The aim of the research. To verify whether netosis is associated with variation of IL-8 plasma level in vitro.

Materials and methods. We used experimental in vitro models of isolated from whole blood non-stimulated and PMA-activated (100 nm) neutrophils suspended in 1 ml of platelets poor plasma. All samples were incubated for four hours and then were centrifuged at 1500 r.p.m. for 10 min. 50 µl of plasma from each sample were transferred into separate tubes to quantify IL-8 using flow cytometry method.

Results. A threefold increase in concentration of IL-8 was revealed in plasma containing PMA-stimulated cells when comparing with non-stimulated samples.

Conclusion. Lytic netosis is followed by release of intracellular store of IL-8, its extracellular level substantial increase and, thus, contributes to circulating neutrophils recruitment and activation in the sites of NETs formation, that promotes additional proteolytic and free radical damage.

The aim of the research. Finding the design of sporadic connections between the sovereign changing exponents of hemostasis, electrolyte and acid-base blood composition of patients depending on the implementation of heterogeneous perioperative volemic correction to determine its most favorable variation.

Materials and methods. The study had 80 patients divided into two groups. In group I, liquid supply was carried out with a Ringer solution, and in group II with sterofundin. The following was determined: deficiency/excess of bases in extracellular fluid, as well as in venous blood and its pH, content of potassium, sodium, chlorine, calcium ionized and magnesium, activated partial thromboplastin time, international normalized ratio and fibrinogen. Studies were carried out before the start of the fluid supply, as well as 12. 24 and 48 hours after the operation. The statistical study included univariate and multivariate comparison, canonical, cluster analysis, and multivariate scaling.

Results. In patients of groups I and II, internal spatial connections of independent variables (features) with personal differences and features were initially recorded. The distribution of the studied signs in patients of group II, unlike patients of group I, after 12 hours practically did not change, compared to the previous term. Distribution of the test indices in patients of group II after 24 hours, compared to patients of group I, had dynamics of minimization of relationships, which suggested minuscule inspiration of sterofundin on the test parameters. After 48 hours, in patients of group I, unlike patients of group II, the connections suggesting negative interference of the Ringer solution on the test indicators were modified and supplemented.

Conclusion. The use of the Ringer solution reforms the internal bonds of exponents of hemostasis, electrolyte and acid-base composition, which indicates its adverse effect on them. The use of sterofundine does not alter the internal spatial relationships of the studied exponents and does not cause their negative kinetics.

Aim was to study the genetic TLR3 (Leu412Phe) polymorphism in patients with influenza A(H3N2) and influenza B.

Methods. The study was performed in 89 patients with influenza A(H3N2) and 80 patients with influenza Baged 15 to 82 years (the average age was 49.0±14.0 years) and 96 healthy residents. The TLR3 gene polymorphism was detected by PCR method.

Results. It was shown that the frequency of the allele -412Leu of the TLR3 gene was significantly higher than among healthy respondents (frequency in patients with influenza A(H3N2) - 0.433, influenza B - 0.325, among healthy people - 0.249; p˂0.05) an increase in the relative risk of the development of this pathology equal to: in patient with influenza A(H3N2) in carriers of the Leu412Leu gene TLR3 – OR=2,39 [СI95%: 1,04-3,61], in patient with influenza B in carriers of the Leu412Phegene TLR3 – OR=2,41 [CI95%: 1,29-4,43].

Conclusion. The -412Leu allele of the Toll-like receptor-3 gene predisposes to the development of influenza A (H3N2) and B.

The aim of the research. To monitor compliance in patients with fatty hepatosis of various etiologies.

Materials and methods. 1152 people out of 1568 residents of the rural therapeutic site agreed to participate in the study. The survey included: subjective data, including alcohol history, physical examination. The biochemical parameters of blood were studied: alanine aminotransferase, aspartate aminotransferase, total protein, albumin, prothrombin index. An ultrasound examination of the abdominal organs was performed. Adherence to therapy was assessed 6 months after treatment and lifestyle counseling.

