Aim of the study was to characterize the intestinal microbiota and its metabolites in hyperlipidemia and analyze the associations between the intestinal microbiota and some biological (prebiotics and probiotics) and lipid-lowering (statins, fibrates) drugs in the treatment of hyperlipidemia.

   In hyperlipidemia, the number of bacteria producing toxic metabolites such as lipopolysaccharide and trimethylamine-N-oxide (TMAO) is increased (Bacillota (former Firmicutes), Pseudomonadota (former Proteobacteria), Desulfovibrionaceae) and the number of intestinal producers of beneficial short-chain fatty acids and bile salt hydrolase is decreased (Bacteroidota (former Bacteroidetes), Verrucomicrobia, Bifidobacterium, Lactobacillus, Streptococcus, Eubacterium). Prebiotics can improve lipid metabolism, but the mechanisms of such effect remain unknown. Probiotics (the best studied are Lactobacillus and Bifidobacterium) can remove cholesterol from circulation (by adsorbing and assimilating it on cell membranes), reduce intestinal absorption of cholesterol (by stimulating de novo bile acid synthesis), and modulate cholesterol synthesis (by inhibiting HMG-CoA reductase and reducing the expression of the ATP-associated cassette transporter type A1 gene family). Lactobacillus, in addition to improving the intestinal microbial profile and lipid metabolism, reduces body weight, blood pressure, inflammation, and insulin resistance. Statins and the intestinal microbiota demonstrate mutual influence: a better response to statin treatment is associated with a higher diversity of microbiota, statins are also able to restore the microbiota altered due to pathology to a healthier state (reduce the number of potential pathogens, such as Parabacteroides merdae, and increase the number of beneficial bacteria – Bifidobacterium longum, Bifidobacterium bifidum, Anaerostipes hadrus, Faecalibacterium prausnitzii, Akkermansia muciniphila and the genus Oscillospira, and reduce plasma TMAO levels). Moreover, the effect of statins on the composition and function of the gut microbiota does not depend on a decrease in cholesterol level. The data on the effects of fibrates on the microbiota, studied in mice, are contradictory: in some studies, fenofibrate can reduce caused by a high-fat diet systemic inflammation and lipid metabolism disorders, while in others, on the contrary, it can increase obesity and inflammation.

   Conclusions. The gut microbiome opens up fundamentally new approaches to the treatment of cardiometabolic diseases in the era of precision medicine.

   The significant prevalence of obesity in children, as well as significant consequences for health, determine the relevance and practical importance of the problem of excess body weight.

   In this regard, the purpose of this publication is to analyze generalizing scientific reviews devoted to the problem of anthropometric approaches to the diagnosis of overweight and obesity in children.

   The results of studies of the last 3 years, presented in the PubMed database, in the scientific electronic library eLibrary.ru for the period from 2015 to 2024, as well as the thematic search of literature, are discussed. Certain differences in the estimates of total and fat body mass, asynchronous growth of body components, the relationship of the state of redundancy with social, national and territorial problems are shown. The issues of methodological unity of research, as well as the lack of a generally accepted base that allows determining the contribution of lifestyle factors to the problem under study, are discussed. The analysis of the literature shows that many issues of practical medicine related to the assessment of the risks of health disorders associated with the accumulation of overweight and obesity remain unresolved today. Largely, this is due to the lack of a unified methodological base that allows to determine the contribution of lifestyle factors to the problem, due to problems of age and sex characteristics of the female body. Anthropometric research methods can serve as a methodological basis for studying the problem of obesity. Despite the fact that at present most studies on the assessment of the fat component of body mass are based on the determination of body mass index, alternative methods of more accurate risk prediction are increasingly being used using a comprehensive study that includes anthropometric methods for determining body size, volume and biophysical determination of body composition. An important task of anthropologists is to adapt the methods used in the practice of pediatrics and to verify the parameters of the component composition of the child’s body. An urgent problem is the development of an algorithm for an effective combination of the most informative anthropometric indicators in solving issues related to the assessment of the impact of behavioral, gender and ethno-territorial factors on human health.

   The review is devoted to the feasibility of using flavonoids in the complex therapy of osteoporosis. Numerous types of pharmacological activity inherent in these polyphenolic compounds of plant origin, including anti-inflammatory, antioxidant, antiproliferative, immunomodulatory, antitumor, anticoagulant and others, forced us to carefully approach the possibility of their clinical effectiveness in bone pathology. Experimental studies of recent years have shown that the protective effect of flavonoids preventing pathological bone loss is primarily due to activation of new bone tissue formation by stimulating proliferation and differentiation of osteoblasts, as well as weakening the bone resorption process by inhibiting osteoclastogenesis. Possible mechanisms of the noted effects are discussed taking into account the impact on intracellular signaling processes. A positive effect of estrogen-like properties of a number of flavonoids on the osteogenesis process is noted. The review considers the promising properties of the most widely encountered flavonols, flavones, flavanones, flavan-3-ods (catechins), anthocyanidins, and isoflavones, allowing one to look with optimism at their clinical application in the future. As many authors believe, further in-depth preclinical studies should answer many remaining questions regarding the mechanisms of action of flavonoids, as well as solve the problem of their bioavailability.

