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The paper analyzes the working conditions of workers in the dairy industry, which showed that the prevailing harmful production factor is the increased noise level. It has been proven that noise has a negative impact not only on the hearing organs, but also on the whole organism as a whole as a general biological irritant, therefore, reducing noise expansion due to engineering solutions is an urgent task of our time. The article assesses the noise impact on operators of the dairy industry as part of a special assessment of working conditions. The analysis showed that the excess noise level is observed at all workplaces. To protect workers from an increased noise level, a design of a sound-suppressing piece sound absorber is proposed, which is distinguished by high sanitary and hygienic properties. The use of sound-suppressing piece sound absorbers will improve working conditions from a harmful class to an acceptable one.

Since the early months of the SARS-CoV-2 pandemic, the understanding that severe forms of COVID-19 are associated with systemic inflammation has spurred the medical community to greater efforts to evaluate the effect of numerous anti-inflammatory and immunomodulatory therapies. Corticosteroids have a broad and non-specific anti-inflammatory action; they can interfere with mRNA transcription of inflammatory cytokines, reducing the production of inflammatory mediators. Therefore, the use of glucocorticoids will reduce the complications caused by the cytokine storm. On the other hand, immunosuppression in the respiratory epithelium may delay viral clearance and predispose to secondary infections and clinical deterioration. Therefore, WHO does not currently recommend the routine use of corticosteroids in the treatment of patients with COVID-19. The RECOVERY study showed a reduction in mortality with dexamethasone in patients with COVID-19 hypoxemia, as well as an increase in the number of days without mechanical ventilation among critically ill patients. The REMAP-CAP Committee concluded that among patients with severe COVID-19, treatment with a 7-day course of various hydrocortisone dose versus no hydrocortisone resulted in 93 and 80% chances of eliminating the need for respiratory and cardiac support for 21 days. The results of studies conducted show that there was no statistical difference between steroid use and mortality in patients with COVID-19 in the high dose group, while there was statistical difference in the medium dose group. The less 5 days group showed a strong association between reduced mortality in patients with COVID-19 and steroid use, while there were no statistically significant associations in the 5–7 days group and the more than 7 days group. Inhaled forms of corticosteroids deserve attention given their effectiveness and logical use.

Gilbert’s syndrome is an autosomal recessive inherited disorder of bilirubin glucuronidation characterized by unconjugated hyperbilirubinaemia in the absence of hepatocellular injury or hemolysis. Gilbert’s syndrome is characterized by mutations to the UGT1A1 gene which encodes the enzyme uridine disphosphate glucuronоsyltransferase which is required for the conjugation and subsequent excretion of bilirubin. Most Gilbert’s syndrome patients experience recurrent and short-term episodes of yellowing of the skin and sclera of eyes caused by bilirubin accumulation in the blood. Approximately 30 % of patients with Gilbert's syndrome do not experience any symptoms, but are detected by blood tests that show elevated levels of unconjugated bilirubin. In addition to traditional methods, genetic analysis of the UGT1A1 gene allows us to confirm the diagnosis of Gilbert's syndrome. The article presents modern concepts of the pathogenesis, diagnosis, differential diagnosis and treatment of Gilbert's syndrome. It is of interest to gastroenterologists, internists and general practitioners who treat such patients.

Background. Praxis disorders are one of the most common consequences of brain damage. In this regard, neuropsychological diagnosis and rehabilitation of patients with praxis disorders is of great practical importance. Since people with apraxia and their families continue to live in society, they have to deal with issues of social functioning in the context of the patient's limited abilities. As social well-being is impossible without taking into account the psychological and behavioral aspects of the patient and his environment, the modern approach to diagnosis and rehabilitation includes working with all of these aspects. This work is implemented through the organization of a partnership between the patient, his environment and a multidisciplinary team of specialists. Objective. The article aims to analyze and summarize the diagnostic and rehabilitation experience accumulated in neuropsychology, as well as to identify quality criteria for neuropsychological diagnosis and rehabilitation of patients with praxis disorders arising from brain damage. These criteria are recommended for use in the practice of a clinical psychologist. Results. Based on the analysis of applied research and practical guidelines, recommendations on the choice of diagnostic tools for detecting praxis disorders are presented. The main directions and methods of rehabilitation work, which have shown their effectiveness in overcoming kinetic, kinesthetic, spatial and regulatory apraxia, are highlighted. Conclusion. The practical work of a clinical psychologist with patients suffering from praxis disorders should be aimed at maintaining the level of preserved voluntary movements and actions as a “support” for further restoration of motor functions or for maintaining the existing level of motor functioning. Practical work should seek to restore disturbed praxis with the help of internal / external means or special techniques and focus on the organization of the patient's household environment in order to minimize restrictions in functioning.

