Objective: to study the effectiveness of a new cardioplegic solution in comparison with Custodiol solution during coronary artery bypass graft surgery (CABG).

Material and methods. A total of 146 patients with ischemic heart disease who underwent isolated CABG surgery in conditions

of artificial circulation in the period from April 2018 to August 2021 were selected. A cohort of patients was randomly divided into 2 groups: Group 1 included 88 patients who underwent isolated CABG using blood isothermal cardioplegia with a new cardioplegic solution; Group 2 consisted of 58 patients who underwent isolated CABG accompanied by cardioplegia with Custodiol solution. As part of the preoperative diagnosis, each patient was assigned a complex of laboratory and instrumental studies. The analysis of the results was based on a comparison of intraoperative and perioperative (24 hours after surgery) indicators in both groups.

Results. Cases of unstable angina pectoris significantly prevailed in the first group (63.5% vs 32.76% p=0.001). The frequency of angina pectoris, on the contrary, was higher in the second group (63.8% vs 35.3%, p=0.001). In both groups, the values of cardiac output were satisfactory (59.24±7.31 vs 57.95±8.57; p=0.561). Lactate levels were lower in Group 1 than in Group 2. Patients from the first group left intensive care units on average 2 times faster than those who received Custodiol in cardioplegia. The number of bed days was lower in Group 1 patients. The frequency of postoperative complications was comparable in both groups.

Conclusion. In the postoperative period, there are no statistically significant differences in the frequency of complications after the use of isothermal blood cardioplegia with a new cardioplegic solution and cardioplegia with Custodiol during CABG surgery.

The Enhanced Recovery Program (ERP) is a special strategy of perioperative management aimed at reducing the duration of treatment with improved postoperative outcomes. There are several main causes of persistent violation of the evacuation function of the kidneys. These are mainly strictures of the ureter or the ureteropelvic junction.

The aim of the study was a comparative analysis of the outcomes of the use of the developed protocol of enhanced recovery in laparoscopic plastic surgery on the ureter and the ureteropelvic junction.

Material and methods. A prospective randomized blind study was performed on 90 patients who were treated in the period 2017-2022. All patients were divided into two comparison groups: the standard treatment protocol (n=46, group I; St), and the group cured by the ERP protocol (n=44, group II; ER).

Results. Both protocols lead to recovery (91.3% vs 95.4%; p=0.883), with a similar level of postoperative complications of classes I–III (p>0.05), indicators of postoperative status (p>0.05) and comparable efficacy after two years of postoperative follow-up (p=0.430), without increasing the risks of repeated treatment or reoperations (p>0.05).

The use of the ERP protocol makes it possible to shorten the period of treatment; reduce postoperative pain (according to VAS); achieve a better postoperative functional state (according to the severity of nausea, vomiting, USSQ and other parameters); shorten the duration of stenting and catheterization (p <0.05).

Conclusion. The use of the developed protocol of enhanced recovery makes it possible to improve the results of surgical treatment of strictures of the ureteropelvic junction and ureter.

Objective of the study is to improve treatment results and reduce the number of postoperative complications in patients with pilonidal sinus.

Material and methods. A comparative analysis of the treatment results in 60 patients divided into three comparable clinical observation groups was performed. In the 1st group (main group), the new developed two-stage method was used (RF patent № 2770283). In the 2nd group, the «cleft lift» procedure was applied. Wide excision of fistulous passages and closure of the postoperative defect without using the «cleft lift» procedure were carried out in patients of the 3rd group.

Results. In patients of the 1st group, the postoperative period proceeded more smoothly. The frequency of wound suppuration was minimal in comparison with other patient groups - 2 cases (10%). There were no significant infiltration-inflammatory complications in patients treated by the new method. In the 2nd group, the suppuration of the wound occurred in 4 patients (20%), in one case (10%) a recurrent fistulous passage was formed, in 2 patients (10%) prolonged resorption of infiltrates which required drainage and sanation of the wound occurred. There were recurrences in 10% of the patients. In the 3rd group, the total proportion of relapses was 15%, the total proportion of postoperative complications amounted to 45%. The duration of treatment in the 1st group was reliably less (4,6±1,3 days) as well as the period of temporary incapacity for work (9,7±1,3 days) in case of smooth course, and in case of wound suppuration it was 15±1 days in comparison with the control groups data.