Results. Fatty hepatosis within the framework of alcoholic liver disease (ALD) was in 167 (14.5%) people, within the framework of non-alcoholic fatty liver disease (NAFLD) - in 225 (19.5%) (p>0.05). There were 43 smokers among patients with liver steatosis with NAFLD (19.1%), while those with ALD - 145 people (86.8%) (p <0.001). Among patients with fatty hepatosis with ALD, medical recommendations were followed in 11 (6.6%), with NAFLD - 45 (20.0%) (p<0.05). There were no gender differences among them (p> 0.05). Of 124 patients with alcoholic fatty hepatosis at the age of 18-59 years, 11 (8.9%) people followed the recommendations, out of 43 patients 60 years and older - none (p> 0.05), while of 108 patients with non-alcoholic steatosis - 29 (26.9%) and 16 (13.7%) (p <0.05), respectively.

Conclusion. Compliance was better in patients with non-alcoholic fatty hepatosis (20.0%), than alcoholic (6.6%) (p <0.05). Gender differences did not affect compliance (p> 0.05). Among patients with non-alcoholic hepatosis, compliance was more pronounced in people of working age (p <0.05). Among patients with liver steatosis with ALD, there were 86.8% smokers, with NAFLD - 19.1% (p <0.001). Smoking is an additional risk factor for the development of ALD. At the first contact with a doctor, only 13% of patients with alcoholic fatty hepatosis admit to alcohol abuse.

Research objective: o study polymorphic variants of the rs670 (APOA1-75 G/A), rs5128 (APOC3 C3238G), rs769452 (APOE Leu28Pro), rs5742904 (APOB R3500Q) genes in patients with the first episode of paranoid schizophrenia living in the Trans-Baikal Territory.

Material and methods. 212 patients with the diagnosis «Paranoid schizophrenia, follow-up period less than a year (ICD code 10 F 20.09)» were examined. The patients were Caucasian race and lived in the Trans-Baikal Territory. The average age of patients was 27±6 years. To form a control group, 152 people were examined, who were comparable in age, gender, and social affiliation with the group of patients. Human genomic DNA was isolated from whole blood leukocytes. rs670 (APOA1-75 G/A), rs5128 (APOC3 C3238G), rs769452 (APOE Leu28Pro), rs5742904 (APOB R3500Q) were studied by real-time polymerase chain reaction.

Results. It was found that patients with the first episode of schizophrenia living in the territory of the Trans-Baikal Territory were 1,3 times more likely to have the genotype G/G SNP rs670 (APOA1-75 G/A) and 1,6 times more likely to have carriers of the heterozygous genotype C/G APOC3 C323G (rs5128). At the same time, the chance of developing schizophrenia in carriers of the G/G SNP rs670 genotype (APOA1-75 G/A) was 1,80, and in carriers of the C/G APOC3 C323G genotype (rs5128) – 2,05. The heterozygous genotype of Leu/Pro SNP APOE (Leu28Pro, rs769425) in patients with schizophrenia was 3,8 times less common, and the frequency of registration of the minor allele was 4,6 times less frequent than in the control group. In the study of SNP rs5742904 (APOB R3500Q) in patients with schizophrenia and in the control group, only carriers of the normal G/G homozygote were found.

Conclusion. In patients with schizophrenia living in the Trans-Baikal Territory, the frequency of occurrence of apolipoprotein gene genotypes differs from healthy people To study the association of polymorphic variants of apolipoprotein genes with metabolic disorders in patients with schizophrenia, further studies are needed.

Objective. To assess preoperational risk factors influencing the development of cognitive impairments in patients with coronary heart disease (CHD) prior to coronary artery bypass grafting.

Material and Methods. To study the clinical functional condition of the cardio-vascular system and cognitive functions in patients with CHD we examined 264 patients admitted to the “Federal center of cardio-vascular surgery” of the Ministry of Public Health of Krasnoyarsk for coronary artery bypass grafting. Five parallel groups were singled out: I (control group); II (comparison group); III, IV and V (depending on the type of follow-up rehabilitation). To exclude initial inter-group differences (before coronary artery bypass grafting), we carried out the comparative analysis of the patients’ clinical and anamnestic data.

