Purpose: to conduct a comparative analysis of the results of femtolaser-assisted cataract phacoemulsification using RayOne diffractive trifocal intraocular lens and M-flex bifocal refractive lens.Material and methods. 66 patients (95 eyes) were examined. Patients were divided into two groups: group 1 included 32 patients (46 eyes) who were implanted with bifocal refractive IOL M-flex 630 F with +3 DPTR addition; group 2 - 34 people (49 eyes)with implanted RayOne Trifocal IOL. Surgical treatment was evaluated by determining uncorrected distant visual acuity, near visual acuity (30-45 cm) and medium distance visual acuity (50-70 cm) at discharge, in 1, 3 and 6 months after surgery in photopic andmesopic lighting conditions, postoperative refractometry data, constructing a defocusing curve, and patient satisfaction subjectiveestimates.Results. In 1 month after surgery postoperative spheroequivalent within ±0.5 DPTR was achieved in 40 cases (82.6%) in group1 and 45 (91.8%) in group 2. By 6 months after surgery near visual acuity without correction in photopic and mesopic light conditions was in average 0.61±0.08 in group 1 patients with implanted bifocal IOLs. In group 2 patients who were implanted with a trifocal IOL, the average values were recorded at the level of 0.64±0.09 and 0.62±0.07, respectively. By 6 month, group 1 patientshad statistically significantly lower uncorrected visual acuity at long and medium distances: 0.81±0.08 in photopic lighting conditions and 0.79±0.08 in mesopic conditions, and 0.41±0.08 and 0.40±0.10, respectively.Conclusion. Patients with implanted RayOne Trifocal lens had higher uncorrected visual acuity at different distances and different light levels compared to patients with bifocal IOLs. The highest rates of subjective satisfaction with the results of surgical treatment were also recorded in patients with implanted trifocal Rayone IOLs. At the same time, they noted greater comfort with actions performed at close and medium distance.

The aim of the study is to identify a correlation between the severity of periodontitis and the glycemic status of diabetic patients. The sample consists of dental patients with type 2 diabetes who have applied for dental care in Belgorod and Arkhangelsk. The patients were evaluated for their hygienic condition using the GAME-Y index; the depth of periodontal pockets was calculated using a different-sized button probe; the gingival fluid exudation was determined. In the process of evaluating the hygiene index, there were no arguments indicating the feasibility of separate study of the clinic of patients with DM2 living in Belgorod and Arkhangelsk, which caused the formation of a single population. In the group of patients with HbA1 c 6%-7%, with good oral hygiene, the amount of gingival fluid corresponded to the values «periodontal, in which preclinical changes are possible». In patients with poor hygiene, excess exudation reached 12-19%. Among patients with HbA1 c ≥8%, in conditions of good and poor hygiene, gingival fluid exudation increased up to 47-63%, and 61-85%, respectively. Assessment of gingival fluid exudation showed a greater dependence of the severity of periodontitis on the glycemic status than on the hygienic state of the oral cavity.

Aim: to evaluate the effect of antiepileptics on the central nervous system (CNS) in children and adults.Material and methods. The treatment of 428 patients with epilepsy, 301 (70.3%) under 18 years old, 127 (29.7%) over 18 years old, 195 - males (45.6%), 233 (54.4%) - females was analyzed.Results. 359 adverse drug reactions (ADRs) were recorded in 223 patients (52.1%). ADRs were registered in 86/223 (38.6%)men and in 37/223 (61.4%) women, and 100/359 (28%) ADRs concerned the effect on CNS. The most significant among them were drowsiness, dizziness, cognitive-behavioral impairment, diplopia. ADR associated with CNS damage was most often detected with carbamazepine and oxcarbazepine (45 and 44%), lamotrigine and topiramate (33 and 28% of cases, respectively). Valproate (19%)and levetiracetam (18%) also effected on the CNS.Conclusions. In 1/3 of cases, antiepileptic ADRs are associated with the CNS effect, often due to the use of carbamazepine, the least - with levetiracetam.

The aim of the study was to evaluate the prospects of using «Biofeedback» technology in women with active labor arrest.Material and methods. The study included the prospective analysis of the labor’s second stage duration in two study groups with uterine inertia in second stage of the labor. Women in group 1 were inducted by standard oxytocin’s scheme to correct uterine inertia, in group 2 along induction by oxytocin «Biofeedback» technology (ultrasonic support of the head movement dynamics) was used.Results. The duration of the second delivery stage in group 1 was 125,5 (116,4; 130,5) min, in group 2 -93,6 (88,4; 101,1) min (U =219,5, p = 0,005). The frequency of operative delivery in group 1 was 37,5% (15/40), in group 2 - 10% (2/20) (χ2 = 4,97, p = 0,03). The indication for operative delivery was the deterioration of the fetal condition and / or lack of effectiveness of oxytocin stimulation.Conclusion. Ultrasound support of childbirth («Biofeedback» technology) in the development of active labor arrest allows to reduce the time of the second period, which allows to reduce the frequency of operative delivery.

