Aim. To study the possible associations of tumor ER, PR and Ki-67 expression with ESR1 and ESR2 genes polymorphisms and blood serum levels of antiidiotypic antibodies IgG2-E2 and IgG2-Pg in breast cancer patients (BCP).

Materials and Methods. Blood serum levels of IgG2-E2 and IgG2-Pg were studied in 1025 BCP (478 with stage I and 547 with stages II-IV) by means of enzyme-linked immunosorbent assay. Real-time PCR was performed for ESR1

(rs2234693) and ESR2 (rs4986938) genes polymorphisms detection. ER, PR and Ki-67 positive tumor cells was determined using immunohistochemistry.

Results. IgG2-E2 and IgG2-Pg blood serum levels were not depended on ESR1 and ESR2 gene polymorphisms in BCP. ER+/PR+ tumors were revealed more frequently and ER-/PR- tumors less frequently in BCP at the I stage with high serum levels of both IgG2-E2 and IgG2-Pg than in BCP with their low levels: in patients with genotype TC ESR1 (91.8 % and 3.3 % vs 73.9 % and 11.1%, p = 0.015). Such differences were not revealed in patients with genotypes TT and CC ESR1. There were not discovered the desired association of ER/ PR tumor phenotype with studied antibodies and ESR2 genes polymorphisms. High levels of tumors Ki-67 positive cells (>20%) were determined less frequently in BCP at the II-IV stages with high levels of both IgG2-E2 and IgG2-Pg than in BCP with their low levels: in patients with genotypes TC ESR1 (48.4 % vs 69.7 %, p = 0.004) and GA ESR2 (46.8 % vs 66.3 %, p = 0.009). There were not revealed such differences in patients with other variants of ESR1 and ESR2 genotypes.

Conclusion. Synergistic effects of IgG2-E2 and IgG2-Pg were discovered in BCP: the maintenance of ER and PR in tumors at the I stage and inhibition of tumor proliferation at the II-IV stages.

Aim. Assess steroidogenesis modulation efficacy of balneotherapy in experimental chronic endometritis model.

Materials and Мethods. The experimental endometritis was induced in laboratory Wistar line rats (n = 30) inoculated with intra-uterine self-fecal suspension. Starting with the 3nd day of the experiment, all animals have recieved wide-spectrum antibiotic within 7 days; from day 41– experimental group animals (n=10) applying 10 procedures of radon therapy one a day lasting 15 minutes. Comparison group animals (n = 10) received radon therapy and 10 procedures of peloid therapy mud according to a radon therapy regimen. Control group (n = 10) received no treatment. The venous estradiol and progesterone levels were analyzed by enzyme-linked immunosorbent assay. Histological verification was conducted by endometrium histology study.

Results. In control group it was found maximal endometrial diffuse infiltrate 180.7 ± 9.0 immunocompetent cells. During balneotherapy treatment density of inflammatory infiltrate was lower in experimental group 125.4 ± 8.1 (by 30.7% vs. control group; p = 0.002), whereas in comparison group density of inflammatory infiltration was minimal (reduced by 88.7 % compared to control group; p < 0.001) and reached 20.5 ± 1.8 cells. Most pronounced rise in serum progesterone level had resulted in experimental group during radon therapy compared to control group (p = 0.008), meanwhile in comparison group featured with no significant change in estradiol level compared to control group (р = 0.95).

Conclusion. During radon therapy is accompanied by significantly increased serum progesterone and decreased estradiol level along with chronic endometritis markers regression which can be used in future prospective studies for confirming its effectiveness in patients with reproductive system patology including diseases accompanied by hyperestrogenism.

Aim. To determine the incidence and risk factors of postoperative cognitive dysfunction (POCD) after coronary bypass (CABG) in patients with pre-operative moderate cognitive impairment (MCI).

Materials and Methods. Up to CABG two groups were formed, consisting of 50 patients with presence and 51 without MCI. Neuropsychological research (12 tests) was conducted up to CABG, on the 10th day and after 1 year. Early (10 days after surgery) and remote (1 year later) POCD were diagnosed with a 20 % decrease in the rate of 20% of tests.

Results. Prior to CABG, they had a lower level of formation (p = 0.03), a lower fraction of the left ventricle ejection, (p = 0.02) and a more severe coronary tract lesion on the SYNTAX scale, (p = 0.01) than patients without MCI. Factors significant for the development of early POCD were the duration of with cardiopulmonary bypass (p = 0.035) and the severity of multi-organ insufficiency, rated on the SOFA scale (p = 0.04). In persons with pre-operative MCI, 72 % of cases were diagnosed with early POCD, 54 % with remote POCD, and 81 % with early POCD.

