Objective - the aim of the study is to analyze changes in arterial vascular wall stiffness in patients with lower extremity obliterating atherosclerosis in the immediate postoperative period after angioplasty with stenting of the iliac segment.

Materials and methods. The analysis of the treatment of 22 male patients with atherosclerotic lesion of the aorto-iliac arterial segment, II B-III degree of chronic arterial insufficiency of the lower extremities according to R. Fontaine - A.V. Pokrovsky, who underwent angioplasty with stenting of the iliac arteries. The control group consisted of 21 male volunteers who were considered to be in good health. The study of arterial wall stiffness included the measurement of the CAVI (cardiac-ankle vascular index) before treatment and on the 5th day after endovascular revascularization of the iliac segment.

Results. In patients with obliterating atherosclerosis of the lower extremities with damage to the aorto-iliac arterial segment, there was an initial increase in arterial wall stiffness (7.16±0.34) compared to the control group (5.63±0.11, p<0.05). Angioplasty with iliac artery stenting leads to an increase in arterial vascular wall stiffness. There is a statistically significant increase in the CAVI index after surgery compared to the data before surgery (8.51±0.35, p=0.0087). There is a significant direct correlation between the initial value of the CAVI index before surgery and its change after endovascular revascularization (r=0.55, p<0.05).

Conclusion. The presence of a relationship between the arterial vascular wall stiffness before and after angioplasty with stenting of the iliac segment has been shown. The assessment of the arterial vascular wall stiffness can be included in the diagnostic algorithm of non-invasive examination of patients as a tool for dynamic monitoring of endovascular revascularization.

The high frequency of the combination of arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) is due to a number of close pathogenetic relationships: the formation of endothelial dysfunction, increased free radical oxidation processes, оxidative stress and chronic systemic inflammation exacerbate hypertension and the risk of cardiovascular complications. In this regard, the use of the antihypoxic cytoprotector meldonium, which has an angioprotective effect, seems justified.

Objective - to evaluate the relationship between the degree of bronchial obstruction and the parameters of the daily blood pressure profile in patients with hypertension combined with COPD during complex therapy including meldonium.

Materials and methods. The study included 80 patients aged 35-67 years (48.3±5.1 years) with stage 2 hypertension and myocardial ischemia during intense physical exertion. Of these, 40 cases had hypertension combined with moderate COPD with impaired respiratory function (FER). Patients were randomized into 4 groups based on the presence or absence of COPD and the nature of drug therapy: Group 1 - patients with hypertension without comorbidities who used only traditional therapy (n=20); Group 2 - patients with hypertension + COPD who used only traditional therapy (n=20); Group 3 - patients with hypertension without concomitant diseases who received meldonium in addition to traditional therapy (n=20); Group 4 - patients with hypertension + COPD who received meldonium in addition to traditional therapy (n=20). At inclusion in the study and after 6 months of therapy, the parameters of respiratory function and daily blood pressure profile (DBP) were assessed.

Results. Before the study, the FEV1 values of patients with AH were within the normal range. In patients with AH combined with COPD, the FEV1 parameters characterizing bronchial patency were significantly reduced, indicating the presence of bronchial obstruction.The inclusion of meldonium in complex therapy in a group of patients with hypertension in combination with COPD was accompanied by a significant increase in FEV1, as well as an increase in the FEV1/VC ratio (p<0.05). At baseline, the parameters studied were above normal. By the sixth month of observation, a decrease in PDBP was observed in all groups during therapy. Patients receiving meldonium along with standard therapy demonstrated a more pronounced decrease in PDBP compared to those receiving traditional therapy.

Conclusion. It has been established that the addition of meldonium to standard therapy in patients with hypertension and COPD leads to a more pronounced improvement in bronchial patency, manifested by a significant increase in respiratory function parameters: FEV1 and FEV1/FVC. The use of meldonium in patients with hypertension and COPD during combination therapy is associated with a more pronounced reduction in BP.

