Frequent development SARS-CoV-2 in patients with a surgical profile of a planned and emergency order indicate the need to study the features of the course of the postoperative period and histological examination of autopsy material of lung tissues in patients with coronavirus infection in these individuals.

In recent years there have been discussions about the universality of the theory of self-regulation of the epidemic process, developed by academician V.D. Belyakov. Its adequacy for infections with different mechanisms of pathogen transmission, as well as for different groups in the ecological classification of infectious diseases (anthroponoses, zoonoses, sapronoses) has been questioned. In this connection, it seemed relevant to test the applicability of the main provisions of the self-regulation theory to the manifestations of the COVID-19 epidemic process.

The aim of the investigation was to determine whether the manifestations of COVID-19 epidemic process in the territory of Samara region were in compliance with certain provisions of the self-regulation theory of epidemic process by academician V.D. Belyakov.

Material and methods. The study was conducted in the Samara region and Moscow, the study period: March 2020 – June 2022. The data of official statistics on morbidity, population mortality from COVID-19, morbidity of community-acquired pneumonia were used as research material. Elements of classical epidemiological analysis were used as research tools, for calculations we used Excel, Statgraphics plus for Windows programs.

Results. The second (key) proposition of the theory of self-regulation of the epidemic process by academician V. D. Belyakov was shown to be applicable to the epidemic process COVID-19. On the example of COVID-19, as an infection with an unspecified group in the ecological classification of infectious diseases, the postulate of V.D. Belyakov on the relative autonomy of the course of the epidemic process in different territories was confirmed.

The article examines the NCI (new coronarovirus infection) from various sides. Particular attention is paid to concomitant pathology and other factors affecting the outcome of the disease. For the first time, the article formulates criteria for the readiness of elderly patients with a new coronavirus infection to perform a tracheostomy, taking into account the state of their respiratory system. Techniques of applying a tracheostomy are presented to avoid serious complications in patients with a new coronavirus infection. A protocol of modified surgical tracheostomy has been developed that takes into account the operation at an early date, only with bronchoscopic control only under anesthesia, only by well-trained personnel, with careful pre and postoperative care.

This work is devoted to the study of the topography of the cavernous sinus and the clinical and anatomical substantiation of neurosurgical operations. Aspects of the topography of the internal carotid artery, cavernous sinus, cranial nerves of the sellar and paraclinic regions, topography and structure of the dura mater on the skull base, dura mater duplicates, cerebellar nave ligament, meningeal membranes (cerebral base cistern membrane, proximal carotid ring carotid membrane) and carotid rings are revealed. The work contains a large number of topograms and diagrams based on scientific literature data, as well as the author's own observations.

The aim of the study is to reconstruct the resected inferior nasal cavity. A new method was developed and introduced, in which a spreader-implant in the form of a sandwich composite, which is a combination of a perforated plate of "Hi-Fatigue Bone Cement" of the required size, covered on one or both sides with the biocomposite material "LitAr", was used for the first time. As a result of the work, it was found that the "sandwich-implant" promotes cartilage and bone reparation, as well as mucosa of the lower nasal concha, stimulates neoangiogenesis and provides stability of the concha volume in the long term.

The pathogenesis of bronchial asthma is based on chronic inflammation as a response to etiological factors. It causes bron-chial hyperreactivity, remodeling of the respiratory tract and hypersecretion of mucus. Epithelial damage is a pathological sign observed in all bronchial asthma phenotypes. The purpose of this review: to analyze changes in the epithelial barrier in bronchial asthma, to reflect potential therapeutic ways of exposure. Changes in the epithelial barrier include a violation of the ratio of mucins (MUC5AC to MUC5B), violations of intercellular connections when exposed to allergens, infectious agents, suspended particles. Currently, various diagnostic approaches are being developed to detect epithelial barrier dysfunction. Exposure to the epithelial barrier of the respiratory tract may be a promising new therapeutic strategy for asthma and related allergic diseases. The preservation or restoration of the function of the air-way barrier is a new area of respiratory diseases that requires extensive further research.

