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The authors have described a clinical case of a spontaneous pregnancy in a patient with decreased ovarian reserve, secondary infertility and a history of an in vitro fertilization failure. Based on literature data and their own experience, the authors believe that intraovarian administration of platelet-rich plasma can increase the ovarian reserve and improve reproductive potential.

Ovarian stromal cell tumors are a rare group of neoplasms that characterized by an ambiguous prognosis and biological activity associated with the hypersecretion of a number of substances. The review presents the latest data on the biochemical diagnosis of tumors of the stroma of sex cord, including granulosa cell tumor of the ovary. The importance of hormones

Due to complications caused by the inevitable use of immunosuppressive drugs in organ and cell transplantation, the use of natural mechanisms of immunological tolerance identified in animal and human organisms arouses interest. It has long been known that there are certain areas in them, including the testis, where immune reactions are virtually impossible. Our review focuses on the role of Sertoli cells that provide testicular immune privilege. Methods of isolation and cultivation of Sertoli cells are described and their potentials in biology and medicine are discussed.

Introduction. Thyroid hormones play an important role during pregnancy, providing organogenesis, growth and development of the fetus, participate in the formation and development of the brain and its structures, affecting cognitive abilities. Thyroid dysfunction is associated with the pathological course of pregnancy and childbirth, as well as a negative effect on the fetus. Iodine deficiency, which persists throughout Russia, creates the preconditions for the more frequent development of subclinical hypothyroidism and hypothyroxinemia in pregnant women. Therefore, early detection of thyroid dysfunction during gestation in the region of iodine deficiency is relevant.Aim. To assess the thyroid status in pregnant women in the region of iodine deficiency.Materials and methods. A single-center, prospective, one-sample study was performed in a population of pregnant women registered from June 2019 to December 2019 to the antenatal clinic in Tyumen.Results. According to the results of biomedical monitoring of iodine deficiency in the population of pregnant women in Tyumen, iodine supply improved, as evidenced by the median concentration of ioduria 154.4 μg / l, the frequency of endemic goiter was 0.37%. Continuous screening of women in the 1st trimester of pregnancy without thyroid pathology revealed subclinical hypothyroidism in 21.5% of pregnant women, carriage of antibodies to thyroperoxidase was found in 10.5% of women.Conclusions. Given the persisting problem of iodine deficiency, the widespread occurrence of subclinical hypothyroidism in the population of pregnant women, it is necessary to include the study of thyroid status in the standard of examination of pregnant women when registering in an antenatal clinic for early diagnosis and timely treatment of hypothyroidism. It is also recommended to continue preventive measures aimed at replenishing the iodine deficiency starting from the stage of pregravid preparation.

Cumulus cells are essential during oocytes growth and development, as well as during their maturation and fertilization. Research results have shown that embryo co-cultivation with autologous cumulus cells increases the frequency of blastocyst formation, and also improves the effectiveness of ART programs. Embryo transfer in such programs is recommended to be carried out using the CAT technology (Cumulus-Aided embryo Transfer), which includes embryo cultivation on a layer of cumulus cells and embryo transfer with a certain amount of diluted cumulus cells. Patient G., 38 years old, came to the department with infertility for 15 years and recurrent implantation failure in history. The patient had ART program with autologous co-cultivation of embryos with cumulus cells and a new CAT transfer technology. The patient fell pregnant and gave birth to a healthy child. Autologous cumulus cells can be a source of biologically active substances and improve embryological parameters and implantation rate in ART programs. Embryo co-cultivation with cumulus cells is especially important for patients with recurrent implantation failure. This technique can become an alternative for optimizing human embryos culturing.

Aim of the study was to investigate the peculiarities of the relationship of polymorbid pathology in arterial hypertension with disorders of lipid, purine and carbohydrate metabolism. Material and methods. Patients with arterial hypertension with the presence of polymorbid pathology, who underwent examination and treatment at the clinic of the Federal Research Center for Fundamental and Translational Medicine (Novosibirsk), were examined. A total of 9775 people were examined. The patients were divided into 2 groups: with arterial hypertension in the dyslipidemia absence (n = 561(252 men (44.9 %), 309 women (55.1 %), average age 57.1 ± 0.60 years) and in the dyslipidemia presence (n = 9214 (3879 (42.1 %) men, 5335 (57.9 %) women, average age 57.82 ± 0.12 years). Results and discussion. Hyperglycemia and hyperuricemia were more common in patients with arterial hypertension with dyslipidemia; the indicators were statistically higher: total serum cholesterol, low-density lipoprotein cholesterol, triglycerides, atherogenic index, serum glucose, uric acid compared with patients with arterial hypertension without dyslipidemia. In patients with dyslipidemia, compared with patients without dyslipidemia, arterial hypertension was more often combined with diseases of the endocrine system, nutritional disorders and metabolic disorders, and other diseases of the circulatory system. Conclusion. The data obtained can serve as a theoretical basis for the concept of care for polymorbid patients, based on the impact on the main key pathogenetic mechanisms of diseases, and new approaches to complex treatment, rehabilitation and personalized prevention, taking into account the impact on modifiable risk factors.

The results of multicenter clinical trials show the broad potential of melatonin since discovery of this adaptogen to the present day. Melatonin is a neuropeptide that is synthesized mainly in the small brain gland, the pineal gland, and has a unique effect in humans and animals. Using melatonin, the pineal gland participates in the organization of circadian periodism and regulation of cyclic processes, acting as an intermediary between the pacemaker mechanism of the suprachiasmatic nuclei (SCN) and peripheral organs. The pineal gland and the SCN of the hypothalamus form part of the system of the so-called biological clock of the body, which plays a key role in the mechanisms of regulation of the biological clock via circadian rhythms and ageing. Initially, melatonin was only considered a hormone involved in the synchronization of the mechanisms of the circadian rhythm, but later it was found that, in addition to this hormonal function, it takes part in the regulation of the seasonal cycle in animals and humans.At present, melatonin drugs have shown high efficacy and safety in various sleep-wake disorders regardless of their genesis, disorganization of circadian rhythms, stress adjustment disorders, rapid change of time zones, shift work and in complex therapy of patients with cerebrovascular diseases.The article considers the multimodal capabilities of melatonin, including adaptogenic, biorhythmogenic, hypnotic, immunostimu-lating, antioxidant effects. The role of melatonin in the treatment of various central nervous system disorders, including neurodegenerative diseases, has been determined.The review emphasizes the wide-ranging effects of melatonin and offers great opportunities for measuring melatonin as a biomarker for early detection and follow-up of various diseases.