The authors describe their experience in a successful treatment of a patient with necrotizing infection of lower limb soft tissues complicated by sepsis. Their comprehensive approach included two-stage surgical intervention and medicamentous therapy. As a result, the patient has completely recovered.

The article describes a clinical case of viral pneumonia associated with COVID-19 of the only lung, it developed in the patient 30 days after pleuropneumonectomy which was done to manage fibrous cavernous pulmonary tuberculosis. The favorable course of COVID-19 was due to its timely detection and initiation of treatment, and possibly, it was due to using anti-tuberculosis chemotherapy containing antibacterial drugs that prevented nosocomial infections.

Non-alcoholic fatty liver disease, or NAFLD – is a pathology that usually has a metabolic cause and is not caused by excessive alcohol consumption. NAFLD is the most frequent chronic liver disease worldwide and is accompanied by a high financial burden for the patient and the healthcare system. NAFLD is generally considered a “benign disease” with low progression to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Nevertheless, due to the large number of affected patients, the prevalence of cirrhosis of the liver has gradually increased, and in fact it represents the third cause of liver transplantation in the world. Moreover, even if the frequency of HCC in patients with NAFLD is lower than in patients with HCV/HBV cirrhosis, the absolute number of HCC associated with NASH is higher due to the higher number of patients with NAFLD. It is likely that the importance of this disease will continue to grow in the future, when new treatments and prevention programs for hepatitis C and B reduce the size of viral liver infections. Many aspects of the disease have yet to be solved. It is very important to understand the mechanisms underlying the occurrence and development of NAFLD, the features of the clinic and diagnosis, as well as the tactics of management and treatment of patients with non-alcoholic fatty liver disease. It is important for patients to get a complete understanding of NAFLD so that they can play an active role in the treatment of their disease.

COG-UK is supported by funding from the MRC part of UK Research & Innovation, the National Institute of Health Research (Grant code MC_PC_19027), and Genome Research Limited, operating as the Welcome Sanger Institute. Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine. Publisher PDF

The problem of comorbidity becomes especially relevant in the conditions of demographic aging of the population. In recent years the number of studies devoted to diagnostic and treatment features of comorbidities, especially in elderly and senile patients, has increased. In spite of this fact, until now there are no clear recommendations for the management of comorbidities in the therapeutic practice.The article is devoted to the presentation and discussion of a clinical case of a comorbid patient with arterial hypertension. The stages of the performed diagnostic search with verification of the clinical diagnosis and the tactics of the prescribed pharmacotherapy are presented. On the basis of the presented data it is shown that exacerbation of one of the chronic diseases of the patient’s general comorbid background may significantly increase the severity of the general pathology and in its turn will determine the prognosis and influence the treatment tactics. The complexity of this case is that the patient has chronic single kidney disease in the stage of chronic renal failure. In analysing this case, it is also important to note the difficulties in the choice of drug therapy, as this situation poses significant limitations in the use of many drugs. This is a challenge that every clinician faces on a daily basis, regardless of clinical experience and medical knowledge. Only a multilevel approach will enable comprehensive medical and social care to be organised for patients with co-morbidities with chronic diseases, provide follow-up not only during exacerbations but also during remissions, contribute to the prevention of exacerbations and complications, which will consequently improve prognosis and quality of life.

The paper analyzes a set of equations that adequately predict the IC50 value for SARS-CoV-2 main protease inhibitors. The training set was obtained using filtering by criteria independent of prediction of target value. It included 76 compounds, and the test set included nine compounds. We used the values of energy contributions obtained in the calculation of the change of the free energy of complex by MMGBSA method and a number of characteristics of the physical and chemical properties of the inhibitors as independent variables. It is sufficient to use only seven independent variables without loss of prediction quality (Q² = 0.79; R²prediction = 0.89). The maximum error in this case does not exceed 0.92 lg(IC50) units with a full range of observed values from 1.26 to 4.95.V rabote analiziruetsia nabor uravneniĭ, adekvatno predskazyvaiushchiĭ velichinu IC50 dlia ingibitorov glavnoĭ proteazy SARS-CoV-2. Obuchaiushchaia vyborka poluchena s ispol'zovaniem fil'tratsii po nezavisimym ot predskazaniia tselevoĭ velichiny kriteriev. V ee sostav voshlo 76 soedineniĭ, testovaia vyborka sostavila 9 soedineniĭ. V kachestve nezavisimykh peremennykh ispol'zovali velichiny énergeticheskikh vkladov, poluchennykh pri raschete metodom MMGBSA izmeneniia svobodnoĭ énergii kompleksa, i riad kharakteristik fiziko-khimicheskikh svoĭstv ingibitorov. Dostatochno ispol'zovat' vsego 7 nezavisimykh peremennykh bez poteri kachestva predskazaniia (Q² = 0,79; R²predskazaniia = 0,89). Maksimal'naia oshibka pri étom ne prevyshaet 0,92 edinitsy lg(IC50) pri polnom diapazone nabliudaemykh velichin ot 1,26 do 4,95.

