Purpose. Comparative assessment of intraoperative parameters of the surgical system in PE (phacoemulsification) using new and well-known method of adaptive infusion in patients with cataracts.
Material and methods. The patients were divided into 2 groups – the main (n=32) - PE using a new method of adaptive infusion management on the Optimed Profi system and the control (n=30) - PE using the well-known method of adaptive infusion on the Centurion Vision System. In each study group, patients were divided according to the degree of cataract density (Buratto) into 4 groups. The main intraoperative parameters studied are the volume of infusion fluid, the duration of removal of the lens nucleus, the dose of exposure and the power of ultrasound.
Results. In an inter-group comparison of the volume of the infusion fluid used, the statistical significance of the differences was noted in patients with grade II and IV cataract density (p<0.05). In the main group, there was a shorter duration of the removal of the lens nucleus compared with the control group without significant statistical differences between the groups (p>0.05).
Conclusion. The use of a new method of adaptive infusion in PE helps to reduce the volume of infusion fluid used and the duration of the removal of the lens nucleus.

Objective. To evaluate the results and analyze the safety and effectiveness of prostatic artery embolization (PAE) for benign prostatic hyperplasia.
Material and methods. We analyzed the treatment of 110 patients with benign prostatic hyperplasia who underwent PAE, each patient having transurethral catheter or suprapubic catheter. In 95.3% of cases, the method of choice was radial access. For embolization, various catheters with a diameter of 2.4 – 4.0 Fr were used in all patients. The embolic material was microspheres with a diameter from 210.0 to 690.0 µm. To evaluate the effectiveness of the operation, we used the International Prostate Symptom Score (IPSS), transrectal prostate ultrasound (TRUS) scores, and prostate-specific antigen (PSA) scores. Clinical success was determined
by the following parameters: removal of the urinary catheter or suprapubic catheter and the ability of patients to urinate naturally.
Results. Analyzing the effectiveness of embolization before and after surgery, we can observe satisfactory functional differences in 1, 3, and 12 months’ time. Change in IPSS: before the procedure: 30.2±4.5 points, after 12 months: 6.1±4.3 points. Dynamics of TRUS of the prostate gland: before embolization 123.5±40.2 cm³, after 12 months: 45.0±10.6 cm³. PSA levels: before the procedure - 3.3±2.5 ng/ml, after 12 months - 3.0±1.4 ng/ml. Bilateral embolization was successfully performed in 100 patients (90.5%), unilateral - in 10 (9.5%). No serious complications were observed after embolization. Urinary and suprapubic catheters were successfully removed in 105 patients (95.5%).
Conclusion. Clinical success was 95.5% based on the results we set. Thus, we can say that embolization of prostatic arteries is a promising, safe and alternative method for the treatment of benign prostatic hyperplasia.

Prostate cancer is one of the most widespread malignant neoplasms in men and today in Russia prostate cancer occurs in 15.1% of all cancers in men. The detection of prostate cancer is based on a pathomorphological assessment of tissues using the Gleason system, which allows to assess the growth and differentiation of the tumor. It is often possible to detect differences between biopsy and radical prostatectomy samples in terms of changes in the amount of points on the Gleason scale.
Material and methods. In this paper, we comparatively analyzed the sum of Gleason scores after a multifocal biopsy and radical prostatectomy in 50 patients of the Bashkir State University Clinic in 2023.
Results. In 59.4% of cases, the results of the examination of prostate biopsy material coincided with the results after prostatectomy according to the sum of points on the Gleason scale, in 13.5% of cases there was a decrease and in 27% of cases there was an increase.
Conclusion. A decrease in the Gleason score after prostatectomy is associated with a more favorable prognosis of survival, in turn, an increase in graduation, in particular, due to the Gleason component 4, in most cases is regarded as a prognostic factor of biochemical recurrence and cancer-specific mortality. In particular, microscopic characteristics reflecting lymphovascular invasion and extraprostatic spread are important, which may affect the staging of prostate cancer.

