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Objective: to assess the structure and influence of chronic pain (CP) on the functional status of patients with geriatric syndromes.Patients and methods. The study included 370 geriatric patients who were divided into two groups. Group A included 300 patients (mean age 75.1±8.25 years) with CP, and group B – 70 subjects of comparable age (75.1±7.75 years) without CP. All study participants were found to have polymorbidity: the Charlson index was 5.55±1.59 points in group A and 5.56±1.64 points in group B (p=0.963). All patients underwent a comprehensive geriatric assessment (CGE) to determine the functional status and diagnose geriatric syndromes.Results and discussion. According to the CGE data, senile asthenia syndrome was detected in 127 (42.3%) patients with CP and in 20 (28.6%) patients without CP (p=0.035). The average number of geriatric syndromes in group A was 7.06±2.68, in group B – 5.2±1.8 (p

Background. Despite advantages in treatment of metastatic melanoma it remains resistant to current therapy. Recent evidence indicates that tumor cells could overcome death through autophagy, a process that degrades cellular proteins and organelles to maintain cellular biosynthesis during nutrient deprivation or lack of energy. Objective: to investigate the involvement of autophagy inhibitors chloroquine (CQ) and LY-294.002 (LY) in temozolomide (TMZ) cytotoxicity in human melanoma cell lines.Materials and methods. The study was performed on patient-derived melanoma cell lines Mel Z, Mel IL and Mel MTP. The antiproliferative activity of combined TMZ and autophagy inhibitors treatment was determined by MTT assay and colony-forming assay. Cell cycle analysis, apoptosis activation and expression analysis of key autophagy markers under combined treatment was evaluated.Results. CQ and LY enhanced the cytotoxicity of TMZ and reduced colony formation in 3 melanoma cell lines, moreover both inhibitors increased cell population in G0 / G1 phase of cell cycle in Mel Z, Mel IL cell lines, but not in Mel MTP. CQ and LY synergistically activated apoptosis in all cell lines. The matrix RNA expression analysis of key autophagy genes showed autophagy involvement in enhanced cytotoxicity.Conclusions. Thus, autophagy inhibition on different stages of this process could overcome resistance to TMZ and be applicable as potent target in metastatic melanoma treatment.

Purpose: analysis of the state of rice industry for determining the points of further growth. Materials and methods. Materials of state and federal programs, technical reports of the FGBU “Management “Kubanmeliovodkhoz”, Rosstat, Krasnodarstat were used and analyzed. The research methodology is based on historical and system analysis. Data analysis was carried out using statistical software packages. Results. It has been stated that rice growing in Russia has been developing for about 100 years, from the beginning of the development of inappropriate lands in the regions of southern Russia, the Far East, Transcaucasia, Central Asia, and the Lower Volga region. It was found that at present the area of land reclamation systems for rice production is 407.8 thousand hectares, of which about 190 thousand hectares are used for rice crops, taking into account the crop rotation. The rice grain production output is 1.2 million tons annually, about 450 thousand tons of cereals are produced from it. It is shown that in connection with the increase in the rate of rice consumption from 4 to 7 kg/(year person), it is required to increase the production of cereals in the country consumer market up to 1.1 million tons in the future. The dynamics of rice yield growth due to the introduction of new varieties and technologies under climate change is substantiated. It has been determined that for the rice growing industry in the Krasnodar Territory, the water intake is 3.0 million m³, or 97 % of the total volume of water for irrigation, water supply is 2.5 million m³, of which about 500 thousand m³ are reused drainage water. It is shown that 40.4 thousand hectares of irrigated lands of the rice irrigation fund are in an unsatisfactory reclamation condition, including in terms of soil salinity, groundwater mineralization and their depth. Conclusions: the further development of the industry should be based on the introduction of new varieties of rice and technologies for their cultivation, rational water use, efficient use of land resources, maintaining the balance of the ecological system of the territories involved in rice growing.

