Objective: To identify additional  risk factors  of   complicated  pregnancy  and to  develop  a mathematical model for prognosing   the course  of gestation  using integrative  analysis.

Materials  and  methods.  We  carried   out  a  prospective   parallel  group  study  of  240 women  with  low perinatal risk in the  first and second trimesters  of pregnancy.  To  study  the  psycho-emotional state  and personality characteristics of pregnant  women, we used the SF-36 questionnaire, Osgood’s Semantic differential,  G.  Eysenck’s   self-assessment  personality test  and  the  Big five questionnaire proposed   by R. McCrae  and P. Costa. To assess the impact  of the environment  on pregnancy,  a questionnaire “Degree of satisfaction  with the urban  environment”  composed  by   Yu.Kataeva was used.

Results. We established  additional  criteria for  predicting  the  course  of gestation.  In  the  first  trimester they were restrictions of everyday functions due to painful manifestations  and signs of early toxicosis, poor health,  bad mood,  high levels of anxiety,  difficulty in being flexible in new life conditions  and a tendency to react  aggressively. In the second trimester they experienced  painful conditions,  mood swings, preferring seclusion to  relationships  and lack of satisfaction  with the  quality  of the  urban  environment.  During the interpretation of the  study  results  we identified  additional  prognostic  factors  of the  unfavorable  course of pregnancy,  which allow us to develop targeted programs  for medical and psychological  support  during pregnancy.

Conclusion. We investigated  the  interrelations between  the  most  important factors  affecting  the  normal course  of pregnancy,  childbirth and the condition  of the newborn.  This study will allow us to predict  the course  of pregnancy  and elicit  additional  criteria to  form  groups  with  increased  obstetric and perinatal risks.  We  also  designed  a  mathematical model  for  prognosing  the  course  of  gestation  that  takes  into account  the identified additional  criteria.

The aim of the study was to evaluate cell-free DNA (cfDNA) in the follicular fluid (FF) of women undergoing IVF treatment and to analyze the relationship between cfDNA levels and the parameters of folliculogenesis and oogenesis as well as the quality of embryos.
Materials and methods. The study included 53 women aged 20 to 45 years. In 49 patients, oocytes were obtained by stimulating ovulation with gonadotropins, and 4 patients underwent natural cycle IVF without hormonal stimulation. Measurement of cfDNA was carried out by fluorimetry using QuantiFluor™ Handheld Fluorometers (BioSilica, Russian Federation).
Results. The FF of women with ovulation stimulation revealed a higher level of cfDNA as opposed to FF of women in the natural cycle. There were no differences in the cfDNA levels in women with infertility and oocyte donors. Women with infertility lasting for more than 5 years had a higher level of cfDNA. Women with the elevated anti-Mullerian hormone (AMH) levels were characterized by the high FF cfDNA concentration and a large number of follicles. Likewise, correlation analysis showed that FF cfDNA was significantly and positively correlated with the AMH level. The obtained data revealed the participation of cfDNA in different stages of oogenesis.
Conclusions. The level of FF cfDNA in women may serve as an additional biomarker of the effectiveness of ovulation induction.

Goal. To identify key links in the pathogenesis of toxic myocardiopathy in conditions of endogenous intoxication in peritonitis.
Materials and methods. Experimental studies were carried out on dogs (n = 24). The model of purulent fecal peritonitis. We studied the run-time content of toxic products in blood plasma, the lipid composition, the intensity of lipid peroxidation, the activity of phospholipase A2 and superoxide dismutase, and hypoxia of myocardial tissue. We evaluated loss of water and proteins, electrogenesis of the myocardium cells and changes in the ECG parameters. We also performed histological examination of the myocardial tissue.
Results. Experimental studies in dogs showed that the development of endotoxicosis of peritoneal origin is accompanied by significant metabolic disorders and cardiac malfunction leading to the development of myocardiopathy. The most important role in the development and progression of myocardial damage in endotoxicosis is played by biomembrane damage and disruption of associated processes. The main processes are quantitative and qualitative modifications of phospholipids in cardiac cell membranes.
Conclusion. The obtained data demonstrate the key role of the interrelation between dyslipidemia in the investigated cellular structures and intensification of lipid peroxidation, an increase in phospholipase A 2 activity, and hypoxia; which confirms the significance of these processes in destabilization of the phospholipid matrix of biomembranes.

