The purpose of the study. To study morbidity rate of rotavirus infection for the period 2014-2020 among hospitalized in regional clinical infectious diseases hospital children with acute intestinal infection aged 0 to 17 years.

Materials and methods of research. A retrospective analysis of the digital data of the statistical reports of the clinical infectious diseases hospital of Chita for the period 2014-2020 was carried out. Statistical processing was performed using "Statistica 10".

Results. From 2014 to 2019, the number of hospitalized children with viral diarrhea increased by 2.3 times. In 2020, the number of patients with intestinal infection decreased by 35%. The incidence of bacterial diarrhea in children decreased by 56.5%, and viral diarrhea increased – 69.3%. Rotavirus infection (RVI) accounted for an average of 24,5% among intestinal infections and was 72,1% among other viral diarrheas. The morbidity rate of rotavirus infection in 2020 compared to 2014 became higher by 27.1%, but the proportion of RVI among other viral diarrheas, on the contrary, became lower by 24.8% and mainly among children of the first year of their life – 1.7 times (p˂0.05).

Conclusions. The increase in the morbidity rate of RVI from 2014 to 2020 was revealed against the background of a significant decrease in the number of hospitalized children with acute intestinal infections in 2020. At the same time, there was a decrease in cases of rotavirus diarrhea among children in their first year of life.

The aim. Comparative analysis of the levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) in patients with chronic heart failure (CHF) and rheumatoid arthritis, as well as the search for possible associations with the morphofunctional parameters of the myocardium.

Materials and methods. The study group consisted of 134 patients with CHF with RA, and the comparison group consisted of 122 patients with CHF without RA. Functional class of CHF, who participated in the study of patients according to NYHA I-II. The volume of CHF therapy in the study group and the comparison group were compared. The basic anti - inflammatory drug for the treatment of RA is methotrexate. The morphofunctional parameters of the myocardium were evaluated, as well as the levels of IL-6 and IL-10 and their possible relationship with the morphofunctional parameters of the myocardium. The processing was carried out using the program STATISTICA 10.0; the paper presents statistically reliable results. The critical level of significance when testing statistical hypotheses is p <0.05.

Results. Statistically significant differences in the values of IL-6 were revealed: in the group of CHF and RA, the level was 18.3±5.05 pg / ml; in the group of CHF without RA, 5.3±1.9 pg / ml (p=0.004). Comparative analysis of IL-10 levels revealed no significant differences: 5.9±1.9 pg / ml and 5.2±0.7 pg / ml, respectively (p=0.4). In the group of CHF and RA, statistically significant correlations of IL-10 with LVEF (r=-0.1; p=0.02) and NT-proBNP (r=-0.1; p=0.04), as well as IL-6 with NT-proBNP (r=0.06; p=0.03) were obtained.

Conclusion. Taking into account the obtained associations, it can be assumed that the increase in the concentration of IL-6 may lead to the destabilization of the course of CHF against the background of RA, but to confirm this theory, prospective studies are necessary.

Aim. To study how the state of the hemostatic system changes in patients with coronary heart disease undergoing coronary artery bypass surgery.

Methods. Observations were performed on 58 patients with coronary artery disease (45 men and 13 women) aged 42 to 75 years. All patients underwent coronary artery bypass surgery. 48 operations were performed using cardiopulmonary bypass and 9 on a working heart using myocardial stabilizers. We studied platelet count, activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen level, and spatial growth of a fibrin clot.

Results. It was established that in patients with coronary heart disease in the early postoperative period, the dynamic properties of the fibrin clot decrease, which is mainly due to consumption coagulopathy. This, in particular, is evidenced by a decrease in the number of platelets, an elongation of activated partial thromboplastin time (APTT), an elongation of the international normalized ratio (INR), and a decrease in the level of fibrinogen. At the same time, the number of leukocytes sharply increases in patients and the number of red blood cells decreases. Before discharging patients from the hospital, the thrombodynamic properties of the clot sharply increase and in some parameters (size and density of the fibrin clot) exceed the indicators in the preoperative period. Negative correlations between the density of the clot and the total blood loss were found. It has been shown that, without exception, all formed blood elements affect the thrombodynamic properties of a clot, including its density and size.