   A literature search was made in the PubMed database to study articles devoted to the results of studies of the features of blood and lymphatic vascularization of gastric cancer (GC). Hemangiogenesis and lymphangiogenesis in any tumor, including GC, are absolutely necessary for growth, invasion and metastatic spread. Tumor angiogenesis is activated via hypoxia of cells, accordingly, the content of factors both induced by hypoxia and associated with vascular growth increases in the GC tissues. In addition, some leukocytes infiltrating the tumor take an active part in angiogenesis, also contributing to the development and progression of GC. Vessel growth is triggered not only in the tumor, but also in other parts of the stomach. Inhibitors of angiogenesis and lymphatic vessel growth contribute to slowing down tumor growth and suppress metastasis. Unfortunately, the state of the vascular network of adjacent organs remains unexplored, while proangiogenic factors spread through existing blood and lymphatic vessels and should affect angiogenesis, at least, in liver and regional lymph nodes.

   The relevance of the study is due to the role of IL-4 and IL-13 cytokines in the pathogenesis of diseases of the respiratory system, including bronchial asthma.

   Changes in the IL4 and IL13 genes can affect their expression levels and, consequently, predisposition to asthma.

   The aim of the work was to analyze the prevalence of polymorphic variants of the IL4 rs2243250, rs2070874 and IL13 rs1800925 genes in populations of Russians, Khakas and Tuvans.

   Materials and methods. School students from Krasnoyarsk, Abakan, Kyzyl at the age of 12–18 years were studied, their nationality was verified by the nationality of both parents and was determined as Russians (n = 293), Khakas (n = 73), Tuvans (n = 158). Polymorphisms rs2243250 IL4, rs2070874 IL4, and rs1800925 IL13 were determined using real-time PCR.

   Results and discussion. It was shown that the CC genotype of the rs2243250 IL4 is more common in Russians (57.7 %) compared with Khakas (34.3 %) and Tuvans (17.1 %) (p < 0.05), allele T – in Tuvans (56.6 %) compared to European (16.8 %) and South Asian populations (18.4 %) (p < 0.05). The Russian population has a predominance of the CC rs2070874 IL4 (54.3 %) compared with other studied groups. The frequency of the allele T is higher among Tuvans (54.7 %) than in Russians (26.8 %), Khakas (41.1 %), European (16.8 %) and South Asian populations (18.6 %), but less than in East Asian populations (77.9 %) (p < 0.05). The CC rs1800925 IL13 is significantly more common in Tuvan (81.6 %) compared with Russians (55.0 %) and Khakas (67.1 %) (p < 0.05). Among Tuvans (81.6 %), this genotype also prevails over East Asian (66.3 %) and South Asian (63.8 %) populations, p < 0,05. Allele T is significantly less common in Tuvans (10.1 %) than in European (17.8 %), East Asian (17.8 %) and South Asian (20.0 %) populations (p < 0.05).

   Conclusions. Rare alleles of the polymorphisms rs2243250 and rs2070874 IL4, associated with the development of bronchial asthma, are more common among Khakas and Tuvans compared with Russians. Genotype TT of the rs1800925 IL13, associated with bronchial hypersensitivity and increased total IgE level, is more common among Russians compared with Tuvans.

   Anthropometric and fetometric parameters of the fetus, including birth weight, are closely related to pregnancy outcomes and the health status of the newborn. The maternal preconception body mass index (BMI) significantly influences on intrauterine development; however, differential growth characteristics between male and female fetuses are often overlooked in such analyses. At the same time, the child’s sex may significantly modify growth rates, the distribution of muscle and adipose tissue, as well as the response to external factors.

   Aim of the study was to determine the patterns of the influence of fetal sex on fetometric parameters, including birth weight, taking into account maternal anthropometric characteristics (BMI and height) and regional peculiarities, in order to optimize perinatal care and improve pregnancy outcomes.

   Material and methods. Medical records of 5161 pregnant women treated at the Kirov Regional Clinical Perinatal Center were analyzed. The study considered maternal anthropometric data (body weight, height, preconception BMI) and fetometric data of the newborns (head circumference, abdominal circumference, birth weight). This retrospective study covered the period from 2016 to 2022. Based on predefined inclusion and exclusion criteria, the women were divided into three groups according to their preconception BMI: below normal (< 18.5 kg/m²), normal (18.5–24.9 kg/m²), and elevated (25.0–29.9 kg/m²). Pregnant women with obesity (BMI ≥ 30 kg/m²) were excluded. Additionally, a stratified analysis of the newborns by sex was conducted to assess the influence of fetal sex on intrauterine growth.

   Results. It was found that, overall, male newborns exhibited higher birth weight, head circumference, and shoulder circumference compared to female newborns, regardless of the maternal BMI group. In the underweight group, infants with lower fetometric parameters were more frequently born; however, the differences between males and females persisted even in this category. In the normal BMI group, children of both sexes had optimal mean birth weights (approximately 3300 ± 400 g), yet male newborns more frequently exceeded the median values. In a group of mothers with elevated BMI group (25.0–29.9 kg/m²), the proportion of infants with a birth weight > 4000 g increased, with male newborns showing even higher values. The statistically significant differences in growth rates between the sexes were evident both in the mean birth weight and in the higher proportion of large-for-gestational-age infants among males. Correlation analysis demonstrated that the combination of fetal sex with maternal preconception BMI and height significantly influences the final fetometric parameters.

