The aim of the study was to establish the association of the prevalence of coronary heart disease (CHD) and sleep disorders among men between the ages of 25 and 64 belonging to an open population of a medium-sized urban city of Western Siberia.

Materials and methods. A cross-sectional epidemiological study was conducted on a representative sample of the population among males of 25–64 years old in Tyumen. The prevalence of coronary heart disease was determined based on standard epidemiological methods. Self-assessments by participants in the study of quality of sleep was determined by the World Health Organization (WHO) Monitoring Trends and Determinants in Cardiovascular Disease-Psychosocial Program (WHO MONICA-psychosocial). When calculating the odds ratio of developing coronary heart disease), self-reports of satisfactory, good, or very good sleep were regarded as a lack of an indicator; while very bad and bad sleep were considered positive indicators.

Results. The prevalence of CHD according to the extended epidemiological criteria for men in an open urban population was 12.4%; the detection rate of “definite” and “possible” CHD was almost equal. The age-standardized prevalence rate of sleep disorders was 50.9%. There is a significant risk of developing CHD with extended criteria (5.05), as well as “definite” (5.28) and “possible” (3.13) forms in the male population at 25–64 years of age. In the 55 to 64 age group, there is a significant risk of developing CHD according to the extended criteria (5.57) and the “definite” form of CHD (10.21).

Conclusion. Thus, the findings suggest the importance of further study of sleep disorders in working age men in Siberian populations, its relationships with conventional and non-conventional risk factors of CHD, as well as the feasibility of preventive measures aimed at reducing the influence of psycho-emotional stress factors among the Russian population.

Background. Identification of predictive molecular markers of triple-negative breast cancer (TNBC) will enable the evaluation of the efficacy of neoadjuvant chemotherapy (NACT) and define optimum approaches for the prognosis of the disease course in TNBC patients.

The aim of the study was to examine the correlation between the expression of the epidermal growth factor receptor (EGFR), its gene’s polymorphic variants and the neoadjuvant chemotherapy (NACT) efficacy in triple-negative breast cancer (TNBC) patients.

Materials and methods. The study included 70 patients with triple-negative breast cancer, who had received 2-4 cycles of FAC and CAX regimens. The efficacy of the neoadjuvant chemotherapy was assessed according to the RECIST scale. The EGFR expression level in tumors before and after the NACT was evaluated with the help of immunohistochemistry. Genotypes for EGFR (rs2227983 and rs1468727) were detected by a real-time PCR.

Results. It was found that NCT significantly decreases the EGFR expression level in the tumor (p = 0.000). The research associates the objective clinical response as well as the pathological complete response with the low EGFR expression level (p = 0.007 and p = 0.000 respectively). Patients carrying the EGFRCC mutant genotype of rs1468727 did not achieve a pathological complete response (p = 0.042). In addition, patients with EGFRCC mutant genotype are more likely to have tumors with a high EGFR expression compared to EGFRTT wild-type genotype patients (p = 0.047).

Conclusion. The EGFR expression level in tumor tissue and the polymorphic variants of its gene in the rs1468727 locus can be considered as potential molecular markers with predictive significance in relation to the NACT efficacy in triple-negative breast cancer patients.

The aim of the study was to investigate the clinical phenomena of asthenia and subjective well-being of women aged 40–65 with non-psychotic mental disorders.

Materials and methods. A complete examination of 204 women aged 40–65 who received treatment for non-psychotic mental disorders within 1 year has been conducted. The data on the clinical phenomena of asthenia were supplemented by patients’ rank assessment of fatigue and mood, determination of asthenia severity using the Multidimensional Fatigue Inventory (MFI-20), a calculation of the Kupperman menopausal index, and an assessment of the emotional component of well-being on the subjective well-being scale. For statistical processing, the methods of descriptive statistics and non-parametric statistics were used (for comparing independent samples – the Kruskal–Wallis criterion and Mann–Whitney U-criterion were applied; for identifying the connection of signs – Spearman rank correlation was used).

