Purpose. Creation of a predictive model for calculating the effectiveness of endoscopic correction of vesicoureteral reflux by binary logistic regression.Materials and methods. The study included 150 children (240 renal units) aged 1 month to 7 years who underwent endoscopiccorrection of vesicoureteral reflux. As possible success predictors were evaluated reflux grade, ureteral diameter ratio, time of reflux at cystourethrography, the dilatation of the renal pelvis and ureter according to ultrasound.Results. Statistically significant differences were found in predicting the outcome of endoscopic correction of vesicoureteral reflux according to the selected prognostic parameters (p<0.001). To assess the diagnostic significance of predictors in predicting the outcome, the method of analyzing ROC curves was used. A predictive model was developed to determine the probability of the results of three attempts at endoscopic correction, depending on the selected predictors by binary logistic regression. The sensitivity and specificity of the models was over 90%. The resulting models are combined into a predictive calculator, where you can enter variables and generate an individual treatment outcome prediction.Conclusion. The resulting computational model is a potentially useful clinical tool in the choice of treatment for vesicoureteralreflux.

The aim of the work is to assess the frequency of allelic variants of renin-angiotensin system genes in moderately and extremely premature newborns.Material and methods. A prospective, controlled, single-center, non-randomized study was conducted. Genomic DNA sampleswere studied in newborns with extremely low body weight (ELBW) and gestational age <32 weeks (n=95), moderately premature newborns with gestational age >28 but < 34 weeks (n=105), as well as a population sample of adults (n=100). The following genes were selected for analysis: AGT (rs4762), AGTR1 (rs5186), ACE (Ins\\Del).Results. The distribution of frequencies of alleles and genotypes between the studied groups of individuals was compared.Conclusion. Newborns with both extremely low body weight and moderately premature infants are significantly more likely, unlike the adult population, to be carriers of the allele with the AGT gene.

Purpose: to study the dynamics of thalamus parameters in mesocephalic men and women in the interval from the first period of adulthood to senile age.Material and methods. The results of magnetic resonance imaging of the thalamuses of 197 people were analyzed. The transverse, longitudinal and vertical dimensions of the thalamus in both hemispheres were determined.Results and discussion. The tendency to the predominance of all thalamus sizes in men in comparison with women was revealed. The tendency of the prevalence of all sizes of the left thalamus over the right one in both sexes was established. In both men and women, the parameters of the longitudinal and transverse dimensions of the thalamus statistically significantly prevail in the first period of adulthood over the parameters in old age (p<0,01). When comparing the vertical size of the thalamus in the age aspect, a tendency to prevail in both sexes in the first period of adulthood over the other age periods was revealed.Conclusions. The results obtained allow specialists to better orient themselves when examining patients in the context of personalized medicine.

Purpose: to identify the features of hemodynamic disorders in women with atrophic form of chronic endometritis (CE).Material and methods. 86 patients took part, who were divided into two groups: group 1 - 44 patients with CE and hemodynamic disorders in the endometrium, group 2 - 42 patients with CE without impaired microcirculation in the endometrium. All patients underwent an ultrasound examination with Doppler scanning on the 7th (+1) day after ovulation and endometrial biopsy withfurther histological and immunohistochemical studies: the expression of VEGF, TGF-β, CD 138 markers was determined.Results and discussion. Thus, in patients with chronic atrophic endometritis with impaired microcirculation, sexually transmitted diseases and Asherman's syndrome were more often detected, cycle disorders such as algomenorrhea and hypomenorrhea, and intrauterine intrauterine interventions in anamnesis are typical.Conclusions. According to immunohistochemical studies in patients with hemodynamic disorders, the expression of VEGF is statistically reduced, the expression of TGF-β is increased.

