The objective of the study was to assess the factors influencing the dynamics of left ventricular ejection fraction (LVEF) in patients with chronic heart failure with mid-range ejection fraction (CHFmrEF) after elective percutaneous coronary intervention (PCI) with coronary artery stenting.

Material and methods. 101 patients with CHFmrEF before elective PCI were studied. The participants were followed up and examined for one year after the surgery. Then two groups were formed: with LVEF remaining in the range of 40-49% after PCI (group 1, n=21), and with increased LVEF 12 months after PCI (group 2, n=76).

Results. No intergroup differences in qualitative and laboratory were found characteristics. The values of linear and volumetric heart parameters were greater in group 1 at all follow-up stages.

Conclusion: one year after elective PCI, LVEF increased to 50% or more in those patients with CHFmrEF who had less pronounced myocardial remodeling.

Objective. To evaluate the method of forming a delayed compression anastomosis of the colon in complicated diverticular disease (DD).

Material and methods. The object of the study were 49 patients with complicated DB of the large intestine, over the period from 2020 to 2022. There were 15 men (30.6%) and 34 women (69.4%). The mean age of the patients was 62.4±6.0 years, 30 (61.2%) out of 49 patients were of working age (under 60 years old). 31 (63.3%) patients were treated conservatively, 18 (36.7%) patients underwent surgical operations. In 7 out of 15 cases, obstructive resections resulted in delayed compression anastomoses with shape memory implants.

Results. In most cases, complications of DD can be controlled and treated conservatively. With the clinical picture of widespread peritonitis, the scope of research is limited, and preoperative preparation is carried out. Obstructive resections are justified. The method of forming a delayed anastomosis technically allows to prevent the risk of anastomosis failure and simplify the recovery stage.

Conclusion. Delayed compression anastomoses in surgery for complicated DD of the large intestine may be the operation of choice for perforated diverticulitis.

Over the period of the new coronavirus infection (COVID-19) pandemic from 2020 to 2022, 411939 cases of the disease were registered in the Chelyabinsk region. In the 2022 season, the structure of the clinical forms of COVID-19 was changed.

Objective of the research: to analyze the current features of the course of COVID-19. Material and methods. A retrospective analysis of the case histories of patients with COVID-19 who were hospitalized at the «Regional Infectious Diseases Center» GAUZ OKB №3 of the Ministry of Health of the Chelyabinsk Region in 2022 was carried out. The diagnosis was verified using polymerase chain reaction (PCR).

Results and discussion. There were two periods of an increase in the incidence of COVID-19: in January-February and in Au- gust-September 2022. 10041 people were hospitalized, in the first 48-72 hours of the disease 32% of patients consulted a doctor, the average age of the hospitalized was 72±5.2 years. At the onset of the disease, patients complained of abdominal pain in 26.3±3.9% of cases, nausea/vomiting in 29.1±4.9% and diarrhea in 32.5±4.1% of cases. The severity of lung damage according to computed tomography CT 0 was recorded more often than CT 1 and CT 2. Mortality among hospitalized patients amounted to 10.5%.

Fever is the most obvious clinical symptom of COVID-19. Understanding the relationship between temperature patterns and the host response to infection can help stratify patients by severity of the disease.

The objective of the study was to determine the relationship between clinical and biochemical differences between temperature patterns and the survival profile of patients with COVID-pneumonia.

Material and methods. Prospective observational study was conducted in adult patients of the Republican Clinical Infectious Hospital and the Clinical Emergency Hospital (Ufa, the Republic of Bashkortostan) from March 2020 to November 2021 during the first 5 days of their hospitalization.

Results. 125 patients with COVID-19 were divided into three groups according to temperature patterns: normothermia group 1 (n=44), hyperthermia group 2 (n=62) and hypothermia group 3 (n=19). Hyperthermia patients had the highest levels of inflammatoфry biomarker - C-reactive protein (p<0.001). Hyperthermia increased the need for mandatory ventilation, vasopressors, and the risk of death (HR 1.44; 95% CI 1.04–1.98; p=0.027) in comparison with other temperature patterns.

Conclusions. Hyperthermia in patients with COVID-pneumonia is associated with increased levels of inflammatory biomarkers, the frequency of cardiovascular and respiratory failure.

