Objective. To study the causes and prevalence of symptoms of the syndrome of dyspepsia (SD) in children.

Materials and Methods. The study involved 550 children of the Transbaikal Territory aged 8-15 years with SD. The study was conducted in 2 stages. First, all patients with SD were examined. Then, patients with functional dyspepsia (FD) had a complete examination. Diagnostics of FD was based on the Rome IV criteria. Upper gastrointestinal endoscopy was made in 156 children. Helicobacter pylori (HP) IgM antibodies were detected by ELISA test in the serum.

Results. The organic causes of SD were found in 144 patients (26.2% cases). FD was found in 406 (73.8%) cases. SD occurred more often in girls than in boys. SD was more widespread in the age group of 12-15. There were no ethnic differences in the prevalence of HP infection. The patients with longer duration of symptoms had HP infection more often. HP infection more often occurred in patients with early bottle feeding and family gastritis or ulcer history. One of the possible causes was HP infection. Patients with family history of gastritis or ulcer had HP infection in 72.9% cases.

Conclusion. In the Transbaikal Territory functional causes of SD were more widespread than organic ones.

Probable causes of the FD were considered to be allergy, early bottle feeding and family gastritis / ulcer history. Antibodies to HP were found in 57% patients. The most widespread symptom in patients, infected with HP, was bothersome epigastric burning.

Aim. The correlation of genetic polymorphism of calcium-ion channels RYR2, CACNA1H, CACNA1C with the development of left ventricular myocardial hypertrophy in patients with essential hypertension was studied.

Methods. The study was performed in 84 patients with essential arterial hypertension with myocardial hypertrophy confirmed by echocardiography, and 80 patients with essential hypertension without myocardial hypertrophy. The detection of the SNP of calcium channel RYR2 (rs2490389), CACNA1H (rs11865472), CACNA1C (rs1006737), CACNA1 (rs11079919) genes was carried out by PCR by real-time PCR. Genotype frequencies were verified to concordance of Hardy-Weinberg equilibrium. The χ2-test were done, and the odds ratio (OR) are estimated.

Results. It was established that the frequency of the minor allele and the TT genotype of SNP G237115840T (rs2490389) of the RYR2 gene in patients with essential hypertension with myocardial hypertrophy is higher than in patients with essential hypertension without hypertrophy. The risk of the left ventricular myocardial hypertrophy development in patients with essential hypertension was higher in carriers of the T allele (OR=2,10[95% СI: 1,34 – 3,27], р<0,001) and the TT genotype (OR=2,85 [95% СI: 1,44 – 5,61], р<0,01) SNP G237115840T (rs2490389) SNP G237115840T (rs2490389) of the RYR2 gene.

The G allele and the GG genotype of the G2236129A polymorphism of the CACNA1H gene (rs11865472) were more common in the group of patients with essential hypertension and the left ventricular myocardial hypertrophy. The risk of developing myocardial hypertrophy in patients with essential arterial hypertension was higher in carriers of the G allele (OR=2,06[95% СI: 1,33 – 3,20], р<0,001) and the GG genotype (OR=2,86 [95% СI: 1,36 – 6,02], р<0,01) SNP G1134967A (rs11865472) of the CACNA1H gene of the potentially-gated calcium channel molecule. At the same time, the frequency of the minor allele SNP G2236129A (rs1006737) of the CACNA1C gene is not differ from each other.

Conclusions. Carrying the T allele and the TT genotype SNP G237115840T (rs2490389) of the RYR2 gene, the G allele and the GG genotype SNP G1134967A (rs11865472) of the CACNA1H gene are risks for development of the left ventricular myocardial hypertrophy in patients with essential arterial hypertension.

The aim of the research. To measure and analyze the levels of autoantibodies (AAB) against dopamine and NMDA receptors in children in relation to the severity of diabetic ketoacidosis (DKA).

Materials and methods. The study included 76 children, of which 38 children (study group) had type 1 diabetes mellitus (DM) and diabetic ketoacidosis (DKA) and 38 were apparently healthy children (control group). The study group children were divided into three subgroups: grade 1 DKA (n=22); grade 2 DKA (n=12); and grade 3 DKA (n=4). Blood serum samples were analyzed to measure the levels of AAB to type 2 dopamine receptors (DAR2) and type 1 glutamatergic receptors (NMDAR1). Statistical data were processed using the Mann-Whitney test, Kruskel-Wallis test, and Spearman's rank correlation coefficient. The statistical significance level was specified as p<0.05.