Purpose: study of the course of a new coronavirus infection COVID-19 in patients with cardiovascular diseases.Material and methods: the course of the new coronavirus infection COVID-19 was studied against the background of cardiovascular diseases in 308 patients hospitalized in the hospital of particularly dangerous infections № 1 in Nalchik with a verified diagnosis. The age of patients is from 45 to 70 years. At admission, all patients underwent a basic electrocardiography in 12 leads, according to the indications, an echocardiographic examination of the heart. The patients were divided into 2 groups: group 1 (n=182) consisted of patients with cardiovascular diseases, group 2 - patients (n=126) without cardiovascular diseases.Results and discussion: analysis of the structure of cardiovascular diseases in COVID-19 patients showed that the most common pathology was arterial hypertension, which was registered in 93.4% of COVID-19 patients, in 2 place chronic heart failure (60,9%), in 3 place cardiac arrhythmias (40,1%). Ischemic heart disease was observed in 21,9% of patients. The study of the structure and frequency of cardiac arrhythmias in dynamics showed an increase in the prevalence of supraventricular extrasystoles among COVID-19 patients (10,4% initially and 14,3% in dynamics), ventricular extrasystoles by more than 2 times.Conclusions: a more severe course of COVID-19 was observed in patients with cardiovascular diseases: complications andmortality rates were significantly higher compared to the group of patients without cardiovascular diseases.

Aim of the study is identification of the main trends in the epidemic process of tuberculosis in the territory of the Republic ofBashkortostan.Materials and methods. For the epidemiological study of tuberculosis, the annual forms of federal statistical observation No. 8«Information on patients with active tuberculosis» and form No. 33 «Information on patients with tuberculosis» for 2005-2018, materials of the Electronic Epidemiological Atlas of the Volga Federal District (VFD) and FSBSI "Central Research Institute of Tuberculosis". The computer program Excel (Microsoft Software, USA) was used for statistical analysis.Results and conclusions. The results of a retrospective analysis of long-term (2005-2018) manifestations of the epidemic process of tuberculosis on the territory of the Republic of Bashkortostan (RB) are presented. In dynamics, а significant decrease in the incidence and prevalence of tuberculosis has been shown both among the population of the RB and among the rural and urban population. At the same time, a statistically significant (p <0.05) excess of the incidence rate among the urban population compared with those living in the village was determined. The highest incidence rates of active tuberculosis in the RB among adults were recorded in the group aged 35 to 44 years. In dynamics, the high intensity of the epidemic process persists among children 0-4 years old, adolescents 15-17 years old. In general, the prevalence of tuberculosis remains at a high level, which determines the high social and epidemiological significance of the infection.

Purpose: to study changes in the intraoperative OCT of the rabbits' cornea during experimental ultrasonic and traditional aspiration of cortex after phacoemulsification.Material and methods: experimental ultrasonic cortex aspiration with using intraoperative OCT on the right eyes of 15 rabbitswas performed (main group). Traditional irrigation-aspiration of cortex on the left eyes was performed (control group). Before the stage of cortex removal, all stages of phacoemulsification were performed in a conventional method with identical settings in both eyes of rabbits. During the stage of irrigation-aspiration of cortex the sealing of paracentesis, the gaping of the outer and inner edges of the paracentesis, and the presence of the Descemet's membrane detachment, signs of thermal damage to cornea using ultrasound were evaluated by intraoperative optical coherence tomography (OCT).Results and discussion: according to intraoperative OCT in both groups, paracentesis in all cases was sealed. In the corneal microarchitectonics in the area of paracentesis changes were found in both groups. The gaping of the inner edge of paracentesis before hydration was observed in 2 cases in the main group and in 4 cases in the control group. In control group, the gaping of the outer edge of paracentesis was founded in 1 case. These changes were eliminated after hydration of paracentesis. There were no signs of thermal damage to cornea caused by ultrasound.Conclusions: according to intraoperative optical coherence tomography, using of the system for ultrasonic cortex aspiration isaccompanied by a lower frequency of intraoperative corneal microarchitectonics in the area of paracentesis changes. Specific changes in the cornea structure associated with excessive exposure to ultrasound have not been registered.

