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In recent years, more and more data have emerged confirming the contribution of non-HLA genetic markers to the predisposition to thedevelopment of Sjögren's syndrome (SS) and its severe complication, MALT-lymphoma. Objective: to study the association of polymorphisms of IRF5 (rs2004640), STAT4 (rs7574865), and TNFAIP3 (rs6920220, rs2230926) genes with predisposition to the development of SS and MALT-lymphoma. Materials and methods. The study included 80 patients with SS and 103 individuals in the control group. Sixteen patients were diagnosed with MALT-lymphoma. Genotyping of polymorphisms of IRF5 (rs2004640), STAT4 (rs7574865), TNFAIP3 (rs6920220, rs2230926) genes was performed by real-time polymerase chain reaction using original allele-specific probes labeled with different fluorescent labels. Results and discussion. The distribution of genotypes and alleles of the STAT4 gene differed statistically significantly in the study and control groups of patients (p = 0.0005 and p = 0.0001, respectively). The presence of the homozygous TT genotype increased the risk of developing SS more than eightfold compared to TG+GG genotypes (odds ratio, OR=8.2; 95 % confidence interval, CI 2.5–30.0; p=0.0001)]. The polymorphism of the TNFAIP3 rs2230926 gene was also associated with the risk of developing SS: the presence of the TG genotype significantly increased the probability of developing SS compared to the TT genotype (OR 6.4; 95% CI 1.2–44.3; p = 0.01). The development of MALT-lymphoma was associated with the rs6920220 polymorphism of the TNFAIP3 gene. In 10 out of 16 patients with MALT-lymphoma (62.5 %) at least one minor A allele (AA+GA) was detected, while in patients without MALT-lymphoma only in 32.8 % of patients at least one minor A allele was detected (OR=3.4, CI 1.1–10.7; p=0.03). In addition, a correlation was found between the rs7574865 TT genotype of the STAT4 gene and the risk of developing severe leukopenia in SS, which was significantly more frequent in carriers of the TT genotype than in individuals with the GG + GT genotype (OR 4.9; 95 % CI 1.7–14.4; p = 0.004). Polymorphism of the IRF5 gene (rs2004640) was not associated with risk of developing SS or with clinical manifestations of the disease. Conclusion. Polymorphisms rs7574865 of STAT4 gene, rs6920220, rs2230926 of TNFAIP3 gene are associated either with the risk of developing SS or with severe complications of the disease, MALT-lymphoma and leukopenia.

Numerous recent studies have shown that TNFAIP3 and TNF-α gene polymorphisms are associated with susceptibility to certain autoimmune and inflammatory diseases, including systemic lupus erythematosus (SLE), systemic scleroderma, rheumatoid arthritis, psoriasis, etc. However, the results of studies on associations between these polymorphisms and the risk of developing SLE in children are ambiguous and few in number.Objective: to test the hypothesis of a possible association between the rs10499194 polymorphism of the TNFA1P3 gene and the rs1800629 polymorphism of the TNF-α gene with susceptibility to juvenile SLE (jSLE) and its clinical phenotypes in the Russian pediatric population.Material and methods. Both polymorphisms were studied by allele-specific real-time polymerase chain reaction in 63 children (15 boys and 48 girls) with a confirmed diagnosis of jSLE, whose mean age was 12.3±3.2 years (3–17 years), and the mean duration of the disease was 4.1±2.4 years. Data on the frequency of genotypes and alleles of the corresponding TNFA1P3 and TNF-α gene polymorphisms in 309 healthy unrelated blood donors over the age of 18 years (20–45 years) were used as controls.Results and discussion. The study showed that the frequency of the rs10499194T mutant allele of the TNFA1P3 gene in patients with jSLE was significantly lower compared to the control (20.6 and 30.7%; p=0.023), and its carriage slightly reduced the risk of developing SLE (odds ratio, OR 0.58; 95% confidence interval, CI 0.32–1.05, p=0.053). The frequency of the rs1800629A mutant allele of the TNF-α gene was slightly higher in jSLE compared with controls (38.1 and 26.2%, respectively; p=0.056), and its carriage slightly increased the risk of developing SLE (OR 1.73; 95% CI 0.93–3.16; p=0.056). An analysis of the frequency distribution of the rs10499194 genotypes in groups of patients with and without arthritis revealed significant differences (p=0.003). Carrying genotypes with the mutant T allele (CT+TT genotypes) in jSLE significantly reduced the risk of developing of arthritis (p=0.003). At the same time, the risk of arthritis in carriers of at least one C allele was 3.76 times higher than in carriers of the other allele (p=0.006). No relationship was found between the rs1800629 TNF-α gene polymorphism and the clinical phenotypes of jSLE.Conclusion. The rs10499194T mutant allele statistically significant reduces the risk of arthritis development as one of the clinical manifestations of jSLE, and the rs1800629A mutant allele of the TNF-α gene is associated with a tendency to increase the risk of jSLE.

