One in four people in the world currently has kidney problems to varying degrees. It is known that the new coronavirus infection (COVID-19) is primarily a respiratory disease, but the kidneys are the target organ. Coronavirus is tropic to renal tissue due to the presence in the organ of the angiotensin converting enzyme type 2 and transmembrane serine protease 2, which are considered the target of this virus. The presence of any stage of renal insufficiency is an independent adverse risk factor for coronavirus infection and results in high hospitalization rates in hospitals and a mortality rate. Kidney damage is caused by a variety of pathogenetic mechanisms: direct cytopathic effect of the virus on their structure (in the kidney body - podocytes, mesangial cells, in the vascular glomerulus - endothelium of capillaries, in the proximal tubules - epithelial cells); cytokine storm; damage to the renin-angiotensin-aldosterone system; immunothrombosis. In many patients with confirmed coronavirus infection, significant changes in urine analysis (hematuria, proteinuria) and an increase in serum creatinine levels have been observed in the laboratory since the first days of the disease. One of the main risk factors for mortality is the development of acute renal injury. More research is needed on the exact effects of SARS-CoV-2 on the kidneys. Understanding the main pathogenetic pathways of kidney damage in COVID-19 is necessary for the development of strategies and the development of effective treatment methods.

The prevalence of non-alcoholic fatty liver disease, according to various estimates, affects a quarter of the world population. Significant interest in this pathology is due to the high frequency of adverse liver (steatohepatitis, liver fibrosis and cirrhosis) and extrahepatic (association with cardiovascular disease) outcomes. One of the key areas is the timely diagnosis of liver steatosis. Reference diagnostic methods, which include liver biopsy and magnetic resonance imaging with assessment of liver fat proportion weighted by proton density, have objective practical and financial limitations for their routine use in detection and quantitative assessment of liver steatosis. Therefore, one of the current trends in hepatology is the development of inexpensive, widely applicable, and reliable noninvasive diagnostic tools. The aim of the present review is a comparative analysis of various ultrasound methods of liver steatosis diagnostics: qualitative, semi-quantitative and quantitative (estimation of hepatorenal index, controlled attenuation parameter). The presented publication reviews the currently available methods of detection and assessment of severity of liver steatosis based on ultrasound examination, including their classification, methodology and comparison of diagnostic efficiency with analysis of intra- and inter-operator reproducibility, sensitivity and specificity.

Lipid-lowering therapy is one of the most important aspects in the treatment of patients with cardiovascular disease, which is still the leading cause of death in the adult population. Over the past 10 years, fundamentally new lipid-lowering drugs have appeared such as alipogene tiparvovec, mipomersen, lomitapide, evolocumab, alirocumab, bempedoic acid, inclisiran, evinacumab, volanesorsen. In order to update information on the effectiveness and safety of the use of lipidlowering drugs, their consumption in the pharmaceutical market in retrospect and at the present time, a systematic search was carried out in the scientific databases eLIBRARY.RU, PubMed, Embase, ClinicalTrials.gov, the Cochrane Library, Russian State Register of Medicines from 1980 to 2023. Statins remain the main drugs of choice for regular use in violation of lipid metabolism. Fibrates are the drugs of choice in patients with rare forms of hyperlipidemia associated with high triglyceride level. A group of other lipid-lowering drugs has been characterized from the point of view of the mechanisms of action, indications for use, and the availability of registration certificates in the Russian Federation and in the world. The growing interest in ezetimibe in the Russian pharmaceutical market is confirmed by the high growth in the share of local companies in its production as part of the import substitution strategy. It has been established that the drug causes undesirable effects with a small degree of probability as part of combination therapy. Inhibitors of proprotein convertase subtilisin-kexin type 9 (PCSK9) open up new possibilities for the treatment of patients at very high risk of cardiovascular disease. Lomitapide is not registered in the Russian Federation, but since December 2021 it has been included in the list of medicines purchased by the Krug Dobra Foundation to help children with homozygous familial hypercholesterolemia. Since 2022, inclisiran, a drug inhibiting synthesis of PCSK9 with RNA interference, has been approved for use in Russia and is safe in patients with hyperlipidemia and statin intolerance. Thus, in the 21st century, fundamentally new positions have appeared in the group of lipid-lowering drugs, which are examples of biotechnological and gene therapy drugs.