Purpose: to investigate dynamic changes of humerus strength in streptozotocin-induced diabetic rats of different ages.Material and methods. 210 male rats were selected for the experiment and three age groups were formed as follows: infantile animals (aged 1 month, body weight - 45-50 g), juvenile (aged 3 months, body weight - 135-150 g), and of pre-senile age (aged 17-18 months, body weight - 290-310 g). Streptozotocin-induced diabetes was caused by a single intraperitoneal injection of strepto-zotocin in dosage 55 mg/kg (35 animals in each age group). The controls for each group were the intact animals (35 animals in each age group). Robustness testing was performed by means by means of three-point bending loading technique at a loading speed of 10µm per minute. Robustness features were calculated from resulting displacement curves. Results and discussion. Robustness of the humerus in streptozotocin-induced diabetic rats exhibited marked decrease mostly due to decrease of the values of ultimate stress, elasticity modulus, and fracture energy. This decrease grew with time in all age groups. In infantile diabetic rats the above mentioned values by the 90th day of the experiment were lower than those of the controls by 9,73%, 6,67%, and 9,28%. In juvenile diabetic rats these values decreased by 11,97%, 4,53%, and 10,59% and finally in presenile diabetic rats they decreased by 13,05%, 7,19% and 7,90%. Conclusions. Robustness of the humerus in streptozotocin-induced diabetic rats decreases due to decrease of ultimate stress, elasticity modulus, and fracture energy. In infantile rats robustness decrease was observed in the period from the 7th to the 90th day of observation yet beginning from the 60th day restoration signs appeared. In older animals, especially in presenile ones robustness decrease only grew with time.

Purpose: to study the chemical composition of anthocyanins and the lipophilic fraction of the fruits of Crataegus rivularis. Material and methods. The object of the study was the dried fruits of Crataegus rivularis, from which acidified alcohol extractsand lipophilic fractions were prepared. The studies were carried out using a Shimadzu UV-1800 spectrophotometer, a Shimadzu LCProminence chromatograph with a UV detector.Results and discussion. The fruits of Crataegus rivularis accumulate anthocyanins with a total content of 3,78±0,19%, the species composition of anthocyanins is typical for the apple subfamily and consists of various cyanidin glycosides. The content of lipophilic substances was 8,9±0,42%; the composition of the lipophilic fraction of fruits indicates the accumulation of carotenoids and lycopene.Conclusions. The conducted studies confirm the feasibility of further indepth pharmacognostic research of this type in order to introduce it into medical practice.

The purpose of the work is to establish the pharmacological activity of a multicomponent plant extract.Material and methods. The object of the study is an extract obtained from: flowers of Helichrysum arenarium L., fruits of Rosa sp., flowers of Tanacetum vulgare L., leaves of Urtica dioica L., leaves of Mentha piperita L., roots of Glycyrrhiza glabra L., in a ratio of 6:2:2:2:1:1. The extract standardized according to the sum of flavonoids in terms of isosalipurposide - the standard and the luteolin standard. Phenolic compounds are the dominant components in the resulting extract.The choleretic activity of the extract was studied in the previously established dose of 250 mg/kg per os on intact animals and on animals having experimental induced damages of gallbladder and hepatitis model in comparison with the preparation of Allochol. Results and conclusions. The multicomponent extract has a bile effect comparable to that of the comparison preparation. The pharmacotherapeutic effect of the extract is associated with the presence of biologically active phenolic substances. Thus, the multicomponent extract is a promising object for creating a medicinal plant agent of choleretic effect based on it.

Purpose: analysis of the assortment of antihistamines for systemic application used for allergic diseases in pharmacy organizations of the Central Federal District.Material and methods. Data from the State Register of Medicines, price lists of distribution companies, pharmacy organizations. In the course of the work, structural, systemic and comparative methods of analysis were applied.Results and discussion. It has been established that the number of analyzed medicines is much lower than in the State Registerof Medicines (μ = 89 vs 215); solid dosage forms are dominant, the bulk of which are tablets (μ = 74,3 %); medicines in the price segment from 100 to 500 rubles are in greatest demand (μ =61,8%), more than 50% of regional markets are provided by domestic enterprises.Conclusions. In the studied regions, all pharmacotherapeutic groups of medicines and almost all dosage forms are present, however, a low depth coefficient (0,4) indicates that many drugs that are registered are not available in pharmacies due to reduced demand due to high cost, side effects or absence in the price lists of firms.