The aim of the study was to assess the impact of surgical revascularization on left ventricular function using standard echocardiographic study and Velocity Vector Imaging technology.
Materials and methods. 40 patients with ischemic heart disease were examined before and 12 days, 6, 12 and 24 months after coronary artery bypass grafting (CABG). A standard echocardiographic (EchoCG) study was performed on ultrasound scanner Acuson Х 300 (Siemens, USA) with a 5–1 MHz sector multifrequency sensor. For objective assessment of myocardial function, the analysis of left ventricular (LV) deformation and rotational properties was performed using Syngo VVI (Siemens Medical Solutions USA Inc., США) in 720 LV segments.
Results. Standard EchoCG showed a stable systolic, diastolic and contractile LV function during 2 years of follow-up. The study of global values of strain (S) and strain rate (SR) showed a decrease in longitudinal S 6 months after CABG in the right coronary artery (RCA) area in the group of patients with complaints compared to those who had no complaints (p = 0.004), in addition, in this zone there was a tendency to a difference in longitudinal SR between these two groups (p = 0.07). In anterior descending artery area was a tendency to decreased strain of longitudinal fibers (p = 0.06) during the same period of observation. 1 year after CABG, strain decreased in patients with complaints (p = 0.04) in the circumference artery area only in circular fibers. Positive dynamics were noted in the diastolic function of left ventricular fibers and rotation indices.
Conclusion. The use of Velocity Vector Imaging after coronary bypass surgery shows a change in the function of myocardial fibers in the areas of coronary arteries, which is important in patients complaining of angina pain. 

Objective: to evaluate the changes in perception of body image in patients with dorsopathies after restorative procedures (with the example of massage).

Materials and methods. The study involved 50 patients with spinal diseases (of which 13 had intervertebral disc hernias, 13 patients had protrusions, 22 had scoliosis, 46 had osteochondrosis and 8 patients had spinal traumas). To assess the dynamics of the psychoemotional state and the attitude toward the body, we used the eight-color version of Lьscher color test and the color metaphors technique offered by I.L. Solomin and modified for the research task. Each patient was treated by a course of medical massage (10 sessions). Assessment of psychological parameters was conducted before and after the course of medical massage with the aim to establish the changes in the psychological state. The methods of descriptive statistics, the Student’s test for dependent samples and the procedure of tree clustering were used.

Results. The average and elevated levels of non-productive neuropsychic tension after treatment of patients either significantly and statistically significantly decreased or completely normalized. Exhaustion and lethargy in most cases were replaced by higher levels of activity and mobilization of physical and psychological resources. Psychosemantic analysis indicates that after massage sessions, important life values related to health and perception of oneself as more necessary and attractive are allocated in clusters. There is a reason to conclude that a person ceases to “indulge in illness,” and opens up to the external environment, thus family and romantic relationships improve.

Conclusion. After a course of medical massage, in addition to the therapeutic effect, patients’ overall psychoemotional state and attitude toward their own bodies improve.

A Mathematical Wave Analysis was conducted to study the frequency-temporal characteristics of sleep spindles in idiopathic generalized epilepsy (IGE) with variable phenotypes in adults. In resistant generalized tonic-clonic seizures (GTCS), the maximum duration of the stationary part of the sleep spindle in the 10–12Hz frequency band in the frontal and parietal regions was greater with Juvenile Absence Epilepsy compared with Juvenile Myoclonic Epilepsy and IGE with isolated GTCS. In patients with GTCS remission who took antiepileptic drugs (AED’s) in the anamnesis, the frequency-time characteristics of the sleep spindle were not different. In the entire group, the maximum duration of the stationary part of the sleep spindles in patients with IGE with a variable phenotype receiving AED’s was significantly less than in patients who stopped receiving AED’s. The revealed differences in the duration of the stationary part of the sleep spindles are due to various pathogenetic mechanisms underlying the different types of generalized seizures in adults, and can be used to refine the subtype of the IGE and evaluate the efficacy of the AED’s.

