The objective is to study the functional reserves of oxygen-dependent metabolism of phagocytes in patients with hemorrhagic fever with renal syndrome (HFRS), depending on the severity of the process.

Material and methods. We examined 100 patients with the disease of varying severity, including 38 patients with severe forms of HFRS complicated by acute renal failure (ARF). The comparison group consisted of 46 healthy individuals. Luminol-dependent chemiluminescence (LDCL) recording was used to measure the number of phagocytes generating reactive oxygen species. The characteristics of the reserve capabilities of phagocytes were assessed by calculating the ratio of reserve to spontaneous luminescence. The absolute value of the reserve capabilities of phagocytes was determined by subtracting the maximum intensity of induced luminescence from the maximum intensity of spontaneous luminescence.

Results. The values of spontaneous oxygen-dependent metabolism in patients with severe HFRS with ARF were higher compared to patients with moderate and severe HFRS, and the rates of induced oxygen-dependent processes, on the contrary, were lower. These patterns determined a stronger drop in functional reserve in patients with HFRS complicated by ARF.

Conclusion. A decrease in the reserve of functional activity of phagocytes in HFRS patients with acute renal failure indicates a breakdown in the body's adaptive capabilities and a decrease in its protective immunoregulatory capabilities.

Objective. To evaluate the frequency of high flow syndrome in patients receiving renal replacement therapy by program hemodialysis and its effect on the development of chronic heart failure depending on the diameter of the native arteriovenous fistula.

Material and methods. 39 patients with native permanent vascular access who were on program hemodialysis were examined. Group I (20 people) consisted of patients with an arteriovenous fistula (AVF) with the diameter of more than 2 cm; Group II (19 people) were patients with an arteriovenous fistula diameter of less than 2 cm.

Results. «High flow syndrome» (volumetric blood flow through the arteriovenous fistula more than 1.5 l/min) was observed in 16 patients of group I (80%), and in 3 patients (15.7%) in group II (the comparison group). The left atrium volume index in group I accounted to 39.65±2.3, in group II it was 30.4±0.8 (p=0.002). The ejection fraction in patients of both groups had no significant differences (55±0.84 and 57±0.77, respectively, p=0.5).

Conclusions.

1. The main cause of the development of chronic heart failure with a preserved ejection fraction is diastolic dysfunction with impaired relaxation.
2. Patients with aneurysmal dilation of the arteriovenous fistula are subject to in-depth examination in order to detect high flow syndrome and chronic heart failure.

Objective. To evaluate the pathomorphological features of heart tissue changes in patients with acute myocardial infarction that developed against the background of COVID-19 coronavirus infection.

Material and methods. The work is based on the results of the analysis of 281 protocols of pathoanatomical autopsies of COVID-19 patients conducted at the pathoanatomical department of City Clinical Hospital №6 (Izhevsk) in the period from January to December 2022.

Results. In persons who died from coronavirus infection and its complications, acute myocardial infarction (AMI) occurs in 33.1% of cases. In 58.1%, signs of AMI were determined macroscopically at autopsy, in 41.9% – on the basis of histological examination (microinfarction was diagnosed). AMI in patients with COVID-19 develops against the background of thromboembolic events and generalized thrombohemorrhagic syndrome. Interstitial myocarditis develops in patients with small-focal infarction in 12.8% of cases against the background of bacterial pneumonia and sepsis.

Conclusion. Small-focal myocardial infarction in patients with COVID-19 poses difficulties for intravital diagnosis. Microinfarction in patients with coronavirus infection may be accompanied by interstitial myocarditis.

The objective is to identify risk factors for the development of bone metabolism disorders and to develop an algorithm for early diagnosis of the detected disorders in premature infants born both naturally and with the help of in vitro fertilization (IVF).

Material and methods. We studied 189 premature babies born after IVF and naturally conceived. We included children conceived by IVF in the main group. The comparison group included children conceived naturally. Each group was divided into 2 subgroups. In the main IVF group, the 1st subgroup included infants weighing 1000-1500 g (n= 52), these are children with very low body weight (VLBW), and the 2nd subgroup included children weighing less than 1000 g (n= 49), that is, with extremely low body weight (ELBW). The comparison group also included a subgroup with VLBW (n=46) and a subgroup with ELBW (n=42). The content of calcitonin, calcium, vitamin D, C-terminal telopeptides of type I collagen and parathyroid hormone were evaluated in each child.