Results: Preoperational risk factors (educational level, time duration of CHD and arterial hypertension, old myocardial infarction and a higher grade of angina pectoris, low left ventricle ejection fraction, elevated level of general cholesterol and triglycerides, degree of impairment and stenosis of the main arteries of the head) play an important role in the pathogenesis of cognitive impairments in patients with CHD.

Conclusion: These patients have such impairments even before coronary artery bypass grafting.

Objective: to identify the features of performing coronary bypass surgery (CABG) on a "working heart" in patients with end-stage chronic renal failure (ESRF), receiving treatment with program hemodialysis (PHD).

Material and methods: in the cardiosurgical Department No. 1 OF the Irkutsk Regional Clinical Hospital from 2010 to 2020, 4468 CABG operations were performed on a "working heart". Of these, 10 (0.2%) of surgeries in patients with IHD ESRF receiving PHD. To solve this problem, two groups of operated patients were formed. The first group of patients with ESRF receiving PHD, and the second group (control) of 20 patients with normal kidney function. Comparison of patients in the groups was carried out by the volume of blood loss by drains, time of ventilator, stay in the hospital, the dynamics of creatinine, urea, potassium and HB, the number of red blood cells, platelets.

Results: operated patients with ESRF did not significantly differ in comparison with patients with normal kidney function in terms of the number of complications, ventilator time (p =0.97), ICU stay (p=0.06) and hospital stay, volume of blood loss by drainage (p=0.3). After surgery, patients with normal kidney function (group 2) showed a significant decrease in the number of red blood cells and platelets, HB levels without significant changes in the level of urea, creatinine and potassium in the blood. Similar changes were observed in the General and biochemical blood analysis in patients with ESRF (the first group).

Conclusion: the immediate results of CABG surgery on a "working heart" in patients with ESRF receiving HD do not differ from the results of coronary bypass surgery in patients with IHD with normal kidney function. The operation does not violate the planned completion of the HD. When performing a coronary bypass operation without artificial blood circulation on a "working heart", a standard approach for pre - and postoperative management of patients with ESRF is acceptable.

The aim of the research. To evaluate the effect of 4-hydroxy-3,5-di-tretbutyl cinnamic acid on neuroinflammation in rats with cerebral ischemia in comparison with ethylmethylhydroxypyridine succinate.

Materials and Methods. Brain ischemia was reproduced in Wistar rats by irreversible right-sided coagulation of the middle cerebral artery. The test-compound-4-hydroxy-3,5-di-tretbutyl cinnamic acid and the reference drug-ethymethylhydroxypyridine succinate were administered orally at a dose of 100 mg / kg 30 minutes after the ischemia modeling and then once a day for 3 days. On the 4th day of the experiment, the degree of permeability of the blood-brain barrier in the Miles test was evaluated. Changes in cytokines (IL- 6; IL-1β; IL-10 and TNF-α) and nitrogen monoxide in brain tissue in animals were also studied. The content of cytokines was determined by enzyme-linked immunoassay, and the concentration of nitrogen monoxide was evaluated spectrophotometrically in reaction with the Griss reagent.

Results. During the study, it was found that the use of the test compound at a dose of 100 mg / kg contributed to a decrease in the concentration of pro-inflammatory cytokines: IL – 6-by 37.2% (p<0.05); IL – 1β-by 42.5% (p<0.05), TNF – α - by 33.4% (p<0.05). At the same time, the content of IL-10 increased by 3.1 (p<0.05). Also, against the background of the administration of 4-hydroxy-3,5-di-tretbutyl cinnamic acid, there was a decrease in the content of nitrogen monoxide in brain tissue and the permeability of the blood-brain barrier by 33.1% (p<0.05) and 38.2% (p<0.05), respectively. It should be noted that the effect of the test compound was superior to that of the reference drug.

