Microvascular obstruction (MVO) of coronary arteries promotes an increase in mortality and major adverse cardiac events in patients with acute myocardial infarction (AMI) and percutaneous coronary intervention (PCI). Intramyocardial hemorrhage (IMH) is observed in 41–50 % of patients with ST-segment elevation myocardial infarction and PCI and is accompanied by inflammation. There is evidence that microthrombi are not involved in the development of MVO, which is associated with infarct size, the duration of ischemia, and myocardial edema. However, there is no conclusive evidence that the latter plays an important role in the development of MVO. There is evidence that platelets, inflammation, Ca2+ overload, neuropeptide Y, and endothelin-1 could be involved in the pathogenesis of MVO. The role of endothelial cell dysfunction in MVO formation in patients with AMI and PCI remains under question. It is unclear whether nitric oxide production is decreased in patients with MVO. It was obtained only indirect evidence on the involvement of inflammation in the development of MVO. The role of reactive oxygen species, necroptosis and pyroptosis in the pathogenesis of MVO is also not studied. The participation of thromboxane A2, vasopressin, and prostacyclin in the formation of MVO is unknown. It was not obtained conclusive evidence on the involvement of coronary artery spasm in the development of MVO. Dual antiplatelet therapy improves the efficacy of PCI in prevention of MVO. It is unknown whether epinephrine or L-type Ca2+-channel blockers improves coronary blood flow in patients with MVO.

Classical knowledge about the pathogenesis of diabetes and its complications in recent years has been supplemented by ideas about the role of chronic inflammation. It has been established that inflammatory reactions play a role in the beta cell dysfunction, the formation of insulin resistance and remodeling of the vascular wall. Cytokines, soluble low molecular weight proteins and peptides that perform informational and regulatory functions, play central role in the development of inflammation. A wide range of biological activity and involvement in many aspects of pathogenesis make it possible to consider cytokines as promising molecules for diagnosing and predicting the complications. In this review, we summarize data from studies that assessed the role of cytokines as diagnostic and prognostic markers for the development of microvascular diabetic complications. Current data indicate that angiogenic and pro-inflammatory cytokines (VEGF, TNF-α, IL-6, IL-8, IL-15, IL-17, MCP-1, IP-10, INF-γ, PEDF, etc.) are promising biomarkers for proliferative diabetic retinopathy, especially when their local production is assessed (in vitreous, aqueous humor and tears). The role of these molecules as biomarkers of non-proliferative diabetic retinopathy and diabetic macular edema needs further research. Serum proinflammatory and fibrogenic cytokines (primarily MCP-1, IL-6, TNF-α, YKL-40, TGF-β and bFGF) and cytokine receptors (sTNFR1, sTNFR2) are considered as promising diagnostic and prognostic markers of diabetic kidney disease. Urinary excretion of IL-6 and MCP-1 turned out to be a predictor of the progression of diabetic nephropathy. Multi-bead assay and mass spectrometry make it possible to study cytokine panels in small samples of biological material. Combined biomarkers, including several cytokines, may increase the reliability of the prognosis of diabetic complications.

Obesity and diseases of the gastrointestinal tract are widespread among the children and have common developmental mechanisms. The article provides a literature review on the relationships between certain pathological conditions of the digestive system (gastroesophageal reflux disease, gastritis, functional intestinal disorders, Crohn’s disease, diverticular disease) in children with overweight and obesity. Excess body weight and obesity can become risk factors for the development of gastrointestinal pathology. The data available in modern literature on changes in the composition of the intestinal and stomach microbiocenosis with increasing body weight are summarized (changes in enterotype, increase in the Firmicutеs/Bacteroides ratio, increase in the number of bacteria Methanobrevibacter, Escherichia coli, Lactobacillus rhamnosus, Lactobacillus delbrueckii and Lactobacillus reuteri). The strains of bacteria that contribute to the anorexigenic effect are considered: Lactobacillus gasseri, some strains of Bifidobacterium, Saccharomyces, Streptococcus and Enterococcus. The pathogenetic aspects of obesity and overweight caused by microbiota are presented: activation of lipid synthesis, breakdown of polysaccharides, absorption of mono- and disaccharides, development of metabolic endotoxemia, etc. Features of the functioning of the autonomic nervous system in obesity in children are presented, indicating the predominance of the hypersympathicotonic variant of autonomic reactivity.

