The aim of the study was to study the efficacy and safety of therapy, including omalizumab, in children with uncontrolled persistent moderate to severe asthma who received high doses of inhaled glucocorticosteroids (ICS).Material and methods. 29 children (mean age 10.4 [8.2; 12.7] years) with uncontrolled atopic bronchial asthma of moderate and severe degree against the background of the inclusion of the biological therapy drug omalizumab in the basic therapy. The study was conducted within 24 months from the moment the genetically engineered drug was included in the basic therapy with control points of observation: initially at the time of prescribing omalizumab therapy, after 4, 9, 12, 18 and 24 months from the start of treatment.Results. Against the background of treatment, indicators of control of symptoms of bronchial asthma improved: according to the c-AST test and AST test from 14.3 [11.5; 15.8] to 27.6 [26.3; 29.0] points; the use of shortаcting β2-agonists decreased by 24.3 times from 9.7 [8.7; 11.4] to 0.4 [0; 0.7] once/week; the number of severe exacerbations decreased from 2.6 [2.4; 3.7] per year to zero after 24 months of therapy; indicators of respiratory function improved to normal values, which ultimately made it possible to reduce the dose of inhaled glucocorticosteroids from high to low doses - from 945.5 [878.8; 1085] to 225.5 [174.8; 255.5] µg/day. Adverse effects on the introduction of a genetically engineered drug were not recorded.Conclusion. Long-term therapy with omalizumab in children with uncontrolled moderate to severe atopic bronchial asthma canimprove disease control and treatment efficacy.

Purpose: development of a software solution that identifies eye tumors on computed tomography (CT) images.Material and methods. The article provides an overview of the stages of developing a software solution that identifies eye tumors on CT scans. Comparison of the effectiveness of a radiologist and a software solution.Results and discussion. During the study, the stages of a software solution for the diagnosis of intraocular tumors on CT using the histogram comparison method were developed, the effectiveness of artificial intelligence was 62.5%, the doctor identified 8 CTimages with an eye tumor, the software solution revealed only 5.Conclusions. According to the results of the study, the shortcomings of the histogram method were revealed, which caused the low efficiency of the software solution in the diagnosis of eye tumors, compared with the effectiveness of the radiologist.

The purpose of the study: to identify the features of concomitant somatic pathology in ophthalmological patients aged over 60.Material and methods. Data analysis of 44928 outpatient medical records of patients receiving ophthalmological care was carried out.Results and discussion. Among all patients in the Arkhangelsk region who sought help from an ophthalmologist, more than 2/3 of patients older than 60 years have cardiovascular pathology. The most common nosological form is hypertension, which is notedin every second patient. The second most common is bronchial asthma, which occurs in almost every fifth patient. Allergic diseases and type 2 diabetes mellitus occur in 1/6 of patients. Coronary heart disease is most often found in patients with lens pathology.Acute myocardial infarction and coronary artery bypass grafting in the anamnesis, type 2 diabetes mellitus are more often observedin people with agerelated macular degeneration and diseases of the optic nerve.Conclusion. The identified comorbid diseases in patients with ophthalmological pathology over the age of 60 years should be taken into account when improving medical care.

Blood, being a functionally mobile system, is a reflection of all physiological processes occurring in the body. Any change in the chemical composition of the blood may indicate not only the occurrence and development of the disease, but also the lack of a certain trace element or vitamin. In this regard, the most relevant and important is the study of a number of biochemical blood parameters in diseases of the oral mucosa, especially in patients with oncological diseases of extraoral localization.Objective: to identify and analyze the indicators of biochemical blood analysis in patients with diseases of the oral mucosa against the background of extraoral oncopathology. Material and methods. To perform the study, a dental examination was carried out, including an assessment of the state of the oral mucosa, the red border of the lips, as well as periodontal tissues, the index of CFE, RMA, PI was determined. All the subjects underwent a biochemical blood test with further analysis.Results. The study revealed the predominance of certain types of dental diseases in patients against the background of extraoraloncopathology. According to the results of a biochemical blood test, changes characteristic of liver pathology were noted.Conclusions. The study revealed changes in the biochemical parameters of blood, characteristic of the pathological state of liver tissues.

