The aim of this study is to improve the quality of care for patients with new coronavirus infection (CV-19). The main objective of the study is to study the characteristics of lesions of the gastrointestinal tract (g.t.) in CV-19.Materials and methods: 237 patients with CV-19 and gastrointestinal involvement were examined. Average age was 67.6±15.0,Me = 70.5; Q25-75 = 60.0-80.0, men - 61.1%, women - 38.9%. Mortality was 46.3% and depended on the age of the patients (age r=0.3; p = 0.003). Mathematical processing of the results was performed using the STATA12. 1 package of applied statistical programs. Statistical concepts were used: «mean value», «standard deviation», medians (Me) corresponding to the 10th and 90th percentiles (P10-P90), Pearson's χ2 criterion, t-criterion for unrelated groups. Statistical significance criterion the probability of a random error is less than 5% (P<0.05).Results. In patients with CV-19, in 70.0% of cases, the distal section from the dome of the cecum to the rectum is affected. Themain clinical manifestations of gastrointestinal lesions are bleeding - 87.5%, while no gross abnormalities in the coagulogram were revealed. The average age of patients with lesions of the upper sections (u.s.) 68.1±15.4 Me = 71.5; Q25-75 = 61.5 - 81.0, lower sections (l.s): 66.6±14.5, Me = 68.0; Q25-75 = 69.5-79.0. In terms of gender, men predominate in the void-72.2%, in the women -61.1%. Mortality in case of u.s. lesion. - 56.9%, l.s. - 25.0%.Conclusions. Questions about the damage to the digestive system in CV-19 remain poorly understood and require further research.

Purpose: to study the use of thulium fiber laser for transurethral enucleation of the prostate and cystolithotripsy in patients with benign prostatic hyperplasia and bladder stones. Material and methods: 32 patients aged 68,8 (54-79) were operated on, with prostate 95,9 (78-140) mm3 and bladder stones18,1 (10-30) mm.Results and discussion. The total operation time was on average 82,0 (43-148) minutes, the time of cystolithotripsy - 12,6 (3-28) minutes, enucleation with morcellation - 69,4 (40-120) minutes. Damage to the prostate capsule was observed in 2 (6,3%) cases, in 1 (3,1%) case - bladder mucosa, which did not require interrupting the operation. The duration of urethral drainage was 2,1 (1-5) days, uroflowmetry 1 month after surgery was 16,4 (10-21) ml/sec. The duration of hospitalization averaged 4,4 (2-8) days.Conclusions. Simultaneous thulium fiber laser cystolithotripsy and prostate enucleation is an effective and safe method of treating patients with benign prostatic hyperplasia and bladder stones.

Purpose: to reveal the dependence of the quality of life of patients with intestinal stoma, after using various methods of parastomal hernia repair.Material and methods. During the study, 27 patients with parastomal hernias were operated on, which were divided into 2groups: control group - 13 patients (hernia repair was performed from the local access with the installation of a mesh implant in the On-lay position); main group - 14 patients (plastic surgery was performed using video endoscopic technologies: Sugarbaker laparoscopic operation on 6 people, Pauli robotic operation on 8 people). After the operation, a questionnaire was conducted using the SF-36 quality of life questionnaire: at the 6th month and 18th month. In addition, the specific Carolinas Comfort Scale (CCS) questionnaire was used at 1 month after surgery, 6 months and 18 months.Results. 1 and 6 months after surgery, the indicators on all scales, including the total score, did not differ statistically in both groups.After 18 months, the patients of the main group show a significantly better quality of life. The final index of physical and mental components of health on the SF-36 scale in patients of the main group was better than in the control group (p=0.010, p=0.034).

