Aim. To determine the content of natural killer cells (NK-lymphocytes) and natural killer T-lymphocytes (NKT-lymphocytes) and their co-aggregates with platelets PNKcelC (Platelet NK-cells Co-aggregates), PNKTcelC (Platelet NKT-cells Co-aggregates) in the peripheral blood of healthy children of different ages by flow cytometry.

Methods. Simples of whole blood of 111 healthy children in age up 7 months to 14 years were studied. Peripheral blood of children was taken into vacuum tubes with EDTA. Monoclonal antibodies to cell markers of platelets and lymphocytes were used to determine the platelet-cells contacts by flow cytometry method. The Kruskal–Wallis test (H), Mann–Whitney (U) test with the Bonferroni correction were applied.

Results. The relative content of NK cells in the peripheral blood was minimal in children of the first year of life and gradually increased by the age of 12. The absolute content of NK-lymphocytes did not change in all age groups. The absolute and relative content of NKT cells gradually increased in children as they grow older and reach maximum values in 12-year-old. It was established for the first time that the absolute content of PNKTcelC was minimal in 1–2 years old and maximal in 2–6 in children. At the same time, the absolute content of PNKcelC did not change in all groups. However, the relative content of PNKcelC had constant low level in all studied groups, except grope of children 2 years old; in those this indicator was increased.

Conclusions. The content of NK and NKT cells, as well as PNKcelC, PNKTcelC depend on age.

The aim of the research. To assess the relationship between the level of oxytocin in the blood and the level of cognitive impairment, anxiety and depression in patients with coronary artery disease hospitalized for coronary artery bypass grafting.

Materials and methods. The "pilot" study included 15 men with coronary artery disease who were hospitalized for coronary artery bypass grafting. The patients' cognitive status, anxiety and depression levels were assessed, and the level of oxytocin in blood plasma was assessed using the method of enzyme immunoassay.

Results. As a result of the study, we revealed a statistically significant relationship between the level of oxytocin in blood plasma and the age of the subjects, as well as a statistically significant relationship between the level of oxytocin in blood plasma and the level of anxiety and depression in patients with coronary heart disease hospitalized for coronary artery bypass grafting. At this stage of the study, there was no statistically significant relationship between the level of oxytocin in blood plasma and cognitive deficits.

Conclusion. Oxytocin can be used as a biomarker to assess levels of anxiety and depression. In the future, with an increase in the sample size, we expect to obtain a relationship between the content of oxytocin in blood plasma and the cognitive status of patients.

The aim of the research. To analyze the operation of the biological clock (perceived passage of time) in adolescents with type 1 diabetes mellitus (DM) in remission.

Materials and methods. The study involved 50 adolescents aged 13 to 18 years. The investigational group consisted of 25 adolescents with a diagnosis of type 1 DM (with a total duration of disease in these adolescents ranging from 2 to 10 years). Adolescents from the investigational group were receiving their prescribed insulin therapy and underwent hospitalization while in remission (scheduled hospitalization). The comparison group consisted of 25 patients without concomitant pathology (conditionally healthy children). Biological clock disruption was assessed using Ritm, a purpose-designed software (relying on a reference sequence of sound signals and inter-signal pauses) that was used to detect mistakes in time perception. The critical significance level for statistical hypothesis testing was specified as p≤0.05.

Results. Adolescents from the comparison group (conditionally healthy children) were overall successful in completing the task. Adolescents with DM tended to greatly decrease the total duration of the time cycle, furthermore, these patients significantly more often underestimated the mean duration of a signal and the sequence of signals produced under schemes No. 1 and 2. Moreover, the pauses held between produced signals in this group deviated to the highest extent from the “specified standard”. Therefore, patients with type 1 DM fared much worse at the task than conditionally healthy children (p≤0.01).

Conclusion. The study has revealed the presence of biological clock disruption in patients with type 1 DM in remission. Biological clock disruption may represent an underlying cause of disruptions in the activity of the central nervous system (CNS), which comprise one of the key complications in DM. A fault in the operation of the internal biological clock may serve as one of the triggers that lead to the development of type 1 DM. Timely diagnosis of biological clock disruption may provide a signal for timely initiation of treatment of CNS dysfunction in pediatric and adolescent patients with type 1 DM.

Abstract. Acute respiratory infections remain an urgent problem in the practice of a pediatrician. Relationships between recurrent respiratory infections and allergic diseases have been identified. An example of such a connection is the obstructive syndrome in acute bronchitis. The article discusses the predictors of the development of acute bronchitis with episodes of obstruction in children.

