The purpose of the work is to determine the role of aldosterone in the development of myocardial remodeling and fibrosis in patients with chronic heart failure (CHF) of ischemic origin. We are going to study the interconnection of aldosterone level and hemodynamics parameters in patients with CHF of III-IV functional class (FC) after myocardial infarction (MI).Material and methods. The study included 120 men with functional class III -IV CHF who had suffered MI.The study of aldosterone was performed by enzyme immunoassay.Results. Patients with CHF III -IV FC had elevated levels of aldosterone, which increased as CHF progressed and CHF FC increased.Conclusion. The intensity of myocardial remodeling and fibrosis in patients with progressive CHF in the postinfarction period is correlated with the level of aldosterone

Purpose: to determine the informative value of OCT-A in the diagnosis of patients with branch retinal vein occlusion (BRVO)complicated by macular edema (MO).Material and methods. In the main group 29 patients were examined with a diagnosis of BRVO with MO; in the control group30 patients without ophthalmic pathology were examined. We analyzed and described the qualitative and quantitative changes that were detected using OCT and OCT-A.Results. The mean central retinal thickness in the fovea in the main group was 523.2±113.6 μm, in the control group - 246±19μm. In the main group the central thickness of the choroid was 259.2±7.4 µm, in the control group - 236.7±8.3 µm. The density of capillaries in the superficial and deep capillary plexus was evaluated in 5 areas. In the main group, the area of the foveal avascular zone (FAZ) was 0.39±0.05 mm2, in the control group the FAZ area was 0.36±0.08 mm2.Conclusion. OCT-A allows detecting changes in FAZ, capillary nonperfusion zones, microvascular anomalies and signs of vascular insufficiency, both in the superficial and deep capillary plexus.

Aim: to establish the clinical and morphological features of uterine fibroids, depending on the level of expression α-SMA, CD34, Ki-67 receptors.Material and methods. We carried out a retrospective analysis of the case histories of patients diagnosed with uterine fibroidsafter surgical treatment in the gynecological department of the clinic of obstetrics and gynecology of the Medical Academy named after S.M. Kirov for the period of 2017-2020.In total, the study included data from the case histories of 110 patients who underwent laparoscopic myomectomy. The size ofthe removed tumor exceeded 8 cm. According to the results of immunohistochemical studies, the patients were divided into 2 groups: the expression of α-SMA, CD34, Ki-67 less than 1% - 1 group (n = 58), the expression of α-SMA, CD-34, Ki-67 from 1% -5% - group 2 (n = 52).Statistical analysis was carried out using Microsoft Office Excel programs and R - Studio software environment.Results. The increased expression level of α-SMA, CD34, Ki-67 (1-5%) is reliably associated with multiple uterine myoma (p = 0.0003), rapid growth of the myoma node (p = 0.004). Also, a significant correlation was found between the volume of intraoperative blood loss and the degree of expression of proliferation receptors (p = 0.0007).Conclusion. Increased expression of proliferation factors can be considered as a criterion for predicting recurrence of fibroids in patients of reproductive age, which determines the need for dynamic monitoring and preventive anti-relapse therapy.

Objective was to identify and analyze clinical features and prevalence of comorbid pathology in patients with agerelated, posttraumatic, metabolic and mixed genesis of gonarthrosis.Material and methods. The study was conducted on 120 patients with III-IV radiological stages of gonarthrosis, divided into 4groups of 30 people, depending on osteoarthritis (OA) phenotype: agerelated, posttraumatic, metabolic and mixed. All patients underwent clinical examination of basic and comorbid diseases with collection of complaints, anamnesis, physical examination, verification of comorbid pathology, knee joints X-ray and statistical processing of data obtained.Results. Agerelated OA was characterized by the latest onset, the highest age of patients, rare synovitis, high prevalence of coronary heart disease, arterial hypertension, osteoporosis, hypothyroidism, and abdominal obesity without metabolic syndrome. Posttraumatic OA was characterized by the lowest prevalence of comorbid pathology, except for chronic cholecystitis. Metabolic phenotype was accompanied by frequent synovitis, IV OA stage, frequent cardiovascular, endocrine, metabolic and gastrointestinal comorbidities. Mixed OA was characterized by frequent comorbid metabolic and endocrine disorders and chronic gastritis.Conclusion. Revealed clinical and pathogenetic differences between phenotypes of gonarthrosis require individualized approachto treatment of different categories of patients with OA, taking into account comorbid pathology.

