Introduction. Currently, chronic kidney disease is called a "silent killer", since patients with the development of a pathological process do not experience pain for a long time, modern functional and laboratory diagnostic methods also do not allow to determine the early signs of this disease, which contributes to the chronicity of the disease. Purpose: to reveal the hidden signs of the pathology of the urinary system according to the structures of the solid phase of the patient's urine. Materials and methods. The urine of 359 patients without signs of renal pathology was studied. The method of analysis of solid-phase structures of dehydrated urine (facies) was applied by microscopy in ordinary and polarized light. Processing the structures of the solid phase of urine with a stream of steam of boiling water caused their recrystallization, which made it possible to reveal hidden markers of renal pathology. Results. Analysis of the structure of native urine facies (N-facies) showed that in all examined patients they were completely covered with salt crystals, which corresponded to the physiological state of the body. Steam jet treatment of urine N-facies revealed organic (non-mineralized) inclusions in 23 patients, and a marker of bacteriuria was detected in 9 patients. The study of urine facies with the Lithos protein reagent (LR-facies) showed that the Lithos-reagent protein dissolves organic inclusions and they cease to appear in LR-facies. In 15 patients, organo-mineral microaggregates were detected in the marginal zone of the LR-facies of urine. After exposure to steam, these microaggregates disappeared in 7 patients, and remained in 8. In 9 patients, in whose N-facies, after steaming, a marker of bacteriuria was manifested, in the LR-facies of urine of 7 patients, a marker of candidiasis was detected. Conclusion. The study of the structure of urine facies before and after their treatment with boiling water steam makes it possible to identify hidden forms of renal pathology: insufficient filtration capacity of the kidneys, the risk of nephrolithiasis, bacterial and fungal infection. The data obtained make it possible to ensure timely prevention and treatment in the early stages of the disease.

Rats are attractive for various kinds of experiments aimed at studying the effect of substances on metabolism and other components of homeostasis. The use of biologically active substances of natural origin offers great opportunities for modulation of physiological processes in the body, increases the body's resistance, facilitates the clinical course of many environmentally caused diseases and has virtually no negative side effects. Purpose of the study: to study the peculiarities of postnatal physical development of the offspring of rats receiving intragastric aqueous plant extracts as an additional load. The experiment was carried out on sexually mature rats (50 females and 15 males), which were divided into 5 groups of 13 rats each. The groups received various compositions of aqueous plant extracts daily for 30 days at a dose of 30 mg/100 g of animal body weight. The animals were then mated, and the offspring were obtained and subjected to examination. Conclusion: loading rats with aqueous plant extracts promotes intensification of the postnatal physical development of the offspring, and the greatest efficiency is observed when using a mixture of aqueous extracts of Centella asiatica and Ginkgo biloba, rather than when using them separately.

The choice of treatment methods for patients with fractures of the trochanteric region of the femur, as well as specific surgical tactics, is justified. According to a number of researchers, hip arthroplasty is an alternative to osteosynthesis in such injuries, especially in patients with limited functional capacity and a poor medical history. The primary results of endoprosthesis and intramedullary blocked fixation constructions in elderly patients with obesity were compared. Purpose of the study. To evaluate the clinical efficacy of intramedullary osteosynthesis and endoprosthesis in obese patients with vertebral fractures of the proximal femur. Materials and methods. The study was carried out on the basis of the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan. A total of 76 patients aged 66 to 91 years were operated on. Two techniques were used in the treatment. 46 patients who underwent primary hip arthroplasty (THA) and 30 patients who underwent blocked intramedullary osteosynthesis (BIOS) with proximal femoral nail of gamma-nail type. Results. 1. A comparative study with a relatively small sample showed that there was no statistically significant difference in the duration of surgery between patients with normal BMI and obese patients with different surgical approaches. 2. Blood loss rates in both groups were less than the critical level (p < 0.05). The study expectedly confirmed that the higher the patient's BMI, the longer the duration of surgery and the greater the blood loss. 3. The presented material suggests that arthroplasty can be used for vertebral fractures of the proximal femur if there are no relevant surgical contraindications. 4. The relative difficulty of performing blocked intramedullary pinning, difficulty in activating and rehabilitating obese patients, and risks of early loading of the injured limb lead to the search for alternative methods of surgical treatment of acetabular femoral fractures. Using the advantages of hip arthroplasty is the most important factor of favorable outcome of treatment and life preservation for this complex group of patients.