For hemodialysis patients, ensuring safe and effective vascular access using an arteriovenous fistula or graft is a top priority. Arteriovenous access dysfunction is associated with increased hospitalization and mortality, so access preservation strategies are important.
Performing endovascular access correction under ultrasound guidance has a number of advantages, including economic ones, over traditional procedures using X-ray imaging.
Objective. Study and analysis of the clinical and economic effectiveness of endovascular angioplasty of native arteriovenous fistulas under ultrasound and X-ray control.
Material and methods. A retrospective analysis was conducted of a group of patients on renal replacement therapy (RRT), hospitalized at the Nizhnevartovsk District Clinical Hospital with permanent vascular access dysfunction (PVD) and operated on using the endovascular method with ultrasound navigation and X-ray control from January 2018 to February 2023.
27 patients (12 men, 15 women), whose average age was 57.12±12.95 years old, underwent 33 procedures of endovascular access correction under ultrasound control, 28 patients (10 men and 18 women), whose average age was 59, 12±11.94 years old, 35 procedures of endovascular access correction under X-ray control were performed.
To determine economic efficiency, a cost-effectiveness ratio (CER) analysis was used. The necessary costs for surgical treatment that are clinically and technically effective and allow the resumption of hemodialysis through an AVF have been determined. The efficiency index (EI) for ultrasound imaging was 736.4 rubles. EI = 69960/95 = 736.4 rub. With X-ray control – 1267.7 rubles per unit of efficiency: EI = 120440/95 = 1267.7 rub.
Conclusion. A list of economic costs for performing endovascular angioplasty of arteriovenous access under ultrasound and Xray visualization is presented and justified. A comparative analysis of these methods was carried out taking into account clinical and economic effectiveness. The economic advantages of ultrasound-guided angioplasty were noted. The conducted clinical and economic analysis showed that the cost of endovascular procedures under ultrasound control is 1.72 times lower than under X-ray visualization. Both methods are comparable in terms of immediate clinical results and have a minimal number of complications, but the introduction of methods for endovascular correction of AVF dysfunctions under ultrasound control will significantly reduce the costs of a medical institution for the treatment of this pathology.

The aim was to determine the management tactics for children with pathologically mobile kidneys.
Material and methods. 266 outpatient records of children with an ultrasound picture of increased kidney mobility were analyzed. Based on the results obtained, three groups of patients were formed. The first - children with pathological kidney mobility less than 3% of height, without pathological clinical and laboratory parameters; the second - patients with kidney mobility more than 3% of height and one clinical manifestation; third - children with kidney mobility of more than 3% of height and one or more clinical manifestations, requiring surgical treatment.
Results. The scope of examination of children with increased kidney mobility based on the results of sonography and indications for surgical treatment of children with nephroptosis have been determined.
Conclusion. The management tactics for children with pathologically mobile kidneys have been determined. Kidney displacement of more than 3% of the child’s height, as determined by sonography, is an indication for intravenous urography. The degrees of nephroptosis are indicated based on intravenous urography. Indications for surgical intervention were determined, including: clinical manifestations, results of sonography and intravenous urography.

The work aims to study the level and redox status of nicotinamide coenzymes in follicular fluid in women of reproductive age in various age categories.
Material and methods. The study was conducted on the basis of the ART clinic "Family" in Ufa. 65 patients aged 23 to 50 years were examined (average age 32.3±3.6). The main group consisted of 45 patients of reproductive age from infertile couples. The comparison group included 20 fertile women who applied to the same clinic for a preventive examination. To measure the concentration of NAD+ in follicular fluid, a colorimetric method (NAD/NADH Cell-Based Assay Kit, Cayman Chemical) was used on a 96-well flatbed analyzer capable of measuring optical density at 450 nm. 100 µl of follicular fluid supernatant was used for analysis. The redox potential (NAD/NADH ratio) was determined using the SigmaAldrich test system.
Results. At a NAD+ level in the range of 56-76 nmol/mg of follicular fluid protein, oocyte fertility was diagnosed. At concentrations NAD+ below this range, infertility is detected. The developed method is recommended to be used to assess female fertility in clinical gynecology and reproductology as an effective additional method for predicting the development of female infertility of unclear etiology.
Conclusion. The method provides an opportunity to increase the accuracy, specificity and simplify the diagnosis of infertility by evaluating the redox potential in oocytes by determining the level of NAD+, which makes it possible to identify violations of redox processes, including those associated with mitochondrial pathology, DNA repair, regulation of apoptosis and early aging of eggs.