The experimental results available in the ProteomeXchange database (accession code PXD016538) (Simats et al. (2020) Molecular and Cellular Proteomics, 19(12), 1921-1936) obtained using a comprehensive multi-omics approach were analyzed in mouse blood to identify potential biomarkers of ischemic stroke. Acetylation, methylation, and ubiquitination were considered as post-translational modifications. The analysis of the significance of changes in the level of protein modification was evaluated for ischemic tissue in comparison with tissue undamaged by stroke and control taken from mice after sham operation. At the level of statistically significant differences according to the Mann-Whitney test (p0.05), 2 proteins were found (Q02248 and Q8BL66); for additional 7 proteins, the differences were at the level of a statistical trend (p0.1). For 7 of 9 selected proteins there are reports in the literature, for their association with cerebral ischemia.Proanalizirovany dostupnye v baze dannykh ProteomeXchange (accession code PXD016538) éksperimental'nye rezul'taty (Simats et al. (2020) Molecular and Cellular Proteomics, 19(12), 1921-1936), poluchennye pri ispol'zovanii kompleksnogo mul'tiomnogo podkhoda po vyiavleniiu potentsial'nykh biomarkerov ishemicheskogo insul'ta v krovi mysheĭ. V kachestve posttransliatsionnykh modifikatsiĭ rassmotreny atsetilirovanie, metilirovanie i ubikvitinirovanie. Analiz dostovernosti izmeneniia urovnia modifikatsii belkov otsenivali dlia ishemicheskoĭ tkani v sravnenii s nepovrezhdennoĭ insul'tom tkan'iu i kontrolem, vziatym u mysheĭ posle mnimoĭ operatsii (sham operation). Pri urovne statisticheski znachimykh razlichiĭ po kriteriiu Manna-Uitni (p0,05) naĭdeno 2 belka (Q02248 i Q8BL66); dlia eshche 7 belkov razlichiia nakhodiatsia na urovne statisticheskoĭ tendentsii (p0,1). Dlia 7 iz naĭdennykh 9 belkov v literature est' dannye o sviazi s ishemieĭ mozga.

Unfavorable clinical outcomes mean that cancer researchers must attempt to develop novel therapeutic strategies to overcome therapeutic resistance in patients with HNSCC. Recently, ferroptosis was shown to be a promising pathway possessing druggable targets, such as xCT (SLC7A11). Unfortunately, little is known about the molecular mechanisms underlying the susceptibility of HNSCC cells to ferroptosis. The goal of this study was to determine whether HNSCC cells with activated Erk1/2 are vulnerable to ferroptosis induction. Our results have shown that xCT (SLC7A11) was overexpressed in malignant tissues obtained from the patients with HNSCC, whereas normal mucosa demonstrated weak expression of the protein. In order to investigate the role of Erk1/2 in the decrease in cell viability caused by erastin, xCT-overexpressing FaDu and SCC25 HNSCC cells were used. The ravoxertinib-dependent inhibition of Erk1/2 signaling led to the decrease in erastin efficacy due to the effect on ROS production and the upregulation of ROS scavengers SOD1 and SOD2, resulting in repressed lipid peroxidation. Therefore, it was concluded that the erastin-dependent activation of ferroptosis seems to be a promising approach which can be further developed as an additional strategy for the treatment of HNSCC. As ferroptosis induction via erastin is strongly dependent on the expression of Erk1/2, this MAP kinase can be considered as a predictor for cancer cells’ response to erastin.

