Non-immune hydrops of the fetus is a heterogeneous pathology, which is accompanied by excessive accumulation of fluid in two or more serous cavities (pericardial cavity, abdominal cavity, pleural cavity) and fetal tissues in the absence of signs of immune sensitization. This pathology in most cases leads to high mortality in both the antenatal and postnatal periods. The incidence of this disease ranges from 0.05 to 5%. Perinatal mortality in nonimmune hydrops fetalis accounts for about 80%, but with the manifestation of the disease in the early stages of pregnancy, the frequency of deaths is already about 95%. Most often, fetal death occurs due to severe heart failure and hypoxia. The most common causes of the development of nonimmune hydrops fetalis are: chromosomal abnormalities, pathology of the cardiovascular system and infectious diseases. Due to the emergence of a new coronavirus infection COVID-19, the question arises how the SARS-CoV-2 virus affects the course and outcome of pregnancy, as well as what effect it has on fetal development. And is it possible to assume that the SARS-CoV-2 virus can be attributed to the etiological factor of the occurrence of nonimmune hydrops fetalis. The article describes a clinical case of non-immune hydrops in a premature baby with a burdened obstetric and gynecological history against the background of COVID-19 during pregnancy, a severe course of the neonatal period. The review of current literature data on the pathogenesis, classification and features of clinical manifestations, diagnosis and treatment of such newborns is carried out.

Sleep is one of the most important and vital physiological processes in the human body. In addition to the length of daylight hours, the nature of work activity, bad habits (smoking, alcohol abuse, excessive consumption of caffeine-containing drinks, psychostimulants), the factors that violate the duration and quality of sleep include the nature and style of nutrition, as well as eating habits that affect daily intake vital nutrients (vitamins, essential amino acids, polyunsaturated fatty acids, etc.). Tryptophan is one of the essential amino acids associated with sleep disturbance. Given the high clinical significance of sleep disorders in the development of neurological diseases and mental disorders, the interest of researchers in the study of modifiable and non-modifiable risk factors for sleep disorders is growing. Objective: to analyze and systematize the results of fundamental and clinical studies of recent years on the role of tryptophan in the development of sleep disorders and anxiety-depressive disorders in adults. Materials and methods. This thematic review included available full-text publications obtained as a result of a literary search in the domestic (E-Library) and foreign databases (PubMed, Scopus, Oxford University Press, Springer, Web of Science Core Collection). Results. The role of tryptophan as a key link in the synthesis of melatonin and serotonin in the occurrence of sleep disorders and anxiety-depressive disorders is significant and can be used for further study. Conclusion. Based on the review of the literature, it can be concluded that one of the important mechanisms of sleep disturbance and the occurrence of anxiety and depressive disorders is insufficient intake of tryptophan in the body. This pattern is a consequence of the consumption of food with a low content of this essential amino acid. Considering the consequences that tryptophan depletion can lead to in the human body, competent nutritional support is a necessary measure.

Objective: to study the features of the course of the wound process both with the isolated use of hexethidine and photoditazine, and in combination with ultrasound therapy. Materials and Methods. The in vivo experiment was performed on 144 animals (male Wistar rats) divided into 4 equal groups. A purulent wound model (S=150mm²) was formed in all rats, which was treated with the studied combinations with and without ultrasound therapy. The percentage of area reduction, healing rate, microbial contamination, and morphological picture of wounds were evaluated. Results. In the groups treated with the combination we developed, complete wound healing had occurred by 15 days. The greatest activity was in phase I of the wound process, which is confirmed by the maximum wound healing rate (1-5 days from the start of treatment), as well as by the morphological picture. At the same time, in the group with the use of ultrasound therapy the indices of microbial siltation and percentage of area reduction were reliably better in comparison with the isolated use of the combination. Conclusion. The developed combinations have a positive effect in the treatment of purulent wounds, speeding up the healing process and reducing microbial contamination.