Introduction. Male infertility poses a pressing issue due to escalating prevalence of males with reproductive system diseases, the most common among which is varicocele being diagnosed in childhood and adolescence. Measuring level of hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and estradiol is the key element while assessing the reproductive male potential.Aim: to compare the parameters of hormonal status in adolescents with varicocele as well as males with diagnosed infertility and identify predictors of hypogonadism in pubertal period.Materials and Methods. Males with diagnosed infertility as well fertile males underwent a single measurement of serum FSH, LH, testosterone and estradiol levels. Adolescents with/without varicocele were measured the serum hormones noted above in dynamics annually between studies for the period within the 14 to 17 years of age. The data obtained were compared in infertile and fertile males, adolescents with/without varicocele, as well as assessed hormone status between different age groups in both cohorts and adolescents aged 17 years.Results. Our study allowed to identify significant differences in hormone level in male patients with infertility and varicocele lacking reproductive pathology. Infertile males had significantly higher levels of LH and estradiol (for both: p < 0.001). The LH level in infertile vs. fertile males was 5.01 ± 2.69 IU/L vs. 3.40 ± 1.17 IU/L, respectively, whereas estradiol level was 136.51 ± 92.79 pmol/l and 82.49 ± 48.33 pmol/l, respectively that might indicate at lowered testosterone level. Fifteenand sixteen-year-old-adolescents with varicocele had significantly lower LH level: 15 years old – 3.72 ± 1.92 IU/L vs. 2.71 ± 1.65 IU/L (p < 0.0123) in subjects without vs. with varicocele; 16 years old – 3.42 ± 1.16 IU/L vs. 2.81 ± 1.66 IU/L (p < 0.0381) in subjects without vs. with varicocele. It may account for decreased testosterone level. Active puberty in adolescents is accompanied by dynamically increased testosterone levels. Starting from the age of 15 years, adolescents with varicocele had significantly increased testosterone level in each subsequent age group. Thus, at 14 and 15 years of age, testosterone level in adolescents with varicocele was 10.61 ± 4.70 nmol/l and 13.60 ± 5.64 nmol/l (p < 0.0001), respectively, whereas at 16 and 17 years of age it continued to rise reaching 16.65 ± 6.44 nmol/l (p < 0.001) and 19.22 ± 7.36 nmol/l (p < 0.0160), respectively. In contrast, age-matched adolescents without varicocele had significantly elevated testosterone level solely at age of 15 vs. 14 years. Whereas at 14 years of age testosterone level in comparison group was 15.73 ± 7.2 nmol/l, at 15 years of age it was significantly increased up to 21.45 ± 9.51 nmol/l (p < 0.0113). In the subsequent age categories of this group, no significant difference in testosterone level was found. While comparing such parameter between the main and control adolescent groups, testosterone level was significantly higher in adolescents lacking varicocele at the age of 14, 15 and 16 years compared with age-matched subjects with varicocele. At 14 years of age, testosterone level in adolescents without/with varicocele was 15.73 ± 7.2 nmol/l vs. 10.61 ± 4.7 nmol/l (p < 0.0007), respectively, at 15 years of age – 21.45 ± 9.57 nmol/l vs. 13.60 ± 5.64 nmol/l (p < 0.0001), respectively, at 16 years of age – 20.02 ± 5.84 nmol/l vs. 16.65 ± 6.44 nmol/l (p < 0.0268), respectively. The FSH level in infertile males and adolescents with varicocele was 5.16 ± 2.67 IU/L and 4.1 ±2.63 IU/L (p < 0.0081), whereas LH level was 5.01 ± 2.69 IU/L and 2.76 ± 1.65 IU/L (p < 0.04), respectively. In adolescents with varicocele and infertile males, estradiol level was 177.45 ± 70.63 pmol/l and 136.51 ± 92.79 pmol/l (p < 0.001), respectively. While comparing hormone levels in fertile males and adolescents lacking varicocele, a significantly higher estradiol level was found in adolescents 181,87 ± 27.14 pmol/l vs. 82.49 ± 48.33 pmol/l (p < 0.001).Conclusion. A study of the hormonal status in infertile vs. fertile males revealed decreased testosterone production accompanied with higher levels of LH and estradiol. Due to profound changes in LH and testosterone levels detected in adolescents with varicocele as well as in infertile males, it is plausible that such hormones may serve as predictors of hypogonadism in the pubertal period. Adolescents with varicocele taking into consideration progressive course of the disease and verified lower testosterone level require further monitoring of hormone level to prevent endocrine infertility.

Riedel's thyroiditis is a rare disease characterized by chronic fibrosis. Clinical performance of this disease is dense stony goiter, which can poorly be displaced during palpation. The overgrowth of the goiter can lead to the development of compression syndrome. To diagnose we need to made fine needle biopsy and made the final diagnose according to its results or according to the morphological description of the postoperative material. An important step in the diagnosis of Riedel's thyroiditis is the determination of serum IgG and IgG4 to exclude an IgG4-associated disease. Treatment of this disease includes drug therapy, which is based on glucocorticosteroids administration or surgical treatment when develops compression syndrome. This article presents a clinical case of a patient with Riedel's thyroiditis; the main complaints were associated with the growth of goiter and the development of compression syndrome. In this regard, patient underwent surgery on the thyroid gland, and after this we get final diagnose. Due to feeling unwell, drug therapy with glucocorticosteroids was prescribed, against the background of which we noted a positive trend.

The aim of the research: to evaluate the effect of transvaginal punction of the endometrioid cyst on the ovarian reserve of patients with infertility. Materials and methods: the study analyzed 65 patients who were planning ART programs and underwent unilateral endometriod cyst puncture with a volume of up to 40 mm, and 69 patients who were operated on in the volume of endometrioma capsule exfoliation with a diameter of up to 40 mm. Before and after the interventions, the parameters of the hormones AMH and FSH, the number of antral follicles (NAF), the volume of the ovary, and the level of the cancer marker CA-125 were evaluated. Results: after the punction, in contrast to the operation, there was no significant decrease in AMH and NAF parameters. The level of FSH also did not change between the punctated patients, while the operated patients showed an increase in FSH from 6.7 ± 0.5 to 9.1 ± 0.4 mME/ml, a decrease in AMH from 2.0 ± 0.3 to 1.1 ± 0.1 ng/ml, and a decrease in NAF from 8.1 ± 0.7 to 4.0 ± 0.8 three months after surgery. The average values of AMH, FSH, and NAF remained unchanged in the group of punctated patients. Conclusion: it has been shown that cyst punction does not reduce ovarian reserve, in contrast to laparoscopic cystectomy, and can be considered as an alternative approach for women with endometriod cyst planning ART. Puncture and aspiration of the contents of the endometriod cyst can serve as a factor in the rapid onset of pregnancy, which in itself is an alternative to hormonal treatment of endometriosis.

Primary hyperparathyroidism (PHPT) is a result of the parathyroid tumors, usually manifesting by elevated serum parathyroid hormone and hypercalcemia. One of the most common complications of PHPT are bone disorders. It mainly occurs as sporadic disease, while the remaining 5–10% is the component of hereditary syndromes, more often – type 1 multiple endocrine neoplasia syndrome (MEN1). MEN1 is caused by the germinal mutation of the oncosuppressor menin gene, founded in all cells of the human body, including the osteogenic cells. Data on the bone state in MEN1 is limited and contradictory. At the same time, some studies indicate that MEN1-related PHPT differs from sporadic form in bone manifestation, which can be presumably associated with the inadequate functioning of mutant menin. The results of experimental works suggest that menin plays an important role in the metabolism and differentiation of bone cells. This article is a literature review on this problem and contains information on the current clinical data on the bone state in patients with MEN1.