Conclusion. The early postoperative period is favorable both for the occurrence of thromboembolic complications and bleeding, while before discharge of the patient from the hospital, there is a risk of thrombosis.

The purpose of this study was to compare the dynamics of right ventricle (RV) size, pulmonary artery pressure, and biomarkers of myocardial injury after pneumonectomy in patients with non-small cell lung cancer (NSCLC).

Materials and methods. The study included 30 men with NSCLC aged 64.5 (61; 68) years old underwent pneumonectomy. The levels of cardiac troponin I (cTnI), creatine phosphokinase-MB (CPK-MB), and N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) were determined 1 day before, 24 and 48 hours after surgery. Echocardiography was performed before surgery and 48 hours after it. The correlation between the dynamics of myocardial injury markers and RV structural and functional parameters was assessed.

Results. cTnI increased from 0.01 to 0.02 ng/ml 24 hours after and to 0.011 ng/ml 48 hours after surgery (p<0.001), NT-proBNP increased from 113 pg/ml to 748 and 712 pg/ml, respectively (p<0.001). In 7 patients (23.3%), postoperative cTnI met the criterion for myocardial injury after noncardiac surgery (>= 0.04 ng/ml). RV size, right ventricular: left ventricular (RV/LV) size ratio, and pulmonary artery systolic pressure increased after surgery. A direct correlation between the increase ratio in RV size and cTnI after 48 hours (r=+0.42), as well as the increase ratio in RV/LV and cTnI after 24 hours (r=+0.45) was found. According to univariate regression data, the increase in RV size was associated with the increase in cTnI concentration 24 hours (odds ratio (OR) 3.25; 95% confidence interval (CI) 1.06-9.97) and 48 hours (OR 1.54 ; 95% CI 1.34-16.24) after surgery, and with the increase in NT-proBNP 24 hours after surgery (OR 2.38; 95% CI 1.04-5.43). The increase in RV/LV was associated with the increase in cTnI 24 hours (OR 4.67; 95% CI 1.34-16.24) and 48 hours (OR 3.25; 95% CI 1.06-9.97) after surgery, and with the increase in NT-proBNP 48 hours after surgery (OR 2.43; 95% CI 1.01-5.86). The increase in pulmonary artery systolic pressure (PASP) was associated with the increase in cTnI 24 hours (OR 7.5; 95% CI 1.72- 32.8) and 48 hours (OR 3.25; 95 % CI 1.06-9.97) after surgery, and with the increase in NT-proBNP 24 hours (OR 3.5; 95% CI 1.41-8.67) and 48 hours (OR 5.0; 95% CI 1.71 -14.63) after surgery.

Conclusion. Pneumonectomy in patients with NSCLC was accompanied by the increase in RV size, RV/LV size ratio, and PASP during the first 2 days after surgery. Myocardial injury syndrome after noncardiac surgery was detected in 23.3% of patients. The increase in RV size, RV/LV size ratio, and PASP were associated with the increase in cTnI and NT-proBNP.

The aim of the research. To study the statement of vascular-platelet link of hemostasis and blood coagulation in dialysis patients during different periods of dialysis therapy.

Materials and methods. Hemostasis analysis was performed in 76 dialysis patients. The number of blood platelets, platelet aggregation, the content and activity of Willebrand factor, as well as screening indicators of plasma hemostasis, indicators of activation of blood clotting, levels of physiological anticoagulants, and indicators of fibrinolysis were determined.

Results. In dialysis patients, multidirectional changes in hemostasis are detected. During the first year of dialysis therapy, there is a slight decrease in platelet aggregation, followed by platelet aggregation increases. An increase in the content of the Willebrand factor is not accompanied by a significant increase in its activity. In dialysis patients, an increase in blood fibrinogen is recorded The increase in soluble fibrinmonomer complexes and D – dimer reflects both the activation of coagulation processes and the response of fibrinolysis. With a duration of dialysis therapy of 13-36 months, the concentration of D-dimer is significantly lower compared to patients on dialysis for less than 1 year and more than 3 years, which suggests a lower risk of hypercoagulation complications in dialysis patients during this period.