The parathyroid glands play an important role in the regulation of calcium and phosphorus metabolism in the body. They are in close anatomical relationship with the thyroid gland and, considering their small size, can be accidentally removed during surgical interventions on it. To avoid mistakes, surgeons need to know the typical location of the parathyroid glands and non-typical variants. The laboratory animals, in particular white rats, can be used to improve the methods of surgical interventions and develop skills. Aim. To study the features of the location of the parathyroid glands relative to the lobes of the thyroid gland, classify into types and establish the frequency of their occurrence in mature rats. Material and methods. The study was carried out on 213 white outbred mature male rats. After taking the lobes of the thyroid gland with the parathyroid glands, the samples were processed according to the standard protocol. The sections of organs were stained with hematoxylin and eosin, toluidine blue, according to Van Gieson and to Grimelius. Light microscopy was used to study the location of the parathyroid glands on histological sections of the thyroid gland; the frequency of occurrence of each type was calculated. Results. In mature male rats, by location, one can distinguish typical, atypical and mixed parathyroid glands, occurring in 53.52, 45.54 and 0.94% of cases, respectively. Typical parathyroid glands in relation to the edge of the lobe of the thyroid gland are divided into centro-lateral and eccentrico-lateral; by invasion in the parenchyma of the lobes – marginal and incomplete; in shape – regular and irregular. Non-typical parathyroid glands are subdivided into single and group ones according to the number on the section of one lobe of the thyroid gland; by location – polar, intracapsular, occupying the center of the lobe or displaced from the center to the capsule; by invasion in the parenchyma of the lobes – without invasion, marginal, incomplete and complete; in shape – regular and irregular. Mixed parathyroid glands involve the presence of the typical and atypical glands by location in the same lobe of the thyroid gland. Conclusions. The parathyroid glands of mature male rats are characterized by a significant variability of localization in relation to the lobe of the thyroid gland – from superficial to complete invasion inside this organ, location in the pole or in the center, variability in shape and quantity.

The aim of the study was to investigate the lipid status and indicators of the system of hemostasis in healthy young men of different linguistic families of the North Caucasus region to assess the risk of development of thrombogenic states.. Material and methods. A survey of young men aged 18 to 21 years was carried out with the subsequent establishment of region of residence and nationality to form ethnic groups. Based on the information received during the survey, 62 people were selected: 32 young men of the Indo-European language family (Russians, Greeks, Armenians) and 30 young men of the North Caucasian language family (Chechens, Ingush, Avars, Dargins). The assessment of lipid status was carried out by the photocolorimetric method on a biochemical analyzer, and the analysis of indicators of the hemostasis system was carried out by the clotting method on an automatic coagulometer analyzer. Homocysteine levels were determined by chemiluminescent immunoassay on a microplate device. Genetic polymorphisms of the hemostatic system were identified using the real-time PCR. Results. Young men of the Indo-European language family have significantly more low density lipoprotein, triglyceride, homocysteine and antithrombine III content, than representatives of the North Caucasian language family (p < 0.001), and less total number and average platelet volume, prothrombin index, prothrombin concentration according to Quick (p < 0.001). There was also a significantly more frequent occurrence of mutations of the gene encoding fibrinase (p < 0.05) in young men of the Indo-European language family. Conclusions. A comprehensive study among young men of different ethnicities illustrates ethnic differences in lipid status and homocysteine level. Analysis of the main indicators of coagulogram and genetic polymorphism of the hemostasis system allowed us to establish a higher risk of thrombogenic conditions and atherosclerosis in young men of the North Caucasian language family

The relevance of the study of the role of macrophages and their multinucleated forms in the pathogenesis of tuberculous granulomatosis is determined by its wide prevalence, the presence of severe socio-economic consequences of its morbidity and necrotic complications, which are based on the high destructive potential of macrophages associated with the role of hydrolases in the degradation of extracellular matrix components. Aim of the study was to investigate the features of the multinucleation, apoptosis and expression of a number of hydrolases in macrophages of BCG-infected mice. Material and methods. The intensity of macrophage multinucleation and apoptosis, the peculiarities of their expression of matrix metalloproteinases (MMP-1, MMP-9), catepsins (CatB, CatD), caspase-3, and p53 protein were studied in peritoneal cells cultures of intact and BCG-infected BALB/c mice. Results. The number of multinucleated macrophages increased according to the terms of the experiment, having a maximum value for 3 months of observation, but after 2 months almost reaching this level. The realization of apoptosis, multinucleation of macrophages had a complex character, determining the composition of their subpopulations. The dynamics of the expression of the studied hydrolases by macrophages indicated their unequal role in tissue necrosis at various stages of granulomogenesis. The high functional ability of multinucleated macrophages to produce hydrolases of certain types is shown. Intense expression of MMP-1 in the early stages of granulomogenesis and its maximum value, as well as CatD expression for 3 months, and strong expression of MMP-9 for 6 months were noted. Conclusions. Stimulation of plastic processes in macrophages under conditions of BCG-granulomatosis determines the formation of multinucleated macrophages with high functional potential and intensive expression of hydrolases by macrophages for 2 and 3 months of granulomogenesis. These are periods of high risk of necrotic complications of tuberculous granulomatosis, which should be taken into account when developing methods for their prevention and therapeutic correction.