Results. The largest clinical impairments in the level of consciousness and biochemical parameters were discovered in children with grade 3 DKA. All patients with DKA had elevated mean levels of AAB against both NMDAR1, amounting to 3.82 [3.0-5.59] U/mL compared with 1.12 [0.65-1.64] U/mL (p=0.000) in apparently healthy children, and DAR2, amounting to 7.24 [3.84-12.19] U/mL compared with 2.13 [1.45-3.15] U/mL (p=0.000) in the control group patients. The elevation of the levels of AAB against NMDAR1 and DAR2 was discovered to depend on the clinical severity of DKA (with the maximal concentrations found in grade 3 DKA). A correlation was shown to exist between elevated levels of AAB and consciousness impairments.

Conclusion. The obtained results indicate the impairment of the glutamatergic and dopaminergic systems in DKA in children with type 1 DM, which points at the presence of brain dysfunction.

The aim of the research. To describe the frequency of occurrence of polymorphisms in bone tissue remodeling genes (vitamin D receptor gene Bsm1 c.IVS7G>A, lactase gene LCT -13910 C>T and collagen gene COL1A1 2046 G>T) in patients with osteoporosis (OP) and healthy women of Russian and Buryat nationalities in Trans-Baikal region.

Materials and methods. 121 women with OP (50 Russian and 80 Buryat nationalities aged from 50 to 80 years) and 145 healthy women of the same age were examined. The diagnosis of OP was established according to the Russian Clinical Guidelines for Osteoporosis 2021. The study of genetic polymorphism was carried out by PCR for VDR and LCT using standard sets of primers SPF "Litekh" - "SNP" (Moscow); and DNA Technology for COL1A1.

Results. Homozygous TT of LCT 13910 C>T and recessive allele A VDR - Bsm1 c.IVS7 G>A were associated with increased risk of osteoporosis in women of both nationalities. Heterozygous GА of VDR Bsm1 c.IVS7G>A, homozygous TT of LCT 13910 C>T were associated with increased risk of osteoporosis in Russian women. Homozygous АА of VDR Bsm1 c.IVS7G>A were associated with osteoporosis risk in Buryat women. Homozygous recessive TT of LCT 13910 C>T is independent predictor of osteoporotic fractures in Russian women.

Conclusion. VDR gene heterozygous GА of Bsm1 c.IVS7G>A and homozygous TT of LCT 13910 C>T were associated with osteoporosis risk in Russian women. Homozygous АА of VDR Bsm1 c.IVS7G>A is increased osteoporosis risk in women of Buryat nationality.

Aims. To study renal function in patients hospitalized with acute decompensated heart failure (ADHF) and factors associated with the development of acute kidney injury (AKI) during hospitalization.

Materials and methods. The study included 100 patients hospitalized with ADHF, who were divided into 2 groups depending on the development of AKI. Group 1 consisted of 79 people who did not develop AKI and group 2 consisted of 21 people who developed AKI. The criterion for the diagnosis of AKI was an increase in creatinine by 25% within 48-72 hours from the moment of hospitalization.

Results. It was found that patients who developed AKI on the first day had high rates of erythrocyte sedimentation rate (ESR), C-reactive protein, increased troponin, leukocyturia, they more often received inotropic support on the first day of hospitalization.

Conclusion. In patients hospitalized with ADHF, the development of AKI is associated with greater inflammatory activity, greater myocardial damage, and more frequent use of inotropic support in the first day of hospitalization.

The aim of the research: to study the clinical and laboratory features of the formation of liver cirrhosis in HDV infection among the population of Yakutia.

Materials and methods of the study: An analysis was made of 120 case histories of patients with chronic hepatitis D who underwent inpatient treatment from 2020 to 2021. The analyzed patients were divided into 2 groups: with the formation of liver cirrhosis (n=76), which was divided according to the severity of the course (3 classes according to Child-Pugh) and without liver cirrhosis (n=44). Epidemiological factors, the duration of infection and the formation of complications, clinical and laboratory markers of the severity of the course were assessed. Data processing was carried out using statistical criteria using the IBM SPSS Statistics 26.0 software package.

Results: It was found that people of indigenous nationality are more susceptible to hepatitis D, while HDV-cirrhosis is formed on average 15 years from the moment of infection. Of 120 patients, 37% had chronic HDV infection without severe fibrosis, and 63% of patients were diagnosed with liver cirrhosis, including hepatocellular carcinoma in 18% of patients. Reliably significant changes in the form of anemia (44,1; p<0,000), thrombocytopenia (38,5; p<0,000), hypoalbuminemia (69,5; p<0,000), a decrease in the prothrombin index (72,6; p<0,000), increased activity of AST (24,0; p<0,000), bilirubinemia (50,3; p<0,000) were observed in the advanced stage of liver fibrosis. Mixed replication of HBV/HDV was observed significantly more often (11,6; р<0,007) in patients with liver cirrhosis and HCC. The overall mortality was 6.6%. The proportion of deaths with liver cirrhosis was 7.3%, with confirmed hepatocellular carcinoma - 19%.

