Genital prolapse is a relevant healthcare issue due to the increase in life expectancy and the need to improve the quality of life for patients. This article provides a review of literature on surgical treatment of genital prolapse, including the history of the evolution of correction methods. The use of mesh implants for correcting genital prolapse is separately described, as well as the complications associated with these surgeries.

   The аrtiсlе summarizes the dаtа оf scientific litеrаturе on miсrocirculаtiоn disоrders in patients with variоus gynecоlogical disеаses. The technique оf lаser dоррler flowmetry fоr assеssing lосаl chаnges in the micrоcirculatiоn оf thе pelvic оrgans is presented, аs well аs the results of clinicаl use оf this method аre presented.

   In recent years, with the rapid development of molecular biology, genomics, high-performance sequencing technology and bioinformatic analysis technology, there has been an active study of a previously overlooked “organ” – the intestinal microbiota (GM). It is known that the microbiota of the human gastrointestinal tract plays a key role in metabolic, physiological, immunological and digestive processes. Microbial composition and colonization, in turn, depend on factors such as the neonatal delivery method, breastfeeding, nutrition, antibiotic treatment and environmental exposure at an early age. Also, one of the factors influencing the maintenance of homeostasis is the relationship between bacterial species or communities of species inside and outside the microbiome. Dysbiosis is the key to understanding the etiology of various diseases. Although the pathogenesis of IBD has not been fully studied, in patients with this pathology, inflammation of the gastrointestinal tract is a common sign of intestinal dysbiosis. Currently, there is a lot of evidence that intestinal dysbiosis leads to a violation of immune tolerance, which can cause or complicate the course of IBD. Thus, research is needed to clarify the role of microbiota in the pathogenesis of diseases. Based on changes in the intestinal microbiota, new diagnostic tools and possible treatment methods can be developed.

   Fibroplastic induration of the penis, known as Peyronie's disease, remains one of the most difficult problems in medicine today. The prevalence of the disease among men ranges from 2.5 % to 9 % between the ages of 40 and 70 (statistics according to studies conducted by scientists in different countries). It is a benign, slowly progressive disease. It is characterized by the formation of idiopathic fibrous plaques in the albuginea of the penis. Peyronie's disease affects not only the organic part of a man's health, but also affects the psychological aspects of his activity, negatively affects the patient's professional activity and family life, which determines not only the medical, but also the social significance of the problem. The hypothesis of the occurrence of Peyronie's disease has received wide publicity as a result of a trauma to the penis, in which bleeding and delamination of the albuginea occur, and a neglected inflammatory process with disorganization of elastic fibers with collagen deposition heals with coarse scarring. Despite the fact that progress has been made in understanding the mechanisms of development of Peyronie's disease, the therapy of this disease remains one of the most complex and controversial. Analysis of literary sources shows that unsatisfactory results of surgical treatment are still at a high level. In modern medicine, there is practically no single focus that allows you to determine the tactics of treatment.

   The brain stem is phylogenetically the most ancient and multifunctional, anatomically complex brain structure. In spite of considerable attention to the study of age variability and sexual dimorphism of the brain stem, no works devoted to determining its volume using in vivo imaging techniques in individuals of both sexes within such a huge age range – from adolescence to old age - have been found.

   The aim is to carry out a comparative analysis of brain stem volume in men and women in adolescence, first and second periods of adulthood, elderly age and old age according to magnetic resonance imaging data.

   Materials and methods. The work is based on the analysis of the results of magnetic resonance imaging studies of 240 patients (124 men and 116 women) who were examined in the Department of Radiation Diagnostics in 2020-2022. The age of the subjects ranged from 16 to 88 years inclusive. The study sample consisted of persons without central/peripheral nervous system pathology, without alcohol/drug addiction, and mesocranes. All investigated material was divided into five groups according to age anatomical periodization.

   Results. We revealed statistically significant decrease of the brain stem volume from the first period of mature age to senile age in both sexes (p < 0,01). In all age groups there was a tendency for predominance of brain stem volume parameters in men compared to women (p > 0,05). The results obtained in the course of the study can form the basis for the age-related anatomy of the human central nervous system in the future. It will help to provide more individualized approach to patients in medical practice, using  these results in the further clinical and basic researches for detailed understanding of age variability of the brain.

   Relevance much attention is paid to the problem of the effect of extrasystolic arrhythmia in pregnant women on the condition of the fetus.

   The aim of the study is to study the effect of extrasystolic arrhythmia in pregnant women on the condition of the fetus by cardiotocography.

   Material and methods. 32 pregnant women with extrasystole (group 1) and 30 without arrhythmia (group 2) were examined in the 3^rd trimester from the 32nd week of pregnancy. All pregnant women of both groups underwent daily registration of electrocardiography (ECG), ultrasound examination of the heart, fetal cardiotocography (CTG of the fetus), determination of the level of human chorionic gonadotropin (hCG), prolactin and thyroid hormones.

   Results. The correlation analysis revealed a close relationship between the number of fetal cardiotocography scores and the level of thyroid-stimulating hormone (TSH) (r = 0,917, p <0,01), free thyroxine (T4c) (r = -0,877, p < 0,01) and the number of extrasystoles (r = -0,872, p < 0,01) in pregnant women.

