Oxidative stress is an important mechanism of myocardial damage during ischemia/reperfusion. To investigate the possibility of restoring the redox balance using “indirect” antioxidant effects, the cardioprotective effect Keap1/Nrf2/ ARE system inducers was studied in long-term ischemia/reperfusion in vivo. Material and methods. We used the original synthetic hydrophilic monophenol sodium 3-(3’-tert-butyl-4’-hydroxyphenyl) propyl thiosulfonate (TS-13) and reference drug tert-butylhydroquinone (tBHQ). Male Wistar rats received 100 mg/kg of TS-13 solution (with drinking water) or tBHQ (intraperitoneally) daily for 7 days. Animals of the comparison groups received the corresponding solvents. Local ischemia (45 min, occlusion of the left coronary artery) and reperfusion (120 min) of the heart were simulated in vivo 1 day after last drug administration. The ECG was recorded during ischemia and reperfusion; at the end of reperfusion, the heart was removed, the zone of hypoperfusion and the zone of necrosis were detected. Changes in the expression of the mRNA of Nfe2l2, Nqo1, Hmox1, Gstp1, Rela, and Nfkb2 gene in myocardial tissue were determined by real-time TaqMan PCR. Results and discussion. Pretreatment with TS-13 and tBHQ did not influence the infarct size and the incidence of ventricular arrhythmias. Preliminary administration of tBHQ did not change the genes expression of the studied in myocardial tissue after prolonged I/R. TS-13 administration was accompanied by an increase in the content of the transcripts of the gene that encodes Nrf2 (by 7.64 times) and Nrf2-driven genes Nqo1 (by 6.46 times) and Hmox1 (by 3.63 times); the expression of the Gstp1, Rela, and Nfkb2 genes did not differ from the corresponding values of the control group; compared to animals treated with tBHQ, the expression of the Nfe2l2, Nqo1, Hmox1, Rela, and Nfkb2 genes was 16.23, 4.44, 2.68, 3.17, and 2.64 times higher, respectively. The results obtained cast doubt on the therapeutic importance of the induction of the Keap1/Nrf2/ARE system during prolonged heart ischemia/reperfusion.

The aim of the investigation was to study the activity of lysosomal chitinases (chitotriosidase and β-glucosaminidase) in the liver of mice using a model of BCG-induced tuberculous inflammation after intravenous administration of apolipoprotein A-I. Material and methods. The study was carried out on male CBA mice weighing 20–22 g. Disseminated tuberculous inflammation was modeled by a single intraperitoneal injection of 0.5 mg of BCG vaccine. The activity of chitinases was determined using fluorescent substrates 4-methylumbelliferyl β-D-N,N′,N′′-triacetylchitotrioside and 4-methylumbelliferyl N-acetyl-β-D-glucosaminide. Results and discussion. BCG-infection of animals after 4 weeks caused a significant increase in the activity of endogenous chitinases in comparison with the control group: chitotriosidase – 3.05 times (p <0.001), β-glucosaminidase – 1.76 times (p <0.01). Intravenous administration of apolipoprotein A-I to animals against the background of BCG infection inhibited the increased enzyme activity, values did not significantly differ from the control values. Conclusions. The results of these studies indicate the ability of apolipoprotein A-I to reduce the increased activity of endogenous lysosomal chitinases in the liver of mice with BCGinduced tuberculous inflammation. 

The research was aimed at analyzing current approaches to the organization and design methodology of visualization database built on the basis of computer vision. Such approaches are necessary for effective development of diagnostic systems using artificial intelligence (AI). A training data set of high quality is a mandatory prerequisite for that. Material and methods. The paper presents the technology for designing an annotated database (SBT Dataset) that contains about 1000 clinical cases based on the archived data acquired by the Federal Neurosurgical Center, Novosibirsk, Russia including data on patients with astrocytoma, glioblastoma, meningioma, neurinoma, and patients with metastases of somatic tumors. Each case is represented by a preoperative MRI. The Results and discussion. The dataset was built (SBT Dataset) containing segmented 3D MRI images of 5 types of brain tumors with 991 verified observations. Each case is represented by four MRI sequences T1-WI, T1C (with Gd-contrast), T2-WI and T2-FLAIR with histological and histochemical postoperative confirmation. Tumors segmentation with verification of the tumor core elements boundaries and perifocal edema was approved by two certified experienced neuroradiologists. Conclusion. The database built during the research is comparable in its volume and quality (verification level) with the state-of-the-art databases. The methodological approaches proposed in this paper were focused on designing the high-quality medical computer vision systems. The database was used to create artificial intelligence systems with the “physician assistant” functions for preoperative MRI diagnostics in neurosurgery. 