Objective is to study the relationship between clinical, laboratory and radiological manifestations of alveolar-bronchiolar dysfunction with the production of interleukin-20 in patients with community-acquired pneumonia. Materials and methods. We examined 60 patients of both sexes aged 18 to 45 years with bacterial community-acquired pneumonia in the first 3 days of the disease, as well as 15 practically healthy individuals. The material of the study was venous blood, in the serum of which the concentration of interleukins (IL) was determined: IL-1β, -2, -4, -8, -10, -17A, -20, -28A, -33, tumor necrosis factor-alpha (TNFα), interferon-gamma (IFNγ), Clara cell protein (CCP), surfactant protein D (SP-D), prostacyclin (PgI2), soluble form of the Fas-receptor (sFas), and its ligand (sFasL), leukotriene D4 (LTD4), thromboxane A2 (TA2). Results. The development of pneumonia is accompanied by an increase in the production of the studied mediators, which is more pronounced in patients with a severe course of the disease. An increase in the concentration of IL-20 from the minimum to the maximum level is accompanied by a significant proportional decrease in the concentration of IL-1β, TNFα, IL-33, TA2, LTD4, Fas, FasL. A high level of IL-20 was associated with a decrease in the concentration of CCP, indicating a weakening of the alveolar-bronchiolar dysfunction and a decrease in the intensity of the inflammatory reaction in the lung tissue. It was also found that a high level of IL-20 was associated with increased production of PgI2, IFNγ, IL-1RA, IL-17A, IL-8, IL-4, IL-28A, IL-10, SLPI. Conclusion. The results of the study indicate the important role of IL-20 in the development of inflammation of the lower respiratory tract, which consists in regulating the activity of the acute phase response, modulating the production of prostacyclin and leukotrienes, determining the limitation of alveolar-bronchiolar dysfunction in patients with pneumonia, as well as the restriction of proapoptogenic influences that determine the decrease in volumes. tissue and cellular damage in such patients.

One of the manifestations of the stress reaction in the colon is an increase in the permeability of its wall due to the development of an inflammatory reaction against the background of changes in neuroendocrine regulation and microbiota state. These processes are accompanied by significant changes in humoral homeostasis and cell activity involved in the development of an inflammatory response in the colon wall. We performed a literature review to analyze and summarize the available research data on the mechanisms of stress-induced changes in the intestine at the molecular, cellular and tissue levels involving the regulatory systems of the body. Scientific information was searched in Web Of Science, Scopus, ScienceDirect, Medline, Russian Science Citation Index (RSCI), as well as in the search engines Google Scholar, PubMed, Semantic Scholar, Taylor & Francis, Wiley Online Library and Bielefeld Academic Search Engine (BASE). Wall permeability has been shown to have a rather complex regulation involving corticotropin-releasing factor, mast cells, dendritic cells, eosinophils, macrophages, Substance P, nerve growth factor, neurotensin, microbiota metabolic factors (serotonin, short-chain fatty acids, indole derivatives and conjugated fatty acids), epigenetic mechanisms, the HES1 (Hairy/Enhancer of Split-1) - GR (glucocorticoid receptor), and the stress-associated polarity signaling pathway. Under stress, there is a change in the functioning of these mechanisms, leading to an increase in the permeability of the intestinal wall. It results in translocation of bacteria from the lumen into the underlying layers which causes activation of the immune response with subsequent development of an inflammatory reaction. The presented data testify to the prospects and validity of the development of methods of correction of stress-induced shifts in the colon by influencing the central and local mechanisms of realization of the stress response and the state of the microbiota.

Objective: to carry out a comparative analysis of the area of the corpus callosum in men and women in adolescence, old age, and old age according to magnetic resonance imaging data. Material and methods. The results of magnetic resonance imaging studies of the brain of 138 patients (72 men and 66 women) were analyzed. The entire study material was divided into three groups. The first group included 44 adolescents (21 men and 23 women aged 16-21 years); the second group included 50 elderly people (27 men and 23 women aged 56-74 years); the third group included 44 seniors (24 men and 20 women aged 75-88 years). We determined the area of the corpus callosum in the sagittal projection along the midline. Results. The analysis of the results of the study revealed a tendency for the prevalence of cerebellar area parameters in boys and girls in comparison to the elderly and senile age representatives (p>0.05). There was a tendency for prevalence of cerebral body area parameters in elderly subjects over elderly ones (p>0.05). In all age groups there was a tendency for superiority of cerebral body area parameters in men compared to women (p>0.05). Conclusion. The obtained results of the in vivo comparative analysis of the area of the corpus callosum in humans in adolescence, old age and senile age extend the scientific knowledge of its age-specific features. Thus, these data can serve as a benchmark of age-related anatomical norm in various instrumental examinations, such as magnetic resonance imaging and computed tomography, and provide a foundation for further clinical research.

