differentiated assessment of the predictive value of recurrent upper and lower respiratory tract infections in children with tuberculosis and HIV coinfection.

Materials and methods. We conducted a retrospective study (2010–2020) of the anamnestic prevalence of recurrent respiratory tract infections in 249 children divided into 4 groups: 72 healthy children (HC); TB – 65 children with tuberculosis; TB/HIV – 56 children with HIV-associated TB; HIV – 65 children with HIV infection.

Results. Recurrent lower respiratory tract infections were detected in the anamnesis of 15 (23 %) children of the TB group and in 3 (4 %) children of the HC group (p < 0.001; odds ratio (OR) – 8.6). Lower respiratory tract infections were most common during the year preceding TB disease (11 out of 15 cases), within 2 years before the inclusion of children in the study – in 4 out of 15 cases (p = 0.027; OR = 11.0). In the TB/HIV group, the prevalence of lower respiratory tract infections compared to the HIV group was established only during the year preceding TB – 24 out of 33 cases (73 %) versus 10 out of 34 cases (29 %) in the HIV group (χ² = 10.9; p = 0.001; OR = 6.4). The occurrence of upper respiratory tract infections in pairs of HC group – TB group and HIV group – TB/HIV group had no statistical differences.

Conclusion. The predictor of TB in children regardless of their HIV status is the recurrent lower respiratory tract infections, registered during the year preceding the TB disease. The recurrent infections of the upper respiratory tract do not affect the realization of TB in children, regardless of their HIV status.

The article presents a clinical case of a 39-year-old patient with thrombosis and postoperative rethrombosis of the superior mesenteric vein. The disease was complicated by the small intestine necrosis and abdominal surgical infection. Successful thrombectomy and bowel resection made it possible to restore mesenteric blood supply, to stabilize the patient’s condition and to perform an enteroenteroanastomosis. Due to antithrombin III deficiency, rethrombosis in the early postoperative period was complicated by anastomotic leak, unformed intestinal fistula and peritonitis. A hybrid treatment (surgical, parasurgical and conservative) was performed, which included selective infusion of a thrombolysis activator at the superior mesenteric artery mouth. The patient recovered.

Clinical and laboratory manifestations of superior mesenteric vein thrombosis, in contrast to acute circulatory disorders in the arteriomesenteric system, are nonspecific and do not always allow timely diagnosis of intestinal ischemia. MSCT angiography identifies venous mesenteric thrombosis in most cases. The ineffectiveness of anticoagulant therapy against the background of antithrombin III deficiency caused superior mesenteric vein thrombosis and rethrombosis. The treatment of the small intestine critical postoperative ischemia included an increase in the volume of antithrombin III and frozen plasma intravenous infusion and selective administration of a thrombolysis activator (actilyse) into the superior mesenteric artery, which made it possible to restore the arteriolovenular intramural blood flow of the small intestine and to prevent another stem rethrombosis of the superior mesenteric vein. Laparostomy using a silicone plate made it possible to constantly monitor the course of the abdominal infectious process and to make timely decisions about the next intervention if medically required. The vacuum assisted design provided permanent lavage of the abdominal cavity without trauma to the soft tissues of the abdominal wall and presenting intestinal loops.

Background. Prolonged inactivity of skeletal muscles is accompanied by the development of oxidative stress and changes in sphingolipid metabolism. The relationship of sphingolipid mechanisms with generation of reactive oxygen species (ROS) in muscles subjected to functional unloading has not been studied.

The aim. To identify the relationship between changes in sphingomyelinase and ceramide abundance and ROS production in rat soleus muscle during functional unloading.

