Hyperactivation of cytokines is a very characteristic symptom in prostatitis.Purpose of the study. The article assesses the content of cytokines in the ejaculate of men suffering from chronic bacterial prostatitis and concomitant infertility to determine their role as predictors of reproductive pathology.Material and methods. The survey included 82 men treated in clinics to restore reproductive function. The control group consisted of 29 patients of reproductive age. A significant increase in the content of IL-18 and IFN-γ was found. At the same time, the content of IL-1β, IL-7, SDF-1α, TGF-β decreased. The study of samples of patients with impaired reproductive function showed the presence of significant differences in comparison with samples of the group of fertile patients.Results. Violations in the regulation of TGF-β and IL-18 are the most prognostic indicators in inflammatory processes of the male genital tract in assessment of the reproductive system status.Conclusions. The results create the basis for the inclusion of cytokine analysis in clinical practice to evaluate the reproductivesystem, primarily in cases of disorders caused by inflammatory and immunopathological processes.

Objective: to improve the results of radical nephrectomy by pharmacological correction of violations of adaptation reactivity of the organism, and the only kidney in the early postoperative period.Material and Methods: Two groups of 45 patients after nephrectomy were examined. Patients of one group received an additional course of synthetic adaptogen Selank within 14 days of the postoperative period.Results: nephrectomy is a powerful stress factor leading to an imbalance of nutrient stress amines, psycho-emotional and vegetative-vascular disorders accompanied by severe violation of the filtration capacity of a single kidney. Additional course of SelankМедицинский вестник Башкортостана. Том 15, № 1 (85), 20209within 14 days (as opposed to its single purpose) was significantly more effective and reliably led to the restoration of the adaptive capacity of the body (reduced plasma levels of adrenaline, histamine and increased plasma levels of serotonin; normalized psychoemotional and vegetative-vascular status of patients), which was accompanied by a less severe impaired renal filtration capacity of the only kidney.Conclusion: Selank demonstrated reliable anti-stress, adaptogenic, anxiolytic, vegetative stabilization and renal protection, that allows to recommend it for pharmacological correction of desadaptation stress and maintainance of the functions of a single kidney after nephrectomy.

The WRN gene is involved in replication, repair, recombination, and telomere support. Biallelic inactivation results in the development of Werner syndrome.Objective. To screen the mutation WRN * p. R1406X in patients with metastatic kidney cancer.Material and methods. The study included 67 metastatic renal cancer patients and 445 control individuals. Detection of WRN gene mutations was performed using melting curve analysis (HRM) on the CFX96 Real-Time PCR Analyzer (Bio Rad) using the Eva Green dye.Results and discussion. As a result of the screening WRN *c.R1406X mutation wasn’t revealed among patients with metastatic kidney cancer. The search for this mutation in the control group revealed six individuals who carried the mutant variant WRN *c.R1406X (1.35%) in the Russian group. In exon 4 of the WRN gene in 44 patients with renal cancer (65.6%) we found a missense mutation p. V114I. According to the analysis of functional significance using 10 predictive programs, p. V114I has a low degree of pathogenicity.Conclusion. It is shown that the WRN *c.R1406X mutation is not the cause of metastatic renal cancer.

Vulvar cancer (VC) is a fairly rare tumor. The incidence of VC, according to a number of researchers, is about 2 cases per 100 thousand population in the Russian Federation.Squamous invasive VC accounts for up to 90% of all malignant neoplasms of the female external genital organs and 1-2% of malignant epithelial tumors in women. The average age of patients with a diagnosis of VC is between 65 and 70 years.VC is the external localization of a malignant tumor. Despite this, neglect is 50-66% at the time of diagnosis. Thus, stages III-IV of the disease are detected.Surgical treatment was performed on 87 patients with malignant tumors of the female genital organs on the basis of the VIII surgical department of the Republican Clinical Oncological Dispensary of the Ministry of Health of the Republic of Belarus for 4 years (2015-2018). An analysis of the volume of operations in patients showed that when performing extended surgical interventions, the operation is most often performed on the outflow paths and a plastic component is used in the form of a displaced skin-fascial flap. With the spread of the tumor to the vaginal mucosa, the anal ring, the external opening of the urethra, the skin of the in- ner thigh, surgical treatment includes resection of neighboring organs and tissues.The most common postoperative complication was regional tissue necrosis of both the displaced skin-fascial flap and the separated flaps during inguinal-femoral lymphadenetomy. The average hospital stay for patients undergoing vulvectomy with inguinal- femoral lymphadenectomy with various combinations was 36 days.