Manifest hypothyroidism occurs in more than 5 % of the population, while prevalence of subclinical hypothyroidism is much higher and reaches 15 %. In the practice of an endocrinologist, in most cases, the diagnosis and treatment of manifest hypothyroidism does not raise questions, while subclinical changes in thyroid hormones quite often generate a lot of discussions. The generally accepted reference range for TSH up to 4.50 μIU / ml is in conflict with data showing that more than 95 % of healthy people with euthyroidism have serum TSH levels up to 2.5 μIU / ml. At the same time, a lot of data has been accumulated on the effect of even slightly altered levels of thyroid hormones and TSH on various tissues, organs and systems of the body, especially on the cardiovascular, nervous and reproductive systems. This review analyzes the results of studies aimed at studying the relationship of subclinical hypothyroidism with cardiovascular and metabolic disorders, cognitive disorders, pathology of pregnant women.

Here we review Russia-wide and international publications released over the last 5 years dedicated to phytoestrogens used in treatment of climacteric syndrome. Effects of isoflavones as the most examined agents are discussed acting on vasomotor, cognitive, psychological, urogenital and sexual symptoms as well as on the cardiovascular system, bones, and metabolic age-related changes. Despite obtaining controversial data resulting from the analysis, it may be concluded phytoestrogens hold promise as an alternative to menopausal hormone therapy. It is reasonable to conduct further extensive studies to evaluate efficacy and safety of using plant-derived compounds in postmenopausal women.

Cholelithiasis and acute/chronic pancreatitis are some of the most common diseases in the practice of any doctor. There are numerous causes of cholelithiasis and pancreatitis (age, female gender, pregnancy, obesity, etc.), but the impact of hormones on these disorders is still poorly understood. One of the conditions for the formation of stones in the biliary tract is an increased level of fat in blood. Adrenocorticotropic hormone, somatotropic hormone, thyrotropic hormone, insulin, and thyroid hormones have lipotropic activity. In particular, deficiency of thyroxine and triiodothyronine disrupts fat metabolism in the body. There is also some evidence that reduced evacuation function of the gastrointestinal tract increases the risk of cholelithiasis, which is probably a result of hypothyroidism. Pancreas functioning is also affected by hormones. Hypothyroidism can be accompanied by a decrease in calcitonin secretion, which will eventually lead to the development of chronic pancreatitis.Objective: to analyze the studies evaluating the impact of hypothyroidism on the formation of concretions in the biliary tract and the risk of acute or chronic pancreatitis and to report a case.Materials and methods. We analyzed the impact of hypothyroidism on the incidence of cholelithiasis and acute or chronic pancreatitis and reported a case of these disorders.Results and discussion. There is evidence that patients with hypothyroidism have increased serum levels of cholesterol; hypothyroidism causes cholestasis, while in patients with cholelithiasis, concomitant thyroid disorders significantly reduce the contractility of the gall bladder. Cholelithiasis was observed in 44.6% of patients with thyroid nodules, 33.3% of patients with autoimmune thyroiditis (AIT), and 22.2% of patients with primary and postoperative hypothyroidism. In 31.9% of women with thyroid hypofunction, concretions in the bile duct developed within 1–1.5 years after hypothyroidism diagnosis. In the study evaluating cases of concomitant hypothyroidism and chronic pancreatitis, the examination of patients with primary hypothyroidism revealed signs of pancreatic dysfunction in 64.1% of patients. Pancreatic dysfunction manifests itself with various changes in exocrine and endocrine functions and aggravates with hypothyroidism progression.Conclusion. Both literature data and our clinical experience confirm that hypothyroidism of any origin leads to the development of cholelithiasis and pancreatitis; therefore, the patients require preventive measures in advance.

The diagnosis and treatment of multiple endocrine neoplasia type 2A syndrome or Sipple’s syndrome, as well as other endocrine hereditary syndromes, presents certain difficulties for several reasons. One of them is the rarity of this pathology and, as a result, the lack of awareness of physicians. In addition, the diagnosis requires a comprehensive examination and a high level of clinical, laboratory, radiation and morphological diagnostics. And finally, surgical treatment, which is essentially the only method, involves an individual approach to each patient. We present the clinical case of Sipple's syndrome in a 39-year-old man. The diagnosis was carried out of medical history, clinical examination, laboratory tests (24-hour urine excretion of metanephrines and normetanephrines; serum calcium, calcitonin and parathyroid hormone levels), neck ultrasound and abdominal CT scan and was confirmed by histopathological examination and genetic testing for RET mutation. The achievement of the endpoint in the form of normalization of blood pressure and the absence of adrenal insufficiency was due to radical surgical treatment.

The tall-cell variant of papillary thyroid carcinoma is a rare malignancy characterized by an aggressive course, low relapse-free survival, early metastasis, and frequent development of radioiodine refractoriness. We report two cases of tall-cell papillary thyroid carcinoma in patients who had disease progression after combination treatment and started to receive lenvatinib. We observed partial and complete regression of metastases in response to lenvatinib. Our findings are consistent with the results of other studies assessing treatment efficacy for disseminated tall-cell papillary thyroid carcinoma.