Disorder of the formation of the cavum septum pellucidum (CSP) occurs in a wide range of pathologies of the brain. Its identification from 18 to 37 weeks is a necessary rule of prenatal screening, which must also be performed in postnatal studies of premature infants. Unimaged CSP should be considered as a potential indicator of cerebral dysfunction and such severe malformations as agenesis (dysgenesis) of the corpus callosum, holoprosencephaly (HPE), schizencephaly, Aicardi syndrome, hydrocephalus and septo-optic dysplasia (SOD). A special place in the differential diagnosis of unimaged CSP is represented by SOD, lobar HPE, and its mild subtype - septopreoptic HPE. The literature describes the isolated absence of SP, without finding other signs related to HPE or SOD, as a variant of development. However, the neurological outcome in these children varies from normal to delayed development of the nervous system by different degrees, so this statement remains controversial. The article discusses in detail the anatomy, physiology, pathology of the septal region, the role of echographic studies in the antenatal and postnatal periods, and the correlation of the detected changes with the clinical picture.

The research aimed to study the restructuring of hemodynamics, gas exchange, and heart rate variability parameters in response to the stress test with breathing in confined space in different generations of young Caucasoid natives permanently residing in Russia’s Magadan region. Material and methods. Two hundred 18–21 year old male migrants and those born to them in 1–3 generations, all Caucasians by origin, participated in the Magadan city survey. During the resting and confined space rebreathing sessions we registered subjective heart rate, blood pressure, oxygen and carbon dioxide level. The heart rate variability was recorded by the Varicard complex coupled with the Iskim-6 software. The exhaled gas level was determined by the Karbonik analyzer. The blood oxygen saturation was measured by a pulse oximeter. An electronic tonometer was used for the blood pressure control. Results and discussion. Both resting and rebreathing tests revealed lower HRV rates in the group of migrants (zero generation): not only did they exhibit a decrease in the activity of the autonomic regulation contour – they also reported an imbalance in the sympathetic and parasympathetic regulation of cardiac hemodynamics. However, the 3rd generation subjects showed an optimal and stable balance between the links of autonomic regulation, both at rest and during functional exercise with rebreathing, which is reflected in the parameters of arterial pressure and gas exchange. Interestingly, the most informative indicators of adaptation are not the absolute values of the studied indicators but the difference between their background and testing values, which to a greater extent hold information on the body functional reserves of those born in the North in different generations constantly living in the extreme conditions of the North. It was found that the increase in parasympathetic activity and its influence on the cardiac rhythm both at rest and in response to a breathing test was most pronounced in the group of natives of the 3rd generation, which reflects a deeper degree of their adaptation to the northern conditions. Apparently, this is a manifestation of the general strategy of functional restructuring of the body’s regulatory systems aimed at the formation of optimal compensatory-adaptive restructuring of gas homeostasis during an increased period of residence in the North.