   Conclusions. In addition to the maternal BMI and height, the newborn’s sex influences on fetometric parameters, including birth weight. Therefore, in perinatal care, in the formulation of dietary recommendations, and in planning the management of pregnancy, it is advisable to consider not only the maternal anthropometry but also the potential differences between male and female fetuses in intrauterine growth patterns.

   Aim of the study was to investigate the frequency of occurrence of HLA alleles and five-locus haplotypes in hematopoietic stem cell donors - residents of the Orenburg region.

   Material and methods. HLA typing of 5529 potential donors of the Orenburg region of the Russian Federation using NGS technology in 2-field resolution at the HLA-A, HLA-B, HLA-C, HLA-DRB1 and HLA-DQB1 loci was performed.

   Results and discussion. 74 alleles were identified at the HLA-A locus, 108 at the HLA-B locus, 68 at the HLA-C locus, 65 at the HLA-DRB1 locus, and 37 at the HLA-DQB1 locus. The most common alleles are HLA-A*02:01 (25.85 %), HLA-A*03:01 (12.96 %), HLA-A*01:01 (11.66 %), HLA-B*07:02 (10.70 %), HLA-B*18:01 (7.40 %), HLA-B*08:01 (6.39 %), HLA-C*04:01 (13.22 %), HLA-C*07:02 (12.43 %), HLA-C*07:01 (11.70 %), HLA-DRB1*07:01 (13.75 %), HLA-DRB1*15:01 (10.93 %), HLA-DRB1*01:01 (10.55 %), HLA-DQB1*03:01 (21.23 %), HLA-DQB1*05:01 (13.23 %), HLA-DQB1*02:02 (11.02 %). Among five-locus haplotype in the studied population the most common is HLA-A*01:01~HLA-C*07:01~HLA-B*08:01~HLA-DRB1*03:01~HLA-DQB1*02:01 (3.66 %). 26 new alleles have been described.

   Conclusions. The examined population of donors recruited in the Orenburg region, according to the distribution of the most common alleles and haplotypes, has great similarity with the studied populations of the European part of Russia, however, a large number of identified rare and new alleles indicates the relevance of further research and recruitment of donors in this region in order to increase the genetic diversity of the Federal Register, which will increase the likelihood of matching a donor for any patient in need of hematopoietic stem cell transplantation.

   Currently, there is a trend towards the internationalization of higher education. At the same time, educational institutions need to meet the individual characteristics of international students by offering a wide range of educational services, taking into account ethnic and intercultural differences, in order to successfully adapt to new environmental conditions
and the education system.

   The aim of the study was to evaluate the psychophysiological parameters of the nervous system of Russian and Chinese medical university students depending on the season of the year.

   Material and methods. The study involved 203 first-year students, divided in to groups by gender and nationality. The measurements were carried out in spring and autumn. Situational and personal anxiety was assessed according to Spielberger – Khanin, the functional asymmetry of the hemispheres and the psycho-emotional state was registered using the hardware-software complex “Activationometer 6”.

   Results and discussion. During the entire observation period, all students had a moderate level of personal and situational anxiety. However, in the fall, the number of Chinese with a high level of personal anxiety, and in the spring, situational anxiety was higher compared to Russians. During the entire study period, students with right-hemisphere asymmetry were more common among Chinese youths. Chinese women had a slight left-hemisphere shift in asymmetry in the spring, and interhemispheric balance in the fall. In the spring, the values of the Chinese students’ psychoemotional state were higher compared to the autumn period.

   Conclusions. The high level of situational anxiety and psychoemotional state among Chinese people in spring is due to adaptation to the learning process and environmental and climatic conditions. The peculiarities of the distribution of the functional asymmetry of the hemispheres in Chinese and Russian students are explained by the difference in information perception and processing.

   The assessment of a child’s physical development, including nutritional status, by the value of the body mass index is not always objective, since it does not take into account the component composition of the body.

   The aim of the study is to compare the results of the assessment of physical development with the data of the bioimpedance study of the body composition of secondary school students.

   Material and methods. Study groups included 165 girls and 170 boys aged 12 [10; 15] years (median [lower quartile; upper quartile]). All children were assessed for physical development in accordance with height SDS (standard deviation score), body mass index (BMI) SDS and bioimpedance analysis of body component composition. A comparative analysis of growth, BMI, body fat (BF %) and skeletal muscle mass percentage (SMM %) was carried out, taking into account gender and age.

   Results. A comparison of growth SDS and BMI SDS, the structure of results of bioimpedance analysis deviations did not reveal statistically significant intergroup differences (p = 0.057–0.979). At the same time, it was found that in girls, compared to boys, the BF% is statistically significantly higher (by 1.3 times, p < 0.001), whereas the SMM % is less (1.2 times, p < 0.001). Girls were 1.5 times less likely to have low LM values (p = 0.024) and 1.4 times less likely to have high SMM values. A direct correlation was established between BMI SDS and the BF% in both sexes (r = 0.71–0.80; p < 0.001).

   Conclusions. The assessment of physical development by the value of BMI SDS correlates with data on the body component composition. Bioimpedance analysis of body composition can be recommended as an additional method for assessing the nutritional status of children and adolescents.

