Diabetes mellitus (DM) is a common endocrine disease with a large number of acute and chronic complications, among which diabetic ketoacidosis (DKA) is the most frequent and severe, especially in children and adolescents with type 1 DM. Oxidative stress (OS) is a pathological condition that develops due to an imbalance between free radicals formation and inefficiency of the antioxidant system. OS is a strong risk factor for the development of numerous diabetic complications. Recently OS has been considered as an important component of DKA, the pathophysiological mechanisms of which have not yet been fully elucidated. This paper describes hypotheses according to which OS not only triggers and exacerbates manifestations of DKA, but itself represents a severe consequence of DKA, leading to the progression of numerous micro- and macroscopic diabetic complications. The formation of glycation end products, activation of protein kinase C, polyol and hexosamine pathways are considered among the key pathophysiologic mechanisms of OS development in DKA. Achieving a better understanding of OS pathogenesis in DKA will optimize the diagnosis of OS and approaches to DKA correction through timely prescription of antioxidants.

A lot of patients with coronary heart disease often suffer from vascular calcification. In many cases it is accompanied by harmful cardiovascular events. The modern ideas of the relationship between osteoporosis, vascular calcification and inflammation, the general mechanisms of development of vascular calcification and low bone mineral density are discussed. Despite a growing number of studies concerning the combined pathology of the cardiovascular and skeletal systems, a causal relationship between vascular calcification and a decrease in bone mass has not yet been established. Moreover, there is insufficient data on the effect of inflammation on ectopic calcification. Based on the analysis of available clinical and experimental studies, this review describes the main pathogenetic mechanisms of vascular calcification in coronary atherosclerosis. The influence of calcium and vitamin D medicines on the development of vascular calcification is discussed in this article. The author’s attention is focused on early and long-term consequences of percutaneous coronary intervention and coronary bypass surgery in patients with vascular calcification.

The literature review examines the problem of obesity in modern society. It has been shown that obesity aggravates concomitant diseases, increases the probability of developing metabolic disorders and related pathologies, increases the risk of complications and mortality. The secretory function of adipose tissue, its participation in the regulation of biological processes is considered in detail. The concept of carbonyl stress and its components is revealed, the role of carbonyl compounds in the body is described, the metabolic pathways leading to the formation of carbonyl reaction products are shown, the participation of free radicals in these metabolic pathways is noted. The mechanisms of pathogenesis associated with the development of carbonyl stress in obesity are discussed; the greatest contribution to the development of car bonyl pathology in obesity is made by two types of processes: lipid peroxidation reactions resulting in the formation of carbonyl products of lipoperoxidation and the processes activated by hyperglycemia (glycolysis, polyol and hexоzamine pathways) leading to the formation of glyoxal, methylglyoxal, and active carbonyl forms of glucose. The question of the contribution of advanced glycation end products (AGEs) and advanced oxidation protein products (AOРР) to the development of carbonyl pathology in obesity remains controversial. It is assumed that AGEs and AOРР levels depend on the severity of obesity and the development of metabolic syndrome.

To date, more than 200 species of mycobacteria have been identified, in addition to the well-known Mycobacterium leprae and Mycobacterium tuberculosis. Among microorganisms belonging to the genus Mycobacterium, there are obligate pathogenic, opportunistic and saprophytic strains. The incidence of non-tuberculous or atypical mycobacteria, which cause opportunistic infections in humans and animals, is steadily increasing. Non-tuberculous mycobacteria are increasingly recognized as a source of healthcare-associated infections.

Aim of the study was to analyze the literature on current methods of microbiological diagnosis of mycobacterial infections.

Material and methods. A search and analysis of scientific literature in the Web of Science, PubMed, eLIBRARY.RU, Europe PMC databases was performed using the following key words: mycobacteriosis, non-tuberculous mycobacteria, mycobacterial infections, MALDITOF MS, atypical mycobacteria. Results and discussion. The review summarizes and presents the classification, morphological, cultural, genetic and ecological features of mycobacterial strains. Modern approaches in the diagnosis of mycobacterial diseases and identification of pathogens are analyzed; their advantages and disadvantages are indicated.

Conclusions. Mycobacterial infections are often considered as diseases associated with the provision of medical care, requiring a detailed assessment of the situation with the definition of criteria for microbiological monitoring of objects of a medical organization, etc. The analyzed literature data demonstrate a variety of methods for laboratory diagnosis of mycobacterial infections with the need for further improvement of methodological approaches.