There is an increased interest in the problem of helping children with skull deformities that occur due to premature closure of cranial sutures and the development of craniosynostosis. Assessment of cranial dysmorphism in skull deformities is often subjective and remains a challenge. Morphometric studies are a significant section that is poorly covered in modern scientific, practical and reference medical literature.
Material and methods. The analysis of the data of craniometric measurements, of cephalic index (CI) according to the results of computed tomography in 24 children with dolichocephaly (14 boys, 10 girls) at the age of 7.4 ± 3.2 months (2–12 months) and in the control group of 25 children (15 boys, 9 girls) at the age of 7.2 ± 4.8 months (2–12 months).
Results. The data showed significant differences in children in norm and in dolichocephaly. CI shows the ratio of the linear dimensions of the skull in normal and dolichocephaly. The most significant differences were revealed when assessing the distances G-Op, CG-TS, CG-MAI, MAI-MAI, Zg-Zg, Ec-Ec, Br-Ba. CG-TS, CG-MAI, MAI-MAI, Br-Ba reflect deformation of the skull base, and Zg-Zg, Ec-Ec – deformation of the facial skeleton in dolichocephaly.
Conclusions. A comprehensive morphometric analysis of the skull structures based on precise anatomical landmarks demonstrated objective differences in the morphology of the skull in children with normal conditions and with dolichocephaly. The data indicate the importance of a comprehensive assessment of changes in the skull for all forms of the skull. Carrying out such an analysis is important for understanding all morphological changes in the skull in health and disease.

The cerebellum is not just a “coordination node” but phylogenetically the most ancient, multicomponent, complex system. The aim of the study was to carry out a comparative analysis of the structural organization of the cerebellar cortex in the upper and lower semilunar lobes in the age aspect.
Material and methods. The data of the sectional study of the cerebellum of 196 men and 180 women who were divided into two groups were analyzed. In the first group, the structural organization of the cerebellar cortex in the area of the upper semilunar lobule and in the second group, in the area of the lower semilunar lobule was studied. The first group included 179 persons (93 men and 86 women) aged 21 to 88 years who died between 2016 and 2018; the second group included 197 persons (103 men and 94 women) aged 22 to 88 years who died between 2019 and 2022. Autopsy material was taken from the upper and lower semilunar lobes in both cerebellar hemispheres, was fixed according to the standard technique, and cortical thickness was determined.
Results. Cortical thickness in both upper and lower semilunar lobules of both cerebellar hemispheres in both men and women statistically significantly decreased by senile age. Thus, by senile age, males depleted their cortex by 19.5 and 22.5 % in the upper semilunar lobule of the right and left hemisphere, respectively, and females by 20.4 % and 21.9 %, respectively. In the inferior semilunar lobule the corresponding decrease in cortical thickness was 21.5 and 21.9 % in males and 23.7 and 21.9 % in females. A positive correlation between cortical thickness of the upper and lower semilunar lobes, both in the right and in the left hemisphere was established.
Conclusions. The results of the study can become starting points for understanding the processes of age-related neurodegeneration and serve as a scientific basis for further morphofunctional, basic and clinical research.

The failure of heart valve bioprostheses, requiring repeated intervention to replace them, is a serious drawback that narrows the scope of such devices. The present study demonstrates the experimental investigation of a medical device designed to partially solve the problem of repeated interventions on heart valves, primarily with an emphasis on reducing the duration and trauma of such procedures due to the sutureless balloon implantation method of the «valvein- valve» method.
Material and methods. The paper presents a series of in silico, in vitro and in vivo experiments to evaluate various aspects of the device under development. Numerical modeling of the final shape setting to the supporting frame of the heart valve prosthesis to select the most promising concept for prototyping was carried out in the Abaqus/CAE (Dassault Systèmes, France) based on the finite element method. The selected optimal support frame model was prototyped in the form of a series of prosthesis samples of four standard sizes for hydrodynamic studies of quantitative characteristics in vitro. The study was carried out in the Vivitro Labs unit (Vivitro Labs, Canada), imitating the physiological mode of the heart, the prostheses were examined for the mitral position. The developed prototypes of the device were supplemented with related products, an implant holder and a balloon catheter, after which the proposed method of sutureless fixation was validated in an in vitro implantation procedure on a bovine heart model and a series of in vivo (n = 3) chronic experiments on animals.
Results. In the course of numerical simulation, it was shown that in Model No. 3 of the supporting frame of the prosthesis, the smallest stresses occur – with an amplitude of up to 490 MPa. For other concepts (Models No. 1 and No. 2), this indicator was significantly higher, 543 and 514 MPa, respectively. Prototypes obtained on the basis of the selected shape of the support frame demonstrated satisfactory hydrodynamic characteristics: effective hole area 190-261 mm2, regurgitation volume 6–9 ml/cycle, average transprosthetic gradient 4.4–6.4 mmHg, depending on size. The study of the technology of sutureless balloon implantation in an in vitro model of the heart and the subsequent chronic experiment on sheep confirmed the main idea of the system – the possibility of a significant reduction in the duration of repeated prosthetics. It has been shown that the time of suture implantation of the “classic” frame prosthesis of the mitral valve is 23–29 minutes, with a total access time of 41–52 minutes. When implanting the experimental device, the sutureless prosthesis itself took 4–6 minutes, access time 24–29 minutes. At the same time, one-month results of an echocardiographic study of the operation of the prosthesis demonstrated satisfactory hemodynamics.
Conclusions. This work demonstrates a consistent series of tests of the system being developed for repeated heart valve replacement, which substantiates some design solutions, confirms the effectiveness and viability of the chosen approach to sutureless minimally invasive implantation.