BACKGROUND: The role of antidiabetic drugs in inpatient with COVID-19 and type 2 diabetes mellitus (T2DM) is usually considered in the context of target glycemiа maintaining. Except for insulin therapy sulfonylurea may be used in moderate COVID-19. The use of original gliclazide MR has advantages due to low risk of hypoglycemia and established cardio- and nephroprotective effects. But it is not clear whether the choice of antidiabetic drugs during hospitalization may affect patient’s condition in post-COVID period.AIM:. To assess the 12-month dynamics of carbohydrate metabolism in patients with T2DM after hospitalization for COVID-19 considering the character of hypoglycemic therapy in the hospital and the use of gliclazide MRMATERIALS AND METHODS: A 12-month prospective study was performed; T2DM patients were observed after hospitalization for COVID-19. They received in hospital: 1) original gliclazide MR (Diabeton MR, n=20) and 2) insulin (control group, n=20). Changes in antidiabetic therapy, glycemic control and biochemical tests were assessed at baseline and after 3, 6, 12 months. RESULTS: In the main and control groups the intensification of T2DM therapy was observed: the proportion of patients without hypoglycemic drugs decreased within a year by 3.0 (p = 0.001) and 2.8 (p =0.010) times respectively. Mean HbA1c values,the dynamics of inflammation markers and transaminases in both groups were similar (p>0.05 at all visits). Blood creatinine was at baseline 82.9±18.67 and 120.9±45.52 µmol/l (p=0.010), after 3 months — 88.0±18.77 and 104, 5±17.99 µmol/l (p=0.024), after 6 months — 89.3±12.17 and 97.5±9.03 µmol/l (p=0.072), after 12 months — 86.7±10.50 and 93.9±16.76 µmol/l (p=0.16). According to the data obtained during «3 months» visit, the dose of original gliclazide MR was directly correlated with the improvement in renal function in terms of glomerular filtration rateGFR (R=0,59, р=0,010). In addition, there was a close-to-significance correlation between continued gliclazide MR at visit 3 and improvement in GFR at visit 6 (R=0.31, p=0.076).CONCLUSION: The post-hospital period in patients with COVID-19 and T2DM was characterized by a tendency to hyperglycemia and increased need for hypoglycemic therapy. The use of original gliclazide MR by in patients with moderate COVID-19 and T2DM is appropriate and safe in terms of clinical and metabolic parameters dynamics during long-term post-hospital follow-up. When original gliclazide MR is continued during the post-hospital period its nephroprotective properties may contribute to the process of renal functions normalization which should be confirmed by further research.

A lithological-paleoecological description of the organogenic structure of Mountain Sestra is given. A macro- and microscopic study of the fauna composing the structure was carried out, its percentage content in limestones and the role of each group of organisms in the reef formation process were determined. Based on the data obtained, six genetic types of limestones were identified: biohermic, biomorphic, detrital, biohemogenic, clastic and granular. Studies of the taxonomic composition and the structure of communities allowed us to identify three distinct stages in the development of organogenic structure corresponding to facies: 1) banks, 2) biostromes and 3) bioherms. A detailed description of each stage of development is given. Based on the description, assumptions are made about the initial stage of reef formation. The findings of some species of sphinctozoa new to this locality are reported: Colospongia globosa Belyaeva, 1991; Amblysiphonella regularis Zhang, 1983 and Discosiphonella squamilis Belyaeva, 1991.

The pancreas belongs to the glands of mixed secretion and simultaneously performs both endo- and exocrine functions. Exocrine pancreatic insufficiency (EPI) is the general name for the malabsorption process caused by inadequate production and decreased activation of the enzymes of the pancreas acinar cells, such as amylase, lipase and protease, which are necessary for digestion. The prevalence of EPI in patients with type 1 diabetes, according to many authors, varies from 25 to 59%, which is determine by the data of pancreatic elastase-1. In this work, we present a clinical case of confirmed exocrine pancreatic insufficiency in a patient with a 6-year history of type 1 diabetes, which became the main cause of the development of episodes of hypoglycemia after meals. In the course of further studies, antibodies to lactoferrin and a reduced prostate volume, determined by MRI data, high levels of antibodies to glutamate decarboxylase and zinc co-transporter 8, as well as residual insulin secretion based on the level of C-peptide on an empty stomach detected.