Expanding the arsenal of drugs with antimicrobial and wound-healing properties is important in connection with the problem of resistance of pathogenic microorganisms to drugs. A heterocyclic palladium complex with S-Pd-S bonds with a bis-(sulfanylmethylazolyl)ethane ligand was synthesized, for which low toxicity and hepatoprotective properties were previously established. Biological tests of wound-healing effects have shown the promise of a palladium complex compound with regenerative properties for therapy in the maxillofacial area.
Purpose of the study. Development of a new wound healing agent, which in the future will be used in dental practice as a reparative drug with high efficacy, safety and a wide range of pharmacological effects: anti-inflammatory, antimicrobial, antioxidant and hepatoprotective properties.
Material and methods. The synthesis of the target compound is based on a multicomponent reaction of thiomethylation of acetylacetone with a mixture of formaldehyde – 1,2-ethanedithiol, heterocyclization with hydrazine, followed by a complexation reaction with PdCl2. Laboratory animals (non-linear mice and rats of both sexes, sexually mature), special equipment for performing surgery under sterile conditions, histological complex MICROM (Karl Zeiss, Germany), devices, reagents and equipment for preclinical experimental studies were used for biotesting.
Results. A highly effective wound healing agent has been identified, superior in reparative properties to actovegin and dexpanthenol, based on a model of experimental wounds in laboratory animals. The new azole compound Pd has a multicomponent pharmacological effect. Its hepatoprotective effect has been previously proven to be superior to the effect of ademetionin. The palladium compound does not have a negative effect on the indicators of general and biochemical blood tests. The results of the determination of acute toxicity by Litchfield-Wilcoxone and subacute toxicity by Lin K.K. indicate the safety of a promising wound-healing azole compound palladium.
Conclusion. A new highly effective palladium azole compound has been identified, which has shown wound healing properties and has a multicomponent effect.

The aim of the research was the standardization of the pharmaceutical substance α(1,2)-L-rhamno-α(1,4)-D-galactopyranosyluronane and the development of a draft specification.
Material and methods. The object of the study is the pharmaceutical substance α(1,2)-L-rhamno-α(1,4)-D-galactopyranosyluronane Acorus calamus L. Authenticity was established by infrared spectroscopy. The quantitative content was determined by spectrophotometry. The validation of the methods was established in accordance with the Guidelines for the validation of analytical Methods for testing medicines and the State Pharmacopeia of the Russian Federation.
Results. The substance is an odorless white powder with a creamy tint, slowly soluble in water, the color of 5% aqueous solution is paler than the BY5 standard. The spectrum contains several characteristic absorption regions that differ from analogues of a hydrocarbon nature. The method of quantitative determination is linear in the concentration range of 0.01-0.50 mg/ml, the analytical range is 40-240%. When assessing the repeatability of the technique, the values of the relative standard deviation were in the range of 0.70-1.10%. When determining the correctness, the recovery percentage was 98.5-101.5%. The accuracy of the method for determining the molecular weight distribution was 4.09-4.84% (linear regression model). The protein content is less than 1.55%, heavy metals and arsenic are less than 0.0001%. The weight loss during drying is 2.11 for 011122 series and 1.68% for 031119 series, the pH of 1% solution is 3.05 and 3.08 respectively.
Conclusion. The substance α(1,2)-L-rhamno-α(1,4)-D-galactopyranosyluronane Acorus calamus L. has been standardized according to the declared indicators, a draft specification has been developed.

The purpose of the study is to determine the quantitative content of flavonoids in the herb of the Cirsium arvense L. collected in various habitats of some regions of the Republic of Bashkortostan.
Material and methods. 60 samples of raw materials of Cirsium arvense L. herb harvested in forest and meadow phytocenoses on the territory of Ufimsky, Iglinsky, Chishminsky, Birsky, Blagovarsky and Gafuriysky districts of the of Republic Bashkortostan in 2018-2021 in the flowering phase were analyzed. The quantitative content of flavonoids was determined by differential spectrophotometry using a specially developed technique. According to this method, standardization of the studied raw materials according to the quantitative content of the amount of flavonoids was carried out in terms of apigenin.
Results. It was found that flavonoids accumulate in greater quantities in samples of Cirsium arvense L. harvested in all six regions of the Republic Bashkortostan in habitats associated with meadow phytocenoses with a sufficient degree of sun exposure and moderate moisture, in smaller quantities – in samples of raw materials harvested in forest phytocenoses. Comparing the herb of
Cirsium arvense L. harvested in various regions of the Republic Bashkortostan, no statistically significant difference in the content of flavonoids was revealed (p<0.05), since in all cases the flat terrain is preferable for Cirsium arvense L.
Conclusions. We have determined quantitative content of flavonoids in terms of apigenin in Cirsium arvense L. herb, growing in forest and meadow phytocenoses in some regions of the Republic of Bashkortostan. No significant differences in flavonoids content in Cirsium arvense L. herb depending on growing area were revealed. It can be due to close location of the chosen regions, as well as similar flat terrain, climate and soil characteristics. However, for Cirsium arvense L. meadow habitat is preferable.