Ischemic stroke in oncological diseases occurs as a result of the prothrombotic effect caused by cancer. Besides that, it is associated with antitumor therapy. In the first instance, cardioembolism should be ruled out for recurrent systemic embolism in patients with a tumor history. In most cases, the cause of cerebral embolism in oncological diseases is non-bacterial thrombotic endocarditis. Its diagnosis preferably based on transesophageal echocardiography. This article presents a clinical case of ischemic stroke developed by marantic endocarditis, methods of its verification and treatment.

An observation from practice is given – surgical treatment of a patient with widespread tuberculosis of the only left lung and a pronounced displacement of the mediastinal organs into the right hemithorax. Patient P., 43 years old, has been suffering from pulmonary tuberculosis for 11 years, 8 years ago, a pneumonectomy on the right side was performed due to fibrouscavernous tuberculosis of the right lung. According to computed tomography of the chest organs, upon admission, a picture of cavernous tuberculosis of the lower lobe was noted, a pronounced displacement of the mediastinal organs and the only left lung to the right. She was admitted to the clinic with complaints of shortness of breath at rest, weakness, dizziness. The patient underwent resection of a lung containing a cavity with simultaneous correction of the mediastinal pulmonary hernia with a mesh implant. Histological examination of the removed preparation revealed a high level of activity of tuberculous inflammation. As a result, the manifestations of dyspnea decreased in the patient, radiographically, the only left lung was visualized in the hemithorax of the same name.

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We present the clinical case of patient Z., 31 years, old with exacerbation of Crohn's disease during pregnancy. Although treatment was given, the pregnancy ended in stillbirth (29 weeks). The degree of activity of the disease determines the occurrence of complications during pregnancy. That is why pre-pregnancy preparation is necessary, especially when the disease is in remission.

In the structure of injuries among patients with fractures of the patella, patients of working age prevail, placing high demands on the functional results of surgical treatment and terms of recovery. Given the low incidence of this pathology in the structure of all injuries of the musculoskeletal system, the authors are of the opinion that patients with patella fractures should receive specialized care that meets the requirements for certain types of fractures in trauma hospitals of any level. The described clinical example describes the medium-term results of treating a patient using a patented method of osteosynthesis of the patella that meets both the requirements of patients and the basic principles of osteosynthesis of intra-articular fractures. The data provided is characterized as good, the use of the patented method is regarded as expedient.

The article presents our own experience of observation during interventions on the distal biliary tract using a combined method – "Rendezvous" in patients with pathology of the pancreatobiliary zone, complicated by obstruction of the bile ducts. In one case, with a pronounced adhesive process of the abdominal cavity with a surgical aid, the endoscope was carried out to the descending branch of the duodenum. Towards the endoscope through the stump of the cystic duct, a conductor string was brought down, which made it possible to visualize the major duodenal papilla (MDP), to perform retrograde papillosphincterotomy with choledocholithotomy. In the second case, if it was impossible to pass the guidewire retrogradely beyond the area of the tumor narrowing, an alternative method was used – bringing it down by percutaneous transhepatic access towards the endoscope to install a retrograde stent delivery system.

Spontaneous asymptomatic intrahepatic portosystemic shunt is a rare anomaly of the hepatic vasculature. The main clinical manifestations may be encephalopathy, bleeding or hyperinsulinism, due to the constant shedding of blood. This article presents a case of an asymptomatic congenital intrahepatic portosystemic shunt, found in patient I., aged 25, with the results of various imaging methods, as well as an analysis of the main types of the described vascular anomaly.

Purpose of the study: analysis of the correlation between the attitude toward compliance with physician's recommendations by surgical patients and their sex and age characteristics.

Materials and Methods. Primary data were obtained by questionnaire study of 400 surgical inpatients. Four age comparison groups (18–29 years, 30–44 years, 45–59 years, 60 years and older) among men and women were formed. Significance of differences was determined by comparing the χ² value obtained in the tetrachoric analysis with the tabulated value for the bilateral distribution. Differences with the 95% probability of null hypothesis rejection were considered significant.