The purpose of this review is to describe the available scientific data on the post-COVID-19 syndrome, formulate the main approaches to classification, determine the potential mechanisms of its pathogenesis, as well as determine the mechanisms of the occurrence of bronchopulmonary system pathology within the framework of the post-COVID-19 syndrome. It is known that long-term persistence of COVID-19 symptoms significantly reduces the quality of life of patients through the direct or indirect effect of the SARS-CoV-2 virus on a number of organs and systems. The review examines in detail the possible pathogenetic mechanisms of the post-COVID-19 syndrome, describes and studies the most common consequences of acute COVID-19, taking into account the severity of the disease, including diseases of the respiratory system, in particular interstitial and broncho-obstructive diseases. Particular attention is paid to the above problems in order to describe and structure the available scientific data on lung diseases within the framework of the post-COVID-19 syndrome. It should be noted, however, that there are very few studies on pathogenesis of changes in the bronchopulmonary system in the post-COVID-19 period. The bulk of them affect only individual manifestations of diseases of the respiratory system, in particular cough and shortness of breath, and are not aimed at determining causeand-effect relationships and the relationship of these symptoms to a specific nosology. Taking into consideration the continued high incidence of COVID-19, there is no doubt that additional studies of bronchopulmonary manifestations of post-COVID-19 syndrome should be conducted. Information from the databases PubMed, eLibrary, Scopus, Jstor was used as literary sources.

The article presents the relationship between the level of psycho-emotional stress and the content of biogenic amines, sex and thyroid hormones in healthy men in the city of Arkhangelsk, taking into account the change of seasons.

Material and methods. The study involved 20 men aged 25–44 years. The content of hormones, biogenic amines in serum was determined by enzyme immunoassay. To assess the level of psycho-emotional stress, a survey was conducted using the questionnaire “Your well-being”, developed by O.S. Kopina, E.A. Suslova, E.V. Zaikin, as well as A. Beck’s depression questionnaire.

Results and discussion. A greater number of relationships between the studied parameters was revealed in the transitional periods of the year (March and September), which allows us to consider the spring and autumn as provoking factors in psychosocial stress development. In healthy people, the higher peripheral conversion of iodothyronines associates with the higher satisfaction with vital needs in the fall. The subjective assessment of the health is characterized by exclusively positive relationships with thyroid (spring and autumn) and sex (summer, winter) hormones. Indicators of personal satisfaction in all seasons of the year negatively correlate with the level of sex hormones and sex hormone-binding globulin, and indicators of stress and depression negatively correlate with content of pituitary hormones (luteinizing, thyroid stimulating). Concentration of such monoamines as dopamine (in winter) and acetylcholine (in autumn) positively correlates with feelings of personal satisfaction, while serotonin content shows a negative relationship with the level of satisfaction in autumn.

The aim of the study was to consider typological photoperiodic changes in the levels of dopamine, cortisol and thyroid hormones in males of Arkhangelsk.

Material and methods. The study sample included 20 young euthyroid males aged 25–44 years, permanently residing in Arkhangelsk. To study the influence of the photoperiodic factor on the functioning of the endocrine system, four months were selected, which are distinguished by the clearest contrast of daylight hours: March (increased daylight hours), June (maximum daylight hours), September (reduced daylight hours) and December (minimum daylight hours). The concentration of dopamine was determined in the blood plasma, and the indicators of the thyroid profile and cortisol level were studied in the serum.

Results. Analysis of the data obtained revealed two types of reactions from the dopaminergic system and cortisol content during the period of minimal daylight hours. Along with the seasonal dynamics of dopamine, there is a change in the activity of the pituitary-thyroid system.

Conclusions. In males, whose dopamine levels increase from September to December, the concentrations of cortisol and thyroid hormones also increase, that is, several stress systems are simultaneously activated – the adrenal medulla and cortex, the thyroid gland. Thus, there is a more pronounced reaction to the appearance of seasonal stress factors, which may be due to the rather successful adaptation of the respondents to the environment and may indicate that respondents with dopamine levels decreasing or not changing from September to December either have reduced reserve capacity of the body, or hormones are more actively spent on metabolic processes.

The aim of the study was to evaluate the change in veloergometry (VEM)-induced dynamic state of peak blood flow velocity (Vps) and resistance index (RI) in the middle cerebral artery after balneotherapy of arterial hypertension with Altai red deer antlers.

Material and methods. A small cohort of patients (n = 48) with grade I–II arterial hypertension aged 56 [50–59] years (median [lower quartile-upper quartile]) was examined. In the course of the duplex research of middle cerebra artery Vps, RI in a prone position, sitting and during a bicycle exercise were registered.

Results. In a prone position Vps was 100 [95–105] сm/s, RI – 0.62 [0.58–0.64]; on the cycle ergometer Vps decreased by 20 % and was 80 [77–85] сm/s. In the course of bicycle exercises of average intensity (60 W for women and 90 W for men), Vps increased by 45 %, to 115 [112–120] сm/s, RI increased to 0.73 [0.71–0.75]. On a maximum excise loading Vps reduced by 25 % up to 88 [86–92] сm/s, RI did not change. After antler balneotherapy Vps in a prone position decreased and was equal 87 [82–92] сm/s (p = 0.0001), it occurred due to the improvement of microcirculation confirmed by decrease in RI to 0.52 [0.5–0.53] (р = 0.0001). To a lesser extent there was also an orthostatic falling of Vps at these patients. In the course of bicycle exercises of average intensity, Vps was registered with higher amplitude (up to 60 %, 122 [120– 125] сm/s). On a maximum of bicycle exercise Vps decreased by 30 % of an average and was equal to 85 [82–86] сm/s.