The purpose of the study: to determine the possibility of applying this approach in the treatment of destructive forms of acute pyelonephritis.Material and methods: The article presents the experience of treating patient K. 18 years old, with a diagnosis of destructive pyelonephritis on the right on the basis of the Department of Urology No. 2 of the Regional Clinical Hospital (Barnaul), in the period from 25.12.21. to 09.01.22 An analysis of the state of renal function was carried out using multispiral computed tomography (MSCT) with bolus contrast before surgery and in the postoperative period with an assessment of laboratory data, duplex of kidney vessels, morphological examination of the material. Minimally invasive organpreserving surgery was performed in the volume of retroperitoneoscopic sanitation of foci of kidney destruction with drainage of the retroperitoneal space and drug correction of kidney circulation by endovascular access.Results: When conducting MSCT of the kidney with contrast, a significant role of tissue perfusion in the pathogenesis of destructive acute pyelonephritis is determined. Within the framework of the early postoperative period, there was a significant positive trend in MSCT. Morphological examination revealed signs of edema and leukocyte infiltration with an admixture of macrophages, dilated peritubular capillaries, in the lumen of which platelet aggregates were observed, completely filling the lumen.Conclusions: Preservation of the kidney, as well as complete restoration of lost renal function, indicates the feasibility of using a similar approach in this category of patients.

Acute mesenteric ischemia (AMI) remains a complex, difficult-to-diagnose disease in abdominal surgery with high mortality. The mortality rate reaches up to 80%.Purpose: based on the review of the world literature, to analyze the issues of AMI diagnostics at the present time.Material and methods. A review of foreign literature (42 sources) from the PubMed database has been carried out.Results and discussion. The most informative methods of diagnosing AMI are computed tomography (CT) with bolus contrast, CT angiography, angiography, which allow you to assess the state of the intestine and determine the etiology of AMI.Conclusions. The review shows that accurate preoperative diagnostics can reduce mortality and determine therapeutic tactics.Diagnostic measures should begin with computed tomography in patients with slowly progressive mesenteric ischemia.

The pace of modern life emphasizes the choice of solving several tasks in the shortest possible time. Simultaneous surgical interventions on the anterior abdominal wall can achieve the solution of a complex of problems in one operation.Purpose: a comparative analysis of scientific literature, surgical approaches to the treatment of aesthetic and functional deformities in the anterior abdominal wall, namely skin-fat excess, diastasis of rectus abdominis muscles, ventral hernias.Material and methods. Data from the world scientific literature covering current aspects of hernio-and abdominoplasty, advantages and disadvantages of isolated and simultaneous operations in the anterior abdominal wall, important surgical moments of surgical interventions performed.Results and discussion. Performing hernioplasty with simultaneous abdominoplasty opens up the opportunity to solve not only functional, but also aesthetic issues.Conclusions. An individual approach and knowledge of the leading surgical techniques used by advanced specialists allows us to apply the most highly effective and safe methods, get a number of technical advantages, reduce the percentage of dissatisfactionwith the results of surgical treatment and minimize complications.

The problem of treating ulcerative gastroduodenal bleeding remains relevant at the present time. Improvement of existing and development of new methods of endoscopic hemostasis, advances in pharmacotherapy, introduction of X-ray endovascular methods for stopping bleeding expand the surgeon's capabilities when choosing a therapeutic tactic, but, despite this, mortality remains high. This is largely due to the lack of clear endoscopic criteria allowing to differentiate acute symptomatic ulcers and peptic ulcer disease, the optimal treatment algorithm depending on the type of ulcerative lesion, the lack of optimal integral scales for predicting recurrent bleeding, unified management tactics for patients with recurrent bleeding or unsuccessful attempts at endoscopic hemostasis, as well as the lack of common views on the scope of surgical intervention in patients with gastroduodenal bleeding caused by gastric and duodenal ulcers of various etiology. The results of research from 67 Russian-language and foreign scientific sources have been discussed in this article. The literature review was carried out using a search in modern search databases PubMed, Сyberleninka, eLibrary according to sources published in the last 10 years with the mention of a number of significant previously published scientific articles.