The aim: to study the macro-microscopic anatomy of the anal glands in adults under the conditions of relative norm.Material and methods: using the MBS-9 binocular stereomicroscope, the size characteristics and structural features of the anal glands from the corpses of 136 people (69 men and 67 women) aged 20-99 were studied. Preparations were stained with 0.05% methylene blue solution.Results: the total number of anal glands varies individually from 0 (in people over 80 years old) to 38 (aged 30-39 years). On total preparations of the anal canal after elective staining, the glands are identified as black (dark blue) compact anatomical formations. The gland can have from one to five end pieces, which, when connecting, form a common excretory duct, which opens with a rounded (oval) mouth at the bottom or side wall of the anal sinus. In the course of the common excretory duct, a local ampoule-like expansion is sometimes formed, which also varies in people of different age groups.Conclusion: the study allowed us to obtain previously unknown data on the macro-microscopic structure of the anal glands,their quantitative and age-related features, to identify the rate of development of involutive changes in the glandular apparatus of this part of the colon.

The Republic of Bashkortostan belongs to the iodine-deficient regions. Iodine deficiency adversely affects the functional state of thyroid gland known to have pronounced effects on bone tissue metabolism. The available literature includes only few reports describing the state of bone tissue in adult population living in the iodine-deficient region.The present study shows the results of remodeling intensity and bone mineral density regarding the severity of iodine deficiency. Study methods included evaluation of thyroid gland volume, thyroid hormone analysis in plasma, investigation of bone mineral density of the axial and peripheral skeleton and bone remodeling intensity. The high prevalence of iodine deficiency was detected in 59.5% of393 examined residents in the Republic of Bashkortostan aged 24-44 (including 14.1% of severe degree and low median ioduria - 75.5 [50.4-122.3] ug/L). It was observed that uncompensated iodine deficiency is accompanied by decrease in mineral density and intensity of bone remodeling, dissociation of the remodeling balance with the prevalence of osteoresorption. The obtained data indicate the need for a screening study of bone strength in individuals with hypothyroidism for correction of bone mineral density.

Ntroduction: Hallux valgus is a pathology that directly affects the quality of life of patients. Dissatisfaction with the results of treatment of Hallux valgus suggests the search for options for operations that can improve the anatomical and biomechanical parameters of the forefoot. The purpose of the study was to analyze the X-ray aspects of hallux valgus during osteotomy using the methods of reserve and metatarsophalangeal joints (osteotomy of the first metatarsal bone by the method of Scarf, Austin, Bosch Magnan).Material and methods: the results of surgical treatment of patients with hallux valgus I, II, III degree were analyzed in 342 patients who underwent osteotomy surgery in the Chelyabinsk Regional Clinical Hospital No. 1 for the period from January 2015 to June 2019. Radiographs were studied and interpreted at intervals of 2, 6 and 12 months after osteotomy with the study of the angles of HVA, IMA, DMMA. The results of surgical treatment were evaluated on the AOFAS scale (Kitaoka).Results and discussion: The best correction of the HVA angle was achieved after an osteotomy using the Scarf technique. The average AOFAS score was the highest in the group of patients operated on by the Scarf method and averaged 86.0 points after surgery. Austin osteotomy led to a greater correction of the IMA angle. On an open angle correction, DMMA was detected after an osteotomy according to Bosch-Magnan.Conclusion: Osteotomy Scarf allows to best normalize the X-ray anatomical parameters of the HVA angles with Hallux valgus. In osteotomy, the Scarf in the postoperative period in patients is marked by the highest AOFAS score, which gives a good functional result.