Conclusions. For the prognosis and prevention of thrombotic and hemorrhagic complications, individual assessment of coagulation parameters in each patient is necessary.

The question of the state of mineral metabolism in patients with idiopathic scoliosis, the presence of osteoporosis and its effect on formation or progression of deformity, especially in connection with the age of patients, cannot be considered conclusively resolved.

Objective. To study indicators of calcium metabolism and markers of bone formation in patients with idiopathic scoliosis depending on age.

Material and research methods. Calcium metabolism indicators (total and ionized calcium, parathyroid hormone, daily urine calcium), phosphorus, markersof bone formation (alkaline phosphatase, osteocalcin, P1NP(N - terminal procollagen type I propeptide) in the blood), morning urine DPID(deoxypyridinoline), blood level of 25 (OH) D(25-hydroxycalciferol, vitamin D) were studied before surgery in 39 patients with scoliosis (21 patients at the age not more than 18 years (group 1), and 18 patients older than 18 years (group 2). All patients were examined by x-ray and computed tomography to determine the degree of deformity.

Results. The results of the work showed that no reliable unidirectional increase was found in all (defined in this study), indicators of both bone formation and resorption. Disorders of calcium homeostasis (decreased excretion of calcium with daily urine at normal levels of calcium in the blood) was found in 20 patients. In all patients, the resorption markers of deoxypyridinoline and osteocalcin were within the reference values, while alkaline phosphatase, P1NP in the blood were high in all examined patients under the age of 18 years, in adult patients, alkaline phosphatase was within normal limits. 21 patients under the age of 18 years had a deficit of 25 (OH) D, in adult patients its deficiency was revealed.

Conclusion. Considering the literature data and our own material, we can confidently assume that mineral metabolism in patients with idiopathic scoliosis in childhood has a more high-rate type of bone remodeling than in adult patients, affecting the progression of deformity.

The aim of the research. To study the severity of anemia of prematurity, laboratory parameters of peripheral blood analysis (MCV, MCH, MCHС), the level of iron in blood serum, ferritin in premature infants of different gestational periods. To assess the effectiveness of conservative therapy and the need for substitution transfusions depending on the term of prematurity.

Materials and methods. 82 medical histories of preterm infants of different gestational periods were retrospectively analyzed. Of these, 12 children were extremely premature, 36 children were very premature, 27 were moderately premature, and 7 were late premature.

Results. In extremely premature (EN) infants, anemia developed in 100%, severe and moderate form - in 16.7%, mild in 66.6%, in very premature infants (OH) anemia was diagnosed in 94.6%, of which severe form in 5.6%, moderate – 22%, light – 67%. In groups of children over 32 weeks of gestation, severe forms were not identified. In infants with EN, the iron level at 2 weeks Me 10.6 μmol / l [8.8; 12.1], which is significantly lower than in the comparison groups: with a gestational age of 29-32 weeks - 15.95 μmol / l [12.3; 18.9], (p = 0.007), 32-34 weeks of prematurity - 21.6 μmol / L [15.8; 20.5] (p = 0.0002), in late prematurity - 21, 3 μmol / L [16.2; 23.8]. Serum ferritin in the EN group is 58.4 μg / L [52.8; 71.7], statistically significantly lower than the level in children with OH, its level is 165.5 μg / L [77.3; 195], the difference is p = 0.03. Indicators of the total iron-binding capacity of serum, MCV, MCH did not reflect the etiology of anemia, MCHC is reduced in all groups of premature babies. With oral subsidization of 3-valent iron in therapeutic doses, a significant increase in the level of iron in blood serum was determined in the EN group before treatment 10.65 μmol / L [8.2; 12.1] after 2 weeks 21.95 [17.8; 23,9] p = 0.011. In infants of the comparison groups, no significant increase in serum iron levels was obtained.

