Objective - to evaluate the dynamics of hydroxyproline concentrations after subcutaneous placement of various polymeric matrices in an in vivo experiment, which would allow us to determine the characteristics of scar tissue formation during medical device implantation. Materials and methods. The study was conducted on 90 male Wistar rats, divided into three groups. The following samples were used: collagen matrix with glutaraldehyde (CGM), CGM with cultured dermal fibroblasts, and collagen wound healing dressing (CWHD). Implantation was performed into the subcutaneous tissue, with subsequent biopsy samples collected on days 7, 15, and 30. Hydroxyproline concentrations were determined colorimetrically, followed by statistical data processing. Results. The study showed different dynamics of hydroxyproline concentrations depending on the type of implanted material. In the early stages (7 days), the highest values were observed in the CGM with cells (0.562 mg/ml) and CGM (0.56 mg/ml) groups. By day 15, a decrease in the parameters was observed, and by day 30, a reverse trend was observed: in the SCM-cell group, the concentration was 0.129 mg/ml, in the SCM-cell group - 0.133 mg/ml, and in the SCM group - 0.2065 mg/ml. Conclusion. It was established that the matrix with cultured fibroblasts demonstrated the most favorable dynamics of periprosthetic capsule formation, characterized by a decrease in hydroxyproline concentration by the end of the experiment. These results demonstrate the potential of using cell-based technologies to optimize tissue regeneration processes during medical device implantation, which may find application in clinical practice for the prevention of excessive scarring.

The experience of the city and two district general surgical hospitals in providing emergency care to patients with urgent complications of peptic ulcer of the stomach and duodenum in the periods 2003-2005 and 2022-2025 was subjected to a comparative analysis. The priority methods of treatment of perforated gastroduodenal ulcers were open operations from laparotomy access with perforation removal. Laparoscopic technologies are of limited use, the reasons for this are morphological factors of localization and the state of the ulcerative process, as well as organizational and economic (low equipment of medical institutions with appropriate equipment and insufficient training of personnel). Complications decreased by 1.2 times, but mortality increased from 5.4% to 7.3%, i.e. the rejection of the radical anti-ulcer stage did not improve the situation. In the surgery of ulcerative bleeding, the main tactical principle is the priority use of endoscopic methods to stop bleeding. Injection or contact thermal degradation is used as the first stage, and if ineffective, remote argon plasma coagulation is used. The effectiveness of endoscopic "hemostasis" was 96.1%, while the effectiveness of repeated photocoagulation procedures was noted in patients with a high risk of recurrence or manifestation of bleeding, which reduced surgical activity to 5.6%. The priority was open surgical interventions in the amount of excision or stitching of the ulcer (42.4%). Radical, resection methods or duodenoplasty (56.9%). Postoperative complications and mortality were 72.1% and 67.0%, due to comorbid patients with a high degree of surgical and anesthetic risk, but the overall mortality decreased from 7.7% to 3.9%, which indicates positive trends in the treatment of patients with ulcerative gastroduodenal bleeding. To facilitate the performance of operations in the subhepatic and central subdiaphragmatic spaces, as well as for a better examination of the gastric cavity during gastrotomy, the use of multifunctional LED lighting instruments is recommended.

Vertebrogenic lumbosacral radiculopathy is one of the leading causes of chronic pain syndrome and temporary disability in people of working age. A comprehensive approach to assessing quality of life using validated scales allows you to personalize therapeutic tactics and increase the effectiveness of rehabilitation. Objective - to analyze the effect of the neuropathic component of chronic pain syndrome vertebrogenic lumbosacral radiculopathy on various aspects of the quality of life of patients. Material and methods. The cohort study included 60 patients (32 male, 28 female; mean age 47,3±9,8 years) with MRI-verified L4-S1 root compression. All patients were evaluated for the intensity of pain syndrome on a visual analogue scale, functional insufficiency on the Oswestry questionnaire, and the presence of a neuropathic component on the DN4 scale. Statistical analysis was performed using Spearman's test and Mann-Whitney U test. Results. The mean pain score on the visual analogue scale was 6.4±1.8 points (severe pain). The average Oswestry disability index is 47.2±14.3%, which corresponds to a severe degree of functional impairment. The most affected areas were weight lifting, prolonged standing, pain intensity, sleep and social activity. The neuropathic component of pain (DN4 ≥ 4) was detected in 48 patients (80,0%). There was a strong positive association between the presence of the neuropathic component and the degree of functional impairment (r=0,72; p<0.01). Patients with neuropathic pain had significantly higher disability scores according to the Oswestry questionnaire (54.1% versus 35.6% in the group without neuropathy, p<0.001). Conclusion. A comprehensive assessment of quality of life using a visual analogue scale and the Oswestry and DN4 questionnaires allows not only to quantify the intensity of pain and the degree of vital activity limitation, but also to identify a clinically significant neuropathic phenotype associated with a more severe course of the disease. The identification of neuropathic pain in 80.0% of patients justifies the need for routine screening using the DN4 scale and the inclusion of drugs in the therapeutic strategy to improve quality of life.