Results. Most surgical patients surveyed according to their subjective perception followed the physician's recommendations (75 and 77 out of 100 male and female respondents, respectively), more frequently at a younger age, whereas after 45 years, adherence to the physician's recommendations declined and the proportion of those who were more critical of them increased, which was manifested in their selective implementation. Patients are much less likely to comply with the recommendations to observe the principles of a healthy lifestyle. With increasing age, the share of men who always comply with the principles of a healthy lifestyle decreases, while for women it remains at the same level. As a result, "strict" and "clearly" formulated recommendations are followed more often by patients, and no gender differences are observed in this aspect. More general recommendations (principles of healthy lifestyle) are more often implemented selectively, that is, when they are considered necessary and necessary, and with increasing age the proportion of such attitude among men increases, while among women it remains stable in all age groups. Dependence analysis showed that compliance with the doctor's recommendations in full by the patient regardless of gender did not guarantee his efforts to maintain his own health sufficiently (p > 0,05) or the absence of bad habits (p > 0,05). There was also no correlation between the presence of bad habits and the subjective perception of the sufficiency of efforts to maintain one's own health (p > 0.05).

The article analyzes in detail the dynamics of the state of health, the movement of the contingent and the impact of harmful factors on the somatic health of water transport workers in a comparative aspect, depending on the time and degree of exposure to various professional factors.

Introduction. The features of the development of infrastructures, regional resource and methodological centers for early care for children and their families in the Russian Federation, the specifics of identifying children of the target group and families in need of early care services are considered.

Goal: To develop scientifically based proposals for the further development of early care for children and their families in the Russian Federation.

Materials and methods: Information from Federal Statistical Observation No. 1-RP "Information on early care for children of the target group" from 85 regions of the Russian Federation (hereinafter referred to as Form No. 1 RP). General scientific methods (content analysis, analytical, system-structured, comparative, statistical) and methodological methods of systematization, comparison, generalization, interpretation using the standard Excel-7.0 software package for IBM PC are applied.

The object of the study: Children from birth to three years of age who need early care services.

The subject of the study: Early care services provided for children of target groups and their families in the constituent entities of the Russian Federation.

Results. Organizations providing early care services operate in all 85 constituent entities of the Russian Federation. According to statistical observation, in the period 2019–2021, there is an increase in the number of organizations providing early care services (in general, an increase of 21.4% was registered in the Russian Federation), regional resource and methodological centers of early care were established in 53 constituent entities. There is an increase in the number of organizations from the healthcare sector (by 3.8%), in the education sector (by 16.5%), in the social protection of the population (by 2.3%). Early care services for children and their families are provided in 17 constituent entities of the Russian Federation by non-governmental organizations. In the Russian Federation, 75 regional resource and methodological centers for early care for children and their families have been established in 53 constituent entities of the Russian Federation, 12 of them in the field of healthcare, 27 in education, 36 in social protection of the population. The number of children assigned to the target group in the Russian Federation amounted to 248,108 people (4% of the total number of children aged from birth to the age of three). The proportion of children in need of early care services in the constituent entities of the Russian Federation in 2021 varies from 0.3% to 23.4%. According to the data of the constituent entities of the Russian Federation, as of 31.12.2021, the number of specialists providing early care services amounted to 38,484 people.

Discussion. Since 2019, the constituent entities of the Russian Federation have been monitoring the state of early care for children and their families in the form of statistical observation No. 1-RP "Information on early care for children of the target group". Information is provided from 85 constituent entities of the Russian Federation. According to statistical observation data, as of 31.12.2021, 6429 organizations provide early care services in the Russian Federation. The formation and development of the infrastructure of early care services and the improvement of human resources are necessary conditions for the development of early care for children and their families in the constituent entities of the Russian Federation. There is a positive trend in the growth of the number of specialists providing early care services. The results of the analysis of the statistical form No. 1-RP allow us to assess the state and level of development of early care for children and their families in the constituent entities of the Russian Federation.

Conclusions. The data from the monitoring results allow us to develop proposals for the development of early care services in the constituent entities of the Russian Federation.