Chronic apical periodontitis is a serious problem of modern dentistry. It occupies a special place in clinical practice and requires complex etiopathogenetic therapy.

The objective of the study was to conduct an X-ray evaluation of the effectiveness of treatment of chronic apical periodontitis with preparations based on highly dispersed calcium hydroxide in the short and long term (after 6 and 12 months) using the proposed algorithm.

Material and methods. In the clinic of the Department of Dentistry of the Medical Institute of Penza State University, a dental examination and treatment of 25 patients (n=25) of the second period of adulthood with a diagnosis of «chronic apical periodontitis» (K04.5) were carried out.

Results. The results of treatment of patients with chronic apical periodontitis were evaluated on the basis of statistical data processing methods.

Conclusions. As a result of the analysis, it was found that the dimensional characteristics of the periodontal gap and the indicators of the optical density of the periapical region, determined at the stages of diagnosis, after treatment in the short and long term (after 6 and 12 months), demonstrated a persistent dynamic decrease and reflected the stabilization of the inflammatory process in the periapical region due to the effectiveness of etiopathogenetic therapy of chronic apical periodontitis, including temporary filling with preparations based on highly dispersed calcium hydroxide. The activity of reparative processes is more pronounced in the area of the apex of the tooth root compared to the zones of the lateral surface of the tooth root, which is due to the closer contact of irri- gation solutions and preparations based on highly dispersed calcium hydroxide with the apical region during the etiopathogenetic therapy of chronic apical periodontitis.

Objective: to study the adherence of patients with chronic prostatitis with chronic pelvic pain syndrome (CP/CPPS) to treat- ment, considering the duration of the disease and the features of the clinical course according to the UPOINT classification.

Material and methods. The transverse randomized uncontrolled study was performed on 112 patients diagnosed with CP/CPPS, with mean age 38.4±3.6 years. The duration of the disease varied from 1 to 12 years. The diagnosis of CP/CPPS was established on the basis of clinical symptoms and laboratory findings. All patients were assessed by their adherence to treatment and underwent a phenotypic classification in six domains depending on the clinical manifestations of the disease using the UPOINT method.

Results and discussion. When analyzing the data obtained in patients with CP/CPPS, an inverse correlation (r=-0.61) of a decrease in adherence to treatment with an increase in the duration of the disease was established. The maximum adherence to treatment was observed in the year of manifestation of the disease and amounted to 71.4%, while with a history of more than nine years, it decreased to 47.6%. The adherence study, taking into account the phenotyping of patients according to the UPOINT classification, showed the highest adherence to treatment in patients with CP/CPPS with a predominance of symptoms associated with the prostate. In this group, adherence to drug therapy was 88.1%, medical support - 84.7% and lifestyle modification - 79.1%.

Conclusions: 1. Adherence to treatment in patients with CP/CPPS is inversely correlated with the duration of the disease (r =- 0.61) and decreases most significantly (by 22.5%) in the period from 3 to 5 years of being ill.

1. Within the framework of adherence to the treatment of patients with CP/CPPS in the first year of the disease, according to the patients, drug therapy is of the greatest importance - 80.1%, medical support is considered less important - 72.6%, and the minimum contribution to treatment, in their opinion, is made by lifestyle changes.

Objective. To determine the influence of sex, age and various clinical characteristics on the urinary stones composition in patients in the Tula region.

Material and methods. A retrospective analysis of 143 patients’ clinical records was performed. The stones were classified according to the classification of the Mayo Clinic and the guidelines of the European Urological Association.

Results. In our study, there were 90 male patients, with male-to-female ratio 1.7:1. 61 stones were collected from patients aged 19-40 years, 61 from patients aged 41-60 years, 21 from patients over 60 years old. Only 9 patients had one-component stones, 92 patients were diagnosed with two-component stones, and 42 patients had three-component stones. Calcium oxalate stones (CaOx) were observed in 116 cases, calcium phosphate (CaPO) was found in 53 stones, 24 stone compositions included uric acid (UA), infection (struvite) stones amounted to 10. In male patients CaOx stones were observed in 60 cases, UA stones - 17, CaPO stones - 12, struvite stone - 1. In females, there were 31 CaOx stones, 10 UA stones, 8 CaPO, 4 infection stones.

