Currently, the effective stop of parenchymal bleeding that has developed for various reasons: trauma, planned and emergency surgical interventions, is a serious challenge for modern clinical surgery. Today, in the arsenal of doctors there are a large number of hemostatic agents that affect the coagulation process, however, local hemostatics attract much attention, since they have a significant advantage - the absence of a systemic effect on the blood coagulation system. The objective: in a comparative aspect, to study the effectiveness of two-component sponge hemostatic agents in the model of marginal liver resection in vivo. Materials and methods. In a comparative aspect, we studied the hemostatic activity of samples of local application hemostatic agents "TachoComb" (No. 1), prototypes of two-layer spongy hemostatic agents based on sodium salt of carboxymethylcellulose of various viscosities (No. 2), Surgicel Fibrillar. Rats under inhalation anesthesia underwent a median laparotomy, modeled marginal resection of the left lobe of the liver. Bleeding was stopped by applying the compared samples, while recording the amount of blood loss and bleeding time. In order to assess the statistical significance of differences between study groups, the Mann-Whitney test (p≤0.05) was used. Results. The minimum time to stop bleeding was noted in group No. 2. When comparing the volume of blood loss, no statistically significant differences were found. Conclusion. The use of samples of two-layer sponge hemostatic agents developed and tested in the experiment based on the sodium salt of carboxymethyl cellulose of various viscosities in stopping parenchymal bleeding in laboratory animals is not inferior to the currently used local hemostatics in terms of blood loss and statistically significantly accelerates the process of stopping bleeding.

Objective of the study: to analyze and systematize the results of fundamental and clinical studies of recent years devoted to the study of the pathogenetic mechanisms of myocardial and coronary artery damage in patients who have undergone a new coronavirus infection (COVID-19). Materials and methods. The search for scientific information was carried out in domestic (E-Library) and foreign databases (PubMed, Scopus, Oxford University Press, Springer, Web of Science Core Collection). Results. It has been shown that the variety of cardiovascular system pathologies after a coronavirus infection is quite wide: heart failure, arrhythmias, sudden cardiac death, coronary heart disease, coronary microvascular dysfunction with coronary insufficiency, formation of coronary artery and aortic aneurysms, hypertension, labile heart rate and BP response to physical activity, acceleration of atherogenesis processes, venous and arterial thromboembolism. Cardiovascular pathology can develop both in patients after severe and moderate COVID-19, and in oligosymptomatic and asymptomatic individuals. Patients with emerging cardiovascular pathology in the acute period of coronavirus infection, as a rule, are under observation and in this situation changes in therapeutic strategies occur faster. Patients with newly diagnosed cardiovascular pathology after suffering COVID-19 need special attention and timely assessment to exclude or confirm cardiovascular complications. Conclusion. The presented data suggest that the tactics and strategy for the management of cardiovascular diseases in the post-covid period should be based on the timely and modern diagnosis of the onset or decompensation of cardiovascular pathology, competent, in accordance with current recommendations management of cardiovascular pathology with emphasis on the use of therapeutic interventions affecting the pathophysiological mechanisms of long covid.

Objective: to develop an algorithm for choosing a treatment method for "difficult" cases of plantar fasciitis. Materials and methods. The clinical research included 40 patients with plantar fasciitis. These patients had so-called «hard-to-treat» cases of plantar fasciitis. These are: patients previously treated with local hormone injections or FSWT. There was no effect from the treatment. Depends on the clinical picture, the patients were divided into 3 groups: the main group (n=20) - patients with «hard-to-treat» cases, who underwent combined focused(FSWT) and radial shock wave therapy(RSWT); compare group (n=10) - patients who received only FSWT; control group(n=10) - patients who underwent local injection of hormones. Results. It was found that that the complex treatment of plantar fasciitis with radial and focused shock wave therapy in patients in «difficult cases» allows obtaining satisfactory results in 97% of patients 4 weeks after the end of treatment. This is significantly higher than with treatment with only focused shock wave and local hormone therapy (p<0.05). Moreover, hormone therapy was effective only in 4 (40%) patients who had previously received shock wave therapy. In patients with previous local injection of hormones, it was ineffective. Only focused shock wave therapy relieved pain syndrome in 6 (60%) patients. Conclusion. The study of the results of the treatment of «difficult» cases of plantar fasciitis by the method of radial and focused shock waves in combination, as well as only by the method of focused shock wave therapy and local injection with hormones will allow us to form an algorithm for the treatment of such patients to increase the number of satisfactory results.