o account morphological characteristics Materials and methods. Retrospective analysis of the results of diagnosis and treatment of patients with CSDH treated in the neurotrauma department of the Romodanov Institute of Neurosurgery NAMS of Ukraine and the City Hospital for Emergency and Emergency Medicine of Zaporizhzhya in 2010‒2019. Among the patients were 80 elderly people, 32 senile and 6 long-lived people. Multispiral computed tomography (MSCT) was performed in 86.7 % of patients, magnetic resonance imaging (MRI) in 13.3 %. In 118 cases, surgical intervention was performed (various types and volume), in 67 % ‒ a morphological study of the fragments of the capsule of the CSDH was performed. Results. The indication for surgery in elderly and senile persons with CSDH is the presence of hematomas with a volume of ≥100 cm3, regardless of the severity of the dislocation syndrome. In 95 % of observations, accompanying somatic diseases were detected. Control of treatment effectiveness was carried out with the help of MRI (in 73.5 % of cases) and CT (in 26.5 %). According to the results of histological studies, three variants of the structure of the capsule of CSDH have been established (according to the density of the location of vessels (the level of expression of the vascular endothelial growth factor (VEGF)) and the ratio of mesenchymal cells), which, together with clinical data, makes it possible to determine the genesis of CSDH. Also, several variants of the structure of the capsule of CSDH were identified, depending on the timing of the diagnosis and morphological examination. Analysis of the relative number and ratio of different cell pools (lymphocytes, fibroblasts, fibrocytes), quantification of immunopositive cells with a reaction to VEGF antibodies, as well as determination of the number of newly formed vessels per unit area makes it possible to predict the course and risk of recurrence of CSDH. Conclusions. The clinical and diagnostic characteristic of CSDH, characteristic of the elderly and senile, is the presence of hematomas with a volume of ≥100 cm3 and the discrepancy between the severity of the condition, clinical and neurological manifestations, and the degree of expressiveness of dislocation-compression changes according to MSCT/MRI data. It is effective to remove CSDH through 1 – 2 milling holes. Microcraniotomy is considered appropriate for a hematoma with complex neuroimaging architecture (multiple septa, layers, trabeculae), in some cases of hematoma recurrence. If the inner surface of the capsule is turned to the blood clot and is represented by a layer of spindle-shaped cells, this indicates a non-traumatic origin of the hematoma. A staged complex clinical and diagnostic examination for CSDH has both clinical and purely practical significance (especially expert), justifying the costs of treatment and insurance payments, ensures the social adaptation of the patient and brings the solution of these issues closer to international standards. Indications, criteria for choosing tactics and the sequence of performing procedures taking into account risks, prognostic clinical-radiological and structural signs are based mainly on recommendations and consensuses and require further detailed study.

BACKGROUND: Diabetic neuroosteoarthropathy (DNOAP, Charcot foot) is a relatively rare complication of diabetes mellitus (DM), which can lead not only to impaired support function of the lower limb in such patients, but also to high amputation. DNOAP is characterized by persistent aseptic inflammation of the bone structures of the foot, which creates significant ­difficulties in planning therapeutic measures. In the medical literature, there are data demonstrating the role of individual ­cytokines and neurohumoral factors in the prolongation of the inflammatory process in diabetes, however, there are currently very few studies that determine reliable markers of aseptic inflammation in DNOAP.AIM: To study the effect of neurohumoral factors and advanced glycation end products on the activity of aseptic inflammation in the bone structures of the foot in patients with type 2 diabetes mellitus (DM2) and diabetic neuroosteoarthropathy.MATERIALS AND METHODS. The study included 88 patients with type 2 diabetes (45 men, 43 women). Group 1 consisted of patients with DM2 and inactive DNOAP (n= 43), group 2 (n= 45) consisted of patients with DM2 and distal diabetic neuropathy without osteoarticular pathology. The diagnosis of diabetic neuropathy was based on the analysis of the clinical picture and indicators of peripheral sensitivity. Diagnosis of DNOAP and determination of its stage was based on clinical data, the results of infrared thermometry and radiology tests of the foot bones. General clinical assessment was used, radiology tests (X-ray, MRI), evaluation of CRP, calprotectin, copeptin, glutathione peroxidase 1 (GP1).RESULTS. According to the results of examination and palpation of the feet, as well as the analysis of the temperature gradient of the skin of the affected and contralateral limb (infrared thermometry), DNOAP was detected and the stage of this complication was determined. The diagnosis of the chronic stage of DNOAP was confirmed by the results of MRI and the clinical picture (no difference in skin temperature on the symmetrical areas of the feet). According to the results of laboratory analysis, a statistically significant difference in copeptin values was revealed — in group 1 — 0.232 µg/ml [0.147; 0.342], in group 2 — 0.115 µg/ml [0.065; 0.203] (p>0.05) and CRP — in group 1 — 7.113 mg/l [2.453; 16.505], in group 2 — 2.187 mg/l [1.131; 5.567] (p>0.05), leukocyte levels in the groups did not differ significantly: group 1 — 7.86 [6.40; 9.00]*10^9, group 2 — 7.00 [6.00; 8.15] (p>0.05). There was a trend towards an increase in the level of calprotectin and glutathione peroxidase-1 in the DNOAP group, however, the differences were not significant. calprotectin — in group 1 — 1.948 [1.229; 2.969], in group 2 — 1.692 [1.16; 2.514] μg/ml and glutathione peroxidase-1 in group 1 — 24.72 [20.1; 31.82], in group 2 — 22.98 [18.94; 31.2] ng/ml.CONCLUSION. In the study, statistically significant differences were obtained in the levels of copeptin and C-reactive protein: in patients with DNOAP, their values were significantly higher, which indicates the persistence of the aseptic inflammatory process in the bone tissue of patients even in the chronic stage of DNOAP. These data may help in deciding whether to use one or another method of unloading the affected joints, which will affect the clinical prognosis. The study of neurohumoral markers of arthropathy in the blood serum of patients with DM2 is carried out for the first time, and therefore it is difficult to compare with the results of other authors. It can be assumed that copeptin and CRP are significant markers of persistent inflammation of the osteoarticular structures of the foot in DNOAP.