The aim of this study was to investigate the possibility of using apolipoprotein A-I (apo A-I) as a transport form of the green fluorescent protein (GFP) gene into rat hepatocytes.
Material and methods. A culture of isolated rat hepatocytes was used as a model. Apo A-I conjugate with fluorescein isothiocyanate (FITC) was obtained by incubation of apo A-I protein with FITC in carbonate buffer pH 9.5 at a ratio of 12.5 μg FITC per 1 mg of protein. Plasmids for pE-GAG transfection with an integrated GFP gene were enriched in the promoter part with cis-elements of the CC(GCC)3-5 type to enhance complex formation with apo A-I. An inverted fluorescence microscope was used for visual analysis of cell fluorescence.
Results and discussion. The paper presents evidence of FITC-labeled apo A-I penetration into the cytoplasm and nuclei of rat hepatocytes by receptor-mediated endocytosis. On this basis, it is proposed an attempt to use apo A-I as a means of targeted delivery of plasmid DNA with an integrated GFP gene into the cell. According to the results of fluorescence microscopy, the use of apo A-I as a plasmid DNA transfection agent led to the accumulation of the GFP protein in the cytoplasm of hepatocytes. No fluorescent protein was observed in the absence of apo A-I.
Conclusions. The result obtained may indicate the delivery of the GFP gene to the nuclear apparatus of the cell, its expression and GFP protein synthesis.

Understanding the molecular mechanisms of atherosclerotic vascular lesions formation is necessary both for assessing the risks of cardiovascular diseases and for finding approaches to their therapy. The task remains relevant, despite the large number of studies carried out, because there are differences in the factors of genetic predisposition to atherosclerosis and its complications between different ethno-territorial groups. The aim of this study was to search for genetic variants of pattern recognition receptors associated with lipid metabolism disorders that can lead to the development of coronary atherosclerosis (CA).
Material and methods. Analysis of exons and adjacent splicing sites of pattern recognition receptors genes in patients with CA (30 men), and then genotyping of a population sample from Novosibirsk (n = 1441) by real-time PCR for selected rs113706342 of the TLR1 gene and analysis of associations of its carriage with lipid metabolism were performed.
Results and discussion. The frequency of the minor allele rs113706342 C of the TLR1 gene in the sample of residents of Novosibirsk was 0.0114 ± 0.0062, the carriage of this variant was associated with an increased level of low-density lipoprotein cholesterol in both women and men (p = 0.009 and p = 0.019, respectively). Women carriers of the minor allele C for rs113706342 also had a statistically significant increase in total serum cholesterol (p = 0.013) compared with TT homozygotes. To test the role of this variant in the development of CA, genotyping of an extended sample of patients is required. In one of the patients with CA, a previously undescribed single nucleotide variant chr16:3614637 G/C was found, leading to the Leu101Val substitution in the NLRC3 gene; segregation analysis is required to assess its functional significance.
Conclusions. The association of rs113706342 C of the TLR1 gene with lipid metabolism disorders in the Russian population is shown.

