The article presents a review of the literature devoted to the analysis of the influence of natural and climatic factors on the human body. We analyzed the influence of parameters such as ambient temperature, including the effects of heat and cold, as well as fluctuations in atmospheric pressure and humidity levels. A number of studies have demonstrated a significant impact of both increase and decrease in ambient temperature relative to comfort level, and a correlation with atmospheric pressure and humidity has been established. The effects of these factors on the functioning of the cardiovascular, respiratory and nervous systems were considered. Extreme weather can disrupt the body’s adaptive processes, leading to oxidative stress, altered blood rheology, vasospasm or vasodilation, and bronchoconstriction. Depending on fluctuations in relative humidity and atmospheric pressure, the ionic composition of the air may change, affecting the human body. Natural and climatic factors can act as a trigger for the exacerbation of chronic diseases. In conclusion, the vector of possible actions is determined to prevent the occurrence of serious consequences for citizens, the health system, and the economy of the country.

Over the past decade, significant progress has been made in understanding the role of microbiota as an ecosystem that functions as a separate organ in a macroorganism. It is known that disturbances in the intestinal microflora affect the pathogenesis and progression of many human diseases. In particular, in gastrointestinal oncology, the gut microbiota affects tumor growth due to dysbiosis, the release of bacterial toxins, and the modulation of cell signaling pathways. Recent studies indicate that the intestinal microbiome plays an important role in the pathogenesis of pancreatic ductal adenocarcinoma, affecting carcinogenesis, immune response, and treatment efficacy. For example, such microorganisms as Porphyromonas gingivalis and Fusobacterium nucleatum are involved in oncogenesis by modulating the tumor microenvironment and stimulating immune responses, which promotes tumor growth, metastasis, and resistance to therapy. In addition, the involvement of kynurenine pathway metabolites (kynurenine, quinolinic acid, and 3-hydroxyanthranilic acid) in cancer has been previously investigated. The current review attempts to clarify the role of bacterial metabolites such as trimethylamine oxide and lipopolysaccharide in influencing antitumor immunity, suggesting potential targets for enhancing the response to immunotherapy. Implementation of microbiome research findings into clinical practice is an emerging field. Personalized therapy for pancreatic cancer is possible through understanding and manipulating the microbiome, which requires further research to develop optimal therapeutic strategies and evaluate combination approaches.

Biobanks are created and operate in the interests of state security and the treatment of socially significant diseases. The high demand for biobanking of umbilical cord and cord blood has led to the emergence of specialized structures – Umbilical Cord Blood Banks.
The aim was to systematize the literature data on the cellular composition of the umbilical cord and umbilical cord blood as an object of biobanking.
Material and methods. The review includes literature sources containing data on the cellular composition of the umbilical cord and umbilical cord blood as an object of biobanking, provided by the eLibrary, PubMed, and Scopus databases.
Results and discussion. Umbilical cord blood is significantly different from the blood of a newborn, even in the first hours of his life. The umbilical cord and umbilical cord blood contain stem cells (mesenchymal, hematopoietic, neural, very small embryonic-like, endothelial progenitors), differentiated cells of the hematogenous differon (monocytes, granulocytes, lymphocytes), as well as exosomes secreted by all of them. Differentiated cells of hematogenous differon are characterized by a decrease in phagocytic and cytotoxic activity, which is associated with the ability of mononuclear cell exosomes to inhibit inflammation, cell proliferation and cytokine production, and promote the transition from the Th1 or Th17 phenotype to the T-regulatory lymphocyte phenotype. Umbilical cord blood is a rich source of T cells with potent suppressive activity. Depending on the producing cell, exosomes may have different modulating characteristics. Mesenchymal stem cells of the umbilical cord are distinguished by high clonogenic potential, proliferative activity and a relatively low ability to differentiate towards the adipocyte lineage. The presence of neural stem cells in umbilical cord blood may explain the high effectiveness of cell therapy for damage to the nervous system using umbilical cord and umbilical cord blood.
Conclusions. Biobanking of umbilical cord cells and umbilical cord blood is a promising area of regenerative medicine. The greatest prospects in the field of cell therapy and exosome production are opened by separate cryopreservation of mesenchymal, hematopoietic, neural and very small embryonic-like stem cells. A source of additional information for the development of this area can be the study of the natural microenvironment of stem cells - umbilical cord blood leukocytes, as well as the development of applied aspects of biobanking of umbilical cord and umbilical cord blood and annotation of the cellular composition of bio-samples.