Results. Calcidiol [25(OH)D] content in the blood serves as a reliable criterion for the sufficiency of vitamin D in the child's body. It was found that most premature infants during the first year of life have vitamin D insufficiency. It turned out that premature IVF and naturally conceived babies have vitamin D deficiency - 4.8%, vitamin D insufficiency – 67.7%, and normal vitamin D level – 27.5% [4]. In children at an early age, there is a violation of bone metabolism (decrease in the levels of calcium, calcitonin, low level of vitamin D, especially in children with ELBW and ELBW (IVF), and a decrease in the C-terminal telopeptides of type I collagen compared to the age norm). These changes were associated with the weight of children. Premature children with VLBW should be recommended to monitor the level of vitamin D in the blood and C-terminal telopeptides of type I collagen.

Conclusion. Risk factors for osteopenia in premature infants conceived using IVF and naturally are low levels of calcium, vitamin D, calcitonin, C-terminal telopeptides of type I collagen and high levels of parathyroid hormone.

The objective is to study the features of changes in the pH of mixed saliva in non-smokers and e-cigarette users, as well as to compare their dental status using hygienic and complex periodontal indices.

Material and methods. At the Department of Therapeutic Dentistry of BSMU, a survey of 50 people aged 20-26 years as well as a comprehensive clinical examination of their oral cavity were conducted, and the acid-base balance (pH) of their mixed saliva was determined. The first group (25 people) consisted of e-cigarette users; the second group was formed from non-smoking volunteers.

Results. The pH of mixed saliva in two groups of patients had significant differences (p<0.05): in group 1 (vapers) pH was 6.68±0.32, and in group 2 (non-smokers) pH was 6.92±0.37. At the same time, in group 1 there were 9 people whose pH of mixed saliva immediately after using an electronic cigarette equaled to 7.8±0.46 (p<0.05).

Conclusions. According to the survey data, vapers complain of dryness and unpleasant odor in the oral cavity as well as discomfort after smoking. A comprehensive clinical examination of the oral cavity of patients of two groups revealed the presence of low indicators of the hygienic index OHI-S and the KPI index in vaping patients. The average pH of mixed saliva in the group of smokers was shifted to the acidic side (6.68±0.32) compared to the group of non-smokers (6.92±0.37), which may be due to poor oral hygiene. At the same time, immediately after smoking an electronic cigarette, the average pH corresponded to an alkaline environment and was 7.8±0.46, which contributes to the formation of tartar.

The objective is to give a descriptive and quantitative characterization of the organs and structures of the chest in 18-22 weeks of development human fetuses on sections correlating with ultrasound sections through four chambers of the heart and lungs.

Material and methods. In the course of the study, sections of 10 torsos of fetuses of both sexes were studied at 18-22 weeks of gestation without signs of pathology. The fetuses were obtained as a result of interruption of physiological pregnancy in healthy women for social reasons in compliance with ethical and deontological norms. The study was carried out using the following methods: macromicroscopic preparation, the N.I. Pirogov method of cuts, histotopographic method, morphometry method, followed by statistical data processing.

Results. Three groups of sections were performed and described during the study: a section at the level of the Th_V lower border, at the level of the Th_VI-Th_VII disk and at the level of the Th_VII body. The sections were obtained in planes corresponding to ultrasound images conducted through four chambers of the heart and lungs (according to International Society of Ultrasound in Obstetrics and Gynecology recommendations). It was revealed that the largest number of heart internal structures is visualized on a section at the level of the Th_VI-Th_VII vertebrae disk. At this level, the anteroposterior and transverse dimensions of the section were 41.9±0.5 mm and 47.3±0.8 mm respectively. The dimensional characteristics of the heart had the greatest values in this section: the longitudinal size of the heart was equal to 23.1 ± 0.5 mm, the transverse size was 21.26 ± 0.6 mm. Based on this, it is advisable to perform ultrasound sections with skeletotopic reference to the level of the Th_VI-Th_VII intervertebral disc during screening ultrasound examination of fetuses in the second trimester. At the same time, the levels of the Th_V lower border and the Th_VII body allow to receive a more detailed study of other organs and structures of the chest visualized on these sections (lungs, esophagus, descending aorta, thoracic vertebrae).

Conclusions. The combination of ultrasound examination based on a fundamental anatomical database will improve the diagnosis of congenital malformations during screening.

Objective. Obtaining new information on the syntopy of parts of the stomach at 16-22 weeks of the intermediate fetal period of human ontogenesis.

Material and methods. 40 fetuses of both sexes aged from 16 to 22 weeks of ontogenesis were studied. Four age groups were formed in the work (16-17, 18-19, 20-21 and 22 weeks), of 2 weeks layout. The method of macromicroscopic preparation, bone cut- ting according to the method of N.I. Pirogov, methods of morphometry, histotopographic, statistical analysis, and photographic method were used.