The objective: to analyze the association of the Asp299Gln (rs 4986790) and Thr399Ile(rs 4986791) polymorphisms of the TLR4 gene with the risk of pulmonary sarcoidosis in the Russian population of the Republic of Karelia.Subjects and Methods. 253 people were examined: 122 patients diagnosed with morphologically verified sarcoidosis with lung involvement (average age – 41.00 ± 12.56 years) (Sarcoidosis Group) and 131 healthy donors (Control Group) (average age – 44.00 ± 14.23 years). All subjects in both groups considered themselves Russians by ethnicity, as reported in the survey. The distribution of alleles and genotypes by the polymorphic markers Asp299Gln (rs 4986790) and Thr399Ile (rs 4986791) of the TLR4 gene was studied in the group of patients with pulmonary sarcoidosis and the group of healthy individuals. Genotyping was carried out by PCR-RFLP.Results. There were no statistically significant differences in the distribution of allele and genotype frequencies for the Asp299Gln (rs 4986790) and Thr399Ile (rs 4986791) polymorphic markers of the TLR4 gene between the group of patients with pulmonary sarcoidosis and the control group: (χ2 = 0, df = 1, p = 0.997 и χ2 = 1.0, df = 2, p = 0.606; χ2 = 0.785, df = 1, p = 0.376 и χ2 = 0, df = 2, p = 1.0).Conclusion. The polymorphic marker Asp299Gln (rs 4986790) and Thr399Ile (rs 4986791) of the TLR4 gene is not associated with the risk of pulmonary sarcoidosis in the Russian population of the Republic of Karelia.

Up-to-date techniques applied in physical-chemical studies made it possible to identify and quantify chemical pollutants in the air inside contemporary dwelling in a large megacity and then create a database on them. This database has a list of more than 600 chemicals from 18 groups of volatile hydrocarbons and covers hygienic standards for their contents, their hazard category, and ranges of detected concentrations. Major sources of air pollution with these chemicals in dwelling were also identified. From the hygienic point of view, a significant fact is that there are no hygienic standards for more than 60 % of chemicals detected in air in dwelling. Formaldehyde, phenol, and styrene are priority chemicals for quality monitoring and risk-based control of hazards posed by chemical air pollution both in newly built houses that are at the approval stage and already exploited ones. Formaldehyde, benzene, phenol, styrene, acetophenone, ethylbenzene, hexanal, nonanal, butyl acetate, ethyl acetate, isopropanol, and trimethylbenzene are the most hygienically significant volatile organic compounds for quality control and health risk assessment considering frequency of their occurrence, concentration levels, concentrations exceeding MPC, group affiliation, hazard category, and ability to transform. When controlling natural chemicals that occur in air in dwelling due to some internal pollution sources, we should bear in mind that transformation may result in a new structure of pollution and new occurring chemicals can be more toxic and hazardous than original ones. To minimize risks associated with exposure to chemical pollution and to assess chemical safety of air in dwelling, we recommend wider use of up-to-date physical and chemical methods for qualitative and quantitative analysis thereby securing identification of a wide range of pollutants including potentially hazardous ones. Since certain chemicals have been detected for which no safety criteria have been developed so far, it is especially vital to perform research in the sphere of hygienic standardization and to develop methodical documents aimed at providing adequate hygienic assessment of quality and chemical safety of internal environment in dwelling.

Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p < 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p < 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p < 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p < 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

The article introduces the methodology used for analyzing networked linguistic data, regarded as a basis of global online discursive fields. The authors scrutinized the discursive fields, which emerged during 2020 US Presidential Election.The research methodology, which combines natural science methods (mathematical analysis, graph theory, network analysis and relational analysis) and modern methods of linguistic research (complex linguo-discursive analysis, and methods of network linguistics), makes it possible to analyze discursive fields as social graphs, identify narratives and discourses that form the basis of the modern global communication space, and their potential for manipulating. The empirical base of the study is comprised of bulks of networked data that include the messages published by ordinary users and D. Trump's team on Twitter platform in March – October 2020. The application of the authors' technique has resulted in discursive fields visualization, abnormal discursive activity areas identification, the interaction of discourses within the discursive field description, the mode of messages and their recurrence level determination. It is shown that the analysis of Internet communication using the developed methodology contribute to understanding the essence of socio-political and socio-economic processes and deepening the predictive analytics of their development, and can also be used for discursive management in order to strengthen constructive and neutralize destructive social practices in online space.