Objectives. To optimize treatment of purulent wounds with the help of a wound coating with a multidirectional action that combines broad-spectrum antimicrobial effect, stimulation of regeneration, sorption activity and local anesthetic action.
Materials and methods. The material for the study was a wound covering in the form of a film developed by the authors at Kursk State Medical University (Russian patent No. 2601897). Theexperiment was performed on laboratory animals (Wistar rats), which were divided into 2 groups (comparison and experimental), each group containing 36 animals. Purulent wound was modeled in the animals according to the method of P.I. Tolstykh. To evaluate the effectiveness of the treatment, the following methods were used: microbiological method (determination of areas of growth retardation and bacterial contamination in the wounds), Renier’s method (determination of local anesthetic activity), visual assessment of wounds, planimetric method (measurement of the wound area, percentage of area reduction and healing speed) and measurement of pH in the wounds. The statistical significance of the differences was determined with the nonparametric Mann–Whitney test. The differences were considered statistically significant at p ˂ 0.05.
Results. Initially, high efficiency of the film was detected in vitro for the most common strains of test organisms, which werewound infection pathogens. The Renier index was 1.2 times higher in the film with chlorhexidine than in 2% lidocaine ointment, and the duration of general anesthesia was 25% longer. Following visual assessment of the wounds we revealed that purification and regeneration of the wounds first occurred in the animals in the experimental group; however, no statistical significance was detected. The maximal differences in the healing speed (1.6 times) were observed at 3–5 days, and the contamination of the wounds was 1.3 times lower in the experimental group than in the comparison group. According to the results of pH assessment, significant differences between the groups were noted only on day 15. Approximation of pH values to intact skin values also proved the effectiveness of treatment.
Conclusion. The developed contact wound covering has high antimicrobial activity against a broad spectrum of wound infection pathogens, creates a fairly good local anesthetic effect, significantly speeds up the healing process and reduces bacterial contamination of the wound area. Thus, the developed wound covering can be recommended for further studies in the clinical setting for treatment of inflammatory processes in soft tissues.

Currently, chemotherapy combined with surgery and radiation therapy is the most effective treatment for cancer. At the same time, the use of this method is accompanied by serious side effects caused by the lack of specificity of most chemotherapeutic agents. In this regard, the development of drug delivery systems (DDS) capable of addressing a chemotherapeutic agent to cancer cells, as well as its controlled release, is a promising approach for the effective treatment of cancer.
The aim of the study is to synthesize a new DDS based on surface-modified microparticles of zero-valent iron, to study its properties as a carrier of a chemotherapeutic agent (encapsulation efficiency, loading capacity, possibility of controlled release of a chemotherapeutic agent) and safety.
Materials and methods. The microparticles were synthesised by reduction of iron (III) chloride with sodium borohydride followed by in situ surface modification by 4-carboxybenzyldiazonium tosylate. To confirm the occurrence of the reaction, FTIR spectroscopy (Nicolet iS5 Infrared Spectrometer (Thermo Scientific, USA)) was used. Hydrodynamic diameter and surface charge of the microparticles in solution were investigated by dynamic light scattering (DLS) and z-potential. DOX release studies were performed in simulated physiological conditions (pH 3.3; 5.5; 7.4) to evaluate the effect of the external pH on the release rate. Release studies under ultrasound irradiation were performed simultaneously in the same conditions. The effect of surface modification on encapsulation efficiency was evaluated at various pH values (3.3; 5.5; 7.4) and doxorubicin concentrations (0.2; 0.35; 0.5; 0.75; 1.0 mg/ml). To demonstrate the safety of the developed system, cytotoxicity studies were performed on HeLa cell lines (ATCC® CCL-2™).
Results. An original method of preparation of the drug carrier, based on iron zero-valent microparticleswith covalently attached chitosan (Fe-CS) on their surface was proposed. Prepared microparticles demonstrated high encapsulation efficiency, drug loading capacity of DOX (0.9 mg per 1 mg of FeCS microparticles), low cytotoxicity and also a possibility to modulate the release rate by ultrasound irradiation and by changing pH of the external environment.
Conclusion. A carrier based on microparticles of zero-valent iron with covalently attached to the surface chitosan (Fe-CS) was obtained. The efficiency of encapsulation, the loading capacity of doxorubicin was determined and the possibility of its controlled release under the influence of an ultrasonic field at different pH values was confirmed. In an in vitro experiment on the HeLa cell line (ATCC® CCL-2™), no toxicity was established for all samples (Fe0, Fe-COOH и Fe-CS), regardless of their concentration.

The aim of the study was to reveal the influence of the JNK inhibitor on the induction of disturbances in the psychoneurological status of experimental animals in the modeling of posthypoxic encephalopathy and to reveal the mechanisms of its action related to the functioning of the neural stem cells of the brain.
Materials and methods. The experiments were performed on 64 male outbred mice. Posthypoxic encephalopathy was modeled in non-native mice with hypoxia of the hermetic volume. The JNK inhibitor was administered to mice subcutaneously at a dose of 15 mg/kg once before hypoxic exposure. We studied the neuropsychiatric status, the content of neuronal stem cells in the subventricular zone of the brain of experimental animals, and the direct effect of the JNK inhibitor on intact neural stem cells in vitro.
Results. The expressed cerebroprotective action of the pharmacological agent was revealed, which consisted of normalizing the indices of orientation and exploratory behavior and conditioned activity in experimental animals. These effects developed against a background of a significant increase in the content of neural stem cells in the subventricular zone of the brain. In the experiments in vitro, a direct stimulating effect of the JNK inhibitor on neural stem cells was found.
Conclusions. The obtained results showed a neuroprotective action of the JNK inhibitor. At the same time, the prevention and compensation of the development of disturbances in the activity of the central nervous system is based on the preservation of the ability of the nerve tissue to repair andassociated with the functioning of resident neural stem cells.