Conclusions. The developed method of two-stage surgical treatment of pilonidal sinus makes it possible to increase the efficiency of surgical treatment, decrease the number of recurrences and complications, and reduce the period of temporary incapacity for work.

The objective is to study the clinical and laboratory features of a new coronavirus infection in outpatients during the circulation of the Omicron gene variant of SARS–COV-2.

Material and methods. The case histories of 100 outpatients (79 men, 21 women) aged 24 to 59 years with confirmed COVID-19 infection were retrospectively analyzed. The etiology of the disease was verified by the determination of SARS-CoV-2 RNA in nasopharyngeal samples by polymerase chain reaction (PCR). Statistical data analysis was carried out using the IBM SPSS Statistics 26 program. The Student and Pearson criteria were used in the calculations. Differences in indicators were considered statistically significant at p<0.05.

Results. In most outpatients, a new coronavirus infection occurred with a predominant lesion of the upper respiratory tract. At the onset of the disease, the characteristic clinical symptom in young patients was sore throat which was recorded twice as often as in middle-aged patients. An increase in temperature to subfebrile figures was recorded in 50% of cases. Cough syndrome was not typical for young patients. In 42% of patients, the level of acute-phase C-reactive protein was 1.2-1.5 times higher than the reference values.

Conclusion. COVID-19 infection caused by the Omicron gene variant in outpatients in most cases had a smooth course, and was characterized by a predominant lesion of the upper respiratory tract.

The progression of the purulent-necrotic process in acute destructive pancreatitis beyond the pancreatic tissue with its spread along the retroperitoneal tissue leads to severe complications.

The purpose of study is to characterize the morphological features of extraorgan adipose tissue depending on the type of acute destructive pancreatitis.

Material and methods. A morphological study of intra- and extraorgan adipose tissue was carried out in 27 patients who died from complications of acute destructive pancreatitis. The control group consisted of 12 patients without signs of diseases of the abdominal organs, who died from acute cerebral circulatory disorder (heart attacks and cerebral hemorrhages). The mean age of the patients was 56.34±6.78 years. Fragments of parapancreatic tissue in the region of the head, body and tail of the pancreas, perirenal tissue on the right and left sides, tissue of both lateral canals, small pelvis and epicardium, root of the mesentery of the intestine and subcutaneous adipose tissue in the region of the anterior abdominal wall were studied. Morphometric study of fat cells consisted in assessing the average number of adipocytes in the field of view, their area, nuclear-cytoplasmic ratio.

Results. With the development of foci of destructive changes in the pancreatic tissue and their spread to certain sections of the retroperitoneal tissue, reactive processes in adipocytes of various localizations differ.

Conclusion. The data obtained give grounds to suggest a systemic nature of metabolic changes and violations of the synthetic function of adipocytes in the development of various types of acute destructive pancreatitis.

The purpose of the research is the study of burdock leaf juice effect on the reproductive function of laboratory rats in order to determine the feasibility of its use in pregnant women.

Material and methods. The intragastric administration of burdock leaf juice at doses of 1 and 10 ml/kg was given to Wistar rats throughout the period of pregnancy (days 1-19). At the end of the antenatal period, embryonic material was studied in half of the obtained females. The second group of females was kept for giving birth and nursing of infant rats to estimate their development in the postnatal period.

Results. As a result of the studies carried out, it was established that the burdock leaf juice did not exhibit embryotoxic and teratogenic properties and had no toxic effect on the postnatal development of the offspring when the doses exceeded the therapeutic ones by 10 and 100 times.