Conclusion. Chronic heart failure with low rates of left ventricular ejection fraction, severe coronary artery damage and low levels of education contribute to the development of MCI in patients with ischemic heart disease. Pre-operational MCI is not the main cause of POCD. However, its presence and development in these patients of early POCD contributes to its retention a year after surgery.

Non-developing pregnancy is one of the most important problems in the practice of an obstetrician-gynecologist. Transthyretin is a transplacental transport protein of T3, T4 and is expressed in cyto- and syncytiotrophoblast cells. Transthyretin may be a promising prognostic marker for non-developing pregnancy.

Aim. The purpose of this study is to evaluate the prognostic capabilities of the serological marker – transthyretin in patients with missed abortion.

Materials and Methods. A prospective cohort study was performed, which included 155 women aged 18-45 years, 155 of them with an undeveloped pregnancy and 47 with a progressive gestation period of 6-12 weeks. All participants were divided into 3 classification groups according to the gestation period. For the examination of the patients, clinical and statistical (questioning of the examined women, analysis of medical records), laboratory (clinical blood analysis, biochemical blood analysis, including thyroid-stimulating and thyroid-stimulating hormones), instrumental research methods (ultrasound examination of the pelvic organs) were used. The concentration of transthyretin in the patients of the studied groups was determined by proteomic analysis of blood serum using liquid chromatography and tandem mass spectrometry (LC-MS)..

Results. Hypothyroidism was diagnosed in 19.3 % of all cases of missed abortion. According to the results of proteomic analysis, the lowest concentration of transthyretin was revealed in missed abortion at 11−12 weeks (p < 0.001).

Conclusion. А significantly reduced level of transthyretin in early pregnancy is a possible predictor of the threat of miscarriage.

Aim. Assessment of epidemiological manifestations of mental disorders in the Omsk region for the period 2010-2022.

Materials and methods. A retrospective epidemiological analysis of data from the federal statistical observation form No. 10 «Information on diseases with mental disorders and behavioral disorders (except for diseases related to the use of psychoactive substances)» for the Omsk region for 2010−2022 was carried out. The incidence rates (relative prevalence) of mental disorders per 100,000 population were calculated for the Omsk region as a whole and municipalities, taking into account the distribution of cases among men and women, by age groups 0−19 years, 20−39 years, 40−59 years, 60 years and older, using relative values.

Results. The incidence of mental disorders in the Omsk region was 3213.5 per 100 thousand people. Among both sexes, the incidence of PR in the region had a moderate downward trend (Tsn = 1.25 %; p < 0.001). There was a moderate downward trend (Tsn = 1.55 %; p < 0.001) in the incidence of psychoses and dementia among men. There were no trends in the female population and the territory of residence (Tsn. = 0.35 %; Tsn. = 1.07 % in urban areas, p < 0.001 and Tsn. = 0.8 % in rural areas, p < 0.001, respectively). In the younger (0−19 years old) and older (40−59 years old, 60 years old and older) age groups, mental disorders of a non-psychotic nature were in the lead in the structure of the incidence of PR, while mental retardation was a priority at the age of 20-39 years.

Conclusion. The incidence of mental disorders in the Omsk region exceeded the national average (by 21.5 %). In dynamics, the trend towards a decrease in the incidence of mental disorders in the region was observed among both sexes, but was largely due to a decrease in this indicator in men. In the age structure of patients with mental disorders in the Omsk region, people aged 20−39 years were in the lead for 2010−2022. A moderate tendency to an increase in the incidence of PD was revealed in the age groups of 60 years and older throughout the region (Tpr. = 1.6 %; p < 0.001), as well as in people aged 40−59 years living in rural areas.

Aim. Approbation of a course of cognitive rehabilitation using multitasking cognitive training in the early postoperative period of coronary artery bypass grafting (CABG).

Materials and Methods. The study involved 10 cardiac surgery patients who underwent a course of multitasking cognitive training in the early postoperative period of CABG. All patients underwent neurological and advanced neuropsychological testing before the intervention and upon completion of cognitive rehabilitation. The results of cognitive rehabilitation of two study participants are described as clinical cases.

Results. Most patients (7 out of 10) responded positively to the course. It was also possible to achieve a reduction in the frequency of postoperative cognitive dysfunction (POCD) to 40 %. The individual relative change (Δ) index showed that 5 patients (50 %) improved by 20 % or more, or did not change their executive and psychomotor functions, attention scores in 3 patients (30 %), short-term memory improvement − 7 patients (70 %). Successful completion of cognitive rehabilitation course (no POCD) was observed in a man, 60 years old, with initial lack of cognitive impairment with sufficient level of motivation to undergo training. Whereas for a 68-year-old patient with preoperative cognitive impairment and reduced motivation, the training course was unsuccessful.