Purpose: to determine the diagnostic significance of the indicators obtained during optical coherence tomography angiography(OCT-A) in the diagnosis and treatment of patients with macular edema (MЕ) due to the branch retinal vein occlusion (BRVO).Material and methods: 54 patients were examined and treated with a diagnosis of ME due to BRVO. We analyzed and described the quantitative changes that are detected using OCT and OCT-A before and after combined treatment, as well as a correlation analysis between functional indicators and indicators obtained using OCT and OCT-A before treatment.Results. During the treatment there was an insignificant decrease of vascular density in all areas under study in the deep vascular plexus (DVP) and superficial vascular plexus (SVP), as well as a decrease of density in the peripapillary plexus and a decrease the thickness of the retinal nerve fiber layer. In the correlation analysis a direct strong relationship was detected between the indicators of central retinal sensitivity and the total density in the DVP and SVP before the treatment.Conclusion. OCT-A is a highly informative method for diagnosing, monitoring and evaluating the effectiveness of the treatment of ME due to BRVO and can also be used for topographyoriented combined laser treatment.

Objective: to study the triterpene saponins of the herb Gynostemma pentaphyllum, introduced in the Republic of Bashkortostan, by the method of high-performance thin-layer chromatography.Material and methods: the object of the study was the herb of Gynostemma pentaphyllum, which is a dried aerial part: stemswith simple long-petiolate deeply palmately dissected leaves and small flowers in paniculate or racemose inflorescences. The studies were carried out by the method of high-performance thin-layer chromatography (HPTLC), which is based on obtaining chromatograms on a thin layer of sorbent with subsequent recording of «fingerprints» in the software. Results and conclusions: in the course of laboratory studies, optimal conditions were selected for conducting chromatographic analysis of alcoholic extracts of the herb. The results of a qualitative analysis of the gynostemma pentaphyllum raw materials by the HPTLC method showed the presence of triterpene saponins, of which ginsenosides and β-escin were identified, the latter was first established in the introduced raw material. It was also found that the dominant triterpene saponin in the analyzed samples was β-escin (Rf = 0,45), which has a dark orange fluorescence in ultraviolet light after staining with a specific reagent. The quantitative content of the dominant saponin in the herb of Gynostemma pentaphyllum was 0,317±0,011%.

Purpose. Comparative analysis of the content of biologically active substances of the flowers of Calendula officinalis L. growing in the Orenburg region.Material and methods. The quantitative content of biologically active substances (BAS) was assessed by the spectrophotometric method, by the method of acid-base titration and by the method of redox titration.Results. Comparative analysis of biologically active substances revealed the maximum content of the sum of flavonoids(1,61±0,16%) and ascorbic acid (1,18±0,05%) in the flowers of Calendula officinalis L. growing in the Asekeevsky district, the sum of organic acids (3,0±0,16%) - in the flowers of Calendula officinalis L. growing of Novosergievsky district, tannins (4,47±0,39%) - in the flowers of Calendula officinalis L. growing in Sharlyksky district.Conclusions. These results significantly exceed the content of biologically active substances in official raw materials, which makes it possible to consider the flowers of Cаlendula оfficinаlis L. growing in different areas of the Orenburg region as a potential source of flavonoids, tannins, organic acids, including ascorbic acid, and the studied areas can be considered as new territories for plant cultivation.

Postoperative complications in the treatment of genital prolapse in the form of pain syndrome and mucosal erosions when using mesh prostheses cause the development of alternative materials for the correction of genital prolapse.The aim of the study was to evaluate multipotent mesenchymal stem cells (MMSCs) in combination with a mesh prosthesis in vivo.Material and methods. 32 Sprague Dawley rats in the experiment were damaged by the posterior vaginal wall, followed by the use of MMSC in combination with a mesh prosthesis, and in the control group healing occurred only with the use of a mesh implant.Results and discussion. As a result of the experiment (on the 30th day) in the experimental group of rats after the use of MMSC, the restored vaginal mucosa of rats was quite intensively supplied with blood vessels, and on the 7th day the wound was epithelizedand granulation tissue was found under it. The use of MMSC led to complete epithelization of the wound and the formation of a structurally complete connective tissue plate of the mucous and submucosal membranes.Conclusion. The use of autologous multipotent mesenchymal stem cells in pelvic floor reconstruction can significantly improvethe results of reconstructive operations.