Conclusion. This study presented a regional stone composition analysis in patients in the Tula region. The most of the urinary stones included CaOx (63.6% ), followed by stones including uric acid (16.8%), and infection (struvite) stones (7.0%).

The objective is to determine the topographic features of the rectum in the intermediate fetal period of the ontogenesis

Material and methods. The study was carried out on the sectional material of 45 male and female fetuses of 16-22 weeks of development from the collection of the Human Anatomy Department. A set of morphological techniques was used, such as maсromiсrosсopic prep- aration, making multi-planar cuts by Pirogov’s method, and multiple histological topograms stained by Van Gieson’s method.

Results. At this time, the high position of the sigmorectal transition is noted, the pattern of changes in its skeletotopy depending on the period of development. The position of the rectum in the frontal plane is unstable in the study period. The most stable sec- tions in relation to the rectum to the median line are the ampoule and the anal canal. The presence of three frontal flexures is determined; the intermediate left lateral and inferior right lateral flexures begin to form after 17 weeks. There is a sacral flexure of the rectum in the sagittal plane in 40% of cases. The syntopy of the rectum, with the exception of the anal canal, is characterized by great variability both in different age groups and within the same group, while the rectal syntopy in the female pelvic cavity is less constant than in the male pelvic cavity.

Conclusions. As a result of the study, new data were obtained on the topographic anatomy of the human rectum in fetuses 16-22 weeks of development, which can be used in interpreting the results of lifetime research methods, as well as for fetal surgery.

Objective. To study the ultramicroscopic features of chromaffin cells of the adrenal medulla of rats after 60-day exposure to tartrazine.

Material and methods. The experiment was carried out on 18 white mature rats. One ml of saline solution was administered in- tragastrically to animals of the control group daily for 60 days, while the rats of groups I and II were given an equivalent volume of tartrazine at a dosage of 750 and 1500 mg/kg, respectively. In accordance with the protocol for electron microscopy, the samples of adrenal glands were processed.

Results. In the nucleus of dark and light endocrinocytes, heterochromatin predominated, distributed in the karyoplasm in the form of moderately dense fine-grained accumulations; in the cytoplasm, small secretory granules and a weakly developed rough endoplasmic reticulum were detected in group I. Some mitochondria have destroyed cristae and membrane. In group II, in addition to the changes described above, more areas of the cytoplasm with destroyed contents between the mitochondria were recorded.

Conclusion. Electron-microscopic changes in chromaffin cells of the adrenal medulla, caused by 60-day exposure to tartrazine, indicate a decrease in their functional activity which is directly dependent on the administered dose.

The objective of the research was to study the subpopulation composition of lymphocytes in peripheral blood in white rats after mechanical injury of the soft tissues of the thigh.

Material and methods. The study was carried out on white mongrel rats weighing 180-200 g, in which, with the help of a special installation (falling load), a mechanical hip injury was caused simulating high kinetic damage to soft tissues [1]. The object of the impact was the right hind limb.

Results and discussion. The study of the subpopulation composition of lymphocytes in peripheral blood was carried out by im- munophenotyping. After 3 days, suppression of the T- and B-cell immunity link and a change in the relative content of immuno- competent lymphocytic cells (CD3⁺, CD4⁺, CD8⁺, CD19⁺, CD56⁺) were determined. After 14 days of the post-traumatic period, partial restoration of the T-cell link and activation of B-lymphocytes occurred.  

Conclusion. The maximum severity of changes in blood parameters after 3 days is associated with immunosuppression of all parts of the immune system in the acute period after injury, and partial recovery at a later date (after 14 days) is due to the activation of sanogenesis processes.

The object of the work was to study the expression of the CD34 marker by endothelial cells of the intrahepatic vascular bed in experimental rat liver cirrhosis.

Material and methods. Liver cirrhosis in Wistar rats was induced with thioacetamide for 17 weeks. The CD34+ cells were assessed by immunohistochemistry.