In women of reproductive age, genital prolapse leads to dysfunction of the pelvic floor organs, which reduces their quality of life. To correct genital prolapse, the use of synthetic materials often leads to complications in the form of rejection and eruption of foreign implants.The purpose of the study in this article is to evaluate the effectiveness of the surgical method of treating rectocele in women of reproductive age using the pubic-rectal muscle.Material and methods. 2 groups of patients were under observation. All patients had a history of childbirth through the natural birth canal, medical abortions, curettage of the uterine cavity, birth trauma was noted. The effectiveness of the proposed surgicalmethod of rectocele treatment reflects the indicators of dynamic observation and the results of profilometry after surgery.The effectiveness of treatment was evaluated after 12 months.Results. The use of a surgical method for the treatment of rectocele with the use of pubic-rectal muscle in patients (group I) contributed to the exclusion of relapses of prolapse and prolapse of the posterior vaginal wall, unlike patients of group 2, who underwent typical levatoroplasty.Conclusion. The proposed method of rectocele correction with the use of the pubic-rectal muscle makes it possible to form a lasting therapeutic effect. This method is a reliable prevention of recurrence of rectal prolapse without the use of a mesh implant.

Purpose of the study: to identify the characteristics of female students' reproductive behavior, their awareness of modern methods of contraception and preferences in their use, the prevalence of gynecological pathology in the course of training at a medical university.Material and methods. The object of the study was 298 students I, III, VI th courses of Bashkir State Medical University. The subject of the study was reproductive behavior, their awareness of contraceptive methods and gynecological morbidity. The authorsconducted an anonymous questionnaire of female students using a questionnaire developed under the direction of E.V. Uvarova tocarry out preventive examinations of teenage girls. Statistical processing of the material was carried out using the Windows XP professional software system in the Microsoft Excel app.Results. The survey data testify to the lack of knowledge of university students about the prevention of gynecological morbidity andeffective contraception, which dictates the need for the introduction of optional training from the first year on family planning methods.

In the development, course and outcomes of acute intestinal infections, a significant role is played by the polymorphism of genes responsible for the induction of the synthesis of inflammatory molecules.Purpose of the work: to identify the features of the clinical picture depending on the polymorphism of the G1082A IL-10 gene and its effect on the induction of IL-10 synthesis.Material and methods. 108 people diagnosed with acute intestinal infection were studied. In the blood serum, the level of IL-10was determined using the test systems of «Vector-Best», Novosibirsk. Determination of the polymorphism of the G1082A IL-10 gene was carried out by PCR using primers of «Litekh» LLC (St. Petersburg). Genomic DNA was analyzed. Statistical data processing was carried out using electronic programs Microsoft Excel 2010, Statistica 6.0.Results. In all the subjects, the predominance of the dominant allele G of the G1082A locus of the IL-10 gene was found. At the same time, in patients with acute intestinal infection, who are owners of the hypoproductive allele A in the -AA1082 variant of the IL-10 gene, a significant decrease in the expression of interleukin 10 was noted, which affected the course of the gastrointestinal tract lesion syndrome.Conclusions. The presence of the IL-10 G1082A gene polymorphism, without affecting the risk of developing acute intestinal infections, affects the induction of IL-10 expression and the clinical picture of the disease.