Results. The article presents the results of studying the syntopia of the cardia, fundus, body and pyloric part of the human fetus stomach with adjacent abdominal organs, as well as the dynamics of changes in the age range from 16 to 22 weeks of prenatal development.

Conclusions. 1. Syntopy features of various parts of the human stomach at 16-22 weeks include a weakly expressed contact with the diaphragm, the anterior wall in the area of the stomach body that is almost completely covered by the lobes of the liver, a small curvature contact with the caudate lobe of the liver for a longer distance, no contact with the left kidney. 2. Throughout the study period, there is a tight coupling of the posterior wall of the stomach with the left adrenal gland. 3. Hepatic-duodenal, hepatic-gastric, gastro-diaphragmatic, and gastro-splenic ligaments are well defined. 4. The pregastric and omentum sacs at 16-22 weeks of ontogenesis are slit-like gaps. 5. Horizontal and sagittal cuts make it possible to determine the characteristic features of gastric syntopia.

The data obtained expand and add new information to the facts already available on the age-related anatomy and topography of the stomach in newborns, children, and adults. The obtained new data on gastric syntopia are of professional interest to morphologists and clinicians.

New compounds from cyanothioacetamide derivatives are of particular interest to pharmaceutical and medical scientists. We have previously established that certain derivatives of fused 3-aminothieno[2,3-b]pyridines and 1,4-dihydropyridines have pronounced antiexudative activity with analgesic properties.

Purpose of research. The study of acute oral toxicity of new condensed derivatives of thienopyridine and 1,4-dihydropyridine synthesized by us, the most promising in terms of creating analgesics.

Material and methods. The study was conducted in accordance with the Interstate Standard GOST 32644-2014 (OECD, Test № 423:2001, IDT) on 60 white laboratory female rats weighing 180-220 g. Compounds in the form of an aqueous suspension were administered once intragastrically at doses of 5, 50, 300, and 2000 mg/kg.

Results. For the entire period of observation, not a single case of death of rats of the experimental groups was registered in any of the indicated dosages. Zero lethality of rats treated with new derivatives of 3-aminothieno[2,3-b]pyridine and 1,4-dihydropyridine with laboratory codes AZ023, AZ331, AZ420 and AZ383 at a dose of 2000 mg/kg allowed them to be assigned to the 5th toxicity class. LD50 for new derivatives of thienopyridine and 1,4-dihydropyridine is >5000 mg/kg.

Conclusion. Four studied derivatives of new heterocyclic compounds containing 3-aminothieno[2,3-b]pyridine and 1,4-dihydropyridine fragments with AZ023, AZ331, AZ420 and AZ383 laboratory codes belong to the 5th toxicity class (low toxicity compounds).

For a systemic analysis of the anti- or pro-oxidant properties of 11-deoxymisorostole (11-DMP) in vivo, the test compound was administered intragastrically in 3 doses daily, followed by assessment of the levels of lipid peroxidation products and oxidative modification of proteins in the brain. In the course of experimental studies, it was established that activation of catalase was observed in brain cell homogenates at certain periods of administration of 11-DMP at doses of 1.0 and 2.0 mg/kg; a moderate increase in metal-catalyzed oxidative modification of proteins (OMP) on the 3rd and 7th days of administration of 11-DMP at doses of 1.0 and 2.0 mg/kg; increase in the capacity of lipophilic antioxidant defense, depending on the dose of 11-DMP. The studies performed showed that the administration of 11-DMP in courses over 3 and 7 days is characterized by a redistribution of free radical oxidation (FRO) processes in the brain without pro-oxidant effects. Research results show the most pronounced antioxidant activity of the test compound when administered in a course of doses of 1.0 and 2.0 mg/kg.

Objective: to determine the anti- or pro-oxidant properties of 11-DMP in the brain during its course administration at doses of 0.5, 1.0 and 2.0 mg/kg.

Material and methods. The test substance (ethyl ester (±)-11,15-dideoxy-16-methyl-16-hydroxyprostaglandin E1, 11-DMP) was synthesized and provided for research by the laboratory for the synthesis of low molecular weight bioregulators of the Ufa Institute of Chemistry, Russian Academy of Sciences, Ufa. Experimental studies were carried out on 120 white laboratory rats. In brain homogenates of experimental animals, the levels of primary, secondary, and end products of lipid peroxidation, oxidative modification (carbonylation) of proteins (OMP), and activity of key antioxidant defense enzymes were determined.