   Conclusion. In pregnant women with and without extrasystole, there are differences between reproductive hormones and electrocardiography indicators within the reference values. It was found that in pregnant women with and without extrasystole, fetal cardiotocography indicators do not significantly differ. A quantitative threshold value of ventricular extrasystole was revealed to reduce the number of fetal cardiotocography scores in the third trimester from week32. The threshold value of extrasystole was 1500 per day, AUC (area under curve) – 0,792, sensitivity – 81,3 %, specificity – 100,0 %.

   Objective. Improvement of treatment results and reduction of the number of relapses in patients with pilonidal disease, by developing and substantiating a two-stage treatment method (with the use of laser treatment and subsequent radical surgical intervention).

   Materials and Methods. A prospective analysis of the treatment results of 76 patients at the clinical sites of the Rostov State Medical University was carried out. The patients were divided into three clinical observation groups: In Group I (the main group, 26 patients), two-stage treatment was carried out according to the original technique (patent № 2770283). In Group II (the first control group, 28 observations), we used the "сleft lift" procedure according to the Bascom authentic method Bascom II method modified by Karydakis). In Group III (the second control group, 22 observations), the pilonidal sinus was dissected with the traditional technique of plastic surgery of the sacrococcygeal region with "deaf" sutures along the gluteal cleft.

   Results. Analysis of the results showed that the postoperative period was smoother in Group I patients due to the smaller size of the surgical defect and the radical surgical stage in the absence of local inflammatory tissue reaction. There were no significant infiltrative-inflammatory complications in the patients operated on according to the original two-stage method. There were no recurrences during the one-year outpatient follow-up period. According to the VAS score, postoperative pain syndrome was significantly lower in Group I patients. The duration of hospitalization and period of disability were reduced in the patients of the main group in comparison with the same parameters in the control groups. The indicated pharmaco-economic effect in comparison with the traditional methods of surgical treatment was obtained due to early healing of the operative wounds with a smaller inflammatory reaction of the soft tissues and a reduced risk of suppurative complications.

   Conclusion. The developed method of two-stage surgical treatment of pilonidal sinus helps to increase the effectiveness of radical treatment, reduce the number of relapses and complications, and reduce the duration of patients' disability. The described efficacy of the technology is achieved with early healing and stable qualitative aesthetic result.

   The clinical and epidemiological characteristics of the incidence of the population of the Astrakhan region with broad lentets are described. The clinical picture of the disease, the epidemiological process of diphyllobothriosis, methods of diagnosis and treatment of helminthiasis, as well as the probable causes of infection of the population are described.

   Objective: to conduct a clinical analysis and evaluate the significance of micronutrient status and vaginal microbiocenosis in pregnant women and develop a method for correcting the identified disorders based on the use of Bellakt Mama+ powdered milk product.

   Materials and methods. We conducted a prospective study on the basis of the professorial advisory center of the EE “Grodno State Medical University”. In the course of the work, we examined 110 pregnant women, 55 of whom took Bellakt MAMA + dry milk product for 3 months, and the second half were observed only according to the clinical protocol. The assessment was made: anamnestic - assessment of the anamnesis of life and disease; generally accepted clinical, laboratory and instrumental (ultrasound examination of the pelvic organs) research methods. Performed blood sampling from the cubital vein in the morning on an empty stomach with the determination of the levels of ferritin, calcium i, iron, total vitamin D, folic acid, osteocalcin. An assessment of the biocoenosis of the urogenital tract was carried out “Femoflor Screen”; statistical processing of the results was carried out.

   Results. We found that in patients who took a dry dairy product of Belarusian production, a persistent positive trend in the increase in the level of folic acid (p = 0,0049), total vitamin D (p = 0,0041), serum iron (p = 0,0041) was established, ferritin (p = 0,0040), as well as improvement of the vaginal biocoenosis (p = 0,0040). There were no statistically significant differences in the levels of ionized calcium and osteocalcin. It should be noted that the patients of the main group had no complaints of discomfort in large joints, bones and cramps in the calf muscles, in contrast to the women of the control group.

   Conclusion. The above results confirm the need to control and correct micronutrient deficiency and vaginal dysbiosis in women at the stage of preconception preparation and in the first trimester of pregnancy.

   The pandemic of a new coronavirus infection COVID-19 initiated research to find methods of non-specific influence on the immune system that can change the course of infectious diseases. Adult study results have been demonstrated the positive effect of seasonal influenza vaccination on morbidity, hospitalization rates, and reducing the severe forms of SARS-CoV-2 infection. That suggests a similar action in children.

   The aim of the study: to establish the possible impact of influenza vaccination on the morbidity and severity of COVID-19 in children in Volgograd.

   Materials and methods. The 303 children 3-17 years old without a history of chronic diseases were included in comparative prospective cohort study on the impact of influenza vaccination (235/303) on morbidity and severity of a new coronavirus infection COVID-19 vs non-vaccinated group (68/303).