Conclusions. Veloergometric Doppler study of a blood-groove in a middle cerebra artery is a representative method for assessing the dynamic state of autoregulation and can be used for diagnostic audit of physical therapy. The antler balneotherapy of the Altai maral products makes positive impact on cerebral vasomotor function.

Students’ adjustment to higher education process depends largely on the body’s individual features. The student’s physiological and psychological status, as well as the initial motivational setting attitudes are the determining factors. Given this backcloth, the search for ways to improve the health, while aiming at enhancing future qualified specialists’ working and adjustment capacity, appears to be an issue of utmost importance.

Material and methods. A longitudinal study involving university students of different years was carried out, through which anthropometric data were evaluated for the same students in their 1st year and then – in their 2^nd year of training; the concentration of testosterone and cortisol in saliva, thyroid-stimulating hormone and triiodothyronine in blood serum was measured by ELISA; also, psychophysiological values were estimated through unified questionnaires.

Results. The results showed that over the course of education, the students had their hemoglobin concentration, average hemoglobin content in erythrocytes, and leukocyte number decreased. Notable was a significant increase in 3rd year students’ thyroid-stimulating hormone content and a decrease of triiodothyronine and testosterone. A test relying on the Buss – Durkee Hostility Inventory helped to detect an increase in the aggression and suspicion criterion indicators among senior students if matched versus similar values obtained for their freshmen-counterparts.

Conclusions. The research outcomes expand the informational and the methodological base required to evaluate an average student’s functional status from the standpoint of a systematic approach and the theory of the norm. Besides, such data will offer an insight into the main mechanisms behind stressinducing, just like stress-limiting, adjustment strategies. This study of the morphofunctional status indicators allows – while within the annual health monitoring approach – identifying the regulatory and the adjustment capacities in students, both at the time they are enrolled as freshmen and further, thus helping predict the potential risk of maladjustment, which, in turn, may serve a useful tool in taking preventive measures, the final goal being to maintain students’ health through their higher education training period.

Aim of the study was to carry out a comparative analysis of the linear size of the right and left ovaries, determined using sonography in women in adolescence, the elderly, and old age.

Material and methods. The study was based on the results of ultrasound examination of 84 women with normal pelvic dimensions who were examined at the gynecology department of the Perm Krai Clinical Hospital during the period 2021–2022 in order to exclude probable pathology of the reproductive system. Measurement of longitudinal (length), transverse (width), and anteroposterior (thickness) dimensions of the ovary was performed using transvaginal access. Women were divided into three groups: the first consisted of 28 adolescents (16 to 20 years old), the second – 29 elderly persons (56 to 74 years old), the third – 27 seniors (75 to 85 years old).

Results. When comparing the indicators of ovarian size, their statistically significant decrease by old age was revealed. Right ovary length from adolescence to the old age decreased by 20.56 % (p < 0.01), left – by 28.62 % (p < 0.01). Right ovarian width becomes smaller by 20.87 % (p < 0.01) in elderly age and by 26 % (p < 0.01) in senile age, left – by 20.8 % (p < 0.01) and by 28.32 % (p < 0.01), respectively, the anteroposterior dimension of the right ovary – by 23.2 % (p < 0.01) and by 38.8 % (p < 0.01), of the left ovary – by 31.19 % (p < 0.01) and by 39 % (p < 0.01), respectively.

Conclusions. The results obtained allow us to expand our understanding of the features of the age-related structure of the ovaries and further continue their detailed study, since new knowledge is needed to develop modern methods for the prevention of pathology of the female reproductive system and the timely provision of quality medical care.

Quality control of medicines is an integral part of the technological cycle, obligatory for the release of products into public distribution. Both in Russia and abroad, when carrying out of laboratory testing of the preparations, it is prescribed to use the reference materials – the certified standard samples. Currently, it is important for the Russian pharmaceutical industry to provide the methods for evaluating the specific activity of human anti-D immunoglobulin with a national standard sample. Its production is impossible without the production of stabilized concentrate of anti-D antibodies and verifying the suitability of each batch for sale. This requires the establishment of specification requirements and the development of regulatory documentation.

Aim is to define the quality criteria for candidate standard for anti-D immunoglobulin.

Material and methods. The national and foreign normative bases in the field of quality control of blood products, manufacturing and application of biological standards of medicines were analyzed. Three series of lyophilized concentrate of anti-D antibodies were obtained and a laboratory-experimental study of their properties was carried out.

Results and discussion. As a result of the work done, technical specifications were approved, including a list of consumer characteristics, a description of the methods for their assessment and relevant norms.

Conclusions. The established requirements can become the basis for the releasing quality control of the candidate standard for anti-D immunoglobulin during its serial production.

Enhancement of methods for protecting target organs during coronary artery bypass surgery determined the development of a technology for delivering nitric oxide (NO) to the systemic blood flow using a cardiopulmonary bypass (CB) apparatus, which makes NO available to all organs and tissues.

The aim of the study was to access the effect of perioperative NO conditioning on the coefficients of microviscosity and polarity of sheep etythrocyte membranes during experimental surgical intervention using CB.