   The development and research of drugs capable of reducing the malignancy of tumors is one of the most promising areas in the differentiation therapy of breast cancer (BC). As the full-size differentiation factor (HLDF) significantly contributes to enhancing the differentiation level of invasive breast carcinoma cells of a non-specific type, it can be considered as a promising tool for differentiating therapy of BC. The disadvantage of full-size HLDF is its rapid biodegradation in the body. In this regard, the acetyl-amide form of the peptide (HLDF-6) was synthesized to protect against hydrolysis. However, the effect of this HLDF-6 on breast cancer cell differentiation remains unclear.

   Aim of the study was to investigate the effect of the acetyl-amide form of the synthetic peptide HLDF-6 on the expression of CD24 and CDH2 clusters of differentiation in BC cells, taking into account differences in molecular genetic subtypes of the tumor.

   Material and methods. The study was conducted on BC biopsies of 33 patients using the methods of tissue cultures and immunohistochemistry.

   Results. It was found that the use of the acetyl-amide form of the synthetic peptide HLDF-6 leads to a decrease in the proportion of cells expressing CD24 and CDH2 in BC samples with luminal subtypes of breast cancer: luminal A (LA) and luminal B HER2-negative (LB). To a lesser extent, this effect was manifested in the study of samples of patients with triple negative subtype of breast cancer (TN). The results of the ROC analysis showed that CDH2 and CD24 molecules are significant predictors for evaluating the effect of stimulating the differentiation of low-grade breast cancer cells within various subtypes of BC.

   Conclusions. The study indicates the prospects of using the acetyl-amide form of the synthetic peptide HLDF-6 for differentiating therapy in patients with LA and LB HER2-negative subtypes of BC.

   The aim of this study was to conduct a comparative analysis of the development of obesity in rats fed a high-fat diet (HDL) for 4 and 7 weeks.

   Material and methods. Sexually mature male Wistar rats were used in the work. Control animals were kept on a diet in which fat was 10–11 %, experimental rats – on an HDL, in which fat accounted for 36 % of the caloric content of the daily diet due to the addition of melted pork fat to the food. The mass of organs and adipose tissue, the content of triglycerides, total and cholesterol, high- and low-density lipoproteins, and the activity of alanine and aspartate amino transferase in blood serum were measured. Liver sections were stained with hematoxylin and eosin to assess the relative number of Kupffer cells. An indirect streptavidin peroxidase method was used for immunohistochemical examination of sections.

   Results and discussion. In rats kept on HDL for 4 weeks, the following parameters increased in comparison with control animals: body weight by 21 %, mass index of retroperitoneal, epidermal and interscapular brown fat (by 56, 33 and 52 %, respectively), serum triglyceride content by 2.3 times, numerical density of Kupffer cells by 2.1 times, the expression of matrix metalloproteinase 9 in the liver by 2.8 times. After 7 weeks of HDL, alanine amino transferase activity in serum increased by 20 %, the numerical density of Kupffer cells remained 2.1-fold increased, and the expression level of matrix metalloproteinase 9 raised 5-fold relative to control rats.

   Conclusions. After 4 weeks of HDL treatment, the rats developed an obesity phenotype, accompanied by negative shifts in the structural and functional state of the liver; after 7 weeks, these negative changes worsened, which allows us to consider the used model of obesity in rats as a tool for studying the effectiveness of approaches to normalizing obesity and related diseases.

   Regular physical exercise causes morphofunctional changes in the heart depending on the load.

   The aim of our study was to identify changes in the bioimpedance spectroscopy parameters of the left ventricle of the heart in rats after physical exercise (swimming) of different duration.

   Material and methods. Morphological and bioimpedance assessment of the left ventricle of the heart was performed in male rats that underwent a 12-week swimming course and in intact animals. Two groups of rats were subjected to swimming (5 times a week): the experimental (200 minutes a day) and the control (5 minutes a day).

   Results and discussion. Histological studies have shown an increase in the diameter of cardiomyocytes in the left ventricle of the heart in animals of the experimental and control groups compared to intact rats. In animals subjected to prolonged physical exercise, a significant increase in the reactance of the bioelectrical impedance of the left ventricle of the heart at an electric current frequency of 50 kHz was revealed compared to those swimming for five minutes a day, indicating greater changes in muscle tissue volume. An increase in the active resistance of the bioelectrical impedance of the left ventricle of the heart was noted along with a smaller volume of connective tissue in the rats of the experimental group compared to the control. The amplitude of the bioelectrical impedance of the myocardium of the left ventricle of the heart in rats of the experimental group was greater than in animals of the control (at 30 and 50 kHz) and intact (at 100 kHz) groups, which indicates differences in the volume of intercellular and intracellular space.

   Conclusions. In rats under the influence of prolonged physical exercise by swimming for 12 weeks, morphometric and bioimpedance changes in the left ventricle of the heart associated with physiological remodeling of the myocardium were revealed.

   Aim of the study was to assess in vitro the impact of enzymatic degradation of collagen on the subsequent calcification of the epoxy-treated bovine pericardium used in the production of bioprosthetic heart valves.