Conclusions. The results obtained suggest that a drug based on burdock leaves can be prescribed to pregnant women in the recommended therapeutic dose in further clinical trials.

The purpose of the study. The presented results of the study show the possibility of intensifying the extraction processes of phenolic compounds from medicinal plant raw materials under the influence of electric voltage.

Material and methods. Studies have been conducted on the effect of electric current on the efficiency of extraction of flavonoids from Thyme herb as a result of the application of alternating and constant voltage. The determination of the flavonoid content was carried out using differential spectrophotometry, rutin was used as a standard sample. In the course of the study, the effects of alternating voltage of 5 V in the frequency range of 10-3-105 Hz and constant voltage in the range of 1.5-12 V were studied.

Conclusion. It has been found that the electrical voltage has a different effect on the extraction of phenolic compounds from Thyme herb. It is proved that the effect of electric voltage increases the efficiency of flavonoid extraction compared to pharmacopoeia methods. The use of electric voltage allows extraction without increasing the temperature, which is a positive factor for the extraction of substances in their native form.

The purpose of the study is the synthesis and study of the structure-activity relationship (SA) of chromone derivatives using quantum chemical parameters (QCP).

Material and methods. QCP of the synthesized compounds were calculated by the PM7 semi-empirical method (WinMopac 2016 program; Intel Xeon ES-1620 processor 3.5 Hz, 20 GB RAM). The results obtained were statistically processed.

Results and discussion. The use of the logical structural approach (LSA) made it possible to construct virtual structures that were subjected to preliminary pharmacological screening using the Way2Drug PASS Online program, which made it possible to select a number of structures that were further synthesized and studied in accordance with the prediction.

Conclusions. Regularities of SA between pharmacological activity and QCP of chromone derivatives were revealed.

The effectiveness of the pharmacy organization (PO) is determined by the ability of its head to adapt the activities of the PO depending on the emerging situation.

The purpose of the study was to assess the most important factors for the work of the PO head in Russia (on the example of Ufa) and the USA.

Material and methods. As an information source, we used the results of a sociological survey conducted by the American Society of Pharmaceutical Workers in 2017. A sociological survey in Ufa was conducted in 2019 with the involvement of 154 pharmaceutical specialists.

Results and discussion. Research shows that the most important factors in the work of the head of the PO in the USA are the job stability (8,6 points), convenient time schedule (8,2 points), multitasking ability (8,1 points). According to the participants from Ufa (general assessment), the three most critical factors are communication skills, stress tolerance and decent wages (8,1 points, 8,0 points and 7,2 points respectively).

Conclusion. Despite the sufficient differences in the importance of most factors, such a factor as stress tolerance is of utmost importance in the work of the head of the PO in both countries.

The purpose of the study: classification of municipal entities of the Novosibirsk region.

Material and methods. The resource potential of 35 municipal entities of the Novosibirsk region was studied according to 77 factorial features copied from the reports of the Medical and Analytical Information Center, the territorial body of the Federal State Statistics Service for the Novosibirsk region, the Ministry of Ecology and Natural Resources of the Novosibirsk Region, the Territorial Administration of Rospotrebnadzor for the Novosibirsk region for 2020-2021. Content analysis, logical, statistical and multidimensional grouping methods were used.

Results and discussion. It has been found that a low and below average indices of availability of pharmaceutical care were detected in 15 (40%) municipal districts that are poorly economically developed agricultural areas (Kochkovsky, Kyshtovsky, Ubinsky, Chanovsky, Chulymsky, etc.), remote from the administrative center, i.e. Novosibirsk. They are characterized by a low standard of living, a shortage of pharmaceutical organizations and pharmaceutical workers. The average and above average indices of availability of pharmaceutical care were found in 15 (40%) municipal districts which are medium-economically developed, agrarian (Barabinsky, Bolotninsky,Dovolensky, Kargatsky, Krasnozersky, Ordynsky, etc.), agro-industrial (Iskitimsky, Severny, Kuibyshevsky), multiindustrial (Suzunsky, Novosibirsk, Kolyvansky) districts. There is a shortage of pharmaceutical workers and pharmaceutical organizations.

