In March of the two thousand twentieth year, the World Health Organization registered the COVID-19 pandemic, a disease caused by the SARS-CoV-2 coronavirus, which was a historical fact, as a global catastrophe of the world level. It is proved that the most common clinical picture of a new viral infection is pneumonia, which is often complicated by acute respiratory distress syndrome in most patients. Unfortunately, the non-decreasing mortality of patients with pneumonia, options for severe pneumonia, and the search for rational treatment have been worrying clinicians for a long time, and in the pandemic of COVID-19 disease remains very relevant. According to WHO, pneumonia ranks 4th in the structure of causes of death, mortality from it is 5 %, and among the elderly reaches 30 %. According to statistics presented by many authors, more than 25 % of pneumonia patients admitted to intensive care units die from septic complications. Currently, clinicians make significant and numerous errors in the diagnosis of severe forms of pneumonia using the severity of the clinical picture, in which there is a distribution of patients in need of resuscitation measures that allow determining the most adequate etiopathogenetic therapy (antiviral, antibiotic therapy, detoxification) and predicting an unfavourable outcome of pneumonia.Many authors have proved that the severity of the severe condition of patients with pneumonia is affected by intoxication syndrome, decreased reactivity of the body and metabolism, comorbid background, respiratory failure and cardiovascular insufficiency.

Nowadays manifestation of atherosclerosis of mesenteric vessels increases with the growth of cardiovascular pathology. The actual problems of the chronic and acute mesenteric ischemia, its diagnosis and treatment effectiveness were analyzed and considered on the basis of a literature review. Etiopathogenesis, clinical manifestations, diagnostic approaches, treatment strategies including conservative and surgical treatment were considered in this article. The absence of common programs of diagnosis and treatment directs scientific and clinical search with using modern material and technical possibilities. 

Studying the issues of pregnancy management with extragenital diseases is a relevant and important task of modern obstetrics. The issue of the influence of thyroid diseases on the formation and function of the placenta remains not fully studied. Purpose of the study: to study the characteristics of the uteroplacental and fetal placental circulation in pregnant women with certain diseases of the thyroid gland. Material and research methods. 170 pregnant women were under observation. The 1st group (64 people) was formed by patients with autoimmune thyroiditis (AIT), the 2nd group (76 people) was formed by patients with diffuse toxic goiter (DTG), the 3rd (control) group was made up of 30 women with normal pregnancy. The study of feto-placental blood circulation was carried out by analyzing blood flow velocity curves (BSV) in the uterine arteries and in the umbilical cord artery. Statistical processing was carried out using the StatSoft program (Russia). The significance of the difference between the compared groups was determined using the Student's t test. Research results. An increase in indices of peripheral vascular resistance of the uterine arteries and a decrease in the systolic-diastolic ratio in the umbilical arteries in pregnant women with thyroid diseases were established, while more pronounced changes were observed in patients with autoimmune thyroiditis. Ultrasound data indicated the formation of fetoplacental insufficiency during pregnancy in women with thyroid diseases. Conclusion. To predict placental dysfunction and the formation of a risk group for the formation of perinatal complications, it is necessary to take into account the identified sonographic changes that are observed during pregnancy in patients with thyroid diseases.

The assessment of the microelement status of newborns is the basis for determining the effect on the child's health of deficiency, excess or violation of the tissue distribution of macro- and microelements. Of particular interest is the participation of the fetus in trace element metabolism during gestation in the “mother – placenta – fetus” system. The purpose of our study was to establish the features of the elemental status of the “mother – placenta – umbilical cord blood – newborn” system in the conditions of military operations. All the subjects were divided into two groups: the main group included newborns whose prenatal development took place in conditions of active hostilities, the second group included newborns whose prenatal development took place in the absence of hostilities. Materials and methods. 126 full-term newborn babies were examined. All the surveyed were divided into two groups. The main group included 72 (57.14 %) newborns whose prenatal development took place in the conditions of active hostilities, the second 53 (42.40 %) newborns whose prenatal development took place in the absence of hostilities. The study of the content of essential trace elements in the hair and umbilical cord blood of newborn children, as well as their mothers. Results and their discussions. The study revealed that the levels of micro- and macronutrients in newborns from the two groups are significantly different. Based on the analysis of the content of essential trace elements in the hair of newborns and their mothers, whose pregnancy took place in conditions of active hostilities, it was concluded that the levels of iron, copper, selenium, magnesium and potassium in children of the main group are reduced, and the content of toxic elements such as cadmium, chromium and lead, on the contrary, is increased. Thus, it is advisable to introduce measures to assess elemental metabolism in various groups of the child population and timely use of macro- and microelement preparations to correct the imbalance.