Wound healing is a complex biological process involving various cells, mediators, and components of the extracellular matrix involved in the processes of coagulation, inflammation, angiogenesis, epithelialization, and fibroplasia. Wound healing is described by four interrelated phases: hemostasis, inflammation, proliferation and remodeling. Each of the phases has its role at the molecular and tissue levels, and if a defect occurs in the chain of one of the phases of the wound healing process, the healing process is disturbed and a chronic wound condition occurs. Various factors such as infections, arterial and venous circulatory disorders, type 2 diabetes and chronic inflammation contribute to this. Prolonged non-healing wounds represent an urgent problem of modern medicine. Oxidative stress plays a crucial role in the pathogenesis of chronic wounds. In this review the pathogenesis of chronic wounds and its involvement of reactive oxygen species (ROS), oxidative stress, the role of mitochondria in ROS generation as well as the prospects of mitochondrial-directed antioxidants in the treatment of chronic wounds are considered.

Osteoarthritis today is one of the most important causes of disability and a decrease in the quality of life of older patients, which, as a rule, is due to the presence of restrictions on independent movement and self-care. Persistent pain syndrome, which is the leading manifestation of the disease, also significantly reduces the quality of life. The number of obese people is increasing every year, and so is the number of operations to replace joints with artificial ones due to the large impact of excess weight on the incidence of osteoarthritis. Objective - to evaluate the effectiveness of pain relief in overweight and obese patients who have undergone total primary hip replacement at 3.6, 12 months. and 5 years in comparison with patients with normal body weight. Materials and methods. A comparative study of 154 clinical observations was conducted using the VAS pain scale in the aspect of impaired weight characteristics of two groups of patients. Results. In the comparative aspect of the two surveyed groups of patients, comparable results were obtained after undergoing surgery for an effective persistent reduction in pain. Conclusion. Total hip arthroplasty has a persistent positive effect in relation to the leveling of pain in all patients with osteoarthritis, regardless of the etiology of the disease and, in particular, the patient's body weight.

Introduction. The principles of construction of the knee joint in the transfemoral prosthesis are considered. The design of the knee joint in the transfemoral prosthesis with an original mechanism for ensuring buckling resistance in the prosthesis is proposed. Goal. Create an artificial knee joint, which provides a reliable mechanism of strut stability during walking by quickly blocking the flexion-extension of the artificial knee joint in the prosthetics for high amputations of the lower extremities when resting on the prosthesis. Materials and methods. One of the main problems that exist in the development of knee joints in a femoral prosthesis is the presence in the design of the module of a mechanism that ensures its blocking from bending when walking at the moment of support of the prosthesis in the transfer phase of a healthy limb. In the knee joints of various companies, this issue is solved in different ways. For example, some simple singleaxis knee joints are designed to lock when the disabled person is in a standing position. Walking is carried out without flexion in the knee joint. To unlock, pull the cable (transition to a sitting position). In some single-axis hinges, a locking function is applied using the weight of a disabled person. In the phase of support on a full foot, the hinge closes due to the weight load on it and opens by transferring weight to the toe. In more complex multi-axis module designs, there is a so-called geometric lock. The closure in the stance phase occurs due to the correct arrangement of the axes relative to each other. The opening occurs in the transfer phase. The object of the study. The mechanisms of the knee joint, which provide a handicapped person's resistance to buckling while walking on a transfemoral prosthesis. The subject of the study. The design of the knee joint, which provides self-braking due to a coupling with a split disc. Results. The study made it possible to substantiate the practical possibility of creating a knee joint of prosthetics for high amputation with a braking device made in the form of a split disc clutch. Discussion. Currently, there are various designs of knee joint that have mechanisms of buckling. When considering modern knee joint of well-known manufacturers, the main ways of ensuring buckling resistance are determined. The polycentric knee module of the company "Ossur" implements the principle of knee locking due to the displacement of the instantaneous axis when the knee is extended, thereby providing buckling resistance. In the Ottobock knee joint, the knee axis is automatically closed under the influence of human weight. Domestic manufacturers of knee modules are ORTHOS (Novosibirsk) and Metiz. Also, the scientific and production corporation "Precision Instrument Engineering Systems" (NPC SPP, part of Roscosmos) announced the production of the knee module "Aktiv-2". Due to the restriction of imports of foreign products, state prosthetic and orthopedic enterprises are interested in the development and production of domestic prosthetic and orthopedic products, including artificial knee joints of various designs. Conclusions. The principles of constructing the design of the knee joint of the above knee prosthesis have been formed.