Worldwide, one of the most important problems in therapy with systemic antimicrobials is antimicrobial resistance. In addition, when prescribing antibacterial therapy to pediatric patients, it is necessary to pay special attention to the selection of the optimal dosage and dosage regimen.
The purpose of this work was to assess the rationality of prescribing antibacterial drugs in outpatient pediatric practice.
Materials and methods. To conduct the study, a methodology was developed that included a structural analysis of drug prescriptions in outpatient pediatric practice, identifying cases of off-label prescriptions of antibacterial drugs and formulating proposals for rational use.
Results. It was found that of the prescribed systemic antibacterial drugs, the combination of amoxicillin with clavulanic acid was most often prescribed (56.3% of the number of prescriptions in group J01). None of the prescribed drugs in this group has “children’s” status. Of the total number of prescriptions for drugs from group J01, 14.0% were classified as off-label. Thus, despite the wide range of antibacterial drugs currently available on the pharmaceutical market, there are cases of these drugs being prescribed outside the instructions.

The main goal of the state drug policy of the Kyrgyz Republic (KR) is to improve the health of the population by providing access to safe, effective and high–quality medicines and medical devices at an affordable cost and their rational use.
Purpose: to study the peculiarities of the commerce of drugs and medical devices in the Kyrgyz Republic.
Material and methods. official websites of the healthcare systems and the Ministry of Justice of the Kyrgyz Republic, annual statistics of international trade in pharmaceutical products have been used in the study. Analytical, statistical, content analysis, graphic methods of investigation have been used here.
The results. Private pharmaceutical organizations and companies (3.860) have been analyzed: assortment, import and export of pharmaceutical products, and their dynamics are shown. The national list of vital medicines is presented; regulatory legal acts on the regulation of drug prices, including a pricing algorithm and a scale of maximum allowances have been studied. The system for tracking the movement of drugs on the pharmaceutical market is based on the labeling of medicines.
Conclusion. In modern conditions in the Kyrgyz Republic, there is a need to strengthen the role of the state and strengthen the system of supervision over the commerce of drugs and medical devices.

Cranioclavicular dysostosis is an inherited orphan disease associated with a mutation in the Runx2 gene located on the short arm of chromosome 6. Clavicular cranial dysostosis is transmitted by an autosomal dominant type and is manifested by delayed ossification of the skull, large fontanelles and closure of cranial sutures. Retention and dystopia of permanent teeth is associated with the presence of one or more super-complete teeth on the upper and lower jaws. One of the characteristic symptoms of the disease is hypoplasia or aplasia of the collarbones.
The article describes the case of cranioclavicular dysostosis (CСD) in a 42-year-old man with severe purulent complication due to lack of timely treatment in childhood. The patient went to the maxillofacial surgery clinic complaining of pain and swelling in the submandibular region on the left side. A series of CT scans of the skull bones revealed a defect in the cranial vault, a lot of retarded teeth of the lower and upper jaws. After the examination, the diagnosis was made: odontogenic phlegmon of the left submandibular region, masticatory, pterygoid-maxillary space on the left side, cranioclavicular dysostosis. The causal tooth of the development of the purulent-inflammatory process turned out to be a retinated 3.8 tooth located next to a group of dystopian and retinated chewing teeth of the lower jaw on the left side. An operation was performed to open a purulent-inflammatory focus, remove a retarded 3.8 tooth. The article presents photos of the patient, CT scans of the skull and chest.

The aim was to analyze the reproductive attitudes of students at Bashkir State Medical University.
Material and methods. Students were offered to undergo anonymous online survey, consisting of 30 open and closed-ended questions. Data analysis was done using Statistica 12 software.
Results. The respondents included 433 females (75.3%) and 142 males (24.7%), with an average age of 19 [18;21] years old. 58.09% of respondents reported having sexual experience. The actual age of sexual debut among the respondents was 17.5 [16;18] years old, with 57.5% of respondents reporting it not aligning with the optimal age. The students considered the optimal age for childbirth to be 25 [24;27] years old. 3.65% of respondents reported pregnancies in a couple, with 71.43% of them considering it desirable. 96.52% of students believe that preparation for childbirth is necessary.
Conclusion. Students' reproductive attitudes are characterized by a sexual debut age of 16 to 18 years old, and by a significant gap between the age of sexual debut and the assumed age of childbirth - 7.5 years. Most respondents prefer barrier contraceptives. Mass media and the Internet were considered the most competent sources of knowledge on reproductive behavior. More than half of the surveyed individuals consider medical abortion an acceptable method of family planning.