Material and methods. Study was carried out on 20 sheep weighing 30–34 kg. Two groups were formed. In the CB group, 10 sheep underwent the standard clinical protocol of artificial lung ventilation (ALV) and CB. In the CB + NO group, 10 sheep received NO at a dose of 80 ppm through the circuit of ALV apparatus immediately after tracheal intubation. At the start of CB, NO was delivered to the extracorporeal circulation circuit at a dose of 80 ppm for 90 min. After disconnection from CB, NO supply continued through the ALV apparatus at a dose of 80 ppm for 60 min. The coefficients of microviscosity and polarity of sheep erythrocyte membranes were determined by spectrofluorimetry using pyrene probe.

Results and discussion. The implementation of CB was accompanied by a statistically significant decrease in the microviscosity coefficient in the zones of proteinlipid contact of sheep erythrocyte membranes. In the zone of total lipids, the microviscosity coefficient did not change after CB implementation. The membrane polarity coefficient at the final stage of the surgery increased significantly in the zone of annular lipids and did not change in the zone of total lipids. NO supply to the circuit of the extracorporeal circulation neutralizes the revealed increase in the microviscosity and polarity of the annular lipids.

Conclusions. The introduction of NO into the extracorporeal circulation circuit at the concentration of 80 ppm prevents a decrease in the coefficients of microviscosity and polarity of annular lipids of erythrocyte membranes that occurs during cardiac surgery.

To date, the integrative involvement of thyroid lymphatic region structures in providing tissue homeostasis in hypothyroidism and during rehabilitation remains a poorly understood problem. The use of phytotherapy is attractive for reducing the effects of hypothyroidism. This issue requires scientific justification during the rehabilitation phase.

Material and methods. The work was performed on 160 white Wistar rats using light and electron microscopy according, data of morphometry and statistical matrix analysis. An adequate model of hypothyroidism was created by mercazolil administration. After the mercazolil withdrawal, we investigated the reversibility of thyroid and regional lymph node changes during the rehabilitation period (on 7, 14, 21 days) on the background of bioactive phytocomposition intake and without it. Phytocomposition from laminaria and medicinal plants of Siberia was used at a dose of 0.2 g/kg for three weeks after the cancellation of mercazolil.

Results and discussion. The study showed a unidirectional change in thyroid and lymph node structure with a preferential decrease in indicators in hypothyroidism. The value of the total normalized index for the lymphatic region (lymphothyroostat) is negative during the recovery period without phytocorrection. The index has a negative value initially and up to 14 days and becomes positive only by the end of 21 days of the study reflecting the inertia of the structural response of organs. Phytotherapy provides high rationed index rates for lymphothyrostat. The index becomes positive starting at day 14. There is an intensification of compensatory and adaptive reactions at all levels of lymphothyrostat organization, starting with ultrastructural. The lymph node contributes significantly to the provision of homeostasis of the lymph region of the thyroid gland.

Conclusions. Reorganization of the lymph node and thyroid gland is interconnected in hypothyroidism. The active role of the lymph node in providing tissue homeostasis in the lymph region of the thyroid is apparent. Thyroid and lymph node function can be enhanced by phytotherapy. Phytocomposition reduces the effects of hypothyroidism. It is a kind of modifier of thyroid and lymph node structure and function

The aim of the work is to study the effect of new azoloazine derivatives on the level of DNA damage to Vero cells (DNA comet test) in vitro by alkaline gel electrophoresis.

Material and methods. The objects of the study are 8-(piperidinocarbonyl)3-cyclohexylimidazo[5,1-d][1,2,3,5]tetrazine-4(3H)-one (1), diethyl ether 4-aminoimidazo[5,1-c][1,2,4]triazine3,8-dicarboxylic acid (2), 4-amino-8-ethoxycarbonylimidazo[5,1-c][1,2,4]triazine-3-N-(p-toluyl)carboxamide (3). Epirubicin was chosen as a comparison drug. The compounds were used in doses of 1/2, 1/10 and 1/50 IC50. The Vero cell line cultured according to the standard protocol was selected as the cell model. To assess genotoxicity, an alkaline version of the DNA comet method was used, which has a high sensitivity and allows detecting DNA damage.

Results. Analysis of the data obtained indicates that the tested compounds 1-3 enhance DNA damage in non-tumor cells. Compound 1 has the most pronounced genotoxic effect. Thus, the use of this substance in a dose of ½ IC50 led to a significant increase in the length of the comet’s tail by 1.5 times. It was noted that DNA damage under the action of compound 1 in the studied doses and of epirubicin was on the same level.

Conclusions. The results obtained prove that compounds 1-3 may have a potentially carcinogenic effect. However, this assumption requires further in-depth experimental studies.

Staphylococcus aureus has a high level of antibiotic resistance and is a common cause of nosocomial infections, which primarily requires development of new therapeutic strategies.

Aim of the study was to investigate the level and spectrum of antibiotic resistance of S. aureus isolates for further isolation of virulent bacteriophages.