Conclusion. Seven out of 10 patients showed satisfactory results in individual transferability of the multitask training course, as well as transfer of the training effect to other cognitive functions not trained. Two clinical cases demonstrated that the initial cognitive status, level of motivation and even gender of patients can affect the effectiveness of cognitive rehabilitation in the early postoperative period of coronary artery bypass grafting.

Aim. In an in vitro experiment, to study the properties of the IPN hydrogel fibrin/high-molecular polyvinyl alcohol with an increased number of cryocycles and fibrinogen concentrations to assess the prospects for its use in the creation of small-diameter vascular prostheses.

Materials and Methods. One-component samples of fibrin hydrogels containing 40 and 50 mg/ ml fibrinogen, PVA polymer (146000-186000 Da) 30 and 40 mg/ml and the corresponding groups of IPN hydrogel samples were polymerized: fibrin 40 mg/ml and PVA 30 mg/ml (F40P30), fibrin 40 mg/ ml and PVA 40 mg/ml (F40P40), fibrin 50 mg/ml and PVA 30 mg/ml (F50P30), fibrin 50 mg/ml and PVA 40 mg/ml (F50P40). PVA was cryostructured for 5 cycles.

The structural properties of the samples were studied using SEM, histological staining of sections with hematoxylin and eosin, and IR spectroscopy. Biological properties were assessed by the viability, number and metabolic activity of cells colonized on the materials. The physical and mechanical properties of the samples were characterized by tensile strength, relative elongation and Young's modulus. The hemocompatibility of materials was assessed by contact activation of platelets and the percentage of erythrocyte hemolysis.

Results. Sequential polymerization of fibrin and high-molecular-weight PVA produced an IPN hydrogel with a uniform distribution of components in the thickness and lower surface, but a predominant presence of PVA on the upper surface. The structural heterogeneity of the material affected the biological properties. The lower surface of IPN hydrogels showed higher biocompatibility compared to the upper surface.

The strength of IPN hydrogels increased with increasing PVA molecular weight, concentration and number of cryocycles, but did not reach a. mammaria. Hydrogels do not hemolyze red blood cells and do not activate platelets.

Conclusion. Using a technique of sequential polymerization of fibrin and high molecular weight PVA over five cryocycles, a double-sided IPN hydrogel with high biocompatibility on the lower side and improved strength was obtained. However, the physical and mechanical characteristics of IPN hydrogel were weaker than a. mammaria, which requires new solutions.

Aim. To substantiate the effectiveness of conservative treatment of CT at the pre-pregnancy stage in order to reduce reproductive losses.

Materials and Methods. The study involved 86 women aged 21−35 years (on average 29.4±4.6 years) with a history of habitual miscarriage and chronic tonsillitis. The main group (n = 45) consisted of patients who were treated for chronic tonsillitis at the pre-gravidar stage. The comparison group (n = 41) consisted of patients who did not receive treatment for chronic tonsillitis at the pre-gravidar stage. The parameters of hemostasiogram and uterine blood flow in dynamics in patients of the main group were analyzed.

Results. Against the background of chronic tonsillitis and habitual miscarriage, all parts of hemostasis are disrupted and uterine blood flow worsens. When studying the effect of circulating RFMC, it was found that their presence increases the risk of abnormal fibrinogen concentrations (OR = 1.95; 95 % CI 0.46– 8.21) and PTI (OR = 1.35; 95 % CI 0.31–5.88), increases the frequency of abnormal INR values (OR = 1.55; 95 % CI 0.42–5.65). At the same time, circulating RFMC does not affect the risk of violation of the duration of ACTV. The presence of RFMC does not significantly affect the dynamics of hemostasiogram indicators before and after treatment of chronic tonsillitis, whereas patients with negative RFMC experience significant changes in hemostasiogram indicators before and after treatment of chronic tonsillitis.

After treatment of chronic tonsillitis, no patient showed a decrease in endometrial thickness. The blood flow rate in the PMA and LMA returned to normal, whereas before treatment, blood flow in the PMA was reduced in 1 (2.2 %), in the LMA was reduced in 7 (15.6 %) patients and increased in 2 (4.4 %) women. The resistance index in PMA and LMA returned to normal in all patients. The index of resistance of the arcuate arteries after treatment − increased values remained unchanged in 2 (4.4 %) patients.