The definition of gastritis is based on the histological features of the gastric mucosa. This is not the erythema observed during gastroscopy, and there are no specific clinical manifestations or symptoms that determine it. The modern classification of gastritis is based on time (acute and chronic), histological features, anatomical distribution and the main pathological mechanisms. Acute gastritis will develop into chronic if left untreated. Helicobacter pylori (H. pylori) is the most common cause of gastritis worldwide. However, from 60 to 70% H. pylori-negative subjects with functional dyspepsia or non-erosive gastroesophageal reflux were also found to have gastritis. H. pylori-negative gastritis is considered when a person meets all four of these criteria: negative triple staining of biopsies of the gastric mucosa, no history of treatment of H. pylori. In these patients, the cause of gastritis may be associated with tobacco smoking, alcohol consumption and / or the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids. Other causes of gastritis include autoimmune gastritis associated with antibodies of serum anti-parietal and anti-internal factor; organisms other than H. pylori, such as Mycobacterium avium intracellulare, Herpes simplex and Cytomegalovirus; gastritis caused by acid reflux; Rare causes of gastritis include collagen gastritis, sarcoidosis, eosinophilic gastritis and lymphocytic gastritis. The clinical picture, laboratory studies, gastroscopy, as well as histological and microbiological examination of tissue biopsies are important for the diagnosis of gastritis and its causes. Treatment of gastritis caused by H. pylori leads to the rapid disappearance of polymorphic-nuclear infiltration and a decrease in chronic inflammatory infiltrate with gradual normalization of the mucous membrane. Other types of gastritis should be treated based on their etiology.

Substantiation of differences between payback and break-even points in the production activities of enterprises is concerned. The method of modeling and research of economic phenomena and processes is offered. The methodological basis of this approach are two elements: the creation of a formalized economic categorical apparatus and the construction of mathematical models of economic processes. The essence of the formation of the categorical apparatus is as follows: three primary categories are proposed, on the basis of which all secondary ones are defined axiomatically. The application of this categorical apparatus makes it possible to solve the following main issues: to formulate the content of qualitative economic concepts (categories) of "stock" and "flow"; to introduce into economic practice such an important indicator as "economic acceleration", as a result of which there is an opportunity to reasonably model and study nonlinear economic processes; change the understanding of many economic concepts - "value", "price", etc., because they become categories that have separate units of measurement, and therefore formed indicators that are significantly different from traditional ("cost", "profit price", etc.). But most importantly, it ultimately provides an opportunity to model and explore important economic processes and indicators. The application of the proposed category apparatus is shown on the example of modeling and research of economic processes occurring at the enterprise in the implementation of operational activities - production and sale of manufactured products. The most important element of this activity is the substantiation of payback and break-even points that correspond to a given technological process. The disadvantage of existing approaches to substantiate these indicators is that when describing these processes using traditional concepts, researchers often confuse which point they consider - payback or break-even, as the main indicators in the obtained models are almost the same - on the X-axis "production volumes ” are put, and on the Y axis -“ costs ”and“ sales ”. Therefore, the main difference between these points is not in the name of the elements of the study (their name is the same in both cases), but in their essence. In the first case, when the payback point is determined, these indicators are considered as a "stock", and in the second - when determining the break-even point - in the form of flows. This means that in order to avoid mistakes, it is necessary to understand clearly in which space (stocks or flows) research should be carried out. Keywords: economic categories, stock, flow, economic acceleration, payback point, break-even point, fixed and variable costs, one-time and current costs.