Material and methods. The study used samples of clinical material obtained on the basis of the City Clinical Hospital No. 3 named after S.M. Kirov (Astrakhan). Bacterial strains isolated from patients were identified on the basis of morphological, cultural, biochemical and molecular genetic characteristics. The determination of the resistance of the isolated cultures was carried out by the disco-diffusion method using standardized commercial discs with antibiotics, in accordance with the guidelines.

Results. Evaluation of antibiotic resistance of Staphylococcus aureus isolated during the study of clinical material from patients and analysis of sensitivity level of isolated strains of S. aureus allow us to conclude that all S. aureus isolated from patients are resistant to at least one antibiotic, and most strains are characterized by multidrug resistance to antibiotics.

Conclusions. The presence of multi-resistant strains indicates the need to search for new approaches in the treatment of staphylococcal infection and to develop effective means for combination therapy based on virulent staphylococcal bacteriophages.

The purpose of this study is to evaluate the fungicidal effect of a chimeric form of recombinant interferon alpha-2b, fused with human apolipoprotein A-I, obtained by biosynthesis in the yeast Pichia рastoris, against significant fungal pathogens – pathogens of human and plant diseases.

Material and methods. The fungicidal activity of the chimeric cytokine was assessed using the agar block method against fungal pathogens: Alternaria alternata, Fusarium oxysporum, Aspergillus spp. and Penicillum spp. The fungicidal effect was assessed visually and by microscopy of a section of the fungal body stained with methylene blue, the germination of fungal spores – by subculture, the cytotoxicity of interferon preparations – on Vero cell culture.

Results and discussion. The studied recombinant interferons suppress the growth and reproduction of pathogenic fungi. Chimeric IFN has the greatest effect against pathogenic fungi A. alternate, Penicillum at a concentration of 15 ng/ml; inhibition of sporulation of fungi F. oxysporum and Aspergillus up to 87 % is achieved at a concentration of 150 ng/ml. The cytotoxicity of the new chimeric cytokine is 5,8 μg/ml, which is significantly more than toxic concentrations for fungi.

Conclusions. The chimeric form of interferon alpha-2b can be used as an immunotherapeutic agent with fungicidal activity.

Currently the “rejuvenation” and an increase in the number of components of the metabolic syndrome (MS) determine its clinical significance in the earlier development of diabetes mellitus, cardiovascular diseases and related complications. Aim of the study was to investigate the features of the MS clinic picture in a population of young men and womenliving in the Khanty-Mansiysk autonomous region – Yugra.

Material and methods. The study included 863 young people between 18 and 44 years of age, including 344 men and women with MS and 519 people in the comparison group. Studied subgroups are represented by non-indigenous men and women living in urban and rural areas, and indigenous rural residents. The analysis of MS clinical and laboratory parameters was carried out and its clinical variants in ethnic groups were identified.

Results and its discussion. According to the results of the survey of young people with metabolic syndrome, it was revealed that the combination of abdominal obesity and two components of MS were most common in young people with MS (in 50.0 % men and in 55.5 % women). The study defined regression models for each MS group and threshold values for waist circumference were set, which changes in lipid and carbohydrate metabolism were predicted.

Conclusions. In groups with MS, hypertriglyceridemia was determined as its most common component. The study identified the most frequent association of abdominal obesity with hyper-LDL cholesterol and hypertriglyceridemia in patients with metabolic syndrome, in ethnic groups, this combination is more common in indigenous rural men (53.3 %) and in non-indigenous urban women (54.3 %).

Aim of the study was to estimate the blood serum level of microtubule-associated protein 1 light chain 3 alpha (MAP1LC3alpha), beclin-1 (BECN-1), Bcl-2 (BCL-2), caspase-3 (CASP3) and autophagy related 5 (ATG-5) protein as potential markers of liver fibrosis in type 2 diabetes (T2D) patients with non-alcoholic fatty liver disease (NAFLD).

Material and methods. A single center cross-sectional observational study was performed. Seventy four patients with T2D and NAFLD were included, 23 men and 51 women, aged 18 to 74 years. Transient elastography was used for the assessment of liver fibrosis. The severity of fibrosis was estimated using the Metavir sсore. In addition, indirect liver fibrosis indices APRI and FIB-4 were calculated. Serum concentration of MAP1LC3alpha, BECN-1, BCL-2, CASP and ATG-5 was measured by ELISA. We applied ROC analysis to assess the value of studied indicators in diagnosis of liver fibrosis.

Results. Liver fibrosis stage F1 was verified in 16 subjects, stage F2 in 12, stage F3 in 7, and stage F4 in 19 individuals. Patients with advanced liver fibrosis (stage 3-4) when compared to those without fibrosis (stage 0–2) had higher content of MAP1LC3alpha (p = 0.01) and BECN-1 (p = 0.01). There were no significant differences in the level of BCL-2, CASP3 and ATG-5 between patients with different severity of fibrosis. In the ROC analysis, MAP1LC3alpha and BECN-1 showed significance for the diagnosis of severe liver fibrosis, which, however, did not exceed that of the APRI index.

Conclusions. In patients with T2D and NAFLD, serum levels of MAP1LC3alpha and BECN-1 are associated with severe liver fibrosis.