To study the possibility of using polymorphisms of genesTCF7L2,FABP2,KCNQ1,ADIPOQas markers for predicting the development of type 2 diabetes mellitus (T2D) in the population of Novosibirsk.On the basis of prospective observation of a representative population sample of residents of Novosibirsk (HAPIEE), 2 groups were formed according to the case-control principle (case people who had diabetes mellitus 2 over 10 years of observation, and control people who did not developed disorders of carbohydrate metabolism). T2D group (n=443, mean age 56.26.7 years, men 29.6%, women 70.4%), control group (n=532, mean age 56.17.1 years, men 32.7%, women 67.3%). DNA was isolated by phenol-chloroform extraction. Genotyping was performed by the method of polymerase chain reaction with subsequent analysis of restriction fragment length polymorphism, polymerase chain reaction in real time. Statistical processing was carried out using the SPSS 16.0 software package.No significant effect of rs1799883 of theFABP2gene, rs2237892 of theKCNQ1gene, and rs6773957 of theADIPOQgene on the risk of developing T2D was found. Genotypes TT and TC rs7903146 of theTCF7L2gene are genotypes for the risk of developing T2D (relative risk RR 3.90, 95% confidence interval CI 2.316.61,p0.001; RR 1.86, 95% CI 1.422.43,p0.001, respectively). The CC genotype rs7903146 of theTCF7L2gene is associated with a protective effect against T2D (RR 0.37, 95% CI 0.290.49,p0.001). When theTCF7L2gene is included in the model for assessing the risk of developing T2D rs7903146, it retains its significance in both men and women.The rs7903146 polymorphism of theTCF7L2gene confirmed its association with the prognosis of the development of T2D, which indicates the possibility of considering it as a candidate for inclusion in a diabetes risk meter. Variants of risk meters have been developed to assess the prognosis of the development of diabetes mellitus 2 in men and women aged 4569 years during 10 years of follow-up. The association with the prognosis of the development of T2D polymorphisms rs1799883 of theFABP2gene, rs2237892 of theKCNQ1gene and rs6773957 of theADIPOQgene was not found.Цель.Изучить возможность использования в популяции г. Новосибирска в качестве маркеров прогноза развития сахарного диабета 2-го типа (СД 2) полиморфизмов геновTCF7L2,FABP2,KCNQ1,ADIPOQ. Материалы и методы.На основе проспективного наблюдения репрезентативной популяционной выборки жителей Новосибирска (HAPIEE) сформированы 2 группы по принципу случайконтроль (случай лица, у которых за 10 лет наблюдения выявлен СД 2, и контроль лица, у которых за 10-летний период не развились нарушения углеводного обмена). Группа СД 2 (n=443, средний возраст 56,26,7 года, мужчины 29,6%, женщины 70,4%), группа контроля (n=532, средний возраст 56,17,1 года, мужчины 32,7%, женщины 67,3%). ДНК выделена методом фенол-хлороформной экстракции. Генотипирование выполнено методом полимеразной цепной реакции с последующим анализом полиморфизма длин рестрикционных фрагментов, полимеразной цепной реакции с обратной транскрипцией. Статистическая обработка проведена с использованием программного пакета SPSS 16.0. Результаты и обсуждение.Не обнаружено значимого влияния rs1799883 генаFABP2, rs2237892 генаKCNQ1и rs6773957 генаADIPOQна риск развития СД 2. Генотипы ТТ и TC rs7903146 генаTCF7L2являются генотипами риска развития СД 2 (относительный риск ОР 3,90, 95% доверительный интервал ДИ 2,316,61,р0,001; ОР 1,86, 95% ДИ 1,422,43,р0,001 соответственно). Генотип СС rs7903146 генаTCF7L2ассоциирован с протективным эффектом в отношении СД 2 (ОР 0,37, 95% ДИ 0,290,49,р0,001). При включении в модель оценки риска развития СД 2 rs7903146 генаTCF7L2он сохраняет свою значимость и у мужчин, и у женщин. Заключение.Полиморфизм rs7903146 генаTCF7L2подтвердил свою ассоциацию с прогнозом развития СД 2, что указывает на возможность его рассмотрения в качестве кандидата на внесение в рискометр СД 2. Разработаны варианты рискометров для оценки прогноза развития СД 2 у мужчин и женщин в возрасте 4569 лет в течение 10 лет наблюдения. Ассоциация с прогнозом развития СД 2 полиморфизмов rs1799883 генаFABP2, rs2237892 генаKCNQ1и rs6773957 генаADIPOQ не обнаружена.

The reproductive potential of a woman depends on indicators of the ovarian reserve, such as the anti-Muller hormone (AMH) and the number of antral follicles (NAF). Autoimmune diseases have a significant effect on fertility and contribute to the development of premature ovarian failure. Aim.To evaluate the parameters of the ovarian reserve in patients with type 1 diabetes mellitus, carriers of antibodies to the thyroid gland in a state of euthyroidism and compare them with similar parameters in healthy women. Materials and methods.In the first block of the study, the level of AMH, follicle-stimulating hormone, luteinizing hormone, NAF was studied among 224 women with diabetes and 230 healthy women in the control group. In block II, the level of the above hormonal indices was studied in 35 carriers of antithyroid antibodies in the state of euthyroidism and 35 healthy women. Results.In patients with type 1 diabetes, the level of AMH, NAF was statistically significantly lower when compared with the control group. Among carriers of antithyroid antibodies and healthy women, no difference in AMH and NAF was found. Conclusion.The autoimmune processes accompanying diabetes are more influenced by the ovarian reserve indices than autoimmune aggression to the tissues of the thyroid gland.

The study objective is to investigate the biological effect of energy substrate (pyruvate) on human sperm motility in vitro.Materials and methods. The study was conducted using human sperm from 14 ejaculate samples obtained by the standard method. Motility and viability were evaluated per the World Health Organization guidelines under 400x magnification. After dilution, 1 ml was sampled from the ejaculate for the experiment and control. The experiment consisted of addition of pyruvate to the test tube with the ejaculate in final concentration of 1 mmol.Results. The level of initial sperm motility corresponded to normozoospermia. The percentage of progressive motile sperm increased by 24, 67 and 84 % after 30, 60 and 120 min of the experiment. The percentage of non-progressive motile sperm and total percentage of motile sperm showed no significant change during this time period. The number of live spermatozoa showed no significant change during the experiment.Conclusion. The study showed that pyruvate can stimulate motility of human sperm in vitro.

Here we review published data from experimental and clinical international studies examining pathogenetic effects of melatonin upon using programs of In Vitro Fertilization (IVF); highlighting various viewpoints on its biological action as a regulator of circadian rhythms: on the one hand, the inhibitory effect of melatonin on pulsating secretion of gonadotropin-releasing hormone was considered, thereby achieving a contraceptive effect; on the other hand, its ability to induce the secretion of human chorionic gonadotropin ensuring ovulation process, was discussed. We also review the data on melatonin acting as a highly active antioxidant. While using melatonin as a metabolic supplement in IVF programs, its positive effect on oocyte morphology and quality of fertilization, embryo division was observed. Moreover, we also highlight the results of studies examining melatonin-related effects on quality of fertilization and embryo division after adding it to culture medium. Such effects demonstrated dose-depended pattern. Taking into account the data of the analyzed publications, adding exogenous melatonin to culture medium may represent a new strategy for personalized approach to improve outcome of IVF programs. Its effectiveness should be further investigated and considered for introduction within the framework of pregravid preparation.

Purpose: to study the features of eye hydrodynamics in patients with thyroid dysfunctions.Patients and methods. The material for this study was the results of a survey of 43 patients (86 eyes) with thyroid dysfunctions: 23 people (46 eyes) with primary untreated hypothyroidism (PGT) and 20 people (40 eyes) with primary untreated thyrotoxicosis (PTT). There weren’t ophthalmic hypertension and glaucoma There weren’t signs of ophthalmic hypertension and glaucoma in the patients included in this study at the stage of primary ophthalmologic diagnostics.Results. Correlation analysis revealed a causal relationship between the ratio of T4 / TSH hormones, on the one hand, and indicators of secretion of aqueous humor per unit of time and ease of outflow, on the other hand. In the group of patients with hypothyroidism, a weak linear inverse correlation was found between the ratio of free thyroxine and thyroid stimulating hormone and the minute volume of aqueous humor: according to the regression model, an increase in the ratio of T4 / TSH hormones by 1 was accompanied by a decrease in the minute volume of aqueous humor by 3 units. In patients with thyrotoxicosis, a statistically significant inverse linear correlation was found between the ratio of the T4 / TSH hormones and the coefficient of ease of outflow. According to the regression model, with an increase in the ratio of hormones T4 / TSH by 1, the coefficient of lightness of outflow decreases by 5 units. The presence of thyroid receptors in the cytoplasm and nuclei of the endothelium cells of the trabecular apparatus, the nuclei of fibroblasts forming the stroma of the trabeculae, as well as in the nuclei of the pigment and non-pigment epithelium of the processes of the ciliary body substantiates the molecular basis of the causal connection of thyroid dysfunctions with hydrodynamic disorders The conducted studies confirm the modern concept that the control of regulation of the tissue and organ homeostasis is carried out by the coordinated interaction of 3 systems: nervous, endocrine, and immune. Regression modeling clearly shows a pronounced causal relationship between thyroid dysfunctions and hydrodynamic processes in the eye.Conclusion. The results of clinical studies demonstrate the fact of controlling regulation by hydrodynamic processes at the eye level by the endocrine system, explain the possible mechanism on a morphological basis, and reveal the potential of a new therapeutic strategy.