Patients with autoimmune gastritis (AIG) often have anemia of various origins. Hematological disorders usually portend severe atrophy, and in many cases, are the only indicators of the disease. Aim of the study was to investigate the electrical and viscoelastic parameters of erythrocytes in patients with AIG for their possible use in diagnostics. Material and methods. 73 patients with AIG (mean age 55.3 ± 12.54 years) and 38 people of the control group were examined. Electrical and viscoelastic parameters of erythrocytes were studied by dielectrophoresis. Results. Statistically significant decrease in the average cell diameter, the proportion of discocytes cells and an increase in the proportion of spherocytes, deformed forms were found in the group of patients with AIG in combination with Helicobaсter рylori (H. pylori, H.p.) infection compared with healthy individuals. Patients with AIG had significantly lower levels of amplitude of deformation, membrane capacity, dipole moment, speed of cell movement to the electrodes, polarizability at high frequencies of the electric field (106 , 0.5×106 Hz), relative polarizability, and, conversely, higher values of membrane conductivity, aggregation, destruction indexes, summarized viscosity, rigidity, than those in the comparison group. Between groups of patients with and without H. pylori infection, differences were found in indicators reflecting the surface charge of erythrocytes – the speed of movement to the electrodes (p = 0.019), the dipole moment (p < 0.001) and the state of the membranes – its capacity (p = 0.004). The diagnostic model, which includes three parameters of erythrocytes – the dipole moment, the speed of movement to the electrodes, the capacity of the cell membrane, provided high diagnostic accuracy of distinguishing AIG H.p. (+) and H.p. (–) – area under ROC curve AUC 0.925, sensitivity 92.4 %, specificity 89.7 %. Conclusions: Electrical and viscoelastic parameters of erythrocytes are promising in the diagnosis of AIG, including on the background of H. pylori infection. 

The study aim wasto evaluate the effectiveness of treatment of postveal uncompensated glaucoma in a patient with chronic infectious uveitis by microinvasive non-penetrating deep sclerectomy using drainage implant Healaflow. Material and methods. In a patient with the history of chronic uveitis, for the purpose of surgical treatment of secondary uncompensated post-uveal glaucoma, a microinvasive non-penetrating deep sclerectomy with the introduction of Healaflow has been performed in order to stabilize intraocular pressure, visual acuity and visual field. Healaflow was used to prevent proliferation and scarring in the early postoperative period. Results. At the follow-up period of 6 months after the operation, the drainage outflow tracts were preserved; intraocular pressure was stabilized. Conclusions. Microinvasive non-penetrating sclerectomy with Healaflow injection is the safe and effective method of surgical treatment of patients with postveal uncompensated glaucoma. The use of Healaflow is an effective method for preventing scarring of formed drainage outflow tracts. 

The frequency of reoperations associated with complications after mammoplasty reaches 15 % during the first year. There are many ways and means for processing the soft tissues of the breast during mammoplasty, helping to reduce the risk of postoperative complications. The purpose of this work was to develop an algorithm for the application of the argon plasma technique for tissue treatment in mammoplasty. Material and methods. The study included 30 females aged 23 to 46 who underwent mammoplasty. The patients were divided into 2 groups of 15 people. In group 1, standard methods of processing soft tissues were used, and in group 2, the argon plasma technique was used in conjunction with the use of Aristo glue. Patients were observed in the early, late and distant postoperative period. Results. In the course of the study, in addition to the excellent coagulation and bactericidal action of argon plasma, the effect of “pulling up” the soft tissues of the mammary gland was found, which, in case of ptosis of I and II degrees, made it possible to use a smaller implant to achieve an optimal aesthetic result. Also, when using the argon plasma technology, no inflammatory processes were observed, the amount of exudative fluid in the drains decreased, the pain syndrome was significantly less pronounced in comparison with patients who underwent the standard method of tissue processing. Conclusions. This study confirms the fact that the use of argon plasma coagulation in the processing of breast tissue has a significant number of advantages compared to standard methods. 