Mortality in patients with acute myocardial infarction is 5–8 % and has not decreased in recent years. One of the causes of death is reperfusion cardiac injury. It is quite obvious that there is an urgent need to develop drugs that can effectively reduce mortality in AMI. Opioids could become such drugs. The activation of peripheral µ2-, δ2-, κ1- opioid receptors reduces in infarct size and improves contractility in reperfusion. Peripheral µ1-, δ1-, κ2-receptors are not involved in the regulation of cardiac tolerance to reperfusion cardiac injury. Opioid postconditioning limits myocardial inflammation, reduces microvascular obstruction, inhibits apoptosis of cardiomyocytes and mitigates adverse postinfarction remodeling. Opioids can reduce excess reactive oxygen species production in the reperfused myocardium. The most promising drugs may be opioid peptides that do not penetrate the blood-brain barrier and therefore, unlike other opioids, do not cause nausea, vomiting, and respiratory depression.

Aim of the study was to conduct a comparative analysis of the linear dimensions of TI and TVI vertebrae in men and women in the first period of adulthood and in old age according to computed tomography (CT) of the chest.
Material and methods: The work is based on CT results of 70 patients of the admission department of the State Clinical Hospital N 3 in Perm in 2023–2024. All patients agreed to a study conducted to exclude possible lung pathology. CT examination was performed on an Optima 660 computed tomograph (GE HealthCare, USA), the height, width and anteroposterior size of the TI and TVI vertebrae were measured. The sample included subjects with normal body weight, mesomorphic body type, without injuries and skeletal abnormalities in the anamnesis. The patients were divided into two groups: 30 people of the first period of adulthood (14 men aged 22–35 years and 16 women aged 21–35 years) and 40 elderly people (20 men aged 61–75 years and 20 women aged 60–75 years).
Results. The height and width of TI and TVI vertebrae in both men and women in the first period of adulthood and old age do not differ (p > 0.05). Age-related changes in the anteroposterior size of the TI vertebra in women consist in its increase (p < 0.05), while in men the parameters do not change (p > 0.05). The anterior-posterior size of the TVI vertebra in both men and women do not change (p > 0.05). No signs of sexual dimorphism of the studied vertebral sizes were found (p > 0.05).
Conclusions. To carry out various diagnostic and therapeutic manipulations in the thoracic spine, a specialist doctor needs a solid body of knowledge about the morphotopometric features of the vertebrae associated with the age and gender of the subject. The results of this study will serve as a scientific foundation for the creation of normative evaluation tables and will become starting points for further research.

Due to the frequent occurrence and development of pathological processes in the temporomandibular joint, the need for detailed information about the width of the articular gap increases significantly.
The aim of the study was to investigate the sexual and bilateral differences in the dimensional characteristics of the articular gap of the temporomandibular joint in persons of the first period of adulthood.
Material and methods. We studied 620 cone-beam computed tomograms in the sagittal and frontal planes of 155 humans aged 21 to 35 years and having orthognathic occlusion, physiological occlusion.
The results and discussion. The width of the articular gap in the anterior section in the sagittal projection on the right was 18 % greater than on the left, excluding gender and sides, while in the upper and posterior sections it was 3.9 and 7.7 % less, respectively; on frontal tomograms, the width of the articular gap in all sections was greater on the right than on the left (in the medial section by 2.0 %, in the lateral – by 1.0 %). In women, the smallest joint gap width was observed in the upper section in the sagittal projection and in the central section on the frontal projection, being 20.2 % smaller than in men in these sections. In the frontal plane, the width of the articular gap on the right in the medial and lateral sections in women was larger (by 8.3 and 19.5 %, respectively). On the left in females the width of the articular gap in the sagittal and frontal planes was statistically significantly greater than in men: by 27.2 % in the anterior department, by 38.1 % in the central, by 9.5 % in the posterior, in the medial and lateral departments – by 44.3 and 6.6 %, respectively.
Conclusions. Bilateral and sexual differences in the width of the articular gap of the temporomandibular joint were revealed. Excluding gender and sides, it was 1.0–18 % greater on the right than on the left in the anterior section in the sagittal projection and in the frontal projection, whereas in the upper and posterior sections – 3.9–7.7 % less on the right than on the left. In the sagittal and frontal planes, the width of the articular gap on the right in men was 11.2–14.0 % less, than in woman, but in the anterior section it was larger by 17.0 % on the right. In women in the sagittal plane in the anterior, upper and frontal sections, in all departments, the width of the articular gap on the left was 7.8–20.0 % less than on the right, while in the posterior section in the sagittal plane it was 2.9 % larger.