   Material and methods. The study involved epoxy-treated bovine pericardium patches, samples of which were incubated with bacterial collagenase solution. The degree of degradation of the samples after enzyme treatment was analyzed by mass loss and changes in mechanical properties. The samples were also subjected to proteolysis, and then placed in a calcification solution for 3 weeks. The calcium content was evaluated by spectrophotometry. The control group included epoxy-treated bovine pericardium patches that were not incubated with bacterial collagenase solution.

   Results and discussion. On average, the mass loss of studied samples was equal to 8 % during 24-hour incubation in collagenase, which is comparable to the values for glutaraldehyde-treated pericardium according to the literature data. Moreover, the enzyme treatment led to a decrease in the tensile strength of the studied material (14.15 [13.08–16.58; 11.4–22.43] MPa (median [25^th percentile – 75^th percentile; minimum – maximum]) in control group vs. 10.67 [7.37–11.6; 6.39–11.95] MPa in the study group, p = 0.0003) and increase in its calcification by 1.6 times (8.61 [6.58–9.81; 4.78–14.53] mg of calcium/g of tissue in the control group vs. 13.41 [10.58–17.27; 7.76–28.41] mg of calcium/g of tissue in the study group, p = 0.0001).

   Conclusions. The enzymatic degradation of collagen in the epoxy-treated bovine pericardium enhances its calcification in vitro. The data obtained suggest that the accumulation of collagenolytic enzymes in the leaflets of xenopericardial bioprosthetic heart valves is an important mechanism of structural degeneration.

   The aim of the study was to study the antimicrobial activity of new quinazoline derivatives against Staphylococcus aureus with the prediction of the structure-activity relationship.

   Material and methods. Primary antimicrobial screening of new quinazoline derivatives was carried out using the serial dilution method. The number of colonies was counted using the BIOMIC V3 software and hardware complex (Giles Scientific, USA). For statistical processing of the study results, the StatTech program (Russia) was used using the parametric method with the definition of Student’s t-test with Bonferroni correction. Prediction of direct biological targets was carried out using the PASS software tool. Structural parameters and octanol/water partition coefficient (LogP) were determined using ProTox 3.0.

   Results. The bacteriostatic effect of the substance VMA-23-10 against S. aureus was established in dilutions of 128, 64 and 32 μg/ml. It has been shown that VMA-23-10, distinguished by the presence of an isopropyl radical in the molecule, is characterized by greater lipophilicity. The mechanism of action of the substance VMA-23-10 was predicted.

   Conclusions. The conducted study made it possible to identify the leading compound among the studied derivatives, which exhibits a bacteriostatic effect against S. aureus. The difference in lipophilicity between VMA-23-10 and other molecules studied probably determines their different ability to penetrate the cell membrane of the pathogen. The predicted probability of the effect of the compound VMA-23-10 on serine/threonine protein kinases suggests that it exhibits an antimicrobial effect due to disruption of peptidoglycan synthesis, as well as suppression of the process of biofilm formation.

   The severity of the catabolic syndrome for burn disease determines the outcome along with the course of shock and immunosuppression, so correction of protein-energy deficiency is an important part of intensive care. The changes in nucleic acid metabolism in patients with severe burn injury that we noted earlier can be the cause of the development and maintenance of catabolic syndrome.

   The aim of the work was an objective assessment of the relationship between the nucleic acids exchange and the amino acids catabolism in severe burn trauma.

   Material and methods. 40 patients of both sexes aged 18–70 years with severe burn injury were included in the study: burn of II–III degree with a total area of more than 40 % (and a deep burn area of > 20 %), who had been in the intensive care unit for burn injuries for more than three days after trauma. The first group included surviving patients (30 people), the second – deceased patients (10 people).

   Results. Significant increase in the level of blood urea was observed starting from the third day of trauma in all patients. In the first group, the blood urea/creatinine ratio on the third day was 0.073 ± 0.007, with a significant increase from the fifth day, and a further increase on the tenth day to 0.124 ± 0.010, i.e. 1.7 times (p = 0.0002). Hypourecemia (decrease in serum uric acid less than 200 μmol/l) was observed in almost all patients, with a maximum decrease on the seventh and tenth days (142.7 ± 9.0 and 139.0 ± 7.5 μmol/l, respectively). It is characteristic that the maximum changes in the blood urea/creatinine ratio and hypourecemia coincided in time. To clarify the relationship between amino acid catabolism and nucleic acid metabolism, a correlation analysis was carried out between the excretion of urea nitrogen and the level of serum uric acid in the first group patients. The analysis showed a significant correlation between the daily excretion of urea nitrogen on the seventh day, and the level of serum uric acid on the third day (r = 0.66, p = 0.0392) and on the tenth day (r = –0.66, p = 0.0376). Considering the revealed relationship, the informative value of the ratio of blood urea/uric acid was assessed. The value of this index in the first group on the third day of observation was 0.032 ± 0.006, with a significant increase to the seventh (0.07 ± 0.010, p = 0.0002) and tenth days (0.072 ± 0.007, p = 0.0002), i.e. more than 2 times.

   Conclusions. An increase in amino acid catabolism occurs almost simultaneously with changes in nucleotide metabolism, with maximum changes on the seventh and tenth days after burn injury. A significant correlation was noted between the daily urea nitrogen excretion and the level of serum uric acid in the first tenth days after a severe burn injury. The results obtained indicate that an increase in amino acid catabolism may also be associated with changes in the metabolism of nucleic acids in a critical condition.