Based on the example of Kazan in the 1920s, the difficulties and problems of implementing the Soviet policy of urbanization and “socialist city” construction in cities with a nationally and religiously heterogeneous population are shown. This policy and the related processes of rural-urban migration, “indigenization”, “apartment redistribution”, and development of the urban outskirts at the expense of the former “bourgeois” center destroyed, deliberately and purposefully, the urban culture that had previously prevailed here and changed the social and national composition of the urban population. Therefore, they can be regarded as the tools of “positive discrimination”. The “positive discrimination” of the formerly dominant urban Russian culture in favor of the developing Tatar culture, mostly in its rural variant, manifested itself very clearly in education, namely in the content and design of the Soviet Tatar alphabet (alifba). However, the practice of granting preferences to the previously discriminated strata turned out to be short-term, tooled for the tasks of immediate strengthening of the social base of the Soviet power, and designed to destroy the former society and culture. These practices of dealing with multiculturalism became less popular by the late 1920s–early 1930s, as the Bolshevik power stabilized and “state-oriented” and unifying tendencies in the power policy increased.

Reduction of technological losses of natural gas during production, transportation and storage is of major energy and environmental importance. Losses of natural gas are the target for active criticism by «green energy» representatives. It is necessary to develop and popularize the new technological solutions aimed at reducing the indirect impact on the environment associated with the production and use of liquefied natural gas, to demonstrate the readiness of specialists of this energy sector to take into account modern social preferences. The article presents the numerical analysis of the energy efficiency for one of the stages of large-scale LNG production, namely, the LNG delivery from a storage tank to a LNG carrier vessel via a cryogenic pipeline. The mathematical model of the thermal enclosure of the pipeline has been considered, and the production cryoproduct losses due to thermal inertia of pipeline materials have been estimated. The performance of the schemes recommended for utilization of LNG vapors has been evaluated

The paper describes the algorithm and the results of the seismic hazard estimate in the Sakhalin and Southern Kurils region based on the data of the Japan Regional Catalogue (JMA). A nonlinear differential equation of the second order is used as a mathematical model, and algorithms for optimization and predictability estimation are presented by the author's solutions. The forecasting algorithm is based on the search for seismic activity zones in which the current activity trends correspond to foreshock sequences recorded before strong earthquakes (precedents) that have already occurred. The earthquake time is calculated with extrapolating the detected trends to the level of activity that occurred at the time of the precedent earthquake. By the example of precedent foreshock sequences in Japan, it is shown that the lead time of such a forecast reaches 10–15 years and its implementation is due to the preservation and stability of the identified trends. A map of potentially dangerous zones for Sakhalin and the Kuril Islands and some examples of calculating the time of strong earthquakes according to the JMA catalogue as of August 31, 2018 are presented. Action sequence in identifying the potentially dangerous trends in seismic activity and the specifics of possible use of the technique in the Sakhalin region are considered.

The paper proposes a new complex solution for automatic analysis and terms identification in regulatory and technical documentation (RTD). The task of terms identification in the documentation is one of the key issues in the digitalization dealing with the design and construction of buildings and structures. At the moment, the search and verification of RTD requirements is performed manually, which entails a significant number of errors. Automation of such tasks will significantly improve the quality of computer-aided design. The developed algorithm is based on such methods of natural language analysis as tokenization, search for lemmas and stems, analysis of stop words and word embeddings applied to tokens and phrases, part-of-speech tagging, syntactic annotation, etc. The experiments on the automatic extraction of terms from regulatory documents have shown great prospects of the proposed algorithm and its application for building knowledge graphs in the design domain. The recognition accuracy for 202 documents selected by experts was 79 % for the coincidence of names and 37 % for the coincidence of term identifiers. This is a comparable result with the known approaches to solving this problem. The results of the work can be used in computer-aided design systems based on Building information modeling (BIM) models, as well as to automate the examination of design documentation.