The causes of thrombocytopenia are very diverse, one of them is using some kind of drugs (including heparin). Most of the patients (81%) with detected reduced level of platelets in blood (<100 х 109/l) didn’t get heparin. The reasons for such thrombocytopenia can be associated with the reaction to drugs of other groups (oncological patients), pathological processes related to the main disease course. Peak frequency of thrombocytopenia despite of heparin intake is found in patients of both oncological and cardiology departments.The purpose of the study is analysis of the relevance and frequency of heparin-induced thrombocytopenia (HIT) in a multispecialty hospital. The frequency of thrombocytopenia (<100 х 109/l) in patients of a multi-specialty hospital can reach 1.36%. Among 350 patients, 66 (19%) received heparins and they can be considered as potentially suffering from HIT. Most patients (62%) were treated in surgical departments. The departments with the largest number of such patients were the cardiology department (20 people per year) and the department of vascular surgery (11 people per year). Thus, the problem of HIT seems to be very important. It is necessary to attract the attention of hospital doctors to this problem for timely diagnosis and laboratory verification of HIT.

Objective. To study the incidence of T-stage and Gleason index elevation after robot-assisted radical prostatectomy (RARP).Material and methods. The Study included 142 patients with localized prostate cancer after standard nerve-sparing RARP (44 patients) and RARP by the technique developed by us with preservation and reconstruction of periprostatic anatomical structures with preservation (64 patients) or without preservation (34 patients) of neurovascular bundles of the penis.Results. Postoperative Gleason score in all groups of patients was higher than the preoperative values (p<0.0001). The dynamicsof changes in Gleason score did not differ significantly between the groups (p= 0.74). The disease upstaging to pT3 was recognized in 20.42% of patients.Conclusions. Risks of upstaging and upgrading in patients who underwent RARP for localized prostate cancer should be consideredwhen determining the management tactics of these patients and analyzing the immediate oncological results of surgical treatment.

Objective. To evaluate the dynamics of IPSS and quality of life (QoL) in patients who underwent robot-assisted radical prostaectomy (RARP).Materias and methods. 142 patients with localized prostate cancer (PCa) underwent RARP: standard nerve-preserving (NRARP, 44 patients), modified with preservation (RARP-A, 64 patients) or without preservation (RARP-B, 34 patients) of nerve-vascular bundles. The IPSS score and QoL were assessed preoperatively and at 12 months postoperatively.Results. The mean prostate volume in the N-RARP, RARP-A, and RARP-B groups was 44 (29;65.5) cm3, 50 (42.5;61.5) cm3, and 40 (33.0;65.0) cm3 (p=0.46), respectively. In the postoperative period, there was a significant decrease in the sum of the IPSS and QoL scores (p<0.0001), with no significant difference in the dynamics between the groups.Conclusions. RAPP for localized PCa with concomitant benign hyperplasia reduces the severity of lower urinary tract symptoms and improves the QoL of these patients.

Purpose of the study. To compare two methods of surgical treatment of ingrown nail in children.Materials and methods. We compared the results of treating of an ingrown nail using the Winograd method among 126 patients(72 patients were operated on by the classical way, 54 - by modified one) and 18 patients according to the Vandenbos method. Conclusion. Surgical treatment of onychocryptosis using the classic and modified Winograd method is justified by low morbidity and short healing time of the postoperative wound 13,4 ± 3,95 days. Therefore, this method is recommended by the authors for use in patients who do not have hypertrophied nail folds. It is necessary to try not to unnecessarily narrow the nail plate, but to resect only its ingrown part. Then the supporting function of the nail and aesthetic appeal will be preserved.Surgical treatment of onychocryptosis using the Vandenbos method is preferred for advanced cases of the disease and for severe hypertrophy of the nail folds. This approach ultimately leads to a very good cosmetic result and a low probable relapse of the disease, which justifies the inconvenience of prolonged 34,4±3,06 days healing of the postoperative wound.

The purpose of the work was study the effectiveness of the surgical treatment results of intumescent cataract by the proposed method (application for invention No. 2020129266 dated 02.09.2020).Material and methods. In a retrospective study, 15 patients (15 eyes) with intumescent cataract were operated on by ultrasoundphacoemulsification with intraocular lens implantation. Observation group (7 people) underwent standard surgical technics. In comparison group (8 people) a trocar with a valve was installed, a portion of intraocular fluid was released from the posterior part of the eye to normalize intraocular pressure, and then surgery was performed as standard.Results. In the observation group, there was one uncontrolled rupture of the anterior lens capsule at the stage of capsulorexis at discharge, visual acuity was 0.16±0.14. In the comparison group, no surgical complications were detected, visual acuity - 0.24±0.16 (p < 0.05, U-criterion).Conclusions. The proposed method proved to be quite effective, well-controlled, and easy to implement.