Conclusion. 4-hydroxy-3,5-di-tretbutyl cinnamic acid reduces the intensity of neuroinflammatory reactions, which is expressed in a decrease in the content of pro-inflammatory cytokines, the concentration of nitrogen monoxide and the permeability of the blood-brain barrier, which may underlie the neuroprotective effect of this compound.

Clinical guidelines developed by the professional community are actively used as an evidence base for legal prosecution of medical employees. The process of preparation, application and status of clinical recommendations remains unresolved, which is a significant factor in the withdrawal of doctors from the profession and the aggravation of personnel problems. It is proposed to postpone the implementation of clinical recommendations with the preliminary creation of a medical decision support system, an adequate legal review of these documents, and delimitation of the binding status of individual points of recommendations.

The aim of the research. To assess the effect of the pron-position maneuver in patients with COVID-19 on the state of the respiratory system.

Materials and methods. The study was performed in 20 patients of both sexes, who developed bilateral community-acquired polysegmental viral-bacterial pneumonia against the background of COVID-19. All patients had background and concomitant pathology: coronary artery disease, diabetes mellitus, alimentary-constitutional obesity. X-ray picture of the lesion with computed tomography - at least 75% of the pulmonary fields. Patients received invasive respiratory support with a ventilator. A total of 8 parameters were investigated: General PEEP (Positive end expiratory pressure), Auto-PEEP (Positive end expiratory pressure), Сdyn (Dynamic Compliance), Cst (Static Compliance), RE (Expiratory Resistance), DO (tidal volume), Total expiratory volume, Residual volume. The study of the state of the respiratory system was carried out using the Neumovent GraphNet Advance ventilator.

Results. When assessing the group of indicators of the respiratory system, a regular decrease in Cst was revealed in patients on invasive mechanical ventilation by 14.7% at p = 0.028. There were no other changes in the parameters.

Conclusion. It was found that when performing a pron-position maneuver in patients with a severe course of COVID-19 who are on invasive mechanical ventilation, static compliance decreased by 14.7%. The tidal volume, Auto-PEEP, dead space and total tidal volume are independent of the pron-position maneuver, provided the patient is completely relaxed.

Cerebrovascular accident (CVA) i.e. a stroke is one of the main causes of morbidity and mortality in Russia and around the world. And as a result, stroke is the most common reason for admission to the intensive care unit. The most difficult issues in the treatment of stroke patients in the intensive care unit is the process of conducting respiratory support.

The purpose of this review: to reflect the contemporary development about the most important points regarding the mechanical ventilation in patients with stroke. The results of the most relevant studies regarding both the understanding of the process in terms of physiology and the clinical features of mechanical ventilation in this category of patients are presented in the article. According to the authors that there are currently insufficient data on the effect of respiratory treatment in patients with stroke, despite the lot of recommendations. And many questions about the features of respiratory support for pactient with damaged brain need to be clarified, so it should be based on clinical trials. Anyway, well-considered and controlled approach to mechanical ventilation can significantly affect the survival of patients with strokes and the results of patient’s treatment. These findings confirm the importance of further research in this area.

The multistage process of reverse cholesterol transport is under the control of microRNAs, which have been widely studied in recent decades. MicroRNAs control intracellular lipid synthesis, transport of lipids, including cholesterol, from the cell and the entry of LP into the cell, LP formation, β-oxidation of fatty acids. Thus, microRNAs take part in lipid metabolism at different stages. Some of microRNAs control the reverse flow of cholesterol. At the stage of cholesterol outflow from foam cells and the formation of mature HDL particles, an important role is played by microRNAs that regulate the expression of ATP-binding cassette transporters A1(ABCА1) and G1 (ABСG1); these are miR-33 a / b, miR-758, miR-144, miR-26, miR-27a / b, miR-148a, miR-128-1, miR-302a. It has also been shown that microRNAs are involved in the selective uptake of cholesterol through class B, type I scavenger receptors for HDL in the liver: miR-185, miR-96, miR-223, miR-125, miR-145. Due to the extensive participation of miRNAs in the reverse flow of cholesterol, they are of interest as therapeutic targets for the correction of atherosclerosis. There is evidence of an increase in plasma HDL when miR-33is inhibited. Another microRNA (miR-223) may be a predictor of myocardial infarction.