Bronchial asthma is a severe, common and disabling multifactorial disease. It has been shown that about 50-60% of differences in sensitivity to asthma therapy in patients are determined by genetics. The aim of the investigation was to study the role of polymorphic variants of the glucocorticoid receptor gene ( NR3C1 ) and the corticotropin releasing hormone receptorgene ( CRHR1 ) in the development and course of asthma. DNA samples of 212 asthma patients and DNA samples of 252 control individuals aged 18-67 years, living in the Republic of Bashkortostan, were used as the study material. Genotyping was performed using PCR-RFLP analysis and real-time PCR methods. The associations of the rs1876828* CT genotype of the CRHR1 gene with asthma in general group of patients and the rs242941* AC genotype of the CRHR1 gene with asthma in men were established. The association of the rs1876828* T allele of the CRHR1 gene with an early age of manifestation of bronchial obstruction was defined. The associations of the rs41423247* CG genotype of the NR3C1 gene and the rs1876828* T allele of the CRHR1 gene with significant reductions in spirometric measures in women were revealed.

Purpose of the study: to determine the current etiological structure of community-acquired pneumonia (CAP) taking into account the sensitivity of pathogens to antimicrobial agents (AMP) in patients with community-acquired pneumonia in a city hospital in Ufa.Material and methods: A total of 196 patients hospitalized in the City Clinical Hospital No. 5 of Ufa were examined for CAPduring the period from January to December 2019, aged 18 to 90 years old. Patients were examined and treated in accordance with Federal clinical recommendations for CAP of 2018. Sputum was taken for bacteriological studies and to determine the sensitivity of microorganisms to AMP with following scientific and statistical analysis of the results. Results and conclusions: the most frequent causative agents of CAP in 2019 in the City Clinical Hospital No. 5 of Ufa were gram-positive bacteria, mainly streptococci, with a predominance of S.haemolyticus (34.6%) and a decrease in the significant role of pneumococcus (up to 5%). β-lactam antibiotics still retain effectiveness against major pneumopathogens. To reduce the likelihood of the formation of antibiotic resistance to cephalosporins, which are most often prescribed in hospitals for the treatment of CAP, it is possible to more widely use AMPs of other classes that retain their effectiveness.

Sepsis and concomitant organ dysfunction are actual problems of modern health care. Any infection in the context of comorbidity becomes a fact that worsens the course of all concomitant diseases, which ultimately increases the risk of death. A significant increase in the number of patients at risk of developing sepsis in the next decade is expected due to the development of invasive medical technologies, the uncontrolled use of broad-spectrum antibiotics, and an increase in the number of microbes resistant to antibiotics. This article analyzes causative agents of community-acquired non-surgical sepsis in elderly patients with comorbid pathology. In order to more quickly identify the pathogen, the MALDI-TOF method was used. Septicemia was detected in 59% of cases of sepsis. Gram-negative microorganisms such as Klebssiella pneumonia and Acinetobacter baumannii played a dominant role in the development of sepsis. 91.3% of microorganisms were multiresistant. The most common antibacterial drugs that were administered empirically were protected aminopenicillins. Carpapenems and polymyxins prevailed when changing antibiotic therapy. Our findings confirm current trends and dictate the need to review the schemes of empirical and causal antibiotic therapy. In our study, the time of the change of antibacterial therapy did not affect mortality, this thesis contradicts the data of modern literature and requires clarification for further research.

Purpose: to analyze the justification and adequacy of prescribing preferential drugs in accordance with the severity of bronchial asthma.Materials and methods: a retrospective analysis of the adequacy of provision of preferential medicines to 160 patients withatopic bronchial asthma for 2019 according to the Regional Register of Asthma. All children were combined into 4 groups of 40 people each: with mild intermittent, mild persistent, moderate and severe severity.Results: according to the register, the therapy of patients with mild intermittent and persistent bronchial asthma was in full, witha tendency to increase due to the use of combined drugs, antagonists of leukotriene receptors, genetic engineering drugs with moderate and severe bronchial asthma. Analysis of the data demonstrates that not all patients are prescribed basic therapy drugs in a timely manner in full and in accordance with federal clinical recomendations, which requires a review of the severity of bronchial asthma.Conclusions: the study showed that a quarterly adjustment of the volume of therapy and prescribed preferential drugs, depending on the severity of the disease, is justified and economically feasible.