Aim: to study the range of effective doses of a new 3-substituted thietane-1,1-dioxide derivative (laboratory code N-199/1), which has antidepressant activity. Materias and methods: in the experiment, the N-199/1 acute toxicity (LD50) was determined according to the method of J. Litchfield and F. Wilcoxon modified by V.B. Prozorovskii when administered once intraperitoneally to male mice, which amounted to 488.85 mg/kg (IV class of hazard - «low-toxic substances», classification of K.K. Sidorov). The compound was administered once per day intraperitoneally for 14 days to outbred male mice at doses of 0.9, 2, 4.5, 10.1, 22.8, and 51.3 mg/kg, which are 1/546, 1/243, 1/108, 1/48,1/29 and 1/9 of the LD50 respectively.Results and conclusions: in the forced swimming test modified by E.V. Shchetinin N-199/1 reduced the depression index by 17-27% in relation to the control group at doses of 0.9 - 22.8 mg/kg, and the duration of immobilization by 37%, 56% and 32% at doses of 2, 10.1 and 22.8 mg/kg respectively. Thus, with repeated intraperitoneal administration to male mice, N-199/1 in a wide range of doses (0.9-22.8 mg / kg) showed antidepressant-like properties.

The well-known drugs pentoxifylline, aminophylline, linagliptin and isradephylline have been created on the basis of natural methylxanthines by chemical modification. It has been identified that some synthetic derivatives of xanthine including thietane containing xanthines exhibit anti-inflammatory, analgesic, antidepressant, antidiabetic and antioxidant activity. We have synthesized 2- [1-isobutyl-3-methyl-7-(1,1-dioxothietanyl-3)xanthynyl-8-thio]acetic acid (I) which exhibits high antioxidant activity in the model system of generation of reactive oxygen species by blood phagocytes. Further pharmacological studies of compound I require the development of methods for determining the authenticity which is an integral part of the standardization of pharmaceutical substances.The aim of this research is to study the chemical and physicochemical properties of 2-[1-isobutyl-3-methyl-7-(1,1- dioxothietanyl-3)xanthynyl-8-thio]acetic acid to develop methods for determining its authenticity.Material and methods. Objects of research are 5 experimental batches of 2-[1-isobutyl-3-methyl-7-(1,1-dioxothietanyl-3)xanthynyl-8-thio]acetic acid. Solubility has been determined in water and various organic solvents. 1H, 13C NMR spectra were recorded on a Bruker AV-500 instrument. IR spectra were taken on a spectrophotometer «Infralum FT-02», UV spectra - on a«Shimadzu UV-1800» device. As a reaction for determining the authenticity a murexide test and a characteristic reaction with a solution of iron (III) chloride 3% were carried out. The melting point was measured by the capillary method on an SMP 30 device.Weight loss on drying was determined according to Method 1. Results. All synthesized batches of 2-[1-isobutyl-3-methyl-7-(1,1-dioxothietanyl-3)xanthynyl-8-thio]acetic acid are odorless white crystalline powders with different solubility in water and organic solvents. The structure of acid I is confirmed by the 1H NMR spectrum which shows the presence of proton signals of isobutyl substituent, methyl group of xanthine, thiethane dioxide ring and thioglycolic acid residue. The structure of acid I is also confirmed by 13C NMR spectrum which besides characteristic carbon signals of xanthine, alkyl substituents and thiethane dioxide cycle contains carbon signals of thioglycolic acid residue. Determination of the authenticity of acid I was carried out by IR and UV spectra. Intense absorption bands of stretching vibrations of SO2 bonds of thiethane dioxide groups and C=O, C=N bonds of xanthine as well as a wide absorption band of stretching vibrations of the O-H bond of thioglycolic acid residue were found in IR spectra. UV spectra are characterized by the presence of two absorption maxima at 219,8 nm, 294,7 nm and one absorption minimum at 259,4 nm in the wavelength range from 210 nm to 350 nm. When carrying out a murexid test for acid I a red-violet coloration was observed. As a result of a characteristic reaction with a solution of iron (III) chloride 3% a light brick precipitate is formed. The range of values of the melting point was 234,6-235,5 °C. Weight loss on drying makes up no more than 0.2%.Conclusions. The description and solubility of 2-[1-isobutyl-3-methyl-7-(1,1-dioxothietanyl-3)xanthynyl-8-thio]acetic acid have been determined. Chemical and physicochemical methods for determining the authenticity of acid I have been studied. According to obtained results IR spectroscopy, UV spectroscopy, murexide test, reaction with a solution of iron (III) chloride 3% and measurement of the melting point have been proposed to determine the authenticity. Weight loss on drying was determined.