Aim of the study was to investigate the immunotropic activity of neuropeptide compound Pro-Gly-Pro-Val under “social” stress.
Material and methods. The study was conducted on nonlinear male rats (6 months old) under conditions of “social” stress, modeled by formation of submissive and aggressive types of animal behavior under conditions of constant sensory contact. The rats were divided into groups: Control I, animals housed alone in a cage and receiving water for injection in an equivalent volume; Control II, groups of stressed animals with aggressive and submissive types of behavior; III groups of stressed rats to which Pro-Gly-Pro-Val at a dose of 100 μg/kg/day; IV groups of stressed rats to which imunofan (Arg-Asp-Lys-Val-Tyr-Arg) at an average therapeutic dose of 0.7 μg/kg/day were administered intraperitoneally. The immunotropic properties of the neuropeptide compounds were evaluated according to the following indices: delayed-type hypersensitivity reaction index, direct hemagglutination reaction antibody titer and leukocytic formula values.
Results. Injection of the tested compound Pro-Gly-Pro-Val under study leads to correction of the immune changes occurring against the background of “social” stress, namely, to an increase in the delayed-type hypersensitivity reaction index and the level of anti-erythrocytic antibodies, to an enhancement in the total leukocyte count and a restoration of the percentage ratio between the form elements of the leukocytic formula. Obtained results correlate with the results of studying the immunotropic action of the comparison preparation immunofan under the conditions of “social” stress.
Conclusions. The results of the study of the immunotropic action of the neuropeptide compound Pro-Gly-Pro-Val under “social” stress indicate the presence of its immunocorrective activity, which is manifested by the restoration of indices of cellular and humoral reactions and white blood cells.

Type 1 diabetes mellitus (T1D) is one of the most frequently diagnosed chronic diseases of childhood. Oxidative stress (OS) is considered as one of the possible mechanisms of its development and complications. The aim of the study was to analyze the content of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GP) in children and adolescents with adequately controlled T1D.
Material and methods. A total of 58 children were examined, including 34 children with type 1 diabetes (study group) and 24 conditionally healthy children (control group). The content of glycated hemoglobin, blood plasma glucose per day, post-prandial glucose, total protein, creatinine and urea were determined by conventional methods, as well as the level of SOD and GP in the blood serum by ELISA.
Results and discussion. A significant decrease in the content of both enzymes was found in type 1 DM patients compared to conditionally healthy children. In patients with the chronic form of the disease, SOD and GP level was significantly lower than in patients with incident T1D. An inverse correlation was revealed between the antioxidant enzymes level on the one hand and age, duration of the disease, and the number of episodes with a poor glucose history on the other hand. The decrease in SOD and GP concentration was associated with an increase in glycated hemoglobin and plasma glucose level over a 24-hour period in patients with chronic type SD 1. The decrease in SOD concentrations was associated with an increase in glycated hemoglobin in patients with T1D chronic type. The discovered abnormalities indicate that decreased antioxidant enzyme level represent a manifestation of OS in patients with adequately controlled type 1 DM.
Conclusions. Content of antioxidant enzymes in children with T1D provides an important criterion for the assessment of OS manifestations in this disease.