The development of a neurological deficit clinic in patients with pulmonary embolism (PE) requires a diagnostic search aimed at excluding the phenomenon of paradoxical embolism in the form of transcranial dopplerography (TCDG) with a bubble test, and to clarify the features of intracardiac hemodynamics – transesophageal echocardiography (TEE). Material and methods. The article presents two clinical examples of the development of PE in the form of embolic ischemic stroke (IS) against the background of deep vein thrombosis of the lower extremities, PE, patent foramen ovale (PFO) in combination with an atrial septal aneurysm. Results and discussion. In the first case, the right-left shunt was confirmed by TKDG with a bubble test, in the second example, during routine transthoracic echocardiography, a ribbon thrombus prolapsing through the PFO was visualized. In our opinion, PE is a possible mechanism of IS in patients with venous thromboembolic events. Consequently, it is necessary to plan a “bubble test” for verifying the cause of a stroke. Conclusions. The management of patients with PE and IS was individual and required a team approach, including the use of thrombolytic therapy, the selection of an anticoagulant therapy regimen, choice of conservative/invasive tactics for the treatment of patients. 

In the modern concept of treatment of patients with injuries of peripheral nerves, the main thing is to understand the mechanism of its sliding and the peculiarities of blood supply. Studying the nerve topographic anatomy, we are convinced that the mobility of the nerve exists not only in relation to the tissues surrounding it, but also at the level of its inner bundles. In this article, we report on the different degree of nerve mobility depending on its location zone, and that the ulnar and median nerves have the highest degree of mobility at the level of the forearm distal third. To calculate the change in the glide of the nerves, a mathematical model was constructed to measure their mobility during flexion and extension in the elbow joint, allowing to personalize the flap plasty depending on the length of the autograph vascular pedicle. The anatomical and topographic features of the angioarchitectonics of the nerve at various levels were studied, the presence and variability of the location of the vascular pedicle of blood-supplied autografts were studied. The obtained knowledge is necessary for carrying out revascularization of the damaged nerve zone with various types of autografts with autonomous blood flow. Conclusions. Knowledge of the anatomical and topographic features of peripheral nerves, their blood supply and mobility is necessary for their recovery for various injuries.

Chronic heart failure is a global cardiac problem. The last decade can rightly be called a breakthrough in the treatment of this nosology, due to the emergence of a new group of drugs – SGLT2 inhibitors (gliflozins), which, both in patients with initial heart failure with different ejection fraction, and in the presence of risk factors for its development, have a persistent positive impact on the number of hospitalizations for heart failure. A number of pleiotropic effects of SGLT2 inhibitors are also attractive to the clinician, which include moderate weight loss, a decrease in body fat in visceral fat depots, a decrease in the level of hepatic transaminases in the blood, stimulation of erythropoiesis, which organically complements the strategy of complex cardiorenometabolic protection and emphasizes the unique role of this class drugs in modern cardiology. In the near future, we will have to learn the results of the ongoing multiple studies of gliflozin, which is highly likely to open new historical horizons in the treatment of patients with cardiovascular diseases, including various categories of patients with acute and chronic heart failure. 

The interest in the anatomy of the splenic artery, which had fallen in the middle of the XXI century, has flared up with renewed vigor at the end of the previous century and the beginning of the twenty-first century. The introduction of new diagnostic techniques, such as a computer tomography (CT) angiography, and the increase in surgical interventions on organs of the splenic artery basin, particularly the pancreas, especially with the use of minimally invasive, interventional, and robotic technologies, have only increased interest in the anatomy of this vessel.  

Material and methods. A systematic literature review of the online databases PubMed, Embase, CyberLeninka, and GoogleScholar covering 1910–2021 was conducted, using the following keywords and their combinations: “rheumatic trunk”, “splenic artery”, “splenic vessels”, “pancreatic body and tail arteries”, “blood supply to the pancreas”, “anatomy”, “variants” and “anomalies”.  