Conclusion: The Republic of Sakha (Yakutia) is a region with a high prevalence of HDV infection, especially among the working population, which requires strengthening measures to prevent the development of cirrhosis and liver cancer. The performed analysis confirmed the importance of further search for predictors of fibrosis formation, including genetic markers of severe course in persons with HDV infection.

Оbjective: to assess the distribution of alleles and genotypes of prothrombotic genes ((FII-20210(G>А), FV-1691(G>A), FVII-10976(G>A), FGB-455(G>A), MTHFR-677(C>T), MTRR-66(A>G), PAI-1-675(5G>4G))  in patients with venous thromboembolic complications (VTEC) with fractures of limb bones in the Transbaikal Region.

Materials and methods. 74 patients with fractures of the long bones of the lower extremities were examined. Group I consisted of 44 patients with uncomplicated fractures. Group II - 30 patients with deep vein thrombosis of the lower extremities. The control group consisted of 100 practically healthy donors. Genetic studies were carried out by determining the mutation FII-20210(G>A), FV-1691(G>A), FVII-10976(G>A), FGB-455(G>A), MTHFR-677(C>T), MTRR-66(A>G), PAI-1(5G>4G) using primer sets "Litekh" - "SNP" (Russia). Statistical processing of the study results was carried out using the IBM SPSS Statistics Version 25.0 software package. Differences were considered statistically significant at p<0.05.

Results. Analysis of the polymorphism of the FII-20210(G>A) gene, the FV-1691(G>A) gene, and the FVII- 10976(G>A) gene in patients with uncomplicated long bone fractures and the development of VTEC did not reveal statistically significant differences in both alleles and genotype distribution frequencies. Establishing the frequency of carriage of alleles and genotypes of the polymorphism of the FGB-455(G>A) gene, the MTHFR-677(C>T) gene and the PAI-1-675(5G>4G) gene, we noted significant differences with the VTEC group, while there was no statistical significance between the control group and the clinical comparison group. Calculation of OR showed a positive association between the carriage of the mutant allele and the genotype of the polymorphism of the FGB-455(G>A) gene and the MTHFR-677(C>T) gene, and, on the contrary, the carriage of the wild allele and the homozygous genotype of the PAI-1-675(5G>4G) gene with the development of VTEC (p<0.05). Determining the frequency of distribution of genotypes and allelic variants of the MTRR-66(A>G) gene polymorphism, we recorded a statistically significant difference only with the clinical comparison group, which may indicate the protective value of the -66A- allele and -66A/A genotype in the development of VTEC. The determination of OR between the groups showed a positive association of carriage of the -66G- allele and the -66G/G genotype of the MTRR gene with the development of venous thrombosis in patients with fractures of the long bones of the lower extremities (p<0.05).

Conclusion. In patients with fractures of the long bones of the lower extremities, a positive association with the development of VTEC was found in the carriage of the -455A- allele, -455A/A genotype of the FGB gene, -677T- allele, -677T/T genotype of the MTHFR gene, -675 5G- allele, genotype -675 5G/5G of the PAI-1 gene and the -66G- allele and -66G/G genotype of the MTRR gene.

The aim of research. Тo study the dynamics of the central body temperature (CВT) and the frequency of cardiac complications in patients with abdominal oncological pathology, depending on the methods of intraoperative warming during laparoscopic and laparotomic operations.

Materials and methods. The results of a prospective study of the dynamics of body CBT in 99 patients with abdominal oncological pathology, depending on the methods of intraoperative warming during laparoscopic and laparotomic operations, are presented. The patients were divided into two groups: group 1 (n=51) – the control group, in which passive methods of warming were used; group 2 (n=48) – the study group, in which the air-convection method of heating and heating of infusion media were used. In group 1, laparotomy was performed in 20 (39.2%), laparoscopy in 31 (60.8%) patients, in group 2 - in 17 (35.4%) and 31 (64.6%) patients, respectively.The cardiovascular system was assessed by measuring heart rate, blood pressure, ECG recording, ultrasound examination of the heart and determination of troponin levels.

Results. It was revealed that in both groups, regardless of the type of surgical approach, the same temperature profile is characteristic. In group 1 patients with laparoscopic operations, there is a tendency to decrease the body CBT throughout the operation, reaching values of 35.7 ±0.20 ° C by the end of the operation (p<0.05 compared to the original). In group 2 patients, a slight decrease in body CBT to 35.9 ±0.11 ° C was detected only for 30 minutes of surgery (p>0.05). Comparative analysis of the dynamics of body CBT in the study groups did not reveal the advantages of laparoscopic or laparotomic operations.

Cardiac complications in the next postoperative hours were revealed in 19.6% of group 1 patients - bradycardia (13.7%), paroxysmal tachycardia (1.9%) and anginal attack (3.9%) and 6.2% of group 2 patients - bradycardia (4.2%) and paroxysmal tachycardia (2.1%).