In conditions of new coronavirus pandemic and high prevalence of myocarditis, myopericarditis, the issues of differential diagnosis, especially in patients who had previously undergone myocardial infarction, appear to be relevant. Against the background of COVID-19 both recurrent acute coronary disease and myocarditis, or myopericarditis are possible, and the differential diagnosis is significantly complicated by the similarity of clinical picture (pain in the heart area (not always typical), increased titers of cardiac troponins). Particular difficulties in diagnosis arise in patients who have undergone myocardial infarction, are in a coma and have unstable hemodynamics, since the detection of zones of local hypo- or akinesis on EchoCG has no proper diagnostic value; changes on ECG can be ambiguous; and the absolute majority of hospitals that provide care to COVID-19 patients have no possibilities of making MRI with gadolinium. In such cases, additional diagnostic methods may be helpful in making a definitive diagnosis. In such cases, additional diagnostic methods may be helpful in making a definitive diagnosis. The most available and well-studied laboratory indicator is D-dimer, which is a marker of hypercoagulation syndrome, however, some scientists also considered it as a marker of necrosis in myocardial infarction. This review shows the advantages and disadvantages of D-dimer in the diagnosis of acute coronary syndrome; the possibility of its use in patients with coronavirus infection, who had previously undergone myocardial infarction; the prospects for further research on this issue are outlined. The combined use of D-dimer test with electrocardiography, echocardiography, and clinical manifestations in patients with coronavirus infection to diagnose recurrent myocardial infarction was substantiated.

Objective: to study the structure of medical prescriptions for antibacterial drugs used in patients with various types of infection of the bronchopulmonary system in the conditions of typical practice in Kursk (Russian Federation) and Chisinau (Republic of Moldova). Materials and methods. In order to assess the structure of prescribing various classes of antibacterial agents used to treat patients with infections of the respiratory system, a survey of doctors from medical organizations in Kursk and Chisinau was conducted in the period from October 2019. to January 2020 as a one-time descriptive study. As model diseases are taken: acute bronchitis with purulent sputum, exacerbation of chronic obstructive pulmonary disease with purulent sputum, non-severe community-acquired pneumonia. Results. The leaders in prescription for acute bronchitis with purulent sputum were cephalosporins: in Kursk, their share was 24% (cefixime was most often prescribed), and in Chisinau, 26.8% (leaders were cefixime and ceftriaxone). In patients with exacerbation of chronic obstructive pulmonary disease and purulent sputum, doctors from both cohorts also more often recommended cephalosporins: 29.4% and 36.1% for Kursk and Chisinau, respectively; among them, cefixime, ceftriaxone and cefotaxime were leaders in Kursk, while ceftriaxone, cefotaxime and cefuroxime axetil were the priorities in Chisinau. For non-severe community-acquired pneumonia, doctors in Kursk preferred macrolides (more often - azithromycin and clarithromycin), inhibitor-protected penicillins (more often - amoxicillin/clavulanate) and cephalosporins (mainly of the 3rd generation), in Chisinau, cephalosporins (mainly of the 3rd generation) and penicillins (including inhibitor-protected) were more often prescribed, the proportion of macrolides was significantly less. Conclusion. Doctors from Chisinau and Kursk implement pharmacotherapy for this group of patients in accordance with modern clinical guidelines; at the same time, cases of irrational use of certain medicines are recorded.

There are no data in the scientific literature on the study and assessment of body parameters and physical development of female applicants to military educational organizations. Objective: to study anthropometric, functional indices, body composition and the main indices of physical development of female applicants to a military educational organization. Materials and methods. The object of the study was 257 practically healthy girls aged 17 years who passed a medical commission in the military commissariats at the place of conscription. Anthropometric research was carried out according to the classical method, taking into account the recommendations of D.B. Nikityuk (2013) using a standard set of anthropometric tools. Results. With the help of anthropometric indices, morphological and functional indicators, body composition and centile assessment of the normal range a characteristic of physical development was given. A wide variability of anthropometric, functional indicators and body composition in the studied girls-entrants was revealed. Conclusion. The results obtained can be used in the preparation of regulatory documents for the selection of females in the Armed Forces of the Russian Federation, as well as standards for the physical development of adolescent girls.