Results. In the liver of intact and all experimental rats, endothelial cells of the interlobular arteries, interlobular, central, and sublobular veins expressed the CD34 marker. They had an elongated shape and a rod-shaped dark-colored nucleus. Before the stage of transformation of fibrosis into cirrhosis, there were no CD34+ cells in the sinusoidal capillaries of liver. At the stage of transformation of liver fibrosis into cirrhosis, CD34+ cells of a rounded elongated shape with light rounded elongated nuclei were observed in sinusoidal capillaries. At the same time, among the cells of the lymphoid-histiocytic infiltrate of the connective tissue septa near the portal zones and interlobular bile ducts, islands of rounded CD34+ cells with dark-colored nuclei were observed.

Conclusions. The experiment revealed three morphological phenotypes of CD34+ cells and a slight tendency to increase their area.

The use of hepatoprotective compounds accelerating the regeneration processes in hepatocytes is based on the restoration of cellular structures. In this regard, it is relevant to expand the range of effective medicines with hepatoprotective activity.

The objective of the study was to conduct biochemical research to study the degree of activity of the hepatoprotective effect of extracts from the fruit body of the polypore Fomitopsis officinalis L. in carbon tetrachloride intoxication.

Material and methods. A fraction of water-soluble compounds of the fruit body of the medicinal polypore Fomitopsis officinalis L. was obtained. The hepatoprotective effect was studied on a model of acute hepatosis. A 50% carbon tetrachloride oil solution was administered to white mongrel male rats per os. The administered dose was 0.15 ml per 100 g of body weight of rats (3 times in 24 hours). The effect of carbon tetrachloride was compared with Carsil hepatoprotector of plant origin.

Conclusion. Biologically active compounds of polypore are able to prevent and eliminate the consequences of toxic damage to the liver with carbon tetrachloride, which indicates the presence of hepatoprotective properties in the fruit body of polypore. The revealed influence on the indicators of acute toxic hepatosis ensures the prospects of using new cultivated strains of basidial fungi in the creation of hepatoprotective agents.

The article presents studies on determination the antioxidant activity of fruit, shoots, flowers and leaves of three unofficial hawthorn species ‒ Crataegus pennsylvanica Ashe, Crataegus prunifolia (Marsh.) Pers., Crataegus macracantha L.

Material and methods. The studies were carried out by the spectrophotometric method. Antioxidant activity of hawthorn was determined by a technique based on the ability of the test solution to inhibit the autoxidation of adrenaline in vitro and thereby prevent the formation of reactive oxygen species. The antioxidant activity of various morphological groups of plant raw material (fruit, shoots, flowers and leaves) of C. pennsylvanica, C. prunifolia, C. macracantha was studied, and a comparative analysis of their water and alcohol extracts was carried out.

Results. According to the experiment conducted, all the studied extracts have antioxidant activity (more than 10%). The highest antioxidant activity was observed in C. pennsylvanica, especially in the infusion of leaves (68.00±1.07)%, and the lowest in the C. prunifolia fruit tincture (24.10±0.59)%.

Conclusion. The antioxidant activity of leaves, flowers, and shoots turned out to be higher than that of fruit of the studied species, therefore, further study of shoots of C. pennsylvanica, C. prunifolia, C. macracantha is promising.

The increase in the prevalence of delivery by caesarean section around the world leads to an increase in patients who have two or more «scars on the uterus». The frequency of CS in the world averages 30%, which inevitably increases the percentage of complications associated with it. There is no consensus in the modern literature on the technique of delivery in patients who have undergone two or more cesarean section operations. With the growth of caesarean section, the percentage of postoperative complications increases. In modern literature, there is no consensus on the delivery technique for patients with two or more caesarean sections.

Material and methods. Our department was contacted by a patient 37 weeks pregnant, who had a history of cesarean section surgery in 2013 and 2016. During operative delivery, it was decided to perform metroplasty (patent №2790787).

Results. During this pregnancy, the patient was diagnosed with a «niche». The pregnant woman was repeatedly hospitalized with the threat of premature birth. After delivery using the proposed method, no early postoperative complications were noted. 6 months after the operation, ultrasound and magnetic resonance imaging were performed: the «niche» was not diagnosed.

Conclusion. The use of the metroplasty technique makes it possible to reduce postoperative blood loss, the risks of forming a «niche» and subsequent complications associated with this.

The objective of the research is to study and evaluate the possibilities of minimally invasive surgical interventions and manipulations in the treatment of complicated forms of liver alveococcosis and post–resection consequences.