The aim: to evaluate the relationship between performed caesarean section operations and complications influencing on fertility rates. Materials and methods. A total of 393 patients aged 19 to 43 years old have been examined to conduct aretrospective cohortre search. Some of their social and biological data, obstetric-gynecological anamnesis peculiarities (including extragenital diseases, development and complications of previous pregnancies), results of clinical, instrumental and laboratory examinations have been studied. Authenticity of difference between two independent groups in terms of qualitative characteristics was determined using Pearson's chi- square test (χ 2 ) (with Yates correction for small samples-df) by compiling four-field contingency tables. When performing analytical statistics, the following levels of significance of differences were established: p < 0,05; p < 0,01; p < 0,001. The statistical significance of the established relationship was being determined using the definition of relative risk (RR, relative risk) and 95 % confidence interval (CI, confidence interval). Results. After performed caesarean sections in the examined women non-developing pregnancy was being observed 1.9 times more often than in the comparison group in patients who gave birth through the natural birth canal (p = 0,003, RR = 1,886; CI = 1,061–3,351). Inflammatory diseases of the genitals in the main group (PID) were registered 1.7 times more often than in the comparison group (p < 0,001, RR = 1,667; CI = 1,290–2,156). It should be especially noted that after the completion of the first pregnancy by CS, repeated similar interventions were performed 6,5 times more often (p < 0,001, RR = 6,466; CI = 4,968–8,416). Other surgical interventions on the abdominal organs were performed 2,7 times more often than in the comparison group (p = 0,003, RR = 2,669; CI = 1,402–5,080). No less significant is the fact that proliferative diseases of the internal organs such as uterine myoma and endometriosis were being developed respectively 2 (χ 2 = 4,454, p = 0,035, RR = 2,062; CI = 1,052–4,508) and 4 times more often (χ 2=4,598, p = 0,033, RR = 4,311; CI = 1,281–14,508) than in patients of the comparison group. Conclusion. The completion of the reproductive debut by abdominal delivery is associated with a significant risk of developing PID, non-developing pregnancy, proliferative diseases of the uterus (myoma, endometriosis), necessity in performing repeated CS operations and other surgical interventions on abdominal organs.

Caspases are a group of cysteine proteases that play a leading role in the processes of apoptosis. There is evidence that apoptosis of cardiomyocytes is the morphological basis for the formation of chronic heart failure (CHF). The aim of the study was to study the role of caspase-6 in the blood serum of patients with severe CHF infected with the human immunodeficiency virus (HIV). In 2019–2022, on the basis of a large hospital, a one-stage screening clinical study was performed with the inclusion of 240 patients infected with HIV, 160 of them (66.6 %) were diagnosed with CHF. Inclusion criteria for the study were the presence of confirmed CHF, the presence of HIV infection, stabilization of the condition due to the disease that required hospitalization, and the patient's consent to participate in the study. The criteria for exclusion from the study were social deprivation and refusal to sign informed voluntary consent, acute decompensation of CHF, acute heart failure, and oncology. The criterion for severe CHF was an increase in the level of NT-proBNP in blood plasma ≥ 1500 pg/ml. According to the results of the study, a direct close relationship was revealed between the formation of severe CHF and the content of caspase-6 in the blood serum, which may indicate an intensification of the processes of cardiomyocyte apoptosis. When the content of caspase-6 is equal to 148.35 pg/ml and above, there is a high risk of developing severe CHF with NT-pro BNP ≥ 1500 pg/ml, the chances of developing the following complications increase – CHF with low left ventricular ejection fraction (LVEF) < 40 % – 11.77 times, left ventricular hypertrophy (LVH) – 1.31 times, cachexia with a body mass index (BMI) < 18 – 18.91 times, valvular heart disease – 2.32 times, arterial hypotension - 5.96 times. In patients with CHF and HIV infection, the patterns obtained allow us to state the role of the effector enzyme apoptosis-caspase-6 as a prognostic factor for the development of such complications as LVEF < 40 %, cachexia, arterial hypotension, valvular heart disease and LVH.