Uncontrolled bleeding is one of the most current problems in both hospital and military field surgery. There is a wide range of available hemostatic agents in modern medical practice to solve this challenging issue.

Objective - to study the effectiveness of arterial bleeding control using a hemostatic powder composition based on a chitosan-collagen complex.

Materials and methods. The experiment was conducted on 45 male Wistar rats, which were equally divided into three groups, such as a control group (modelling arterial bleeding without using the drug), an experimental group (a produced composition based on a chitosan-collagen complex), and a comparison group (Celox hemostatic powder). The animals underwent abdominal aortotomy followed by non-hermetic suturing of the wall. Then hemostatic powder was applied to the damaged vessel wall followed with tamponade. During the study it was determined the volume of blood loss, the time to complete cessation of bleeding and the volume of powder expended. Animals were withdrawn from the experiment immediately after the intervention and manipulation. It was used a section of the abdominal aorta in the frame of intact tissues as the autopsy specimen for modeling and exposure to samples from the study groups. Histological examination was performed using standard methods. The statistical significance of differences between groups was determined using the Mann-Whitney test (p≤0.05).

Results. The experimental results revealed a significantly lower blood loss in the experimental group compared to the comparison group, which was 58.82% lower. Another important indicator was the time required to completely stop bleeding, which was 37.5% shorter in the experimental group compared to the comparison group. The third parameter studied was the required volume of the expended powder, which was also significantly lower for 45.45%, so it also demonstrated the higher efficacy of the developed composition compared to its analogue and control.

Conclusion. Based on the obtained results, as well as the histological examination, it can be concluded that the developed powder composition is an effective hemostatic agent for vascular wall damage, required further studies to confirm its safety.

All over the world, artificial intelligence is becoming increasingly widespread in clinical medicine, which contributes to improving diagnosis, treatment and prevention, as well as reducing morbidity and mortality. In surgery, the development and implementation of artificial intelligence is slower than in other areas of modern medicine.

Objective - to to study the historical aspects of the development of artificial intelligence and modern directions of its application in the diagnosis and treatment of surgical diseases.

Materials and methods. The analysis of literary data was carried out in the search engines Pubmed, Google Scholar, Scopus with a depth of coverage of publications of 10 years.

Results. This article presents the latest data on the use of artificial intelligence for making diagnoses, analyzing and subsequently interpreting the results of examinations, the operation of robotic systems, planning and determining the tactics of surgical intervention. The advantages, disadvantages and modern challenges of using artificial intelligence technologies in medicine are considered.

Conclusion. Despite the fact that currently the introduction of artificial intelligence into medicine and, in particular, into surgery is facing a number of specific problems and difficulties, it can be assumed that in the coming years artificial intelligence will become one of the components of an integrated approach to patient treatment. At the same time, it is important that surgeons understand the basic principles of artificial intelligence and participate in their development. Keywords: artificial intelligence, artificial neural networks, machine learning, surgical diseases, digital networks, model, information, efficiency, patient.

Objective - analysis of the structure of neurological pathology in pregnant women of the Smolensk region.

Material and methods. A retrospective analysis of the medical records of pregnant women, women in labor and maternity patients examined by a neurologist due to complaints of neurological disorders characteristic of them, as well as existing neurological diseases in the anamnesis or debuted into a real pregnancy in 2019 and 2023.

Results. The total number of pregnant patients with a neurological diagnosis was 407 in 2019, which accounted for 8.1% of all hospitalizations in the Perinatal Center, in 2023 - 431 cases (9.3%). The study shows the structure of neurological pathology: dorsopathies, primary and secondary headaches, mono- and polyneuropathies, epilepsy, multiple sclerosis, vestibulopathy and others. A statistically significant decrease in the incidence of post-puncture headaches in 2023 compared to 2019 (p = 0.032) was revealed, while the incidence of migraines increased (p = 0.023). Possible causes of the described changes are considered. There is a low incidence of thromboembolic complications of pregnancy and childbirth (less than 1% of cases), which indicates a clear organization of the prevention of these complications as a result of careful obstetric and therapeutic monitoring during pregnancy and timely delivery.