The aim of the study was to establish age- and gender-related patterns of liver topography in children and adolescents based on intravital visualization data for use in determining the skeletotopy of abdominal organs.
Material and methods. Abdominal computed tomograms of 88 children and adolescents without visible pathology of the abdominal organs were analyzed. The subjects were divided into 4 age groups: periods of early, first and second childhood, and adolescence. The study was performed on 16-slice computed tomographs to determine the distance from the liver to the body surface, adjacent organs and anatomical structures of the abdomen, and skeletotopy. The obtained data were subjected to variational statistical processing to determine the median, the values of the 25th–75th percentiles, and the reliability of differences according to the Mann – Whitney U criterion.
Results and discussion. A statistically significant increase in the distance from the liver to the transverse colon, loops of the jejunum and ileum, abdominal aorta and spleen and a decrease in the distance from the liver to the duodenum from early childhood to adolescence were established. Skeletotopically, a tendency towards a lower location of the liver was determined with age. The right lobe of the liver in most cases was located between Th VIII and LIII–LIV in those examined in early childhood, and between ThX and LIV in adolescents. The left lobe of the liver in most cases was located between Th IX and LI–LII in early childhood, and between ThX–ThXI and LII–LIII in adolescence. The porta hepatis was located at the level of ThXII in early childhood and at the level of ThXII–LI in adolescence. The distance between the liver and the body surface statistically significantly increased along all lines from early childhood to adolescence. Reliable differences between the indicators of girls and boys of the same age group were established among adolescents along the left middle axillary, left scapular, right scapular and right middle axillary lines.
Conclusions. The article presents the topographic and anatomical characteristics of the liver in children and adolescents and establishes patterns of change taking into account the gender and age of the subjects.

In case of complex injuries to the nerves of the upper limb during surgery in augmented reality and when creating artificial transplants, knowledge of the three-dimensional structure of the brachial plexus is necessary. The aim of this study is to develop a method for manufacturing maximally detailed and accurate hollow three-dimensional models of the brachial plexus from photopolymer resins.
Material and methods. Using the developed technique, all elements of the right brachial plexus were dissected and isolated from 10 corpses of men and women aged 39–89 years, 3D scanning was performed, digital models were created, and 3D printing was performed. The accuracy of the reconstruction was checked by comparative measurements with an electronic vernier caliper of the diameters of the elements of the brachial plexus in identical places in preparations and three-dimensional models. The data obtained were entered into the MS Excel 12.0 program and the analysis of the generated database was carried out using the Statistica for Windows 12.0 0 program.
Results and discussion. The developed 3D printing technique made it possible to reproduce the most accurate models of the brachial plexus with all elements (5 spinal nerves, 3 trunks, 6 divisions, 3 bundles and 15 nerves) in full size. A comparative qualitative analysis has shown that the created complete three-dimensional models have a high structural correspondence, improve depth perception, and emphasize spatial relationships. Quantitative analysis did not reveal significant differences in the diameters of the brachial plexus elements in the initial preparations and threedimensional models. The developed method and 3D-printed models make it possible to identify detailed features of the structure of the brachial plexus at the perineural level.
Conclusions. Creating a complete set of three-dimensional models of all variants of the structure of the brachial plexus will allow you to operate in augmented reality and increase the efficiency of operations. The conducted research is also the basis for the subsequent manufacture of biocompatible and biodegradable transplants that will allow to repair complex nerve damage in the upper limb.

The aim of the study was to investigate influence of microbiological characteristics of infections caused by Klebsiella pneumonia on formation of antibiotic resistance and severity of infectious process.
Material and methods. A comparative analysis of biofilm mass, thickness of capsule of K. pneumonia isolated from 26 patients with sepsis and from 8 patients with chronic obstructive pulmonary disease was carried out. The influence of capsule thickness on severity of infectious process and antibiotic resistance was studied.
Results and discussion. The mass of K. pneumoniae biofilm isolated from patients with sepsis was 28.2 [16.5; 41.3] μg/well (median [lower quartile; upper quartile]), exhibited resistance to most of the antibacterial drugs used, and was greater than the biofilm mass isolated from patients with chronic obstructive pulmonary disease (24.3 [20.0; 28.2] μg/well, p = 0.04), which remained susceptible to the drugs used. K. pneumoniae bacterial capsule was identified as a species characteristic or pathogenicity property using developed method with alcian blue. Panresistant K. pneumoniae isolates had the thickest capsule (0,44 [0,32; 0,53] μm), carbapenem-resistant isolates sensitive to colistin and tigecycline had thinner capsule (0.38; 0.35–0.41 μm). Thickness of capsule of Klebsiella that retained sensitivity to carbapenems was 4 and 3.5 times thinner than thickness of panresistant (p = 0,031) and carbapenem-resistant isolates sensitive to colistin and tigecycline isolates (p = 0,044), respectively and was 0,11 [0,08; 0,16 мкм]. A positive correlation was revealed between thickness of capsule, mass of microbial biofilm and length of hospital stay.
Conclusions. The pathogenicity of bacteria and severity of disease are explained by thickness of K. pneumoniae capsule that makes a certain contribution to formation of antibiotic resistance in microorganisms.