One of the stages of treatment of urolithiasis is prevention and metaphylaxis. The removal of stones is a consequence of the disease and the high number of relapses is proof of this. Possible anatomical changes associated with urolithiasis may be - medullary spongy kidney, narrowing of the ureteropelvic junction (UPJ), the presence of a diverticulum or cyst of the kidney cup, ureteral stricture, horseshoe kidney, ureterocele, vesicoureteral reflux. To reduce recurrence, surgical correction is performed using transurethral, laparoscopic, percutaneous surgery. Endoscopic and laparoscopic surgical interventions can be attributed to the methods of metaphylaxis - carried out during the presence of the disease. The stricture of UPJ, as a factor associated with stone formation, should undoubtedly be eliminated and one of the most common manipulations - endoscopic correction of ureter stricture. Also, the most well-known operation of UPJ plastic surgery is the Andersen-Hines operation performed by open or laparoscopic access, as well as using robot-assisted technology. Another anatomical defect associated with urolithiasis is the ureterocele, which is corrected by endoscopic incision. Reconstructive plastic surgery on the ureter, urethra, removal of prostatic hyperplasia, removal of foreign bodies of the urinary system - this is a small list of surgical aids that are used to reduce the recurrence of urolithiasis.

Pelvic organ prolapse is an urgent problem in women of different age groups, the disease tends only to increase in prevalence, and the frequency of postoperative complications increases. The nature of the clinical course of the disease and the need for repeated surgical interventions significantly reduce women's quality of life. A possible solution to the problem may be the development of measures for the primary prevention of genital prolapse.Purpose: to conduct an analytical review of the data of domestic and foreign literature on the etiopathogenetic foundations of genital prolapse, its risk factors and the possibilities of influencing them in order to develop preventive measures.Material and methods. Analysis of foreign and domestic literature.Results and conclusions. According to many foreign and domestic authors, traumatic vaginal childbirth is the main risk factor for genital prolapse. Reducing birth injuries in women at high risk of genital prolapse may be a promising direction in the development of primary measures for the prevention of the disease.

One of the leading places in the structure of malignant diseases in Russia, as well as throughout the world, is occupied by cervical cancer (CC). The age of the patient, the stage of the tumor process before the start of treatment, the localization of the malignant process, the histotype of the tumor, previous therapy, all this must be taken into account when choosing a method of treating cervical cancer. Extended hysterectomy according to Wertheim-Meigs is the standard treatment for invasive cervical cancer stages IB-IIA. This surgical intervention is currently the most commonly used worldwide. Available oncological results comparable to the results of using chemoradiotherapy, which is an alternative to surgical treatment of early invasive cervical cancer. Since the majority of patients diagnosed with cervical cancer are of fertile age, sometimes with unrealized reproductive function, and radiation therapy will inevitably lead to irreversible radiation castration, surgical treatment is preferable, which, in the absence of risk factors for recurrence and metastasis, according to a pathomorphological study, will avoid radiation and chemotherapy in adjuvant treatment, and thereby reduce the risks of postradiation complications and depletion of ovarian tissue.Purpose: to review the literature on modern problems in the surgical treatment of cervical cancer.Material and methods. Russian and foreign literary sources devoted to various aspects in the surgical treatment of cervical cancer.Results and discussion. Extended extirpation of the uterus, or Wertheim's operation, is the standard treatment for invasive cervical cancer of IB-IIA stages. This method of surgical treatment is currently the most widespread and often used all over the world, but the question of the method of access to the abdominal cavity is still open.Conclusions. Today one of the priority areas in the development of oncogynecological diseases and surgical treatment of cervical cancer. Of undoubted interest is the problem of surgical treatment of cervical cancer in oncogynecology, at the indicated momentit is impossible to fully achieve minimally invasive intervention in the use of laparotomy from a possible surgical treatment.