Validation of pharmacopoeial methods is carried out at the stage of development of normative documentation for new medicines. It’s aim is to confirm the validity of the method for determining the indicators and quality standards of pharmaceutical products.The aim of the research was to validate the developed methodology for the quantitative determination of luteolin in plant composition with hypoglycemic activity.Material and methods: the object of the study was plant composition with hypoglycemic activity developed at the Departmentof pharmacognosy with the course of botany and fundamentals of phytotherapy of the BSMU. Quantitative determination was carried out by the spectrophotometric method using a complexing component. We selected optimal conditions for the method of spectrophotometric quantification of luteolin, and then the proposed method was validated.The results of the studies showed the linearity, repeatability and precision of the developed method of spectrophotometric quantification of luteolin.Conclusions: the developed method can be used to standardize the plant composition with hypoglycemic activity.

Medicines, the molecule of which contains a hydrazone fragment, are widely used as antibacterial and antioxidant agents. Pyrimidine derivatives show high activity in the treatment of Alzheimer's disease, have antioxidant, antitumor, antiviral activity. Therefore, the prospects for the synthesis of previously undescribed hydrazones 6-methyl-1- (2-oxopropyl) -3- (thietan-3-yl) pyrimidin-2,4 (1H, 3H) -dione containing a pyrimidine ring and a hydrazone residue as the pharmacophore fragment, is of interest for obtaining new series of potential biologically active substances.Purpose: In order to obtain new methyluracil derivatives, we studied the alkylation of 6-methyl-3- (thietan-3-yl) pyrimidine-2,4(1H, 3H) -dione with chloroacetone and the interaction of the resulting 2-oxopropyl derivative with hydrazine derivatives.Material and methods: The structure of the newly synthesized substances was investigated by NMR spectroscopy. The prediction of biological activity and toxicity was carried out using the online resources PASS and GUSAR. Statistical processing of the results was carried out using the method of correlation analysis using the universal software package STATISTICA 8.0Results and conclusions: As a result of the work, a new series of compounds with potential biological activity was obtained. Some structure-activity relationships have been identified. Based on the data obtained, promising areas of research have been formed that directly cover the study of predicted types of biological activity.

Objective: identification of the features of the anatomical structure of hip joint ligaments in fetuses of different ages and newborns.Material and methods. The study was carried out on the corpses of 200 fetuses aged from 12 to 38 weeks and 10 newborns. The object of the study was the capsule and the ligaments of the hip joint. Anatomical research methods were used. Ligament morphometry was performed.Results. As a result of the study, it was found that the anlage, growth and maturation of the fibrous frame in different joint ligaments inthe fetal period have an uneven course. The periods of accelerated growth of ligaments, accompanied by changes in their internal structure, were revealed. In newborns, the ligamentous apparatus of the hip joint has component and structural differences from the definitive one.Conclusions: 1. The ligament of the femoral head is laid at 12-14 weeks from an independent source. 2. The iliofemoral ligament is laid at 16-19 weeks, the pubic-femoral and ischiofemoral at 20-23 weeks from the fibrous structures of the surface layer of the articular bag. 3. The growth of the size of the ligaments is uneven. The acceleration of the growth of length and width is accompanied by the appearance of bundles of collagen fibers of a new level of organization.

The article presents the experience of the work of a specialized mobile medical team of Bashkir State Medical University in Karachay-Cherkess Republic. The dispatch of specialized mobile teams to the regions is a mechanism for prompt response to emerging problems in assisting patients with the novel coronavirus infection COVID-19.The specialized mobile team included 17 physicians having great experience in treating patients with COVID-19. On07/01/2020 940 beds have been deployed for patients with the new coronavirus infection COVID-19. A rehabilitation center for 170 beds was opened. There were 4568 people under observation, of which 4098 were in self-isolation. Among medical workers, 726 people fell ill. 52 patients with the new coronavirus infection COVID-19 were in serious condition, including 19 on mechanical ventilation. 13 deaths from the new coronavirus infection COVID-19 have been officially confirmed. The mortality rate was 0.57% (the average Russian indicator is 1.35%). Most of the dead people were over working age.Due to the active involvement of medical workers, additional payments, the personnel deficit in medical organizations waseliminated. In mid-June 2020, the Karachay-Cherkess Republic began the first stage of lifting restrictions imposed by the COVID-19 coronavirus pandemic.

The article is devoted to topical issues of physical rehabilitation - as part of the medical rehabilitation of patients who have suffered pneumonia, associated with the new coronavirus infection COVID-19. Physical pulmonary rehabilitation is primarily aimed at the prevention of early and late complications, restoration of bronchial passage and morphological structure of the lung tissue, activation of alveolar-capillary transport. The features of physical rehabilitation of this category of patients are shown with the mechanisms of therapeutic action of physical exercises, hardware physiotherapy, natural therapeutic physical factors - kumys, mineral waters, therapeutic mud. The developed program of the third stage of medical rehabilitation of patients after pneumonia, associated with the new coronavirus infection COVID-19 in sanatoriums and clinics lasting 14 days, has been presented. In the programs, special attention should be given to the intensity, timing of rehabilitation activities in elderly patients, in the presence of comorbidities of the cardiovascular and nervous systems, obesity, diabetes. At the same time personalized approach determines the choice of methods and forms of physical rehabilitation, contributing to the restoration of external breathing function, improving the cardiovascular system, increasing physical performance.

