Objective. To improve the results of organ-preserving treatment of acute purulent pyelonephritis by the combined use of retroperitoneoscopic sanitation of the purulent focus and prolonged intra-arterial perfusion of drugs.

   Material and methods. As part of the study conducted in the second urology department of the Regional Clinical Hospital, the authors examined and operated on 30 patients with purulent pyelonephritis using an innovative hybrid technique (patent No 2620756). This technique involves the removal of the affected areas of the kidney by retroperitoneoscopic access, followed by a regional arterial infusion of alprostadil through a catheter inserted endovascularly into the renal artery. Upon admission, all patients underwent a general clinical examination. Surgical materials were subjected to microbiological and morphological analysis. To assess the condition of the kidneys before and after surgery, MSCT with bolus contrast and duplex scanning of the renal vessels were performed.

   Results. On the first day after surgery, patients noted pain reduction in the area of the operated kidney. Comparison of CT data before and after the intervention showed the elimination of destructive foci in the kidney and improvement of blood supply in the affected area. Morphological examination revealed leukocyte infiltration and edema, accumulations of platelets in the lumen of dilated peritubular capillaries. In all cases, it was possible to avoid removal of the kidneys.

   Conclusion. The proposed method of treating purulent pyelonephritis, including an integrated approach to restoring blood circulation in the kidney and improving the access of antibiotics to the organ parenchyma, demonstrates its high efficiency. This method provides a targeted effect on each level of the vascular system and kidney tissues, affecting areas with microabscesses.

   In hemorrhagic fever with renal syndrome (HFRS), intoxication syndrome (IS), an integral part of which is endogenous intoxication, plays a major role in the pathogenesis.

   Study objective. To evaluate objective criteria of IS during the infectious process depending on its severity against the background of basic therapy for HFRS.

   Material and methods. 57 patients were examined: 36 with moderate and 21 with severe course. Biochemical indices and parameters of IS were studied: average mass molecules at two wavelengths, 254 and 280 nm (MCM254, MCM280), total and effective albumin concentration (TAC and ECA) with calculation of its binding capacity (ABC) and toxicity index (TI).

   Results. Liver damage with the development of reactive hepatitis with cytolytic syndrome, an increase in MCM254, MCM280, IT, a decrease in TAC, ECA and ABC, which depended on the period of HFRS and were more pronounced in severe cases, were revealed. Basic therapy did not lead to the normalization of the above indicators of endogenous intoxication by the time of clinical recovery.

   Conclusion. Presence of cytolytic syndrome of hepatocytes and objective laboratory criteria of IS by the time of clinical recovery will help to optimize approaches to pathogenetic therapy.

   The aim: to study the role of DNA repair system gene polymorphisms XRCC1 rs25487 and rs415407 as risk factors for male infertility.

   Material and methods. The study was conducted at the ART clinic «Family» in Ufa. 197 men of reproductive age were examined. The main group consisted of 112 infertile patients, the comparison group – 85 fertile men. Sperm analysis was performed in accordance with the WHO protocol (2010). DNA was isolated from sperm using the QIAamp DNA Micro Kit. Determination of the genotypes of polymorphic loci gene XRCC1 was performed using the TaqMan allele discrimination method. Allelic discrimination analysis was performed on the CFX96 Real-Time PCR Detection System. The results of allelic discrimination were analyzed using the CFX96 Real-Time PCR Detection System software.

   Results. It was found that the rs25487*GG genotype and rs25487*G allele are markers of an increased risk of autopathic male infertility, while the rs25487*AA genotype and rs25487*A allele are associated with a reduced risk of decreased fertility.

   Conclusion. Polymorphisms of the genes of the DNA repair system are associated with the reproductive status of men. The obtained data are evidence that polymorphic variants of the XRCC1 protein gene contribute to an increased risk of pathospermia.

   The importance of molecular-oriented and genetically-based analyses aimed at studying gingival sulcus and periodontal pocket is becoming an important direction in science, especially in the context of understanding the relationship between the health of the dental alveolar structure and multiple system-wide pathologies.