Rationale: In Russia, assessment of anti-P450c21 antibodies (AB) in the diagnosis of autoimmune adrenal insufficiency (AAI) has not been commonly used, and the disease screening has not been implemented.Aims: 1) To determine the sensitivity and specificity of anti-P450c21 AB determination in the AAI diagnosis; 2) To estimate the prevalence of anti-P450c21 AB carriage in patients without AAI.Materials and methods: Anti-P450c21 AB were assessed in 40 patients (group 1) with manifest AAI; 171 patients without established diagnosis of AAI, including 113 subjects with autoimmune thyroid disorders or type 1 diabetes mellitus (AID, group 2); 25 carriers of AB markers of thyroid AID and/or type 1 diabetes mellitus without any target organ dysfunctions (group 3); 33 patients with non-autoimmune endocrine disorders (group 4), and 25 healthy individuals (group 5).Results: Determination of anti-P450c21 AB for the diagnosis of AAI had 95% sensitivity, with specificity of 100%, predictive value of a positive result of 100%, and predictive value of a negative result 92.6%. Anti-P450c21 AB were inversely correlated with the duration of glucocorticoid replacement therapy (r=-0.222, p

Aim.To study an activity of the Renin-Angiotensin-Aldosterone System (RAAS) components in patients with primary hyperparathyroidism (PHPT) before and after parathyroidectomy (PTE). Materials and methods.A comparative study of patients with PHPT and control group. The first stage of the study included 56 patients with PHPT (group 1) before and on the third day after PTE. The second stage was carried out in 27 patients with remission of PHPT (group 2). All patients and healthy volunteers were tested for the main parameters of phosphorus-calcium metabolism and the RAAS parameters (plasma renin activity PRA, serum aldosterone, angiotensin II AT II). Results.Patients with active PHPT demonstrated changes in RAAS activity (lower PRA, higher AT II level) comparing to control group, that have statistical significance in group 1 (p0.001 for both parameters). There were no significant differences in aldosterone levels (p1=0.090;p2=0.140). On the third day after PTE (group 1), a decrease in aldosterone level (p=0.009) and a tendency to decrease in PRA (p=0.030) were detected. However, an increase in PRA (p=0.018), a decrease in AT II concentration (p=0.032) comparing to the initial values and their normalization were observed 12 months after surgery when permanent normal serum calcium and PTH levels had been achieved. There were controversial correlations between the parameters of phosphorus-calcium metabolism and RAAS. The influence of angiotensin-converting-enzyme inhibitors and AT II receptor blockers on phosphorus-calcium metabolism in patients with PHPT was not observed. Conclusion.In patients with PHPT, there were no сlear correlations of phosphorus-calcium metabolism parameters with RAAS, however an increase of AT II concentration was noted, that can take part in a development of hypertension for this endocrinopathy. PTE can have a positive effect on AT II level.

Objective ‒ to evaluate the influence of age, gender and localization on the clinical manifestation of cerebral bifurcational-hemodynamic arterial aneurysms (AA). Materials and methods. The retrospective study is based on the results of a comprehensive examination and surgical treatment of 547 (100 %) patients with bifurcational-hemodynamic cerebral AA in the Department of neurosurgical pathology of head and neck vessels of Romodanov Neurosurgery Institute during the period from 2011 till 2019. Recruiting of the patient to the clinical groups was done during the period between 2011‒2016 with their follow-up examination until 2019. It were enrolled 268 ((49.0 ± 4.2) %) men and 279 ((51.0 ± 4.2) %) women with bifurcational-hemodynamic aneurysms. The age of the patients was 18‒84 years (mean age ‒ 49,0±12,2 year). Results. Clinical manifestation of the cerebral bifurcational-hemodynamic AA was more often seen in patients during working age (16‒60 years) — 430 ((78.5 ± 3.4) %) patients, more often in men (p˂0.05). The peak frequency of clinical manifestation of AA ‒ 34.2 % (187 patients) was seen in the age interval 51‒60 years (the male/female ratio ‒ 51.3 % (96) and 48.7 % (91)). In patients with AA, a significant predominance of women was observed in age group older 61 years (χ2 = 21.68, p 0.05). At other localizations, gender-age dependence was not observed. Multiple cerebral aneurysmal lesions were associated with clinical manifestation at the age of 41‒50 years in males with 3 AA. Conclusions. A statistically significant influence of age, gender and the presence of multiple cerebral AA on the clinical manifestation of the disease was revealed. Localization of AA did not affect the timing of the clinical manifestation.