Methods. Male Wistar rats were subjected to hindlimb suspension for 12 hours or 14 days with the acid sphingomyelinase (ASM) inhibitor amitriptyline (AMI). The levels of ASM, ceramide and ROS were determined by fluorescence microscopy on histological sections. Pro-oxidant enzymes (NADPH oxidases 2 and 4 (NOX2 and NOX4)), cytochrome c oxidase (COX IV), the regulator of mitochondrial biogenesis PGC-1α (peroxisome proliferator-activated receptor gamma coactivator 1-alpha) in muscle homogenates were studied by Western blotting, which also was used for assessment of ceramide and ASM in the isolated mitochondrial fraction. The effects of sphingomyelinase and prooxidants on ceramide, ASM, ROS and NOX2 levels were studied in an ex vivo model by incubating the muscle with exogenous sphingomyelinase or H₂O₂.

Results. 12-hour hindlimb suspension was accompanied by an increase in the level of ASM and ceramide in rat soleus muscle. Unloading for 14 days was characterized by an increase in ASM, ceramide, ROS, NOX2, NOX4 and a decrease in COX IV and PGC-1α levels. ASM and ceramide were also increased in the mitochondrial fraction of muscle. The ASM inhibitor amitriptyline partially or completely prevented the changes caused by the unloading. In the ex vivo model, the stimulating effect of exogenous sphingomyelinase on the ROS and NOX2 levels in rat soleus muscle was found, whereas H₂O₂ stimulated muscle ASM and ceramide production.

Conclusion. A close relationship has been established between the sphingomyeli-nase pathway of ceramide formation and ROS production in skeletal muscle under conditions of functional unloading.

It is well known that the acidity of the microenvironment has a significant impact on the functional activity of cells involved in tissue repair. To date, the effect of biomaterials containing components of the human dermis intercellular matrix on fibroblasts under acidosis has not been fully studied.

The aim of the study. To evaluate the effect of a composite hydrogel containing dermal components on the functional activity of intact fibroblasts and fibroblasts with acid-induced dysfunction.

Materials and methods. To simulate the physicochemical conditions of acute inflammation, human fibroblasts were incubated for an hour at 39 °C in a nutrient medium overacidified to pH = 6. The morphometric characteristics of human skin fibroblasts were assessed using light and fluorescence microscopy methods. The number of apoptotic cells and proliferation index were assessed using flow cytometry.

Results. It has been established that exposure of fibroblasts to an acidic medium inhibits their adhesive properties and reduces the rate of cell growth. The introduction of hydrogel into a cell suspension with damaged cells restores adhesive properties and cell growth. In the fibroblast population, after acid exposure, the number of living cells decreases, and the number of apoptotic cells increases. Cultivation of damaged fibroblasts in the presence of a composite hydrogel increases the number of living cells in the population and reduces the number of apoptotic cells. Acid-induced fibroblast damage reduces the proliferative activity index. It was revealed that the introduction of hydrogel into the culture medium stimulates the proliferative activity of both intact and damaged fibroblasts. The results obtained indicate that a composite hydrogel consisting of extracellular matrix components is capable of restoring the functional activity of fibroblasts damaged as a result of exposure to an acidic medium. The results obtained can be used to create biomaterials that increase the efficiency of skin regeneration in cases of excessively intense acute inflammation.

Background. Ozonation products of unsaturated fatty acids in fats and oils – 1,2,4-trioxolanes – which contribute to the normalization of oxidative and energy metabolism in various diseases, may be a promising substance for the creation of new combined anti-burn drugs.

The aim. To study the effect of 1,2,4-trioxolanes in a pharmaceutical composition with betulin, which exhibits wound-healing properties, on indicators of oxidative stress and on energy metabolism in the treatment of burns in an experiment onrats. Methods. The experiments were carried out on 50 male Wistar rats with seconddegree skin burns. We assessed the activity of glutathione reductase, glucose-6-phosphate dehydrogenase, lactate dehydrogenase, aldehyde dehydrogenase, superoxide dismutase and catalase, as well as the level of lipid peroxidation indicators.