The aim of the study is to identify the features of the ultrastructural organization of the WAG/Rij rats retina.Material and methods. The retinas of WAG/Rij rats, which are an experimental model of retinitis pigmentosa, have been studied by electron microscopic methods from birth to maturity.Results and discussion. Certain patterns of structural changes in the retina have been established as the animals grow older. By the end of the 3rd week after birth, ultrastructural signs of dystrophic and destructive processes begin to be determined in the retinaof rats, which intensify with age and lead to retinal degeneration.Conclusion. The early manifestation of signs of pathomorphological changes makes it possible to recommend WAG/Rij rats for experiments not only at puberty, but also at a young age, when an attempt can be made to treat the retina to prevent the development of degenerative disease.

Purpose of the study - to determine the microbiological characteristics of asymptomatic bacteriuria in pregnant women living in the Far North.Objective of study - pregnant women, representatives of the indigenous population of the Far North.Results. The socio-demographic and natural-climatic factors contributing to the formation of asymptomatic bacteriuria in the inhabitants of the Far North have been determined. The most significant group of microorganisms for the development of asymptomatic bacteriuria in pregnant women, representatives of the indigenous population of the Far North, has been determined.Conclusions. The ethnic lifestyle of the indigenous population of the Far North of Russia, leading a nomadic lifestyle in the tundra, affects the reproductive sphere, the course and outcome of pregnancy of the aboriginal population, which suggests that urgent measures must be taken to comply with the requirements of the concept of «protection of motherhood and childhood» for specialized and more detailed monitoring of pregnancy among peoples of the Far North.The risk group for complications during pregnancy and childbirth includes representatives with a low social status, which is characterized by the absence of favorable living and climatic conditions, among which the level of diagnosis of asymptomatic bacteriuria is observed 3 times more often compared to representatives of other social groups.

Purpose: to compare the effectiveness of different methods of therapeutic gymnastics for primary schoolaged children with visual pathology with scoliosis.Material and methods. This study was conducted with the participation of 18 visually impaired children, with I-II-degree scoliosis, who were divided into 2 groups. Standard and improved methods of therapeutic gymnastics were used in the process of physical rehabilitation. Comprehensive morpho-functional examination was performed before the beginning of rehabilitation and after the completion of rehabilitation measures.Results and discussion. The application of therapeutic swimming in the method of therapeutic gymnastics promoted statistically significant improvement of all the studied indices: proper vital capacity of lungs, thorax excursion, power endurance of back mus- cles, abdominal muscles strength, podometrics and general physical efficiency.Conclusions. Thus, the dynamics of the studied parameters of the morphofunctional state of children with visual deprivationcombined with scoliosis testifies to the fact that the inclusion of swimming into the main part of the therapeutic gymnastics class has a more effective effect on the rehabilitation measures.

The most common and the most disabling rheumatoid disease in children is juvenile arthritis (JA), this multifactorial disease develops in children under the age of 16, as a result of interactions of genetic and environmental factors [1]. This disease is characterized by a progressive course, accompanied by a significant decrease in the quality of life of patients in childhood and in adulthood.It is important to search for genetic markers for predicting the effectiveness of the use of drugs, primarily methotrexate [1,2]. Methotrexate remains the drug of choice in patients with JA, despite the existence of a number of basic drugs. A large number of clinical studies demonstrate the efficacy, toxicity and resistance of methotrexate therapy, depending on its dose and form of administration. The study of the genotype of patients and the analysis of the correlation with the effectiveness of methotrexate therapy may contribute to the selection of the correct therapeutic dose of the drug.

Atrial myocardial infarction is currently one of the undeservedly neglected problems of cardiology. A search was conducted in the databases PubMed, Web of Science, eLibrary, Google Scholar of articles published since January 01, 1960, using the keywords: atrial infarction, acute ischemic atrial injury, atrial ischemia. Additional articles were obtained by viewing the literature lists previously included in the publication. There is practically no modern literature on this problem. Characteristic features of acute ischemic atrial damage are transmural myocardial damage due to the small thickness of the atrial wall, frequent occurrence of supraventricular rhythm disturbances. Currently, there are no reliable diagnostic criteria for atrial infarction. In some cases, electrocardiographic signs of atrial infarction outstrip the appearance of signs of ventricular myocardial ischemia and may be the only in vivo manifestation of acute ventricular myocardial infarction. Currently, there are no reliable diagnostic criteria for atrial infarction, but there are large and small electrocardiographic criteria for the diagnosis of this disease. In addition to electrocardiographic signs, there are ultrasound criteria for ischemic damage to the atrial myocardium in transesophageal echocardiography. Further study of the problem is needed to develop appropriate recommendations for its diagnosis and treatment.