The aim of the research. Identification of predictors of the development of episodes of obstruction in children with acute bronchitis.

Materials and methods. The study involved 148 pediatric patients. The children were divided into three groups: the first - children with acute bronchitis, accompanied by rare episodes of obstruction. The second group included children with acute bronchitis who had three or more episodes of obstruction per year. The control group included relatively healthy children. Statistical analysis was carried out using the Statistica software package using the criteria: Mann - Whitney, Spearman's correlation coefficient. Regression analysis was used to obtain a mathematical forecasting model.

Results and сonclusion. Predictors of the development of frequent episodes of obstruction in children with acute bronchitis were identified: a high level of IgE, low concentrations of α-defensins 1-3, a high rate of lymphocytic-platelet adhesion in blood serum, a low content of SP-D surfactant protein and a high level of Ca ++ in the condensate exhaled air. Based on the results obtained, a model for predicting the number of episodes of obstruction in children with acute bronchitis was proposed.

The aim of the study was a morphological assessment of the neuroprotective effect of the combined use of polyunsaturated fatty acids concentrate from fat of the Baikal seal and “Cortexin” in cerebral ischemia rats.

Materials and research methods. The objects of the study were the concentrate of polyunsaturated fatty acids from the fat of the Baikal seal (PUFA) and “Cortexin”. The studies were carried out on Wistar rats of both sexes. Cerebral ischemia was reproduced by unilateral occlusion of the common carotid artery. The effect of the test agents on spatial memory in rats was determined using the “Morris water maze”, and general morphological studies of the brain were performed.

Results. It was found that the course introduction of PUFA together with “Cortexin” to rats subjected to cerebral ischemia had a nootropic effect: in the Morris water maze, the number of exits to the platform was 2 times more, and the average search time for the hidden platform was 1.8 times less compared with control (p≤0.05). By morphological methods, it was found that the severity of ischemic brain damage was noticeably less compared to the indicators of control and experimental rats receiving monotherapy (PUFA or “Cortexin”).

Conclusion. The combined use of “Cortexin” with a PUFA concentrate from Baikal seal fat has a pronounced neuroprotective effect in cerebral ischemia in rats and improves cognitive functions due to the complex action of polypeptide compounds and fatty acids of both drugs.

Aim was to study of the lymphocyte-platelet adhesion function and interleukin 4 concentration in blood of patients with influenza A(H3N2) depending on polymorphic variants of the IL-4 gene promoter (C589T).

Methods. The study was performed in 89 patients with influenza A(H3N2) and 96 healthy residents.

Results. It was found that the chance of developing influenza A(H3N2) increases in persons carrying the allele T (OR=2,37 [CI95%: 1,50-3,74]) (p=0,0002), heterozygous C/T variant (OR=1,88 [CI95%: 1,03-3,42]) and homozygous T/T genotype (OR=3,04 [CI95%: 1,12-8,23]) of the IL-4 gene promoter (C589T) (p=0,001). Among influenza A(H3N2) patients, the C/C homozygous carriers had the lowest concentration of IL-4, while the highest concentration was found in the carriers of the T/T variants. Carriers of the C/C genotype of the IL-4 gene promoter (C589T) have the highest ability for lymphocytic-platelet adhesion in influenza A (H3N2).

Conclusion. Indicators of the function of lymphocyte-platelet adhesion and interleukin 4 concentration in blood of patients with influenza A(H3N2) depend on the carriage of genotypes of the IL-4 gene promoter polymorphism (C589T).

The aim of the research. To study the gender and national characteristics of the new coronavirus infection COVID-19 among Russian and Buryat nationalityresidents of the Trans-Baikal Territory.

Materials and methods. The study involved 196 patients of Russian and Buryat nationality who were being treated in the mono-hospital of the State Clinical Hospital № 1, Chita, with a clinical picture of the new coronavirus infection COVID-19, typical changes in multispiral computed tomography of thoraxorgans, a positive SARS-CoV -2 smear by a polymerase chain reaction; or a negative smear combined with clinical data and multi-helical CAT scans of the thorax organs. Descriptive statistical methods were used for statistical data processing.

Results. In most patients of the studied groups, pneumonia on the background of coronavirus infection had a severe course and was combined with pathology of the respiratory, cardiovascular and endocrine systems. At the same time, patients of Russian nationality had a history of myocardial infarction, acute cerebral circulatory disorders and oncological diseases more often. Russian patients were more likely than Buryat patients to suffer from diabetes mellitus, Russian patients were more likely to have post-infarction cardiosclerosis compared to Buryat patients. Both men and women of Buryat nationality had a frequency of pneumonia of the 3-4 radiological stage against the background of COVID-19 exceeded this parameter of patients of Russian nationality. A positive smear for SARS-CoV-2 was more often registered in Buryat nationality. The frequency of use of GIBP in the treatment of a new coronavirus infection in patients of Russian and Buryat nationalities did not differ. In laboratory blood tests in patients of the studied groups, significant differences in the levels of neutrophils, aspartate aminotransferase and glucose were revealed.