Kidney involvement is a common manifestation of the systemic autoimmune rheumatic diseases. Kidney biopsy is the gold standard for the diagnosis of kidney diseases, however this method has not yet become the standard-of-care in rheumatology practice.To assess the diagnostic value of kidney biopsy in the management of patients of the rheumatology department.In this retrospective observational study we analyzed the medical documentation including kidney morphology findings in the patients of the Department of Rheumatology at Tareev Clinic of Internal Diseases. All patients included in the research had signs of kidney involvement and had undergone needle biopsy of the kidney or re-evaluation of the kidney tissue received previously.From June 2016 to October 2021, 3110 patients were admitted to the rheumatology department. Among them 63 (2%) underwent kidney biopsy and were included in the study. Twenty (32%) were male. Mean age was 42.513.9 years. The most common preliminary diagnoses before kidney biopsy were ANCA-associated vasculitis (n=17), systemic lupus erythematosus (n=12), and AA-amyloidosis associated with inflammatory joint diseases (n=7). In 14 (27%) patients diagnosis was unspecified at the time of biopsy. Among 49 patients with established preliminary diagnosis morphological findings were in line 38 (78%) with the pre-liminary diagnosis. However, in 11 (22%) patients morphological findings resulted in the change of the diagnosis. In all 14 patients with unspecified condition kidney biopsy helped to establish clinical diagnosis. Ultrasound evaluation demonstrated hematoma formation in 18 (31%) patients, and among them two required blood component transfusions.Our study demonstrates significant value and safety of kidney biopsy in the patients with autoimmune rheumatic conditions. We suggest that kidney biopsy should be implemented in the management of this category of patients.Обоснование. Поражение почек частое проявление системных ревматологических заболеваний. Несмотря на то что биопсия является золотым стандартом диагностики поражения почек, этот метод еще не вошел в стандартную практику ревматологических отделений. Цель. Определить диагностическую ценность биопсии почки у пациентов ревматологического отделения многопрофильного стационара и оценить ее влияние на тактику ведения пациентов. Материалы и методы. Нами проведена ретроспективная оценка историй болезни и протоколов морфологического исследования биоптатов почки пациентов ревматологического отделения Клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева Университетской клинической больницы №3 ФГАОУ ВО Первый МГМУ им. И.М. Сеченова. У всех пациентов наблюдалось поражение почек, в связи с этим выполнена пункционная биопсия почки либо повторная экспертная оценка готовых препаратов ткани почки. Результаты. За период с июня 2016 по октябрь 2021 г. в ревматологическом отделении проходили стационарное лечение 3110 пациентов, среди них морфологическое исследование ткани почки было выполнено 63 (2%) пациентам. Среди включенных в исследование 63 пациентов 20 (32%) мужчины. Средний возраст пациентов составил 42,513,9 года. Наиболее частыми предварительными диагнозами до проведения биопсии были васкулит, ассоциированный с антителами к цитоплазме нейтрофилов (n=17), системная красная волчанка (n=12), AA-амилоидоз, ассоциированный с воспалительными заболеваниями суставов (n=7). У 14 (22%) пациентов диагноз основного заболевания на момент выполнения биопсии был неясен. У 38 (78%) из 49 пациентов с установленным предварительным диагнозом морфологические изменения в ткани почки соответствовали наиболее ожидаемым вариантам поражения, ассоциированного с основным заболеванием. Однако в 11 (22%) случаях морфологические находки в биоптате стали основанием для пересмотра диагноза и изменения тактики ведения. У всех 14 пациентов с неясным диагнозом биопсия позволила верифицировать основное заболевание. Осложнение пункции в виде образования гематомы по данным ультразвукового исследования было зарегистрировано у 18 (31%) пациентов, что стало показанием к назначению трансфузии препаратов крови 2 пациентам. Заключение. Исследование демонстрирует существенную ценность и в целом высокую безопасность пункционной биопсии почки у пациентов ревматологического профиля и обосновывает ее более широкое внедрение в практику ведения этой категории пациентов.

Background: According to numerous studies, from 30% to 50% of patients with chronic heart failure (CHF) are resistant to cardiac resynchronization therapy (CRT) and cardiac contractility modulation (CCM), despite their careful selection in accordance with current guidelines. It is of interest to study neurohormones characterizing myocardial (NT-proBNP) and fibrosis (sST2) as potential additional markers of CHF patients' “response” to CRT and CCM.Aim: To evaluate the potential to use NT-proBNP and sST2 biomarkers in CHF patients combined with transthoracic echocardiography (Echo) and contrast magnetic resonance imaging (MRI) parameters of the heart to predict a positive response to CRT and CCM devices.Materials and methods: The study included 51 patients (41 men, 10 women) aged 58 ± 12 years (26 to 79 years) with ischemic heart disease post acute myocardial infarction (n = 22) or non-ischemic cardiomyopathy (n = 29), left ventricle (LV) ejection fraction (EF) < 35%, and CHF II–III NYHA functional class despite ≥ 3 months of optimized medical therapy. The patients were assessed by serum biomarkers NT-proBNP and sST2 measurements, transthoracic Echo, and contrast- enhanced cardiac MRI. After the diagnostic assessment, CRT defibrillators (CRT-D) were implanted to 39 patients and CCM to 12 patients. After prospective follow-up of the patients for 18 to 24 months, predictors of the response to each device type were analyzed in univariate, multivariate, and ROC analysis.Results: The response to CRT-D was found in 21 (54%) patients, to CCM in 7 (58%) patients. Multivariate analysis showed the following predictors of the response of patients to CRT-D were: 1) sST2 < 50 ng/mL, 2) NT-proBNP < 3900 pg/mL, 3) < 3 LV segments with fibrosis (by MRI) and 4) anteroposterior dimension of the left atrium < 4.8 cm (by Echo). Any 2 of these 4 characteristics made it possible to predict the response to CRT with an accuracy of 87% (sensitivity 90%, specificity 83%). The predictors of the response to CCM were: 1) sST2 < 30 ng/ml, 2) LV end diastolic diameter < 78 mm (Echo), 3) age < 56 years, 4) body mass index < 27 kg/m2. Any 2 of these 4 characteristics predicted the positive response to CCM with an accuracy of 92% (sensitivity 86%, specificity 100%).Conclusion: The preoperative sST2 level was the only universal marker of the response to either CRT (< 50 ng/mL) or CCM (< 30 ng/mL) devices in CHF patients with reduced LVEF. The results indicate the potential for improved efficacy of these devices with their earlier implantation after the onset of the heart disease, as well as provided that maximal control CHF in these patients has been achieved.