Results. The profile of the identified disorders included neurotic, stress-related and somatoform disorders (F40-49) – 67.7%, organic non-psychotic disorders (F06.4; F06.6) – 27.0%, and affective disorders (F34.1) – 5.4%. The organic asthenic disorder was also the second most frequent diagnosis among 69 patients. 196 women complained of fatigue. Patients with complaints of constant fatigue were
significantly more likely to report headache, irritability, low mood, pessimistic thoughts, drowsiness, and asthma attacks. Their low level of subjective well-being correlated with higher rates of asthenia on MFI-20 subscales, except for the “Reduced Motivation” subscale.
The rates for all MFI-20 subscales among women with asthenic syndrome were lower than for patients with the depressive syndrome. A lower level of subjective well-being was revealed in patients with depressive, anxiety-depressive and anxiety-phobic syndromes, which differed by more pronounced manifestations of asthenia.

Conclusion. The conjugation and complementarity of the scales used in the study made it possible to measure both asthenia and the emotional state and subjective well-being of women with non-psychotic mental disorders associated with it.

The aim of the study was to reveal clinical and dynamic characteristics of affective disorders (AD) in comorbidity with alcohol addiction (AA).

Materials and methods. 65 patients with affective disorders [22 women (34%) and 43 men (66%)] were examined. The main group included 34 patients aged 44.5 [36.0; 51.5] with affective disorders and comorbid alcohol addiction The comparison group included 31 patients aged 45 years [32; 52] with affective disorders without comorbid narcological pathology. Compared groups were matched by sex, age and nosological structure (p > 0.05). The following methods were used in the study: clinical and psychopathological, clinical follow-up, psychometric, statistical, as well as these psychometric scales: Clinical Global Impression (CGI), Hamilton Depression Rating Scale (HDRS-17), Hamilton Anxiety Rating Scale (HARS), Social Adaptation Self-evaluation Scale (SASS).

Results. The comparative assessment of clinical and dynamic characteristics of affective disorders and social adaptation level was conducted. Chronology of occurrence of comorbid affective disorders and alcohol addiction was analyzed.

Conclusion. Addition of alcohol addiction to affective disorders worsens the clinical and dynamic indices and social adaptation level of patients.

Aim. The study objective was to examine fibrin monomer hemostatic effects in post-traumatic parenchymal hemorrhage in the setting of pharmacologically associated platelet aggregation inhibition.

Materials and methods. In the in vivo experimental study on male rabbits, the hemostatic effects of fibrin monomer (FM) (0.25 mg/kg) were evaluated in comparison with tranexamic acid (TA) (15 mg/kg) in post-traumatic parenchymal hemorrhage against the background of preliminary inhibition of platelet aggregation function with acetylsalicylic acid (2.0 mg/kg) and clopidogrel (8.0 mg/kg). Volume and rate of blood loss were estimated, as well as the parameters of the hemostatic system.

Results. It has been established that FM versus placebo when administered intravenously 1 hour before the injury can prevent severe bleeding associated with taking antiplatelet agents. The volume of blood loss after FM administration decreased in median by 6.0 times, the rate of blood loss – by 5.9 times, and when using TA – by 2.4 (РFM-TA < 0.02) and 4.8 times respectively. The hemostatic effects of TA were realized when the hemostatic balance was shifted towards the increased fibrin formation (an increase in the level of D-dimer in the blood plasma). The use of FM was not accompanied by any significant changes in the blood coagulation system.

Conclusion. The fibrin monomer at a dose of 0.25 mg/kg i.v. is capable of preventing severe  posttraumatic parenchymal bleeding caused by the combined use of drugs with different antiplatelet action. The phenomenon is not completely clear and needs to be analyzed in further research. The mechanism of hemostatic effects associated with FM is currently being studied.

The aim of the study was to study the physical and psychological components regarding the quality of life of patients with cervical dystonia.

Material and methods. 170 respondents were examined. The main group included 120 patients with cervical dystonia, 50 patients were included in the control group, consisting of patients with cervicalgia of various genesis. The diagnosis of cervical dystonia met uniform criteria for the diagnosis and treatment of dystonia adopted in 2011 by the European Federation of Neurological Societies and the Movement Disorders Society (European Federation of Neurological Societies / Movement Disorders Society, EFNS / MDS). In the control group, the pain syndrome of the cervical spine was caused by a degenerative process and was confirmed by X-ray examination and /or MRI. As part of our research, we determined the quality of life in men and women in both groups using the SF-36 questionnaire with a study of the parameters of physical and psychological well-being.