Purpose of the study. To determine the practical value of puncture methods for obtaining spermatozoa in azoospermia. Patients and methods. The results of 127 puncture biopsies of testis (TESA) and testicular appendage (PESA) in patients with azoospermia of presumably obstructive origin were analyzed. The sperm production frequency (SPF) was calculated, as well as the frequency of transition to an open testicular biopsy. Was built a logistic regression model to analyze factors influencing the result, TESA / PESA, which included as independent variables the following parameters: patient age, duration of involuntary infertility, the level of sex hormones (testosterone, estradiol, luteinizing hormone, follicle-stimulating hormone, prolactin, progesterone, inhibin B), the total volume of testes, presence of varicocele, the presence of chemotherapy or radiation therapy, a history of alcohol abuse, Smoking, regular violation of the thermal mode, surgery in the inguinal and scrotal region. Indicators of the probability ratio (PR) with a 95% confidence interval (95% CI) were obtained. Results. 92 biopsy attempts out of 127 were successful, and the NPV was 72.4%. Independent statistically significant predictors of PESA / TESA success were testicular volume (PR = 1.113; 95% CI = 1.026–1.207) and inhibin b level (PR = 1.026; 95% CI = 1.011–1.041). In 35 patients whose spermatozoa were not found during the puncture biopsy, conversion to open microsurgical biopsy was performed. Conclusion. PESA and TESA have only limited effectiveness in azoospermia. We believe that puncture biopsy of the testicles and epididymis is justified only in patients with normal testicular volume and high levels of inhibin B. PESA / TESA should be performed in conditions that allow immediate transition to an open biopsy in case of failure.

In recent decades, the Russian Federation has seen an increase in the incidence of the population, including children and adolescents.Objective: to identify trends in the incidence and “to chronize” the pathology of young men in the Russian Federation. Using the method of descriptive statistics, the authors analyzed the overall and for the first time recorded incidence in 15–17-year-old men in 2000–2017. The authors noted a 35,8% increase in the overall incidence rate and a 35,4% increase in the for the first time recorded incidence rate. The maximum increase in the overall incidence is observed in the following classes: neoplasms (2,6 times), blood and bloodforming organs diseases (2 times), congenital anomalies (malformations; 1,8 times), circulatory system diseases (1,7 times), the musculoskeletal system and connective tissue diseases (1,6 times), endocrine and metabolic disorders (1,5 times). Based on theoverall and for the first time registered incidence the authors calculated the “chronicity” of diseases. With a general growth rate of this indicator of 0,3% there is a significant growth of this indicator for certain diseases: mental disorders and behavioral disorders (2,1 times), congenital anomalies (malformations; 1,9 times), endocrine system diseases, metabolic disorders (1,5 times).

The objectives of our investigations are to describe the variation by muta-tions of stem architecture of the modern Ukrainian winter wheat varieties accord-ing to their interactions with mutagen nature, concentration and genotype-mutagen interaction specific. 7 modern Ukrainian winter wheat varieties and one line were treated by 1.4-bisdiazoatsetilbutan water solution at 0.1 and 0.2% concentrations. Types of visible mutations like as high and short stem, dwarfs and semi-dwarfs, changes in a waxy bloom, stem thickness have been investigated. New genetic- and breeding-value mutant lines have been obtained in terms of research program. Main components for mutation induction successful were geno-type-mutagen interaction and peculiarities of genotype as a subject of mutagen action (due to discriminant and factor analyses). By mutation occurs (in sense of mutation rate and spectra) genotypes can be subdivided on several groups. Effect of recurrent mutagenesis was identified as decrease of mutation rate under mutagen action by variety Kalinova, which obtained with same mutagen. Other geno-types reaction on mutagen action depends on genotype specific only, not kind of treatment. Bisdiazoatsetilbutan as a mutagens for creation new material by plant height and stem structure has been shown as less successful than gamma-rays and nitrosoalkylureas, but this mutagen may be used for special investigation by some types of mutation induction. But it was more specific in a mutagen-genotype interaction and more clearly demonstrate some effects of recurrent mu-tagenesis regarding nature of chemical agents. As for example action on variety Sonechko with great number of mutations by waxy bloom. These peculiarities may be caused by previous chemical mutagens damages of DNA in complex with recurrent action of bisdiazoatsetilbutan. Genotype-mutagen interaction and classification of mutant material are possible by rate of high and short stem, with and without waxy bloom forms. Concentration affected on rate of high stem forms. Mutagen cannot induce dwarf and semi-dwarf forms in significant amount and completely unpromising in this regard. Our research will be further focused on transformation of scientific and technological achievements and mutagenic mech-anism of bisdiazoatsetilbutan on plant at the molecular level in the recent future.

New method is proposed for operational differentiation of pink salmon runs with different time of spawning and different state of gonads measured quantitatively with a gonad-somatic index. Results of this new method and traditional methods of differentiating are compared. The conception of spatial niches in the Pacific waters adjacent to Kuril Islands for certain temporal groupings of the Okhotsk Sea pink salmon is critically revised on the base of these new results. The runs cannot be separated using any fixed value of the gonad-somatic index. The zones of different groupings could be spatially overlapped. The method is tested on the data of trawl survey conducted aboard RV Professor Kaganovsky in May-July 2018, during anadromous migration of pink salmon, and shows a high compliance with the regional groupings ratio determined on the data of pink salmon catch in the Okhotsk Sea and their escapement to rivers. Tendency of the late-maturing forms of pink salmon to migrate through the southern Kuril waters is confirmed, whereas the portion of early-maturing pink has increased toward the Ocean.