Microalgae are a source of various biologically active substances, including carotenoids. One of the carotenoids of diatom microalgae is fucoxanthin, which has antioxidant, antimicrobial, antitumour and anti-inflammatory properties that can be used in the treatment of a wide range of human and animal pathologies. The aim of the study was to investigate the effect of alcohol and oil extract of fucoxanthin on biochemical parameters and levels of serum cytokines in mice during intragastric administration. Material and methods. Fucoxanthin extracts from the microalga Nanofrustulum shiloi were used. Mice of Balb/c strain were intragastrically administrated with 0.5 ml of oil (500 μg/ml) or alcoholic extract of fucoxanthin (187.5 μg/ml), mice in the comparison group were given 0.5 ml of olive oil or 45% ethyl alcohol once a day within 5 days. On the 8th day, blood serum was obtained and the level of albumin, triglycerides, cholesterol, low (LDL) and high density lipoproteins (HDL), urea, uric acid, creatinine, aspartate (AST) and alanine aminotransferases (ALT), lactate, stable nitric oxide (NO) metabolites (nitrites), cytokines (IL-1β, IL-6, IL-10, TNF-α, IFN-γ) was determined using ELISA with photometric detection. Results and discussion. In the comparison group, ethyl alcohol promoted an increase in serum triglyceride, cholesterol, LDL, HDL, ALT, AST, nitrite, IL-10, IFN-γ and TNF-α content compared to intact animals. Fucoxanthin alcoholic extract administration increased the level of LDL, HDL, uric acid, TNF-α and decreased albumin, cholesterol, uric acid, creatinine, ALT, AST, IL-6 content compared to control. The olive oil group showed a decrease in serum triglycerides, cholesterol, urea, uric acid, ALT and AST content but an increase in LDL, HDL, nitrite level compared to the control. Administration of fucoxanthin oil extract to animals decreased albumin, triglycerides, cholesterol, HDL, uric acid, ALT, AST, lactate, IL-6, IL-10 compared to control. Conclusions. Thus, it was discovered that fucoxanthin in Balb/c mice contributes to a decrease in hepatic synthetic function, as evidenced by the change in the concentration of albumin, triglycerides, uric acid), influences energy metabolism (creatinine, lactate), cell membrane stability (cholesterol, LDL, HDL), serum transaminase activity, pro- and anti-inflammatory cytokines content.

Postoperative complications in surgery, including thrombosis, are often associated with the suture material. The search for new types of suture materials that reduce the risk of vascular anastomotic complications remains an urgent task. The aim of the study was to compare and evaluate the effectiveness of two types of suture materials modified with heparin in terms of the hemocompatibility. Material and methods. The study involved a thread based on the Prolene 3.0 Polypropylene Suture (Ethicon, USA) that had undergone subsequent modification. The suture was modified with either heparin with polydimethylsiloxane or heparin with polyhydroxybutyrate/oxyvalerate. The consistency and hemocompatibility of the modifying layer were evaluated by scanning electron microscopy, diffuse scattering spectroscopy, hemolysis, platelet adhesion and aggregation. Results and discussion. The modifying layer based on heparin and polydimethylsiloxane was nonhomogeneous, with either thick or completely absent coating layer. The modifying layer based on heparin and polyhydroxybutyrate/oxyvalerate was homogeneous, without signs of thickening. Diffuse reflectance spectroscopy confirmed its presence on the thread surface. Evaluation of the hemocompatibility of the modified thread revealed the absence of hemolysis in all the studied groups. The modifying layer based on heparin and polyhydroxybutyrate/ oxyvalerate significantly reduced the maximum platelet aggregation (46.28 %) compared with the unmodified thread (82.64 %), the thread modification with heparin and polydimethylsiloxane did not influence on the indicator (77.72 %). The number of platelets adhered on the surface of the thread modified with heparin and polyhydroxybutyrate/oxyvalerate was insignificant, consisting of single inactivated platelets, in contrast to a thread modified with polydimethylsiloxane rubber and heparin, on the surface of which a large number of adherent activated platelets were found. Conclusions. The results obtained indicate the promising approach for the prevention of postoperative thrombosis by layer-by-layer modification of thread with heparin and polyhydroxybutyrate/oxyvalerate.