Introduction. The detection of the first cases of tick-borne human granulocytic anaplasmosis in Russia, discovery of genetic markers for Anaplasma spp. in ixodid ticks and reporting of a significant number of cases of tick-borne infections in the southern part of Western Siberia give reason to suppose that causative agents of tick-borne anaplasmosis may be transmitted in Tomsk and its suburbs.
Objective. To study the distribution and species biodiversity of A. phagocytophilum in ixodid ticks in Tomsk Region.
Materials and methods. The analysis of 690 individual ixodid ticks (larvae and adults) was carried out for Ixodes persulcatus (n = 530) and Dermacentor reticulatus (n = 160) ticks collected in 2015–2016 on the territory of urban and suburban biotopes of Tomsk. Primary screening of ticks for the presence of genetic material of A. phagocytophilum was conducted using two-round PCR with species-specific primers for the 16S rRNA gene. The amplification (1,220 kB) of the groESL fragment of the heat shock protein operon was performed for positive isolates with subsequent determination of the nucleotide sequence in the gene fragment for phylogenetic analysis.
Results. The number of A. phagocytophilum positive samples for I. persulcatus (larvae) was 1.2 ± 0.6%, I. persulcatus (adult) was 1.8 ± 0.7%; and D. reticulatus (adult) was 0.6 ± 0.3%. Analysis of the nucleotide sequence of the gene fragments in groESL operon for nine isolates confirmed that the genetic material of the granulocytic anaplasmosis was detected. Phylogenetic analysis showed that all the isolates belonged to the first group of the “new cluster” of A. phagocytophilum.
Conclusion. The causative agent of human granulocytic anaplasmosis has been newly detected in I. persulcatus ticks collected in urban and suburban biotopes of Tomsk and in D. reticulatus from urban foci.

Aim. To study the features of regulating the electrical activity and mechanical tension of smooth muscle cells (SMCs) of the guinea pig ureter as modulated by cyclic adenosine monophosphate (cAMP) in hypoxia.
Materials and methods. The effects of isoprenaline (100 μM), forskolin (1 μM), 3-isobutyl-1-methylxanthine (IBMX, 100 μM) and tetraethylammonium chloride (TEA, 5 μM) on the contractile and electrical properties of isolated smooth muscle segments of the guinea pig ureter in normoxia and hypoxia were measured by the double sucrose bridge. Hypoxic conditions were created by placing the SMCs in Krebs solution containing (10.0 ± 0.2) vol. % O2.
Results. It was found that an increase in the intracellular cAMP level caused by isoprenaline, the β-adrenergic receptor agonist, and activation of adenylate cyclase by forskolin, an inhibitor of phosphodiesterase IBMX, caused a decrease in the electrical and constrictor properties of the SMCs in the guinea pig ureter. The decrease in the level of oxygen in the perfusion solution resulted in the increase in the action potential amplitude and contraction of smooth muscles from the ureter. With an increase in the intracellular cAMP level, the activating effect of hypoxia on smooth muscle segments decreased. Inhibition of potassium conductivity of the ureteral SMCs with TEA in normoxia suppressed the cAMP-dependent processes induced by forskolin, whereas in hypoxia it caused the potentiation of an activating effect on the electrical activity and contractions of smooth muscle segments.
Conclusion. Thus, the results suggest the involvement of cAMP-dependent signaling system in the influence of hypoxia on the electrical and contractile properties of ureteral SMCs. Modification of the intracellular cAMP level reduced the stimulatory effect of hypoxia on the smooth muscle strips of the ureter caused by increase in the ionic conductivity of the membrane and contributed to their adaptation to environmental conditions.

