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The review represents an analysis of recent year publications in connection with preventive and therapeutic use of postbiotics (PB). Postbiotics are widely used as immunomodulators, anti-inflammatory agents, protectors and the normalizers of metabolism of the open cavity mucosal biotopes, liver, brain and other organs, tissues and innate immunity cell populations that co-function to intestinal microbial metabolites as a network (cofunction within a number of metabolic axes “intestine-other locations”). They act in combination with other effectors as auxiliary agents prolonging the effect of drugs and supporting them. Prophylactic and therapeutic uses of PB are directed against groups of intestinal infection diseases, hepatitis, tumors, neurodegenerative brain disorders, other metabolic disorders and pathologies. New aspects of research of PB include the study and application of recognizing and binding therapeutic PB according to and in connection with a network of “Probiotic lectins—Glycoconjugates” interactions. The data indicate the prospects of a search and application of the new groups and combinations of PB directed at glycoconjugate exposed targets in accompanying and supportive therapy. Probiotic bifidobacteria, lactobacilli, baker’s yeast and probiotic lectins are perspective resources of synergistic sets of metabolite-cellular PB against diseases, pathologies and groups of infections.

The main dominated factors and strategies of non-antibody immunity (the human innate and others, microbial probiotic) aimed at maintaining and strengthening health in connection with the pandemic disease COVID-19 are considered and currently systematized. An integrated current evaluation of the non-antibody immunity is given and preventive and therapeutic approaches to its use for combating diseases accompanying COVID-19 (or on the it’s background) are indicated. Innate immunity is considered as the basic and deep support for the antibody level immunity as the higher and super-structure. The concept of increasing sensitivity to be infected with COVID-19 in population groups depending on the presence and/or the progress of spectrum pathologies and diseases and in connection with the waves of the pandemic COVID-19 is proposed.

The overview focuses on our own data on the use of water-soluble glycoconjugates (www.lectinity.com) based on a linear polyacrylamide chain in relation to recombinant therapeutic human protein hormones and probiotic recognition proteins such as enzymes and lectins. The results obtained characterize the basic principles of multilevel relationships between proteins and glycoconjugates, including the assembly of complexes and nanoparticles on the solid phase. Prospects for the application of these principles and cases of interaction of proteins and glycoconjugates, including taking into account the participation of enzymes, in the study of human proteins and viruses, are noted. The presented data can help in development of the protective network communication systems as well as new combined preparations against infections and pathogens. These data can serve the keys to be applied in medical biotechnology.

New aspects of human mucosal cavity protection systems are under consideration. On the basis of own data it was suggested that mucosal cavities function as mucosal organs. New players of mucosal organ were proposed. They included system probiotic lectins and probiotic microorganisms, and system synthetic polymeric multivalence pattern glycoconjugates. Lectins and glycoconjugates (mucin-like or imitating, antigens, polysaccharides and other high molecular mass metabolites and postbiotics) were suggested to communicate to other glycoconjugates-recognizing molecules and receptors of the human higher hierarchic protection systems. Concept of functioning mucosal organs is supported by own proposals, strategies, approaches, methods and algorithms. The data are useful for constructing biotope ordered pro/synbiotic microbiocenoses for application in medical biotechnology.

Modern digital healthcare, biophysics and biology create new problems that stimulate the development of a new biophysical circuit and mathematical models from nuclear fusion (nuclear medicine) to genomic cell-organizational prognosis in neurophysiology, neuroendocrinology, psychoneuroimmunology and psychoneuroimmunoendocrinology. In this case, the following are effectively used: deterministic, stochastic, hybrid, multiscale modeling methods, as well as analytical and computational methods. The solution of a genetical-mathematical problem of interaction of cages of human population and virus population in relation to COVID-19 pandemic problem is submitted. A mathematical model based on the Hardy-Weinberg law is used, consisting of two interdependent differential equations. The equations reflect the temporal dynamics of the cells of human and viral populations during their interaction. Solutions of differential equations were found and the results of these solutions were analyzed. The pandemic duration is estimated using parameters of human liver cells and influenza virus. Perspective of further development of psychoneuroimmunology as interdisciplinary science, through algorithms and routing of digital health care, with expansion of psychoneurocommunications of professional interests in medicine, economics, sociology, cultural studies is shown. Modern neurobes and neuromarketing are built around Homo sapiens within a “reasonable environment” — a healthy individual space.