Relevance. Despite numerous efforts made in recent decades, the arsenal of cancer diagnostics is still significantly limited. The purpose of study: to analyze the problem of differential diagnosis of early stage stomach cancer and non-oncological diseases of the abdominal cavity. Materials and methods. In the course of the work, current literary sources of domestic and foreign authors on a given topic were analyzed. Results. The early stages of malignant neoplasms of the stomach are usually asymptomatic or accompanied by nonspecific signs, such as dyspepsia. Symptoms of the development of malignant tumors of the stomach at an early stage may be indistinguishable from the symptoms of benign dyspepsia, while the presence of established "alarming" symptoms may mean a progressive inoperable disease. However, the evidence supporting the use of "alarming" symptoms as selection criteria for endoscopy still remains contradictory, since the presence of "alarming" symptoms in the clinical picture is not always associated with the detection of malignant neoplasms, it is also worth noting that the overall prevalence of these symptoms in the population of patients suffering from dyspeptic disorders is high, while while the number of patients with a history of gastrointestinal cancer is relatively low. Conclusion. Despite the observed trend of decreasing morbidity and mortality, malignant neoplasms of the stomach remain an important part in the structure of oncological diseases. Many of the risk factors remain insufficiently studied and should be the subject of further research to achieve more specific, targeted preventive measures.

Background. According to the literature and our own observations, there is an increase in the number of victims of young, ablebodied age with severe injuries to the pelvic structures. Despite numerous developments and studies in this area, high mortality and a high percentage of unsatisfactory treatment results remain. The publication reflects the advantages of using bilateral lumbopelvic fixation in the treatment of injuries to the cross. Load calculation, biomechanical modeling of damages and displacing factors are presented. Bilateral lumbopelvic fixation has proven to be a reliable method capable of providing reliable fixation of the fracture at all stages of treatment. Aim. To substantiate and test modified lumbopelvic stabilization of the pelvic ring in patients with vertically unstable (C1-2-3 according to Tile M.) sacral fractures. Material and methods. Based on the treatment of 20 patients with severe sacral fractures, it was proved that the best result was achieved with bilateral lumbopelvic stabilization. The use of the author's version (RF Patent No. 2684870 "Method of fixation in unilateral unstable sacral fractures") of osteosynthesis is presented on the example of the treatment of multiple pelvic trauma, a good clinical result was obtained, and neurological symptoms were stopped. Results. Lumbar-iliac osteosynthesis for vertically unstable sacral fractures is the optimal method of fixation. The distribution vector of the levers of the latch corresponds to the biasing force, which ensures maximum reliability of the synthesis. The method, if necessary, creates conditions for decompression of the roots, prevents the early development of arthrosis of the sacroiliac joints. Using it allows you to maintain or correct the sagittal and frontal balance of the spine. The use of bilateral 8-screw lumboiliac fixation with the installation of a transverse tie is recommended, since unilateral fixation or a decrease in the number of fixing elements can lead to loosening of the fixator. Conclusion. Based on biomechanical modeling and the results of treatment of patients with severe injuries of the posterior pelvic ring, the effectiveness of the proposed method of lumbopelvic fixation was proven.