The available data convincingly show the presence of multiple pathophysiological links that explain the high probability of developing metabolic syndrome (MetS) in patients with affective disorders, and MetS itself has been proposed as a premorbid condition in patients with depression in cardiovascular diseases and type 2 diabetes mellitus. The aim of the study was to investigate the association of depressive disorders with MetS and its components in migrants of the Far North with arterial hypertension after moving to new climatic and geographical living conditions.
Material and methods. 267 patients of both sexes with arterial hypertension who arrived from the regions of the Far North for permanent residence in Central Siberia were examined. MetS verification was carried out in accordance with the clinical recommendations of the All-Russian Scientific Society of Cardiology (2009). To identify and assess the severity of depressive disorders, the hospital scale of anxiety and depression HADS was used.
Results and discussion. Among migrants of the Far North with hypertension symptoms of depression and depressive disorders of a clinically pronounced nature occurred more frequently (36.3 and 14.1 %, respectively) compared to persons permanently residing in Krasnoyarsk (21.4 and 6.1 %, respectively, p = 0.001 and p = 0.011). Former residents of the Far North with signs of depression were much more likely to have three- and four-component combinations of MetS. Migrants of the Far North with MetS suffering from depressive disorders are characterized by the highest frequency of the five-component cluster of MetS.
Conclusions. Among migrants of the Far North with hypertension, the incidence of depression in general, and especially of a clinically pronounced nature, is significantly higher compared to patients permanently residing in Krasnoyarsk; when their depression level rises, three- and four-component MC combinations become more common. The results of the correlation analysis suggest the existence of relationships between the level of depression and lipid metabolism in migrants of the Far North.

One of the serious intra-abdominal complications after surgery is intestinal obstruction of adhesion origin (IOAO). Mortality during postoperative intestinal obstruction is 16.2–52.5 %. Aim of the study – laparoscopic diagnosis of IOAO in the early postoperative period and optimization of adhesiolysis.
Material and methods. In the early postoperative period 70 patients with IOAO of upper gastrointestinal tract were examined and treated; laparoscopic operation was performed to 46 patients (the main group), an open method (laparotomy) – to 24 patients (the control group).
Results and discussion. It was revealed that upper-middle and lower-middle incision laparotomies are more likely to cause intestinal obstruction. The sensitivity of preoperative ultrasound diagnosis of movable visceroparietal adhesions of small intestinal loops is 94.6 %, and the sensitivity of laparoscopic diagnosis is 99.2 %. When using minimally invasive technology, the frequency of intraoperative (4 (8.7 %) and 8 (33.3 %), respectively, p < 0.05) and postoperative complications (5 (10.9 %) and 13 (54.1 %), p < 0.05), mortality (0 and 4 (16.6 %), p < 0.05) and length of stay in hospital (5.7 (3–8) and 14.3 (10–17) days, p < 0,05) was less compared to laparotomy.
Conclusions. Using of laparoscopic adhesiolysis and anti-adhesion barrier is appropriate in patients with I-II grade adhesion process. In cases where technical difficulties arise during laparoscopic adhesiolysis, it is more pathogenetically justified to separate adhesions by passing through a mini-laparotomy incision. If this is not possible, it is advisable to perform complex anti-adhesion measures, including conversion to laparotomy and systemic enzymotherapy after adhesiolysis.

The aim of the study was to identify the features of the unfavorable clinical course of a new coronavirus infection.
Material and methods. The analysis of clinical data, laboratory results and comorbidity of 168 patients with a confirmed diagnosis of a new coronavirus infection aged 65,0 [57,0; 74,0] years was carried out. Two groups of patients were distinguished – 126 persons with a moderate course and with clinical recovery in the outcome of the disease and 42 persons with a severe course and a fatal outcome of the disease. Transnosological polymorbidity was assessed by the average number of nosologies corresponding to the three-digit ICD-10 rubricification, transsystemic – by the number of affected systems. Hemogram parameters, blood content of C-reactive protein, creatinine, urea, glucose, prothrombin index, international normalized ratio, activated partial thromboplastin time, platelet count, D-dimer concentration were estimated.
Results. In the group of patients with fatal outcomes, compared to patients with recovery, there were statistically significantly higher indices of transnosological and transsystemic polymorbidity (1.5 and 2 times, respectively), they were more likely to have ischaemic heart disease, myocardial infarction, transient ischemic attack in anamnesis, atrial fibrillation, chronic heart failure; blood concentration of C-reactive protein, fasting glucose, urea, D-dimer in the blood serum was higher, the number of thrombocytes was less.
Conclusions. A high degree of transnosological and transsystemic polymorbidity, a history of myocardial infarction and transient ischemic attack, comorbid chronic heart failure, atrial fibrillation, an increase in D-dimer, CRP content, and a decrease in platelet number are predictors of severe course and the lethal outcome of COVID-19.