Aim. To evaluate a 12-week course of combined alloturinol-lowering therapy with a prophylactic anti-inflammatory dose of movalis for the frequency of exacerbations and the quality of life of patients with gout. Materials and methods. Allopurinol was administered orally, 1 time per day. Every 3 weeks, the dosage of the drug was increased by 50 mg to 300 mg per day under the control of the level of serum uric acid (sUA). The total daily dose of the drug movalis, used in the form of different dosage forms, was 7.515 mg. The clinical effectiveness of the treatment was evaluated after 3, 6, 9 and 12 weeks according to physical examination, the dynamics of joint pain at rest, during movement and palpation, according to the visual analogue scale (VAS) in millimeters, Likert scale, EuroQol-5D-5L questionnaire, care for oneself, habitual daily activities, the presence of anxiety and depression, assessment of satisfaction with treatment (on a scale of 1 to 5, where 1 is the complete absence of improvement or worsening, and 5 is a very good result); took into account the period of remission, as well as the time before the onset of relapse of gouty arthritis. An adverse event (AE) was recorded. Results and discussion. On the background of treatment with movalis 7.5 mg per day more than two-thirds of patients showed no worsening of the articular syndrome with an increase in the dose of allopurinol to 300 mg per day. By the 12th week of observation, a significant difference was found between the severity of gouty arthritis characteristics in the direction of improving mobility, self-care, normal daily activities, reducing soreness, reducing anxiety and depression (p0.05). In addition, the ESR and sUA levels were significantly different initially and at the final observation point (p0.05), which indicates a positive effect on the inflammatory process. A 3-month course of combination therapy was not accompanied by significant increases in blood pressure, changes in creatinine clearance in blood serum. There were no adverse events from the gastrointestinal tract. 90.9% of patients rated the treatment result as very good. AE in the form of a skin allergic rash was observed in one patient; it did not require interruption of treatment and completely stopped without consequences after completion of the course. Conclusion. 12 a week-long combined therapy of the allopurinol-reducing drug with the anti-inflammatory dose movalis prevents the exacerbation of the articular syndrome and improves the quality of life of patients with gout.

Background: The high incidence of cervical lymph nodes metastasis in highly differentiated thyroid carcinoma (DTC) and insufficient of existing diagnostic methods determines the urgency of finding reliable and more effective tests. Aims: The aim of our study is to determine the prognostic significance of the thyroglobulin measurement in washout fluid from fine-needle aspiration biopsy (FNA-Tg) and the cut-off value in the diagnosis of DTC lymph nodes metastasis. Materials and methods: 245 patients evaluated for suspicious cervical lymph nodes were retrospectively reviewed. All patients underwent FNA-Tg, serum thyroglobulin (sTg) levels, thyroglobulin antibodies (Tg-Ab), thyroid-stimulating hormone (TSH) were measured. 125 patients with malignant changes according to FNA and/or high FNA-Tgvalues underwent surgical treatment. Patients were divided into 2 groups with reactive (n = 23) and metastatic (n = 102) changes. FNA-TG was assayed on automated system Cobas 601 (Roche, France). Results: All patients were comparable by sex, age and levels of TSH, sTG, Tg-Ab. The FNA-Tg median in metastatic group was 537.0 [0.1; 1000], and in benign group 17.9 [0.5; 158.0], p = 0.003. The sensitivity of isolated FNA was 85%, specificity 57%, AUC = 0.618, 95% CI 0.5160.713. The sensitivity and specificity of FNA-Tg was 73% and 100%, respectively, AUC = 0.865, 95% CI 0.780.92. The optimal cut-off point for malignancy was 9.2 ng/ml (sensitivity 75%, specificity 100%), Youden Index 0.73. Conclusions: Additional FNA-Tg may increase the sensitivity of isolated FNA in evaluation of DTC lymph node metastasis. The optimized cut-off value 9.2 ng/ml can be proposed as a diagnostic threshold for the definition of malignancy.

The problems of peace and war and foreign policy in general became the main issues in the development of the situation and in the fate of the government in Russia in 1917. The confrontation on foreign policy issues within the Provisional Government and with the Petrograd Council moved from the reality to the historiographic level. The paper defines the main stages in the study of this problem in the Soviet and post-Soviet historiography, shows the specifics of each of these stages. Special attention was paid to the period of 1960s–1980s, the time of acute discussions, during which a number of odious historiographical clichés (about the “imperialist”, “anti-national” nature of the foreign policy of the Provisional Government, its dependence on the Anglo-French capital, etc.) were rejected, flexibility and independence of the foreign policy of the Provisional Government were shown, its focus on defending the interests of Russia was revealed. The influence of historiographical discussions on the development and modernization of Soviet historiography, on the creation of assumptions for qualitatively new research approaches that emerged at present was investigated. One of the most pressing problems in the history of Russia's foreign policy in 1917 – the problem of “conflict” of information contained in sources of different types and different origins – was examined in detail. The specificity of source basis formation for the problem was traced. The reasons for gaps in the sources were identified, and ways to overcome them were demonstrated.