Morphology of cerebrospinal fluid flow structures in CNS is an important and complex area of research and is associated with the problems of metabolites transport, including pathological ones in neurodegenerative pathology, e.g., Alzheimer's disease. Since Virchow and Robin first described the perivascular spaces in the 19th century, their role in the transport of cerebrospinal fluid and intracerebral metabolites has been established. On the grounds of the 20th century studies, a modern theory of intracerebral liquor transport of metabolites, the glymphatic system theory, has emerged, creating the basis for new areas of treatment of neurodegenerative diseases. The article presents an overview of the history of description and study of CNS perivascular transport pathways, terminology issues and clinical problems such as amyloid transport and its disruption as a mechanism of Alzheimer's disease and glaucoma. We present our own descriptive data on the morphology of the perivascular spaces (PVS) of the rat brain in normal and simulated glaucoma-like increases in intraocular pressure. Structures corresponding to perivascular spaces (PVS) in their original description are present in the rat brain along arteries and arterioles. They are represented by intervals between the medium and adventitia, in the adventitia, and between the adventitia and the inner pial fibrous layers. At the level of capillaries they are closed. In the venous link there are only paravenular spaces between the vascular wall and glial boundary membrane. Periarterial-like leptomeningeal structures and spaces are absent. In glaucoma-like experimental increase in intraocular pressure, the periarterial spaces respond with expansion, and in addition to them, intermyocyte spaces are formed in the medium On the basis of glymphatic theory we propose the possibility of regulation of intracerebral metabolic transport and hydrodynamic system”eye - optic nerve -brain” via vascular mechanisms of perivascular transport.

Objective: to evaluate the features of adaptation of patients to complete removable dentures, taking into account the correctness of determining the central ratio of the jaws during dental rehabilitation. Materials and methods. A dynamic follow-up was carried out on 32 elderly patients with complete loss of teeth with complete removable acrylic dentures made for the first time, which were divided into 2 groups: without defects in determin-ing the interalveolar distance (n=10) and with a decrease in the interalveolar distance by 2-6 mm (n=21). The patients were examined on the day of prosthetics and 30 days after the start of using the prostheses. During the examination a month after the start of using the prostheses, it was recommended to use a cream for fixing the prostheses of Aseptaparodontal, followed by a comprehensive examination after 10 days with the determination of chewing efficiency using a chewing test according to I.S. Rubinov, indicators of myotonometry of the chewing muscles themselves, as well as with the study of the syndrome of psychosensory-anatomical-functional maladaptation according to M.M. Soloviev. Results. It was found that during prosthetics of patients with complete loss of teeth with removable dentures, the in-teralveolar distance is correctly determined in 65.62% of cases. 31.25% of patients showed a decrease in the interalveolar dis-tance on new dentures by 2-6 mm, and in 3.13% of cases - “overbite”. The adaptation period was easier in patients with re-duced interalveolar distance on manufactured dentures, although they had somewhat worse grinding of the nut kernel used as a food irritant. Conclusion. The study reliably noted the optimization of the use of complete removable dentures when patients use a domestic cream for fixing dentures. The study also showed the importance of internal quality control of medical care, which should be carried out by the head of the orthopedic department or a senior orthopedic dentist due to errors in deter-mining central occlusion, which amount to more than 34%.