Introduction. The problem of gastric ulcer is of particular socio-economic importance and has a tremendous impact on the quality of life of people. The relevance of our study is due to an increase in the incidence of peptic ulcer in the population, the variability of the clinical picture depending on the age category of patients, and the peculiarities of the treatment of this gastrointestinal pathology.The aim of the study is to study the features of the course of gastric ulcer in different age groups of patients under dispensary supervision in the outpatient department of the State Budgetary Healthcare Institution of the Republic of Moldova “Republican Clinical Hospital No. 5” in the period from 2017 to 2020.Materials and methods. A retrospective analysis of outpatient records of 100 patients of different age groups with gastric ulcer who were under dispensary observation at the outpatient clinic of the Republican Clinical Hospital No. 5 in Saransk in 2017– 2020 was carried out. Statistical analysis of the data obtained was carried out using the Microsoft Office Excel program.Results and discussion. It was found that gastric ulcer is more often observed in middle-aged and elderly patients and is accompanied by blurring of the clinical picture of the disease, in contrast to young people, who have vivid clinical manifestations of this disease. Ulcerative defects in young and middle-aged patients are more often small in size and are located mainly in the area of the stomach angle, and in elderly and senile patients, ulcers are localized mainly in the cardiac region, can be gigantic and often lead to the development of complications (primarily gastrointestinal intestinal bleeding).Conclusions. The blurring of the clinical picture, the absence of pathognomonic symptoms in elderly patients determine the late diagnosis of gastric ulcer, which ultimately leads to a high incidence of complications requiring surgical intervention. In clinical practice, it is necessary to take into account these features of the course of peptic ulcer disease in elderly patients and to prescribe the necessary complex of laboratory and instrumental studies and preventive therapy in a timely manner.

The experimental data obtained by Simats A. et al. (Molecular and Cellular Proteomics, 2020, 19(12), 1921-1936) was analysed using a bioinformatic approach. Original experimental results available in the ProteomeXchange database were obtained using a comprehensive multidomain approach to identify potential blood biomarkers in ischemic stroke in mice. The identification of peptides with post-translational modification (PTM) was performed by us using the raw data (accession code PXD016538). Only phosphorylation and deamination were considered as PTMs. Different combinations of data sets (ischemic tissue with intact tissue, ischemic tissue with control taken from mice after sham surgery, etc.) were compared both in terms of the ratio of abundance for the modified peptide to the unmodified variant and in terms of absolute values of abundance. The most likely change in precisely PTM levels was shown for 27 proteins, which include dynamin, glycogen phosphorylase and 70 kDa heat shock protein.Proanalizirovany éksperimental'nye dannye (Simats A. et al. (2020) Molecular and Cellular Proteomics, 19(12), 1921-1936), poluchennye pri ispol'zovanii kompleksnogo mul'tiomnogo podkhoda po vyiavleniiu potentsial'nykh biomarkerov krovi pri ishemicheskom insul'te u mysheĭ, dostupnye v baze dannykh ProteomeXchange (accession code PXD016538). Identifikatsiia peptidov s posttransliatsionnymi modifikatsiia (PTM) byla provedena zanovo. V kachestve PTM rassmatrivali tol'ko fosforilirovanie i dezaminirovanie. Razlichnye kombinatsii dannykh (ishemicheskaia tkan' s nepovrezhdennoĭ, ishemicheskaia tkan' s kontrolem, vziatym u mysheĭ posle mnimoĭ operatsii, i t.d.) sravnivali kak po otnosheniiu predstavlennosti (abundance) dlia modifitsirovannogo peptida k nemodifitsirovannomu variantu, tak i po absoliutnym znacheniiam predstavlennosti. Naibolee veroiatnoe izmenenie urovnia PTM pokazano dlia 27 belkov, k chislu kotorykh otnosiatsia dinamin, glikogenfosforilaza i belok teplovogo shoka 70 kDa.