Material and methods. In total, in the period from 1995 to 2021, 72 patients with liver alveococcosis were treated in the conditions of the G.G. Kuvatov Republican Clinical Hospital. The patients were divided into two groups. The main group consisted of patients with alveococcosis of the liver who were treated from 2008 to 2021, the comparison group consisted of patients hospitalized at the G.G. Kuvatov Republican Clinical Hospital with liver alveococcosis from 1995 to 2007. Out of 72 patients, 60 had various liver resections: 34 (57%) in patients with uncomplicated liver alveococcosis, and 26 (43%) in patients with complicated liver alveococcosis. Among 14 (100%) patients of the main group with complicated liver alveococcosis, minimally invasive surgical interventions before various liver resection options were performed in 12 patients (86%). In the comparison group, minimally invasive interventions were performed only in 4 (33%) patients out of 12 (100%) with complicated alveococcosis.

Results. Post-resection complications in both groups of patients were observed in 16 cases, of which 5 (31%) in the main group and 11 (69%) in the comparison group. In patients of the main group, complications were stopped by minimally invasive surgical interventions.

Conclusion. The use of minimally invasive surgical interventions can reduce the number of post-resection complications. In case of complications after liver resection, minimally invasive manipulations provide a favorable outcome without the use of extensive surgical approaches.

The objective of the study was to conduct a three-dimensional quantitative analysis of the arterial and venous bed of the kidney with the identification of areas of arterial blood supply and venous outflow in the parenchyma in the dichotomous variant of renal artery division.

The material for the study was 124 polychrome corrosion specimens of arterial and venous vessels of the human kidneys, which were subjected to 3D scanning followed by a three-dimensional analysis of the vascular bed of the kidney. Scanogram data were imported into special modules of IntelliSpase Portal and Synapse 3D workstations for automatic calculation of the volume of vascular beds.

Results and discussion. Dichotomous and trichotomous variants of division of the main renal artery in relation to the frontal, sagittal and horizontal plane into vessels of the 2nd order were determined, that is, zonal arteries - “A. (zonal)» (II) which form certain arterial pools in the parenchyma of the organ, consisting of 3 groups. The first group included kidneys with a dichotomous division of the main renal artery in relation to the frontal plane, forming 2 arterial pools in the ventral and dorsal half of the kidney (that is, with a dual-zone blood supply), which amounted to 11 variants (51.8%). The second group consisted of kidneys with a dichotomous variant of division, forming arterial pools in the parenchyma of the upper and lower poles of the kidney, which included 4 variants (27.1%).

Conclusions. It has been found that the sources of blood supply to the zones of the kidneys, that is, the number of zonal arteries, have their own differences depending on the variants of division of the main renal artery and the types of branching of its intraorgan arterial vessels. The number of venous vessels involved in the drainage of various zones of the kidney and the places of their confluence at the level of the links of the main venous vessels depend on the variants and types of vein fusion in its intraorgan venous bed.

Objective of the study. Determination of the most effective ways to improve social support measures for children and adolescents with autism spectrum disorder (ASD), as well as the development and expansion of the material and technical base of institutions providing them with medical and rehabilitation support in the Republic of Bashkortostan.

Material and methods. The analysis of modern domestic and foreign literature and official statistics on the organization of social work carried out with children and adolescents with ASD in specialized institutions of the Republic of Bashkortostan, was performed.

Results and discussion. Today in Russia, there are about 725,000 children with special needs. The range of severity of developmental disorders in people with ASD is quite wide, which complicates the creation of uniform standards to help them. To effectively solve the problems of adaptation and socialization of persons with ASD, an integrated approach is required, including the availability of modern diagnostic methods. In the structure of diseases that are the main causes of childhood disability in the Republic of Bashkortostan, the first place is occupied by diseases of the nervous system - 30.3%; second - mental and behavioral disorders - 25.1%; third - congenital abnormalities - 15.8%. As of January 1, 2023, there were 2,174 children diagnosed with ASD under the supervision of psychiatrists in the Republic of Bashkortostan, 342 of whom attend preschool educational organizations.