Objective - to identify approaches to studying the effects of hypoxic exercise (loads) on the cardiovascular system (CVS) in healthy individuals, in patients with high cardiometabolic risks, and in patients with various circulatory diseases, followed by an assessment of the potential of this method as an additional preventive and ther-apeutic-rehabilitative approach to the treatment of cardiovascular diseases. Materials and methods. A thematic and semantic search was conducted across the following databases and information systems: PubMed; Wiley; WoS; Google Scholar; eLIBRARY (until December 2025) to identify randomized controlled trials eligible for inclusion in the review, comparing the effects of chronic hypoxic and normoxic exercise on cardiovascular function in individuals without cardiovascular disease, with high cardiometabolic risk factors, and in patients with cardio-vascular disease. A systematic review was conducted according to the PRISMA 2020 guidelines. The review period was lim-ited to 10 years. Study identification. Exclusion criteria: duplicate records and studies using animal models were removed. Results. Eight randomized clinical trials (RCTs) with a total of 408 participants were selected for inclusion in the review. Search criteria: adults over 18 years of age, clinical and laboratory-instrumental parameters compared before/after: SBPmax, HR, resting blood pressure, EF. Indicators: Hb, SpO₂, blood lactate level, total cholesterol (TC), LDL cholesterol, non-HDL cholesterol, triglycerides (TG), atherogenic index of plasma (AIP), lipid metabolism, and catecholamines. Conclusion. Intermittent hypoxic and hypoxic-hyperoxic training represent a promising non-invasive method for addi-tional prevention and rehabilitation of cardiovascular diseases. Despite the encouraging results, large, multicenter, random-ized trials are needed to standardize protocols and confirm clinical efficacy.

Objective - to identify and analyze the relationship between the level of education, the financial situation of patients who have had CANCER, and the degree of their compliance. Materials and methods. In the period from 05/24/2025 to 01/24/2026, a comprehensive study was planned and conducted on the basis of the neurological department for the treatment and early rehabilitation of patients with cancer at the Smolensk Regional Clinical Hospital, aimed at assessing adherence to therapy in 214 patients (average age 64.8 years, 44.4% of men, 55.6% of women) with ischemic/hemorrhagic stroke and TIA, taking into account their education and financial situation. Compliance was assessed using the Morisky-Green questionnaire (MMAS-4), supplemented with author's questions characterizing the socio-economic status of the respondents. The statistical analysis was performed using the SPSS program. Results. The number of compliant patients was 49 (22.9%), insufficiently compliant 77 (36%), and noncompliant 88 (41.1%). A statistically significant relationship was established between the level of education of patients and their commitment to treatment (p <0.05). People with secondary education predominate in the group of insufficiently compliant (83.1%) - partially complying with the recommendations. People with higher education either strictly follow the recommendations (their share is 25.9%, compared with 21.8% among people with secondary education), or ignore them altogether (51.7% and 37.2%, respectively). There is a significant relationship between income and compliance with recommendations (p <0.05). People with average incomes are most likely to adhere to treatment (65.7%), and among those with high incomes, there are fewer of them (35.3%). Conclusion. The study shows that the problem of compliance with recommendations in medicine remains relevant. The data shows that education and income affect the effectiveness of treatment. To overcome these obstacles, it is necessary to include social support and educational programs in the treatment process, which will require the joint work of the health care system and social protection.