   The components of the vascular endothelial growth factor (VEGF) system are involved in the pathogenesis of bladder cancer (BC) and type 2 diabetes mellitus (T2DM). However, data regarding the state of the VEGF system in patients with non-muscle-invasive bladder cancer (NMIBC) and concurrent T2DM are lacking.

   The aim of the study was to investigate the characteristics of the content of VEGF system components in the blood and tumor tissue in NMIBC in patients with T2DM.

   Material and methods. VEGF component level was measured using ELISA in the blood of patients with both BC and type T2DM (main group, 8 men, 3 women), patients with BC without T2DM (control group, 6 men, 5 women), patients with T2DM without BC (comparison group, 4 men, 4 women), and age-matched healthy donors (norm, 5 men, 6 women), and in homogenates of tumor tissue.

   Results. In BC, VEGF-A and VEGF-C concentrations were similar to those in the donor group. In T2DM, only VEGF-C content was elevated. VEGF-C concentration in men of the main group was lower than in the comparison group, whereas in women – was higher. Circulating sVEGF-R3 content exceeded the norm only in the main group. In tumor tissue, there were no significant differences in VEGF-A, VEGF-C, sVEGF-R1, or sVEGF-R3 level between BC patients with or without T2DM. However, patients with concurrent conditions exhibited lower sVEGF-R2 levels in tumor tissue.

   Conclusions. In the case of a combination of BC and T2DM, there is an increase in the involvement of the VEGF system during the course of the oncological disease, while in all patients, changes associated with the components responsible for lymphangiogenesis prevail.

   Despite the active development of diagnostics, therapy and accumulation of knowledge in oncology, mortality rates from malignant neoplasms remain high all over the world to this day. The reason is the untimely diagnosis, provision of assistance and incorrectness of the prescribed therapy. The latter, in addition to the possible ineffectiveness of treatment, is closely associated with the development of a life-threatening condition: tumor lysis syndrome (TLS).

   Aim of the study was to determine the prevalence of TLS depending on the type of diagnosed malignant neoplasm in cancer patients using the example of data from the Penza region for 2021-2023.

   Material and methods. The data of the Regional Information and Analytical Medical System “ProMed” were analyzed. Mortality was studied during the period from 2021 to 2023.

   Results. There were 16 cases of deaths from malignant neoplasms accompanied by TLS, which constitutes 0.4 % of the total number of deaths due to malignant neoplasms. TLS mainly accompanied malignant neoplasms of the lungs and bronchi – 25 % of cases, malignant neoplasms of the sigmoid colon – 12.5 % and malignant neoplasms of the larynx – 12.5 % of the total number of TLS cases for the specified period, despite global statistics indicating the highest incidence of TLS among hematological and lymphoproliferative types of cancer.

   Conclusion. The prevalence of TLS in malignant neoplasms of the lungs, bronchi, larynx and sigmoid colon has been established. TLS extremely rarely accompanies malignant neoplasms. The increase in the frequency of detection of tumor disintegration syndrome in 2021–2023 shows the improvement of diagnostic methods for the syndrome.

   The problem of developing optimal plastic materials for replacement of jaw defects capable of replacing autogenous bone tissue is one of the central problems in modern maxillofacial surgery. A promising direction in this regard is the use of bone allografts preserved by various methods.

   The aim of the study was to investigate the osteoplastic properties of demineralized bone grafts (DBG) at transplantation into the mandibular defects in animal experiment and to evaluate the possibilities of their application in clinical practice at reconstructive surgeries on the facial skeleton.

   Material and methods. 3 series of experiments on 10 dogs were carried out. In the first series the 3×1 cm marginal defects of the mandible were replaced by orthotopic DBG, in the second – by mineralized BG (MBG) preserved by freezing at the temperature –25 °C, in the third – by combined grafts preserved by freezing in combination with DBG. The results of bone grafting were evaluated according to the data of macroscopic, radiologic and histological studies 1, 3, 6, 9 and 12 months after the operation. 143 patients were operated on in the clinic: 45 patients with cavity defects of the jaws after removal of benign tumors and tumor-like formations, 34 patients with injuries of the lower wall of the abdomen in explosive and zygomatic-vertebral fractures, 32 patients with ununited fractures of the mandible complicated by chronic traumatic osteomyelitis, 26 patients with penetrating defects and 6 patients with deformations of the mandible.

   Results and discussion. Experimental studies have shown that DBG transplanted into the freshly formed defects of the mandible in animals are replaced by the bone regenerate much faster (after 6 and 12 months respectively) and more completely in comparison with MBG. MBG transplantation in combination with DBG contributed to the acceleration of bone formation processes and led to the defect replacement with bone regenerate in 9 months. In clinical practice positive results were obtained in 136 (95.1 %) out of 143 operated patients.

   Conclusions. DBG is a full-fledged osteoplastic material that can be used for replacement purposes in cavity defects of the jaws, defects of the lower orbital wall of the orbit in explosive fractures of the orbit and zygomatic fractures, in sequestrectomy in ununited fractures of the mandible complicated by chronic traumatic osteomyelitis. In case of mandibular defects with violation of its continuity the transplantation of MCT in combination with DBG is indicated, which creates conditions for preservation of osteoplastic and mechanical properties of the transplanted biomaterial.