Caesarean section (cS) is one of the most common obstetric operations in the world. About 32 % of all births end by caesarean section. Postpartum infection at the surgical site, wound infection and endometritis are the main causes of long stays in maternity hospitals and are a source of additional costs for the healthcare system. In 2–16 % of cases postpartum endometritis develops. Many risk factors for the development of postpartum infections have been described. These include maternal factors (such as tobacco use, inadequate prenatal care, obesity, corticosteroid use; prematurity, multiple gestation, and uterine scar), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged anhydrous period; prolonged labor , especially a long second period; large incision of the anterior abdominal wall; subcutaneous tissue thickness more than 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; rapid labor; massive blood loss during childbirth). Effective measures to reduce the incidence of obstetric infectious complications include prophylactic use of antibiotics (preoperative preparation with first-generation cephalosporins and intravenous azithromycin), preoperative showering with chlorhexidine instead of iodine, shaving immediately before surgery, vaginal sanitation, removal of the placenta by traction of the umbilical cord, suturing of the subcutane-ous tissue, if the depth of the wound is larger than 2 cm and suturing the skin with sutures instead of using staples. Establishing an evidence-based optimal care algorithm for patients after caesarean section can reduce the incidence of serious infectious complications.

Aim of the study. Evaluation of efficacy of plasma currents in treatment of soft tissue wounds.Materials and methods. 682 patients with purulent inflammation of soft tissues were included into the study: in all of them argon and plasma-air currents were used. The results were compared with 440 patients, who received only standard therapeutic regimens.Results. Use of plasma-air currents was associated with diminishing of frequency of necrectomy procedures, intra-operative blood loss and postoperational pain. Plasma current accelerated necrolysis, regeneration and epythelisation of wound defect, as well as reduction of paravasal inflammation in patients with thrombophlebitis.Conclusion. Plasma current use is effective in treatment of inflammatory diseases of soft tissues.