   The aim of the study was to identify possible mechanisms of interrelation between severity of hearing loss and oral cavity periodontogenes.

   Material and methods. In the course of the work, the dental status was assessed in 120 participants with varying degrees of hearing loss. Microorganisms identification was performed by polymerase chain reaction (PCR) using Multident-5 reagents with control before the start of prevention, after six and twelve months. Every three months, the patient came for examination and received individual recommendations on oral hygiene.

   Results. Significant improvements were recorded in patients with the first, second, third and fourth degrees of hearing impairment compared to the baseline data.

   Conclusion. In patients with mild and moderate hearing loss (1st and 2nd degrees), there is a slight but noticeable decrease in the number of pathogenic microorganisms in the gingival sulcus compared with patients with severe hearing loss (3^rd and 4^th degrees) due to a higher level of hygiene measures. The control of dental hygiene and individual recommendations help to improve the condition of the oral cavity.

   Objective. To conduct a qualitative and quantitative analysis of electrocardiograms (ECG) of patients with COVID-19-associated pneumonia (COVID-19-AP) with a registered J-wave (J) and to evaluate the relationship between the width of the QRS complex and the duration of the corrected QT interval (QTc) in the presence and absence of J in patients with COVID-19-AP.

   Material and methods. Out of 386 patients in the COVID hospital, 47 patients with COVID-19-AP with J were selected and they formed the main group. The average age of patients was 62 ± 10.5 years (58-72.5) old, females predominated – 35 patients (74.5 %). 339 patients with COVID-19-AP without J formed the control group. The average age was 58 ± 9.5 years (48.5-66) old, females predominated - 195 patients (57.5 %). All underwent ECG.

   Conclusions. Among patients with COVID-19-AP with J, in half of the cases J was recorded in the inferior leads (II, III, aVF - 51.1 %), in the other half of the patients – in the lateral leads (I, V5, V6 - 48.9 %). 2) The width of the QRS complex and the duration of the corrected QT interval among patients with COVID-19-AP were significantly greater in the group of patients with J compared to patients without J.

   Cholestasis leads to the development of biochemical, physiological and morphological changes. Therefore, accurate information about the morphology of the structural components of the biliary tracts is necessary for cholestasis.

   Aim. To evaluate the structural and morphometric characteristics of the lymphoid formations of the left and right hepatic ducts of animals after mechanical blockade of the common hepatic duct.

   Material and methods. The study was conducted on 30 rabbits of no specific breed (15 in the main group, 15 in the control group). By taking the common hepatic duct into a ligature, a model of cholestasis was created. For macromicroscopic examination, pieces of the left and right hepatic ducts of rabbits from the experimental and control groups were taken. The prepared sections were stained with hematoxylin-eosin, methylene blue, and the Van Gieson method. Lymphoid nodules on whole preparations were studied using the Hellman T method.

   Results. According to our data, after mechanical blockage of the common hepatic duct, in the walls of the left and right hepatic ducts swelling and stagnation in the veins are observed, the size and quantitative indicators of lymphoid structures decrease, the percentage of cells in a state of degeneration increases, large lymphocytes and cells with a pattern of mitosis are not observed.

   The aim of the study was to assess the damaging effect of generalized convulsive seizures on the brain in the acute and long-term periods of traumatic brain disease.

   Material and methods. The experiments were performed on white rats with high and low convulsive readiness after severe traumatic brain injury (TBI). Spontaneous and audiogenic seizures were evaluated. Memory was studied by the method of conditioned reflex of passive avoidance, a general assessment of the state of neurons, their numerical density in the fields of CA₁, CA₃ of the hippocampus on preparations stained with hematoxylin-eosin, according to Nissl.

   Results. In the acute and long-term periods of TBI, a decrease in memory volume, a decrease in the density of neurons in the fields of CA₁, CA₃ of the hippocampus with an increase in the number of dystrophic and necrobiotically altered neurons were revealed. In rats with trauma-induced epileptic status, cognitive deficits and damage to the neural network were more significant. With high convulsive readiness, memory loss correlated with a decrease in the total numerical density of neurons in the hippocampus.