Hyaluronidase is an enzyme that helps maintain an optimal balance of hyaluronic acid in connective tissue and ensures full tissue regeneration. Currently, hyaluronidase drugs are used in various fields of medicine. Meanwhile, there are no oral preparations based on hyaluronidase on the pharmaceutical market due to its low bioavailability in this method of administration. One of the options to increase enzyme bioavailability is electron-beam pegylation, which involves obtaining drugs with a modified pharmacokinetic profile in the direction of increasing enteral bioavailability, as well as having additional protection from the action of proteolytic enzymes. Aim of the study was using the electron beam pegylation method to obtain a laboratory batch of a preparation based on highly purified hyaluronidase, which can be further used in the development of an oral drug product. Material and methods. Hyaluronidase, which was isolated from bovine testicular hyaluronidase and polyethylene glycols of different molecular weight, was used in the experimental study. Experiments were carried out using a pulsed linear accelerator ILU-10 for enzyme electron beam immobilization on a water-soluble polymer matrix of polyethylene glycol molecules. The formation of hyaluronidase and polyethylene glycols conjugates was confirmed by exclusion chromatography. Results. As a result of accelerated electron irradiation of hyaluronidase and polyethylene glycol of molecular mass 1500 Da conjugates of enzyme and polymer matrix were formed. After electron-beam pegylation, the specific activity of the enzyme was retained. Conclusions. A laboratory batch of prototype pharmaceutical substance based on immobilised hyaluronidase on polyethylene glycol was obtained.

The aim of the research was to experimentally evaluate the effectiveness of infusion solutions with different osmolarity during acute blood loss in experiments on rats. Material and methods. Experiments approved by the local Ethics Committee, have been done on 30 male rats line Vistar (320 ± 35 g). Design of the research included anesthesia, simulation of acute blood loss to 50 % of circulating blood volume, its replenishment with experimental infusion solutions based on polyglycan derivatives (estimated osmolarity 1026.6, 1784.2, 2566.6 mOsm/l), research of survivability, functional state of cardiovascular and respiratory systems, blood acid-base status and gas partial pressure 5, 30, 60, 120, 180 min after the beginning of replenishment of circulating blood volume. The infusion solution Hemostabil was used as a comparison product. Results. The highest survival rate, restoration of hemodynamics and acid-base state and blood acid-base status and gas partial pressure were obtained as a result of infusion of solution with osmolarity 1026.6 mOsm/l. In this group of animals survivability accounted for 100 %, arterial pressure restored in 5 minutes after the start of infusion, indicators of blood acid-base status and gas partial pressure normalized in 120 min of experiment. All of the results had statistically significant differences (p < 0.05) relative to values in other experimental groups. Conclusions. Sample of solution with osmolarity 1026.6 mOsm/l is the most effective in restoration of hemodynamics of rats with the blood loss up to 50 % of circulating blood volume. The expediency of the researches of safety of this infusion solution based on polyglucan derivatives in the capacity of medication for replenishment acute blood loss is substantiated.

Non-malignant breast diseases (NMBD) may increase the risk of developing a malignant neoplasm. Therefore, it seems relevant to search for criteria for cell malignancy in NMBD. Aim of the study was to investigate the relationship between expression of proliferation and epithelial-mesenchymal transition (EMT) markers and histidine-rich glycoprotein (HRG) mRNA in breast diseases. Material and methods. In breast biopsy specimens of 37 patients with invasive carcinoma of a non-specific type (ICNT) and 17 patients with NMBD expression of proliferation markers (Ki-67, cyclin D1 (CCND1)) and EMT markers (E-cadherin (CDH1), type II collagen (CII) and β1-integrin (CD29)) was determined immunohistochemically. HRG mRNA expression was estimated using real time PCR. Results. HRG mRNA expression was detected in 91.9 % cases (34 of 37) in ICNT, 82.4 % (14 of 17) in NMBD and in the latter case was inversely related to the expression of CDH1, CD29 and Ki-67. A direct relationship has been established between the presence of Ki-67 and CCND1, CII, between CCND1 and CD29 in NMBD. In patients with ICNT, a direct correlation was found between the HRG mRNA expression and the presence of CII, and an inverse correlation between the number of cells containing CII and CD29. It was found that in ICNT and NMBD with the presence of HRG mRNA expression, the CDH1 expression is less than in its absence. Conclusions. Indicators of HRG mRNA expression in NMBD, combined with the assessment of proliferation and EMT markers, can be useful in developing criteria for cell malignancy in benign breast diseases.