Conclusion. The study demonstrates the structure of neurological pathology among pregnant women in the Smolensk region. Based on the presented data, niches are opened that require deeper knowledge and understanding of the pathological processes occurring during pregnancy.

Objective - to study the associations of total blood cholesterol with body mass index and waist circumference in people aged 20-75 years.

Materials and methods. 442 men and 608 women aged 20-75 years were examined. Body length, body weight, waist circumference and hip circumference were measured. Anthropometric indices were calculated: waist-to-hip ratio, waist-to-length ratio, and body mass index. The level of total cholesterol in fasting blood was determined using an SD LipidoCare express analyzer.

Results. The median values of total cholesterol were 4.6 [3.8; 5.4] mmol/L in men and 5.0 [4.2; 5.8] mmol/L in women, with statistically significant differences (p=0.0002). Overweight and obesity, defined by body mass index, were found in 58.8% of men and 55.4% of women, while waist circumference was estimated at 42.8% and 51.3%, respectively. The increase in body weight was accompanied by an increase in the level of total cholesterol in blood plasma in both sex groups. There were no statistically significant differences in total cholesterol levels in overweight and obese individuals. The chances of developing hypercholesterolemia are higher in the case of abdominal obesity, compared with overweight and obesity, estimated by body mass index.

Conclusion. The most significant prognostic predictors of hypercholesterolemia are the index of the ratio of waist circumference to body length and increased values of waist circumference.

Objective - to summarize the available data on current views on the role of risk factors in the development of cardiovascular diseases.

Materials and methods. The search and analysis of sources in the Pubmed, e-library and cyberleninka databases were carried out by keywords: "risk factors for cardiovascular diseases", "arterial hypertension", "obesity", "dyslipidemia", "smoking", "hyperuricemia", "depression". The search years are 2017-2025. This descriptive review includes generalized and systematized data from 51 sources: current clinical trials, reports, and systematic reviews.

Results. The continuing high mortality rate from cardiovascular diseases determines the tendency to find ways to minimize it. It has been determined that the possibility of influencing risk factors can further prevent up to 80% of premature deaths and the burden of cardiovascular diseases. This review analyzes risk factors such as gender, age, hypertension, dyslipidelia, elevated body mass index, smoking, mental illnesses, and their contribution to the development of cardiovascular complications. It has been shown that in women, psychoemotional disorders, increased body mass index, hypertension, dyslipoproteinemia are most common, and for men, smoking and low levels of low-density lipoproteins are more common risk factors. The development of cardiovascular pathology is directly dependent on the age of the subjects. The presence of hypertension, depression, and obesity significantly worsen the prognosis and affect mortality rates from cardiovascular diseases. Smoking causes changes in the vascular wall, and as a result, atherosclerosis. Smokers have a higher risk of developing dyslipidemia, the link between cardiovascular diseases and hyperuricemia lies in the oxidative effects of uric acid, the development of endothelial dysfunction and local inflammation, which in turn contributes to the development of arteriosclerosis and aggravation of the course of existing cardiovascular diseases.

Conclusion. The study of risk factors requires closer attention due to the need to find ways to influence them to reduce mortality, morbidity and disability.

Objective - to identify the features of the structural organization of the bone tissue of the alveolar arches of the jaws in healthy males aged 18-25 under normal conditions.

Materials and methods. The study was conducted on computed tomography (CT) scans of the oral cavity of 32 males aged 18-25 with a full dentition including the third molar, orthognathic permanent occlusion, and centric occlusion. Using onDemand3dCommunicator software, the following parameters were measured on reconstructed scans of the jaw images: the thickness of the vestibular and oral cortical plates, the thickness of the cancellous bone, the total thickness of the alveolar part of the mandible and the alveolar process of the maxilla, the half-width of the palatine process, and the half-width of the maxilla and mandible at four reference points: at the level of the distal edge of the medial incisor, the canine, the first molar, and the third molar. Non-parametric statistical methods were used, including Spearman's correlation analysis.