Circadian stress causes dysregulation of brain Homo sapiens software followed by impairment of the cognitive and visceral brains. The body’s circadian rhythms are programmed with a system of circadian genes. Circadian clock and circadian system — are the biophysical and biochemical regulators of immune protection. Circadian synchronization system is an evolutionary software product of biocomputer for survival and preparation of the organism for expected cyclic challenges, different epigenetic orientation. Understanding the temporal relationship between stressors and stress reactions is critical to understanding the molecular foundations of the physiology and pathogenesis of the disease. Chronic stress and circadian mismatch trigger a cascade of failures in the functioning of neurophysiological, neuroendocrine, and psychoneuroimmune mechanisms. Epigenetic loading and allostatic overload reduce both the body’s overall workability and its physical, occupational, and cognitive components. Circadian stress has a pathological effect on a person, in all his age periods of life. The level of disease exposure depends on the stability of the body’s protective systems. In the works of N. P. Romanchuk, it is established that modern solution to the problem of rehabilitation of cognitive brain H. sapiens with the use, on the one hand, tools and technologies of artificial intelligence, and on the other — multidisciplinary interaction of neurophysiologist with clinical universal specialist in the field of neurology, psychiatry, psychotherapy, psychoanalysis, and geriatrics. Modern artificial intelligence technologies are capable of much, including predicting cognitive disorders and cognitive disorders, through combined and hybrid neuroimaging, next-generation sequencing, etc., with the aim of initiating timely and effective rehabilitation of brain H. sapiens. Chronotherapy and psychochronobiological strategies to protect various groups and categories of the population from the effects of circadian stress allow blocking the transition of cognitive disorders to cognitive disorders. The skin is a unique synchronized near interface of the skin-circadian system, and the condition of the skin of the face and hands is an individual indicator (biomarker) of the effect of chronic circadian stress on accelerated (premature) aging of the human body.

Small intestinal obstruction is a very rare complication of gallstone disease. It occurs when large stones are found in the gallbladder for a long time, which penetrate into the lumen of the duodenum through the cholecysto-duodenal fistula. Obstruction is more often observed in the terminal part of the ileum. The clinic is atypical and has a two-phase character. At the beginning of the disease, the clinic resembles acute cholecystitis, and then the clinical picture of acute intestinal obstruction develops. With the viability of the small intestine, the enterolithotomy is the optimal operation.

The article is dedicated to the 85th birthday of the famous scientist, honored worker of science of the Russian Federation, honored worker of science of the Republic of Mordovia, honored doctor of the Republic of Mordovia, laureate of State prize, head of the scientific-pedagogical surgical school, doctor of medical Sciences professor Piksin Ivan Nikiforovich. I. N. Piksin is the author of fundamental studies of the biomedical effects of quantum radiation at the molecular, cellular and organismal levels in patients with acute destructive diseases of the lungs, purulent-septic diseases, lactational mastitis and other pathologies. The team of the scientific-pedagogical school led by I. N. Piksin explores the problems of diagnosis and treatment of gastroduodenal bleeding, mechanical jaundice, pancreatitis, suppurative diseases of the lung and pleura, surgical diseases of the heart, blood vessels, prevention of complications of limb injuries, diabetes and diabetic foot care, pediatric orthopedics. Under the leadership of I. N. Piksin, new minimally invasive technologies have introduced: transthoracic drainage and rehabilitation therapy of purulent cavities of the lung and pleura, percutaneous and transhepatic cholecystocholangiography, diagnostic and treatment interventions in space-occupying lesions of the abdomen and thyroid gland, ultrasound techniques of diabetes in acute destructive pancreatitis and others. He is considered as one of organizers of higher medical education system in the region. The professor is actively working on improvement in training of medical and scientific personnel for various regions of the Russian Federation.