Mutations in the Dmd gene encoding the membrane protein dystrophin are associated with the development of severe X-linked muscle diseases Duchenne and Becker myodystrophy. At the same time, along with the classic symptoms of striated muscles, dystrophin mutations can lead to a decrease in cognitive functions and behavioral abnormalities. Objective: conducting a pilot analysis of behavioral and cognitive characteristics in mice with a genetic defect that reproduces the phenotype of Duchenne myodystrophy. Materials and methods. To assess the features of motor functions and behavior, Dmd^Del8-34(n=13) and control animals of the wild type (n=12) were subjected to research in the tests "Load retention", "Rotarod", "Elevated plus maze" and "Object recognition". Results. It was found that mice carrying the Dmd^Del8-34 mutation are characterized by a decrease in motor functions, show signs of anxiety, and also show low exploratory activity. The detected features of the cognitive and emotional status are consistent with clinical observations indicating an increased risk of developing autism spectrum disorders and obsessive-compulsive disorder in patients with Dmd gene mutations. Thus, it was proved that from the 8^th week of life, mice of the Dmd^Del8-34 line show a decrease in performance in the Rotarod and Load Retention tests. Behavioral testing in the Elevated Plus Maze test revealed a decrease in time reaching a statistically significant difference compared to the wild-type control at week 12, and when assessing cognitive functions in the Object Recognition test, it was shown that Dmd^Del8-34mice show an increase in the discrimination index value, which is a sign of increased efficiency of hippocampal memory. Conclusion. The study made it possible to identify some behavioral anomalies in genetically modified mice carrying a large deletion of exons 8-34 of the Dmd gene encoding dystrophin.

Objective: to examine the morphofunctional status dynamics of female athletes who had COVID-19 during training in the middle altitude. Materials and methods. The study of the morphofunctional status was conducted in the beginning and at the end of training camps in Kislovodsk at an altitude of 1240 meters. It included 78 elite female athletes during the preparatory period of the training process. We have identified the initial level and dynamics of the functional state of the cardiovascular and respiratory systems, heart rate variability and body composition. We have also carried out a questionnaire of the state and collected medical background about the COVID-19. Results. According to the data obtained, training in the middle attitude did not significantly influence the morphofunctional status of female athletes, both who had and who did not have COVID-19. All indicators were within physiological standards. The functional state dynamics of athletes was mostly connected to the response to mountain hypoxia, which in higher degree is shown in athletes with the third type of the heart rate autonomic regulation. The athletes who were ill with COVID-19 were slightly different (within normal limits) from those who were not in terms of body composition indicators, expiratory volume and rate, as well as blood pressure. The systemic analysis has demonstrated that the factor-based structure of variables of the morphofunctional status of female athletes who were ill with COVID is described with an increased correlation connection between structural and functional indicators, stress of the body’s adaptation. Conclusion. Despite the seemingly favorable morphofunctional status of female athletes, who had COVID-19, in terms of systemic connections it is still characterized with an emergency transitional process of adaptation, during which complication of various diseases is possible. It should be noted by working doctors in sports medicine and coaches working with athletes, especially in the middle altitude conditions.

Objective: to study the morphoscopic and morphometric characteristics of the L_V-S_I intervertebral disc according to magnetic resonance imaging. Materials and methods. The analysis of magnetic resonance imaging of 90 patients (66 men, 24 women) who did not have diseases of the lumbar spine was performed. Various morphometric parameters of the intervertebral disc (IVD) and nucleus pulposus (NP) at the L_V-S_I level were measured using software for processing images created on an MRI machine. The obtained data were compared between men and women, asthenics, normosthenics, hypersthenics and young (from 18 to 44 years old) and middle-aged (from 45 to 60 years old) people. In addition, morphoscopic characteristics were studied: the shape of the IVD and NP in the axial plane. Results. It was found that in normal IVD L_V-S_I is most often represented by elliptical (54,5%) less often kidney-shaped (45,5%) forms. Normally, the NP has an oval (57,8%) and kidney-shaped (42,2%) shape. It was shown that in men, the dorsal height of the IVD, its width, anteroposterior size, square as well as the longitudinal-transverse index of the NP were significantly higher. It has been proven that there are no significant differences in the shape of the IVD between asthenics, normo- and hypersthenics, while the height of the IVD in the center, its ventral, dorsal heights and most lateral IVD height are significantly greater in hypersthenics. It has been proved that the kidney-shaped form of NP was significantly more common in asthenics, and the oval form - in hypersthenics, while the morphometric parameters of NP did not significantly differ between extreme body types. A tendency to a decrease in IVD height in middle-aged people compared to young people was shown. Conclusion. The results obtained are necessary when planning the operation, as well as for the manufacture of rigid implants and artificial discs for arthroplasty and interbody fusion.