Objective: to study the role of SAA1, CRP and STAT4 gene polymorphisms in the development of panniculitis (PN) and their relationship with clinical and laboratory parameters in the Russian cohort of patients.Patients and methods. The study included 74 patients (67 women and 7 men aged 15 to 76 years) with diagnosis of PN. In addition to the general clinical examination, immunological and histological studies, computed tomography of the chest, and tuberculin tests were performed. For genetic study, two groups of patients were formed: with septal PN (SPN, n=26), represented by erythema nodosum (EN) and with lobular PN (LPN, n=48), including predominantly with idiopathic LPN (iLPN, n= 18) and other rare variants (n=30). As a control, the results of DNA genotyping of 142 healthy non-related individuals were used. Genotyping of polymorphisms rs12218 of the SAA1 gene, rs1205 of the CRP gene, and rs7574865 of the STAT4 gene was performed by the allele-specific real-time polymerase chain reaction.Results and discussion. Significant differences were found between the groups in terms of age and duration of the disease. Patients with SPN were younger than those with LPN (p=0.013), had a shorter duration of the disease (p=0.001), and a lower ESR (p=0.001). Carriers of the TT genotype of the SAA1 gene polymorphism were twice as likely to develop LPN as compared to controls (odds ratio, OR 2.25; 95% confidence interval, CI 1.04–4.87; p=0.038), and this genotype was regarded as a risk factor. For patients with SPN, a significant risk factor was identified in the form of carriage of the mutant TT genotype of the CRP gene polymorphism. This genotype increased the predisposition to the development of EN by 4 times compared with the control (OR 4.39; 95% CI 1.26–14.11; p=0.009). There was a 6-fold increase in the risk of developing EN in carriers of the TT mutant genotype and the T allele of the STAT4 gene polymorphism compared with the control (OR 5.89; 95% CI 1.14–31.75; p=0.016 and OR 2.07; 95 % CI 0.99–4.19, p=0.030, respectively). Comparison of the frequencies of the T allele of the SAA1 gene polymorphism in the groups with EN and with iLPN revealed a higher frequency of the SAA1TT genotype and the SAA1T allele in iLPN than in EN (66.7 and 26.9%, p=0.066; 88.5 and 55.8 %, p=0.016, respectively).Conclusion. The present study confirms the involvement of genetic factors, in addition to generally recognized environmental factors, in the pathogenesis of inflammatory diseases of adipose tissue. Polymorphisms of the SAA1, CRP, and STAT4 genes play a role in the formation of a genetic predisposition to the main clinical phenotypes of PN.

Systemic lupus erythematosus (SLE) with juvenile onset (jSLE) is a complex autoimmune disease involving many organs and systems. The single nucleotide polymorphism rs7574865 of the STAT4 (signal switch and transcription activator 4) gene is associated with the risk of developing several autoimmune diseases, including SLE in adults.Objective: to verify the hypothesis of the association of the rs7574865 polymorphism of the STAT4 gene with a predisposition to jSLE. Patients and methods. In the present case-control study, the rs7574865 polymorphism was studied in 50 children with jSLE and 103 healthy control volunteers using real-time polymerase chain reaction.Results and discussion. The distribution of genotype frequencies among patients had statistically significant differences compared to controls (p=0.005). The frequencies of GG, GT, TT, GT + TT genotypes in patients with jSLE and in the control group were 36.0 and 63.1% (p=0.003); 54.0 and 33.0% (p=0.021); 10.0 and 3.9% (p=0.153); 64.0 and 36.9% respectively (p=0.003). The frequency of the mutant T allele of the studied polymorphism was higher in patients with jSLE compared with controls (37 and 20.4%, respectively; p=0.002). The association of the T allele with clinical, laboratory, and immunological phenotypes of jSLE was studied.Conclusion. The obtained data indicate the significance of the rs7574865 polymorphism of the STAT4 gene as an important risk factor for susceptibility to jSLE. An analysis of the distribution of allele frequencies between alternative groups of patients with different phenotypic manifestations of jSLE (their presence or absence) showed an association of this polymorphism with arthritis.