Aim: to evaluate the possibilities of ultrasound imaging in the diagnosis of acute pancreatitis and criteria of E.J. Balthazar classification according to the results of computer tomography of the pancreas.Material and methods. An ultrasound study of 390 patients with acute pancreatitis was performed, among which 285 (73%)were mild, 88 (22,5%) moderate and 17 (4,5%) severe. The study was conducted at the time of hospitalization, in the absence of visualization of the pancreas within 48-72 hours after hospitalization.Results. Ultrasound criteria for pathological changes in the pancreas are proposed in accordance with the computer tomographic classification of acute pancreatitis according to E.J. Balthazar. The diagnostic effectiveness of ultrasound in acute pancteatitisreached 96,5%, sensitivity and specifity - 84,7 and 78,4% respectively, according to our data.Conclusions. 1) Ultrasound reveals signs of acute pancreatitis, determined by CT according to E.J. Balthazar classification. 2) Рatients with stage B and C by E.J. Balthazar classification have mild course of acute pancreatitis with no complications. Most complications are noted in patients with stage D and E of this classification. 3) The use of the Balthazar classification in ultrasound allows predicting the severity of acute pancreatitis and detecting patients with high risks for complications development.

Each year morbidity and mortality of acute pancreatitis is increasing. This is due to a change in the quality of nutrition, stress, bad diet, physical inactivity.The aim of the study was to analyze the territorial prevalence of cases of illness and death at acute pancreatitis in dynamics for2010-2019.Material and methods. The study was carried out on the data of Rosstat and the reporting documentation of medical organizations. Cartographic analysis of indicators in dynamics for 2010-2019 was carried out.Results. An increase in morbidity and mortality of acute pancreatitis in the region was revealed. Municipal districts and medicaldistricts of the Republic of Bashkortostan with high, moderate and low levels of primary morbidity and mortality have been identified. The territorial features of the dynamics of the studied indicators are revealed. Thus, in the areas of Sibaysky, Sterlitamak and Duvan Medical Districts, high values of both indicators were noted for the period under study.Conclusion. The data obtained will make it possible to carry out targeted specialized medical care for acute pancreatitis, taking into account the research results.

The article is devoted to the study of the humoral immune response to Epstein-Barr virus (EBV) proteins in respiratory pathology.The aim of the study was to identify the features of the immune system response to EBV proteins in different clinical phenotypes of chronic respiratory pathology.Material and methods. 140 patients were examined using immunoblotting for semi-quantitative evaluation of IgG antibodies to virus-specific capsid, nuclear, and early EBV proteins.Results. In rhinosinusitis and bronchial asthma induced by nonsteroidal anti-inflammatory drugs (NSAIDs), the pattern of anti-bodies AVCAgp125+/VCAp19+/EBNA-1+/p22+/EA-D-prevailed. High-titer antibodies to VCAgp125 were found in all patients with rhinosinusitis and 62.5% with asthma. In atopic asthma, antibody profiles uncharacteristic of NSAID hypersensitivity were detected in 40.2% of cases.Conclusion. Bronchial asthma and rhinosinusitis associated with NSAID intolerance develop against the background of chronic EBV infection (IVEB) and have a similar spectrum of IgG antiviral antibodies. The type of immune response to EBV proteins in allergic and NSAID-induced variants of bronchial asthma is different.