The aim. To experimentally study the possibility of forming reservoir colostomies.
Material and methods. On 10 sections of the colon of adult corpses, the main (n=5) and control groups (n=5) of the study were formed for a comparative study of the volume and diameter of the colon after serosomyotomy and without it. The comparative characteristics of the parameters of the diameter and volume of each colon preparation were studied. A prognostic model characterizing the dependence of a quantitative variable on factors was developed using the linear regression method.
Results. An increase in the volume of injected barium suspension in the main group after serosomyotomy compared with the control group without serosomyotomy indicates the formation of an additional intraluminal volume.

Neurogenic bladder is a dysfunction of the bladder caused by congenital or acquired pathology of the nervous system, is a common pathological condition, manifests itself by the inability to carry out voluntary reflex accumulation and excretion of urine due to organic and functional damage to nerve centers and pathways, and significantly complicates the quality of life of patients. Neurogenic bladder is often accompanied by myofascial syndrome, pelvic venous congestion syndrome, and infectious complications.
Objective of the study. To evaluate the effectiveness of probiotics in the prevention of symptomatic bladder infection in patients with bladder neuropathy according to data presented in Russian and foreign literature.
Methods of the study. The search for literary sources from 1993 to 2023 was carried out in the databases CENTRAL, MEDLINE and EMBASE, conference materials, the search portal of the International Clinical Trials Registry Platform (ICTRP) for randomized controlled trials dedicated to the use of probiotics for the prevention of bladder infection in patients with bladder neuropathy.
Results. Three studies involving 109 patients met the necessary RCT criteria. In these studies, the effectiveness of introducing probiotics into the bladder to create a harmless colony of microorganisms in the urinary tract in patients with bladder dysfunction was investigated.
Conclusions. The relative safety of introducing probiotics into the bladder to create a harmless colony of microorganisms in the urinary tract in patients with bladder dysfunction is shown. The effectiveness of using probiotics to prevent the development of infectious complications in patients with neurogenic bladder has not been proven. Further carefully planned research is needed.

Purpose of the study is to provide literature review on surgical aspects affecting the risk of developing colorectal anastomotic failure (CAF).
CAF frequency ranges from 7 to 25%. This review focuses on the technical aspects of surgical intervention that may influence the risk of CAF. The authors of the publications obtained data on the dependence of the risk of CAF on the experience of the surgeon, the features of mobilization of the intestine before resection, the choice of the type and height of colorectal anastomosis, the technique of suture formation, its strengthening and protection with a preventive stoma using pelvic and transanal drainages.
Conclusion. The frequency of CAF, along with other factors such as age, gender of the patient, concomitant pathology, bad habits, underlying disease, antibiotic prophylaxis, etc., depends on the technical aspects of surgical intervention.

Aim. Generalization of the domestic experience of advanced purulent peritonitis treatment.
Material and methods. The analysis of the results of domestic research works and scientific studies of recent years (from 2012 to 2023) devoted to various aspects of the diagnosis and treatment of advanced purulent peritonitis has been carried out.
Results. The study evaluates the effectiveness of methods of early diagnosis, determination of the severity of the inflammatory process, prognosis of the course, indications for management tactics, surgical and additional methods of treatment of advanced peritonitis according to domestic authors.
Conclusions. In our opinion, there are no methods that affect all aspects of the pathogenesis of peritonitis and have an absolute advantage over other methods today. There are no unified approaches to the management of patients with the most complex form of peritonitis, tertiary peritonitis. The issues of early diagnosis and improvement of the results of treatment of the inflammatory process in the abdominal cavity require further study.

Hemorrhagic stroke (HS) represents the most severe form of strokes. Early prediction of the outcome of HS allows choosing personalized approach to the patients’ treatment and potentially improve the outcomes.
The aim is to analyze existing approaches to prediction of the outcomes of HS. A review of the literature on the prediction of the outcomes of HS was conducted.
Conclusion. Laboratory predictors of the unfavorable outcome of the HS include low red blood cell count, high white blood cell count as well as high D-dimers level and platelet count. Prolongation of the corrected QT interval according to ECG increased the risk of the lethal outcome of the HS. Computer-tomographic (СТ) predictors of the early enlargement of hematoma represent one of the significant factors explaining unfavorable outcomes of HS. Hence timely detection of those predicting signs on СТ scans of the brain and correction of the factors contributing to the hematoma enlargement can potentially improve the outcomes of HS.