The article describes the phenomenon of suicidal behavior in people dependent on synthetic cathinones - drugs of a new generation of “designer” synthetic drugs. The purpose of the article is to assess the level of forms of suicidal behavior, to analyze the association of internal and external forms of suicidal behavior and anxiety, to identify genetic markers of suicidal behavior risk in people dependent on synthetic cathinones and healthy individuals.Results: a significant increase of the level of suicidal behavior was found in those dependent on synthetic cathinones comparedwith healthy individuals (p = 0.0063). Among those dependent on synthetic cathinones, 74 (41%) were among the healthy and 11 people (6.6%) who had external forms of suicidal behavior. Internal forms of suicidal behavior were determined in 111 (61%) patients, in the control group - 26 (15.6%). The presence of anxiety in a state of intoxication and prolonged abstinence dependent on synthetic cathinones increases the risk of suicide. Analysis of the data obtained showed a statistically significant association between the presence of anxiety, detected during clinical interviewing, in the structure of the syndrome of synthetic cathinones and suicidal attempts (p = 0.028; χ² = 4.772); the presence of anxiety in the period of prolonged abstinence (p = 0.002; χ² = 9.232). Our analysis of the frequency distribution of the genotypes and alleles of the polymorphic loci rs6313 of the HTR2A gene and rs6296 of the HTR1B gene did not reveal statistically significant differences between patients and healthy individuals. Data analysis revealed the presence of a statistically significant association of the frequencies of the polymorphic loci of the rs6313 *C/C genotype of the НТR2А gene with the internal form of suicidal behavior (χ² = 9,146; p = 0.01) in those dependent on synthetic cathinones.Conclusion:1. We have identified a significant increase of the level of suicidal behavior among those dependent on synthetic cathinones compared with healthy individuals.2. The presence of anxiety in a state of intoxication and prolonged abstinence in synthetic cathinones addicts increases the risk of suicide.3. We found that markers of an increased risk of an internal form of suicidal behavior in dependent on synthetic cathinones are the genotype rs6313 *C/*C of the НТR2A gene.

Teenage addiction is a formidable phenomenon for a long time. Many researchers are studying factors that contribute to the use of psychoactive substances by adolescents. Currently, there is a tendency to increase the use of new psychoactive substances by adolescents, in particular, the group of synthetic cannabinoids. This study shows the role of microsocial family factors. We performed a psychosocial online testing of 7987 students of secondary schools of the Republic of Bashkortostan aged 13-18. The study revealed that an important preventive moment in the issue of using synthetic cannabinoids by adolescents is the role of harmonious family relations, which consist of confidential communication, with the absence of quarrels, conflicts.

The purpose of the study was to assess the effects of Taldinskyi spring water on cytoonstructionl of the thyroid gland.Material and methods. The work was performed on 20 white male rats weighing 120-140 g. The animals were divided into 2 groups: control and experimental. Animals of the experimental group received 10 baths of water containing about 450 mg / l of hydrogen sulfide (water temperature 36-37°C). Taking baths was carried out in conditions close to medical. Macro-and microscopicmeasurements were performed. Under a light microscope, the diameter of the follicles, the height of the follicular epithelium, theaverage area of the thyrocyte nuclei were measured, and the brown index was calculated, reflecting the ratio of the diameter of the follicle cavity to the height of the thyrocyte (d/2h). The concentration of thyroid hormones in the blood plasma was determined by radioimmune method (set "RIO-T3-PG" HOP IBOH AN Belarus).Results. In experimental rats, there was a large variability in follicle diameters. A 14% reduction in the size of follicle diameters was revealed. The average diameter of thyrocyte nuclei increased by 1.3 times. It was found that the relative volume of lymphocytic infiltration increased by 1.7 times, compared with the control group. The content of thyroxine in the blood serum increased by 83% in comparison with the indicators in the intact group; T3 - by 28%; and TTG - by 52% (P≤0.05). A number of morphological changes are associated with the influence of specific (temperature, hydrostatic) factors, and the hormonal activity of the thyroid gland is largely determined by the nature, character and intensity of the impact of mineral waters.