Determination of perfusion of tissues of the lower extremities using radioisotope research is a promising diagnostic method that allows us to assess the state of blood flow in large and mediumsized vessels, arterioles and capillaries of the feet, shins, as well as to detect violations of venous outflow.Purpose. To evaluate the effectiveness of treatment in patients with a neuroischemic form of diabetic foot by lower limb scintigraphy.Material and methods. We analyzed 28 patients with neuroischemic form of diabetic foot by lower limb scintigraphy.Results. Comparative analysis of scintigrams showed an asymmetric pattern in the accumulation of the radiopharmaceutical in the symmetrical muscles of the lower extremities towards a decrease in the accumulation in the lower extremity with trophic ulcers. Before treatment, the quantitative indicator of impulses from the muscles of the affected leg was 446±31.3, from the healthy leg -1082±37.1. After treatment, the number of impulses from the affected and healthy limb averaged 610±32.8 and 1147±35.4, respectively. The number of impulses in the course of treatment in the affected limb increased by an average of 195±34.1, and in the healthy one by 81±29.6. The indicator of the number of RP pulses from the affected limb before treatment was significantly lower than after treatment (U = 0, p <0.001).Conclusions. Conducting radionuclide diagnostics of the lower extremities in dynamics using the radiopharmaceutical Pirfotech99mTc in patients with diabetic foot syndrome can help to evaluate the effectiveness of conservative treatment. Further research in this area is promising and will reveal the potential of this research method.

One of the directions in the search for new safe biologically active compounds is the chemical modification of natural compounds. Such an object for the development of new and improvement of known synthesis methods is natural methylxanthine, which possesses a wide range of pharmacological activity.The aim of this research is synthesis and study of the antiaggregatory, anticoagulation and antioxidant activities of 2-[(1-isobutyl-3-methyl-7-(1,1-dioxothietanyl-3)xanthine-8-yl)thio]acetic acid salts. Material and methods. The melting point of the obtained substances was measured by the capillary method on a «SMP 30» apparatus, IR spectra were recorded by an «Infralum FT-02» spectrophotometer. The 1H, 13C NMR spectra were recorded on «Bruker AM-300» or«Bruker AV-500» instruments. Deuterated chloroform or dimethyl sulfoxide were used as solvents, the residual solvent signals were used as the internal standards. The study of antiaggregatory activity was carried out on an aggregometer «AT-02», anticoagulation activity - «SolarCGL 2110». Chemiluminescence indicators for the study of antioxidant activity were recorded on the «KhLM-003» device. Results. 8-Bromo-1-isobutyl-3-methyl-7-(1,1-dioxidothietanyl-3)xanthine (II) was synthesized by oxidation of thietanecontaining 8-bromo-1-isobutyl-3-methylxanthine (I) with potassium permanganate. 2-((1-Isobutyl-3-methylxanthin-8-yl)thio)acetic acid containing dioxothietane ring (III) was synthesized with yield of 91% by reaction of nucleophilic substitution of compound II with thioglycolic acid. The salts of 2-[(1-isobutyl-3-methyl-7-(1,1-dioxidothietanyl-3)xanthin-8-yl)thio]acetic acid (IV) were obtained by reaction of acid III with different bases. The structure of synthesized compounds was confirmed by IR, 1Н and 13С NMR spectroscopy. The antiaggregatory, anticoagulation and antioxidant activities of the synthesized compounds were studied.Conclusions. A preparative method of synthesis has been developed for the previously undescribed salts of 2-[(1-isobutyl-3- methyl-7-(1,1-dioxothietanyl-3) xanthine-8-yl)thio]acetic acid. It has been established that the synthesized compounds exhibit antioxidant and antiplatelet activities that exceed indicators of some comparison drugs.