It was found that a very high and high indices of availability of pharmaceutical care were identified in 5 (14.28%) multi-industry urban districts that are located in the administrative center (Novosibirsk, Koltsovo), or geographically close to the administrative center of the region (Novosibirsk, Ob). There is no shortage of pharmaceutical workers or pharmaceutical organizations in these urban districts.

Conclusion. The use of classification made it possible to assess the potential of the environment, the availability of pharmaceutical care in municipal entities for making scientifically sound management decisions by the health authorities of the Novosibirsk region to align it, to model the directions of optimization of regional drug policy.

Objective. Analysis of the use of digital technologies by pharmacy organizations.

Material and methods. The results of a sociological survey of 116 employees of pharmacy organizations were used as research objects. Analytical data processing was carried out in the Microsoft Excel program. Methods of grouping, sociological, comparative, mathematical and statistical analyses, and content analysis were used in the performance of the work.

Results. The main directions of the introduction of digital technologies were electronic internal document management systems and employee training. The majority of respondents noted the effect of the use of digital technologies as significant and decisive. Automation of activity had the greatest impact on the activity of the pharmacy organization. The main problems are the lack of experience in implementing such projects and insufficient technological competence of users. The main barriers to the wider use of digital technologies by pharmacy organizations were the lack of staff qualifications and resource constraints.

An injury of a large vessel is a serious trauma and poses a danger to the patient’s life. The frequency of iatrogenic damage to blood vessels in the joint structure of vascular damage ranges from 15% to 40%.

A rare case of damage to the pulmonary artery, which caused a potentially fatal complication, has been described. A 68-year-old patient, during coronary artery bypass grafting surgery, had a linear rupture of the trunk of the pulmonary artery closer to the bifurcation with a length of up to 2-3 cm.

In our case, the proposed sealing technique with tamponing of the aortopulmonary space helped to stop the bleeding and avoid further complications.

At the moment, when managing patients with non-organ retroperitoneal tumors, doctors are faced with the lack of a generally accepted classification, treatment tactics and diagnosis of this disease, which is due to the low number of cases in clinical practice.

Material and methods. Patient N., female, 56 years old, was admitted to the clinic with complaints of periodic pain of unclear genesis in the lumbar region, fatigue, headaches. The symptoms appeared in 2014, the patient was examined on an outpatient basis, an ultrasound examination of the abdominal cavity was performed (no abnormality). With the increase in the clinical picture, she turned to the polyclinic at her place of residence again, an ultrasound examination was performed, the results of which revealed a cystic formation presumably in the retroperitoneal space.

Results and discussion. The patient underwent a comprehensive diagnosis using laboratory and instrumental research methods, surgical removal and histological examination of the cyst. The duration of observation of a persistent relapse-free period was 1.5 years.

Conclusion. A favorable result of treatment of non-organ retroperitoneal cysts can be achieved with a multidisciplinary comprehensive diagnostic approach in the process of evaluating clinical and instrumental data, which allows identifying and establishing indications for endovideosurgical treatment of the disease, which is the method of choice due to low traumatization.

The article describes a clinical case of Purtscher’s retinopathy against the background of acute pancreatitis in a 33-year-old man. This disorder belongs to rather rare ocular fundus pathology and can develop against the background of an acute pancreatitis attack. The clinical case is interesting for modern ophthalmologists.

Material and methods. The article presents and describes common diagnostic methods: examination, visometry, tonometry, ophthalmoscopy, optical coherence tomography (OCT), fundus camera examination, laboratory biochemical blood tests, abdominal ultrasonography.

Results and discussion. In the course of treatment, the patient achieved a stable, relatively favorable result, which was expressed in an increase in visual acuity, reduction of retinal edema, and restoration of blood circulation in the parapapillary area.