Background. The non-genomic effects of thyroid hormones, mediated through exposure to the membrane receptor CD51/CD61, are expressed in the activation of atypical cell proliferation, stimulation of tumor angiogenesis and cell migration. In connection with these cellular effects, the thyroid status of cancer patients can have prognostic value. The aim of study: to assess the effect of thyroid status on disease-free survival of patients with stage III ovarian cancer (OC). Materials and methods . Prospective trial with eligibility criteria for the inclusion and exclusion of participants was conducted. The study included 128 patients with stage III OC aged 45 to 70 years. All patients before treatment was determined thyroid status by examining the serum levels of thyroid hormones and performing an ultrasound examination of the thyroid gland. All patients received a comprehensive treatment of OC, including surgery and chemotherapy, and have complete remission following after treatment. After confirming the recurrence of the disease and/or death of the patient, the duration of the disease-free survival was determined. Results. Medians disease-free survival were 13.5 months, 17.8 months and 11.1 months for the euthyroid, hypothyroid and hyperthyroid groups, respectively, while significant differences in the medians disease-free survival occurred between the euthyroid and hypothyroid groups (p = 0.0206) and between the hypo- and hyperthyroid groups (p = 0.0156). Conclusions. Patients with hypothyroidism before the treatment of advanced OC have better disease-free survival. Thyroid status is independent favorable prognostic factor for survival in OC.

Changes of the hormonal activity of the hypophyseal-thyroid system under the influence of a course injection of melatonin in physiological doses have been studied on old rats (18-20 months) of the Wistar population with age-related hypothyroidism. It is shown, that making up for the age-related deficiency of melatonin in an old organism causes a dose-dependent stimulating action on the hormonal activity of the thyroid gland, and this influence is direct as the thyrotropic function of the hypophysis is not involved in this particular process., На старых крысах 18-20 мес. популяции Wistar с возрастным гипотиреозом изучены изменения гормональной активности гипофизарно-тиреоидной системы под влиянием курсового введения мелатонина в физиологических дозах. Показано, что восполнение возрастного дефицита мелатонина в старом организме вызывает дозозависимое стимулирующее действие на гормональную активность щитовидной железы, причем это влияние прямое, поскольку тиреотропная функция гипофиза не вовлекается в данный процесс., На старих щурах 18-20 міс. популяції Wistar із віковим гіпотиреозом вивчені зміни гормональної активності гіпофізарно-тиреоїдної системи під впливом курсового уведення мелатоніну у фізіологічних дозах. Показано, що поповнення вікового дефіциту мелатоніну в старому організмі викликає дозозалежний стимулювальний вплив на гормональну активність щитоподібної залози, причому цей вплив прямий, оскільки тиреотропна функція гіпофіза не залучається в даний процес.

A direct dependence of the indices of the endothelial vasomotor function on the state of the melatoninforming function of the pineal gland has been demonstrated. A prolonged intake of melatonin in doses of 0,5 and 3 mg caused a correction of the disturbed vasomotor function of the endothelium. In order to improve the endothelial functioning, the intake of melatonin in a physiological dose of 0,5 mg has been found to be sufficient., Показана прямая зависимость показателей сосудодвигательной функции эндотелия от состояния мелатонинобразующей функции эпифиза. Длительный прием мелатонина в дозах 0,5 и 3 мг приводил к коррекции нарушенной сосудодвигательной функции эндотелия. Для улучшения функционального состояния эндотелия достаточный прием физиологической дозы мелатонина – 0,5 мг., Показана пряма залежність показників судинорухової функції ендотелію від стану мелатонінутворювальної функції епіфіза. Тривалий прийом мелатоніну в дозах 0,5 мг і 3 мг призводив до корекції судинорухової функції ендотелію. Для покращання функціонального стану ендотелію достатньо приймати фізіологічну дозу мелатоніну – 0,5 мг.

Five variants of the lоbules of the thyroid gland have been revealed. Their age-related dynamics is characterized by bilateral assymetry and sexual dimorphism. The developed complex model of evaluating makes it possible to determine the shape of the thyroid gland., Выявлено пять вариантов формы долей щитовидной железы. Их возрастная динамика характеризуется билатеральной асимметрией и половым диморфизмом. Разработанная комплексная модель оценки дает возможность определить форму щитовидной железы., Виявлено п'ять варіантів форми часток щитоподібної залози. Їх вікова динаміка характеризується білатеральною асиметрією та статевим диморфізмом. Розроблена комплексна модель оцінки дає змогу визначити форму щитоподібної залози.

В данной статье представлен анализ научной литературы, содержащей данные о влиянии бисфенола А (ВРА) на структуру и функцию внутренних органов, включая бесплодие, метаболические расстройства, онкогенез, фиброз легких и другие. ВРА является ксеноэстрогеном и имеет эстрогеномиметические свойства, нарушая, прежде всего, функцию эстроген-зависимых органов. Известно, что ВРА способен влиять на формирование фолликулярного резерва в яичниках путем изменения экспрессии антиапоптотичес-кого фактора 151 Bcl-2 и проапоптотического фактора BAX. BPA имеет влияние на пролиферативную активность клеток стромы эндометрия путем инициации гипометилирования CpG-сайтов регуляторных генов, а также через снижение экспрессии мРНК CCND2. Установлена положительная корреляция между концентрацией ВРА и снижением уровня тестостерона у самцов крыс. Влияние различных доз BPA на качество спермы реализуется через активацию апоптоза сперматозоидов по Ca2+/CaM/CaMKII-зависимому, PERK/EIF2a/chop-зависимому сигнальным путям, через влияние на мембранный потенциал митохондрий, а также путем повышения внутриклеточной концентрации свободного Ca2+ в сперматозоидах. ВРА может взаимодействовать со щитовидной железой, связываясь с ее рецепторами и нарушая гомеостаз тиреоидных гормонов in vitro. Установлено, что ВРА замедляет созревание легких у мышей в пренатальном периоде, приводя к постепенному развитию фиброза, а также нарушению процессов дифференцировки и репарации альвеолоцитов I типа., Азербайджанский Медицинский Журнал, № 4 (2021)

A study of the ultrastructure of the rat thyroid gland under the action of x-ray radiation has been carried out for the purpose of exposure of investigating the specific characteristics of the structure of the cellular membranes of the follicular epithelium, employing the method of electron microscopy. Changes of the plasmatic membranes of the thyroid follicular epithelium, a disturbance of intercellular contacts among thyrocytes and a varying degree of sensitivity of cell organelles to the action of x-ray radiation have been revealed., Проведено исследование ультраструктуры щитовидной железы крыс под действием рентгеновского излучения в разных дозах с целью изучения особенностей строения клеточных мембран фолликулярного эпителия. Выявлено изменения плазматических мембран фолликулярного эпителия щитовидной железы, нарушение межклеточных контактов между тироцитами и различную степень чувствительности клеточных органелл к действию рентгеновского излучения., Досліджено ультраструктуру щитоподібної залози щурів при дії рентгенівського випромінювання у різних дозах з метою вивчення особливостей будови клітинних мембран фолікулярного епітелію з використанням методу електронної мікроскопії. Виявлено зміни плазматичних мембран фолікулярного епітелію щитоподібної залози, порушення міжклітинних контактів між тироцитами та різний ступінь чутливості клітинних органел до дії рентгенівського випромінювання.