Results and discussion. All currently available cases of congenital absence of the splenic artery were described and analyzed. According to anatomical and radiological studies over the past 100 years, the main source of the splenic artery is the splenic trunk, and the frequency of this variant ranges from 90.6 % to 100 %. According to the results of morphometry, the length of the splenic artery varies from 2 to 32 cm and the diameter (caliber) from 4 to 11 mm. In relation to the pancreas, the splenic artery may be located suprapancreatically (63.3–99.33 % cases), anteropancreatically (prepancreatically) (4.2–18.5 %), intrapancreatically (1.2–6.66 %) or retropancreatically (2.8–36.6 %). The major pancreatic branches of the splenic artery are the dorsal, great and caudal pancreatic arteries with frequency 24.7–47.2 %, 45.7–100 % and 26–100 %, respectively.  

Conclusions. A systematic review of the literature showed differences in the topography of the splenic artery in anatomical and radiological studies. Original studies with the inclusion of both sufficient anatomical and radiological material, with the unified statistical approaches and data interpretation strictly considering the international anatomical nomenclature seem to be promising. 

Aim of the study was to assess the risk of bronchopulmonary pathology in workers of the production of synthetic polyacrylonitrile fiber as a result of exposure to harmful chemicals and smoking tobacco products. Material and methods. During the periodic medical examination, the function of external respiration and adherence to smoking in 137 employees were studied, medical records were analyzed (025/u accounting form). Hygienic assessment of working conditions was carried out on the basis of the results of in-situ sanitary and hygienic studies. Results and discussions. As a result of a hygienic assessment of working conditions, it was found that workers engaged in the production of polyacrylonitrile fiber are subject to the combined intermittent effects of harmful chemicals of hazard classes 1–3 (acrylonitrile, methyl acrylate, hydrocyanide, ammonia, sodium rhodanide, sulfuric acid, methanol, isopropyl alcohol, ethylene glycol), the content of which in the working area exceeded the maximum permissible concentrations in 1.6% of samples. The occupational risk of developing bronchopulmonary diseases in groups of workers who smoke is assessed as unacceptably high, while in people exposed to harmful chemicals, its level is 28.46 times higher than in people who are not exposed to these effects. The risk of the formation of ventilation disorders in groups of smoking workers is unacceptably high, while its level is 2.46 times higher in workers exposed to harmful chemicals than in non-workers in such conditions. In groups of workers exposed to harmful chemicals, the occupational risk of obstructive disorders is unacceptably high, in the group of smokers the risk is 2.32 times higher. Conclusions. Among the employees of the enterprise producing synthetic polyacrylonitrile fiber, the influence of tobacco smoking on the development of bronchopulmonary pathology is higher than the influence of harmful working conditions, and the use of smoking tobacco products significantly increases the negative effect of chemical pollutants. 

Osteoporosis (OP) is a metabolic bone disease, characterized by a decrease of bone mineral density, leading to the development of low-energy fractures. Serum pyridinoline (PYD) and C-terminal cross-linking telopeptide type I (β-CrossLaps) are among the specific markers of bone resorption. Vitamin D is involved in the metabolism of bone tissue, its deficiency accelerates the processes of bone tissue breakdown. Material and methods. 60 women with osteoporosis were studied (30 Russian and 30 Buryat nationalities) aged 50 to 80 years; the control group included 20 women (10 Russian and 10 Buryat nationalities). Serum bone resorption markers, namely pyridinoline and β-CrossLaps, 25-hydroxyvitamin D (25(OH)D) were measured using immunoassays. Results and discussion. The level of β-CrossLaps was higher and the content of 25(OH)D was lower in women with osteoporosis compared to the control group. There was a positive relationship between β-CrossLaps concentration and body mass index < 20 kg/cm2 , frequent falls, and a hip fracture, between the level of 25(OH)D and hereditary history of osteoporosis in Russian women. There was a positive relationship between Serum pyridinoline and smoking, between 25(OH)D and low physical activity, β-CrossLaps and the major osteoporotic fractures in Buryat women. It was found that the β-CrossLaps is an independent predictor of the development of fractures in Russian women (β = 0.678, p = 0.04). In Buryat women, independent predictors of fractures are pyridinoline (β = –0.38, p = 0.04) and β-CrossLaps (β = 0.671, p = 0.01). Conclusions. The systemic markers of bone resorption (pyridinoline, β-CrossLaps) and 25(OH)D can be used in the diagnosis of osteoporosis and fractures in residents of the Trans-Baikal Region in addition to risk factor assessment and bone mineral density measurement.