Abdominal adhesions result from the organization of fibrinous exudate and subsequent fibrosis, attributed to the low phagocytic activity of macrophages associated with their M1 phenotype. Oxidized dextran (OD) can limit the development of fibrosis by exerting a stimulating effect on phagocytosis.
The aim of the study is to investigate the morphofunctional status of macrophages during the formation of abdominal adhesions in an experimental model and under exposure to OD.
Material and methods. In male Wistar rats (n = 30), the adhesive process in the abdominal cavity was simulated. The animals were divided into 3 groups: group 1 – control, with adhesions in the abdominal cavity; group 2 rats were injected once with 2 ml of OD 5 % aqueous solution; the 3rd group consisted of intact animals. The rats were removed from the experiment on the 7th and 21st days. Histological immunohistochemical (Il-10, IFNγ, Il-1, TNFα, TGF-β) and electron microscopic study of abdominal adhesions, morphometry of structures were performed.
Results and discussion. Macrophages in adhesions of group 1 and 2 rats were larger, compared to those in intact animals. On days 7 and 21 macrophages in group 2 rats were 19 % and 2.5 times larger, respectively, compared to group 1 animals, contained in the cytoplasm a greater number of phagosomes, phagolysosomes and rough endoplasmic reticulum, by the 21st day nuclear-to-cytoplasmic ratio was shifted towards the cytoplasm. The expression of IFNγ in the infiltrates of adhesions in group 2 rats increased 3,2-fold, indicating greater phagocytotic activity of macrophages. The expression of IL-10 and TGFβ on the 7th and 21st days was represented in a larger number of macrophages of group 2 than group 1 rats (2.7 and 4.1 times, respectively), but IL-1 and TNFα ‒ in a smaller number (4.6 and 3.2 times, respectively), which corresponded to the phenotypic characteristics of M2 macrophages.
Conclusions. The population of macrophages in inflammatory infiltrates of abdominal adhesions is heterogeneous, there are signs of M1 and M2 type. Under the influence of OD, the phagocytic activity of M2 type macrophages increases, preventing the formation of adhesions.

Exposure to ionizing radiation during antitumor radiotherapy can cause undesirable side effects. This is damage to healthy tissues and organs. The use of radioprotective drugs can provide protection for normal cells, but there are risks of their negative impact on the antitumor effect of radiotherapy. The aim of the work is to study the possibility of using promising biotechnological radioprotective drugs to reduce the side effects of antitumor radiotherapy.
Material and methods. The study was performed on model of Ehrlich’s carcinoma in BALB/c mice with experimental radiation treatment (4 Gy X-ray). Biotechnological products, developed by Russian specialists, were administered to mice before irradiation on the 12th day after the tumor was transplanted. Chitin-glucan complex extracted from Pleurotus ostreatus was administered at a dose of 500 mg/kg intragastrically, recombinant flagellin at a dose of 1 mg/kg intraperitoneally. The volume of tumor nodules was assessed at different time points during the experiment, the degree of tumor growth inhibition was calculated, and the spread of the tumor into nearby tissues was recorded.
Results and discussion. The absence of stimulation of tumor growth during the use of drugs has been established. The drugs did not reduce the inhibition of Ehrlich tumor growth in mice caused by experimental X-ray treatment. In some periods of the experiment, mice with combination therapy showed a tendency to increase the effectiveness of radiation treatment by 4–6 %. The use of recombinant flagellin led to a decrease in the number of animals with a total spread of Ehrlich’s carcinoma. When using the mushroom chitin-glucan complex, there was a tendency to decrease the value of the integral dissemination score compared to control.
Conclusions. It was shown that the chitin-glucan complex from the Pleurotus ostreatus and the deimmunized recombinant flagellin did not have a negative effect on the antitumor effect of radiation exposure. The possibility of their use as a means of accompanying radiotherapy of tumors has been experimentally confirmed.