Conclusions. Comprehensive examination using instrumental and laboratory methods and timely etiological treatment allow correct diagnosis and obtaining a relatively positive treatment outcome.

The article presents a review of the literature on superficial venous thrombosis of lower limbs for the last 10 years. The article presents the relevance of the problem of superficial venous thrombosis in real time, determines the indications to surgical and medical treatment for patients with acute superficial venous thrombosis, describes the types and features of the main surgical methods of treatment and possible complications.

Over the past decades, superficial venous thrombosis of the lower limbs has been one of the most frequent causes of acute vascular pathologies patients have been referred to surgeons with, which requires hospitalization both in specialized and general surgical departments. This pathology has been repeatedly studied and continues to be studied, taking into account the emergence of new methods of both conservative and surgical treatment (crossectomy, flebectomy, mini-flebectomy, laser, radiofrequency, and cyanoacrylate obliteration methods). The choice of the appropriate treatment method, in view of the multiple different methods, is still directly connected to the personal opinion and experience of the doctor and remains a difficult moment in the treatment of patients.

The work reflects the unsolved problems in choosing the optimal tactics of treatment of patients with acute superficial venous thrombosis.

Keyword search in PubMed, MEDLINE, Medscape and ScienceDirect databases was used.

Against the background of the ongoing pandemic, the most important pathogenetic mechanisms of COVID-19 are being intensively studied, which largely determine the severity of the course and prognosis of the disease, including the immune-inflammatory syndrome and disorders in the hemostasis system. In this regard, it is important to study the polymorphism of genes that control the blood coagulation system.

The purpose of the work is to analyze the polymorphism of some genes of the hemostatic system, the influence of its most significant indicators on the course and outcomes of COVID-19 according to the available literature.

Material and methods. A search for sources in the databases PubMed, elibrary, cyberleninka was carried out in order to determine the polymorphism of some genes of the hemostasis system in patients with COVID-19.

Results. In comorbid patients with COVID-19 on the background of chronic diseases of the cardiovascular system, neurological and oncological pathology, it is possible to study the polymorphism of the MTHFR C677T gene and associate it with the formation of thromboses. Since it has been established that a violation of the MTR gene polymorphism leads to hyperhomocysteinemia. Homocysteine can have a damaging effect on the vascular endothelium with the development of endothelial dysfunction, hypercoagulation, which can lead to thrombosis.

Mutation of the MTRR gene may not lead to endothelial dysfunction, but is clearly associated with severe chronic heart failure in women. A severe course of COVID-19 is often recorded in this group of patients.

The polymorphism of the F2 G20210A, F5 G1691A, FGB G-455A, ITGA2 C807T, ITGB3 T1565C, PAI-1 5G-6754G genes should also be investigated, since their mutations can lead to thrombosis and complications during the course of the disease.

Findings. Literature data indicate that polymorphism of a number of genes of the hemostasis system can affect the severity and outcomes of COVID-19. However, according to the results of the studies, no genetic markers that could predict the development of an unfavorable course and thrombosis in COVID-19 have been identified.

This article presents an analytical review of the literature data on the prevalence of ticks, carriers of the Congo-Crimean hemorrhagic fever virus, on the territory of Kazakhstan. According to the literature review, Southern Kazakhstan, which includes the Kyzylorda, Zhambyl and Turkestan regions, is unfavorable in terms of the Congo-Crimean hemorrhagic fever. The most common carriers of the virus in these areas are Hyalomma asiaticum, Hyalomma scupense, Hyalomma anatolicum. The infection rate of ticks ranges from 0.3 to 20.2%.

A significant range of true altitudes and features of water relationships determine the presence of various landscapes in Kazakhstan, which have a significant impact on the species composition and the number of carriers and vectors of the Congo-Crimean hemorrhagic fever virus. It is recommended to carry out timely and effective preventive measures to control ticks in the areas with a high incidence of Congo-Crimean hemorrhagic fever.