Results. The thickness of the alveolar process of the maxilla was found to be significantly greater than the thickness of the alveolar part of the mandible at the 1st and 3rd reference points. At the level of the last molars, the alveolar part of the mandible was significantly thicker than the alveolar process of the maxilla. The thickness of the compact bone tissue of the jaws-the vestibular cortical plate on the mandible-increases towards the posterior (chewing) teeth. A statistically significant predominance of the thickness of the compact bone plate of the mandible over the maxilla was revealed on the oral side at the 1st, 3rd, and 4th reference points, and on the vestibular side at the 3rd and 4th reference points. The structural organization of the alveolar sections of the jaws was found to be complex. The maximum number of correlations was identified between the thickness of the alveolar part of the mandible and its vestibular cortical plate with the studied parameters of the maxilla. Within the structure of the maxilla, the maximum number of significant correlations was found for the thickness of the vestibular cortical plate and the cancellous bone.

Conclusion. The correlation pattern indicates a mutual influence of the jaw parameters on each other and their greater interdependence at the level of the medial incisor and the last molar. In both cases, the vestibular cortical plate of the compact bone tissue was the most correlated parameter.

Diagnosis of triple-negative breast cancer (TNBC) is challenging due to its low differentiation and the lack of reliable markers. Existing markers (Mammaglobin, GATA-3) possess insufficient sensitivity and/or specificity for the differential diagnosis of TNBC, especially in metastatic disease.

Objective - to compare the expression of NIS (sodium-iodide symporter), Mammaglobin, and GATA-3 in TNBC to evaluate the rationality and effectiveness of using NIS as a diagnostic marker.

Materials and methods. Retrospective study (n=161) of TNBC biopsy samples using immunohistochemical analysis (IHC) to assess the expression of NIS, Mammaglobin, and GATA-3.

Results. NIS showed the highest sensitivity (70.0%) compared to Mammaglobin (31.0%) and GATA-3 (63.7%). Combined use of NIS and GATA-3 achieved a sensitivity of 82.5%.

Conclusion. NIS is a promising marker for the diagnosis of TNBC, especially in combination with GATA-3.

Objective - to determine the dental and somatic status of residents of Kursk and the Kursk region.

Materials and methods. A dental examination and a study of concomitant somatic pathology were performed in 613 dental patients (198 men and 415 women) aged 18 to 89 years, permanently residing in Kursk and the Kursk region (the cities of Zheleznogorsk and Kurchatov). The data was processed statistically.

Results. The results obtained made it possible to identify the features of the condition of the hard teeth tissues and periodontal tissues, the hygienic condition of the oral cavity in residents of the Kursk region belonging to different age groups, as well as to determine the effect of the somatic status of patients on the level of dental morbidity.

Conclusion. The conducted research is the theoretical basis for the development of therapeutic and preventive measures aimed at improving the dental health of the population, taking into account concomitant somatic diseases and regional living conditions of patients.

Objective - the research of morphological changes in bone marrow, thymus, and spleen in experimental postmenopausal osteoporosis and its treatment with resveratrol.

Material and methods. The study was performed on 15 female Wistar rats. A model of postmenopausal osteoporosis was created by bilateral ovariectomy with a follow-up period of 28 days. Resveratrol therapy in the experimental group was administered daily intraperitoneally at a dose of 2 mg/kg for the same period of observation. Histological and densitometric examinations of the proximal femur, as well as histological and immunohistochemical examinations of the thymus and spleen with computer image analysis and morphometry, were performed.

Results. Bilateral ovariectomy in experimental animals, Wistar rats, 4 weeks after ovariectomy, together with osteoporotic lesions, leads to increased proliferation of cortical thymocytes, accompanied by activation of the reticuloepithelial microenvironment, increased migration of activated (CD45RO+) thymocytes to the spleen, and activation of B-lymphocytopoiesis in the bone marrow and spleen. Resveratrol therapy reduces the severity of morphological manifestations of T- and B-cell activation in the immune system.