The exposure to chemical substances remains a priority risk factor for the health of the working population in the chemical, petrochemical, and pharmaceutical industries. The liver, as the primary organ of detoxification, is a primary target for many chemical agents, highlighting the necessity for in-depth studies of the pathogenetic mechanisms underlying its toxic damage. Understanding the temporal dynamics of changes in molecular-genetic and biochemical markers will enable more accurate determination of disease stages, prediction of disease progression, and formulation of pharmacological correction strategies. The aim of this study is to investigate the dynamics of changes in biochemical and molecular-genetic markers of damage when modeling acute toxic hepatitis at varying levels of toxic exposure.
Material and methods. This work is based on data obtained from an experimental in vivo study, during which acute toxic hepatitis was modeled in outbred male rats aged 12–14 weeks and weighing 200–220 g using carbon tetrachloride, a widely used hepatotoxic agent in research settings. After 24 and 72 h of exposure, we assessed changes in the activity of key “liver” enzymes and in the expression of genes associated with antioxidant defense, the glutathione system, apoptosis regulation, and cell death.
Results and discussion. In the first 24 h of carbon tetrachloride exposure, there was a statistically significant increase in alanine aminotransferase and aspartate aminotransferase activity, as well as a lesser extent increase in lactate dehydrogenase and alkaline phosphatase activity. After 72 h, changes in biochemical markers became more pronounced. The expression of studied genes changed ambiguously. In the dose-response relationship, differences were observed between the 24- and 72-hour periods, with steeper slopes for several biomarkers during the first 24 h.
Conclusions. The data obtained in this study may contribute to and serve as a potential basis for developing strategies for pharmacological correction of toxic liver damage.

Over the past decades, there has been a steady increase in the incidence of depressive disorders. Modern antidepressants predominantly are drugs with a high incidence of side effects and drug interactions. The aim of the study is to investigate the thymoanaleptic effect of new substances of the substituted furylated nitrogen-containing heterocyclic derivatives of alpha-cyanothioacetamide in the haloperidol-induced catalepsy test.
Material and methods. The experiments were performed on 110 animals divided into 11 groups: a control group, two comparison groups (comparison drugs – amitriptyline and fluoxetine), eight experimental groups (respectively, eight experimental samples). In the haloperidolinduced catalepsy test, the effectiveness of furylated dihydropyridine-2-thiols with codes d02-20, CV-103, AZ-381, AZ-127, d02-26, CV-133, AZ-618, AZ-128, which have already shown thymoanaleptic properties in the tail suspension and forced swimming tests, as well as anxiolytic properties in the dark-light chamber test, was studied.
Results and discussion. Fluoxetine was more effective in eliminating the cataleptogenic effect of the typical neuroleptic haloperidol than amitriptyline. The absolute leaders in terms of thymoanaleptic properties under this technique are AZ-127 and AZ-128 compounds (p < 0.01 relative to amitriptyline and fluoxetine at each time point). Sample d02-20 also showed high activity, exceeding the efficacy of amitriptyline (p < 0.01 relative to amitriptyline at each time point), (the overall effectiveness is 47.64 % and 67.51 % higher than fluoxetine, respectively).
Conclusions. High antidepressant activity of alpha-cyanothioacetamide derivatives AZ-127, AZ-128, d02-20d02-26 was revealed.

The aim of the study is to evaluate the impact of metadata added to the training dataset on the performance of an artificial intelligence system aimed at working with diagnostic brain images.
Material and Methods. An expanded set of computed tomography scans of the brain with and without signs of intracranial haemorrhage, supplemented with clinical and technical parameters, was used as a basis. From the dataset, 176 studies were selected (106 for training, 70 for testing), which were specially prepared for input into the neural network: they were segmented with the region of interest (the brain) highlighted, normalized, and the background was removed. The ResNet10 neural network architecture, which is capable of analyzing 3D medical images, was used as the underlying neural network. It was combined with another neural network to form the ResNet10_Meta architecture, which, using a One-HotEnconding (OHE) approach, connects other metadata to analyze images directly. Four parameters were selected as metadata: ‘Manufacturer’, ‘SliceThickness’, ‘PatientAge’, and ‘XrayTubeCurrent’.
Results. Twelve experiments were conducted to train the neural network with one, two, or all of the additional parameters added alternately. The model with the addition of the ‘XTube’ parameter showed the highest specificity (82.3 %, 95 % confidence interval (95 % CI) [69.6–94.9]), outperforming the Baseline model without additional metadata (specificity 79.4 %, 95 % CI [66.0–92.8]). The ‘XTube + SliceT’ model with the addition of multiple metadata showed comparatively higher sensitivity (69.7 %, 95 % CI [54.5–84.9]) relative to Baseline model. The model with the addition of all metadata ‘All params’ did not show significant improvements. However, all differences found were statistically insignificant (p > 0.05).
Conclusions. Our data demonstrated that there were no statistically significant differences in the performance of a neural network analyzing diagnostic images without or with metadata added to the training dataset. However, this study is pilot and was conducted on a limited sample, so it remains to be seen whether commercially available artificial intelligence tools can be completely insensitive to image specifications.