   Conclusion. Experimental data indicate the destructive effect of TMI on memory, which are based on structural damage to the brain. Cognitive and morphological disorders were most pronounced in rats with trauma-induced epileptic status. The data obtained will allow us to create pathogenetically proved approaches to psychocorrection, more accurate and effective methods of treating post-traumatic epilepsy.

   Aim. Synthesis of new O-(thietan-3-yl)-2-thiopyrimidine amide- and hydrazone derivatives with antioxidant, antiaggregatory, and anticoagulant activity.

   Material and methods. New O-(thietan-3-yl)-2-thiopyrimidine amide derivatives were obtained by counter synthesis: the thietanylation of 6-methylpyrimidin-2-ylthioacetic acid amides and the interaction of ethyl 2-[6-methyl-4-(thietan-3-yloxy)pyrimidin-2-ylthio]acetate with aliphatic amines. New hydrazone derivatives of O-(thietan-3-yl)-2-thiopyrimidine were obtained by interaction 2-[6-methyl-4-(thietan-3-yloxy)pyrimidin-2-ylthio]acetohydrazide with aldehydes and ketones of various structures. The structure and purity of the synthesized compounds were confirmed by thin-layer chromatography, melting point determination, nuclear magnetic resonance and infrared spectra, as well as elemental analysis. The antioxidant properties of the compounds were evaluated in vitro in three model systems using a chemiluminescent express method. The effect on platelet aggregation was studied using the Born [1] aggregometry method on an «AT-02» aggregometer (RPC «Medtech», Russia). Anticoagulant activity was determined using generally accepted clotting tests on a Solar CGL 2110 turbidimetric hemocoagulometer (CJSC «SOLAR», Russia).

   Results. Methods for synthesizing new O-(thietan-3-yl)-2-thiopyrimidine amido- and hydrazone derivatives were developed, the structure of the obtained compounds was determined, studies of antioxidant, antiaggregation, and anticoagulation activity were conducted, and the most promising compounds were selected for further in-depth studies.

   Conclusions. New amido- and hydrazone derivatives of O-(thietan-3-yl)-2-thiopyrimidine with antioxidant, antiaggregation, and anticoagulation activity have been synthesized.

   The objective of this study is to develop a technology for the selective extraction of hesperidin from plant material with high purity and yield, followed by its modification into diosmin.

   Material and methods. Samples of raw material (dried peels of Citrus sinensis fruits) were extracted with and without pretreatment with a CaCl₂ solution. Purification was conducted via recrystallization from dimethyl sulfoxide (DMSO). The transformation of hesperidin into diosmin was achieved by its dehydrogenation into a basic medium using crystalline iodine.

   Results. The use of calcium salts reduces the time required for extraction and produces purer hesperidin raw material at this stage as compared to raw material extraction with no processing. The content of impurities in such a product can be reduced by 2 times. The process of isolating of crude hesperidin from the mother liquor can be accelerated by heating it to 60 °C. It is more efficient to precipitate hesperidin in DMSO: water : volume ratio of components 1:1. The conditions for the reaction of converting hesperidin into diosmin were determined.

   Conclusion. The proposed technology for obtaining diosmin differs from previously suggested methods in its simplicity, high purity of the obtained extraction, and efficiency. It can be utilized for industrial production of the substance.

   Oncological diseases are among the most common in Russia and in the world, and their treatment requires adequate drug provision. At the same time, the Russian market as a whole, as well as the St. Petersburg market, is dominated by imported antitumor drugs in value terms, the share of which exceeds 76.1 %. Although more domestic drugs are purchased in packages, in some cases their share is insignificant, and sometimes equals zero. In this regard, it is relevant to organize the production of antitumor drugs, which are characterized by small volumes of Russian manufacturers.

   The objective of the project is to assess the economic efficiency of the project for the new production of antitumor drugs in various dosage forms at a Russian pharmaceutical enterprise in St. Petersburg.

   Material and methods. Reports on the state of cancer care to the population of Russia, data on sales of anticancer drugs in the Russian pharmaceutical market, presented by the analytical company DSM Group, official statistical information. The economic efficiency of the investment project was assessed based on the calculation of net present value, profitability index, payback period and internal rate of return.