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic inflammatory conditions of the gastrointestinal tract characterized by a relapsing and remitting course. Aim - to analyze clinical data and the most significant hematological and biochemical blood parameters used for diagnosis in patients with ulcerative colitis. Materials and methods. Between 2020 and 2021 examined 50 patients with the diagnosis "Ulcerative colitis" living in the Samara region. The diagnosis of ulcerative colitis was confirmed by a combination of clinical, radiological, endoscopic, and histopathological criteria generally accepted for inflammatory bowel diseases. A hematological blood test was performed on an automatic hematological analyzer Sysmex KX-21N, Japan, and a biochemical blood test was performed on an automatic biochemical analyzer Hitachi 902, Japan. Results. In the biochemical analysis of blood, an increase in the content of C-reactive protein in the blood is expected in 64% of patients. In 40% of patients, the concentration of total protein and electrolytes decreases. An increase in glucose levels was revealed in 44% of patients, in 10% of cases, a decrease in creatinine concentration, an increase in the activity of ALAT and ASAT was noted in 6 and 4% of cases, respectively. Reduced urea levels are noted in 6% of patients. Conclusion. As a result of the study, the data necessary for the diagnosis and monitoring of the effectiveness of the treatment of ulcerative colitis were obtained.

Colorectal cancer is one of the most frequently diagnosed malignant tumors in men and women, which is a highly heterogeneous group of neoplasms consisting of subclasses with different molecular and clinical characteristics, and, as a consequence, patients with different types of tumors require different treatment protocols. Among the predictive factors of treatment response in patients with metastatic colorectal cancer, the most studied are the genes of the RAS family (KRAS, NRAS). Determination of RAS status is the first step in individual selection of drug therapy in patients with metastatic colorectal cancer. Patients with certain mutations in KRAS and NRAS genes are resistant to anti-EGFR therapy and have a lower median survival than WT (wild type) genotypes, indicating a negative prognosis in the presence of mutations.

In 19-26% of patients hospitalized with suspected stroke, the cause of neurological symptoms are not cerebrovascular diseases. In this case of newly diagnosed thyrotoxic periodic paralysis we presented the clinical, laboratory and instrumental features of the disease. The search for the cause of periodic paralysis allowed to identify an endocrinological disease - diffuse toxic goiter, prescribe antithyroid therapy. The data of prospective patient observation are presented. We discussed a differential diagnostic range of diseases with acute low paraparesis, including rupture of an aneurysm of the anterior communicating artery, bilateral infarction in territory of anterior cerebral arteries, thrombosis of upper sagittal sinus, acute spinal strokes and Guillain - Barre syndrome. The need to include thyrotoxic periodic paralysis in patients with acute lower paraparesis in the differential diagnostic series is substantiated.

The article presents an analysis of the developed calculated echocardiographic indicators: the final diastolic pressure in the pulmonary artery, the pressure gradient on the pulmonary artery valve, the volume of tricuspid regurgitation, as well as the work of the heart on the pulmonary artery valve.