An important task in the design of drugs for intranasal use is the choice of the type of dosage form and excipients. We settled on a soft medicinal formgel.Purpose: to select substances from all possible components of gels to create a dosage form with the ginkgo biloba phytocomplex and to study the possibility of creating gel structures that include the synthetic object nifedipine.Material and methods. Methods of molecular modeling and quantum chemistry involving elements of cluster analysis were used for theoretical research. For the confirmation experiment, the method of diffusion into a 2% agar gel with ferric oxide chlorideand the method of equilibrium dialysis through a semipermeable membrane. The selected active model is a well-known phytopreparation, obtained ginkgo biloba extract, as a dosage formgel.Results and discussion. The geometrical and electronic structure of 12 objects (in hydrate form and in vacuum) is characterized.Precision physico-chemical descriptors characterizing the affinity of all components of gels to each other are calculated: hydration heat, ionization potential, specific hydration, heat of formation, dipole moment, energy of the highest occupied molecular orbital, energy of the lower vacant molecular orbital, reactivity and stability indices (chemical rigidity and chemical potential).Conclusions. The theoretical search made it possible to reduce and concentrate the confirmatory experiment, which was traditionally performed using biopharmaceutical techniques in vitro, synthetic object nifedipine.

Purpose: the study of morphological and anatomical features and the determination of some numerical indicators for the flowers of Crataegus macracantha.Material and methods. The objects of the study were dried flowers of Crataegus macracantha. All studies were carried out according to the methods described in the State Pharmacopoeia XIV of the Russian Federation. Microscopic analysis was performed using an MVZ-103 microvisor. In the quantitative determination of flavonoids, Sorbfil chromatographic plates (TU 4215-002-43636866-2007) and a SHIMADZU UV 1800 spectrophotometer (Japan) were used.Results and discussion. The main morphological and anatomical features of Crataegus macracantha flowers were studied. Some numerical indicators were determined in the flowers of Crataegus macracantha: the content of hyperoside is 1,01±0,04%; the moisture content is 9,06±0,41%; the total ash content is 10,61±0,50%; the content of ash insoluble in hydrochloric acid 10% is2,05±0,05%. The data comply with the requirements of pharmacopoeial monograph 2.5.0062.18 «Hawthorn flowers».Conclusions. The studied indicators confirm the feasibility of using this species of Crataegus macracantha as a hawthorn flower producing plant and can be used for further research to develop regulatory documentation.

The coefficient of capillary filtration in the intestine is very high and almost 30 times higher than in the capillaries of skeletal muscles. Therefore, with a decrease in capillary pressure, the volume of liquid in the intestine will rapidly decreases, especially quickly this happens with a decrease in systemic blood pressure.Purpose: to identify morphological structures that regulate hemocirculation in the intestinal wall.Material and methods:. The study was conducted on infertile dogs (n=9) of both sexes. Anesthesia - sodium thiopental intraperitoneally (50 ml/kg). Bloodletting from one femoral artery continued until blood pressure in the other femoral artery decreased to60-70 mm Hg. After that, a median laparotomy was performed. A polyethylene tube was inserted into the first jejunal artery, which advanced to the main trunk of the superior mesenteric artery. Portal vein catheterization was performed through the first jejunalvein. The intraorganic blood bed of the intestine was impregnated with a weak solution of silver nitrate and then restored to metal on the walls of microvessels with a 4% hydroquinone solution. After 10 days of fixation, paraffin sections were prepared from the intestinal wall. Sections 3.0-5.0 μm thick were stained with hematoxylin and eosin, according to Van Gison, pararosanilin and toluidine blue, Weigert iron hematoxylin. Results and discussion. When studying histological injected drugs, the most significant changes in the microvascular channel were found in the wall of those areas of the intestine whose blood supply was carried out from zones of adjacent blood flow. In them, signs of impaired vascular permeability were determined in the submucosa. The diameter of a significant number of arterioles decreased so sharply throughout that it indicated the cessation of blood flow in them. The diameter of the venules decreased fragmentary with a uniform alternation of sections of narrows resembling a peristaltic wave. If microvascular bed perfusion of intestinal wall is disturbed, blood flow rate in superior mesenteric artery decreases and internal diameter of its main trunk decreases.Conclusions. The intestine is the most resistant of all internal organs to ischemia. After bleeding from the femoral artery, themost significant changes in the microvascular channel were found in the wall of those areas of the intestine whose blood supply was carried out from areas of adjacent blood flow.