Objective: to determine the main clinical signs of COVID-19 that allow differentiating COVID-19 from seasonal respiratory infections in hospitalized children in the initial period of the disease.Material and methods. The case histories of 44 patients (24 boys, 20 girls) aged from 1 to 17 years old who were admitted to a specialized hospital in Moscow with symptoms of acute respiratory infection (ARI) were retrospectively analyzed. To verify the etiology of the disease, the RNA of the SARS-CoV-2 virus was determined in nasopharyngeal smears( PCR), IgM and IgG antibodies to SARS-CoV-2 (ELISA), and infection markers (Mycoplasma, chlamydia, herpesvirus infections, and respiratory viruses). Statistical analysis was performed using the IBM SPSS Statistics 26 program. The calculations used Student's t-test, Mann-Whitney's Utest, Pearson's χ2 test, and Fisher's exact test. Differences in indicators were considered statistically significant at p<0.05.Results. Group 1 included 17 children (39%) who had SARS-CoV-2 RNA detected in oropharyngeal smears, and the comparison group included 27 children (41%) with negative test results. Coughing was more common in patients with ARI (p=0.04), while complaints of sore throat, in contrast, were more common in children with COVID-19 (p=0.01). Fever was reported equally frequently in children of both groups. Upper respiratory tract (URT) damage occurred in 55% of patients, lower respiratory tract (LRT) damage with the development of pneumonia or bronchitis - in 45%. When comparing the levels of airway damage depending on the presence of COVID-19, statistically significant differences were obtained: LRT pathology was more often observed in patients with ARI (p=0.005).Conclusion. The course of COVID-19 in children has few specific clinical and laboratory signs, which makes differential diagnosis with seasonal ARI difficult. The high proportion of combined infections makes it necessary to screen for major respiratory pathogens.

Relevance: with the increasing incidence of COVID-19, it is clear that early detection of the risk of death in patients on artificial lung ventilation (ALV) can help to ensure proper treatment planning and optimize health resources.The aim of our study was to identify predictors of the risk of death in ICU patients with COVID-19 on mechanical ventilation.Material and methods: research design - retrospective, observational, multicenter. Inclusion criteria: clinical, laboratory, and radiological criteria for severe viral community-acquired pneumonia. Exclusion criteria: death in the first 12 hours of hospitalization. End points: need for mechanical ventilation and death. 168 patients met the inclusion criteria. The number of patients who were given ALV was 69 (41,1%), 47 (68,1%) of them died. Risk factors were determined by calculating the odds ratio with a 95% confidence interval. The discriminative ability of factors was evaluated using ROC analysis with the calculation of the area under the curve (AUC ROC).Results: the most significant risk factors for ALV in patients with COVID-19 were a large extent of changes in the lung parenchyma, a higher score on the SOFA scale (> 5 points) and blood D - dimers > 3000 ng/ml. The deceased patients were more likelyМедицинский вестник Башкортостана. Том 15, № 6 (90), 202087to be men and initially had statistically significantly higher scores on the SOFA scale, neutrophil-to-lymphocyte ratio, and blood interleukin 6 (IL-6) content >186 ng/ml. However, the discriminative ability of these risk factors was moderate (AUC ROC from 0.69 to 0.76) in deceased patients, there was almost no dynamics of changes in the P/F ratio, blood D-dimer content, and SOFA severity assessment in the first three days of intensive care.Conclusion: Predictors of the development of an unfavorable outcome of the disease with moderate discrimination in patients with severe COVID-19 who are on ALV are: an increased score on the SOFA scale, an increase in the neutrophil-lymphocyte ratio, high levels of D-dimers and IL-6 in the blood.