Objective - to evaluate the clinical and pathomorphological features of rare immune-related dermatological adverse events (sarcoid-like, vitiligo-like and scleroderma-like reactions) in cancer patients receiving PD-1/PD-L1 immune checkpoint inhibitor therapy. Materials and methods. An open prospective single-center study included 204 patients treated with PD-1/PD-L1 immune checkpoint inhibitors in 2023-2026. The clinical form was established on the basis of the clinical presentation and histopathological examination. Histopathological examination of skin biopsies (punch biopsy, hematoxylin and eosin staining, light microscopy) was performed in 54 patients. Results. Among immune-related dermatological adverse events, maculopapular, lichenoid and psoriasiform eruptions predominated, whereas sarcoid-like, vitiligo-like and scleroderma-like reactions were rare (vitiligo-like depigmentation - n=3 (5,5%); scleroderma-like reaction - n=2 (3,7%); sarcoid-like reaction - n=1 (1,8%)). Each form reproduced the morphology of the corresponding dermatosis while retaining features of a drug-induced, immune-mediated process: sarcoid-like - non-necrotizing epithelioid-cell granulomas with Pirogov-Langhans giant cells; vitiligo-like - complete absence of melanocytes in the basal layer; scleroderma-like - epidermal atrophy, diffuse dermal sclerosis and hyalinization with loss of skin adnexa. Conclusion. Rare irDAE subtypes display characteristic clinicopathological features and warrant mandatory histopathological verification, which holds both diagnostic and prognostic significance and helps prevent the unwarranted discontinuation of life-saving antitumor immunotherapy.

Objective - to evaluate the association between the fibrinolytic profile and the risk of hemorrhagic complications at 5-8 weeks of gestation following in vitro fertilization (IVF) in an ovulation induction cycle. Materials and methods. A retrospective post hoc study of 21 women with pregnancies achieved via IVF in an ovulation induction cycle was conducted. The fibrinolytic profile served as the independent variable, specifically: concentrations of plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA), and urokinase (uPA), along with the activities of plasminogen, α2-antiplasmin, and thrombin-activatable fibrinolysis inhibitor (TAFI). The dependent variable was the occurrence of hemorrhagic complications at 5-8 weeks of gestation, including subchorionic hematomas (SCH) and/or bleeding. To evaluate the association between variables, a multiple ridge logistic regression was employed, followed by validation and assessment of discriminative capacity via bootstrapping. Results. Subchorionic hematoma without bleeding was diagnosed in 3 women (14,3%), SCH with bleeding in 4 (19,1%), and bleeding without SCH in 3 (14,3%). Consequently, hemorrhagic complications were recorded in 10 women (47,6%). Regression analysis revealed that α2-antiplasmin and plasminogen were the only statistically significant predictors, with odds ratios (OR) of 1,63 (95% confidence interval (CI): 1,15; 2,1; p=0,008) and 1,27 (95% CI: 1,08; 1,41; p=0,012), respectively. The resulting model demonstrated acceptable discriminative capacity, with an area under the receiver operating characteristic curve (AUC-ROC) of 0,77 (95% CI: 0,61; 0,92). Conclusion. This study identified an association between the fibrinolytic profile - specifically α2-antiplasmin and plasminogen levels - and the risk of subchorionic hematoma and/or bleeding at 5-8 weeks of gestation in pregnancies achieved via IVF within an ovulation induction cycle.

Objective - to identify the features of the structural organization of the bone tissue of the alveolar arches of the jaws in healthy females aged 18-25 under normal conditions. Materials and methods. The study was conducted on computed tomography (CT) scans of the oral cavity of 34 females 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 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 of the girls was significantly greater than the thickness of the alveolar part of the mandibula only at the level of the last molar tooth, while the thickness of the spongy substance of the upper jaw was significantly greater than that of the lower jaw at all reference points. The thickness of the compact bone tissue of the lower jaw was found to be greater, both from the vestibule and from the oral cavity itself. The analysis of the thickness of the compact bone tissue of the alveolar process of the upper jaw at the 1st to 4th reference point revealed a pattern of large values of OEVO (incisor - oral cortical plate, canine - equal, first molar - vestibular cortical plate, third molar - oral cortical plate), lower jaw OOVV (incisor - oral cortical plate, canine - the oral cortical plate, the first molar - vestibular cortical plate, the third molar - vestibular cortical plate). 11 correlation dependencies were revealed between the parameters of the upper and lower jaws. The most correlated parameters of the maxilla were the thickness of the cortical plate on the lingual side at the level of the first molar and at the level of the third molar on the vestibular side. They have connections with the thickness of the vestibular cortical plate at the level of the first molar of the lower jaw and with the thickness of the alveolar part of the lower jaw at the level of the medial incisor. Conclusion. A complex structural organization of the bone tissue of the alveolar parts of the girls' jaws was revealed, which is not always reflected by changes in the thickness of the compact and spongy bone tissue.