Results and conclusion. A considerably significant effect of cervical dystonia on the somatic and mental  parameters regarding the quality of life in both men and women has been established. Significant decrease in all indicators representing the quality of life in patients with cervical dystonia was revealed compared with respondents without dystonic hyperkinesis. As a chronic disease, cervical dystonia leads to psycho-physiological stress, which significantly impairs the quality of life of patients. Significant gender differences were identified: women from the groups of cervical dystonia and cervicalgia were more often exposed to psychological deprivation and reduced physical activity than men from the same groups.

Ovarian cancer is one of the most aggressive and hard-to-treat cancers. About 75% of ovarian cancer cases are detected at later stages of the disease. Ascitic fluid is promising biological material to get information about the tumor nature in ovarian cancer. Peritoneal dissemination is one of the most unfavorable factors of malignant tumor progression. However, prognostic factors associated with malignant ascites are not well understood.

The aim of the study was to evaluate various tumor cell populations in ascitic fluid of ovarian cancer patients by laser multicolor flow cytometry using a molecular panel of EpCam, CD45, CD44, CD24, CD133, and N-cadherin markers. The prospective study included 16 patients aged 36 to 76 years with newly diagnosed FIGO stage Ic–IV ovarian cancer, who were admitted for treatment to the Cancer
Research Institute of Tomsk National Research Medical Center.

The study material included EDTAstabilized ascitic fluid sampled during laparoscopy. Various populations of ascitic tumor cells (with stemness features, with epithelial mesenchymal transition (EMT) features, without stemness and EMT features, with a combination of these features, as well as atypical / hybrid cell populations) were identified by multicolor flow cytometry on a BDFACSCanto apparatus (USA) using fluorochrome-labeled EpCam, CD45, CD44, CD24, CD133, and N-cadherin monoclonal antibodies and the BD FACSDiva software. The study revealed twelve populations of Epcam-positive cells in ascitic fluid of ovarian cancer patients. The cell composition of ascitic fluid in ovarian cancer patients is represented by a heterogeneous population. A large fraction of ascitic tumor cells are atypical / hybrid tumor cells with stemness features as well as Epcam+CD45–CD44+CD24+CD133+/-cancer stem cells, both with and without EMT features.

Objective. To estimate the value of measuring plasma eosinophilic cationic protein (ECP) levels in patients with chronic obstructive pulmonary disease (COPD) as a potential biomarker for determining the activity of eosinophilic inflammation. To compare it to determining the number of blood eosinophils and predicting the severity of COPD by determining such clinical characteristics as respiratory function, exacerbation frequency and the BODE index.

Materials and methods. Based on the protocol, 161 patients with COPD participated in the study. They made 2 visits for the collection of anamnestic data and the performance of the main study procedures: respiratory function test, 6-minute step test, dyspnea assessment according to the Medical Research Council Scale questionnaire and sputum and blood analysis in order to determine the level of eosinophils and ECP. The second visit was conducted 12 months after the first to assess the dynamics of the disease. We paid particular attention to the presence of allergies in the case history, the frequency of exacerbations, the number of courses of treatment with antibacterial drugs and inhalants, and systemic glucocorticoids.

Results. The study has demonstrated that high plasma levels of ECP in patients with COPD are associated with a more severe course of disease and the development of more frequent infection-related exacerbations of the disease, which require the administration of inhaled glucocorticoids and antibiotics. We have demonstrated an inverse relationship between the ECP level and forced expiratory volume in 1 second (FEV1). This allows the use of this indicator as a predictor of the severity of COPD in patients.

Conclusion. According to the obtained data, measuring the ECP level of blood plasma can be recommended for use as a clinical marker in the prognosis of COPD and selection of personalized therapy. It is a noninvasive and a relatively easily accomplished research method.  

Macrophages as the effector cells play a key role in initiating the inflammatory process and predetermine the manifestation of the postinfarction cardiosclerosis. The population of these cells is heterogenous and is mainly represented by M1 and M2 phenotypes. Alloplant biomaterial (ABM) is resorbed by the macrophages which became the regulators of the cellular interaction in tissues.

The aim of the investigation was to reveal the peculiarities of the postinfarction healing of the myocardium following the ABM insertion and to assess the population change in the dynamics of macrophages and c-kit+ cells.