Depression is a widespread disease throughout the world. Currently existing methods of pharmacotherapy are effective only in30-40% of patients, which makes the search for new effective and safe drugs with antidepressant activity relevant [10]. In our earlier studies, we have found compounds from a number of 1- (thietanyl-3) imidazole derivatives exhibiting antidepressant activity [13]. Compound I (dipotassium salt of 2-bromo-1- (thietanyl-3) imidazole-4,5-dicarboxylic acid) has low toxicity and exhibits pronounced antidepressant properties, which characterizes this molecule as promising for further indepth study.Медицинский вестник Башкортостана. Том 16, № 1 (91), 202153Therefore , the aim of this work was to study the mechanism of action of compound I in tests of neuropharmacological interaction.Research methods. To assess the effect of 1- (thietanyl-3) imidazole derivative on dopaminergic and / or noradrenergic neurotransmission, tests of apomorphine hypothermia and haloperidol catalepsy were used. The ability of the studied compound to alter serotonergic neurotransmission was studied in the 5-hydroxytryptophan (5-OTP) hyperkinesis test, and in the L-DOPA test, the ability of compound I to inhibit the activity of monoamine oxidase was assessed.The results of the studies showed that when administered to non-inbred male mice, compound I (2 and 14 mg / kg once intraperitoneally) aggravated apomorphic hypothermia, reduced the severity of haloperidol catalepsy and 5-OTP-induced hyperkinesis and did not affect the effect of low doses of L-DOPA.Сonclusion. Thus, the antidepressant-like effect of compound I is possibly associated with the activation of dopaminergic and suppression of serotonergic neurotransmissions, but not with the effect on the activity of monoamine oxidase.

The aim: to describe the macromicroscopic anatomy and microtopography of a thyroid gland in the interim fetal period of onto- genesis. Material and methods: the research material includes 35 organocomplexes of fetal necks of both sexes from 19th to 22nd weeks of fetal development.Results. According to the study anteriorly from the thyroid gland there is loose connective tissue, which is thickest in the area of the right and left lobes. The thickness of connective tissue of the posterior surface of the lobes and the esophagus is bilaterally dif-ferent, due to the deviation of the cervical part of the esophagus to the left. The right and the left lobes of the thyroid gland are ap-proximately equidistant form the body of the cervical vertebra - 2,32±0,29 mm and 2.27±0.31 mm, respectively. The thyroid capsule is thickest in the isthmus area and equals 40,10 (25,10-40,00) mcm. In the abovementioned period of ontogenesis there is a pattern of follicle distribution in the thyroid parenchyma: the larger ones are located peripherally, the smaller ones are concentrated in the center of the lobes and the isthmus.Conclusion. The study allowed us to obtain new data on the macro- and microscopic structure of the thyroid gland in the intermediate fetal period of ontogenesis.

The aim of the work is to present the main criteria for determining the management tactics of patients with a new coronavirus infection COVID-19.Material and methods. The results of clinical and laboratory examination and data on complex therapy of 52 patients with mod-erate and severe forms of new coronavirus infection are presented.Results. We have studied the main clinical and laboratory manifestations of COVID-19 (dry cough, shortness of breath, decrease in SpO2, increase in the level of CRP, D-dimer, and volume of lung tissue damage (CT 1-4)) in the dynamics of the disease and justified their significance as criteria for assessing the severity, stage of a new coronavirus infection, and severity of hyperinflammation syndrome. The tolerability and effectiveness of the main components of complex therapy in the studied patients with a new coronavirus infection were evaluated and the leading prognostic role of pathogenetically based immunosuppressive and anticoagulant therapy was confirmed.Conclusions. The severity of clinical and laboratory symptoms of COVID-19 depends on the severity of the disease. Proactive anti-inflammatory and anticoagulant therapy is crucial in the complex treatment of patients with a new coronavirus infection.

The pandemic of the new coronavirus infection COVID-19 is a challenge for the health systems worldwide. To adequately address the progressing challenges at each step of the epidemic, the healthcare managers have to plan resources accordingly. Thus, it is important to provide decision makers with a timely COVID-19 epidemic forecast. This article provides an overview of the classical epidemiological models and time-series analysis models for predicting the development of the COVID-19 pandemic in the world. On the example of data on the spread of a new coronavirus infection in the Republic of Bashkortostan, SIRD and ARIMA models were build. Short-term forecasts (10 days ahead) of new cases of COVID-19 were received, as well as forecasts of recoveries. The obtained forecasting results indicate the relative accuracy of the modeled predictions: the average absolute percentage error for 10 days of forecasting infections in the Republic of Bashkortostan according to the SIRD model was 5.28%, according to the ARIMA model - 4.65%, and for cases of recovery according to the SIRD model - 15%.