Discoid (DLE) and systemic lupus erythematosus (SLE) are chronic inflammatory diseases of the connective tissue. Along with pathogenetic features, they have common characteristics. Immune disorders and oxidative stress are involved in pathogenesis of DLE and SLE. Development of oxidative stress is closely associated with the activation of xanthine oxidoreductase (XOR) enzyme system.

Aim of the study was to reveal the features of XOR activities profiles in blood of DLE and systemic lupus erythematosus (SLE) patients.

Material and methods. 31 patients with DLE, 56 patients with SLE, 35 apparently healthy individuals were enrolled in study. The activities of two convertible forms of XOR (xanthine dehydrogenase (XDG; EC 1.17.1.4) and xanthine oxidase (XO; EC 1.17.3.2)) were measured in plasma, lysed WBC and lysed RBC. The level of uric acid (UA) was determined in plasma.

Results and discussion. In contrast to the control, XO activity was higher and XDG activity was lower in plasma of DLE patients; activities of both XOR forms were decreased in lysed lymphocytes. Activity of XO was lower in plasma, XO and XDG activities were higher in lysed lymphocytes in DLE regardless of the SLE activity. XDG activity in plasma of and XO activity in lysed erythrocytes DLE patients was lower than in low activity SLE, but higher than in the subgroup with moderate and high disease activity. XDG activity of lysed erythrocytes in DLE was higher than in patients with low and moderate SLE activities, but lower than in patients with high diseases activity. Uric acid content in plasma of DLE patients was not differ from the control values, its level was increased at II and III degrees of SLE activity.

Conclusions. Changes in XOR activity in plasma and lysed WBC in DLE and SLE are unidirectional, but are more pronounced in the systemic form of the disease. Thus, DLE and SLE are characterized by some common changes in XOR activity, at the same time, XOR blood profiles have distinctive features, which are characteristic for nosology.

Aim of the study was to evaluate the effectiveness of early rehabilitation methods for medical workers with severe or moderate lung damage caused by a new coronavirus infection, who are in intensive care units, to improve lung ventilation, gas exchange and bronchial clearance, correct muscle weakness, increase overall physical endurance, mobility, psycho-emotional stability.

Material and methods. We examined 53 COVID-19 women with moderate lung injury at stage I of rehabilitation, divided into two groups: main (n = 31, medical personnel) and control (n = 22, working outside of contact with pulmotropic risk factors, including no risk of SARS-CoV-2 infection). Early rehabilitation was carried out in the intensive care unit and in the infectious diseases hospital of City Clinical Hospital No. 2, for patients with COVID-19 rehabilitation plan was drawn up in accordance with temporary guidelines for the medical rehabilitation of a new coronavirus infection.

Results and discussion. It was established, that rehabilitation in the conditions of the intensive care unit and the specialized department can significantly reduce the severity of dyspnea, anxiety and depression, positively affects the increase in exercise tolerance, and helps to reduce the activity of systemic inflammation. In patients who have industrial contact with patients with COVID-19, the effectiveness of rehabilitation measures is lower than in the comparison group.

Conclusions. To increase the effectiveness of stage I of the rehabilitation of medical workers with COVID-19 and lung damage, it is necessary to conduct more intensive and longer rehabilitation than indicated in the current guidelines.

Aim of the study was to evaluate the antiradical and immunomodulatory effects of gynecological capsules (ovules) developed for the complex treatment of diseases of the female reproductive system.

Material and methods. Antiradical activity of gynecological capsules (ovuli) was evaluated in cell-free model systems by the ability to suppress the hyperproduction of free radical agents caused by the introduction of iron sulfate. Immunomodulatory activity was determined in the whole blood by their effect on the ability of phagocytic cells to generate reactive oxygen species.

Results. In cell-free model systems, the studied drug composition suppressed the activation of free radical oxidative processes induced by the iron sulfate, while at the same time enhancing the production of reactive oxygen species by leukocytes.

Conclusions. The results obtained may indicate that the developed gynecological capsules have antiradical and immunomodulatory activity, which allows us to consider them as a promising tool for the treatment of diseases of the female reproductive system.

Aim of the study was to investigate the associations between TLR gene polymorphism and the risk of rheumatic heart disease (RHD).

Material and methods. 251 RHD patients (190 females and 61 males) and 300 healthy donors (190 females and 110 males), whose age was 57 [29; 77] and 53 [21; 80] years (median [lower quartile; upper quartile]), respectively, were recruited in the presented study. Eight polymorphic variants in the TLR gene were genotyped by realtime PCR.

Results. We found no statistically significant differences in the frequency of eight polymorphic variants in the TLR1, TLR2, TLR4 and TLR6 genes in the general group of patients. Stratification by gender and age showed that the frequency of the C/C genotype of the TLR1 gene (rs5743551) was increased in females with RHD (11.6 %) compared to the control group (5.3 %); a risk effect was determined for recessive inheritance patterns (odds ratio 2.43, 95 % confidence interval 1.07–5.52, p = 0.029). Moreover, the combination of polymorphic variants TLR2 (rs5743708) – TLR4 (rs4689791) – TLR1 (rs5743551) – TLR2 (rs3804099) showed the greatest significance in RHD risk.