Objective. The authors tried to identify the typology, severity and overlap of neurocognitive deficits with positive/negative symptoms in patients with schizophrenia.
Materials and methods. Fifty patients aged 22–55 years (25 women (50%) and 25 men (50%)) with schizophrenia diagnosed according to ICD-10 were examined. The average age was 38.0 ± 4.8 years, the average age of onset was 23 ± 3.2 years, the average disease duration was 15 ± 3.7 years. The patients were examined using battery tests to quantify their cognitive functions: Trail Making Test A&B; Stroop Color Word Interference Test; Verbal Fluency; Benton Visual Retention Test; 10 words learning; WAIS Digit Symbol Test; and WAIS Trail Making Test. The evaluation of cognitive deficits was carried out using z-scales. Association of neurocognitive deficits with other schizophrenia symptoms was also estimated using PANSS. The control group that was formed on the basis of the cognitive sphere parameters included 50 healthy volunteers. Statistical processing was carried out using the Mann–Whitney U test, k-means clustering, and the Kruskal-Wallis one-way analysis of variance.
Results. The patients with schizophrenia and healthy individuals had significant differences in the second part of the Stroop Color Word Interference Test, both parts of the Verbal Fluency, average score of Benton Visual Retention Test, 10 words learning basedon 5 reiterations, WAIS Digit Symbol Test and WAIS Trail Making Test with p < 0.05; in the Trail Making Test B with p < 0.01. The cognitive sampling profile was determined and compared with the PANSS scores. The significant predominance (p < 0.05) of the symptoms across all scales was found with impaired attention, visual memory, performance function, and/or orientation/coordination, as opposed to the other manifestations of cognitive deficits.
Conclusion. Neurocognitive deficits form syndromal overlaps with positive and negative schizophrenia syndromes, and the presence of attention, visual memory, performance and orientation / coordination disturbances is associated with the severity of schizophrenia in general.

The aim of the study was to determine subpopulation content, proliferative activity and T-lymphocyte apoptosis level in adult mice-recipients that in the juvenile period underwent multiple transplantation of immune cells with different functional properties from opposite behavioral types of donors.
Materials and methods. The study was carried out on male mice (CBAxC57BL/6) F1 (n = 190), which underwent transplantation of immune cells with definite functional properties three times starting from the age of 4–5-weeks. Phenotyping of recipients’ spleen cells was carried out by flow cytometry with monoclonal antibodies against CD3+, СD4+, CD8+. Splenocyte proliferation and apoptosis were estimated.
Results. Animals that underwent threefold transplantation of immune cells from singeing opposite behavioral types of donors in the juvenile period revealed different functional properties of spleen lymphocytes in adults. The most pronounced changes were detected in the animals receiving the immune cells from donors with passive behavior type. The lymphocytes of these recipients were characterized by relatively low proliferative activity and T-mytogen sensitivity, decreased CD4+, CD8+ apoptosis level under deficient medium conditions and increased level of activation and dexamethasone-induced apoptosis in CD4+ lymphocytes.

Objectives. The aim of this study was to investigate diagnostic capabilities of a new electrophysiological method  of omega-electroencephalography in the  estimation  of change  in functional  and metabolic  state  of the cells of nervous tissue during ischemic adaptation.

Materials and methods.  Brain ischemia was modeled  based on a hyperventilation test  (HVT). Recording  and  analysis  were  made  on  concomitant changes  in direct  current potential level (DCPL) and EEG in 38 derivations  for the same test person  in a fourfold-replicated HVT.

Results. Brain ischemia that  occurs  during volitional  hyperventilation was initially followed by DCPL negativation   (negative  shift)  (0.5–1  mV) and  increase  in amplitude  of all EEG  waves. Cessation  of HVT and return to  initial  DCPL were followed by positivation  (positive  shift) of DCPL (about  1 mV), combined  also with  high-amplitude EEG waves. Adaptation to  hypoxia and  ischemia,  modeled  using replication-based HVT,  and  improvement  of brain  resistance  to these  unfavorable  factors  manifested  themselves first in a short-term  electropositive deviation of DCPL at the start  of the test followed by DCPL positivation  reduction and then in complete substitution of electronegative response  to  positive  shift in DCPL (about  0.5 mV) during  the test.

Conclusion. The analysis of concomitant changes in DCPL and EEG during and after hyperventilation and literature data  analysis suggests that  HVT  was initially  responded  to  by depolarization in neocortical nerve  cells, combined  with  intensification  of  neuronal  activity. Activation  of compensatory mechanisms,  resulting  in improvement  of nerve  cell resistance  to ischemic conditions,  is associated  with  ischemic depolarization followed by hyperpolarization, and  enhancing  adaptive  capabilities  of brain  cells manifest  themselves  in substitution of cell membrane  depolarization to hyperpolarization in response to unfavorable  factor,  also combined with intense neuronal  activity.