   The aim of the study is a comprehensive assessment (including the patient’s opinion) of the impact of cataract phacoemulsification on the state of visual functions, morphological biomarkers of disease activity in patients with neovascular age-related macular degeneration (nAMD) against the background of antiangiogenic therapy.

   Material and methods. The study included individuals with nAMD and cataract; the main group included 117 patients (117 eyes) (age 76.2 ± 5.7 years, arithmetic mean ± standard deviation), and the control group included 96 people (96 eyes) (age 77,01 ± 6,02 years). All patients received angiogenesis inhibitor therapy (aflibercept 2 mg), in Treat&Extend regimen, patients in control group – after phacoemulsification. In the main group, phacoemulsification was performed under the condition of monitoring disease activity. A questionnaire including 10 questions was developed to interview patients, 9 of which were assessed before, 1 and 6 months after phacoemulsification, and a 10th question on patient satisfaction with the results of surgery – 1 and 6 months after cataract surgery.

   Results. The number of injections was 6.85 ± 1.78 before surgery, 7.85 ± 0.83 in the first year with a subsequent decrease to 7.04 ± 1.50 and 3.85 ± 1.22 in the second and third years, respectively; the interval between injection was prolonged accordingly (to 13.35 ± 1.84 weeks by the third year). In 100 % of eyes, there was a significant improvement in best-corrected visual acuity with an absolute increase from pre-surgery baseline to the end of follow-up by 0.28 (from 0.22 ± 0.17 to 0.50 ± 0.18). Positive dynamics of the central retinal thickness reduction (by 138.5 μm, 36.5 %) was noted in comparison with value at the beginning of therapy, as well as neuro- and pigment epithelium detachment throughout the entire observation period. Statistically significant correlations of best-corrected visual acuity, number of injections, and interval between injections with morphologic biomarkers of nAMD activity were found throughout the follow-up. There was a significant improvement in patients’ assessment of vision-related quality of life. The most compromised aspect before surgery was the ability to read text in newspapers, books, and magazines. After surgery there was a significant improvement of the indicators characterizing the patient’s adaptation to navigation and outside activities. 99 patients (84.0 %) reported satisfaction with the results of the surgery.

   Conclusions. Cataract surgery and continuation of antiangiogenic therapy of nAMD based on MNV activity are accompanied by a reduction in the number of intravitreal injections and contribute to the positive dynamics of functional and anatomical parameters in the short and long term, which is of clinical value to the physician and has an important impact on the daily functioning of the patient.

   The use of implantable intracardiac devices (ICD) has increased significantly over the past few decades. The incidence of ICD-associated infections has increased disproportionally to the increase in the number of device implantations. As with other forms of infective endocarditis, microbiological testing of blood for sterility and echocardiographic (ECHO) examination are the basis for diagnosing ICD infection. Positive blood culture and clinical signs remain key to diagnosing infective endocarditis, which is currently characterized by an erased, low-symptom clinical picture, and sometimes a completely asymptomatic course. In this regard, the search for “silent” forms of vascular and immunological phenomena using modern diagnostic methods (18F-fluorodeoxyglucose positron emission tomography/computed tomography) is of particular importance. However, the use of these methods in routine practice is limited. That is why a carefully collected anamnesis with a special emphasis on the search for cardiological problems, identification of predisposing social factors and pathology of internal organs is of great importance. A clinical case is presented, the peculiarity of which is the recurrent course of the disease with the formation of complications characteristic of infective endocarditis - embolic syndrome, development of acute kidney injury, decompensation of chronic heart failure. Considering the negative results of the analysis of microbiological blood tests at all stages of the recurrent course of the disease, the diagnosis was determined on the basis of echocardiography/transesophageal echocardiography and the clinical picture of the disease.

   The aim of the study is to analyze the existing scientific data on the use of chitosan-based wound dressings and their effectiveness, as well as to present our own experience with the use of chitosan-based polymer coatings in the treatment of chronic wounds in a lymphoma patient in the purulent surgery department.

   Material and methods. A clinical case of a 69-year-old patient with recurrent B-cell lymphoma, initially treated in the hematology department, and subsequently transferred to the purulent surgery department due to the development of necrotizing fasciitis, is presented. Chitosan-based polymer dressings were used for the healing of a large chronic skin defect that developed after necrosectomy. Dressings were applied for 20 days in the hospital and for 30 days in the outpatient setting.

   Results. The application of chitosan-based polymer dressings showed significant positive dynamics: the wound began to epithelialize, which was accompanied by an improvement in the patient’s overall condition and compensation of comorbidities during the treatment. As a result, significant progress was made in restoring the patient’s functional activity, and they were
discharged with the ability to move independently. At the 6-month follow-up, complete wound healing was noted.

   Conclusions. The analysis of the existing literature and our own experience with chitosan-based biopolymer dressings demonstrated their effectiveness in the treatment of chronic wounds in patients with severe comorbidities. This method represents a promising trend in the surgical treatment of such patients.