Purpose of the article it consists of studying the incidence of allergic diseases in children with constitutional exogenous obesity living in the Astrakhan region. Materials and methods. During the study, allergy history data was copied from 167 children: 134 patients with constitutional exogenous obesity (median age 13 [3.9; 17] years) and 33 patients from the control group (median 14 [1.5; 17] years) from “Child Development Stories” (f.112/u) and “Dispensary Observation Control Cards” (f.030/u). Results. Using these methods, significant differences were identified (χ 2 = 8.151; p = 0.005); When comparing a group of children with constitutional exogenous obesity and a control group, it was revealed that in obese children, food allergies are registered more than three times more often (67.4 %) than in children without obesity (23.0 %). Conclusion. Our study showed that obese children are more likely to develop multivalent (food and / or drug) allergies, which are registered three times more often than in children with normal body weight.

Changes in body composition, in particular sarcopenia and sarcopenic obesity, are complications of liver cirrhosis affected by unfavorable parent substances. The selection of diet and exercise for at least 8 weeks allows you to get the best results when taken by patients with cirrhosis of the liver. The correlate of motor activity in the bioimpedance analysis of the active fraction of the active cell mass in the lean mass of the human body. Aim of the study. To assess the relationship between increased cell mass and the severity of ascites and hepatic encephalopathy in liver cirrhosis. Material and methods. 46 patients with liver cirrhosis were examined. The component composition of the body is felt with the help of ABC-01 "Medass" devices (STC Medass, Russia). Ascites was assessed during the clinical examination, as well as the results of the examination of the abdominal cavity and retroperitoneal space. Diagnosis of hepatic encephalopathy impact test on the speed of cognitive reaction: "Number connection test". Results. A significant relationship was found between the proportion of active cell mass and the severity of ascites (r = –0.312, p-value = 0.034), indicating that a decrease in active cell mass is a prognostically unfavorable disease for the progression of ascites in patients with liver cirrhosis. Correlation analysis showed the presence of a negative correlation average strength between the values of the share of AKM in TMT and high body weight of PE: r = –0.229 (p value = 0.125), which requires research on studies between the values of the relationship between active cell mass and body weight. hepatic encephalopathy. Conclusion. Sensitive relationships have been found between active cell mass and the severity of liver cirrhosis. Determination of body composition products, in particular the absolute and relative indicators of active cell mass, in patients with liver cirrhosis can be of practical use in compiling promising mathematical models of prognosis.

The leading principle of burned patients’ treatment is to perform free autodermoplasty with split autodermografts. The main criterion for a successful plastic surgery is the percentage of engraftment of skin grafts. The issues of readiness of burn wounds for such surgical interventions continue to be studied and remain open at the present time. The degree of readiness of burn wounds for skin grafting is known to depend on many factors, among which the state of the microbial flora and the level of bacterial contamination of the wound surface play an important role as one of the main criteria for maintaining inflammation in the wound. The method of cytological examination of prints from burn wounds has found wide application, which is associated with the peculiarities of pathomorphological processes in burn wounds. Great importance is attached to studying the state of microcirculation in the wound using laser Doppler flowmetry in order to determine the perfusion and reparative ability of granulation tissue of a burn wound. However, in addition to local criteria, general condition of the body and the state of its immune system in particular should be taken into account. A great number of research works is devoted to the study of immune reactions in response to burn injury. The results of these studies also make it possible to identify certain criteria for predicting the success or chance of unsatisfactory outcomes of autodermoplasty. The levels of hemoglobin and total protein allowing to expect successful surgical treatment have been determined. In spite of the wide range of methods to determe the readiness of a wound for autodermoplasty, many of them are imperfect and nonspecific. The development of complications in the form of lysis or rejection of skin grafts, the maintenance of inflammatory processes, the development of a shortage of donor resources, mortality and the likelihood of developing severe cicatricial deformities in long-term results depend on the quality and timing of surgical treatment. Therefore, the problem of uniform criteria identification for the readiness of a burn wound surface for plastic surgery remains relevant for combustiologists and surgeons.