The aim of this study is to determine the morphometric features of the vessels of the venous system of the rectum of men of different body types using the X-ray method.
Materials and methods. To carry out X-ray contrast study of rectum veins in a direct projection of the pelvic organs was performed.
Results. As a result of the study, it was established that the developed method of radiological examination of rectum veins, consisting of three consecutive photographs of the stage contrasting of the organ vessels, allows to determine the features of angioarchitectonics and the spatial arrangement of rectal vessels of corpses of men of different body types according to J.M. Tanner without extracting it. The maximum values of the corners of the formation of the second-order portal system of the corpus gynecomorphic somatotype male corpuscles, as well as the minimum values of the angles of vein formation of the first order of their caval system, the constancy of the loose type branching of the portal system parallel to the organ of the vessels, and the frequent occurrence of a single type of branching of the direct vascular organ in the absence of constitutional features branching of the vessels of the cadavers of the rectum of the investigated corpses of men.
Conclusion. This finding can be used to assess the effect of venous outflow on the structural characteristics of the vascular system of the rectal wall, depending on the body type of the individual.

The aim of the research is to study the possibility of using track-etched membrane, including track-etched membranes modified with cold plasma, followed by layering prenatal stem cells (PSC) on the material surface in surgical treatment of bullous keratopathy (BK).
Materials and methods. The track membranes made of polyethylene terephthalate were obtained by irradiating the polymeric film with the 40Ar+8ion beams and by chemical etching. The study was conducted on 16 rabbits (Sylvilagus bachmani), which after BK modelling were divided into 4 groups: the 1st group was a control group of 4 animals (4 eyes); the 2nd group was a group of 4 animals (4 eyes) into which were implanted TM; the 3rd group was a group of 4 animals (4 eyes) into which were implanted TM with PSC; the 4th group was a group of 4 animals (4 eyes) into which were implanted plasma modified TM with PSC. TM was obtained by irradiating the PET film with 40Ar + 8 ions and subsequent chemical etching. The eyes were enucleated for histological examination after 8 weeks from the start of the experiment.
Results. As a result of the research, it was found that the implantation of TM with a preliminary layeringof human PSC promotes the growth of the fibroblast population in the cornea stroma and intensifies leukocyte (lymphocytes and eosinophilic granulocytes) infiltration as opposed to the implantation of PET TM without a cellular component. In addition, the implantation of TM contributes to a twofold decrease in the cornea edema induced by BK. Modification of TM with cold plasma did not affect the studied histomorphometric parameters.
Conclusion. The implantation of TM based on PET during bullous keratopathy contributed to the development of the productive phase of infiltrative inflammation in the cornea of the eye. Pre-layering of human PSC reduced the severity of destructive changes in the rabbit cornea after BK modeling. The modification of TM by cold plasma did not affect the studied histomorphometric parameters.

The aim of the study was to evaluate electrophysiological remodeling of the right ventricle in rats in experimental heart failure of different etiologies.
Materials and methods. Isadrin-, doxorubicin- and monocrotaline-induced heart failure models were developed. Unipolar epicardial electrograms of the ventricles (256 recording sites) were recorded using a 144-channel system. The cardiac output and pressure in both ventricles of the heart were measured. Activation-recovery intervals were used as an index of duration of local repolarization, and the general and local dispersions of activation-recovery intervals were used as an index of heterogeneity of ventricular repolarization.
Results. In all models of heart failure, the following were identified: 1) non-uniform prolongation of repolarization with the greatest elongation at the apex of the right ventricle; 2) an increase in apicobasal differences of repolarization with the greatest change in the right ventricle; 3) an increase in the heterogeneity of the repolarization of the epicardial layer of the ventricles with heterogeneous changes in the local heterogeneity of repolarization and a decrease in the interregional differences in the heterogeneity of the electrophysiological properties of the myocardium; 4) more pronounced changes in the repolarization of the right ventricle than in the repolarization of the left ventricle.
Conclusion. Thus, irrespective of the cause of the heart failure, the following changes occur: 1) prolongation of the right ventricular repolarization occurs non-uniformly (mostly due to the apical area), which results in an increase in the right ventricular repolarization heterogeneity; 2) an increase in the heterogeneity of right ventricular repolarization is observed, which causes an increase in the overall heterogeneity of the ventricular epicardial surface.