The human albumin solution in intensive therapy contributes to effective hemodynamic stability, when it is necessary to limit the volume infusion. Indicators and dynamic markers of albumin infusion in newborns are conditionally defined. The choice of albumin therapy rate is subjective. Aim of the study was to investigate the predictive ability of albumin level in blood and urine for choosing regimen for albumin injection in newborns with severe somatic or surgical pathology.
Material and methods. A prospective comparative study was conducted involving newborns in the first week of life. Two groups were formed: somatic (n = 104) and surgical (n = 119). The human 10% albumin solution was included in the infusion therapy in two modes: mode 1 (shortened) ‒ up to 12 hours (median 8 hours), mode 2 (extended) ‒ up to 24 hours (median 20 hours). The albumin level in urine and blood in a complex of other indicators was determined at three stages (upon admission, on the first and third days after surgery).
Results. In the somatic group the need for albumin therapy in admission was determined by a decrease in its content in blood less than 27 g/l (sensitivity (Se) 54 %; specificity (Sp) 95 %), in the surgical group ‒ on the first day after surgery by reducing the colloid osmotic pressure less than 11,35 mmHg (Se 44 %; Sp 98 %). In both groups, on the third day, microalbuminuria more than 21,5 mg/l (Se 84 %, Sp 72 %) was associated with the albumin infusion. The prolonged infusion of 10% albumin solution (from 12 to 24 hours, 1 g/kg per day) is relevant for newborns with blood albumin content less than 25 g/l, regardless of the profile; if in the early postoperative period albuminuria exceeds 100 mg/l (Se 57 %, Sp 82 %; AUROC 0,820, standard error 0.052, p < 0.001), a shortened transfusion regimen (up to 12 hours) is indicated.
Conclusions. In intensive care of critically ill neonates, the need for correction of hypoalbuminemia is high. Clarification of the values of previously known indicators and the search for new diagnostic markers for albumin transfusion make it possible to use a differentiated approach when choosing drug administration regimens.

The aim of the study was to analyze the effect of autograft characteristics on the restoration of hemogram parameters and the need for hemotransfusions in oncohematological patients.
Material and methods. The study included 118 patients with multiple myeloma, 23 with non-Hodgkin’s lymphomas, and 21 with Hodgkin’s lymphoma who underwent autologous hematopoietic stem cell transplantation. The number of live CD34+ cells in thawed autografts stored in liquid nitrogen in the presence of dimethyl sulfoxide was calculated, in addition, the number of viable nucleated cells was determined by testing with vital dye. The number of CD34+ cells in autografts stored in liquid nitrogen in the presence of dimethyl sulfoxide was calculated. The number of viable nucleated cells was determined by testing with a vital dye. The restoration of hematopoiesis after transplantation of autologous hematopoietic stem cells was assessed by the timing of compensation for neutropenia and thrombocytopenia, and the number of transfusions of platelet concentrate and erythrocyte-containing components in the posttransplantation period was taken into account.
Results. With infusion of a dose of live CD34+ cells of more than 5×106 per kilogram of body weight in patients with multiple myeloma, a shorter period of neutropenia was observed, with non-Hodgkin’s lymphomas, a significant reduction in the duration of cytopenia and a decrease in the number of transfusions of erythrocyte–containing components were revealed, in all nosological groups – a decrease in the number of necessary transfusions of platelet concentrate. With the viability of nucleated cells in leukoconcentrates of more than 70 % in patients with non-Hodgkin’s lymphomas, a decrease in the timing of neutropenia and thrombocytopenia was found without significant intensification of transfusion therapy.
Conclusions. The infusion of live CD34+ cells into oncohematological patients at a dose exceeding 5×106 per kilogram of body weight, with a viability of nucleated cells in leukoconcentrates exceeding 70 %, ensures a reduction in the duration of neutropenia and thrombocytopenia, as well as a decreased need for hemotransfusions during the early post-transplant period. The results obtained should be taken into account when planning the procurement and storage of autologous leukoconcentrates.