   Results and discussion. In recent years, the need for the use of anticancer drugs has increased in Russia due to the rise in the incidence of cancer in the population. A project has been developed to create a domestic production of 20 names of antitumor drugs in sterile liquid and solid dosage forms, the implementation of which in St. Petersburg will require investment costs in the amount of 1.16 billion rubles.

   Conclusion. As a result of the assessment, the necessity and economic efficiency of the practical implementation of the project of creating a new domestic production of antitumor drugs in various dosage forms at a Russian pharmaceutical enterprise in the territory of the city of St. Petersburg are substantiated.

   Retinal hemorrhages (RH) are common in newborns after natural, especially traumatic, labor. RH in infants differ in morphological characteristics, localization, severity, involvement of the fovea zone and optic nerve, time of desorption, and long-term consequences. Long-term desorption of RH is estimated as amblyogenic factor, which can cause fibrotic changes in the retina, and, as a result, a decrease in visual functions. The paper presents a clinical case of a 2-year follow-up of a patient with an intrapartum mechanical injury. In early neonatal period little female patient had moderate grade of RH with fovea involvement in both eyes with complete resorption of hemorrhages by 3 months. An assessment of ophthalmostatus at the age of two y.o. did not show adverse effects of RH.

   The purpose of the work is to find an effective method for diagnosing the risks of relapse of obesity after bariatric surgery by measuring the level of ghrelin in the blood serum of patients with morbid obesity.

   Material and methods. The results of changes in serum ghrelin levels in 23 patients with morbid obesity after bariatric surgery were analyzed.

   Results. We found that there is an inverse correlative relationship between body mass index and the level of ghrelin in the blood. In case of weight loss and reduction of body weight, the secretion of ghrelin increases. And, conversely, its concentration decreases sharply with increasing body weight.

   Conclusion. A favorable course of the postoperative period and minimal risks with a restrictive type of operation can be determined when the ghrelin level is 350 pkg/ml and more. If the concentration of this peptide hormone in the blood is less than 350 pkg/ml, there is a risk of relapse of obesity in the patient. In this case, bariatric surgery is supplemented with a bypass component.

   The aim of the study was to establish the sizes of various structures of the heart in women using the Hitachi Aloka ProSound Alpha 6 ultrasound scanner (Japan), as well as to analyze the correlation between the studied structures of the heart with the age and body mass index (BMI) of the study participants.

   Material and methods. An analysis of protocols of sonographic study of 64 women was carried out. To measure heart parameters, an Hitachi Aloka ProSound Alpha 6 scanner was used. Statictical processing was made using STATISTICA v. 6.0 programme.

   Results. Left ventricle posterior wall thickness (H = 8,763; p = 0,013) in female of the second period of mature age prevails in comparison with other groups. The correlation analysis revealed a direct relationship between right ventricle anterior wall thickness (r = 0,352; p = 0,008) and BMI. There was no statistically significant relationship between age and studied parameters.

   Conclusions. The received data can be used in practice of ultrasound doctors, making it possible to take a fresh look upon the standards of sonography. The obtained results contribute to the development of personalised medicine for early detection and prevention of cardiovascular diseases.

   Currently, the development of 3D technologies in modern dentistry inspires precise planning of any dental procedure, taking into account all the details and nuances. Thanks to technological developments, it is becoming possible to create customized surgical templates and immediately load implants in a short time. Surgical navigation templates, in turn, help to install dental implants in the jaw tissue with high precision and without risks, which facilitates the accuracy of the orthopedic load.

   Material and methods. During the discussion of the treatment plan, the patient chose the option of dental implantation using a navigational surgical template, with simultaneous loading on the implants. The resulting virtual impressions of the dentition were examined and combined with CT scans using software. A 3D image obtained using cone beam computed tomography (CBCT) was loaded in DICOM format, then general landmarks were found from the image and on a virtual cast.

   Conclusion. Modern treatment approaches make it possible to predict all outcomes of manipulations, and also improve the process of diagnosis and treatment of patients with secondary edentia.