This review contains information on the SARS-CoV-2 virus, its resistance to environmental factors, the gateway for the pathogen to enter the human body, the mechanisms and routes of transmission, age groups at risk of developing various forms of new coronavirus infection, and the epidemiological significance of various categories of sources of infection, which ensure the activity of the first link of the epidemic process, the principles of selection and rational use of personal protective equipment in conditions of the epidemiological risk of the spread of the new coronavirus infection COVID-19. This information indicates the need for integrated interactions of various areas of scientific research, giving objectification of the development processes of the incidence of the new coronavirus infection COVID-19. The results of scientific research in a complex epidemiological situation are of a pronounced applied nature, which ensures the formation and optimization of the epidemiological surveillance system for the new coronavirus infection and determines the vector of studying a wide range of issues related to ensuring the epidemiological safety of the population. It is concluded that it is necessary to continue multidirectional research in order to solve multiple applied questions that ensure the optimization of the epidemiological surveillance system in all subsystems and determine the vector of effective management of the epidemic process.

The article presents the organization of advanced training for doctors and pharmacists on the basis of the Institute of Continuing Professional Education of the Federal State Budgetary Educational Institution of Higher Education «Bashkir State Medical University» of the Russian Ministry of Health in the context of the spread of the new coronavirus infection COVID-19.Changes in the organization of the educational process provide, if possible, a transition to distance educational technologies andelearning, online control of knowledge and available practical skills. Considering that many of the skills required in the professional activity of a doctor cannot be practiced online, the transition to a remote training format requires the development of a new teaching design, an optimal balance between distance and face-to-face training. Full-time practical classes are conducted on the basis of simulation centers, clinical bases, taking into account antiepidemic requirements.Additionally, programs have been developed for the diagnosis, treatment and prevention of new coronavirus infection. According to these programs, 115 cycles were carried out, 15,237 specialists from 83 regions of the Russian Federation were trained. Programs are being implemented for school medical inspectors, for people with non-medical education, including medical inspectors - employees of enterprises and organizations of the Republic of Bashkortostan who monitor compliance with sanitary and epidemiological requirements.

An analysis of the clinical and laboratory data of 790 patients with a new coronavirus infection was carried out at the Clinic of the Bashkir State Medical University from April to July 2020. No significant differences in age and gender were found. Concomitant pathology was detected in 400 patients (50.63%). More than 50% of patients were overweight and had associated diseases. There were 758 (96.0%) discharged patients with improvement and 32 (4.0%) deaths. The average length of hospitalization was12.4 days. Treatment with invasive ventilation was given to 66 patients. All patients underwent a general blood test, analysis of biochemical parameters and hemostasis system. Serum iron levels are reduced in all patients. All patients showed a high level of C-reactive protein, and in those who did not survive, the level of CRP was higher than in those who survived, which correlates with the severity of the course. The LDH level was high in all groups of patients. In the group of patients who did not survive and on mechanical ventilation, hypercoagulation was more pronounced. Mortality in obese patients was 5.8% versus 3.4% without obesity.

Timely and highquality surgical care is an extremely important task in the conditions of pandemic.Objective. To analyze the results of surgical treatment of patients against the background of a new coronavirus infection.Material and methods. This article presents the experience of treating patients with a new coronavirus infection who received surgical treatment in the Infectious Diseases Hospital based at City clinical hospital No. 8 in Ufa for the period 12.04. - 18.11. 2020.Results. According to the results of the analysis, it was found that acute surgical pathology among patients with new coronavirus infection occurs equally in both men and women. In most cases, the percentage of lung tissue damage during the most pronounced clinical manifestations is between 25 and 50%. The moderate course (gravity) of the disease prevails (89.4 %) and the severity of the manifestation is agedependent. The average duration of postoperative treatment is 12.2 bed days. The fatal outcomes occurred in 27 (28.4%) patients. Among the fatal cases, hypertension (12.6%) is more common. Repeated surgical interventions were performed on 6 (6.3%) patients.Conclusions. Chronic diseases tend to worsen the gravity of the disease. In the presence of surgical pathology timely surgicaltreatment significantly improves the prognosis.