Conclusion. In experimental animals, Wistar rats, hypoestrogenism for 4 weeks caused morphological changes in the bone marrow, thymus, and spleen, indicating T- and B-cell activation in the immune system. Resveratrol therapy during the period of estrogen deprivation, along with its osteoprotective and osteoreparative effects, has a negative modulatory effect on immune structures, which may be one of the ways to reduce the osteoreзорбтивной activity of osteoclasts.

Objective - to evaluate the pharmacological potential of inhibitors of lipopolysaccharide biosynthesis in interrupting the pathogenesis of aggressive periodontitis.

Materials and methods. The study included 60 patients diagnosed with aggressive periodontitis. The patients were randomized into two groups: the main group (n=30) received therapy with lipopolysaccharide biosynthesis inhibitors, while the control group (n=30) received standard treatment consisting of occupational hygiene and anti-inflammatory measures.

Results. The study of the effectiveness of lipopolysaccharide biosynthesis inhibitors in the treatment of aggressive periodontitis showed significant changes in inflammatory and microbiological parameters, as well as in the structure of periodontal tissues.

Conclusion. Inhibitors of lipopolysaccharide biosynthesis have shown a pronounced pharmacological effect in the treatment of aggressive periodontitis, including reduction of bacterial load, suppression of inflammation, improvement of periodontal tissue and regeneration of bone structure.

Objective - to provide anatomical features of the coronary sinus (CS) in the human fetal heart.

Materials and methods. We examined 43 heart specimens using an Olympus SZX2-ZB10 stereomicroscope (magnification 4.725-45) to measure CS dimensions, analyze its valve, and assess intimal surface morphology. We studied the microscopic anatomy of the CS walls using hematoxylin-eosin, Masson trichrome, van Gieson staining, and scanning electron microscopy.

Results. The CS originated at the midpoint between the left pulmonary surface and the cardiac "crux". Its length increased from 6.26 mm (16-22 weeks) to 12.63 mm (23-36 weeks), showing a strong correlation with ventricular complex length (Rs=0.88; p<0.05). In 70% of cases, we observed that CS width expanded along the blood flow direction, reaching 1.84 mm (16-22 weeks) and 2.62 mm (23-36 weeks) near the "crux". At the transition from the great cardiac vein to the CS, we consistently identified an ostial valve, formed by a fold and/or ridge. We detected a valve at the CS orifice in 19 out of 20 specimens. The CS received 2 to 6 tributaries (median: 4), including 2-3 inferior left ventricular veins and 1-2 posterior left atrial veins. The middle cardiac vein, the largest tributary, appeared as a single vessel in all cases. A myocardial "sleeve" surrounded the CS, defining its wall thickness and typically displaying two muscle layers: longitudinal and circular. Some specimens showed intimal folds aligned with blood flow.

Conclusion. The study showed that the human fetal coronary sinus exhibits both consistent anatomical features and individual variations in size, valve structure, and wall histotopography.

In the pathogenesis of hypertension, stress-induced Hsp70 family chaperones and the transcription factor NF-κB, which regulates inflammatory and immune responses, play key roles.

Objective - to assess the effects of normobaric intermittent hypoxic therapy combined with stimulated hypercapnia on immunological parameters in patients with stage I hypertension.

Materials and methods. 160 men aged 35-50 years with stage I hypertension were examined. Serum concentrations of Hsp70, interleukins IL-6, IL-10, TNF-α, and NF-κB levels in blood mononuclear cells were measured by solid-phase ELISA before and after the hypoxic therapy course.

Results. After an 18-day course, patients showed significant decreases in Hsp70 from 3.65±0.24 to 2.95±0.23 ng/mL (p<0.05) and NF-κB from 5.67±0.31 to 4.45±0.36 ng/mL (p<0.05), along with normalization of the cytokine profile: IL-6 and TNF-α decreased from 7.21±0.31 to 6.34±0.22 pg/mL (p<0.05) and from 4.63±0.34 to 3.56±0.27 pg/mL (p<0.05), respectively, while IL-10 increased from 2.41±0.18 to 3.18±0.26 pg/mL (p<0.05). Significant positive correlations were found between IL-6, TNF-α, and blood pressure levels. Oxidative stress was attenuated, with a decrease in malondialdehyde and increased activity of antioxidant enzymes.