Anaplastic thyroid cancer (ATC) is a rare form of thyroid malignancy with a high aggressiveness and an extremely poor prognosis. Currently, two main models of ATC origin are considered: anaplastic carcinoma arises either from a patient’s pre-existing highly differentiated thyroid tumor cells through dedifferentiation, or de novo. Between 20 and 50% of ATC have activating V600E mutations in the BRAF gene. The combination of the two targeted drugs dabrafenib and trametinib has shown promising results in a number of rare cancers with V600E mutations in the BRAF gene, including a cohort of patients with BRAF-positive ATC. We present two clinical cases, namely the treatment of two patients, aged 74 and 71, in whom, against the background of highly differentiated thyroid carcinoma, dedifferentiation to ATC occurred. Molecular genetic analysis revealed a BRAF ^V600E mutation in both patients. Both patients have been receiving targeted therapy for more than 12 months according to the regimen: Dabrafenib 300 mg daily + trametinib 2 mg daily. Treatment was tolerated satisfactorily, without significant adverse events, no data for relapse or progression of the disease were obtained according to follow-up examination. Quality of life was maintained at a high level.
Conclusions. In recent years, the prognosis of BRAF-positive ATC has been improved by new drug therapies, such as targeted therapy. The low prevalence in the ATC makes it difficult to conduct large randomized clinical trials, making the need for international multicenter initiatives particularly important.

Aim of the study was to demonstrate the clinical observation of a patient with pseudomembranous colitis occurring under a gastroenterological clinical simulation of acute pancreatitis. Patient S., 68 years old, was taken several times by emergency medical personnel or admitted independently to medical institutions with recurrent abdominal syndrome. Using the diagnostic algorithm presented in the work, the patient was diagnosed with leukocytosis up to 12×109/l, a decrease in the total protein content to 42 g/l, and an increase in the creatinine level to 90.2 μmol/l. Colonoscopy and bacteriological examination of feces revealed – pale grayish-yellow plaques ranging in size from 0.5 to 2.0 cm in diameter on a slightly raised base. Against the background of areas of hyperemia of the colon mucosa, multiple fibrinous overlays were detected in all parts of the colon. Microscopically, pseudomembranes consisted of necrotic epithelium with fibrin effusion and neutrophils. Timely diagnosis allowed the patient to be hospitalized in a specialized hospital and to prescribe adequate treatment according to Clinical recommendations, to exclude possible complications.
Conclusions. The diagnostic algorithm presented in the work demonstrated the effectiveness of its application to practice and showed perspectiveness on this direction with further research on other nosologies manifested by abdominal pain syndrome.

The issues of diagnosis, treatment and tactics of pregnancy management in patients with Gaye – Wernicke syndrome remain poorly illuminated and are represented by few observations. The article describes a clinical case of complication of gestosis in the first trimester of a pregnancy in the form of Gaye – Wernicke syndrome due to severe vomiting complicated by dehydration, pronounced electrolyte imbalance, protein, carbohydrate and fat metabolism in combination with comorbid pathology. The possibilities of early diagnosis and treatment of thiamine deficiency are considered. Gaye – Wernicke syndrome was diagnosed on the basis of clinical (combination of ophthalmoplegia, nystagmus, cerebellar ataxia and amentia) and laboratory and instrumental data. The vitamin B1 was administered according to the scheme: 200 mg 3 times a day intravenously for 7 days, then 100 mg 3 times a day intramuscularly for 7 days, then 100 mg orally 1 time a day for 7 days. Against the background of pathogenetic therapy, positive clinical and laboratory results were achieved within 20 days. Thus, when monitoring pregnant women with excessive vomiting, it is necessary to have high alertness regarding the development of disorders associated with thiamine deficiency. Timely and adequate replacement therapy prevents irreversible damage to the subcortical structures of the brain, disability, and possibly death in such patients, and also minimizes the risks of complications in the fetus.