Results and discussion. It was found that the introduction of 11-DMP was not accompanied by the accumulation of free radical oxidation products in the brain. The results of the studies show that the course administration of 11-DMP for three and seven days is accompanied by a redistribution of free radical oxidation processes in the brain without a prooxidant effect: the power of lipophilic antioxidant defense (AOD) systems increases while the reserve-adaptive potential of proteins is limited.

Conclusion. The results obtained allow us to draw conclusions about the presence of both direct and indirect antioxidant activity in the studied compound, which is most pronounced with a course (3-time, 7-time) daily intragastric administration at doses of 1.0 and 2.0 mg/kg.

Objective: synthesis of new 8-benzylydenehydrazinyl-substituted 1-butyl-3-methyl-7-(thietan-3-yl)-3,7-dihydro-1H-purine-2,6-diones as promising biologically active substances.

Material and methods. Target 8-benzylydenehydrazinyl-substituted 7-(thietan-3-yl)-, 7-(1-oxothietan-3-yl)- and 7-(1,1-dioxothietan-3-yl)-1-butyl-3-methyl-3,7-dihydro-1H-purine-2,6-diones were obtained from the corresponding 8-bromo-3,7-dihydro-1H-purine-2,6-diones in two steps. First, 8-hydrazinyl-substituted purine-2,6-diones were synthesized by interaction with hydrazine hydrate. Then condensation with 5-bromo-2-hydroxybenzaldehyde and 4-(dimethylamino) benzaldehyde gave the corresponding 8-benzylydenehydrazinyl-substituted 7-(thietan-3-yl)-, 7-(1-oxothietan-3-yl)- and 7-(1,1-dioxothietan-3-yl)-1-butyl-3-methyl-3,7-dihydro-1H-purine-2,6-diones with 71-94% yield. The structure of the synthesized compounds was confirmed by GC/MS, UV, IR, and 1H NMR spectra. When determining the antimicrobial activity, it was found that the test compounds exhibit mild antimicrobial properties (the minimum inhibitory concentration is more than 100 mg/ml). Calculation of physicochemical descriptors, prediction of parameters of adsorption, distribution, metabolism, excretion, pharmacokinetic properties, and toxicity of the synthesized compounds in silico using the SwissADME and pkCSM websites were carried out.

Results and conclusions. New 8-benzylydenehydrazinyl-substituted 1-butyl-3-methyl-7-(thietan-3-yl)-3,7-dihydro-1H-purine-2,6-diones were synthesized in good yields, their antimicrobial properties were studied. A weak antimicrobial effect indicates the need for modification of the structure to achieve the required pharmacological activity. The results of in silico prediction can be used in the further study of 8-benzylydenehydrazinyl-substituted 1-alkyl-3-methyl-7-(thietan-3-yl)-3,7-dihydro-1H-purine-2,6-diones as potential biologically active connections.

The objective of the research is studying the appearance and anatomical characteristics of various morphological groups of Crambe abyssinica (leaves, flowers, fruits and roots) and rhizomes of Gynostemma pentaphyllum, and chemical composition using macro-, microscopic and phytochemical methods.

Material and methods. The main diagnostic signs of the studied objects and their frequency of manifestation (%) were determined, the results of which can serve as an indicator of the quality of raw materials. The data of quantitative determination of some biologically active substances are also presented: polysaccharides (gravimetric method), ascorbic acid (titrimetric method), tannins (titrimetric method) and saponins (spectrophotometric method).

Results. According to the results of quantitative determination of biological compounds, it turned out that in the herb of C. abyssinica harvested during the flowering phase, their greatest accumulation occurs. In the rhizomes of G. pentaphyllum, the predominant biological compound was saponins of the triterpene series in terms of β-escin. The obtained results of the study of the appearance and anatomical structure, as well as the quantitative content of biological compounds of C. abyssinica and G. pentaphyllum, can later be used in the selection of medicinal raw materials from the studied morphological groups and their standardization for the purpose of their introduction into medical practice.

Objective. The personnel’s readiness for innovations by the example of Saint Petersburg Research Institute of Vaccines and Sera and Manufacturer of Bacterial Preparations (parent company) and a foreign enterprise – the Latin American Institute of Biotechnology MECHNIKOV (Republic of Nicaragua) was assessed.

Material and methods. The source information was collected from 727 respondents through a questionnaire survey. The method was passed by psychometric test using Cronbach’s Alpha coefficient. Additionally, a comparative analysis of the responses of management and ordinary personnel was implemented using Student's t-test.

