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Aim To compare long-term outcomes of x-ray endovascular (percutaneous coronary intervention, PCI, and lower limb angioplasty with stent placement, LLA; group 1) and combination treatments (PCI and open LLA surgery; group 2) in patients with chronic lower limb ischemia (CLLI) associated with ischemic heart disease (IHD).Material and methods This retrospective study has been conducted in the Vishnevsky National Medical Research Center of Surgery since 2019. The study includes 92 patients with stage 2B CLLI associated with IHD who were managed from January 1, 2017 through December 31, 2020. Long-term outcomes were evaluated in 76 (82.6 %) patients. The endpoint was severe cardiovascular complications (CVC), including death, myocardial infarction, and acute cerebrovascular disease (ACVD).Results In group 1 during the long-term period, 1 (2.7%) fatal outcome due to pneumonia was observed. In group 2, 4 (10 %) patients died: 1 (2.5 %) patient due to ACVD, 1 (2.5 %) patient due to progression of oncological process, and 2 2 (5 %) patients due to COVID-19. Also, 2 (5.5 %) and 1 (2.5 %) cases of acute coronary syndrome (ACS) were observed in groups 1 and 2, respectively (p=0.61).Conclusion In the x-ray endovascular (group1) and the combination (group 2) intervention groups, lethal outcomes due to myocardial infarction were absent. This fact confirms the importance of PCI in patients with CLLI for prevention of possible ACS in the long-term. Both therapeutic tactics in managing CLLI patients with IHD demonstrated high safety and clinical efficacy during the hospital and long-term periods and can be extensively used in routine clinical practice.

Introduction. Connective tissue is ubiquitous in the human body, hereditary connective tissue disorders affect several systems and organs, undifferentiated connective tissue dysplasia is often not diagnosed, proceeds under the guise of another pathology, and the pathogenetic basis of COVID-19 is a systemic disease associated with vascular inflammation and endothelial damage. The goal is to study the clinical and laboratory features of a new coronavirus infection in patients with connective tissue dysplasia.Materials and methods. The study included 117 patients diagnosed with a new coronavirus infection COVID-19 aged 35 to 65 years, hospitalized in an infectious diseases hospital City Clinical Hospital No. 40 in Ekaterinburg. The patients were divided into 2 groups: the main group (n=90) people with the stigmas of connective tissue dysplasia and the comparison group: (n=27) people without signs of connective tissue dysplasia. Inclusion criteria: the presence of stigma of connective tissue dysplasia, the presence of a confirmed infection with COVID-19 (PCR of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2). Exclusion criteria: age over 65, comorbidities: diseases of the musculoskeletal system, chronic kidney disease, pregnancy, HIV infection, oncohematological and lymphoproliferative diseases.Results. The course of a new coronavirus infection against the background of connective tissue dysplasia is characterized by: 1) fever in 100% of patients; 2) damage to the lungs of more than 50% of the lung tissue with signs of respiratory failure in 63%; 3) a pronounced systemic inflammatory response syndrome, manifested by a significant increase in C-reactive protein and creatine phosphokinase.Discussion. An analysis of the results showed that one of the predictors of the severity of the course of COVID-19 infection may be the presence of connective tissue markers of dysplasia (odds ratio 7.4, 95% CI 2.6-21.3).Conclusion. The new coronavirus infection COVID-19 proceeds against the background of connective tissue dysplasia more severely with a pronounced intoxication syndrome with an early and longer manifestation of acute respiratory failure.