Conclusions. Future research on the different populations will allow to discover the general patterns of RHD pathogenesis, which will finally lead to the establishment of therapeutic targets for treatment of streptococcal infection and RHD prevention.

Infectious mononucleosis is an acute anthroponotic disease that develops as a result of human infection with viruses of the Herpesviridae family: Epstein – Barr virus (EBV), cytomegalovirus (CMV), herpes viruses of the 6th (HHV-6) and 7th types.

The aim of our work was to study the clinical features and laboratory parameters of the course of infectious mononucleosis in patients of three age groups.

Material and methods. A retrospective analysis of 156 medical records of patients who were on outpatient treatment by an infectious disease specialist at Clinical Medicine Center MedMix was carried out. Patients were divided into three categories according to the age criterion: the first group from 0 to 5 years consisted of 58 (37.2 %) children, the second group was represented by persons from 5 to 18 years old – 58 (37.2 %), the third group was formed by patients from 18 to 53 years old – 40 (25.6 %) people.

Results and its discussion. Among children aged 0 to 5 years, boys (67.2 %) more frequently fell sick, and in the group from 18 to 53 years, females (70 %) were more likely to have the disease. Clinical symptoms such as generalized lymphadenopathy (82.7 %), nasopharyngeal lesions (79.3 %) and changes in the general blood test (86.2 %) were most frequently detected in children aged up to 5 years, while fever (81 %) and oropharyngeal lesions (74.1 %) were most frequently detected in patients aged from 5 to 18 years. Liver damage with the development of acute induced viral hepatitis was recorded in all age groups (24.1, 27.6 and 30 %). EBV infection was most frequently diagnosed among children aged from 5 to 18 years and persons aged from 18 to 53 years (in 62.1 and 70 % of cases, respectively, p < 0.05). Mixed infection with the combination of VEB + CMV + HHV-6 was significantly more frequent in children under 5 years of age (34.5 %; p < 0.05).

Conclusions. In childhood, the clinical manifestations of infectious mononucleosis were more pronounced. Such intense course of the disease caused frequent visits to an infectious disease specialist and diagnostics with the establishment of an etiological agent. The dominance of EBV infection in the development of infectious mononucleosis in all groups was established. However, at the age up to 5 years, the most common mixed infections were the following combinations: EBV + CMV, EBV + HHV-6, EBV + CMV + HHV-6 and CMV + HHV-6.

The origin, development and differentiation of enteric nervous system neuroglia and its involvement in the pathogenesis of gastrointestinal diseases and neurodegenerative diseases have been little studied.

Aim of this work is a comparative morphological study of glial cells in the ganglionic plexuses of the enteric nervous system and analysis of neuroglial relationships in chronic slow-transit constipation using immunohistochemical methods.

Material and methods. Resection material obtained at the Department of Faculty Surgery, S.P. Fedorov Faculty of Surgery of S.M. Kirov Military Medical Academy during planned surgical operations was used. The objects of the study were fragments of the sigmoid and colon obtained as a result of surgery for chronic slow-transit constipation (five cases, women aged 37–40 years). The study was carried out using immunohistochemical glial markers (GFAP, S100β protein, etc.).

Results. Two types of glia were found in the myenteric ganglionic plexus of the large intestine: astrocyte-like and neurolemmocytic. The astrocyte-like type is similar to the neuroglia of the central nervous system, the neurolemmocytic type is similar to the glia of the autonomic nervous system. It has been established that astrocyte-like glia is found only in the Aauerbach ganglionic plexus, while neurolemmocytes are found in all innervated tissues of the intestinal wall. Reactive, dystrophic and degenerative changes in neurocytes, glial elements, agangliogenosis in the Auerbach plexus were found in all cases of chronic slow-transit constipation. Destructive changes in the neuromuscular terminal plexuses, interstitial edema and inflammatory monocytic reaction and leukocyte infiltration in the intestinal mucosa and intestinal submucosa, found in several cases.

Conclusions. The results obtained allow classifying chronic slow-transit constipation as a neurodegenerative disease.

Funnel-shaped deformity of the chest is a serious disease with an unknown etiology and pathogenesis. Pathological changes occurring in the cartilaginous tissue of the ribs are one of the leading mechanisms for the development of chest curvature. Analysis of the phenotypic features of cells isolated from the site of localization of the pathological process will create a more complete picture of the deformation development.

Aim of the study was to identify the phenotype of rib cartilage cells in funnel-shaped deformation of the thorax.

Material and methods. Rib cartilage cells of children with funnel-shaped chest deformity were cultured up to the 2–3rd passage, then were identified by histochemical and immunohistochemical methods.

Results and discussion. The study revealed cells of two different phenotypes. The first type is oval and polygonal chondroblasts expressing a marker of chondrogenic differentiation. The second type is the cells of the neural phenotype with the expression of early neural markers Musashi1 and PAX6 and the neurospecific protein III β-tubulin, as well as the substance Nissl.