Conclusions. The level of blood neutrophils in Buryat patients exceeded this parameter in Russian patients, which suggests a more frequent development of viral-bacterial association in Buryat patients, which may explain the subtotal and total volume of lung tissue damage during X-ray examination in patients of this group.

Оbjective: to study the effect of polymorphism of the TLR2-753(Arg>Gln), TLR4-299(Asp>Gly) genes for the content of IL-1β, TNF-α, IL-4 and IL-10 in patients with a cerebral contusion.

Materials and methods. 96 young patients (according to WHO classification) with cerebral contusion were examined. The first group (n=50) was compiled by patients with a contusion of moderate severity at the age of 29.5 [24; 33] years. The second (n=46) - patients with a severe degree (average age 32.5 [28.5; 35] years), and in this group in 10 patients an unfavorable outcome (exitus. letalis) was registered. The control group is 100 practically healthy residents of the same sex and age. Patients with any acute and/or chronic concomitant pathology, as well as females, were excluded from the study. Clinical, laboratory (genes polymorphism: TLR2-753(Arg>Gln), TLR4-299(Asp>Gly); Citokine content: IL-1β, TNF-α, IL-4, IL-10) and instrumental (craniography, computed tomography) the studies were carried out at the inpatient stage of treatment (the fence of the material for the study was performed for 3 days after the injury). Statistical processing of research results was carried out using the IBM SPSS Statistics Version 25.0 program.

Results. Allele -753Arg- and genotype -753Arg/Arg prevailed in the control group (82.5% and 65%, respectively) and in patients with moderate cerebral contusion (100%), while in the group of patients with severe cerebral contusion, the allele - 753Gln- (60.9%) and heterozygous -753ArgGln genotype (78.3%). The mutant genotype -753Gln/Gln of the gene under consideration was detected only in the group of patients with severe cerebral contusion and in the group with a fatal outcome (21.7% and 100%, respectively). The presence of -299Asp- allele in the control group was detected in 67.5% of residents, in patients with favorable outcome of cerebral contusion in 66.3% of cases and in 100% of patients with unfavorable outcome. In all patients with a fatal TBI, 100% had a homozygous -299AspAsp genotype. It was shown that in patients with cerebral contusion on the 3rd day after injury, the content of such parameters as IL-1β, TNF-α, IL-4 and IL-10 significantly exceeded the control values by 1.3, 1.3, 1.2 and 1, 1 times, respectively, while in patients with an unfavorable course of cerebral contusion in dynamics (St. letalis), in comparison with the group of cerebral contusion with a favorable course (recovery), their level significantly exceeded the control values by 2, 2, 1.6 and 1.3 times , respectively.

Conclusion. The presence of the -299Asp/Asp genotype of the TLR4-299Asp>Gly gene polymorphism indirectly contributes to a higher serum level of the cytokine IL-1β, TNF-α, IL-4 and IL-10. When carrying the -753Gln/Gln mutant genotype of the TLR2-753Arg>Gln gene polymorphism, one can state a significant effect of their carriage on a higher content of the studied cytokines in the blood serum.

The aim. Detection of changes in nutritional status in patients with moderate and severe novel coronavirus infection (COVID-19).

Methods. On the basis of the Regional Clinical Infectious Diseases Hospital of Perm in 2020 - 2021. A comprehensive clinical and laboratory study was conducted to study the nutritional status in 246 patients with a new coronavirus infection (COVID-19). Of these, the first group - 142 people. with a moderate course – was treated in the infectious diseases department, the second group - 104 people. with a severe course – hospitalized in the intensive care unit. On days 1, 10, and 21, the nutritional status was assessed in patients with COVID-19 using anthropometric, laboratory, and clinical methods to assess the somatic protein pool, identify the degree of nutritional deficiency and the severity of systemic disorders.

Results. At the time of admission, nutritional status disorders from mild to severe were recorded in both groups. By the 10th day of hospitalization, all patients showed a decrease in the amount of visceral pool proteins - total protein, albumin, transferrin, which indicates their active consumption as part of the formation of hypermetabolism syndrome - hypercatabolism, regardless of the severity of the disease. An increase in the main laboratory markers of liver and kidney failure was recorded, as well as the dependence of these dysfunctions on the identified lack of protein macronutrients, which was a predictor of the severe course of COVID-19.