Conclusion. Active intraoperative warming allows maintaining a stable temperature profile and reduces the number of cardiac complications in the postoperative period in cancer patients.

The aim of the research. Evaluation of the dynamics of the content of pro- and anti-inflammatory cytokines in the blood plasma of experimental animals with an explosive wound of thigh after early local injection of hyaluronic acid (HA).

Materials and methods. The study was carried out on 106 male Wistar rats, divided into 32 animals into groups: main, comparison, control. Under anesthesia, an explosive wound was inflicted on the thigh. 3 hours after the injury, all rats underwent primary surgical treatment of the wound, standard treatment, local injection of hyaluronic acid (main group), 0.9% sodium chloride solution (comparison group), without local treatment (control). The dynamics of manifestations and the timing of wound healing, the concentration of myoglobin and potassium in blood plasma, as well as inflammatory cytokines (IL-1β, IL-6, TNF-α and IL-10) were assessed on days 3, 7, 14, and 28 after injury. The intact group consisted of animals without injuries (n=10). The obtained data were processed using the Microsoft Excel 2013 application package in the Statistica 10.0 software environment.

Results. Perifocal administration of HA 3 hours after the explosive wound during the first 3-7 days contributed to a decrease in the concentration of myoglobin by 22.1-23.8% (p<0.05) and potassium by 26.8% (p<0.05) in blood plasma, a decrease in the level of pro-inflammatory cytokines: IL-1β by 25.9% (p<0.05), IL-6 - by 22.5% (p<0.05), TNF-α - by 29.1 % (p<0.05) in comparison with the comparison group. In the period of 14-28 days, the level of pro-inflammatory cytokines decreased, reaching the values of intact animals. The level of IL-10 moderately increased (by 2.1-3.1 times, p<0.05) in comparison with intact animals, mainly in the period 14-28 days after injury. Complete closure of the wound defect after local application of HA occurred 4-5 days earlier than in animals from the comparison group.

Conclusion. Perifocal administration of HA 3 hours after an explosive injury to the soft tissues of the thigh reduces the severity of post-traumatic rhabdomyolysis, reduces the trauma-induced level of circulating pro- inflammatory cytokines (IL-1β, TNF-α, IL-6) in the inflammation phase, increases the concentration of anti- inflammatory cytokines (IL-10) in the phase of regeneration and formation of granulation tissue, reduces the healing time by 19% (p<0.05).

The article describes the use of one of the lean management tools "process mapping". Examples of the recommended sequence of actions of a specialist when using this tool are presented.

The history of platelet function studies has begun relatively recently, at the end of the 19th century. Although humanity has treated blood with reverence since ancient times, attributing supernatural powers to it. Initially, people believed that blood can influence person’s character, for example, dark blood contains harmful substances which are need to be disposed of by bloodletting.

There is a rational grain in this thought, but the implementation method entails serious side effects. As time were passing by, the interest grew bigger. With the invention of optical devices, researchers have seen that blood can be divided into components. Thus began the history of the formed elements of blood. The first were erythrocytes, but then the rest did not hide from the tenacious eyes of researchers. Various functions were attributed to shaped elements, some of the functions were proved later, some were refuted. Now, in modern times, we still do not know all the functions. As for platelets, their eras of research can be divided into an initial "descriptive period" extending from about 1880-1960, during which many of the classic clinical features of platelet disorders were described in detail; the subsequent "mechanistic period", covering the last 50 years, made possible by the introduction of biochemical, cellular-biological, molecular-biological and, more recently, structural-biological, genomic and computational methods.

The review article presents up-to-date information on the clinical and pathogenetic features of multiform exudative erythema based on the analysis of available scientific articles indexed in the RSCI, PubMed and Web of Science databases. Erythema multiforme exudative is an immuno-mediated disease, the pathogenesis of which is based on a type 4 hypersensitivity reaction with the appearance of cytotoxic T- lymphocytes in the epithelium. The main cause of the disease has not been identified, but predisposing factors have been identified, which include infectious and/or drug triggers. This disease is characterized by the appearance of acrally located foci-targets, sometimes accompanied by erosions of the mucous membrane of the oral cavity, genitals and eyes. anamnesis of the disease and the results of an objective clinical examination are sufficient to diagnose multiform exudative erythema.

The proposed article presents a modern review of the literature covering the mechanism of development, clinical, laboratory criteria and tactics conducting of children with rare coagulopathy – deficiency of factor XIII of blood coagulation (Laki-Lorand disease). The review is illustrated by a spectacular clinical example of an early-age girl with the described pathology, manifested by repeated recurrent bleedings from the newborn period, confirmed by a specific molecular genetic testing.