Cervix cancer is the most common tumor disease in women. In Russia, the incidence of cervical cancer in 2018 was 17766 cases. In the Russian Federation, the death absolute numbers was 6,392 cases, with an average age of 57.8 years. In the Republic of Bashkortostan, 346 new cases of the disease were registered, including 117 cases of detection at stage III-IV of the disease. Approximately 75% of invasive cervical carcinomas are squamous cell carcinoma. Chemotherapy is the only one treatment option for the vast majority of patients with recurrent or metastatic disease. However, the successful use of platinum-containing regimens is associated with the development of adverse events; in particular, the sprout of myelopoiesis is inhibited. Frequent adverse effects are anemia, thrombocytopenia, neutropenia. For the last few years success has been achieved in cancer immunotherapy. Pembrolizumab is an anti-PD-1 monoclonal antibody that connects the PD-1 receptor and blocks interaction with PD-L1 and PD-L2, thereby releasing PD-1-mediated inhibition of the immune response, including an antitumor immune response.Case presentation. A patient with metastatic cervical cancer turned for specialized help complaining of pain in the lower abdomen. In the history of the disease, the patient had diathermoconization of the cervix, chemoradio therapy, evisceration of the pelvis with the formation of ileoconditis according to Bricker. Before starting therapy, MRI of the abdomen and pelvis was performed. One targeted lesion was isolated, in the right obturator fossa there was a conglomerate of lymph nodes. The sum of measurable foci was 38-mm. PDL1 status ≥ 1%, positive status of microsatellite instability (MSI) were determined. The patient received 25 courses of anti-PD1 / PDL1 therapy: pembrolizumab 200 mg every 21 days. According to the results of an MRI scan of the pelvic organs - the size of the measurable lesion is 15 mm; a partial response is achieved according to the RECIST / iRECIST criteria.Conclusions. In this case anti-PD1 / PDL1 therapy for advanced and metastatic cervical cancer helped to achieve partial or complete remission of the disease. Improvement of treatment results with addition of pembrolizumab into the treatment scheme is connected with a decrease in the size of the measurable lesion by more than 30%, a decrease in the number of adverse events, and an improvement in the general condition of the patient.

Purpose. To describe the case of neuroendocrine tumors (NET) response to low molecular weight tyrosine kinase inhibitor imatinib. The latter is widely used for the treatment of chronic myelogenous leukemia as well as gastrointestinal stromal tumors. It inhibits tyrosine kinase BCR-ABL, tyrosine kinase KIT receptors and platelet-derived growth factor receptors (PDGFR), however it has never been approved for the treatment of NET.Material and methods. We report the case of NET liver lesion stabilization according to the ultrasound follow-up during the whole imatinib (400 mg daily) therapy period lasting 33 months. 10 months after the imatinib discontinuation the patient developed disease progression that eventually led to the death caused by the congestive heart disease 98Results. We also discussed the literature data concerning the attempts to use imatinib for the treatment of NET. We found few reports of unexpectedly long remission and/or stabilization of NET in patients receiving imatinib.Conclusion. The presented data show that it looks reasonable to identify the NET subtypes sensitive to imatinib. We believe that such approach is able to develop the new treatment strategies as well as to reveal the NET patient subgroups that can benefit from the imatinib therapy.

Echinococcosis is a cyclical parasitic disease that affects vital organs - the liver and lungs. Despite the fact that the diagnosis, prevention and surgical treatment of liver echinococcosis have already been well studied and widely covered, pulmonary echinococcosis, as a less common disease, requires generalization of the experience of thoracic surgeons to select the most optimal methods of surgical treatment. The article presents the experience of diagnostics and surgical treatment of patients with pulmonary echinococcosis in the department of thoracic surgery of the Republican Clinical Hospital named after G.G. Kuvatov, Ufa for the period from2010 to 2019. The study revealed that the most sensitive research methods are radiography and computed tomography of the lungs. The greatest number of lesions occurred in the lower lobe localization. There was a tendency towards a decrease in the size of parasitic cysts in patients over a 10-year follow-up period. The main variants of surgical interventions used for pulmonary echinococcosis have been studied. The analysis of the operations showed a decrease in the growth of lobectomies and an increase in the number of organ-preserving operations. Relapses of the disease identified at various times (from 6 months to 5 years) after the primary surgery accounted for about 8% of cases.

The purpose of this investigation was to make a comparative analysis of the results of treatment of inguinal hernias in the BSMU Clinic by TAPP - transabdominal preperitoneal plastic and the open method by Liechtenstein, based on a comparison of indicators such as: duration of surgical intervention, types of anesthesia used, time spent in hospital and postoperative complications.Material and methods. 266 not urgent cases of inguinal hernia treatment were analyzed. A total of 187 patients were treatedwith an explant hernioplasty of Liechtenstein during 2018. In 2018-2019 TAPP was performed on 79 patients.Results: The advantages and disadvantages of these methods were identified.Conclusion: Based on the results of the study, it can be concluded that it is necessary to develop and apply the laparoscopic method of inguinal hernioplasty at the BSMU Clinic.