Introduction. Syngeneic hematopoietic stem cell transplantation is a type of allogeneic stem cell transplantation when the donor of stem cells is a genetically identical (monozygotic) twin of the recipient. After this type of transplantation, there is no immunological conflict as the graft versus host disease, but at the same time, there is no positive effect of the graft-versus-leukemia effect. Aim: to assess the overall survival, event-free survival, probability of relapse, and transplant-related mortality rates associated with syngeneic stem cell transplantation. Patients and methods. In the National Research Center for Hematology from January 1988 to December 2018 we performed 654 allo-HSCT: 17 (2.5%) of them from a syngeneic donor. We performed a «paired analysis» with patients after allo-HSCT from a HLA-identical sibling donor. We included patients after allo-HSCT from an HLA-identical related donor (n = 28) in Group 1 and patients after syngeneic stem cell transplantation in group 2 (n = 14). Patients with aplastic anemia (n = 3) were excluded from the «paired analysis». Results. Patients after syngeneic stem cell transplantation did not develop a graft-versus-host disease. The relapse developed in 50% of cases (n = 7). Five patients (35.7%) died: 4 of them due to the relapse of the disease, and 1 - due to the graft failure. The relapse probability in patients after syngeneic HSCT was higher and amounted to 18.4% versus 54.2% (p = 0.047) for allo-HSCT from HLA-identical sibling donor and a syngeneic donor, respectively. Overall and event-free survival in patients after syngeneic HSCT is comparable to those in patients after allo-HSCT from an HLA-identical sibling donor. Conclusion. Syngeneic hematopoietic stem cell transplantation is justified in the absence of another related or unrelated donor of hematopoietic stem cells. The use of myeloablative conditioning regimens, peripheral blood stem cells as a source of stem cells, or high doses of nucleated cells/kg in the case of using bone marrow will improve post-transplant parameters in patients after syngeneic hematopoietic stem cell transplantation.

Relevance. The questions of research of physical and chemical characteristics of reinforcing tapes, peculiarities of chemical connection of composite material and reinforcing component of the splint, physical indicators of strength of their connection, optimal thickness of composite material for reinforcing tape covering remain not fully studied and require further work in this direction in order to optimize splinting stages of mobile teeth in various clinical situations and nosological forms of diseases. The aim of the study - to study the microscopic structure of splinting constructions containing in their structure reinforcement tapes based on organic and inorganic matrices. Material and research methods. 10 groups of 10 specimens of splinting construction, with different chemical composition of reinforcing tapes, 8 of which were made using tapes based on inorganic matrix, 2 - based on organic. Results of the study. Microscopic examination of the splinting samples showed good integration of the composite polymer matrix into the structure of the tapes in the samples using inorganic matrix-based tapes. Peripheral layer delamination was not detected, pores in the splint thickness were absent or were single, which may be due to silanization of glass fibers incorporated into the thermoplastic polymer and light-curing composite matrix. Conclusion. Resin-impregnated inorganic parallel fiberglass tapes impregnated in the factory showed an advantage compared to woven and braided tapes and unimpregnated tapes.

Introduction. Every driver of a vehicle must be able to provide first aid (FA). Ignorance of the rules of FA can lead to untimely or poor quality of its provision and consequently to an increase in disability and mortality of people involved in a road traffic accident (RTA). Purpose: to assess the level of knowledge about the rules for providing FA, depending on the driving experience. Materials and methods. An anonymous survey was conducted among drivers of vehicles in the city of Krasnoarmeysk. The survey involved 85 respondents who were divided into three groups. Group 1 (n = 30) - drivers with less than 2 years of experience; group 2 (n = 30) - drivers with experience from 10 to 15 years; group 3 (n = 25) - drivers with more than 25 years of experience. In the course of the survey, the level of knowledge about FA was assessed, the readiness to provide it and experience in this, possible reasons for the low level of knowledge about FA and possible ways to improve it. Results. Group 1 drivers are more informed (96,7 %) regarding the designation of the place of an RTA and the rules for calling an ambulance. Respondents of the 1st group also remember best and can put into practice FA. There is a decrease in the level of theoretical and practical knowledge, depending on the increase in driving experience. Respondents of group 1 considered the lack of practice on mannequins in driving schools to be the reason for the decrease in knowledge, drivers of groups 2 and 3 - the lack of updating old knowledge about FA; also, some drivers pointed to the low level of education in driving schools. The higher the driving experience and the lower the level of knowledge about FA, the higher the desire of drivers to increase the level of knowledge and make classes or courses to improve them mandatory and regular. Conclusion. Young drivers have a fairly good level of theoretical and practical knowledge about the provision of FA, drivers with more than 10-15 years of experience have a rather low level of knowledge. Many drivers will not be able to apply this knowledge in life on their own. Therefore, in our opinion, it is necessary to introduce mandatory regular courses or classes in order to increase the level of knowledge about FA.