Results. The properties of 1,2,4-trioxolanes were studied and a pharmaceutical composition of 1,2,4-trioxolanes with betulin from birch bark in fish oil was developed. The effect of this composition on oxidative and energy metabolism in rats during the treatment of burns was studied. The activation of NADP/H and NAD/H dependent enzymes (glutathione reductase, glucose-6-phosphate dehydrogenase, lactate dehydrogenase, aldehyde dehydrogenase), as well as superoxide dismutase and catalase, and the normalization of lipid peroxidation parameters under the influence of the studied composition in the treatment of burns were revealed. The effect of the composition on the energy metabolism of erythrocytes was noted, which was assessed by changes in the ratio of lactate dehydrogenase activity in the reverse and direct reactions. Morphohistological studies showed that using the composition under normal conditions and in case of a burn had no effect on the structure of the stomach wall, and also improved the condition of the burn wound on the day 10 compared to the wound condition in animals without treatment.

Conclusion. The proposed composition of 1,2,4-trioxolanes and betulin in fish oil, which allows normalizing oxidative and energy metabolism and improving the condition of a burn wound without toxic effects on the stomach wall, can be used as an element of additional therapy in the treatment of burns.

Anthrax remains relevant in the world and in the Russian Federation. In Siberia and the Far East, epizootological, epidemiological, environmental and microbiological monitoring of anthrax is constantly carried out. To analyze the epizootological and epidemiological situation of anthrax, we used the information from veterinary institutions and Rospotrebnadzor for 24 regions, as well as reference and archive materials. On the territory of Siberia and the Far East for the period from 1985 to 2023, pronounced epizootological and epidemiological problems of anthrax are observed in the Yamalo-Nenets Autonomous Okrug, the Republic of Buryatia, Omsk Region and the Altai Territory. Over the last five-year observation period, high epizootic activity has been observed in the west of the Republic of Tyva. A total of 3,375 livestock animals and 128 people fell ill. The anthrax database contains information on 7,491 stationary anthrax-infected points in 22 subjects and 562 anthrax burials and cattle burials in 17 subjects of Siberia and the Far East. B. anthracis strains have slight variability in biological properties and belong to two global genetic lines – A and B. In order to prevent anthrax, it is necessary to ensure surveillance of soil foci of anthrax (anthrax burials and cattle burials, “plague fields”), a high level of livestock animals registration and their specific vaccination coverage; to control the implementation of veterinary and sanitary requirements for pre-mortem inspection and emergency slaughter of livestock, the sale of meat and meat products, and biological waste disposal; to carry out explanatory work among the population.

The aim of this article was to show the labor valour during the Great Patriotic War of the employees of the first research institute in Irkutsk, which began its history in 1912, as well as their success of the present time. The oldest scientific institution in the Irkutsk region was originally created on the initiative of the Siberian Medical Society as a laboratory and was transformed into the Chemical and Bacteriological Institute in 1918, and in 1930 it became the Institute of Epidemiology and Microbiology of the People’s Commissariat of Public Health of Russia.

By the beginning of the Great Patriotic War, the institute had an epidemiological department and a microbiological laboratory that carried out epidemiological surveillance and diagnosis of a wide range of infections in Siberia. During the war years, the manufacturing sector with the production of vaccines and serums acquired particular importance. By the end of the war, 285 employees worked at the institute, 32 of them had higher education. During the war years, the production of vaccines against typhoid, paratyphoid, dysentery, diphtheria, tuberculosis, and smallpox was significantly increased. Serums against tetanus and measles, and a dysentery bacteriophage were produced. At the same time, research projects and thesis works were carried out. The employees of the institute received national and departmental awards, commendations, honorary distinctions, and rewards for their scientific work and production excellence.

Currently, the institute continues the glorious traditions of the past and demonstrates truly heroic efforts in the development of virology and microbiology, working in priority areas of medical and biological science. Of course, the works of scientists of the present time will be appreciated only by descendants, as is now happening with the assessment of the work of the Institute of Epidemiology and Microbiology during the Great Patriotic War.