Background. Recently, numerous studies have shown that TNFAIP3 gene polymorphisms have been associated with susceptibility to certain autoimmune inflammatory diseases, including systemic lupus erythematosus, scleroderma, rheumatoid arthritis and psoriasis. However, the results of studies devoted to the study of associations between TNFAIP3 gene polymorphisms and the risk of ankylosing spondylitis (AS) are ambiguous and few.The aim of the study was to study the possible association of hs10499194 polymorphism of the TNFAIP3 gene with a predisposition to AS and its clinical phenotypes.Material and methods. The rs10499194 S/T polymorphism of the TNFA1P3 gene was studied in two hundred patients with AS (130 men and 70 women). All patients were diagnosed with AS, according to the modified New York criteria, 1984 and high activity of the disease. Demographic and clinical-serological characteristics were studied in all patients. The average age of patients was 39.4±12.6 years; the average duration of the disease was 15.0±10.6 years. Out of 200 patients, 175 (87.5%) were seropositive for HLA-B27 antigen. Extra axial arthritis was detected in 125 (62.5%) patients, 148 (74.0%) had enthesitis, 137 (68.5%) had coxitis. The polymorphism rs10499194 of the TNFAIP3 gene was studied using an allelespecific polymerase chain reaction in real time (PCR-RV) using the Synthol kit.Results. The analysis of the frequencies of genotypes and alleles did not show significant differences with the control group. Stratification by sex, age, and clinical manifestations showed an association of the CT genotype with an increased risk of AS among men (OR=2.24; p=0.010), the TT genotype and the T allele with a high risk of predisposition to the development of extra axillary peripheral arthritis (OR=3.94; p=0.019 and OR=1.64; p=0.027 respectively). The BASDAI index was statistically significantly higher in carriers of the TT genotype compared to the CT genotype (p=0.002).Conclusion. The present study confirmed the association of the genetic polymorphism rs10499194 of the TNFAIP3 gene with AS. Stratification by gender and clinical manifestations showed an association of the CT genotype with an increased risk of AS among men, the TT genotype and the T allele with a high risk of predisposition to the development of extra axillary peripheral arthritis and a high BASDAI index in carriers of the TT genotype.

Cells of two molecular genetic types of breast cancer—hormone-dependent breast cancer (ZR-75 cell line) and triple-negative breast cancer (BT-20 cell line)—were studied using atomic force microscopy and an optical nanomotion detection method. Using the Peak Force QNM and Force Volume AFM modes, we revealed the unique patterns of the dependence of Young’s modulus on the indentation depth for two cancer cell lines that correlate with the features of the spatial organization of the actin cytoskeleton. Within a 200–300 nm layer just under the cell membrane, BT-20 cells are stiffer than ZR-75 cells, whereas in deeper cell regions, Young’s modulus of ZR-75 cells exceeds that of BT-20 cells. Two cancer cell lines also displayed a difference in cell nanomotion dynamics upon exposure to cytochalasin D, a potent actin polymerization inhibitor. The drug strongly modified the nanomotion pattern of BT-20 cells, whereas it had almost no effect on the ZR-75 cells. We are confident that nanomotion monitoring and measurement of the stiffness of cancer cells at various indentation depths deserve further studies to obtain effective predictive parameters for use in clinical practice.

To date, modern outpatient minimally invasive interventions for varicose veins, such as endovenous laser or radiofrequency ablation, microphlebectomy, sclerotherapy, non-thermal non-tumescent methods (NTNT), are widely introduced into clinical practice in the Russia. In the approved by the Ministry of Health of the Russian Federation in 2021 clinical guidelines "Varicose veins of the lower extremities" they are recommended as preferred over open surgery. At the same time, there are no federal regulations of preoperative examination of patients before these minimally invasive procedures for varicose veins. That is why the medical community is often forced to prescribe unnecessary diagnostic tests on the "just-in-case" principle, in order to protect itself for cases of complications and subsequent checks. This undoubtedly harms both the patients and the medical service, which has an additional useless and inappropriate burden. The purpose of the round table held on September 28, 2021 under the auspices of the Self-Regulatory Organization “The National College of Phlebology” together with the legal partner “The Faculty of Medical Law LLC” (Moscow), was to review the existing legislation on this issue and then to prepare a resolution regarding the justified preoperative examination of patients before minimally invasive interventions for varicose veins of the lower extremities. The prepared document consists of two parts. The first part presents the legal regulation of the diagnostic tests before interventions in phlebology. The second part contains the opinion of the professional community regarding the appropriateness or inexpediency of different pre-procedural examinations. In addition, based on the conclusions of legal analytics, a form of order of the chief physician has been developed, which regulates the diagnostic tests before the considered phlebological interventions in the clinic.