Alcohol abuse with resultant alcoholic liver disease (ALD) are a leading cause of morbidity and mortality worldwide. Due to absence of clinical symptoms of the disease in the early stages, it is diagnosed in the later stages with higher complications and mortality rates. Diagnosis of ALD requires a better determination of life history and prognostic factors, as well as the search for reliable non-invasive techniques. Early detection of alcoholic steatohepatitis in primary care settings and subsequent interventions will facilitate the satisfaction of this requirement. Despite some important advances in understanding the pathogenesis and clinical features of ALD, the past 40 years have not seen significant advances in the therapy. The long-term alcohol abstinence is the main therapy for ALB patients, regardless of the disease stage. It is associated with improved clinical outcomes across the ALD spectrum: from asymptomatic early cases to complicated severe cases. Clinical ultimate outcomes depend on the ALD stage. The ultimate outcomes are associated with normalisation of abnormal laboratory test results and reduction in liver fibrosis in compensated patients. These ultimate outcomes can be monitored using non-invasive tools, but current medical interventions are largely limited and ineffective. Supportive therapy forms the basis of the treatment, it is worth paying special attention to combined herbal medicines as less toxic ones with single contraindications and consistent with the desire of many patients to use natural preparations.

At present, it is widely recognized that machine perfusion allows for a decreased rate of delayed function of the renal graft and of the risk of liver graft early dysfunction. The aim of the review is to present the actual changes of the donor pool related to prevailing numbers of donors by expanded criteria, to determine the prospects of expanding of the available donor pool based on their selection, as well as development of functional rehabilitation and modification at tissue, cell and molecular levels with the help of perfusion technologies. The article presents the state-of-the art view on the mechanisms of ischemic-reperfusion injury of donor organs, delineates the trends in the maintenance of their viability, and gives the literature data on the role and outlook of perfusion methods in organ transplantation. The authors provide the rationale for a comprehensive systemic approach to the assessment of the functional status of a donor organ with any baseline parameters and discuss a number of theoretical provisions on the implementation of a personalized perfusion approach to ensure the availability of transplantation care.

Liver cancers are among the deadliest malignancies due to a limited efficacy of early diagnostics, the lack of appropriate biomarkers and insufficient discrimination of different types of tumors by classic and molecular methods. In this study, we searched for novel long non-coding RNA (lncRNA) as well as validated several known candidates suitable as probable biomarkers for primary liver tumors of various etiology. We described a novel lncRNA HELIS (aka “HEalthy LIver Specific”) and estimated its expression by RT-qPCR in 82 paired tissue samples from patients with hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), combined HCC-CCA, pediatric hepatoblastoma (HBL) and non-malignant hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH). Additionally, we examined expression of cancer-associated lncRNAs HULC, MALAT1, UCA1, CYTOR, LINC01093 and H19, which were previously studied mainly in HCC. We demonstrated that down-regulation of HELIS strongly correlates with carcinogenesis; whereas in tumors with non-hepatocyte origin (HBL, CCA) or in a number of poorly differentiated HCC, this lncRNA is not expressed. We showed that recently discovered LINC01093 is dramatically down-regulated in all malignant liver cancers; while in benign tumors LINC01093 expression is just twice decreased in comparison to adjacent samples. Our study revealed that among all measured biomarkers only down-regulated HELIS and LINC01093, up-regulated CYTOR and dysregulated HULC are perspective for differential diagnostics of liver cancers; whereas others demonstrated discordant results and cannot be considered as potential universal biomarkers for this purpose.

The article presents the clinical case of successful treatment of a patient with heel plantar trophic ulcer. The results of plastics a neuropathy heel ulcer by medial plantar island flap are demonstrated.

The article describes a clinical case of successful treatment of a patient with disseminated bilateral fibrous cavernous tuberculosis and extensive drug resistance, with preserved sensitivity to only one anti-tuberculosis drug; the fifth chemotherapy regimen and pleuropneumonectomy were used.