The COVID-19 pandemic is affecting all healthcare industries. In frequency, significant difficulties in the field of oncology and gynecological oncology are associated with both restrictive measures and the course of malignant neoplasms in patients with COVID-19. The relevance of oncogynecological diseases is beyond doubt. More than 50,000 patients with gynecological cancers are diagnosed in the Russian Federation annually. Aggressive course, a tendency to early generalization force to take measures to treat these patients as early as possible. According to the recommendations of various national communities, both surgeons and oncologists, it follows that it is necessary to minimize the amount of surgical treatment, wherever it is possible to replace it with alternative methods of treatment, such as chemotherapy, radiation therapy. Of course, it will be possible to evaluate the results of this approach in a few years. Time is needed to form statistical reports under COVID-19 pandemic. In our work, we provide data on the recommendations and approaches to the treatment of gynecological cancer in the context of the COVID-19 pandemic according to the opinion of foreign medical communities.

The article presents the results of the study of the attitude of medical workers to the advertisement of over-the-counter medicines in the Kyrgyz Republic (KR).The aim of the study is to analyze the attitude of specialists (medical and pharmaceutical workers) to the advertising of over-the-counter medicines.Material and methods. The documents of the Department of Drug Supply and Medical Equipment of the Ministry of Health of the Kyrgyz Republic, questionnaires of the sociological survey of medical and pharmaceutical workers (232 questionnaires) were studied. The results of content analysis, sociological survey, logical, graphical and statistical analysis based on the calculation in Microsoft Office Excel 2007 were evaluated. The analysis was carried out on the basis of a sociological survey using a questionnaire of doctors and pharmaceutical workers in urban and rural areas.Results. The features of advertising of medicines are revealed, which consist in the specificity of objects related to medicine and health, as well as state regulation. The differences and similarities in the attitude of medical and pharmaceutical workers to the advertising of over-the-counter medicines are determined.Conclusions. Doctors believe that advertising of over-the-counter drugs is a source of unjustified purchase and "lobbying" the interests of the drug manufacturer. Pharmaceutical workers assign advertisement a key role in the promotion of medicines and note that the main source of information about over-the-counter drugs should be instructions for use and recommendations of a specialist.

Given the wide prevalence of Epstein-Barr virus (EBV) infection and the ability of the virus to infect nasopharyngeal cells, the goal was to determine the role of EBV investigate the expression of EBV proteins in the tissues of nasal polyps in nonallergic polypous rhinosinusitis (NAPR).Material and methods. A study of 20 nasal polyps obtained during polypectomy in patients with intolerance to nonsteroidal antiinflammatory drugs (NSAIDs) was conducted. The expression of Epstein-Barr virus proteins was evaluated by immunohistochemistry. Statistical assessment was conducted using basic software package «Microsoft Excel 2007», «Statistica 6.0».Results. Specific EBV proteins were found in all the studied nasal polyps. LMP 1-protein was detected in 76% of polyps, most epithelial cells did not express this protein. The PE2 protein was expressed in many epithelial cells (in 80% of cases) and inflammatory cells (in 64% of cases). The EBI3 protein was detected mainly in the cytoplasm of lymphocytes (in 65% of cases).Conclusion: In NAPR, the leading is the inflammatory endotype of polyps with a predominance of the fibroedematous component. In the cells of nasal polyps with NSAID-induced pathology, EBV proteins are expressed in 100% of cases. LMP1 and BI3 proteins are detected mainly in inflammatory cells, while PE2 protein is detected in epithelial and stromal cells.