Materials and methods. The experimental investigations were carried out on 100 male Wistar’s rats weighing 0.18–0.25 kg. All the animals had coronary occlusion by way of ligating the arteries. In the experimental group, the ABM (12 mg) suspension was intramyocardially administered simultaneously with the vessel stricture formation. The harvesting of hearts was carried out at 3, 7, 14, 30, 45 days.

Results. In the experimental group the course of the inflammatory process was characterized by the onset of the early proliferative stage, whereas in the control group colliquative necrosis was developing. It was caused by different degrees of the macrophage reaction expression. The number of CD68+ cells in the rat reactive zone of the control group was bigger than in the experimental one. In the experimental group the ABM-induced macrophages of mesenchyme origin were revealed and с-kit+ cells were considerably more in number than in the control one. After 45 days, the scar area index in the experimental group was significantly less than in the control group.

Conclusion. ABM had a histoprotective effect under the conditions of the acute myocardial ischemia due to the inhibition of macrophage migration and induction of cellular cardiomyogenesis.

Aim. The study objective was to assess the age and gender characteristics of the metabolically healthy obesity phenotype (MHO) prevalence, taking into account various classifications.

Materials and methods. The materials used are the cross-sectional studies of the population cohort (Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) project, Novosibirsk), with the total of 3,197 people, among them 857 men (26.8%) and 2,340 women (73.2%), with BMI ≥30 kg/m². The MHO is defined according to different classifications: 1. IDF (International Diabetes Federation, 2005) – Waist circumference (WC) ≥ 94 cm in men and ≥80 cm in women and one or none of the components of metabolic syndrome (MS); 2. NCEP ATP III (the National Cholesterol Education Program Adult Treatment Panel III, 2001) in the presence of 2 and / or less components of the metabolic syndrome and 3. RSC (The Royal Society of Chemistry) – the index of waist circumference / hip circumference (WC / HC) ≤0.9 in men and ≤0.85 in women.

Results. According to IDF the frequency of MHO in the group was 23.2%; NCEP ATP III – 41.8; RSC criteria – 27.1%. The frequency of MHO was higher in women than in men, and it significantly decreased with the age in women population. In all classifications, increased average blood pressure (BP) level, with normal average values of the level of triglycerides (TG) and high-density lipoprotein (HDL) is typical for persons with MHO. The surveyed according to the RSC criteria people with MHO demonstrate higher frequency levels of all cardio metabolic risk factors than those surveyed with the use of other criteria of MHO.

Conclusion. The frequency of MHO varies depending on the used classification. In women, the frequency of MHO is reliably higher than in men. With the age, a significant reduction of the frequency of MHO in women is manifested. The frequency of arterial hypertension and abdominal obesity, the level of fasting blood glucose and LDL (low density lipoprotein), hypertriglyceridemia is higher in persons with MHO according to the criteria RSC.

The aim of the study was to investigatey the association of single-nucleotide polymorphism (SNP) rs10507391 (A>T) with the acute cerebrovascular accident (CVA) development in patients of the East Siberian population with cardiovascular pathology and its risk factors.

Material and methods. The study involved 260 patients with acute CVA (age [57.0; 51.0–62.0]) and 272 patients of the control group (age [55.0; 51.0–62.0]). Among the patients who had acute CVA there were 157 men and 103 women. The control group included 170 men and 102 women. The examination of the experimental group included: collection of complaints, anamnesis, clinical examination, computed tomography of the brain, electrocardiography, echocardioscopy, ultrasound duplex scanning of extracranial brachiocephalic arteries, daily blood pressure and heart rate monitoring, and analysis of the blood coagulation system. In patients of the experimental group, the following cardiovascular pathology and risk factors were present: arterial hypertension, paroxysmal supraventricular tachycardias, dyslipidemia, atherosclerosis of the brachiocephalic arteries, and disorders of the hemostatic system. The control group was surveyed in the framework of the international “HAPIEE” project. Molecular genetic research was performed by real-time PCR. Statistical processing of the material was carried out using the following software: Statistica for Windows 7.0, Excel and SPSS 22.

Results. When studying the association of SNP rs10507391 (A>T) with the acute CVA development in all the analyzed groups and subgroups of patients, a link was established between the rare TT genotype and the T allele and an increased risk of acute CVA.