The key aspect of therapy is the correct prescription of medications and the selection of the treatment method. Such a choice (correct or incorrect) will depend, among other things, on the patient’s knowledge. Aim of the study was to investigate the awareness of patients with diseases of the digestive organs about treatment methods and the choice of drugs.
Material and methods. The analysis was conducted in three groups of patients formed on the basis of observation and treatment technology. Group 1 and Group 2 included patients undergoing routine treatment in outpatient (n = 531) and inpatient settings (specialized gastroenterology department) (n = 822), respectively. Group 3 comprised patients admitted for inpatient treatment on an emergency basis to the Emergency Care Hospital (n = 147) due to complications of the underlying disease (digestive system disorders). Patients’ behavior patterns were identified by analyzing their responses to the author’s questionnaire. The groups were compared using nonparametric criteria: the association coefficient (Kass) and the χ2.
Results and discussion. The most popular source of information for Group 1 and Group 2 about treatment methods and choice of medications was the Internet (34.3 and 37.1 per 100 respondents, respectively) unlike representatives of Group 3 (14.4 out of 100 respondents). The second most frequently used source of information among patients in the Group 1 and Group 2 was advice from relatives, friends, and acquaintances (30.0 and 35.4 per 100 respondents, respectively), and this source was most popular among Group 3 patients (47.2 out of 100 respondents). Sources with one-way communication to the information recipient (television, radio, newspapers) were used significantly less frequently across all comparison groups, with no statistically significant differences observed between them. Specialized literature was considered the most adequate source of information, which was also not very popular among patients in the compared groups. It should be noted that not only its paper version was considered as specialized literature, but also electronic literature that the patient could find on the Internet. In this case, the Internet can be considered both as a source of knowledge (blogs, news, etc.) and as a way to search for special literary sources, usually popular science. The study showed that the distribution of such sources of information as advice from others (not doctors or health workers) is quite high among Group 3 patients. Such advice can be recognized as interfering with the treatment process and, possibly, contributing a late start to the treatment process itself.
Conclusions. Most patients undergoing routine treatment in outpatient (n = 531) and inpatient settings use adequate sources of information to select medications and methods, while inadequate sources of information are more popular among patients admitted for inpatient treatment on an emergency basis to the Emergency Care Hospital.

The mining industry is constantly developing increasingly remote areas of the Arctic, Subarctic and Siberia, and due to the geographical, geological, demographic and infrastructural features of these regions, there remains a great need for specialists with high mobility potential, primarily men of economically active age. Attitudes to health related to family status, and in particular, its self-assessment among “shift workers” with increasing length of service in expeditionary-shift work seem to be a reliable indicator for the formation of a comprehensive program for the prevention of cardiovascular diseases. Aim of the study was to determine the family status of men engaged in expeditionary rotational work, its associations with self-assessment of health in working conditions at the oil and gas production complex in the Arctic.
Material and methods. The object of the study was two “random” representative samples formed from male workers aged 25‒54 years engaged in expeditionary-shift work in the Arctic latitudes of the Tyumen region. The work experience on an expeditionary rotational basis in the Arctic was assessed according to three gradations: 3 years or less, 4–9 years, 10 years or more. Self-assessment of health was determined by analyzing the standard WHO MONICA-MOPSY questionnaire.
Results. Negative trends in the change in marital status among men engaged in expeditionary rotational work in the Arctic have been identified, both in the general organized population of persons aged 25–54, and in each of the three decades of life (25–34, 35–44, 45–54 years), regardless of length of service in expeditionary watch mode. The lowest self-assessment of health was found in the absence of a life partner, as well as in single men with more than three years of work experience.
Conclusions. The results of the study indicate the need to intensify preventive and social programs aimed at stimulating and strengthening the role of the family among men of economically active age, mainly after three years of work on expeditionary rotations in the Arctic zone of Russia.

The prognostic significance of arterial stiffness in children is currently being actively studied. The aim of the study was to identify the characteristics of arterial stiffness and develop criteria for increased and decreased (supernormal) arterial stiffness in preschool children.
Material and methods. Twenty-four preschool children (10 boys and 14 girls) aged 62.3 ± 11.5 months were examined. Carotid-femoral pulse wave velocity (cfPWV) was determined by sphygmography (cfPWVs) and using Doppler ultrasound (cfPWVd). The difference between the time from the apex of the R wave on the ECG to the onset of the Doppler signal on the common femoral artery and the time from the apex of the R wave to the onset of the Doppler signal on the common carotid artery was taken as the pulse wave propagation time (t). The length of the arterial bed (L) was measured with a tape measure between the signal location points and multiplied by 0.8.
Results. The values of cfPWVs and cfPWVd were 4.40 [4.10; 4.60] (median [lower quartile; upper quartile]) and 4.03 [3.81; 4.23] m/s, respectively (p = 0.015). The direct correlation between cfPWVs and cfPWVd (r = 0.536; p = 0.008) was established. Both indicators are directly related to the level of diastolic blood pressure. The boundaries of reference intervals for increased and decreased arterial stiffness in this age group were determined (more than 4.89 m/s for cfPWVs and more than 4.88 m/s for cfPWVd).
Conclusions. Sphygmographic and Doppler ultrasound methods of registration show comparable values of cfPWV and can be used to assess arterial stiffness in preschool children.