Purpose of the study. To assess the clinical significance of transcranial triplex scanning (TTS) of the vessels of the Willis circle in patients with serous meningitis during the period of convalescence.Material and methods. 32 patients were examined. 22 patients with serous enteroviral meningitis during the period of convalescence and 10 patients in the control group. Patients with serous meningitis in the acute period in the first 10 days of hospitalization were assessed for the strength of headaches using a visual analogue 10-point scale. On the day of discharge from the hospital, a neurological examination was performed. After the end of hospitalization, the patients were prescribed TTS of the vessels of the Willis circle with an assessment of the velocity parameters and the resistance index (Pi) of the cerebral arteries.Results. Analysis of TTS indices of cerebral vessels in patients with serous meningitis during the period of convalescence revealed significant (in 100% of the subjects) deviations of hemodynamic indices in the arteries of the Willis circle and veins of Rosenthal.Conclusions. Transcranial triplex scanning of cerebral vessels in patients with serous meningitis is clinically significant during the period of convalescence and makes it possible to assess the dynamics of functional disorders in these neuroinfections.

The work carried out a retrospective analysis of the surgical treatment of twelve girls with gastric bezoar and one case of intestinal bezoar treated at the Republican Children's Clinical Hospital from 2000 to 2020. The girls ranged in age from 4 to 13. The authors note the difficulties of diagnosis associated with the absence of specific symptoms. At early stages, the clinical picture of the disease was manifested by dyspeptic disorders, general weakness, lack of appetite, weight loss, nausea, vomiting, pain in the epigastric region after eating. Palpable formation in the epigastrium is a late symptom. Clinically, bezoar of the small intestine is realized in the form of intestinal obstruction.For the early diagnosis of gastrointestinal bezoars in children, we consider it necessary to include children with dyspeptic disorders and «bad habits» (chewing, biting off the ends of their hair) in the risk group for the occurrence of bezoars for monitoring this condition.

The types of self-inflicted eye injuries involve eye socket injuries, including damage to the eyeball and various periorbital injuries. Predisposing factors to self-inflicted injury are often mental illness and drug abuse. The article presents two cases of selfinflicted injury in young drug addicted men. The first patient hit himself in the eye with a ballpoint pen. The foreign body removed a week later represented a fragment of a pen 12 cm long and 7 mm in diameter. The injury did not have a fundamental effect on the visual acuity and the general somatic state of the patient. Knife orbitocranial self-inflicted injury, received by the second victim, led to the development of subatrophy of the damaged eyeball, atrophy of the optic nerve of the paired eye. The management of these patients requires a multidisciplinary approach.

The article describes a case of Castleman disease in the maxillofacial region in a woman aged 51 years. A tumor-like formation of the lateral surface of the right neck without significant anxiety grew over 18 years. A histological examination of a distant neoplasm after a surgical operation made it possible to diagnose a rare pathologyangiofollicular hyperplasia of the lymph node. Angiofollicular lymph node hyperplasia was first described by Benjamin Castleman in 1954, when solitary mediastinal lymph node hyperplasia was discovered in a patient [3].E.K. Egorova claims that Castleman disease must be divided into local and generalized (multicentric) [1]. With local Castleman disease, 3 morphological variants should be distinguished: hyaline-vascular, plazma-cellular and mixed-cellular. According to her, hyaline-vascular variant is found in 48,7% of patients, plazma-cellular - in 23,7% and mixed-cellular - in 27,6%.Manifestation of Castleman disease on the face or neck is a red flag for cancer alert.