Conclusions. The analysis of the phenotypic features of rib cartilage cells with funnel-shaped curvature of the chest allowed us to expand the idea of a possible etiological factor in the deformation development.

The presence of infectious inflammatory process in a pregnant woman can lead to a disorder in the “mother – placenta – fetus” system.

Aim of the study was to investigate the level of regulatory and pro-inflammatory molecules in pregnancy occurring against the background of chronic pyelonephritis without exacerbation.

Material and methods. The concentration of IL-17A, monocytic chemotactic protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and IgG autoantibodies to double-stranded DNA (AAT to nDNA) was determined in the blood serum of pregnant women with a gestation period of 36–40 weeks using ELISA.

Results. It has been shown that in the third trimester of pregnancy occurring against the background of chronic pyelonephritis without exacerbation, compared with a normal pregnancy, the level of MHP-1 and IL-17A increases, the content of VEGF decreases, and the concentration of AAT to nDNA does not change significantly. An increase in the proinflammatory cytokine IL17A and a decrease in VEGF level can lead to intrauterine fetal growth retardation due to inhibition of amino acid transporters in the placenta.

Conclusions. In pregnancy occurring against the background of chronic pyelonephritis without exacerbation, a change in the level of IL17A, MСP-1, VEGF can have a significant impact on the course of pregnancy.

A clinical case of the co-medication of valproic acid and cilastatin/imipenem in a 17-year-old girl with generalized tonic-clonic seizures is described. As an antiepileptic therapy, the child was prescribed valproic acid, the concentration of which in the blood plasma was more than 80 µg/ml, and seizures were not observed during this therapy. At the same time, due to the developed pneumonia, the girl was imipenem/cilastatin prescribed. Co-medication of drugs led to a decrease in the concentration of valproic acid in the blood plasma less than 50 µg/ ml, relapse of epileptic seizures was noted. Correction of antiepileptic therapy with phenobarbital did not lead to the seizure control. The removal of imipenem/ cilastatin contributed to the increase in the concentration of valproic acid in blood plasma above 50 µg/ ml, which corresponds to the recommended therapeutic range. Within two weeks after discontinuation of imipenem/ cilastatin, the concentration of valproic acid reached values as close as possible to the values before the start of antibiotic therapy. The authors of the article concluded that it is necessary to conduct therapeutic drug monitoring in children receiving valproic acid and imipenem/ cilastatin (antibiotic of carbapenem group), based on the known mechanisms of pharmacokinetic interaction.

A clinical case of the development of tubular-villous adenoma with moderate epithelial dysplasia (high grade) is described, taking into account the presence of foci of squamous metaplasia in the epithelium of the glands. The pathology presented in the article according to ICD-O has code 8263/2.

Description of the clinical case. The patient had an initial colonoscopy in 2020 and was diagnosed with chronic ileitis and colitis with moderate and in some areas high inflammation activity, which is most characteristic of nonspecific ulcerative colitis. The patient was treated by a gastroenterologist. In December 2021, she had a follow-up colonoscopy with the histological material sampling. Endoscopic conclusion: ulcerative colitis, total lesion, exacerbation phase.

Results and discussion. When the device was inserted into the rectum at a distance of 13 cm, a neoplasm was visualized, the mucosa was pale, shiny, when trying to pass the device through the narrowing of the contact-vulnerable mucosa, with instrumental palpation, the formation was displaced by a conglomerate, a polyfragmentary biopsy was taken. In the study of histological preparations of the recto-sigmoid junction, a tubular-villous adenoma with moderate epithelial dysplasia (high grade) is determined, taking into account the presence of foci of squamous metaplasia in the epithelium of the glands. According to the literature, with ulcerative colitis affecting almost the entire colon for more than 10 years, there is an increased risk of colon cancer formation (10 %), which increases by 2–5 % annually. The possibility of malignancy is present in 10–20 % of patients with ulcerative colitis for more than 20 years. Other researchers describe the identified low-grade dysplasia as progressing to high-grade dysplasia and carcinoma in 29–54 % of cases.

Conclusions. The study of patients with this pathology should be carried out against the background of thorough preparation of the large intestine with modern preparations using high-tech verification methods and polyfragmental biopsy with a qualified assessment of biopsy specimens.

Eosinophilic endomyocarditis is caused by direct infiltration of heart tissue by eosinophils with the development of specific inflammation. The main etiological factor of the disease is a significant increase in the level of eosinophils in peripheral blood. Loeffler syndrome can be caused by such factors and pathological conditions as idiopathic hypereosinophilic syndrome, allergic diseases, parasitic infections, autoimmune processes, cancer. A clinical case of Loeffler syndrome in an 84-year-old patient with heart, lung, liver, kidney and pancreatic lesions is presented. Difficulties of differential diagnostics of this syndrome because of individual clinical picture and signs of the course are discussed in the article. Timely diagnosis of such a condition will prevent the rapid development of severe complications and carry out appropriate therapy, which will significantly prolong the life of patients with Loeffler syndrome. However, in the presence of nonspecific symptoms, the diagnosis of this disease may be diagnostically difficult for the physician.