Conclusion. COVID-19 has a direct impact on the development of severe metabolic disorders and the formation of nutritional insufficiency, therefore, nutritional support should be a mandatory component of therapy for patients, regardless of the severity of the disease.

The article analyzes the theoretical and experimental issues of sclerotome and sclerotomy pain from the standpoint of the modern development of science.

In modern conditions of development of the healthcare system, medical activity is considered as a complex of interrelated processes aimed at maintaining and restoring health, which is implemented in medical organizations. A modern manager is faced with the task of managing the activities and resources of a medical organization using modern approaches, including the application of the principles of lean technologies that will ensure high efficiency and efficiency of the organization.

Due to the high prevalence of the posterior eye segment diseases, the search for effective methods of their treatment is especially relevant. In recent years, neuroprotective therapy has been widely used, which is considered a promising direction due to a pathogenetically proven mechanism of action. The use of biogenic peptides in ophthalmology, including pediatric ophthalmology, makes it possible to activate the processes of reparation and intercellular interaction of retinal cells. The literature review presents data on the structure and pharmacological action of Retinalamin®, as well as the results of its use in various ophthalmic diseases.

Ischemic stroke is a multifactorial disease, the pathogenesis of which is closely related to genetic predisposition. The results of the conducted studies indicate an increased risk of ischemic stroke in the presence of an aggravated family history. It has been established that the development of acute cerebral ischemia under the age of 65 increases the risk of acute cerebrovascular accident in the next of kin by 4 times. It is also known that stroke occurring at a young age is more associated with the carriage of various genetic polymorphisms than with the presence of cardiovascular risk factors.

The literature review presents current data on acute cerebrovascular pathology and its relationship with the carriage of various polymorphic variants of genes: the renin-angiotensin-aldosterone system (RAAS), genes that regulate endothelial function, folate metabolism, and ion channels.

The paper is literature review of ionic sodium channels, the structure of sodium channels and physiological functions of the betasubunit are considered.

Drug-induced (steroid) ophthalmohypertension and glaucoma is an actual problem due to the widespread use of glucocorticoids in treatment of various ocular and systemic diseases. Intraocular pressure may increase with different routes of glucocorticoid administration, at different times of treatment and can also stop on its own after discontinuation of these drugs. Prolonged uncontrolled glucocorticoid administration may cause persistent morphological optic nerve damage with perimetric loss. The literature review presents risk factors, mechanisms of eye hydrodynamic disturbances, clinical course features and principles of secondary steroid ophthalmohypertension and glaucoma treatment.

This review article provides current information on the pathogenetic and genetic features of primary adrenal insufficiency (1-HI) based on the analysis of available scientific articles indexed in PubMed and Web of Science. The aim of this article is to review the immunological and molecular genetic mechanisms of 1-HI development of various genesis. The diversity of etiological causes of adrenal cortical insufficiency has raised the need for the medical community to expand knowledge of proven gene mutations that lead to decreased adrenal function combined with lesions of various organs and systems. This review presents the latest data from the first genome-wide association study (GWAS) of 1-HI of autoimmune origin. The study showed associations of autoimmune 1-HI with risk loci variants PTPN22, CTLA4, LPP, BACH2, SH2B3, SIGLEC5, UBASH3A, and AIRE gene. Four previously unknown loci have been identified: LPP, SH2B3, SIGLEC5 and UBASH3A. 1-HI may be a component of autoimmune polyglandular syndromes type 1 and type 2 with a mutation in the AIRE gene. Despite the achievements of modern science, modern methods of genetic research allowing to establish the diagnosis of 1-HI, to clarify its pathogenetic mechanisms, and to individualize treatment are yet to be introduced into clinical practice.

The article presents up–to–date data on the diagnosis, management features, and possibilities of surgical correction of children with a rare congenital pathology of the tracheobronchial tree - Williams-Campbell syndrome. The review of scientific literature is supplemented by a case from clinical practice in a child of the first year of life, demonstrating the difficulties of diagnosis and treatment of a child from the first months of life.

Cystic fibrosis (CF) is a severe, progressive, multisystemic disease that is caused by mutations in the cystic fibrosis transmembrane conductance regulator gene. Meconium intestinal obstruction is often the first manifestation of CF and occurs in about 20% of patients. This situation undoubtedly requires close attention from specialists who observe children with suspected CF, since early diagnosis is important for optimizing both short-term and long-term treatment. The article describes a clinical case of meconium ileus complicated by intestinal volvulus.