Background The COVID-19 pandemic has highlighted the importance of whole genome sequencing (WGS) of SARS-CoV-2 to inform public health policy. By enabling definition of lineages it facilitates tracking of the global spread of the virus. The evolution of new variants can be monitored and knowledge of specific mutations provides insights into the mechanisms through which the virus increases transmissibility or evades immunity. To date almost 1 million SARS-CoV-2 genomes have been sequenced by members of the COVID-19 Genomics UK (COG-UK) Consortium. To achieve similar feats in a more cost-effective and sustainable manner in future, improved high throughput virus sequencing protocols are required. We have therefore developed a miniaturized library preparation protocol with drastically reduced consumable use and costs. Results We present the ‘Mini-XT’ miniaturized tagmentation-based library preparation protocol available on protocols.io (10.17504/protocols.io.bvntn5en). SARS-CoV-2 RNA was amplified using the ARTIC nCov-2019 multiplex RT-PCR protocol and purified using a conventional liquid handling system. Acoustic liquid transfer (Echo 525) was employed to reduce reaction volumes and the number of tips required for a Nextera XT library preparation. Sequencing was performed on an Illumina MiSeq. The final version of Mini-XT has been used to sequence 4384 SARS-CoV-2 samples from N. Ireland with a COG-UK QC pass rate of 97.4%. Sequencing quality was comparable and lineage calling consistent for replicate samples processed with full volume Nextera DNA Flex (333 samples) or using nanopore technology (20 samples). SNP calling between Mini-XT and these technologies was consistent and sequences from replicate samples paired together in maximum likelihood phylogenetic trees. Conclusions The Mini-XT protocol maintains sequence quality while reducing library preparation reagent volumes eightfold and halving overall tip usage from sample to sequence to provide concomitant cost savings relative to standard protocols. This will enable more efficient high-throughput sequencing of SARS-CoV-2 isolates and future pathogen WGS.

Novel hydantion and thiohydantoin-based spiro-compounds were prepared via theDiels–Alder reactions between 5-methylidene-hydantoins or 5-methylidene-2-thiohydantoins and 1,3-dienes (cyclopentadiene, cyclohexadiene, 2,3-dimethylbutadiene, isoprene). It was shown that the cycloaddition reactions proceed regioselectively and stereoselectively with the formation of exo-isomers in the reactions with cyclic dienes andthe less sterically hindered products in the reactions with isoprene. Reactions of methylideneimidazolones with cyclopentadiene proceed viaco-heating the reactants; reactions with cyclohexadiene, 2,3-dimethylbutadiene, and isoprene require catalysis by Lewis acids. It was demonstrated that ZnI2 is an effective catalyst in the Diels–Alder reactions of methylidenethiohydantoins with non-activated dienes. The possibility of alkylation and acylation of the obtained spiro-hydantoinsat the N(1)nitrogen atoms with PhCH2Cl or Boc2O and the alkylation of the spiro-thiohydantoinsat the S atoms with MeI or PhCH2Cl in high yields have been demonstrated. The preparativetransformation of spiro-thiohydantoins into corresponding spiro-hydantoinsin mild conditions by treating with 35% aqueous H2O2 or nitrile oxide has been carried out. The obtained compounds show moderate cytotoxicity in the MTT test on MCF7, A549, HEK293T, and VA13 cell lines. Some of the tested compounds demonstrated some antibacterial effect against Escherichia coli (E. coli) BW25113 DTC-pDualrep2 but were almost inactive against E. coli BW25113 LPTD-pDualrep2.

We investigated the stability of silver nanoisland films, which were formed on glass surface by the method of out-diffusion, in biocompatible buffers and the applicability of the films in surface enhanced Raman scattering (SERS). We have shown that silver nanoisland films are stable in one of the most widespread in biological studies buffer—phosphate buffer saline (PBS), and in 1:100 water-diluted PBS, in the PBS-based buffer, in which NaCl is replaced by the same amount of NaClO4, and in acidic phosphate buffer. At the same time, the replacement of NaCl in PBS by N(CH3)4Cl leads to the degradation of the nanoislands. It was shown that after exposure to PBS the nanoisland films provided a good SERS signal from a monolayer of 1,2-di(4-pyridyl)ethylene (BPE), which makes silver nanoisland films promising for biosensor applications. Additionally, in our experiments, we registered for the first time that silver nanoparticles formed in the bulk of the samples dissolved after exposing to PBS, while nanoislands on the glass surface stayed unchanged. We associate this phenomenon with the interaction of ions contained in PBS solution with silver, which results in the shift of corresponding chemical equilibrium.