Objective is to improve the results of treatment of patients after kidney transplantation by reducing the frequency of vascular complications and associated kidney transplant loss.Material and methods. From October 1996 to August 2021, 483 kidney transplantations were performed at the Surgical department No. 3 (organ transplantation and donation center) of the G.G. Kuvatov RCH, of which 401 (83%) cadaveric and 82 (17%) living related donors.Results and conclusions. Vascular complications were observed in 18 (3.7%) patients, the most common were thrombosis as a result of an acute crisis of graft rejection. Of these, 13 (2.6%) patients had a crisis stopped conservatively. In the remaining 5 (1.1%) patients, the acute rejection crisis was complicated by thrombosis, which led to the loss of a kidney transplant: 1 case led to rupture of a kidney transplant; 4 cases were due to thrombosis of the renal artery (2) and vein (2).Conclusions. Thus, careful selection of a donor-recipient, early diagnosis and adequate treatment of an acute rejection crisis in the postoperative period can prevent vascular complications and loss of a kidney transplant.

Diabetic retinopathy (DR) is a disease belonging to the group of ischemic retinopathy, the prevalence of which is progressing. As it is known, the main cause of disability in diabetes mellitus is diabetic macular edema (DME). The article provides a review of domestic and foreign literature on topical methods of laser treatment of focal DME. A modern and noninvasive diagnostic method - optical coherence tomography-angiography has been a significant progress in the visualization of the microcirculatory bed, as well as the layers of the retina and choroid in clinical diagnostic studies of macular edema in DR. The necessity of a multimodal approach to the management of patients with DME to improve the clinical and functional results of treatment is emphasized. The currently used technologies for the treatment of DME, their advantages and disadvantages are described, data on the anatomical and functional result are given. The prospects of further improvement and use of combined techniques in the treatment of DME are considered. The prospects of further improvement and use of innovative laser technologies based on navigation systems and multimodal visualization data are considered.

One of the most often congenital malformations of the intestinal tube is atresia. The clinical feature of an incomplete web is a partial intestinal obstruction. The intensity of the symptoms of the disease varies depending on many factors, but the main one is the size of the hole in the web. As a result, symptoms can appear at any age. Since at the initial stage of the manifestation of the disease, the child has a positive dynamics of weight, regurgitation or vomiting are periodic, has stool, then diagnosis can be difficult. The child's condition may deteriorate significantly if surgical care is not provided in a timely manner. The analysis of domestic and foreign literature confirms that there is a number of difficulties in the diagnosis of an incomplete membrane. The analysis also provides information on the reasons for the development of intestinal atresia, the improvement of instrumental diagnostic methods, the development of genetic diagnostics, and modern technologies of surgical treatment.

Purpose is to analyze bibliographic data containing information on insomnia in patients with schizophrenia.Material and methods. A search and analysis of bibliographic sources published for the period from 2015 to 2021 was carried out on the indicated topics in the databases Elibrary.ru, Google Scholar, Web of Science, Scopus, PubMed, Cochrane Database of Systematic Reviews.Results and discussion. This paper discusses the possible mechanisms of insomnia in patients with schizophrenia, presents methods for studying sleep, sleep disturbances and detectable changes in sleep rhythms, presents the results of studies in patients with schizophrenia and concomitant insomnia. The existing impairment of cognitive functions in such patients is aggravated by comorbid insomnia. The study of this topic is due to the need to improve the quality of life in patients with schizophrenia.Conclusions. When examining and treating patients with a diagnosis of schizophrenia, it is necessary to take into account the possibility of concomitant insomnia, which can significantly affect their quality of life.