Objective: to detect possible causes of calcification of the placenta, identify patterns between excessive deposition of fibrinoid, calcium salts and various disorders in the mother-placenta-fetus system. Materials and methods. 6,089 afterbirths and placental tissue sections were examined, of which 193 specimens complying with the purpose of the study were further studied and divided into three groups (group of biological norm; afterbirths in which there is fibrinoid deposition without accompanying calcification; afterbirths with pronounced deposits of calcium salts). Each section of placental tissue was studied macro- and microscopically according to the method of A.P. Milovanov and A.I. Brusilovsky to reveal structural and functional changes. Statistical processing of the results was performed using methods of descriptive statistics, nonparametric methods: compilation of contingency tables, calculation of Pearson's χ2 test with Yates correction. Results. It was found that all the afterbirths studied had similar macroscopic characteristics. Microscopic examination revealed that calcification contributes to a more pronounced separation of the lobules of the maternal part of the placenta. Various inflammatory, alterative processes, as well as hemodynamic disorders in the placental tissue contribute to the deposition of calcium salts. Conclusion. The involutive processes observed in normal aging of the placenta become most pronounced in various pathological processes in the mother-fetus-placenta system. The study revealed a statistically significant relationship between the number of labor and the appearance of calcifications in the placental tissue. Large focal deposits of calcium salts were more often observed in women who gave birth not for the first time.

Objective: to study changes in immunological parameters in patients with true eczema during complex therapy with the use of upadacitinib. Materials and methods. The work was performed with the participation of 131 patients aged 18 to 70 years (average age 58.7±3.6 years) with a diagnosis of true eczema, who were on inpatient treatment. The patients were divided into 4 groups: the first group received basic drug therapy (BMT), the second - phototherapy (FT) and BMT (BMT+FT), the third - upadacitinib (UPA) and BMT (BMT+ UPA), the fourth - BMT+FT+UPA. The content of IL-1ß, IL-2, IL-6, IL-10, INF-γ, TNF-α in the blood serum of patients was determined by enzyme immunoassay before the start of treatment and 2 and 4 months after its start. Results. Before the start of treatment, the values of IL-1ß, IL-2, IL-6, IL-10, INF-γ, TNF-α in the blood serum of patients in comparison with healthy individuals were significantly increased (3.7-4.2 times) against the background of a decrease in the level of IL-10 (2 times). In patients of the first group, the cytokine level did not change significantly after 2 and 4 months from the start of treatment in comparison with the indicators before the start of treatment. In the second group, at all follow-up periods, the content of IL-10 significantly increased with a decrease in the levels of IL-1ß, IL-2 and IL-6. When using UPA in the third group, the content of IL-10 increased against the background of a marked decrease in all other cytokines studied. The greatest changes were noted in the fourth group during the complex treatment of UPA with FT and BMT: a significantly significant decrease in the levels of IL-1, IL-2, IL-6, INF-γ, TNF-α (by 53-67%, p<0.001) against the background of an increase in the content of IL-10 (by 69%, p<0.001). The preservation of the orientation and severity of the identified shifts after 4 months indicates their stability. Conclusion. In patients with true eczema, the use of upadacitinib as part of complex treatment in combination with basic drug therapy and phototherapy causes a pronounced and prolonged correction of the cytokine profile in the blood.