The article presents the incidence of chronic lymphocytic leukemia in the Astrakhan region. The regularity of the development of infectious complications of chronic lymphocytic leukemia depending on the gender, age of patients, type of pathogens of bacterial, viral and fungal etiology was revealed. Infectious complications of chronic lymphocytic leukemia have been studied depending on the localization of the process and the stage of the course of the underlying disease.

The purpose of the study – to study the effect of combination therapy, including magnetolaser exposure and the use of photodynamic therapy on the state of matrix metthaloproteinases in acute bacterial prostatitis. Materials and methods. An analysis of the treatment of 30 patients from whom approval was received for conducting a study with an established diagnosis of acute prostatitis of bacterial nature. For this purpose, men aged 18–40 years were selected, the average age was 32 ± 2 years. To conduct the study, the men were divided into three groups of 15 people each. Group 1 included patients who received a combination of antibiotic therapy and magnetic laser therapy as the main treatment. In group 2, patients who received antibiotic therapy and magnetic laser therapy were supplemented with photoditazine at a dose of 0.8 mg/kg per 100 ml. To compare laboratory parameters, a third group (group 3) of 15 relatively healthy men of the same age was formed. To assess the effectiveness of treatment, a dynamic study of metalloproteinase-1 inhibitor (TIMP-1), as well as metalloproteinases (MMPs) -1, -2, -3, -7, -8, -9, into the blood serum. Results. It has been established that the use of photodynamic therapy and laser irradiation of blood in the complex treatment of acute bacterial prostatitis leads to an early recovery of serum MMPs, and as a result, an early relief of signs of inflammation, while the use of this method contributes to a greater number of recoveries, is well tolerated, has a few side effects, which can serve as recommendations for a wider range of the use of this technique in the treatment of acute bacterial prostatitis.

Objective of the study: to evaluate the protective effect of lactoferrin on improving spermatogenic function in testicular dysfunction caused by low-intensity electromagnetic radiation of the millimeter range. Materials and methods: 48 mature male rats were used. They were divided into four groups: a control group, a group exposed to low-intensity electromagnetic radiation of the millimeter range, a group of lactoferrin with oral intake of lactoferrin 10 mg per day, a group of combined irradiation with lowintensity electromagnetic radiation of the millimeter range and taking lactoferrin. Testicular spermatogenesis was assessed using traditional methods. Testicular tissue homogenate was used for Western blot analysis. Serum testosterone concentrations were determined using enzyme-linked immunosorbent assay (ELISA) kits. Data were analyzed using one-way analysis of variance (ANOVA). A statistical difference was accepted at p < 0.05. Results. Low-intensity electromagnetic radiation in the millimeter range causes a significant decrease in sperm concentration by almost 2 times (51.7 % of the control). Combined oral administration of lactoferrin with low-intensity millimeter-wave electromagnetic radiation has a protective effect on sperm concentration. Electromagnetic radiation in the millimeter range causes a significant decrease in testosterone production in the testicles. Oral administration of lactoferrin during radiation maintained normal testosterone levels. Lactoferrin also improves the integrity of the blood-testis barrier, which is compromised by exposure to millimeter-wave radiation. Millimeter-wave radiation significantly reduces the expression of claudin 11 by 40 %. The combined use of millimeter-wave radiation and oral administration of lactoferrin maintains claudin 11 production at control levels. Irradiation significantly reduces the production of N-cadherin; the combined use of irradiation and oral administration of lactoferrin does not restore the level of this protein. Conclusion. Taken together, the results showed that lactoferrin ameliorated spermatogenesis and integral aspects of the blood-testis barrier that were compromised by exposure to millimeter-wave radiation, which was achieved by improving the integrity of the blood-testis barrier, restoring claudin-11 expression, as well as restoring testosterone levels.