Recently, a large number of studies have been conducted to investigate the variability of response in the treatment of diabetes mellitus (T2DM), which make personalized medicine possible. However, the available data are insufficient to decide on the choice of sugar-lowering drugs in T2DM. The search for phenotypic and clinical factors of pharmacogenetic response to therapy continues. Aim of the study was to investigate the relationship between the effectiveness of sulfonylurea therapy and structural variants of the ABCC8 (rs757110) and KCNJ11 (rs5219) genes in T2DM patients with clinical phenotypes. Material and methods. A cross-sectional clinical and pharmacogenetic study of 1271 patients with T2DM receiving sulfonylurea monotherapy (SU) or in combination with metformin and divided into three clinical phenotypes: with insulin deficiency (insulinopenic phenotype), with obesity and moderate insulin resistance (classical phenotype) and with severe insulin resistance (insulin-resistant phenotype) was performed. A glycated hemoglobin content of less than 7% was considered as a good response to SU therapy. Results. Patients with a good response to SU therapy with a classic phenotype had a longer duration of diabetes compared to patients with absence of good response (5.68 ± 5.22 vs 9.12 ± 6.10 years, respectively, p < 0.001) and a later age at diagnosis of T2DM (54.05 ± 7.18 vs 49.37 ± 7.65 years, respectively, p < 0.001); patients with an insulin-resistant phenotype had T2DM established at an older age (54.35 ± 7.91 vs 50.10 ± 7.51 years, respectively, p = 0.001). Logistic regression analysis did not reveal a statistically significant association of the genotype of the structural variant of the ABCC8 gene (rs757110) with the effectiveness of SU in clinical phenotypes. The T/T genotype of the KCNJ11 gene (rs5219) was associated with a better response to SU therapy only in the group of T2DM patients with the classic phenotype (odds ratio 1.85, 95% confidence interval 1.05–3.25, p = 0.041). Conclusions. In patients with type 2 diabetes, predictors of a good response to SU with a classic phenotype were a later age of T2DM diagnosis, a shorter duration of diabetes, and the presence of the T/T genotype of the structural variant of the KCNJ11 gene (rs5219); with an insulin-resistant phenotype, a later age of T2DM diagnosis; with the insulinopenic phenotype no clinical and genetic predictors of the SU effectiveness were identified.

Long-term surgical treatment outcomes in children with congenital hip dislocation can be various and depend on many factors, including the age in time of surgery. The quality of life assessment systems are modern tools to study the effectiveness of previous treatment, as well as to plan subsequent comprehensive rehabilitation. Material and methods. The study included 68 children divided into the groups according to the age of the primary surgical intervention. There were three groups: group 1 – 21 patients under 1.5 years, group 2 – 22 children aged 1.5–4-years, group 3 – 25 children over 4 years. Objective medical assessment of the clinical outcomes was carried out with the McKay’s criteria. The PedsQL4.0 questionnaire, pediatric and parental forms were used to assess the patients’ quality of life. Results. The majority of children in the 1st age group had excellent results (52.3%), in the 2nd and 3rd groups there were fewer such results (40.9 and 32 %, respectively). Having analyzed the data of the questionnaires for children and their caregivers we found that the both categories from group 3 demonstrated the lowest quality of life parameters. Conclusions. The frequency of consequences such as discomfort, limping, limb length discrepancy was also higher in children underwent surgery at the age of over 4 years old. It correlates with the questionnaire results and demonstrates a lower quality of life in children from group 3.

One of the factors in the development of uterine fibroids is a genetic predisposition to its occurrence in some women, but the real molecular genetic mechanisms of this phenomenon remain unknown. Aim of the study was the distribution analysis of gene polymorphism of cytokines TNFα, IL-1β, IL-4, IL-6, IL-10, factors of angiogenesis (vascular endothelial growth factor, VEGF) and remodeling of extracellular matrix (metalloproteinases MMP2, MMP3, MMP9), which are associated with their levels. Material and methods. Genotyping was performed by real-time PCR using commercial test systems SYBR GreenI (Litech, Russia) and TaqMan (Syntol, Russia) in accordance with the instructions of the developer. Cytokine content in blood serum was determined by flow cytometry using microspheres coated with monoclonal antibodies to cytokines (Bio-Plex ProTM Human Cytokine 27-plex Assay), according to the instructions for Bio-Plex 200 (Bio-Rad Laboratories, USA).To evaluate the results obtained, in addition to the generally accepted methods of statistical processing for case – control studies, computational methods of bioinformatics were used for comparative analysis of the diagnostic value of various combined genetic traits. Results. It was shown that the maximum odds ratio value of uterine fibroids development are combined genetic traits that include representatives of all four regulatory factors: cytokines with pro-inflammatory activity, cytokines with anti-inflammatory activity, vascular endothelial growth factors and metalloproteinases (p = 0.002). Conclusions. The presented data reveal the real mechanisms of manifestation of the genetic predisposition of individual women to the uterine fibroids development, associated with the presence of polymorphism of certain genes in their genome, which provide features of the structure of cytokine networks with the predominance of certain activities in the regulation of tissue processes in the uterus. In addition to purely scientific interest, these results indicate the real possibility of their clinical application in the form of prognostic criteria with a certain level of prognostic significance.