   The aim of the study is to establish ethnic differences in odontometric parameters of teeth in permanent dentition and anatomical features in the complex mutual arrangement of tissues of the orofacial region as a morphological basis for a natural-aesthetic type of smile in children.

   Object and methods. In 432 adolescents of Russian and Finno-Ugric ethnic groups aged 14 years old, the parameters of teeth were measured, the standard of natural color of groups of teeth was assessed, and the soft tissues of the orofacial region involved in the formation of a natural smile were described. The digital material was processed statistically.

   Results. Differences in odontometric data of permanent teeth in adolescents of different ethnic groups were revealed, expressed in odontological parameters, VITA Vitapan classical A-D color standards, their degree of transparency; features of the cutting edge; complex mutual arrangement of surrounding soft tissues of the lower third of the face, forming a natural smile in adolescents of the Russian and Finno-Ugric groups.

   Conclusions. The identified ethnic features must be taken into account in order to ensure the quality of dental restorative work, and to identify the ethnicity of the individual.

   Breast milk is recognized as an ideal food for newborns and infants due to the presence of not only a variety of nutritional and bioactive components, but also beneficial bacteria. Recently, there has been a growing interest in breast milk (BM) as a potential source of probiotics and commensal bacteria for the infant, which can affect both the colonization of the gastrointestinal tract and the maturation of the child's immune system. As a physiological and constant source of commensal bacteria and probiotic substances, BM plays a primary role in programming a child's health. In modern literature, there is an increasing amount of data indicating better protection of breastfed children from infectious (otitis media, respiratory and intestinal infections) and non-infectious chronic diseases that manifest themselves at a later age (type 2 diabetes mellitus, obesity, cardiovascular, allergic diseases, including atopic dermatitis and bronchial asthma).

   The purpose of this review was to summarize modern data on the microbiota of breast milk as a predictor of the health of a growing organism.

   Simultaneous surgeries are the performance of several surgical procedures on a patient within a single treatment session. This approach is widely used in various branches of surgery, allowing to eliminate combined pathological conditions, reducing the number of treatment stages and decreasing surgical stress. Simultaneous surgery does not increase the risk of postoperative complications and helps to reduce the overall rehabilitation period. At the same time, better financial efficiency of the organization of surgical care at the outpatient and inpatient level is achieved, and the quality of life of patients after simultaneous surgery exceeds that after staged treatment. However, the implementation is associated with significant organizational and legal difficulties, and the problem is also of a deep ethical nature and gives rise to the prospect of social conflict caused by unequal access to simultaneous surgery. An overview of the current state of the problem of simultaneous surgery, its historical aspects, features of patient selection, as well as an analysis of the results of scientific research and meta-analyses in the application of the principles of simultaneous surgery in urology is presented in the paper.

   This article is a review of the current literature, which reflects data on the survival of dental implants and methods for predicting the effectiveness of their osseointegration. The article provides a review of the description of the mechanisms of bone damage and restoration during the installation of dental implants, as well as existing methods for monitoring the state of bone homeostasis in the implantation zone, including instrumental, biochemical, immunological and genetic techniques. The review also discusses the role of polymorphism of such genes as the type 1 collagen gene - Col1A1; matrix metalloproteinases: MMP1-1607insG and MMP9A-8202G; protease inhibitor - TIMP1C536T in predicting the success of osseointegrative processes.

   Pupillometry is a method based on the quantitative measurement of pupil diameter in dynamics. Integration of afferent signals and motor signals, both at the level of the central nervous system and at the level of peripheral nervous system, continuously affects the change in pupil diameter. The main processes that affect the regulation of pupil size include pupil reactions to light, accommodation and emotional states. Understanding these criteria is important for the diagnosis and treatment of various neurological and mental disorders. Near infrared connection technology is used to examine the pupil together with a high-resolution electrical outlet. This technique has become widespread in various fields of medicine, including pediatrics. Pupillometry provides objective information about the state of various structures of the child's nervous system and does not require significant time and financial costs. This brief review presents data on the mechanisms of pupil diameter regulation, as well as on the clinical application of this method in neuropediatric practice.