Objective - to study the tissue reaction of samples of combined sponge hemostatic agents during subcutaneous implantation in vivo.

Materials and methods. Seven study groups were formed. Under general inhalation anesthesia, male Wistar rats were subjected to a 7-cm-long cut through the skin and subcutaneous fat layers along the paravertebral line on the right. Two pockets were bluntly made in the subcutaneous tissue between the muscle and skin layers on both sides of the cut, 3.5 cm deep, along the entire length of the cut. The studied samples measuring 2 x 2 cm were placed in each pocket. The surgical wound was tightly sutured, capturing the muscle layer in order to isolate the pockets containing the experimental samples. The animals were excised on the 7th, 14th, and 28th days after placement of the HPCS in the subcutaneous fat. An autopsy was then performed, followed by morphological examination. For statistical processing of the results, the median Me [25; 75] was determined. To check the statistical significance, the Kruskal-Wallis criterion was used. The level of p≤0.05 was considered acceptable for experimental biomedical studies.

Results. In experimental group #1 (Na-CMC+15% collagen), an almost uniform distribution of the fibrous layer of the capsule was noted at all observation periods, and in experimental group #2 (Na-CMC+25% collagen), the severity of the fibrous layer of the capsule decreased by the 28th day of the experiment. In experimental group #3 (Na-CMC + 50% collagen), an increase in the thickness of the fibrous layer of the capsule around the studied samples was noted.

Conclusion. Analysis of the obtained data in three series of experiments with subcutaneous placement of a combined sponge consisting of collagen and Na-CMC of increasing concentration showed that an increase in the proportion of collagen relative to the content of CMC in the HPCS leads to an increase in the inflammatory reaction in the area of its placement, which is confirmed by the statistical significance of the differences (p<0.05).

Objective - to conduct an integrated assessment of the main properties of spongy polymer hemostatic agents (SPHA) to select the most optimal option.

Materials and methods. Seven study groups were formed. The study assessed the degree of residual deformation of SPHA under 50% compression, the pore area and fiber thickness of the samples, their hygroscopicity, porosity, adhesion degree and hydrogen index. The next block of studies included in vivo methods. The thickness of the periprosthetic capsule, cellular index and hydroxyproline concentration in the implantation area of the study object were assessed. Hemostatic efficiency was assessed by determining the bleeding time and blood loss in an acute in vivo experiment, as well as the effect of SPHA on the clotting time of donor blood in vitro. The Kruskal-Wallis criterion was used to analyze the significance of differences between the experimental groups. An error value of 5% (p≤0.05 level) was considered acceptable for experimental biomedical studies. The licensed version of Statistica 13 and GraphPad Prism 9.5.1 were used as software.

Results. Ranking of material samples in the experimental, control and comparison groups (from the least to the most positive effect) made it possible to identify the material most beneficial for use in stopping bleeding by summing up their positions. This turned out to be the experimental sample of CMC + Collagen 25%, which scored the maximum sum of ranks - 83.

Conclusion. The maximum number of points according to the results of the integral rank assessment of the parameters of new multicomponent spongy polymer hemostatic agents was received by the sample containing 25% collagen, which allows us to judge the most optimal composition of the HPCS for further implementation in clinical medicine.

Emergency surgical pathology is one of the most difficult and complex problems of clinical surgery. Ulcerative gastroduodenal bleeding occupies a special place in the structure of urgent surgical diseases. A promising technology for improving medical care for patients with ulcerative gastroduodenal bleeding is the use of expert digital algorithms to support medical decision-making.

Objective - to develop a mobile application «Expert digital decision support system for endoscopic hemostasis of ulcerative gastroduodenal bleeding».

Materials and methods. At the first stage of the work, an algorithm for endohemostasis of ulcerative bleeding in the form of a decision tree was developed. However, the decision tree is extremely inconvenient, which has limited the possibilities of its practical application. The development of the mobile application «Expert digital decision Support system for Endoscopic hemostasis of ulcerative gastroduodenal bleeding» (Certificate of state registration of the computer program № 2024680004 RU) allowed to solve this disadvantage of the algorithm.