The p14ARF-Hdm2-p53 signaling pathway targets tumor growth suppression, inhibits clonal proliferation, and maintains genome stability. It is inactivated in most human malignancies. The p14ARF protein is one of the main participants in the cascade. The aim of the study was to determine the prognostic value of the number of p14ARF-expressing tumor cells in biopsies of patients with diffuse large B cell lymphoma (DLBCL). Material and methods. The formalin-fixed paraffin embedded samples of tumor tissue of 104 patients with newly diagnosed DLBCL were included to the study. The relative number of cells expressing p14ARF was determined by immunohistochemical and morphometric methods. Differences in the content of p14ARF-positive tumor cells between groups of patients divided according to clinical and laboratory parameters were determined using the Mann–Whitney U test. Prediction of an unfavorable response to therapy was carried out using binary logistic regression with calculation of the odds ratio and 95 % confidence interval; variables were selected using Wald backward elimination method. The risk of an event occurring was calculated using Cox regression analysis. Results. The content of p14ARF-positive cells is higher in tumor biopsies of patients with high and high-intermediate risk according to the international prognostic index than in patients with low and lowintermediate risk. A relationship between an increase in the number of p14ARF-positive tumor cells, the absence of a complete response to first-line R-CHOP therapy, and an increased risk of death in patients with DLBCL has been established. Conclusions. The studied marker p14ARF can be used as an additional morphological predictor of the unfavorable course of DLBCL.

Pelvic organ prolapse (POP) is a chronic slowly progressive disease. One of the most significant risk factors for the formation of omissions and prolapses of the internal genitalia is connective tissue diseases. Type I collagen is the most common protein of the intercellular substance of connective tissue, mutation of the COL1A1 gene encoding it leads to the synthesis of a defective protein. The aim of our study was to investigate the significance of COL1A1 gene polymorphism in POP development and in the occurrence of relapses of the disease in operated patients of different age groups. Material and methods. The study included 68 patients with verified pelvic organ prolapse, divided into two age groups (n = 34 in each): the first group included women aged from 23 to 44 years, the second – aged from 46 to 72 years. In all patients, the presence of manifestations of undifferentiated connective tissue dysplasia (UCTD) was assessed, a laboratory study of the polymorphism gene COL1A1 was conducted and the content of type 1 C-terminal collagen peptide (β-CrossLaps) in venous blood was measures. Results and discussion. 86.8 % of the examined patients had clinical signs of UCTD. Statistical analysis indicates that there is a relationship of the frequency of UCTD detection and severity of manifestations with age: the age of the patients with moderate to heavy UCTD (38 [37; 41] years, median [lower quartile; upper quartile]) was statistically significantly lower than that of the women with light degree (45.5 [38; 62] years; p < 0.001 years) and without UCTD (56 [48; 65] years; p < 0.001). There were no statistically significant differences in the polymorphism of the COL1A1 gene between patients under 45 (1 group) and over 45 (2 group) (p = 0.25), however, there is a tendency to decrease the frequency of G/G and increase T/T types of polymorphism in women of reproductive age. In patients with recurrent POP after surgical treatment, G/G polymorphism was less common (p < 0.001) and G/T was more common (p = 0.04). The level of β-CrossLaps was higher than the normative level in 8.8 % of the examined women; in 2 cases of identified heterozygous (G/T) polymorphisms, its significant rise was noted. ROC analysis performed to identify the relationship between age, gene COL1A1 polymorphism, signs of UCTD and the level of β-CrossLaps indicates the effectiveness of the integrated use of these indicators as predictors of POP development in women of the reproductive period. Conclusions. The results of the study suggest that the features of gene COL1A1 polymorphism, the level of β-CrossLaps can serve as predictors of the development of POP in women of reproductive age with clinical manifestations of signs of UCTD. Complex of these indicators allows to develop a prognostic model of POP early manifestation.