Conclusion. TT genotype and T allele of the SNP rs10507391 (A>T) increase the risk of acute CVA in patients regardless of previous cardiovascular pathology and its risk factors, including patients with arterial hypertension, supraventricular tachyarrhythmias, atherosclerosis of brachiocephalic arteries, impaired lipid metabolism and hemostasis system.

The aim of the study was to investigate the effect of the carbon monoxide (CO) donor on the Ca2+-activated potassium permeability of the erythrocyte membrane and platelet aggregation ability.

Materials and methods. Healthy volunteers (n = 27) and patients with chronic coronary heart disease (CHD) (n = 32) of both sexes were examined. The material of the study was packed red blood cells and platelet-rich plasma obtained from patient’s venous blood. The change of Ca2+-dependent potassium conductivity of the erythrocyte membrane was evaluated by potentiometric method, and the platelet aggregation was studied by turbidimetric method. Carbon monoxide releasing molecule-2 (CORM-2) was used as a CO donor. The amplitude of A23187- and redox-induced hyperpolarization response (HR) of erythrocytes, and the rate and degree of platelet aggregation were estimated.

Results. It was shown that the addition of CORM-2 (10 and 100 μM) in the erythrocyte suspension caused a dose-dependent decrease in the amplitude of A23187- and redox-dependent HR in healthy donors, as well as in patients with chronic CHD. The maximum decrease was observed in the presence of 100 μM CORM-2. The effect of CORM-2 at concentrations of 10 and 100 μM on collagen-induced platelet aggregation led to a decrease in the degree and rate of aggregation in healthy donors. The maximum effect was shown at 100 μM of CO donor. However, such an unambiguous effect of CORM-2 on the aggregation parameters in patients with CHD was not observed.

Conclusion. The results suggest that CO has a significant effect on the ion transport function of the erythrocyte membrane and platelet aggregation activity of both healthy donors and patients with CHD.

The aim of the study was focused on the development of a decision rule for classifying patients as functional class (FC) II or III of chronic heart failure (CHF) by discriminant analysis with inflammatory markers.

Materials and methods. The study included CHF patients (n = 61) of both sexes. According to symptom severity, they were assigned to FC II (n = 20) and III (n = 41). In addition to conventional clinical and biochemical parameters to evaluate a patient’s state, parameters characterizing inflammation (IL-6, soluble IL-6 receptor, sgp130) were used. Statistically significant differences were revealed with the use of Mann – Whitney U test, Student’s t-test, Pearson’s χ2 test and Fisher’s exact test. Discriminant analysis was employed to formulate the decision rule. Receiver Operating Characteristic (ROC) analysis was used to evaluate the quality of the developed diagnostic test. The results were considered statistically significant at p < 0.05.

Results. Discriminant analysis included significantly different variables (age, brain natriuretic peptide, sgp130, CHF etiology, ischemic heart disease) and additional clinically important variables (diastolic and systolic arterial blood pressure (BP), IL-6). The decision rule for assigning patients to different CHF FC was developed. The optimum cut-off value was found with the use of the ROC curve with a sensitivity of 75.6% and specificity of 85%.

Conclusion. The decision rule for assigning CHF patients to FC II or III was developed using discriminant analysis. In addition to conventional clinical parameters, the model included the ones reflecting inflammatory processes (IL-6 and sgp130). ROC analysis revealed high quality of the model.

We identified significant functions of susceptibility-genes and performed an analysis of pathway enrichment for Alzheimer’s disease, Parkinson’s disease and for both of them. Genes were extracted from a Catalog of Published Genome-Wide Association Studies (GWAS). We uploaded genes into Cytoscape version 3.2.1. ClueGO plugin was used for functional and pathway enrichment analysis of genes based on the hypergeometric test. Two databases, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and
REACTOME, were selected for analysis.
The identified susceptibility genes are involved in the synthesis regulation and accumulation of toxic proteins, β-amyloid and α-synuclein, and lead to apoptosis of neurons. We have defined 14 shared functions: collagen catabolic process, cellular response to retinoic acid, regulation of calcium-mediated signaling, negative regulation of cell projection organization, negative regulation of neuron projection development, glial cell activation, microglial cell activation, macrophage activation, regulation of cholesterol metabolism, clathrin-mediated endocytosis, regulation of protein oligomerization, regulation of dendritic spine development, kinesin binding and clathrin binding. Also, we have defined 3 shared signaling pathways: trans-Golgi Network Vesicle Budding, Clathrin derived vesicle budding, Intestinal immune network for IgA production. These pathways contain genes susceptible to Alzheimer’s disease and Parkinson’s disease. The results suggest the metabolic, neuronal and immunological factors participate in the development of Parkinson’s disease and Alzheimer’s disease.