The paper deals with basic approaches to monitoring of the currency risk. The purpose of the paper is to substantiate the theoretical and methodological foundations of the complex application of risk assessment methods to prevent the adoption of its excessive level, as well as instruments for monitoring the profitability of operations in the foreign exchange market, based on the calculation of the consolidated balanced index. It was determined that in the context of the volatility of the national currency the exposure of banks to currency risk increases significantly, it means that is, the magnitude of the consequences of its manifestation for most financial intermediaries increases. The authors of the paper consider the system of currency risk management as a set of goals, principles, functions, methods, tools and specific techniques of purposeful, continuous influence of the management system on the managed one for timely estimation and monitoring of currency risk in order to minimize it and achieve specified parameters of currency yields. In according to current management standards, implemented by leading financial institutions and international regulators, currency risk monitoring mechanisms must not only timely and effectively identify deviations from key risk targets, but also provide for the ability to identify unforeseen situations. It was proved that that the monitoring tools, policies and procedures have to meet a number of criteria, which are taken into account at the achievement of the main goals of the bank and increase its resistance to external shocks on the foreign exchange market. Taking into account the fact that the value of currency risk by the ES metric is included in the calculation of the consolidated balanced index, the change in the regulatory regimes is made on the basis of the projected deviations of the CEI from the target corridor, recorded at the initial stage in determining the level of risk exposure of the bank. Thus, the proposed balanced approach to forecasting involves the use, on the one hand, of statistically reliable quantitative analysis tools and, on the other hand, qualitative environmental change signals that aggregate the benefits of structural methods, while providing the flexibility and timeliness of managerial decision-making. The specification of currency risk management regimes should be tailored to the specific features of a particular bank and have a combinatorial nature that involves the integration of individual impulses by analysis tools, forecasting, time horizons and levels of management, as well as in terms of components of the CEI consolidated balance sheet and risk level of activity in the foreign exchange market. This approach allows for the flexibility of management systems and their adaptability to the external conditions of the bank, and the use of quality monitoring signals increases the speed of decision-making and elimination of deficiencies that can be inherent in econometric assessment tools.

One of the problems when you create a bioengineered liver, as an alternative to transplantation of the donor liver in the treatment of end-stage liver failure, is the matrix, able to temporarily perform the functions of the natural extracellular matrix (ECM) and provide the necessary conditions to maintain the viability of the liver cells. The main disadvantage of resorbable biopolymer matrices is the absence of tissue specifi c properties and the impossibility of reproducing the unique structure of the ECM of the liver.Aim:to develop technology for decellularization of liver tissue fragments, saving the structural properties of native ECM of the liver.Materials and methods.The decellularization of mechanically grinded human liver fragments was carried out in three changes of buffer solution (pH = 7.4) containing 0.1% sodium dodecyl sulfate and increasing the concentration of Triton X100 (1%, 2% and 3%, respectively). During technology development were investigated the effects of duration, conditions (static, dynamic, rotary system, magnetic stirrer) washing and methods of liver tissue grinding on the completeness of removal of cellular elements and detritus preserving the the liver ECM structure. Slices of decellularized liver tissue samples were stained by hematoxylin and eosin, and Masson method for the detection of connective-tissue elements.Results.Histological analysis methods showed that the best from the point of view of effi ciency of decellularization and the safety of the structure of own human liver ECM, is a mode of washing of liver fragments for three days at room temperature in static conditions, accompanied by stirring by a magnetic stirrer for 2–3 times a day for one hour. Longer time or a large multiplicity of mixing mode is accompanied by increased risk of liver tissue damage. On the basis of the experimental results obtained the algorithm of preliminary study of donor human liver designed to optimize the process of obtaining decellularization fragments of liver tissue was elaborated.Conclusion.It was elaborated the algorithm and technology of obtaining of decellularized liver tissue fragments from the human donor liver which saved the structural properties of native ECM of the liver and complete removal of cellular elements and detritus.