Results. The developed mobile application «Expert digital medical decision support system Endoscopic hemostasis of ulcerative gastroduodenal bleeding» is a program implemented for smartphones and tablets, which allows on-line and off-line modes to evaluate personalized clinical features of patients with various types of ulcerative bleeding and to give doctors expert recommendations on tactics of emergency endohemostasis and prevention of recurrence of bleeding. The mobile application provides doctors with quick access to an expert algorithm for endohemostasis of ulcerative bleeding, which speeds up decision-making in a limited time, and also allows doctors, relying on this algorithm, to improve the quality of medical care.

Conclusion. Thus, for the first time, the mobile application " Expert digital medical decision support system Endoscopic hemostasis of ulcerative gastroduodenal bleeding» was developed, implemented for smartphones and tablets, allowing to evaluate personalized clinical manifestations of ulcerative gastroduodenal bleeding and provide expert recommendations on patient treatment tactics.

Objective - to evaluate the possibilities of correcting hyperlipoproteidemia (a) in patients with very high cardiovascular risk (SSR) during the use of combined lipid-lowering therapy with PCSK9 inhibitors.

Materials and methods. The present study included 66 patients with ischemic heart disease with very high SSR who did not reach the target ranges of low-density lipoprotein cholesterol (LDL cholesterol) during long-term optimal lipid-lowering therapy. All patients were prescribed a combination of statin, ezetimibe and alirocumab for a duration of 6 months. During treatment, the concentration of lipoprotein (a) (Lp(a)), LDL cholesterol and high-density lipoprotein cholesterol was determined at 6 visits.

Results. A statistically significant decrease in Lp(a) concentration by 21.8% was shown from 22.75 [6.58; 34.78] mg/dl to 17.93 [6.03; 28.31] mg/dl (p<0.001) during therapy. Hyperlipoproteidemia (a) at the screening stage was registered in 40.91% of patients. The target values of LDL cholesterol were reached by 71.21% of the study participants (n=47). LDL cholesterol decreased by 63.21% from 3.86±0.71 mmol/l to 1.42±0.31 mmol/l (p<0.001), high-density lipoprotein cholesterol increased by 30% from 0.7±0.09 mmol/l to 0.91±0.06 mmol/l (p<0.001).

Conclusion. The use of combined lipid-lowering therapy with alirocumab makes it possible to achieve a significant decrease in the concentration of Lp(a) in patients with very high SSR. However, the use of this treatment regimen is possible only in patients who have not reached the target values of LDL cholesterol against the background of long-term optimal lipid-lowering therapy.

The study of the features of higher nervous activity in cyber-dependent individuals and cybersportsmen is relevant because digitalization increasingly covers all areas of our lives, including professional sports.

Objective - to investigate the psychophysiological characteristics of people with cyber addiction and video game-independent students, as well as the impact of prolonged alpha training with biofeedback (BFB) on them to optimize higher brain functions.

Materials and methods. Using a questionnaire, we identified students suffering from video game addiction and cyber-independent students. To assess higher brain functions and coordinated work of motor and sensory processes in subjects to determine their efficiency, warm-up ability, and mental stability, we used Schultz tables and tests for determining visual-motor reaction time. Subsequently, the students underwent prolonged alpha training with biofeedback (BFB). A statistical analysis of the obtained results was conducted, including nonparametric methods for verifying differences' reliability.

Results. During the research, significant differences were found between the psychophysiological indicators of professional gamers and cyber-independent students at baseline, indicating higher reaction speed, psychological resilience, and work efficiency among cyber-oriented participants compared to independent students. Further implementation of prolonged alpha training in both groups showed improvement in test scores.

Conclusion. The results of this study demonstrate the beneficial and optimizing effect of alpha training on cortical and subcortical activity in both gamers and independent students when performing tasks, which allows recommending this method for optimizing higher brain functions also for people in various professions requiring high speed, accuracy, attention, mental productivity, and psychological stability.