Мета. Аналіз хірургічної техніки, результатів хірургічного та комбінованого лікування хордоми крижів. Матеріали і методи. У 28 хворих з хордомами крижів проаналізовано симптоми захворювання та їх динаміку, цін- ність методів нейровізуалізації, особливості патогістологічної картини, хірургічну техніку, ефективність променевої те- рапії та віддалені результати лікування. Результати. Серед клінічних проявів хордоми крижів домінував больовий синдром. Середня тривалість анамнезу ста- новила близько одного року. Хірургічну резекцію пухлини через задній доступ виконали 18 хворим, через комбінова- ний – 9 хворим. Видалення пухлин оцінене як радикальне у 21 хворого, часткове – у 7 хворих. У післяопераційному періоді всім хворим проведено курс променевої терапії на лінійному прискорювачі. Протягом 5 років у 26 хворих ви- ник рецидив хордоми. Повторне оперативне втручання виконали 22 хворим. Висновки. Лікування хордом потребує комплексного підходу. Методом вибору залишається виконання радикального хірургічного втручання, що можливо не у всіх хворих.

Enhancing the role of entrepreneurship as an instrument of export diversification for sustainable development of the economy of the country and regions is a topical problem. The research is focused on the regional export potential including youth startups (small and medium enterprises, or SME), whose non-raw exports should increase by 1.5–2 times by 2020 according to the roadmap «Export» approved the Government of the Russian Federation The purpose of the article is to clarify theoretical and methodological foundations as well as to develop assessment methodology and appropriate recommendations on the enhancing the export potential of technology SME. As a hypothesis, we have suggested that there is a relationship between the regional export potential and the development of the start-up youth movement. The study used mathematical methods for processing statistical data, in particular, a correlation analysis of export statistics and start-up companies. The methodological tools were tested on the example of statistical data of 2016 for 39 regions of Russia. According to the correlation analysis, we have identified the direct moderate dependence between the specific weight of technologies export in the gross regional product (GRP) and the number of residents of business incubators in regions. In other words, the influence of the development of regional technology export on the number of existing startup companies is positive but moderate. This conclusion contributes to the solution of the task to ensure Russia’s status as a global technology leader by increasing a share of high-tech export, including SME and start-ups focused on export. The content analysis has shown that the emerging regional concepts and export development strategies give insufficient consideration to the export potential of SME. Therefore, we offer a set of measures to enhance this potential including organizational and coordination aspect of the export ecosystem. The results can serve as a guideline for developing mechanisms and instruments to promote the development of non-raw exports of technology SME to diversify the regional economy.

The aim of the study is to compare qualitative and quantitative characteristics of the experimental mice bone pathology using of Na18F and prospective radiotracer"Oxabigal, 68Ga" (complex of gallium-68 with oxa-bys-ethylenenitrile tetra (methylene phosphonic acid). Material and Methods. 30 nonlinear mice-female with the model of bone pathology were used in the experiment. Na18F and "Oxabigal, 68Ga" were injected to animals (i.v). Then mice were scanned using PET-imaging with subsequent calculation of pharmacokinetics parameters. Results. The intravenous injection of two radiotracers enabled to visualize of simulated bone pathology using PET. Conclusion. The experimental pathological foci were able to visualize within the first hour after i.v using of the "Oxabigal, 68Ga" and Na18F. There is a statistically significant difference between blood accumulation of radiopharmaceuticals labeled different radionuclides. However the difference doesn't matter for positive results we have got. 68Ga-labeled bone-seeking radiopharmaceuticals and its generator producing method are important supplement for independent choice of using different radiotracers for PET-imaging (such as Na18F) of bone pathology.

The paper is devoted to the problem of death as a separate subject of socio-humanitarian studies in the West during the second half of the 20th century. In the recent decades, thanatological aspects have gained increasing attention in socio-cultural studies. In this regard, the aim of this paper, which seems to be relevant to the field, is to identify the specifics of investigating the problem of death in socio-humanitarian studies using historiographical analysis. The obtained results show that death studies, which were mainly the research on death and funerary rites, appeared in the first half of the 20th century due to anthropologists' efforts. However, a new impetus was given to the research in the middle of the 1950s. The “repression of death” in modern society caused intense debate which triggered the research interest in death on the whole and, in particular, its phenomenon in modern developed countries. Consequently, a number of publications appeared and such of disciplines as death psychology, sociology of death and dying, and historical thanatology were developed. By the turn of the centuries, the intensification of death studies in various disciplines contributed to the transformation of the overall problem of death within the scope of a broad interdisciplinary cooperation. It is important to understand these processes in order to unlock the cognitive potential of socio-humanitarian thanatological studies, as well as to understand the role of their results in historical, cultural, and social research.