At the present time the complete loss of teeth is frequent, especially in older age groups, and their rehabilitation with the use of full removable acrylic dentures is not always effective. Objective: to estimate the peculiarities of patients adaptation to the full removable dentures taking into account the jaw strength characteristics and application of adhesive agents to improve denture fixation. Materials and methods. 34 elderly women suffering from the total loss of teeth were under observation. Group 1 consisted of 15 patients, who after fabrication of full removable dentures, during the whole adaptation period did not use any adhesive means for improvement of fixation of removable dentures and group 2 used ASEPTA parodontal cream for fixation of dentures. Indexes of gnathodinamometry and indexes of test with nucleus according to I.S. Rubinov were evaluated in all patients after fitting and application of prosthesis. Results. It has been established, that good jaw strength characteristics (81-105 N), as well as good fixation and stabilization of new dental restorations are determined during rehabilitation of patients with full tooth loss using removable dentures. The study has shown that to optimize the force characteristics of the jaws while using the full removable acrylic dentures and to increase their stability it is possible to use adhesive means for fixing dentures, thus reducing the number of visits for denture correction to 1.25±0.41 and improving gnathodinamometry parameters by 7.21-29.1%. Conclusion. Dental rehabilitation of complete tooth loss with full removable acrylic dentures is quite effective, especially when using removable denture fixation means. The use of the latter requires increased oncological vigilance due to the presence of chronic traumatic lesions of the oral mucosa, proceeding without painful symptoms and being facultative precancer.

The research data revealed the existence of various pharmacological effects of Alchemilla vulgaris herb infusions and confirmed the prospects of introducing these infusions into medical practice. Biologically active substances (BAS) in the Alchemilla herb are of high variability, which adversely affects the phytochemical composition of the infusion and its pharmacological properties. The expansion of the raw material base of Alchemilla is possible due to Alchemilla mollis, which is a micro-specie with a stable chemical composition. Objective: a comparative analysis of the phytochemical composition of infusions of A. mollis and A. vulgaris herbs to assess the possibility of expanding the raw material base of the aerial part due to the cultivated micro-specie A. mollis. Materials and Methods. The objects of the study are A. vulgaris herb infusion (AVI) and A. mollis herb infusion (AMI). The harvesting of raw materials was being produced during the period of mass flowering from cultivated Alchemilla mollis (Buuser) Rothm and wild-growing Alchemilla vulgaris L. s. I. Preliminary qualitative analysis was performed by conventional methods. The content of tannins, polysaccharides, ascorbic acid, and flavonoids were quantified. Results. A preliminary qualitative analysis showed the similarity of the studied infusions, including the presence of phenolic compounds, markers of the genus Alchemilla (caffeic acid, luteolin and quercetin derivatives). The peculiarity of AMI is the predominant content of condensed tannins, which is consistent with the data on the accumulation of this group of biologically active substances in A. mollis herb. Significant higher amounts of tannins (p<0.05) and ascorbic acid (p<0.05) were found in BAS; no differences were found in the amount of polysaccharides and flavonoids. Conclusion. The conducted study indicates the similarity of the chemical composition of the studied infusions, which allows the use of AMI similarly to AVI, and A. mollis herb to expand the raw material base of the herb.

Objective: optimization of extraction conditions for anthraglycosides of alder buckthorn bark, development and validation of a method for their quantitative determination using high performance liquid chromatography. Materials and methods. The object of the study was alder buckthorn bark from different manufacturers. The work was performed on an Agilent 1100 liquid chromatograph complete with a G1311A four-solvent supply and degassing system, a G1315B diode array detector, a G1316A column thermostat, and a G1313A automatic sample injection device. Chromatographic analysis was carried out on a Zorbax SB-C18 reverse-phase column (4.6×250 mm, 5 μm) in a gradient elution mode of the mobile phase consisting of acetonitrile and highly purified water, adjusted to pH 2 with phosphoric acid. Results. As a result of the study, the optimal conditions for the chromatographic separation of anthraglycosides of alder buckthorn bark were determined. The optimal conditions for their extraction have been established: the grinding of plant raw materials is 250 µm, the extractant is ethyl alcohol 40%, the extraction temperature is 80℃, the extraction time is 90 minutes, the ratio of raw materials and extractant is 1:50. It has been proved that the developed method for the quantitative determination of anthraglycosides of alder buckthorn bark is specific, linear, correct, accurate and robust. The stability of the solution of the standard sample of glucofrangulin A and the obtained extract was established. Conclusion. A specific method for the quantitative determination of anthraglycosides of alder buckthorn bark has been developed, which can be used in quality control of this type of medicinal plant material.