The Declaration on Patient-Oriented Healthcare of theTomsk Region was accepted by the medical and patient communities on August 24, 2018. It was the first document of its kind in Russia. It was created based on several elements: modern international experience in the field of protection of patients’ and medical workers’ rights, particular qualities of Russian legislation, principles of humanistic medicine, and broad analysis of specific complaints from patients of regional public health institutions in the Tomsk region.
The reason to create the Declaration was the necessity to build a healthcare system in which both medical staff and patients comply with such principles as mutual respect, choice and responsibility, involvement, accessibility, and openness. The document explains the need for constant adherence to these principles for the effectiveness of treatment, the protection of the individual, professional dignity, and equality.

This review of the literature is devoted to the consideration of mechanisms of the antitumor effect of flavonoids. The anticanceromatous effect of flavonoids is discussed in the context of their impact on the main stages of development of malignant tumor cells. At the same time, the influence of flavonoids on the activity of protein kinases, metalloproteinases, apoptosis, angiogenesis and the cell cycle of tumor cells is considered in detail.

Autophagy is the main catabolic process required for the removal of damaged organelles, aggregated proteins and intracellular pathogens from cells. Oxidative stress is accompanied by an increase in autophagy, which has a protective effect by maintaining the qualitative composition of mitochondria (mitophagy) and peroxisomes (pexophagy) followed by lysosomal degradation of organelles with high production of reactive oxygen species. Aggrephagy also removes toxic products formed during oxidative and carbonyl stress. Furthermore, autophagy can activate the antioxidant response element system and increase the expression of antioxidant enzyme genes. The protective role of autophagy can be useful in many pathological processes accompanied by the development of oxidative stress while at the same time it may cause chemoresistance, reducing the effectiveness of anti-tumor therapy.

Survival analysis is one of the most common methods of statistical analysis in medicine. The statistical analysis of the transplantation (or death) probability dependent on the waiting time on the "waiting list" is a rare case when the survival analysis is used to estimate the time before the event rather than to indirectly assess the risks. However, for an assessment to be adequate, the reason for censoringmust be independent of the outcome of interest. Patients on the waiting list are not only at risk of dying, they can be excluded from the waiting list due to deterioration of the comorbid background or as a result of kidney transplantation. Kaplan – Meier, Nelson – Aalen estimates, as well as a cause-specific Cox proportional hazards regression model, are consciously biased estimates of survival in the presence of competing risks. Since competing events are censored, it is impossible to directly assess the impact of covariates on their frequency, because there is no direct relationship between the regression coefficients and the intensity of these events. The determination of the median waiting time on the basis of such analysis generates a selection bias, which inevitably leads to a biased assessment.
Thus, in presence of competing risks, these methods allow us to investigate the features of cause-and-effect relationships, but do not allow us to make a prediction of the individual probability of a particular event based on the value of its covariates. In the regression model of competing risks, the regression coefficients are monotonically related to the cumulative incidence function and the competing events have a direct impact on the regression coefficients. Its significant advantage is the additive nature of the cumulative incidence functions of all possible events. In the study of etiological associations, it is better to use Cox regression model, which allows to estimate the size of the effect of various factors. The regression model of competing risks, in turn, has a greater prognostic value and allows to estimate the probability of a specific outcome within a certain time in a single patient.

This literature review is devoted to the study of recent advances in the field of neurorehabilitation using robotic technologies. Objective: to study best practices of applying robotic rehabilitation technologies in stroke patients, its clinical efficacy and influence on the molecular mechanisms of neuroplasticity.
Keywords were searched in the Web of Science, Core Collection, Scopus and PubMed databases.
Results. Robotic neurorehabilitation occupies a certain place in the comprehensive rehabilitation of patients with motor deficiency after stroke. An interdisciplinary patient-oriented approach and consistency at all stages of medical rehabilitation are especially important when using rehabilitation methods that implement advances in robotics and information technologies in patients after stroke. Rehabilitation with the use of high-tech computerized rehabilitation systems operating in the biofeedback mode is one of the promising areas and requires further neurophysiological and laboratory studies to create scientifically based methodological approaches. It will have great social significance and tangible economic effects from improving the quality of neurorehabilitation and reducing its duration.

The review summarizes the history of the discovery in the mid-70s of the impaired ion transport across the plasma membrane of cells during primary arterial hypertension. A half-century’s history of studies on the molecular nature of the ionic transporters underlying these disorders and the mechanisms mediated by them leading to the development of hypertension and complications caused by a long-term increase in blood pressure is analyzed.