This literature review is devoted to the problem of vulvodynia. The article summarizes information about the etiology and pathogenetic factors of this syndrome, touches the aspects of diagnosis and treatment of this form of chronic genital pain. Despite the prevalence of this pathology, women with pain in the vulva often remain undiagnosed and do not receive adequate therapeutic and psycho-emotional support. Currently, the focus is in searching of the definition, classification, prevalence, pathophysiological factors of occurrence and adequate personalized therapy of this nosology.

One of the most significant events in recent years in the field of molecular biological research has been the recognition of the biological significance of non-coding ribonucleic acid (RNA). It turned out that a significant part of the non-coding part of the genome, which constitutes 98% of the genome, is rewritten. In addition to small RNAs (such as microRNAs (miRNA)), long non-coding RNAs (lncRNAs), which are a large  group of non-coding RNAs (ncRNAs) over 200 nucleotides in length, have been discovered. They play a role in the regulation of a number of basic molecular processes (cell division, chromatin function, microRNA activity, etc.). Many of these long non-coding RNAs were expressed in tumors compared with healthy tissues, for example, H19, HOX antisense intergenic RNA HOX (HOTAIR), Metastasis Associated Lung Adenocarcinoma Transcript 1 (MALAT1). A large amount of evidence revealed their roles at all stages of carcinogenesis and in modulating metastasis through regulatory networks. Aberrant expression of lncRNAs has been observed in cancer patients. In this context, lncRNAs can regulate the main characteristics of cancer cells by controlling gene expression programs associated with their suppressive and oncogenic functions. Therefore, they can be excellent biomarkers and therapeutic targets for tumors.

The authors of the study analyze various definitions of chronic heart failure (CHF). CHF, having many faces, despite the consensus concerning the paradigm of its pathogenesis, is given different definitions, using both the syndromic and nosological approaches. Most authors share a view of CHF as the final stage (outcome or complication) of many diseases in which there is impairment of ventricular filling or ejection of blood, i.e. as a syndrome, and not an independent nosological form. Nevertheless, at the beginning of the XXI century leading Russian specialists in heart failure presented a reasoned point of view on CHF not only as the final stage of the cardiovascular continuum, complicating the course of a disease of the cardiovascular system, but also as an independent nosological form. This approach, which contradicts the standard rules for the formulation of the final clinical and pathological diagnoses, as well as the agreed positions of the International Statistical Classification of Diseases and Related Health Problems, has been the subject of reasonable criticism. Since the identification of the underlying cause of heart failure is crucial for therapeutic reasons, the only correct view is that of CHF as a syndrome, the detailed description of which in clinical diagnosis is an important intranosological characteristic that allows building the most effective differentiated therapy and accurately determining the prognosis of the disease.

The use of virtual patients for students and for advanced training of medical doctors is a definite pedagogic innovation. The computer-based interactive multimedia simulations of scenarios for diagnosis and treatment allow for the avoidance of the risk of improper actions in regard to a real life patient, to repeat the clinical situations an unlimited number of times, and to standardize the tasks and criteria of their completion. Virtual patients represent a factual basis of problem-based learning. This review article focuses on the use of this educational technology for the development of medical decision making skills internationally, on its pedagogical effectiveness, and on the variants of the linear and branching scenarios. Meta-analyses demonstrate the pedagogical effectiveness of virtual patients and an interest of the trainees. An integration of the virtual patients into the learning contributes to clinical training gamification, which inspires the students and medical doctors to engage in interactivity and teamwork. The creation of a repository or a web-service of multimedia virtual patients in the tradition of national clinical school is of great current interest for implementation in the system of higher and continuing medical education.

According to official medical statistics, liver fluke infections caused by Opisthorchis felineus, Opisthorchis viverrini and Clonorchis sinensis, are reported annually in the Southeast Asia, European countries and the Russian Federation. These infections are the main cause of digestive system diseases in the population of endemic regions.

The aim of the review is to analyze the findings of epidemiological studies and to assess the relationship between liver and bile duct cancer and Opisthorchiidae liver fluke infections.