Objective – to study the effect and effectiveness of a derivative of LBK-527on the dynamics of apoptosis and regenerative potential of hepatocytes in reversible cholestasis in rats in an experiment. Material and methods. Reversible occlusion of the choledochus was formed in 130 white non-linear male laboratory rats by fixing the common bile duct to the inner surface of the anterior abdominal wall using a latex tourniquet. After 5 days, the passage of bile was restored, followed by intravenous administration of LBK-527 and a comparison drug (ademethionine) in medium therapeutic doses. The animals were removed from the experiment on 1, 3, 7, 14, 21 days after the restoration of the bile passage, followed by liver extraction for immunohistochemical study of the expression of markers of proliferation and apoptosis of liver cells. Results. It was found that intravenous administration of the substance under study and the comparison drug from the 3rd day leads to a significant decrease in the expression of caspase-3, followed by the restoration of its level to normal values by the end of the experiment. In addition, when studying the expression level of Ki-67, a marked increase in this indicator was observed from the 1st day after the restoration of the bile passage, which indicates the activation of the proliferative potential of hepatocytes. Conclusion. When studying the molecular and cellular mechanisms of action of LBK-527, it was found that it has a pronounced hepatoprotective effect and consists in reducing the severity of apoptosis and intensification of regenerative processes in the liver.

Coronavirus infection in children is milder than in adults, nevertheless the true reason of pathogenesis is still uncertain. There has been an increasing interest to possible connection between the severity of the disease and biomarkers including chemokines. Study objective. To study the possibilities of neural network analysis in early diagnostics of severity form of new coronavirus infection in school-age children depending on the plasma level of chemokines. Materials and methods. The concentration of 10 chemokines was quantified using multiplex analysis on a flow cytometer in 98 blood serum samples (main group) of school-age children (13 [10; 14] years old) divided into subgroups: first – 16 children with asymptomatic form of COVID-19, second – 54 children with mild form and third – 28 patients with moderate form of the disease. There was a group of 93 healthy children (13 [10; 15] years old) who were taken before COVID-19 pandemic. Results. Nine chemokines have shown statistically significant differences in serum concentration between school-age children with COVID-19 and the control group: CCL11 (Eotaxin), CCL5 (RANTES), CCL3 (MIP-1α), CCL4 (MIP-1β), CCL20 (MIP-3α), CCL17 (TARC), CXCL11 (I-TAC), CXCL5 (ENA-78), CXCL1 (GROα). There was no statistically significant difference in CXCL9 (MIG) levels between study groups. As a result of the study, a neural network was created based on a comprehensive assessment of the plasma levels CCL11 (Eotaxin), CCL5 (RANTES), CCL3 (MIP-1α), CCL4 (MIP-1β), CCL20 (MIP-3α), CCL17 (TARC), CXCL11 (I-TAC), CXCL5 (ENA-78), CXCL1 (GROα) that allowed to determine the severity form of COVID-19 in school-age children at the time of admission to the hospital. Conclusion. Plasma levels measurement of CCL11 (Eotaxin), CCL5 (RANTES), CCL3 (MIP-1α), CCL4 (MIP-1β), CCL20 (MIP-3α), CCL17 (TARC), CXCL11 (I-TAC), CXCL5 (ENA-78), CXCL1 (GROα) can be useful in diagnostics of severity form of new coronavirus infection in school-age children and further determining the treatment strategy.

The Astrakhan region is not a natural focus of Lyme borreliosis, however, the geographical proximity of endemic territories contributes to the migration of this disease. In 2019, for the first time, a case of Lyme disease was registered in a resident of Astrakhan, who was on vacation in Kislovodsk. In 2022, 3 cases of Lyme disease were again reported in residents of Astrakhan who traveled to regions endemic for tick-borne borreliosis. In 2022, Lyme disease was detected in a resident of Astrakhan who did not travel to the Lyme-borreliosis-endemic regions.