Conclusion. A study of world and regional experience in the social adaptation of children with ASD was carried out, as well as the collection and analysis of statistical data to enhance rehabilitation assistance.

The objective of the study: to review the literature illustrating modern ideas about the potential role of the thyroid gland and adrenal glands in the infectious process of the COVID-19 new coronavirus infection.

Results: The new COVID-19 coronavirus infection is well known for its respiratory complications. However, as experience with COVID-19 patients has shown, it can also cause extrapulmonary manifestations, including cardiovascular, gastrointestinal, renal, hematological, hepatic, neurological, and endocrine disorders. Endocrine complications of COVID-19 are rare, and therefore less studied and require special attention. At the moment, COVID-19 is known to be a cause of the development of endocrine pathology on the part of the thyroid gland and adrenal glands, which is manifested by the following diseases: subacute thyroiditis, non-thyroidal illness syndrome, Hashimoto's thyroiditis, Graves’ disease, adrenal insufficiency and Cushing's syndrome. Studying the interaction between COVID-19 and the endocrine system in the future will make it possible to assess the severity of the disease and predict its outcome.

Acute leukemia accounts for approximately 2-3% of human malignant tumors; however, among hemoblastoses it occupies one of the first places in terms of frequency of occurrence. The incidence of acute leukemia averages 3-5 cases per 100000 of the population per year. In 75% of cases the pathology is diagnosed in adults, in 25% of cases in children. The average ratio of acute myeloid to lymphoid leukemia is 6:1. At the same time, persons over 40 years of age are statistically more frequently diagnosed with acute myeloid leukemia, while in children acute lymphoblastic leukemia is observed more often. For a long time, acute leukemia was considered incurable, but with timely treatment the recovery rate now ranges from 45% to 80%. This result has been achieved through the introduction of high-dose risk-based chemotherapy, hematopoietic stem cell transplantation and concomitant treatment, but unfortunately, there are still significant differences in the effectiveness of therapy. This literature review of current approaches to the treatment of acute leukemia presents predominantly Russian studies.

The frontal sinuses are highly variable structures of the human body. Despite the long history of description and study, today there are still many questions related to the features of their structure and biological role in the organism. The structure of frontal sinuses is determined by a combination of internal and external factors, as a result of which the morphology of the frontal sinuses is strictly individual for every person. Modern imaging methods allow a detailed assessment of the structure of the sinuses, which is widely used in practice. The article highlights issues related to the development, shape, features of communications of the frontal sinuses, their individual variability. The uniqueness of the morphological features of the frontal sinuses allows them to be used in such branches of science as forensic medicine and anthropology for the purpose of identifying a person. The course of a number of diseases can be modified depending on the morphological features of the frontal sinuses. Also, today the problem of providing prompt access to the sinuses during rhinosurgical intervention remains relevant as a result of high variability and inaccessibility. Thus, planning of modern minimally invasive and microsurgical methods of treatment requires knowledge of the individual features of the structure of the frontal sinuses.

The bipedalism that developed in anthropogenesis process radically changed the functional basis in human pelvic floor muscles. In quadrupedals the main function of levator ani muscle is the movement of the tail associated with the flexion of tailbones and tail tucking towards the trunk; in humans it is the closure of the pelvic cavity and organs support, as well as the regulation of urine, feces, seminal fluid passage in men, and labor activity in women. Analysis of dynamic protection mechanisms in the area of pelvic outlet will allow understanding pelvic diaphragm and perineal muscles morphofunctional aspects during physiological processes (urination, defecation, labor, etc.); but also it will form the knowledge about possible causes of pelvic floor insufficiency, urinary and fecal incontinence, sexual dysfunction, and pelvic organ prolapse.

Objective. According to literature data review and own research, the objective is to develop a new concept about pelvic floor and perineal muscles activity, pelvic organs dynamic support, and regulation mechanisms in metabolic products excretion and labor regulation.

Results. We developed conceptual schemes of pelvic floor and perineal skeletal muscles sling shape architecture based on literature data analysis. We describe five skeletal muscle sling structures in men, and six in women. This theory of sling structures in pelvic floor and perineum may allow expanding the approach to the pathogenesis and treatment of pelvic floor dysfunctions, perineal muscle injuries, urinary and fecal incontinence, as well as pelvic organ prolapse.