Triple therapy with inhaled corticosteroid (ISC) / long-acting β2 agonist (LABA) / long-acting muscarinic antagonist (LAMA) in single inhaler expanded the possibilities for prevention of chronic obstructive pulmonary disease (COPD) exacerbations. Heterogeneity of COPD determines the needs in search of target population and efficacy markers for each existing therapy. Disease phenotype depends on a complex of factors, with respiratory viral infection among the most significant. Aim of the study was to assess the efficacy of triple therapy with ICS/LABA/LAMA in single inhaler for subsequent COPD exacerbations prevention and to search molecular markers of the efficacy depending the etiology of index exacerbation. Material and methods. It was a prospective observational study of three COPD patients’ strata: after COPD exacerbation required hospitalization with viral (n = 60), bacterial (n = 60) and viral-bacterial (n = 60) infection. Triple therapy in single inhaler (n = 104) or in free combinations (n = 76) were prescribed in real clinical practice. COPD was diagnosed according to spirography criteria. To establish the COPD exacerbation etiology the real time PCR of sputum or bronchoalveolar lavage fluid, standard cultural method, blood procalcitonin, as well as marker blood proteins, hyaluronic acid by ELISA measurement were done. Associations were revealed using Cox regression. Results. Triple therapy in single inhaler in comparison with free combinations decreased time to first re-exacerbation, hazard ratio (HR) in viral-associated index exacerbation strata was 0.38 (95% confidence interval (95% CI) 1.15–0.40), in bacterial – 0.47 (0.39–0.72), in viral-bacterial – 0.39 (0.14–0.39). In strata of COPD patients after viral and viral-bacterial exacerbations, in subgroups treated with triple therapy in single inhaler blood procollagen III N-terminal propeptide (PIIINP) (HR for group after viral index exacerbations was 1.03, 95 % CI 1.02–1.28, HR for group after viral-bacterial exacerbations was 1.04, 95 % CI 1.02–1.28), granulocyte-macrophage colony-stimulating factor (GM-CSF) (HR 1.03, 95 % CI 1.02–1.32, 1.01, 95 % CI 1.00–1.35, respectively) content was associated with time of re-exacerbations. Conclusions. Blood PIIINP and GM-CSF during COPD exacerbation are perspective markers of subsequent exacerbations within 1 year in patients after virus-associated or viral-bacterial index exacerbation. In these groups of patients triple therapy in single inhaler is more effective than free combination for subsequent exacerbations prevention.

The prevalence of back pain in pregnant women is quite high nowadays. A special place is given to myofascial pain. They progress with the course of pregnancy and can lead to a decrease in a woman’s quality of life. However, the issues of back pain treatment, including the selection of methods and doctors training, still remain unresolved. The aim of our work was to identify the effect of manual therapy (in particular, myofascial release) on the dynamics of pain syndrome in pregnant women with low back pain. Material and methods. The study involved 90 patients of the MIRT Medical Center (Krasnoyarsk) with myofascial lumbosacral pain syndrome at different gestation phases. We used myofascial release techniques and training device to retrained their muscular system. We evaluated the effectiveness of treatment by using a visual analog scale of pain, test with two scales (patented model) and manual muscle testing methods. Results and discussion. The average pain score was 5 points before treatment and 0.6 points after treatment. Pain completely disappeared in most patients after treatment. The maximum decrease in pain score showed women in the third trimester. The pathological difference in the load on the limbs after treatment was 17 times less than before treatment, for all trimesters in general. In the first trimester it was not detected at all. The study revealed correlation between the pain syndrome and positive sacroiliac ligament compression test. Conclusions. We have developed a general scheme for examination and treatment of back pain in pregnant using patented technologies and myofascial release technics. It has proven to be effective in reducing lower back pain at different gestation phases. Tension in the sacroiliac ligaments should be investigated in the future and taken into account for back pain treatment of pregnant women, as well as at pregnancy planning stage.

A significant contribution to the preservation and improvement of the population health is made by a healthy lifestyle, one of the components of which is rational nutrition. Considering severe stress experienced by students due to the changed social environment, the study of nutritional characteristics and the role of behavioral factors in eating behavior among medical students remains an extremely topical issue of modern preventive medicine. Material and methods. As a result of a cross-sectional study, 197 students of the Saratov Medical University were interviewed, 100 (51 %) of them were russian students, 97 (49 %) were citizens of Central African countries. The method of 24-hour reproduction of daily diet, program complex “Individual diet 5.0 professional version”, questionnaire were used. Results and discussions. The study showed an imbalance in macro- and micronutrients intake of the daily food ration, a violation in the diet, insufficient consumption of vegetables and fruits, rare hot meals, dissatisfaction with the organization of meals in student canteens, frequent use of fast food by students regardless of their country of origin. The relationship of physical activity and smoking with the diet and the frequency of consumption of vegetables and fruits, low awareness of unbalanced nutrition as a risk factor for the development of alimentary-dependent diseases have been established. Conclusions. The nutritional behavior of russian and foreign students of Saratov Medical University does not meet all the principles of healthy eating recommended by WHO. Thus, it is necessary to improve the organization of catering in student canteens, taking into account the taste preferences of foreign students, the introduction of educational activities and healthy nutrition programs with the involvement of the students themselves in their preparation. The analysis of actual nutrition is a very important task, as it allows assessing the current socio-economic situation, as well as the effectiveness of educational programs in the framework of national projects on a healthy lifestyle and proper nutrition.