Aim of the study was to prove the possibility of using red blood cell probe microscopy as a predictor of the development of pancreonecrosis.
Material and methods. Atomic force microscopy was performed in 143 people (82 were male and 61 were female). The study was performed on an Integra Aura probe microscope (ZAO NT-MDT, Russia). Each erythrocyte was scanned for cell membrane and cell as a whole. A total of 940 red blood cells were examined. According to the severity of acute pancreatitis, patients are distributed in three groups. As a control group, 37 people without somatic pathology were examined. Diagnosis and treatment of patients was carried out in the public health institution “Design Bureau” Russian Railways-Medicine “Krasnoyarsk” from 2015–2019.
Results. The study showed that the shape of erythrocyte does not depend on the severity of pancreatitis and does not change, however, structural changes of the membrane occur in the form of the formation of multiple erosions on its surface. The membrane is deformed, and its adhesion increases. These changes reduce the transport capacity of the blood, which, in our opinion, leads to an increase in the general intoxication of the body and to a deterioration in the condition of the patient.
Conclusions. Apparently, pancreatic enzymes entering the free bloodstream in the first phase of pancreatitis cause not only oxidative stress, but also the reorganization and destruction of the erythrocyte membrane. The increase in membrane rigidity and deformation of the erythrocyte surface cytoskeleton against the background of increased adhesion seems to disrupt the gas transmission function of erythrocyte and microrheological properties of blood, which in turn disrupts the exchange of amino acids, lipids and detoxification capabilities of blood. The appearance of erythrocytes in the free bloodstream with the presence of erosion on the surface of the erythrocyte membrane can serve as a prediction of a non-favorable course of acute pancreatitis and a predictor of a possible transition of edema pancreatitis to pancreonecrosis.

According to the International Classification of Diseases the trachebronchial tree (TBT) anomalies are grouped into class XVII “Congenital anomalies (malformations), deformities and chromosomal disorders” (Q30–Q34, namely Q32.1 – “Other malformations of the trachea”).This paper presents a clinical case of congenital anomaly of TBT. Patient M., 18 years old, diagnosis of ICD-10 J90 Pleural effusion, not classified elsewhere, was referred from the pulmonology department to perform bronchoscopy for differential diagnosis with pulmonary tuberculosis. When the device was passed through the trachea, in the lower third towards the right main bronchus, a diverticuloid protrusion of the tracheal wall with deformation of the cartilaginous ring was found.
Results and discussions. After examination, the conclusion was formed: Anomaly in the development of the lower third of the trachea (reduced tracheal bronchus on the right). Anomalies in the development of TBT are an extremely rare pathology, the pathology we describe is called “tracheal bronchus”. The tracheal bronchus, the rarest malformation of TBT with a frequency of no more than 1–2 % of cases, is the result of dysontogenesis. It is usually located on the right side of the trachea and may end blindly in the form of a diverticulum. In our description, there is no other anomaly of the TBT, so it can be attributed to the supernumerary variant of the tracheal bronchus. When anomalies in the development of TBT are detected, it is necessary to carry out differential diagnostics with tracheal diverticula, in which only its membranous part suffers.
Conclusions. The clinical case we are describing refers to a supernumerary variant of the tracheal bronchus and requires the additional use of high-tech verification methods. We do not exclude that the environmental factors in the city of Zheleznogorsk could be the cause of its development.