The aim of the work was to improve the results of treatment of children with widespread peritonitis of various origin by means of a differentiated approach to intensive treatment in connection with the differences in the pathomorphosis of pathogens. The article investigates the features of the development and course of acute purulent perforated peritonitis of appendicular origin of variousМедицинский вестник Башкортостана. Том 15, № 6 (90), 2020109etiology in children, the possibilities of effective treatment of patients. The studies were carried out in 152 patients with this disease aged from 2 to 15 years old. To identify the pathogens, the computer program «Microbe-automaton» and «Microbe-automaton-2» were used, which made it possible to correct antibacterial therapy in the early stages of the postoperative period and, thus, to reduce the material costs of the hospital. Patients have been treated at the Voronezh Pediatric Surgery Clinic since 2017 to 2019. The clinical course of diffuse pseudomonas aeruginosa was more severe and dangerous than in similar patients with peritonitis of escherichiosis, enterococcal, enterobacterial and other etiology. Insufficient efficiency of traditional complex treatment of children with perforated peritonitis of pseudomonas aeruginosa etiology was established, which is due to the resistance of pseudomonas aeruginosa flora to traditional antibacterial drugs. Patients with pseudomonas aeruginosa perforated peritonitis, in addition to complex treatment, effectively were given the developed differentiated antipseudomonal therapy. It contributed to the prevention of the development of abdominal pseudomonas aeruginosa sepsis in patients and a complete clinical recovery.

An up-to-date method of medical imaging, such as dual-energy computed tomography (DECT), enables to identify the composition of kidney stones even before surgical treatment, which is especially important for optimizing and personalized approach to the treatment of nephrolithiasis. Detection of urate urinary stones by DECT makes it possible to avoid surgical intervention and to prescribe specific metaphylactic therapy aimed at reducing the density and size of the concretion. Special recommendations allow achieving remission in the formation of new stones and the suppression of the growth of existing ones. 120 people were examined by the DECT method, of which 15 were found to have urate type of stone formation. These patients were prescribed a personalized program of metaphylactic treatment. This allowed us to abandon the surgical intervention. Correction of metabolic disorders detected by biochemical blood and urine tests prevents the formation of concretions in the urinary tract. The remaining 105 patients underwent anti-relapse treatment, and after 3 years, only 12% of them developed concretions again.

According to the literature tumours of the parotid salivary gland among other neoplasms make up 1.2%. Localization in the pharyngeal section of the parotid salivary gland is 5.4%. (Paches A.M. 1958). A sufficient rarity of a parapharyngial tumor requires differentiation from neurinoma, carotid artery aneurysm of this location.The article describes a rare case of parapharyngial tumor detected in a woman E. at the age of 56 years. A tumor formation inthe mouth area grew without significant worries for 7 years. The patient associates the appearance of a neoplasm with a catarrhal disease. She was consulted by an oncologist. A cytological study number 1107 from 10.01.2020 made it possible to diagnose a mixed tumor of the pharyngeal process of the right parotid salivary gland. On MRI of the soft tissues of the head dated 23.12.2019, a volumetric formation with clear tuberous contours 33x35x57 mm in size was revealed in the pharyngeal region of the right heterogeneous structure. The formation lies behind the branch of the lower jaw, anterior to the common carotid artery, can not be clearly differentiated from the right jugular vein. The airway of the oropharynx is compressed.Ultrasound of the lymph nodes of the neck from 19.12.2019 showed ultrasound signs of reactive cervical lymphadenopathy. In the right submandibular and parotid region, the volume hypoechoic formation of 66x59x68 (volume 127 cm3), uneven, clear, heterogeneous.

Purpose. To evaluate the clinical and functional results of endothelial keratoplasty in endothelial insufficiency of a penetrating corneal graft.Material and methods. In 2019 6 femtolaser-assisted posterior lamellar keratoplasty with inverted formation of an ultrathingraft were performed in patients with secondary endothelial insufficiency of a penetrating corneal graft in Ufa Eye Research Institute. The observation period was 6 months.Results. In all cases, the graft acceptance was 100%. The graft remained clear, the border between grafts didn’t vary. Posteriorlamellar keratoplasty 3 weeks, 3 months and 6 months after surgery demonstrates a high visual acuity, low rates of induced postoperative astigmatism, as well as a lower loss of endothelial cells.Conclusion. Endothelial keratoplasty is a gentle method of treating endothelial failure, showing high clinical and functional re-sults. However, to assess acceptance and long-terms results follow-up is needed.

Vaginal microflora in women of reproductive age functions normally due to the production of glycogen by endogenous estrogens and the growth of lactobacilli. The menstrual cycle makes a change in the total number and species composition of the microflora (there is a decrease in the number of Lactobacillus, but the balance is maintained by saprophytic microflora). Anatomical features of the genitals, namely: a defective posterior spike, a low-lying external opening of the urethra, the presence of scar deformities, abnormalities of the genitourinary system, omission and prolapse of the pelvic floor organs contribute to changes in the microecosystem of the vagina and the development of the inflammatory process in the genitals. Timely correction of the vaginal microflora allows to effectively perform surgical methods for the treatment of defects and scar deformities of the external genitals, which also contributes to the formation of a normal topographic anatomy of the external genitals.