Researches of elemental composition of wild-growing raw materials are actual and significant because of high efficiency and bioavailability of their metal-organic forms contained in plants. Available data on the content of elements in medicinal plant raw materials of the Voronezh region showed that studies are conducted mainly on a few elements, which does not allow to determine the full chemical composition of plants and to describe the specificity of accumulation of the whole complex of minerals in them. Objective. The aim of the investigation was to study the accumulation of macro- and microelements in common yarrow herb of natural phytocenosis of the Voronezh region. Materials and methods. Preparation of medicinal plant raw materials was carried out during the flowering of the plant in the Voronezh State Natural Biosphere Reserve. The microelement of medicinal plant raw materials was determined by mass spectroscopy with inductively coupled plasma on the ELAN-DRC device. Results. It was found that the content of microelement complex is 3.28%, 59 elements were determined. Macronutrients account for 93.78% of the total elemental composition of common yarrow herb. The basis of macronutrients is potassium (more than 14 mg/g), and calcium (more than 10 mg/g). Essential microelements make up 5.51% of the total mineral complex of the common yarrow herb. Among them the highest content was noted for silicon (more than 1.6 mg/g), iron (more than 0.1 mg/g). The content of the rationed heavy metals and arsenic in the herb common yarrow corresponds to the requirements of the normative documentation. The proportion of toxic and understudied elements in the total mineral complex of common yarrow herb is 0.71%. The highest content was noted for aluminum (116.5 µg/g), strontium (81.6 µg/g), titanium (12.5 µg/g), rubidium (9.5 µg/g), barium (9.31 µg/g). The high ability of common yarrow herb to accumulate phosphorus, potassium, copper, zinc, molybdenum, strontium from soil was shown. Conclusion. The data obtained are of great interest and can serve as a basis for further research with the aim of using their results in medical and pharmaceutical practice to create drugs and biologically active additives for correcting physiological norms of element content in the human body.

Objective: analyze and evaluate scientific literature data on the need for the use of plant sterols and stanols for the treatment of hypercholesterolemia in order to reduce the risk of coronary heart disease. Materials and methods. The article summarizes the information of scientific publications in the journals of search systems PubMed, Scopus, Google Scholar, as well as library databases (eLibrary). Results. Phytosterols (phytosterols), phytostanols, are lipid-like compounds found in foods of plant origin. Their structure is similar to cholesterol and therefore they successfully compete with it for absorption in the intestine, thus reducing the flow of cholesterol into the bloodstream. As a result of this therapy for hypercholesterolemia, the risk of coronary heart disease is reduced. The factors influencing the efficacy of sterols/stanols and ways to improve therapy with their use are discussed in the review. The effect of stanols on the immune system is also presented. Conclusion. Food products enriched with sterols and stanols (yoghurt, kefir, milk, spreads, etc.) are promising tools in the complex of non-medicinal measures to reduce LDL cholesterol levels, an established risk factor for CHD, and their introduction into the diet will contribute to the prevention of CHD among the Russian population.

Plants of the genus Artemisia have a rich complex of biologically active compounds, among which essential oils, sesquiterpene lactones, flavonoids, and acetylenic compounds predominate. Particular attention is drawn to Artemisia scoparia Waldst. et Kit. Due to a wide range of therapeutic activity, wormwood paniculata is used as a choleretic, hepatoprotective, antimicrobial, anti-inflammatory agent. Flavonoids are one of the leading groups of biologically active compounds (BAS) in water and water-alcohol extracts from the aerial part of Artemisia scoparia. These compounds have powerful hepatoprotective, choleretic, anti-inflammatory, antiviral effects. Objective: development of a method for quantitative determination of the amount of flavonoids in the herb Artemisia scoparia. Materials and methods. The object of the study was Artemisia scoparia herb, collected in the flowering phase in the Nikitsky Botanical Garden in 2016-2020. Quantitative determination of the amount of flavonoids in raw materials was carried out by UV spectroscopy. Results. It has been established that the differential spectrum of the complex compound of the studied extract with aluminum chloride does not differ in terms of the position of the light absorption maximum (410 nm) from the differential spectrum of the complex of rutin with aluminum ions. The content of total flavonoids in terms of rutin in Artemisia scoparia herb was 1.95% ± 0.05. Conclusion. A method has been developed for the quantitative determination of the amount of flavonoids in the raw material of Artemisia scoparia by UV spectrophotometry in terms of rutin.