This article includes a literature review on the ophthalmic manifestations of chronic myeloproliferative diseases. Currently data of prevalence and clinical manifestations of damage of the visual organ of this group of hemoblastoses are insufficient and inconsistent. The article describes some variants of ophthalmic disorders in different eye structures in the pathology of blood. Leukemic infiltrates, hemorrhages, ischemic and infectious lesions and changes during treatment are found in patients with hemoblastosis in the eye tissues. Hemorrhagic syndrome is a basis of the majority of the ophthalmic manifestations in this group of hemoblastoses. Сhoreoretinal pathology prevails in chronic myeloproliferative diseases. The main methods of diagnostics of pathologies of posterior segment of eye are optical coherence tomography and optical coherence tomography with angiography. Various chemotherapeutic agents used in the treatment of chronic myeloproliferative diseases can have side effects on the organ of vision. All patients with this pathology are recommended for ophthalmological examination.

Placenta accreta spectrum is a type of abnormal placentation associated with premature delivery, a high risk of bleeding and massive blood loss during childbirth. The article provides an overview of the modern literature on the problems of diagnosis and conservative surgical treatment of placenta accreta (PAS). Invasive placentation is associated with a high risk of massive blood loss during delivery. The main historical stages of the study of the problem are listed. The article describes the most likely risk factors for PAS, diagnostic criteria and discusses modern classifications. The role of immunecompetent cells in the implementation of pathological placentation, promising directions for studying their function at different degrees of PAS are considered. Various approaches to surgical hemostasis, tactics of delivery of patients with PAS are described.

The ongoing global COVID-19 pandemic requires continuous improvement of the system of prevention, detection, and treat- ment of this disease based on an in-depth study of the pathophysiological and pathogenetic features of SARS-CoV-2 infection.Purpose: to analyze the literature data on the clinical and pathogenetic features of the course of COVID-19, with the determination of the role of the gastrointestinal tract, intestinal permeability, and intestinal microbiome.Material and methods. Analysis of data from domestic and foreign literature, taking into account the existing clinical experience in the curation of COVID-19 patients.Results and conclusions. The importance of the intestinal microbiome in maintaining intestinal permeability, immunological coordination of the functional axes of the body against the background of COVID-19 has been established. The perspective of studies aimed at studying the epithelial permeability, the intestinal microbiome in combination with the analysis of the concentration ofproinflammatory cytokines and zonulin is emphasized. The necessity of using new models of early, including radiation, diagnostics of changes in target organs in the fight against COVID-19 is justified. Further analysis and application in the treatment of patients with COVID-19 require complex treatment regimens with the inclusion of drugs with cytoprotective and probiotic effects on the gastrointestinal tract.

The gastrointestinal tract is one of the most susceptible systems of the body to the SARS-CoV-2 virus. Typical gastroenterological complaints of patients, clinical and laboratory changes from the intestines, hepatopancreatobiliary system, increased activity of liver and pancreatic enzymes, especially in patients with a severe course of the disease are confirmation of changes on the part of the digestive system against the background of the debut and the expanded picture of COVID-19.Purpose: to present in the form of a lecture the results of an analytical review of the data of domestic and foreign literature devoted to the study of the features of the clinical and laboratory-instrumental course of COVID-19.Material and methods. A systematic analysis of domestic and foreign literature data based on our own experience in the examination and treatment of patients with COVID-19.Results and conclusions. The course of COVID-19 is characterized not only by signs of respiratory damage, but also by fairly pronounced symptoms from the gastrointestinal tract. The scientific substantiations of the need for new approaches are presented not only to the early comprehensive diagnosis, stratification of the risks of severe disease and its complications, but also to the treatment of COVID-19, prevention of its complications and Post-COVID-19 syndrome.