BACKGROUND. The standard treatment for hypothyroidism is levothyroxine (LT4), which in the Republic of Belarus is available in tablet form whereas liothyronine (LT3) is not registered, but patients can purchase them on their own abroad. AIM. This study aimed to investigate Belarusian endocrinologists’ attitude of thyroid hormones in hypothyroid and euthyroid patients. MATERIALS AND METHODS. An online survey was conducted, for which members of the Belarusian Medical Association of Endocrinology and Metabolism were invited by posting information in the group chat and by e-mail. The research period was from October 1 to December 26, 2020. 210 questionnaires were received, 146 of which were used. RESULTS. The majority of participants, 145 (99.3%), indicated that they were using LT4 as the first-choice drug for the treatment hypothyroidism. Sixty-one (41.8%) doctors answered that LT3 + LT4 combination likely can be used in patients with long-term untreated hypothyroidism and 15 (10.3%) — in patients with persistent symptoms of hypothyroidism, despite biochemical euthyroidism on therapy LT4. Over half of the respondents 84 (57.5%) answered that thyroid hormone therapy was never indicated for euthyroid patients, but 50 (34.2%) would consider it for female infertility with high level of thyroid antibodies and 36 (24.7%) for simple goiter growing over time. In various conditions that could interfere with absorption of LT4, most responding Belarusian endocrinologists do not expect a significant difference with different formulations (tablets + “I do not expect major changes in different forms” vs. “soft gel capsules” + “liquid solution”; p

The author has established desynchronization of the functioning of the hypothalamo-hypophysal-thyroid and suprarenal neuroendocrine complexes that were accompanied with an increase of blood serum adrenocorticotropin, cortisol, somatotropin, prolactin and a decrease of the level of the thyroid hormones both in patients with prevalent psoriasis and concomitant essential hypertension., У больных с распространенным псориазом, в т.ч. с сопутствующей гипертонической болезнью обнаружено десинхронизацию функционирования гипоталамо-гипофизарно-тиреоидного и надпочечникового нейроэндокринных комплексов, что сопровождалось повышением в сыворотке крови адренокортикотропина, кортизола, соматотропина, пролактина и снижением уровня тиреотропного гормона., У хворих на поширений псоріаз, у тому числі із супутньою гіпертонічною хворобою встановлено десинхронізацію функціонування гіпоталамо-гіпофізарно-тиреоїдного та наднирникового нейроендокринних комплексів, що супроводжувалося підвищенням у сироватці крові адренокортикотропіну, кортизолу, соматотропіну, пролактину та зниженням рівня тиреоїдного гормону.

Introduction: Changes in hormonal status in patients with prolonged disorders of consciousness (PDC) remain poorly understood. There are no studies devoted to the investigation of prognostic value of hormonal changes to predict the outcome which is primarily due to a relatively small number of patients, different variants of structural brain disorders in vegetative state (VS) patients, concomitant somatic pathology including typical complications.The objective: to study the correlation between outcomes in VS patients with hormonal status and the level of natriuretic peptide. Subjects and methods. 275 patients in VS were examined for the time period from 2007 to 2017. 152 patients had sequela of traumatic brain injury (TBI) and 123 patients suffered from hypoxic brain damage. All patients matched the international criteria of VS diagnosis. In all patients, blood samples were collected during the first week after admission to ICU to test hormones and natriuretic peptide levels. ACTH, cortisol, TSH, free T3 and T4 , STH, prolactin and natriuretic peptide were tested in the period from 2 to 4 months of staying in VS. In men, the level of total testosterone, LH and FSH was additionally tested. The obtained data were compared with VS outcome.Results. The tested hormones were stably insufficient only in few VS patients. None of the tested hormones of the hypothalamic-pituitary-adrenal axis made a reliable criterion for predicting VS outcome. The tendency of disrupted rhythm of cortisol secretion was found to be most frequent and consistent, with higher rates in the evening hours. The average value of STH was higher in men with sequela of traumatic brain injury who had recovered consciousness versus those who remained in VS. A significant decrease in testosterone levels, regardless of age, was found in the patients with TBI sequela. Mean levels of LH were higher in patients with TBI sequela and hypoxia who remained unconscious versus patients who later restored consciousness. The average level of FSH was higher in patients who had recovered consciousness compared to those who remained in chronic VS. The increased level of natriuretic peptide was observed both in patients who remained in chronic VS and in those who restored consciousness.Conclusions. When investigating levels of certain hormones, no specific endocrine background characterizing this category of patients was found. Abnormal rhythms of some hormones secretion, in particular cortisol, can be considered typical of VS patients especially patients with TBI sequela.

Aim: to characterize the function of the reproductive system in women after organ-preserving surgery for uterine myoma: hysteroresectoscopic (HRS) myomectomy and laparoscopic (LS) myomectomy.Materials and methods. Forty one patients were examined and divided into 2 groups: Group 1 – 18 patients after HRS myomectomy and Group 2 – 23 patients after LS myomectomy. The control group included 20 healthy women of reproductive age.Results. The HRS operation led to a significant decrease in the production of anti-Mullerian hormone (AMH), estradiol and progesterone, while the levels of luteinizing (LH) and follicle-stimulating (FSH) hormones increased. After myomectomy performed by the laparoscopic access, the levels of estradiol, progesterone, and AMH decreased but the levels of both LH and FSH increased so that the ratio LH/FSH remained unchanged. Almost all indices of gonadotropic and steroid hormone production became normalized over 6 months of the postoperative period.Conclusion. The main factors of unfavorable prognosis in patients with ovarian tecoma are tumor necrosis, degree of malignancy and mitotic activity.

The article dedicates to the study of microelements in the blood serum of women of reproductive age, with newly diagnosed hypothyroidism (subclinical and manifest), living in disadvantaged areas of the Aral Sea region. This article presents the study of 1154 women. Every fourth woman (25%) has an essential deficiency of such microelements like iodine, selenium, iron, zinc independently of thyroid function. Our study discovered negative associations of TSH concentration with essential microelements like manganese, copper, selenium, and positiveassociation with iodine. We also obtain positive relationships between AT-TPO and zinc and iodine. The relationship of zinc with AT – TPO level and thyroid status, especially in the regions with sufficient ioduria among residents,require further researchto study it’spossible effecton thyroid dysfunctions. We established positive associations of free T4 with essential microelements like manganese, iron, and negative association with iodine. Estimation of thyroid status and toxic microelementsrevealed positive association of free T4 with cadmium, nickel, and lead, and negativewith mercury.

Рresents results of the self-activation the specialists’ (N=26) and secondary schools teachers (N=26), as well as orphans (N=50) and adolescents from families (N=50). The study was conducted during 2017 — 2018 years after the Resolution of the Russian Federation Government N 481 output about the orphan organizations activities, aimed at family life of children and the creation close to family conditions for orphans who are not transferred to the family for different reasons. It demanded of specialists engaged in orphans parenting to acquire such professional competencies that would contribute to the preparation for successful integration into society orphan graduates. These include the ability to self-activation. It’s demonstrated that parenting orphan adolescents specialists have less self-activating characteristics in comparison with secondary schools teachers. These differences are also typical for orphans with whom they work, in comparison with adolescents from families.