Aim. To assess probability of atrial fibrillation (AF) in patients after ST-elevated myocardial infarction (STEMI) with undergone primary percutaneous coronary intervention (PCI).Material and methods. Prospective study in the period from December 2015 to November 2017 was carried out with consecutive inclusion of 107 patients at outpatient follow-up stage after STEMI who have undergone primary PCI. The mean age of patients was 69,5+7,8 years (40 (37,4%) women). Follow-up period was 18 months and included three visits (V): V1 — when included in the study, V2 — after 12 months, and V3 — after 18 months. The endpoints of the study were cases of first diagnosed AF, cardioembolic stroke and death. At all visits predictive markers (Willebrand factor, Cystatin C, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), galectin-3) in the blood plasma were determined.Results. After 18 months of follow-up period in 19 (17,8%) patients were diagnosed AF, 5 of them (4,7%) had cardioembolic stroke, and 3 patients died. Median time of AF development from the onset of STEMI was 308 days. Cox multivariate analysis showed that the risk factors for first diagnosed AF were NT-proBNP — relative risk (RR): 1,05; 95% confidence interval (CI): 0,99-1,10 (p=0,038), cystatin C — RR: 1,44; 95% CI: 0,98-2,12 (p=0,043), galectin-3 — RR: 1,20; 95% CI: 1,03-1,40 (p=0,022).Conclusion. There was a highly significant relationship between NT-proBNP of ≥400,0 pg/mL, cystatin С of ≥1,45 ng/mL and galectin-3 of ≥25 mg/mL in patients after STEMI who underwent primary PCI. These markers might serve as predictors of first diagnosed AF. Identification of these biomarkers may have potential therapeutic benefit in improving the prognosis of patients after STEMI who have undergone primary PCI and reduce mortality from cardioembolic stroke.

The aim of this research was to study the effects of complex therapy with Remaxol inclusion on laparotomy wound tissue reparative process in patients with obstructive jaundice in early postoperative period.Clinical and laboratory studies were carried out in 55 patients undergoing surgery of the biliary tract, including 35 patients with mechanical jaundice of non-tumor origin and 17 of them received Remaxol (for 5 days daily intravenous infusions of 400 ml each) in the early postoperative period.It has been proved that mechanical jaundice is a significant complication in the reparative process of laparotomy wound tissue structures. A significant decrease in the reparative potential of tissues can occur due to a local deterioration of the tissue metabolism of regenerating structures, and on the organism level - endogenous intoxication syndrome, hypoxia, oxidative stress, hypoalbuminemia.Remaxol is a drug with hepatoprotective, antioxidant and antihypoxant effects and its use in patients with obstructive jaundice makes it possible to correct disease pathogenetic impact on organic and organism level, which leads to optimization of reparative regeneration. A noticeable decrease in the early postoperative period of wound complications has been established as well as a significant reduction in days patients spent in the hospital.Цель исследования - изучение эффектов влияния комплексной терапии с Ремаксолом на репаративный процесс тканей лапаротомной раны у больных механической желтухой в раннем послеоперационном периоде. Материал и методы. Клинико-лабораторные исследования проведены у 55 пациентов, оперированных по поводу патологий билиарного тракта, из них 35 больных механической желтухой неопухолевого происхождения, среди которых 17 пациентам в раннем послеоперационном периоде вводили Ремаксол (в течение 5 сут ежедневные внутривенные вливания по 400 мл). Результаты. Доказано, что механическая желтуха является существенным отягощающим фактором репаративного процесса тканевых структур лапаротомной раны. Снижение репаративного потенциала тканей во многом обусловлено локальным ухудшением трофики тканей регенерирующих структур, а на организменном уровне - синдромом эндогенной интоксикации, гипоксией, окислительным стрессом, гипоальбуминемией. Заключение. Использование больными с механической желтухой Ремаксола, обладающего гепатопротекторным, антиоксидантным и антигипоксантным эффектами, позволяет существенно корригировать указанные патогенетические компоненты на органном и организменном уровне, что и обусловливало оптимизацию репаративной регенерации. Установлены заметное уменьшение в раннем послеоперационном периоде раневых осложнений, существенное сокращение пребывания больных в стационаре.