Obesity is currently widespread among the working population and is a pressing issue in modern medicine. It has been proven that complications of obesity are caused by the localization of fat accumulation. Ectopic deposition of adipose tissue is observed in the heart, liver, kidneys, muscles, and also in the pancreas. The role of obesity in the development of pancreatic pathologies is currently being actively studied. Pancreatic steatosis is the accumulation of intracellular fat in the organ tissues, which is accompanied by clinical and laboratory changes. In recent years, the term «non-alcoholic fatty pancreas disease» has been used to formulate a diagnosis. Currently, pancreatic steatosis remains a poorly understood problem of modern medicine. It is considered a diffuse process of development of adipose tissue in all part of the pancreas, occurring mainly against the background of metabolic syndrome and combined with sluggish inflammation of the organ under the influence of various damaging factors. Metabolic syndrome develops gradually and for a long time proceeds without obvious clinical symptoms. With a long course and progression, it can lead to the development of lipomatosis of internal organs, in particular, pancreatic steatosis. Disturbance of lipid metabolism is manifested by atherogenic dyslipidemia, in which the concentration of free fatty acids in the pancreatic parenchyma increases significantly, which in turn leads not only to a decrease in insulin activity, but also to dysfunction in cells, mainly to their apoptosis. This clinical analysis will examine the biochemical indicators of the functional state of the pancreas with steatotic degeneration, and also describe the experience of treating non-alcoholic fatty pancreas disease in a patient with metabolically complicated obesity.

Objective - to conduct a comparative assessment of the sorption capacity of polymer enterosorbents and a mineral enterosorbent based on zeolite in relation to priority microelements.

Materials and methods. To determine the sorption capacity, the most widely available biopolymer enterosorbents on the consumer market (based on cellulose, pectin, alginates, chitin and chitosan) were used as objects of study. Polysaccharides were used as biopolymers, the unique property of which is the ability to absorb large amounts of water and form gels in the presence of divalent metal cations. The efficiency of using a mineral enterosorbent based on zeolite was assessed by comparing the sorption capacity. A method for assessing the efficiency of enterosorbents using solutions based on whey, as a typical biological fluid simulating the gastroduodenal contents of the human body, is proposed.

Results. The danger of constant metal intake from various sources of pollution in the territory of a megalopolis is described. To protect the body from polymetallic exposure, the use of the enterosorption method is justified - a therapeutic and preventive measure aimed at stopping the action of toxins of various origins and eliminating them from the body. The use of enterosorbents to correct the microelement imbalance of the body of a megalopolis resident in conditions of polymetallic pollution of the environment is justified. As a result of the study of the selected enterosorbents under the same conditions, it was found that the chitosan-based enterosorbent has the greatest efficiency, the second place is occupied by chitin and pectin-based enterosorbents. The rest of the studied enterosorbents have a significantly lower sorption capacity.

Conclusion. The considered mineral enterosorbent based on zeolite is a weak enterosorbent in relation to essential metals and quite effective in relation to toxic metals, for example, cadmium. That is, the drug belongs to the group of selective enterosorbents. To increase the effectiveness of its use, a combination with more effective non-selective sorption materials, such as activated carbon or chitosan, is necessary.

Metoprolol belongs to beta-adrenoblockers, which are one of the most important classes of cardiovascular drugs, and is considered the basis of therapy in heart diseases such as heart failure and atrial fibrillation.

Оbjective - to develop a method for the determination of metoprolol in biological material.

Materials and methods. The object of the study is metoprolol ((±)-1- [4- (2-Methoxyethyl)phenoxy]-3- (1-methoxyethyl)amino]-2-propanol succinate). The model biological matrices were liver tissue and blood plasma.

Results. To isolate metoprolol from biological material the insistence in two stages with three times by weight amount of chloroform at half an hour duration of each contact of biomatrix and extractant was proposed. The possibility of purification of the analyzed compound isolated from biological objects by extraction and TLC methods was determined. Sufficient efficiency of the proposed purification scheme was shown.

Conclusion. The technique of identification and quantitative determination of metoprolol in extracts from cadaveric material using TLC and UV-spectrophotometry methods has been developed.