Results. Organizational and methodological approaches to assessing the readiness of personnel for innovative processes have been developed. The approaches include diagnostic measures in the form of a questionnaire which allows to assess the readiness of personnel for innovations, and development of methodological support in the form of conversation on personnel development to identify the potential and determine the prospects for the promotion of existing employees, as well as to establish the needs for training and development of personnel in the context of the implementation of innovations in the organization.

Conclusion. The results obtained make it possible to determine the required management goals and functions, and to develop a strategy for managing personnel in the context of knowledge and technologies transfer in the implementation of the pharmaceutical enterprise export policy.

Objective: to analyze the main legal aspects regulating the providing of an accessible environment for persons with disabilities in pharmacies.

Material and methods. The source materials were the texts of legislation of the Russian Federation and court decisions. During the research process, systematic, comparative, and logical methods of interpretation of legislation were used.

Results and discussion. Based on a content analysis of legislation, the main legal norms regulating the providing of an accessible environment in pharmacies have been identified. It has been proven that the scope of regulation of the current order of the Ministry of Healthcare of the Russian Federation dated November 12, 2015, № 802n also includes pharmacies, regardless of their form of ownership. It has been revealed that compliance by pharmacies with legal norms to ensure their accessibility for people with dis- abilities is carried out through federal state control (supervision) in the field of drug commerce, carried out by Federal Service of Supervision in Healthcare (Roszdravnadzor) and its territorial departments.

Conclusions. It has been shown that the current legal norms allow pharmacies to provide entry and exit for people with limited mobility, as well as their movement within pharmacies with the help of employees of these organizations. It has been revealed that in relation to providing a pharmacy with an accessible environment for persons with disabilities, licensing requirements include the need to have a button to call a pharmacist at the entrance to the facility. At the same time, failure to comply with other legal norms regulating accessibility may constitute an administrative offense under Article 9.13 of the Code of the Russian Federation on Administrative Offences.

Hemosiderosis can lead to the development of pigment dystrophies characterized by excessive accumulation of iron-containing pigment hemosiderin in the tissues of the body. There are local forms of the disease (cutaneous and pulmonary hemosiderosis) and generalized ones (with the deposition of hemosiderin in the organs of the thorax, abdomen and retroperitoneum). The literature describes clinical observations of hemosiderosis of these organs, but there is no data on hemosiderosis of the colon. Therefore, the authors in the article present a clinical case of colon hemosiderosis in a 47-year-old surgical patient operated for acute constrictive intestinal obstruction in combination with a mobile caecum inversion complicated by gangrene of the right flank of the colon and peritonitis. Emergency surgical treatment was performed – diagnostic laparoscopy, conversion to laparotomy, also right-sided hemicolectomy and ileostomy were performed. The postoperative period was smooth sailing, without complications. The patient underwent planned surgery after 2 months: restoration of intestinal continuity by applying a term-lateral ileotransverse anastomosis. When applying an inter-intestial anastomosis, surgeons paid attention to the dark black color throughout the colon mucosa, and assumed hemosiderosis. Mucous membrane biopsy was taken. At the same time, the color of the mucosa of the small intestine was normal, not changed. An inter-intestinal anastomosis was imposed, despite the presence of these mucosal changes, and in the postoperative period the insolvency did not develop. The course of the postoperative period was normal, without complications. The patient was discharged with recovery. Pathologic and anatomical examination of the biopsy material confirmed the presence of a rare pathology – hemosiderosis of the colon.

The authors conclude that intestinal hemosiderosis in this case was an accidental finding, and the diagnosis was made on the basis of morphological investigation of organ bioptate. It can be assumed that intestinal hemosiderosis is more common, but in most cases it is not diagnosed during clinical and pathomorphological studies, due to the inflammatory and ischemic changes of an organ.

Bladder cancer is a common disease in the world and the Russian Federation. The most common is its non-muscle invasive form, the main treatment of which is transurethral resection of the bladder followed by intravesical chemotherapy. The peculiarity of this operation is the gradual removal of the tumor, which leads to a fragmented histological specimen and various complications in the postoperative period. Transurethral removal of a bladder tumor using an en-bloc method, is not inferior to traditional surgery in terms of results and has some advantages over traditional surgery, namely in reducing intra- and postoperative complications, obtaining a high-quality specimen for histological examination. The use of holmium and thulium lasers for the en-bloc removal of a bladder tumor provides additional advantages in treatment outcomes.

The review presents world data on the possibilities of using the surgical method and the use of modern lasers in transurethral resection of the bladder using the en-bloc method.