This review analyzes the biological role and therapeutic potential of three key cell wall components and metabolites of Lactobacillus bacteria: exopolysaccharides (EPS), biosurfactants (BS), and lipoteichoic acids (LTA). The Lactobacillus genus, which has GRAS (generally recognized as safe) status, is widely used in medicine and the food industry for its probiotic properties, but the mechanisms of its protective action are still being actively studied. This paper systematizes data on the functional properties of EPS, which demonstrate a wide range of activity: from antioxidant and antitumor to immunomodulatory and antibiofilm. EPS from various strains is shown to be effective against Helicobacter pylori , rotaviruses, and a number of Gram-negative pathogens, suppressing virulence factors such as violacein and pyocyanin. It is emphasized that EPS functionality is critically dependent on culture conditions and molecular weight. The second component, biosurfactants, are amphiphilic compounds with pronounced anti-adhesive and antimicrobial activity. According to the presented data, BS effectively reduce the biofilm formation of pathogens such as Candida albicans , Staphylococcus aureus , and Streptococcus mutans , and also exhibit antiviral activity against the Epstein-Barr virus. The third component, lipoteichoic acid, plays a key role in immunomodulation by suppressing proinflammatory cytokines and inhibiting the adhesion of cariogenic bacteria and enterotoxigenic E. coli . In conclusion, EPS, BS, and LTA are promising agents for the development of new anti-biofilm and therapeutic agents. However, it is noted that many studies were conducted in vitro and do not fully reflect in vivo conditions, requiring further investigation to expand the applications of lactobacilli in medicine and biotechnology.

Objective - to develop a methodology for the total content of flavonoids in the herb of Agastache rugosa by differential spectrophotometry. Materials and methods. The object of the study was dried grass Agastache rugosa, grown in the Penza region. Quantitative determination was performed by differential spectrophotometry at a wavelength of 385 nm using cinaroside as a standard. Results. Optimal conditions for flavonoid extraction have been established: 70% ethyl alcohol extractant, 1:50 ratio of "raw material - extractant", extraction time - 60 minutes, degree of grinding of raw materials - 1.0 mm. The amount of flavonoids in terms of cinaroside was 2.80±0.06%. A validation assessment of the methodology was carried out in terms of linearity, precision and accuracy; the relative error of a single determination with a confidence probability of 95% is ±2.68%. Conclusion. The developed technique can be used to standardize the herb mulberry as a promising source of flavonoids. This technique makes it possible to evaluate the quality of Agastache rugosa by the content of one of the main groups of active substances - flavonoids.

The problem of accumulation of radionuclides in medicinal plant raw materials is multifaceted and requires a deep understanding of the physicochemical and biological mechanisms underlying their migration in the soil-plant-drug system. Therefore, regional monitoring is needed to study the radioecological situation, including the analysis of not only man-made, but also natural radionuclides. Objective - to study the peculiarities of accumulation in plant resources of the flora of the Voronezh region of potassium-40. Materials and methods. A number of widespread species were selected for the study, including bird highlander grass (Polygonum aviculare L.), wormwood (Artemisia absinthium L.), yarrow (Achillea millefolium L.), motherwort five-lobed (Leonurus quinquelobatus Gilib.), plantain leaves large (Plantago major L.) and dioecious nettles (Urtica dioica L.), heart-shaped linden flowers (Tilia cordata Mill.) and common tansy (Tanacetum vulgare L.), the roots of dandelion medicinal (Taraxacum officinale F.H.Wigg) and burdock large (Arctium lappa L.). In parallel, soil samples were taken from a depth of 0-20 cm to assess the background content of radionuclides. Measurements of potassium-40 specific activity in soil and plant samples were performed using the RADEK MKGB-01 spectrometer. Results. Statistical analysis revealed the presence of a strong positive correlation between the specific activity of the radionuclide in the soil and in plant raw materials. This allows us to assert that the main way potassium-40 gets into the raw materials is its absorption from the soil. With an increase in the specific activity of potassium-40 in the soil, its specific activity in plant raw materials increased. The unevenness of the distribution of the radioisotope in various plant organs has been established. Potassium-40 is most concentrated in the leaves and grasses of the analyzed species. Conclusion. The results of the study demonstrate the need to take into account regional features and industrial history of the area when assessing the quality of medicinal plant raw materials, in particular, in relation to natural radionuclides, and can also be used in the development of regional standards for its quality.