Modern methods of diagnosis and treatment of infectious diseases should be based on reliable data obtained through various methods of laboratory research. The main characteristics of the methods used are high sensitivity (the ability to analyze a small amount of sample, 10–6–10–4 g/ml), selectivity, reproducibility and others. Proteomic methods of research satisfy all the principles of evidence-based medicine. The advantages of using these methods to identify biomarkers (identifying proteins with altered expression levels), timely diagnosis and treatment of infectious diseases, described in the article, are obvious. Their introduction into practice is an element of personalized medicine.

Objectives. Allergic rhinitis (AR) is highly prevalent all around the world. It adversely affects the quality of life of patients and leads to the development of bronchial asthma, which determines its high socioeconomic burden. International and Russian authorities establish control of the disease as a primary efficacy end point of allergic rhinitis treatment. Nevertheless, there is no international, standardized, validated tool to assess control of allergic rhinitis. In this regard, this review aims to analyze research on the development of such tools and to provide their comparative analysis.
Review methods. Using PubMed, Web of science and Russian Citation Index database, we searched from 1991 to 2019 with logical combinations of the following key words: “allergic rhinitis control”, “AR control”, “AR questionnaire”. A total of 96 publications were included in the study.
Results. All studies were arranged in chronological order and their main results were described. Questionnaires on the quality of life, tools offered by the clinical guidelines, visual analogue scales, and specialized questionnaires for measuring the control of allergic rhinitis were considered separately. The advantages and disadvantages of these instruments are described.
Conclusion. The evidence based on the quality of the tool to support the use of specialized questionnaires was shown. Many disease control scales have been validated, but have some practical disadvantages asprimary efficacy criteria in clinical practice.

Aim: to review current scientific literature concerning the main advances and problems of magnesium (Mg) alloys for traumatology and orthopedics.
Methodology of the study. Analytical review based the comprehensive investigation of public scientific and technological sources.
Results of the study. Modern knowledge about classification, in vitro and in vivo biodegradation, biomechanics, local and general biocompatibilities, clinical efficacy, and hazards of infectious complications in conditions of osteosynthesis with implants made of Mg alloys with or without protective (anticorrosion and antimicrobial) coatings is presented.
Conclusion. Fast degradation and a risk of periprosthetic infection strongly limit clinical application of implants made of Mg and its alloys. Development of novel Mg alloys and their modification by incorporating antimicrobial elements into their body or protective coating is a promising direction to control biomedical characteristics of Mg alloys.

61 people suffering from persistent allergic rhinitis and asthma accompanying food allergies were studied using case histories, the NHANES questionnaire, polyspecific serum levels, allergen-specific IgE, IL4, IFNg and IL10 assays, and allergy skin tests. Four different endotypes have been identified, including entopic, which can be the basis for new approaches to the diagnosis and treatment of allergic rhinitis and asthma.

Achalasia cardia (“cardiospasm”, “phrenospasm”, “dolichoesophagus”, “megaesophagus”, “stenosis of cardia”) represents a primary impairment of esophageal motor function associated with impaired lower esophageal sphincter relaxation and peristalsis defects of the thoracic esophagus. It is diagnosed at the age of 25 to 60 years, making up to 20% of all diseases of the esophagus, and is characterized by a triad of symptoms: dysphagia, regurgitation and chest pain when swallowing. In most cases the first manifestations of achalasia are preceded by stress situations in the anamnesis that complicates the differential diagnosis of psychogenic esophageal spasm.
The presented clinical case illustrates difficulties of early diagnosis of achalasia cardia in a young femalepatient with severe anxiety and depressive symptoms which develop under conditions of chronic stressful situations in the family or at work. The issues of interdisciplinary interaction of health professionals (physician, gastroenterologist, psychiatrist, psychotherapist, and surgeon) on the course of examination and management of patients with comorbid physical and mental pathology are discussed. The efficiency of the integrative approach to treatment and rehabilitation with the use of modern reconstructive surgical interventions as well as conservative methods of therapy, psychopharmacotherapy and personality-oriented psychotherapy proves the relevance of studying psychosomatic aspects of achalasia cardia.

We  present  a  rare  case  of  the  combination   of  cervical  cancer  and  unilateral complete   aplasia  of  the uterine  adnexa.    Female  genital  tract anomalies  account  for  about  4% of all congenital  malformations.

Congenital  malformations  of the  adnexa  are  very  rare,  accounting  for  less than  0.5%. In  the  presented case, this abnormality was found incidentally during surgery for cervical cancer. Medical genetic counseling confirmed  the presence  of the isolated congenital  pathology.