The review summarizes literature data on the role of endoscopy in the diagnosis of Correa’s cascade, which is sequential development of adenocarcinoma through the stages of precancerous conditions’ progression from chronic non-atrophic gastritis to chronic atrophic gastritis with subsequent appearance of intestinal metaplasia and intraepithelial neoplasia. We paid special attention to criteria of early endoscopic diagnosis of gastric adenocarcinoma. We presented endoscopic monitoring principles and standards of patients with gastric precancerous conditions.

The proposed article presented a contemporary literature review of the obscure disease in children - Sturge-Weber syndrome. The review is illustrated by a clinical example of a rare bisymptomatic form of this syndrome manifested by left-sided hemangioma of the skin of the face and neck, the presence of calcifications in the brain matter on the side opposite to the vascular tumor, characteristic convulsive seizures of the "Jacksonian seizures" type, starting also on the side opposite to the cutaneous manifestations.

Children with gastroesophageal reflux disease can develop a rare neurological pathology, Sandifer syndrome. There is a high probability of erroneous diagnosis of primary lesions of the nervous system. Differential diagnosis of epilepsy and Sandifer syndrome is complex. One of the reasons for the difficulties in makingthe diagnosis is that the data of instrumental methods do not always have an absolute diagnostic value. The article presents a case of a patient with Sandifer syndrome with clinically insignificant epileptic changes on the electroencephalogram.

Ixodidae tick borrelliosis (ITB) or Lyme Disease (LD) - natural focal infectious vector-borne multisystemic disease, caused by Borrelia spirochetes transported by ixodidae ticks. Causative agents of the disease – Borrelia burgdorferi shows tropism to nerve system, dermis, connective tissue structures. As disease patterns of ITB vary, its diagnostic is accompanied by particular difficulties, to this reason ITB is called «the new great imitator». The article describes ITB clinical cases of a young female patient, which has appeared and manifested by multi-level damage of the nerve system. Dominance of neurological symptoms in the disease patterns, without an epidemiological anamnesis, without rashes on the part of the skin, as well as without any disorders from the heart and musculoskeletal system, caused certain difficulties in the diagnosis, and expanded the circle of differential diagnosis.

The aim of the research. The subject of the research was to study the basics of using survival analysis, which allows predicting the time of the event onset on the basis of independent variables. The research’s topic was survival analysis in biomedical research. The aim of the study was to describe the main survival analysis algorithms in biomedical research using the SPSS software package.

Materials and methods. The scientific review of the main methods of survival analysis in biomedical research is carried out. The practical foundations of using survival analysis to determine the time of the event occurrence are considered on the example of the IBM SPSS Statistics Version 25.0 software package (International Business Machines Corporation, USA).

Results. The optimal algorithms for survival analysis application in biomedical research have been determined. The possibilities of survival analysis using in the SPSS program are described in detail, recommendations for the interpretation of the obtained analysis results are given.

Conclusion. The use of the described survival analysis algorithms will improve a presentation’s level of biomedical research results.

The aim of the research. The subject of the research was to study the basics of using ROC curve analysis, which allows to determine and compare the main indicators of information content of the studied diagnostic methods or tests. The research’s topic was ROC curve analysis in biomedical research. The aim of the study was to describe the ROC curve analysis algorithm in biomedical research using the SPSS software package.

Materials and methods. The scientific review of the possibilities of using ROC curve analysis in biomedical research is carried out. The practical basics of using ROC curve analysis to determine the sensitivity and specificity of the studied diagnostic methods or tests are considered on the example of the IBM SPSS Statistics Version 25.0 software package (International Business Machines Corporation, USA).

Results. The optimal algorithm for ROC curve analysis application in biomedical research have been determined. The possibilities of ROC curve analysis using in the SPSS program are described in detail, recommendations for the interpretation of the obtained analysis results are given.

Conclusion. The use of the described ROC curve analysis algorithm will improve a presentation’s level of biomedical research results.