One of the most frequent manifestations of diseases of the cardiovascular system are cardiac arrhythmias. For emergency relief of paroxysmal ventricular arrhythmias, especially those developing against the background of ischemia, class I ant arrhythmic drugs are most often used. Employees of the Department of General and Organic Chemistry of the Perm State Pharmaceutical Academy synthesized a new biologically active compound, a derivative of aryl amides of diethylaminoacetic acid (called monomecaine) - GP-15, which has anti arrhythmic activity. Currently, the compound is undergoing preclinical studies.The purpose of this study was to study the pharmacokinetics of the biologically active compound GP-15 after a single intravenous administration of the substance to laboratory animals. As a result of the research, data were obtained on the quantitative content of GP-15 in the blood plasma of animals after a single intravenous administration, the calculation and analysis of the pharmacokinetics parameters of the compound were carried out. According to the data obtained, the duration of the half-life (T1/2), elimination constant (Kel), total clearance (ClT), total area under the pharmacokinetic curve (AUC), and distribution volume (DV) were calculated.

The article shows the results of a marketing analysis of non-steroidal anti-inflammatory medicines (NSAIMs) of the oxycam group in the Kyrgyz Republic. The results of the study revealed that the Kyrgyz pharmaceutical market has forty trade names (TN) of NSAIMs of the oxycam group, where the majority are meloxicam (MO1AC06), 29 TN of medicines (72,5%), and tenoxicam (M01AC02), 7 TN medicines (17,5%). Studies have shown that among manufacturers of drugs of these groups, medicines from non-CIS countries are leading, more than half - 57,5%, where Turkey takes the first place. The countries of the near abroad account for 32,5% of medicines, and for medicines of domestic production - 10%. In the Kyrgyz Republic, medicines manufactured in 13 countries of the world are registered, while NSAIMs of the oxycam group, which are produced in the Eurasian Union countries, account for 27,5%. Among oxycams, solid dosage forms are mainly represented, the specific gravity of which is 67,5%. Most of the NSAIMs from the oxycam group are in the mid-price segment.

Colonic anastomoses leakage is still a serious problem in abdominal surgery with significant morbidity and mortality. Incidence of this complication ranges from 1,8 to 19,2%, and depends on various risk factors: male sex, age, low level of anastomosis, malignant nature of the disease, high level of ASA scores, long duration of surgery, emergency nature of the operation, preoperative radiation therapy and perioperative blood loss and / or transfusion of blood components. Observation data lead to the development of various algorithms and scales for predicting the failure of anastomoses (for example, the PROCOLE index). Preventive methods include correction of a patient's nutritional deficiency in the perioperative period, elimination of a preventive stoma, use of tissue adhesives, transrectal drainage for decompression of a rectal anastomosis, use of stents or a collagen matrix coated with fibrinogen and thrombin. Given the validity and legitimacy of additional (preventive) interventions during the formation of the anastomosis, it should be noted that at present there is no clearly defined standard for operation on the digestive tract when anastomoses are applied.

The stroma of the neoplasm plays an important role in the pathogenesis of malignant tumors. One of the main elements of the tumor stroma are tumor associated macrophages (TAMs), which can stimulate uncontrolled cell proliferation and vascular network growth, as well as inhibit antitumor immunity, which leads to tumor progression [1]. The malignant potential of TAMs is expressed in the secretion of growth factors, extracellular matrix compounds, and the induction of the synthesis of certain cytokines [8]. Quantitative accounting of TAMs is actively used as a prognostic marker, however, the study using various markers of M1 and M2 macrophages will more confidently determine the concept of therapy aimed at inhibiting the pro-oncogenic activity of TAMs [1]. The aim of the work is to study the latest markers of TAMs, which will be useful as both prognostic and diagnostic markers of tumors or will be applicable in the field of creating new targeted antitumor drugs [8].