The purpose of this study is a detailed review of various methods of diagnosis and therapeutic correction of cervical pathology associated with the human papillomavirus (HPV). The article discusses traditional tests and current methods for detecting the virus.Material and methods. The following key words were used to search the literature review: human papillomavirus (HPV), cervical intraepithelial neoplasia (CIN), cervical cancer, cervical cancer prevention. The inclusion criteria were set from 2012 to 2019. We searched for publications according to these criteria on the following platforms: Web of Science, elibrary.ru. The results of the analysis of the data presented in the scientific articles were included in the final text of the review.Results. The article presents methods of diagnostics and treatment of cervical diseases in HPV-associated diseases and the main components of cervical screening and modern technologies used in the world.Conclusions. Traditional diagnostic tests have a low sensitivity for detecting oncological pathology of the cervix. To increase the effectiveness of cervical screening, it is necessary to introduce new, more sensitive methods into the compulsory medical insurance system.

The article presents current information on risk factors, immediate and long-term outcomes in premature babies. Preterm birth is one of the most significant factors in infant morbidity and mortality. Children born with very low and extremely low body weight have a high risk of both severe complications in the first days and months of life, and severe long-term consequences. The risk of developing disabling diseases is associated with gestational age and birth weight. Currently, there are no generally accepted criteria for minimum body weight and gestational age for nursing and intensive treatment of premature newborns. Studies conducted in various countries show that the frequency and number of severe diseases significantly increase in children born at 22-24 weeks of gestation. The most significant disabling diseases in children born very prematurely are cerebral palsy, severe delay in mental and motor development, visual and hearing disorders. Predicting the risk of disability and life expectancy of premature babies using mathematical models allows us to estimate the duration of treatment and rehabilitation of these children in the long term period.

The problem of nutritional support for patients at risk, especially for dysphagia syndrome of any etiology, remains one of the most pressing topics for decades. The article discusses current trends in assessing the nutritional status of a patient and reflects the main pathophysiological changes in its disorders, as well as their clinical significance. Analysis of foreign and domestic literature has shown that various indices are used today: body mass index, subjective global assessment of nutrition status, predictive nutritional index, predictive hypotrophy index, perioperative nutritional screening, etc. Summarizing the literature data, it can be stated that in predicting the course of the disease and assessing the risk of surgical methods of treatment, determining the nutritional status is one of the fundamental factors for therapeutic tactics aimed at correcting the course of the disease complicated by dysphagia.

Based on isolation from adipose tissue, the stromal vascular fraction (SVF) is a heterogeneous cell population of endotheliocytes, erythrocytes, fibroblasts, smooth muscle cells, pericytes, macrophages and mesenchymal stem cells, which are plasticadhesive in nature. These cells provide anti-inflammatory, immunomodulatory and anti-apoptotic effects, as well as stimulate angiogenesis, growth and differentiation of cells at the site of injury. Therefore, SVF has great potential for therapeutic use in diseases accompanied by local damage to soft tissues and the development of an inflammatory process. Although the use of SVF is useful for the treatment of many diseases, such as degenerative diseases of the musculoskeletal system or cardiovascular diseases, SVF is not widely used in clinical practice at present. Despite extensive research, the exact mechanisms of the effect of SVF on regenerative processes are still unclear, and this undoubtedly hinders progress in the use of SVF for therapeutic purposes. The presented work highlights the results of studies published in the modern literature and devoted to the mechanisms of action of SVF, as well as the potential of its use in various human diseases.

The article presents the results of literature analysis on the problem of myocardial fibrosis in patients with arterial hypertension. The work analyzes modern ideas about the mechanisms of fibrosis formation as one of the main components in the progression of most cardiovascular diseases, the role of left ventricular remodeling as a multimodal myocardial response to many external or internal stimuli is determined. The concepts of extracellular matrix and its volume, their clinical significance for the progression of cardiovascular diseases are considered. The connection between metabolic markers of myocardial fibrosis with heart remodeling has been analyzed, the results of studies describing an increase in activity of TIMP-1 have been considered.TIMP-1 helps to strengthen the collagen interstitial network to counter the increased functional tension of the myocardium, subsequently leading to cardiac remodeling and the formation of diastolic dysfunction. The main signal-dependent transcription factors controlling cardiac plasticity are discussed.

The paper presents the generalized results of clinical studies, meta-analyzes and systematic reviews on the use of physical therapy in patients with chronic kidney disease (CKD), in the form of a scientometric analysis based on search queries of various domestic and foreign information scientific systems and databases for the general period of publications.Purpose of the work: to conduct a scientometric analysis of clinical studies on the use of physical therapy in patients withchronic kidney disease.Material and methods: analysis of search queries of scientific papers and research on key formulations in international information retrieval databases in Russian and English.Results. The first sources containing information on specialized works dated back to the beginning of the 50s of the last century and reached their maximum by the last year, the largest number of publications is systematic reviews and clinical studies.Conclusions: analysis of the works showed a lack of information regarding the use of physical therapy in patients with CKD.Particular attention is focused on physical exercise, therapeutic exercises and aerobic exercise, least of all information regarding the methods of instrumental physical therapy in the treatment of patients with chronic kidney disease.