Conclusion. Severe and moderate degrees of early anemia of preterm infants are diagnosed in groups of extremely and very preterm infants. A significant deficiency of serum iron was found in extremely premature infants at the age of 2 weeks of life. MCHC less than 33.1% registered in all groups of premature babies, is a marker of early anemia of premature babies. Iron supplementation in a therapeutic dose is required for children with EN; if enteral forms are impossible, it is advisable to prescribe parenteral forms of the drug.

Тhe aim of the research. To study the acoustic characteristics of breathing in children of preschool age with acute obstructive bronchitis.

Materials and methods. 75 children age from 1 to 5 years with obstructive and nonobstructive bronchitis were examined by the method of computer bronchophonography. The control was the data of bronchophonograms of practically healthy children (n=29) of preschool age.

Results. The breathing pattern in children with bronchial obstruction syndrome against the background of acute respiratory infection (n = 75) is characterized by impaired ventilation in all sound ranges compared with the control group. Patients with a history of three or more episodes of obstructive bronchitis have more significant functional disorders of the respiratory system.

Conclusion. Children with acute obstructive bronchitis have a violation of bronchial patency at all bronchial level. Recurrent bronchial obstruction syndrome is characterized by an increase in the acoustic characteristics of breathing in the upper, middle and lower airways.

The aim of the research. Evaluation of the impact on cognitive functions (CF) of technologies for performing CABG surgery on the "beating heart" without clamping the aorta (Ao) or with partial clamping of the Ao.

Material and methods. According to the selection criteria, 57 patients were included in the study. All patients were operated on without artificial blood circulation on a "beating heart" access from a median sternotomy. A standard anesthetic manual was used. Patients are divided into three groups depending on the technique used. The first group included 25 patients who underwent partial clamping of Ao during the operation. The second group consisted of 22 patients in whom the HS system was used to create a proximal anastomosis, and the third group consisted of 10 patients who underwent mammary coronary artery bypass grafting. Evaluation of CF disorders was carried out before surgery and on the 7th day after surgery. The MMSE (Mini-mental State Examination) scale was used to assess violations.

Results. Before surgery, all patients had CF impairments, which were regarded as pre-dementia cognitive impairments. In patients of the first and third groups, there were no differences in the number of assessment points (p = 0.04 and p = 0.09). In patients of the second group, the difference between the initial data and 7 days after the operation is statistically significant (p = 0.004). In the first group, the number of points after surgery was 27.4 (26.5 - 29), in the second group - 28.5 (28 - 29) and in the third group - 25.9 (25 - 28). When compared between the groups, CF impairments after surgery did not have significant differences (p = 0.04).

Conclusion. Evaluation of CF in dynamics showed that when performing surgery on the "beating heart", regardless of the technology used for performing the proximal anastomosis with Ao, "controlled hypotension" with a decrease in SBP to 80 mm Hg does not cause cognitive dysfunction.

The aim of the research. To study morpho-functional changes, frequency and nature of cardiac arrhythmias in patients with mild and moderate forms of coronavirus infection (COVID 19).

Materials and methods. Echocardiography and Holter ECG monitoring were performed 3 months after the coronavirus infection, of 40 patients were examined. The patients were divided into 2 groups: 1 - 21 patients with upper respiratory tract lesions; 2-19 patients with bilateral pneumonia, the average age of patients was 35,7 years. Statistical data processing was performed using the program Statistica 10,0.

Results. According to echocardiography, the peak diastolic rate of on the tricuspid valve, the speed and peak gradient of tricuspid regurgitation in group 2 increased, and the E/A ratio decreased, P <0,001. The amplitude of the atrial peak of Am on the fibrous ring of the tricuspid valve in groups 1st and 2nd increased by 14% and 19% compared to the control, and the Em/Am ratio decreased by 25% and 34%, respectively, isovolumetric contraction and relaxation in patients of groups 1st and 2nd increased in comparison with the control group, p <0,001. In addition, patients in group 2 showed increased pressure in the pulmonary artery in comparison with the control. In group 1 patients speed decreased the rate of regional myocardial deformation of the basal segments of the septum, anterior-septum region, and posterior wall of the left ventricle decreases, P <0,001. In group 2 patients, a decrease in regional velocity was detected in the basal segment of the lower wall, in the middle segments (septum, anterior-septum, anterior, lateral), and in the posterior segment of the left ventricle, P<0,001. in 26,3% of group 2 patients and 10,5% of group 1, free fluid was detected in the pericardial cavity. In both groups, cardiac arrhythmias were detected, most often in patients in group 2. The relationship between the coronavirus activity parameter and the structural and functional parameters of the myocardium, P <0,001, was established.