The paper deals with basic approaches to monitoring of the currency risk. The purpose of the paper is to substantiate the theoretical and methodological foundations of the complex application of risk assessment methods to prevent the adoption of its excessive level, as well as instruments for monitoring the profitability of operations in the foreign exchange market, based on the calculation of the consolidated balanced index.It was determined that in the context of the volatility of the national currency the exposure of banks to currency risk increases significantly, it means that is, the magnitude of the consequences of its manifestation for most financial intermediaries increases. The authors of the paper consider the system of currency risk management as a set of goals, principles, functions, methods, tools and specific techniques of purposeful, continuous influence of the management system on the managed one for timely estimation and monitoring of currency risk in order to minimize it and achieve specified parameters of currency yields.In according to current management standards, implemented by leading financial institutions and international regulators, currency risk monitoring mechanisms must not only timely and effectively identify deviations from key risk targets, but also provide for the ability to identify unforeseen situations.It was proved that that the monitoring tools, policies and procedures have to meet a number of criteria, which are taken into account at the achievement of the main goals of the bank and increase its resistance to external shocks on the foreign exchange market. Taking into account the fact that the value of currency risk by the ES metric is included in the calculation of the consolidated balanced index, the change in the regulatory regimes is made on the basis of the projected deviations of the CEI from the target corridor, recorded at the initial stage in determining the level of risk exposure of the bank. Thus, the proposed balanced approach to forecasting involves the use, on the one hand, of statistically reliable quantitative analysis tools and, on the other hand, qualitative environmental change signals that aggregate the benefits of structural methods, while providing the flexibility and timeliness of managerial decision-making. The specification of currency risk management regimes should be tailored to the specific features of a particular bank and have a combinatorial nature that involves the integration of individual impulses by analysis tools, forecasting, time horizons and levels of management, as well as in terms of components of the CEI consolidated balance sheet and risk level of activity in the foreign exchange market. This approach allows for the flexibility of management systems and their adaptability to the external conditions of the bank, and the use of quality monitoring signals increases the speed of decision-making and elimination of deficiencies that can be inherent in econometric assessment tools., Рассмотрены основные подходы к мониторингу валютного риска банков. Целью работы является обоснование теоретико-методических основ комплексного применения методов оценки риска для недопущения принятия его чрезмерного уровня, а также инструментов мониторинга доходности операций на валютном рынке, на основе расчета сводного сбалансированного индекса.Доказано, что инструменты, политики и процедуры мониторинга должны отвечать ряду критериев, учет которых способствует достижению основных целей деятельности банка и приводит к росту уровня его устойчивости к внешним шокам на валютном рынке. Получен вывод о том, что спецификация режимов регулирования валютного риска должна осуществляться с учетом особенностей функционирования конкретного банка и иметь комбинаторный характер, что предполагает интеграцию отдельных импульсов по инструментам анализа, прогнозирования, временным горизонтам и уровням управления, а также в разрезе составляющих сводного сбалансированного индекса CEI по уровню риска и доходности деятельности на валютном рынке., Розглянуто основні підходи до моніторингу валютного ризику банків. Метою роботи є обґрунтування теоретико-методичних засад комплексного застосування методів оцінки ризику для недопущення прийняття його надмірного рівня, а також інструментів моніторингу прибутковості операцій на валютному ринку, на основі розрахунку зведеного збалансованого індексу.Визначено, що в умовах волатильності курсу національної грошової одиниці значно посилюється експозиція банків до валютного ризику, тобто зростають масштаби наслідків його прояву для більшості фінансових посередників. Розглянуто систему управління валютним ризиком як сукупність цілей, принципів, функцій, методів, інструментів і специфічних прийомів цілеспрямованого, безперервного впливу керуючої системи на керовану для своєчасної оцінки та моніторингу валютного ризику з метою його мінімізації та досягнення заданих параметрів дохідності від валютних операцій.Відповідно до сучасних управлінських стандартів, що впроваджуються провідними фінансовими інститутами і міжнародними регуляторами, механізми моніторингу валютного ризику повинні не лише своєчасно та ефективно визначати відхилення ключових показників ризику від планових значень, а й передбачати можливість ідентифікувати непередбачувані ситуації.Доведено, що інструменти, політики та процедури моніторингу повинні відповідати низці критеріїв, урахування яких сприяє досягненню основних цілей діяльності банку та призводить до зростання рівня його стійкості до зовнішніх шоків на валютному ринку. Ураховуючи той факт, що величина валютного ризику за ES-метрикою включається при розрахунку зведеного збалансованого індексу, зміна режимів регулювання здійснюється, виходячи з прогнозованих відхилень показника CEI від тергетованого коридору, зафіксованого на початковому етапі при визначенні рівня схильності банку до ризику. Запропонований збалансований підхід до прогнозування передбачає використання, з одного боку, статистично надійних інструментів кількісного аналізу, а з другого — якісних сигналів зміни стану середовища, які агрегують переваги структурних методів, забезпечуючи при цьому гнучкість та оперативність ухвалення управлінських рішень.Специфікація режимів регулювання валютного ризику повинна здійснюватися з урахуванням особливостей функціонування певного банку і мати комбінаторний характер, що передбачає інтеграцію окремих імпульсів за інструментами аналізу, прогнозування, часовими горизонтами та рівнями управління, а також у розрізі складових зведеного збалансованого індексу CEI за рівнем ризику та прибутковості діяльності на валютному ринку. Такий підхід дозволяє забезпечити гнучкість управлінських систем та їхню адаптивність до зовнішніх умов функціонування банку, а застосування якісних сигналів моніторингу сприяє зростанню оперативності ухвалення рішень та усуненню недоліків, які можуть бути притаманні економетричним інструментам оцінки.