   Results. All children with new coronavirus infection COVID-19 (diagnosis confirmed by laboratory testing - U07.1) had mild symptoms of the disease. In all age groups, the morbidity and the severity of the new coronavirus infection COVID-19 among children vaccinated against influenza did not have significant differences with non-vaccinated group.

   Conclusion. The results of our study did not support the hypothesis of a protective role of seasonal influenza vaccination on the morbidity and severity of COVID-19 in healthy children. Further research is needed to establish the effect of influenza vaccination on the severity of COVID-19 in children with chronic diseases.

   Objective. To analyse the course of coronary heart disease within a year after the development of myocardial infarction in residents of Astrakhan region with chronic obstructive pulmonary disease.

   Materials and Methods. We examined 325 patients with myocardial infarction, residents of Astrakhan region. 195 patients had heart attacks against the background of COPD and 130 patients without COPD. During 12-month follow-up 30 people dropped out - 19 in the group of patients with myocardial infarction against COPD, 11 in the group of patients with myocardial infarction without COPD. Correspondingly, by the end of the observation period the number of patients under observation was: 176 - in the group of patients with myocardial infarction against COPD, and 119 - in the group of patients with myocardial infarction without COPD.

   Results. It was found that in patients with myocardial infarction against COPD the annual mortality from conditions associated with cardiovascular pathology was twice as frequent as in patients with MI without COPD. There was also a tendency to more frequent development of recurrent myocardial infarction. In the structure of mortality in patients with myocardial infarction against COPD and without COPD and there was a tendency to a more frequent occurrence of acute heart failure expressed stages (Killip III-IV) and decompensation of chronic heart failure as causes of mortality. The odds of developing a combined endpoint, including recurrent myocardial infarction, stroke and mortality from cardiac causes, among patients with myocardial infarction against COPD were 2.7 times higher compared to patients with myocardial infarction without COPD. The combined endpoint, which combines clinically significant events in patients with myocardial infarction, makes the existing differences in the outcomes of infarction in patients with and without COPD evident.

   Experimental study is devoted to the study of the nootropic effect of the extract Scutellaria baicalensis Georgi in normal conditions and in modelling anxiety-depressive disorders by creating "social" stress in rats during the development of a conditioned passive avoidance reflex.

   Materials and methods. The study was made of the extract obtained by maceration of the underground part (rhizomes with roots) of the plant Scutellaria baicalensis Georgi. The experimental work involved the study of the behavioural characteristics of laboratory animals (non-linear rats) in the amount of 159 males aged 7-9 months, divided into groups in accordance with the stages of the study. The study of nootropic activity in the norm formed the basis of the first stage and included work with animals divided into 4 groups: receiving water for injection (intact); Scutellaria baicalensis Georgi extract, medicinal product «Tetramethyltetraazocycloocyandione»; medicinal product «Piracetam+Cinnarizine». The creation of conditions providing for paired sensory contact of individuals, contributing to the development of inter-male confrontations, was achieved by modelling “social” stress in groups identical to the normal state at the second stage of experimental work. The use of the standard setting of the passive avoidance conditioned reflex made it possible to analyse the cognitive functions of the animals.

   Results. The nootropic effect of Scutellaria baicalensis Georgi extract has been proven. The decrease in the consequences of stress in the form of a deterioration in memorization and reproduction of a conditioned reflex of passive avoidance was shown when it was administered to laboratory animals. Extension of the latent period of entry into the dark chamber of the passive avoidance conditioned reflex test, an increase in the total time spent in the illuminated compartment, and a decrease in the percentage of animals that visited the dark "aversive" compartment under the influence of the extract were described.

   Conclusion. The preservation of a memory trace in laboratory animals after the introduction of an extract made on the basis of Scutellaria baicalensis Georgi has been established. The presence of a complex of various groups of biologically active substances in the composition of the Scutellaria baicalensis Georgi determines this plant object as a source of obtaining new drugs recommended for use as nootropic drugs that reduce the reactions that develop during “social” stress.

   The authors are demonstrating a positive outcome of treatment of a 52-year-old patient using endoscopic vacuum therapy for spontaneous rupture of the esophagus (Burhave syndrome). The patient was discharged after 15 days with epithelization of the defect. Thus, this method, in the form of a combination of use of a special polyurethane sponge and constant aspiration, prevented the development of complications and contributed to the reparation of esophageal rupture.

   The article describes a clinical case of pseudoscabies. The parents of the child G., 10 yearsт old, turned to the pediatrician at the place of residence with complaints about sluggish and long-lasting rashes in the neck area on the left. The boy has been ill for two months. He was observed by a dermatovenereologist with suspected allergic dermatitis, received treatment with desensitizing drugs and corticosteroids. It was noteworthy that on the skin of the neck on the left, multiple papules of a rounded shape, pink in color were visualized, some of them were covered with hemorrhagic crusts. Due to the lack of effect from therapy and due to the fact that pseudo-scabies was suspected, a 10 % sodium benzyl benzoate ointment was prescribed. On the 4^th day from the start of therapy, there was a positive trend. Thus, this clinical case is of practical interest for attracting the attention of doctors to a thorough history taking, searching for the causes leading to a protracted course of the disease and timely change of treatment regimen.