Conclusion. In patients with stage I hypertension, the combination of intermittent hypoxic therapy and stimulated hypercapnia reduces Hsp70 and NF-κB, normalizes the cytokine profile, and lowers oxidative stress, confirming its immunomodulatory and anti-inflammatory effects.

Objective - validation of the developed method by HPLC for the quantitative determination of risperidone and paliperidone for the purposes of chemical-toxicological studies and drug therapeutic monitoring.

Material and methods. The objects of the study were standard samples of risperidone and paliperidone, model mixtures for the preparation of model and blank solutions.

Results. During the validation process, the specificity and separation ability of the method for the determination of risperidone and paliperidone were evaluated. The metrological characteristics were evaluated for the following validation parameters: linearity, correctness, and precision. The correlation coefficient was more than 0.99, and the openability is in the specified range. The calculated data meets of parameter convergence correspond to the specified criteria.The limit of quantification for both substances was 1 µg/ml.

Сonclusion. The validation of the method for the quantitative determination of risperidone and paliperidone with their combined presence in model mixtures, as well as individually for the purposes of chemical and toxicological analysis and drug monitoring for a number of parameters was carried out.

When evaluating the risk of elemental impurities for which no permitted daily exposure (PDE) has been established, but which are present in a medicinal product, it is necessary to comply with requirements regarding the permitted content of such elements as specified in the relevant regulatory documents. The elements with undefined PDE are characterized by reference exposure doses (RfD), exceeding which is associated with a non-carcinogenic risk.

Objective - based on a generalization of requirements from regulatory documents of manufacturers of human albumin, blood clotting factors and insulin, to permissible content of elements with undefined PDE, assess the non-carcinogenic risks of their negative effects on the human body.

Materials and methods. The object of the study is the regulatory documentation of manufacturers of human albumin, blood clotting factors and insulin, materials from national and regional pharmacopoeias, the State Register of Medicines. The work used an information-analytical research method.

Results. An analysis and generalization of the requirements of regulatory documentation from manufacturers regarding the permissible content of elements with undefined PDE (K, Na, Al for albumins; Ca, Na, Al - for human blood clotting factors; Zn - for insulins) and corresponding methods for their determination was conducted. An assessment of non-carcinogenic risks of adverse effects was carried out for Al and Zn.

Conclusion. It was established that the impact of Al and Zn on human health when consuming maximum therapeutic doses of these drugs is characterized as acceptable and does not pose a risk of developing non-carcinogenic effects. The use of a pharmacopoeial method for determination of Al in albumin leads to the risk of obtaining false negative results.

Objective - study the anti-inflammatory activity of a 10% mild dosage form for topical application of red-stem buckwheat on a model of formalin edema of the hind paw of rats.

Materials and methods. The object of the study was a dry extract of red-stem buckwheat. Confirmation of the presence of flavonoids in the dry extract was carried out by thin-layer chromatography. Quantitative determination of the total content of flavonoids, in terms of rutin, was carried out by differential spectrophotometry. The anti-inflammatory activity of red-stem buckwheat extract was studied using the "acute formalin edema" model in white Wistar rats.

Results. According to the results of the study, it was proved that the dry extract contains flavonoids (rutin, quercetin, isoquercetin), the total content was 8.03%. When buckwheat extract was applied topically as a 10% gel to the affected area for 3 days after modeling formalin edema of the rat's hind paw, it had a pronounced decrease in inflammatory edema by 70.37% (p<0.05), comparable to the effect of 5% diclofenac sodium gel 74.07% (p<0.05) and surpasses the effect of dimexide gel by more by more than 30% (p<0.05).

Conclusion. The data obtained as a result of the experiments indicate the prospects for further development of dosage forms with red-stem buckwheat extract.