Prevention of circulatory system diseases (CSDs), preservation of the health of the working population is a priority task of the Russian Federation healthcare, in the solution of which it is of interest to study the causal relationships of the influence of production factors on the development of CSDs in workers of various professional groups. The purpose of this study was to assess the prevalence and occupational causality of diseases of the circulatory system in the main professional groups of bearing production workers. Material and methods. The occupational risk of developing CSDs in workers of the main professional groups in the bearing production was assessed based on the hygienic classification of production factors and chronic non-infectious morbidity according to medical examinations using the methodology for assessing occupational health risk. Results and discussion. It has been established that bearing production workers in the course of labor activity are exposed to the complex effects of harmful (class 3.1–3.4) factors of the working environment of various nature, which determine the a priori occupational health risk in categories from low to very high. The level of CSD prevalence was 446.4‰, while arterial hypertension was the most frequently established nosologic form (80.66 %). A high degree of causal relationships of arterial hypertension with the work was established for adjusters and machine operators (RR = 2.44; etiologic fraction (EF) 58.98 %; CI = 1.335–4.450), turners (RR = 2.32; EF = 56.93 %; CI = 1.184–4.451), grinders (RR = 2.31; EF = 56.63 %; CI = 1.189–4.469), hot-spot workers (RR = 2.16; EF = 53.64 %; CI = 1.193–3.901), which indicates professional conditioning. Conclusions. The complex impact of production factors contributes to the development of CSDs among workers in the production of bearings, which is confirmed by a high degree of causal relationship between arterial hypertension and work.

Due to the high information and communication importance and potential of the medical blogosphere in the formation of health literacy of the population, there is the increased need to study the opinions of Russian social media users on the impact of the content of medical blogs on personal and public health. Aim of the study was to find out the opinion of social media users on the extent to which the activities of bloggers specializing in public health and health care topics influence the prevention of major non-communicable and infectious diseases, public and personal health, within the changing boundaries of medical knowledge broadcasting (using sociological methods). Material and methods. The authors conducted a quantitative sociological survey of 178 respondents - users of social media: 55 (30.9 %) women and 123 (69.1 %) men about visiting blogs specializing in public health and healthcare. The collection of information was carried out by e-mailing a questionnaire developed by the authors, and analyzed the answers to questions from active blog users through a Google form in April – May 2023. Results. The study results of the impact of bloggers’ activities on personal and public health, including those related to the quality of medical information disseminated in social media, are described. Respondents believe that medical bloggers have a greater impact on public health than personal health. At the same time, according to the respondents, the spheres of influence in the field of public health do not coincide with the spheres of influence in the field of personal health. Thus, 74.7 % of respondents believe that medical bloggers have an impact on maintaining a healthy lifestyle of the population, prevention (61.8 % of all respondents think so) and treatment of infectious diseases (61.2 %). The requirements for the quality of information provided by bloggers are considered. Based on the analysis of Russian and foreign scientific literature, the authors developed a graphical diagram of the effect of dissemination through the blogosphere of information in the field of health care and disease prevention. Conclusions. The content published on medical blogs affects the health literacy of the population. That is why, medical blogs can be seen as a social determinant of health, because health blogs can be the key to the success of disease prevention and control efforts for public health maintaining. For organizing a communication intervention of medical personnel in social media to inform the population about methods for preventing the risk of developing major non-communicable and infectious diseases and increasing the level of health literacy of the population, medical blogs can and should be used to inform and educate patients as part of general or targeted multimodal educational practices or as a means of delivering electronic content. The risks of publishing inaccurate information in the blogosphere must be considered, whereby patients can easily become misinformed, which can have serious consequences for their health, and even increase their risk of mortality. To make the best use of the blogosphere, it is necessary to solve the problems of content accuracy and increase the level of professionalism of bloggers who write on medical topics. They need to be professionally trained to work for health, contributing to the prevention of the risk of developing major non-communicable and communicable diseases, improving the health of the population through education, and raising the level of health literacy. It makes sense to assess the success of the communicative intervention of doctors in social media and their management of the training of medical bloggers as a personnel determinant of public health, since it will depend on the personnel potential of the healthcare sector.