   Opsoclonus-myoclonus syndrome is a rare symptom complex, the development of which can be induced by various factors, including infectious and oncopathology, and lead to persistent neurological deficiency, which requires timely diagnosis, treatment and long-term monitoring by specialists of various profiles. In the presented clinical case, a 2-year-old child developed a neurological syndrome in the form of a characteristic combination of opsoclonus, myoclonus, ataxia, psycho-emotional and insomnia disorders after immunization and non-specific general infectious manifestations. Stable clinical remission was achieved against the background of immunosuppressive therapy. Long-term observation for 5 years showed restoration of lost functions of the nervous system and rates of psychomotor development. The need for a comprehensive study of the long-term consequences of parainfectious opsoclonus-myoclonus syndrome is determined by the risk of developing persistent neurological deficit, developing other immunopathological conditions, relapse, and oncopathology. Diagnosis and determination of a treatment strategy for this disease in children is a complex interdisciplinary problem that requires long-term interaction and continuity of specialists of various profiles.

   Pacemaker implantation is the primary treatment for bradyarrhythmias such as atrioventricular and sinoatrial block. Currently, it is a routine practice to implant a pacemaker’s electrode into the apex of the right ventricle. However, a number of studies performed in recent years have shown the negative consequences of chronic right ventricular pacing. Electrical and mechanical dissynchrony, leading to abnormal ventricular contraction, leads to remodeling of the left ventricular myocardium, which in turn causes the appearance and progression of heart failure symptoms, the occurrence of atrial arrhythmias, and increased mortality from cardiovascular causes. Pacing of the heart’s conduction system is a promising direction in the treatment of bradyarrhythmias, causing a more physiological response to stimulation through the His-Purkinje system.

   Material and methods. This article presents a clinical case of changing the area of permanent cardiac pacing in a patient with complete atrioventricular block, previously corrected with a pacemaker.

   Results. The patient underwent surgery, which consisted of replacing the pacemaker with a change in the ventricular stimulation area. As a result of the transition from apical stimulation to stimulation of the left bundle branch of the His bundle, the patient’s well-being improved: exercise tolerance and quality of life increased, and some myocardial dyssynchrony indicators changed.

   Introduction. Short bowel syndrome is a rare disease that occurs after the removal of a large part of the small intestine or due to developmental abnormalities in the embryonic period. Such patients need long-term treatment, the vital component of which is parenteral nutrition (PN). PN requires constant vascular access, the problem of choosing which is always an urgent topic due to the risks of various complications. The venous port system is the optimal type of vascular access for PN due to the low level of intraoperative and postoperative complications and ease of operation.

   The aim of the study is to present a clinical case of venous port system implantation and its use as a vascular access for PN of a patient with short bowel syndrome.

   Clinical case. Patient G., 30 years old, with a diagnosis: “Condition after appendectomy on 24.03.2023, laparotomy, adhesiolysis on 30.04.2023. Condition after 9 sanitation relaparotomies for
tertiary peritonitis. Short bowel syndrome (distal): resection of the distal ileum for small intestinal perforations with the formation of a high jejunostomy at a distance of 90 cm from the ligament of Treitz (residual process 90 cm). Intestinal failure type III, malabsorption syndrome stage 2, severe course. Severe protein-energy malnutrition. Hypoalbuminemia, hypoproteinemia”. Surgery was performed in the Clinics of Samara State Medical University: Implantation of the venous port system into the superior vena cava through the right internal jugular vein with the chamber located in the right
subclavian region. He was discharged for outpatient follow-up treatment in a stable condition with positive dynamics.

   Conclusions. The use of the venous port system as an access for PN in severe and asthenic patients with short bowel syndrome minimizes complications, effectively and conveniently provides PN.

   The international Oral Health Assessment Tool (OHAT) index in its relevant language versions is widely used in dentistry and medicine in many countries around the world to determine the level of oral health and assess the effectiveness of medical interventions.

   The aim of the study was to develop, determine the validity and reliability of the Russian-language version of the OHAT.

   Material and methods. The study involved 148 elderly and senile individuals hospitalized in the emergency cardiology department. During the study, the feasibility, inter-expert reliability, and stability of the tool for assessing oral health were evaluated.

   Results. When using the OHAT, the evaluation of oral health status across specific domains and the pain parameter, as well as the scoring process, did not cause any difficulties. The formulations proposed in the OHAT index were found to be clear, correct and unambiguous. The most frequently identified deviations in health status (2 scores) were recorded for the parameters of “natural teeth” – 30,19 %, “dentures” – 21,28 %, and “oral hygiene” – 16,4 %. The average OHAT index value for patients was 3.38 ± 0.16 scores indicating a level of loss of dental health in elderly individuals. The agreement among experts ranged from an average for the parameters of “oral hygiene” (84.90 %) and “tongue” (85.85 %) to a high for the parameter “dental pain” (98.11 %). The Cohen’s kappa coefficient for the experts’ responses was in the range of good agreement (0.61–0.80) for the parameter’s “tongue”, “saliva”, “oral hygiene” and in the range of excellent agreement (0.81–1.0) for all other analyzed parameters. The correlation coefficient for the total score of expert responses was 0.949 (p < 0.05), indicating very high inter-rater reliability.

   Conclusions. The results of the study confirm that the Russian-language version of the OHAT index is a valid and reliable tool for the screening assessment of oral health by healthcare providers without dental training. The absence of a need for special conditions to determine the index, as well as its applicability by specialists without dental education, significantly increases potential of index use.