Materials and methods. The authors reviewed original studies published in 1974–2019 via the MEDLINE databases and the eLIBRARY scientific digital library.

Results. The studies have shown that cholangiocarcinoma is a significant medical and social problem in the trematode-endemic areas of Southeast Asia due to the absence of specific symptoms, long asymptomatic course, resistance to therapy and high mortality of patients. Long-term infection caused by trematodes Opisthorchis viverrini and Clonorchis sinensis is associated with a significant risk of developing cholangiocellular cancer. An epidemiological multicenter study is required to establish the relationship between the Opisthorchis felineus infection and cholangiocarcinoma in the population of endemic regions in the Russian Federation.

MicroRNAs and small interfering RNAs (siRNAs) belong to an extensive class of small non-coding RNAs and play an important role in gene expression regulation in cells. It is shown that changes in the amount or activity of these molecules may lead to the development of various diseases, including cancer. This made it possible to consider them as promising diagnostic and prognostic markers, as well as tools for the directed regulation of protein synthesis in the cell and targets for therapy. This review summarizes the basic knowledge about the biogenesis, distribution and the mechanisms of action of microRNA and siRNA, as well as currently used ways of target genes expression management with their help. Possible methods of these molecules delivery into the cell in vitro and in vivo are considered.

Vascular calcification is a distinctive feature of cardiovascular diseases of atherosclerotic origin. Visualization of calcifications is carried out by invasive and non-invasive methods. Knowledge of the presence and degree of calcification can predict clinical outcomes in patients at high risk of coronary events, help in the prevention and treatment of coronary heart disease.
The article presents a brief description of the methods of visualization of vascular calcium and a review of studies on the relationship of calcification with the risk of long-term adverse cardiovascular events.

Atrial fibrillation (AF) is the supraventricular form of tachyarrhythmia characterized by uncoordinated atrial stimulation and manifested in the increased frequency of their contraction. The frequency of this pathology directly correlates with the patients’ age and reaches 50% in an older age group. This fact determines the need for search of any markers of individual AF risk, which may contribute to an increase in the effectiveness of preventive actions. Among such markers, polymorphic variants of genes involved in the pathogenesis of AF are the most promising markers. This review discusses the results of studying the genetic markers of the AF development, as well as the possibility of their use as predictors of this pathology.

Congenital heart defects (CHDs) are recognized as the most common type of congenital pathology. The frequency of CHDs reaches 2.4–14.2 % per 1 000 newborns. Ebstein’s anomaly is a rare and complex pathology that can be manifested clinically at any age. Drug treatment is ineffective in patients with this pathology. Preference in this case should be given to surgical treatment. Cardiac surgeons must know basic methods of correction of this pathology, their advantages, and disadvantages. The literature review shows the evolution of Ebstein’s anomaly surgical correction techniques from the middle of the XX century to the present moment. The description of the main tricuspid valve repair techniques, which had an impact on the development of Ebstein’s anomaly surgery, is given. The volume of flap tissue that can be separated from the wall of the right ventricle is the key to successful valve repair. A case of tricuspid valve repair and replacement is given. “Cone” reconstruction is the most promising modern technique. There is also a need in new techniques and modification of the existing ones. The works aimed at their improvement and elimination of imperfections are promising.

The article describes the case of Takotsubo syndrome, which arose in a 71-year-old female patient after a mitral heart valve replacement , performed due to its severe (3rd degree) insufficiency of non-rheumatic genesis. This pathology is quite rare. Questions of its etiology and pathogenesis remain controversial. A special feature of this case is the development of reversible left ventricular dysfunction in the early postoperative period after mitral valve replacement. The reduction of the left ventricular ejection fraction to 25% with hyperkinesia of its basal parts with subsequent recovery of the ejection fraction to 56% 3 weeks after the onset of the disease was observed. There were also electrocardiographic changes simulating acute circular myocardial infarction with the absence of hemodynamically significant lesions of the coronary arteries. The patient had risk factors for this syndrome (age, female gender, stress situation, surgical intervention, administration of dobutamine and fluoroquinolones). For the reasons given above, the presence of Takotsubo syndrome was suspected. This case demonstrates the possibility of developing takotsubo syndrome after cardiosurgical interventions and defibrillation.