Aim: to present a clinical case of amiodarone-induced hypothyroidism in a patient with paroxysmal atrial fi brillation.Results. Before taking amiodarone, the patient suffered from subclinical hypothyroidism. The level of thyroid stimulating hormone (TSH) was 6.2 mIU/L, thyroxine (T4) — 9.2 pmol/L. Against the background of taking amiodarone in a maintenance dose of 200 mg per day 5 days a week with a break of 2 days, clinically severe hypothyroidism developed with a TSH level of more than 16 mIU/L. An electrocardiogram (ECG) recorded sinus bradycardia with a heart rate (HR) of 37 beats per minute. Paroxysms of atrial fi brillation have stopped. According to the daily ECG monitoring recorded throughout the sinus rhythm with maximum heart rate of 92 beats/min., minimum of 35 beats/min. The circadian rhythm profi le was correct. No pauses were detected for more than two seconds. Transient atrioventricular block was of 1 degree (during sleep). Ectopic activity was represented by supraventricular extrasystoles 112 per day: 107 single, 1 pair, 1 group. Ventricular extrasystoles: 55 per day: polymorphic, solitary. No diagnostically signifi cant elevation or depression of the ST segment was detected. After the abolition of amiodarone, thyroid function was recovered. Levothyroxine was not prescribed. However, paroxysms of atrial fi brillation began to occur again. For the prevention of paroxysms, sotalol 160 mg per day was prescribed.Conclusion. Thus, the development of clinically pronounced amiodarone-induced hypothyroidism has contributed to the existing thyroid dysfunction in the patient. The assessment of the thyroid gland function and its further monitoring in the process of taking the drug is prescribed. Amiodarone therapy is performed in case of ineffectiveness of other antiarrhythmic drugs and, as a rule, is not used for primary prescription.

Background. The dynamic balance between the immune and neuroendocrine systems and their mutual regulation provide the formation of protective reactions of the body in conditions of pathology and various stress-inducing effects. The aim of the research was to establish the nature of the relationship between the indicators of the immune status and hormonal profile in patients with coxarthrosis before and after hip replacement. Material and methods . The study involved 73 patients with stage HI dysplastic coxarthrosis, who, using cluster analysis according to immunological parameters, were divided into two groups. The first clinical group included 46 patients, the second - 27 patients. The control group consisted of 28 clinically healthy individuals. Results. In the preoperative period, correlations between indicators of the immune status and hormonal profile were different in patients of the 1st and 2nd groups and depended on the level of hormones. Moreover, in patients of the 1st group, the hormones of the stress-limiting system made the greatest contribution to this dependence, and in patients of the 2nd group - peripheral thyroid hormones. After endoprosthetics, the correlation dependence in patients of the 1st group differed from the initial one in a number of indicators of the immune status and hormonal profile, which reflects the coordinated work of these body systems under the influence of stress factors. In patients of the 2nd group, the spectrum of these indicators was limited, which indicates the failure ofmechanisms, in particular, limiting the intensity ofinflammatory reactions after surgery. Conclusion. The relationship of the studied parameters in patients of the 1st group indicates the adaptive nature of the immune and endocrine reactions in response to surgery. In patients of the 2nd group, they reflect disadaptive rearrangement, which leads to an increased risk of postoperative complications.

Justification of the study. The normalization of vitamin D levels in both children and adults is the goal of numerous studies around the world, and the setting of a number of objectives related to this vector of preventive medicine, dictates the need for a more detailed study of regional features of the status of calcidiol and the identification of both risk factors and risk groups. Aim of the study: to analyze the impact of risk factors on the provision of vitamin D to adolescents in the Moscow region. Methods: 360 children over 11 years of age (average age was 14.74 ± 1.92 years) who attended a children’s polyclinic for preventive check-ups or are under observation in a day-care centre. After the examination, all schoolchildren were determined to have serum content of calcidiol – active metabolite of vitamin D. Results: the analysis revealed low vitamin D levels in children, with a median of 16.1 ng/ml. Normal vitamin D levels were found in only 6.7% of cases. The following risk factors for vitamin D deficiency were identified in Moscow schoolchildren: time of year (p < 0.001), inclusion of such foods as fish (p = 0.021) and liver (p = 0.036), gastrointestinal pathology (p < 0.001), endocrine system pathology (p < 0.001), musculoskeletal system pathology (p = 0.045): course of chronic inflammatory process (p = 0.01) in the body. The correlation between acute respiratory diseases and calcidiol supply was analyzed: at low frequency of acute respiratory infections during the year, the median level of vitamin D was 17.1 ng/ml (Q1-Q3: 12.6-22.1 ng/ml), at an average frequency – 11.4 ng/ml (Q1-Q3: 8.45-16.05 ng/ml), at high frequency – decreased to 7.94 ng/ml (Q1-Q3: 5.89-9.06 ng/ml). Conclusion: Vitamin D deficiency prophylaxis should be provided to children all year round, without a break for the summer months. If a child has a risk factor for vitamin D deficiency, the metabolite correction should be controlled by the calcidiol serum content.

Background: In the last decades, a number of clinical studies have been conducted where both the positive and neutral effects of Se on thyroid autoimmunity have been demonstrated. Aims: The aim of our study was to assess the effects of selenmethionine among euthyroid patients with elevated TPO-Ab (TPO > 100 IU/ml) and patients with subclinical hypothyroidism and elevated TPO-Ab. Materials and methods: 40 euthyroid patients with elevated TPO-Ab and 11 patients with subclinical hypothyroidism plus elevated TPO-Ab were included in our study. Patients of both categories were randomized to recieve Se 200 μg/day or to the dynamic observation. TSH, f. T4, f. T3, AT-TPO were measured at baseline and every 3 months of follow-up. The volume and echogenicity of the thyroid were also evaluated every 3 month of follow-up period (12 month). Results: There were no significant difference between the groups on the dynamics of TSH, f. T3, f. T4, AT-TPO titers, volume and the echogenicity of the thyroid gland during the whole observational period among euthyroid patients with elevated TPO-Ab. Among the patients with subclinical hypothyroidism there were also no significant difference between the groups on the dynamics of f. T3, f. T4, AT-TPO titers, volume and the echogenicity of the thyroid gland during the whole observational period. But by the 12 month of the follow-up there were significantly more euthyroid patients in Se group compare to dynamic observation group. Conclusions: Our study, failed to show possitive effects of Se supplementation on thyroid autoimmunity.

Autoantibodies recognizing the cancer-retina autoantigen called recoverin (RCVRN-AutoAb) may serve as a highly specific biomarker of cancer-associated retinopathy. However, they may also be found in some cancer patients without clinical evidence of retinopathy. In the present study, dot-ELISA and Western blot assays were used to demonstrate the presence of circulating RCVRN-AutoAb in 4/7 (57%) of patients with recently recognized pathological entity, non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP); other thyroid tumors represented by follicular adenomas, and classical and follicular variants of papillary thyroid carcinomas, demonstrated low frequencies of RCVRN-AutoAb (0/15, 1/20 (5%) and 1/15 (7%), respectively), with no significant differences from healthy individuals (0/15). Our data implicate the circulating RCVRN-AutoAb as a potential biomarker of NIFTP capable of discrimination of this novel pathological entity from other thyroid tumors.