The problem of comorbidity - the coexistence in one patient of two or more diseases related to each other by common links of pathogenesis and coinciding in timeis becoming increasingly relevant in community-acquired pneumonia (CAP). The presence of comorbidity significantly worsens the prognosis and increases the mortality rate in CAP up to 15-30%. Comorbid disorders of carbohydrate metabolism, metabolic syndrome (MS) and type 2 diabetes mellitus (DM) have a significant mutually aggravating effect on the development and severity of the course of CAP. In our opinion, it is advisable to separate such patients into a particular and at the same time very common phenotype of CAP with a high incidence, a more severe course and a risk of fatal outcome both directly from CAP and from various other causes in the period of convalescence. The key points are priority vaccination, early diagnosis and intensive care, taking into account comorbidity in MS and type 2 diabetes.

The purpose of this publication is to review and systematize the literature data on the development of modern ideas about atopic dermatitis (AD) in childhood. Molecular studies contributed to the creation of a new concept of the pathogenesis of AD, which includes a triad of leading mechanisms: genetic predisposition to atopy, violations of the integrity of the epidermal barrier and a cascade of immune reactions that implement allergic inflammation in the skin. At the initial stage atopy manifests itself at the level of immune changes and connection with certain genetic markers - today localization of genes responsible for the development of allergy on 1, 3, 4, 5, 6, 11, 12, 13, 14, 16, 17, 19, 21 chromosomes are established.The effect of a mutation of the filaggrin structural protein gene on the severity of blood pressure was revealed, and a deficiency of the main lipid components of the skin barrier was established. The most significant cytokines in the pathogenesis of AD are: : IL-2, IL-4, IL-5, IL-8, IL-10, IL-13, IL-17, IL-23, IL-29, IL-31, IFN-γ, TNF-α. Recent studies of the local immune response of the skin indicate the importance of IL-4, IL-5, IL-9 and Il-13 in the development of a skin allergic reaction.The modern view considers a violation of microflora resistance of the skin and intestine to be one of the factors that negativelyaffects AD course.Conclusion. A study of immune response in the target organ of inflammation-the skin and peripheral blood using modern molecular genetic techniques and the study of the relationship of disorders of the skin microbiome and intestines with local and systemic immunity in torpid course AD is an actual problem of modern medicine. An active search for biomarkers of inflammation can be used for diagnosis and determination of AD severity.

Prostate cancer is the most commonly diagnosed cancer among men in the Russian Federation, as well as in the United States and most Western countries. At an appointment with an oncologist, a man reports the presence of cancer in a firstdegree relative (father, brother, son), which indicates of family history as the only established risk factor for the disease, which is important in cancer screening. Familial aggregation of prostate cancer is considered a marker of genetic predisposition to the development of the disease. It is a clinically and genetically heterogeneous disease with hereditary factors accounting for about 40-50% of cases, including both rare gene variants and frequent genetic variants. To date, international guidelines have prescribed criteria for testing for mutations in the BRCA1 / 2 genes for men with prostate cancer. Genetic research allows the identification of germline mutations in patients with prostate cancer, which makes it possible to determine the role of heredity in the development of the disease. Genetic testing for hereditary cancers is needed to create personalized approaches to screening and treating prostate cancer.

The article analyzes 197 sources of domestic and foreign literature over the past twenty years, of which domestic made up70.6%, foreign - 29.4%. All publications were divided into four groups with a fiveyear interval. The article analyzes publications concerning individual anatomical structures of the nose: the walls of the nasal cavity, nasal conchae, nasal septum, vascular system, nasal mucosa, innervation of the nasal cavity, as well as works on the paranasal sinuses and methods of their research, anomalies of the development of the nasal cavity.The analysis of the literature data allows us to state the presence of a steady interest of morphologists and ORT specialists to the study of the nasal cavity and paranasal sinuses. A significant number of publications are devoted to the study of the human nasal cavity using methods of vital visualizations: in the prenatal period of ontogenesis - ultrasound imaging, in the postnatal period - radiation methods of research. At the same time, the number of works devoted to prenatal ontogenesis and the structure of the nasalcavity over the past twenty years is about 15%. The study revealed the need for of further study of the macro-microscopic anatomy of the nasal cavity of human fetuses both from the theoretical and practical points of view for the development of fetal surgery of the nose and nasal cavity.