Conclusion. Damage to the cardiovascular system after a coronovirus infection occurs in 71% of patients with mild and 95% of moderate severity and is characterized by a decrease in the rate of regional LV myocardial deformation, as well as heart rhythm disorders. In patients with pneumonia, these changes were more pronounced and were also accompanied by structural and functional disorders in the form of impaired diastolic function of the right ventricle and increased pressure in the pulmonary artery.

The incidence of type 1 diabetes in children is on the rise worldwide. Diabetic ketoacidosis is one of the most common complications of this disease, with a high hospital admission rate and high mortality. Half of children with newly-diagnosed type 1 diabetes mellitus have clinical signs of this complication. The list of risk factors linked to the development of diabetic ketoacidosis in patients with diabetes mellitus comprises social and economic factors, violation of the insulin treatment regimen, and infectious disease. The pathophysiological mechanism of this condition is rooted in the development of metabolic acidosis in the setting of hyperglycemia, glucosuria and hypoglycemia, coupled with the generation of a large number of ketone bodies. Diagnosis of diabetic ketoacidosis is based on clear clinical and diagnostic criteria. In case of this complication, the therapeutic tactics must be based on a clear treatment algorithm, which has its own distinctive aspects in pediatric practices, and includes infusion therapy, intravenous insulin therapy, prevention and treatment of cerebral edema, and correction of hypokalemia. Of great therapeutic importance are measures aimed at prevention of diabetic ketoacidosis, which may reduce the incidence of this complication in children and adolescents.

Based on the data of foreign literature, an analytical review of the role of asymptomatic forms of new coronavirus infection in the spread of the disease is presented. The causes of the asymptomatic course of infection are discussed. Approaches to the determination of presymptomatic and truly asymptomatic patients are considered. The data on the main foreign studies devoted to the study of the duration of viral release in asymptomatic patients, the possible tactics of management of such patients in different countries are presented.

The paper is literature review of ionic sodium channels. The structure of sodium channels and physiological functions of the alpha-subunit are considered, as well as the classification of voltage-gated channels for sodium ions.

The review summarizes literature data on precancerous diseases of esophagus such as leukoplakia, achalasia cardia, cicatricial stricture of the esophagus (post-burn), papillomatosis caused by HPV, Plummer-Vinson syndrome, tylosis. The materials presented information about frequency of occurrence of each pathology, diagnostic sighs and criteria. The article describes issues of differential diagnosis and therapeutic tactics in all patology cases.

The novel coronavirus infection potentiates the development in genetically predisposed patients of a severe systemic inflammatory syndrome, reminiscent of Kawasaki disease (CD), often accompanied by shock. First, there is a fever and an increase in biomarkers of systemic inflammation and myocardial damage, then acute left ventricular failure occurs very quickly, and in some patients signs of secondary hemophagocytic syndrome (HPS) join. Such patients are usually older than 5 years, they often have gastrointestinal symptoms, blood tests show a shift in the leukocyte formula to the left, an increase in ESR, thrombocytosis or thrombocytopenia, a sharp increase in the level of CRP, LDH, ferritin, troponin, D-dimer and, in contrast to the classical BC, sometimes the level of procalcitonin rises. Coronary dilation occurs in a subset of these patients. A fairly effective treatment is the introduction of human IVIG, with signs of secondary HPS - the introduction of dexamethasone, or pulse therapy with methylprednisolone. Further research is needed to investigate the mechanisms of AIM, hyperimmune vasculitis, and cardiac involvement in COVID-19 infection, which may be useful in preventing adverse outcomes in children.