Conclusion. The results obtained in our study prove the negative effect of chronic tonsillitis on the hemostasis system and, as a result, deterioration of uterine blood flow and substantiate the effectiveness of conservative treatment of chronic tonsillitis at the pre-gravidar stage in order to reduce reproductive failures.

Today, the contribution of mesenchymal stem cells (MSCs) to the mechanism of development of pathologies such as calcification of heart valves and blood vessels is being actively discussed. This is due to the fact that the formation of calcifications in the cardiovascular system (CVS) repeats the process of ossification, that is, it is mediated by specific bone cells - osteocytes. Since MSCs are progenitor cells capable of multilineage differentiation, they are considered as a source of osteocytes in the cardiovascular system. The question of what stimuli activate the osteogenesis program in MSCs localized in the CVS organs remains open. The presence of risk factors for cardiovascular diseases (CVD) has a systemic effect on the body, as it contributes to the development of pathological processes such as hypoxia and inflammation, which lead to remodeling of the MSC niche and changes in their function. This review systematizes scientific studies devoted to the influence of modifiable and non-modifiable CVD risk factors on the morphofunctional properties of MSCs.

The purpose of this review is to systematize existing knowledge about the role of modifiable and non-modifiable CVD risk factors in changing the morphology and function of MSCs.

The functioning of MSCs depends on the age of the donor and the duration of their cultivation in vitro, due to the activation of cellular aging processes. The influence of gender on MSCs is controversially described in the literature; however, there is evidence of the participation of estrogen in regulating the balance between osteogenic and adipogenic differentiation of progenitor cells. The presence of comorbid conditions such as hypercholesterolemia, obesity, and diabetes mellitus contribute to the acceleration of cellular aging, modification of the MSC phenotype, and influence the activity of their proliferation and differentiation potential. Thus, the complex of pathological processes accompanying obesity and diabetes mellitus leads to a decrease in the differentiated potential of MSCs, and also induces the expression of genes that are markers of cellular aging. An increase in the concentration of cholesterol esters in the microenvironment of MSCs induces a program of osteogenic differentiation in them, and exposure to high density lipoproteins (HDL) has a positive effect on proliferation. Cigarette smoke activates stem cell apoptosis, reduces proliferation, and induces osteogenesis.

Over 80 % of patients seeking treatment at the general surgical hospital on duty complain of abdominal pain. The paper presents current understanding of the dynamics of incidence of common acute abdominal surgical pathology in Kuzbass from 1993 to 2023. A comparative analysis was conducted between the first and last decades and revealed that acute cholecystitis was the leading cause by 2023 − 122 cases per hundred thousand population per year. This level was observed in both the first and third decades. The average annual number of patients treated for acute pancreatitis increased from 64.3 to 109.6 per hundred thousand residents, an increase of 70.4 %. On the contrary, the number of patients with acute appendicitis decreased from 190.8 to 93.5 per hundred thousand, a decrease of 51%. The fourth position is occupied by patients with intestinal obstruction; the incidence in the first and third decades was 41.7 and 45.2 per hundred thousand, respectively, an increase of 8.4%. In the dynamics of thirty-year observation, there was a decrease in the number of people operated on with perforated gastric and duodenal ulcers by 47.3 %, the incidence was 28.8 and 15.2 per 100,000, respectively. On the contrary, the average annual number of people treated with strangulated hernia increased by 35.1 %, the incidence increased from 29.9 to 39.8 per hundred thousand residents of the region. Severe, extremely intense abdominal pain at the onset of the disease is observed in 0.1−2 % of hospitalized patients with acute large-focal pancreatic necrosis, strangulation intestinal obstruction, perforated ulcer, and acute mesenteric ischemia. The lecture outlines the issues of diagnosing urgent abdominal surgical pathology, taking into account the nature, intensity and localization of pain. Issues of surgical tactics for diffuse, non-localized, extremely intense pain and differential diagnosis with peritonism syndrome and pseudoperitonitis are separately considered.

Teratomas are the most common congenital tumors, and are composed of various tissues of ectodermal, mesodermal, and endodermal origin. Usually, they contain derivatives of all three germ layers such as bone, cartilage, muscle, epithelial and glandular tissue. Mediastinal teratomas are extremely rare, and usually arise in the anterior mediastinum as a median or paramedian mass. In the perinatal period, up to 15% of all teratomas are observed. The tumor is more often located in the anterior mediastinum, may be associated with the thymus or thyroid gland, in some cases it is not possible to determine a clear connection between the tumor and adjacent organs. Mediastinal teratoma can cause hydrops fetalis, which worsens the effects of the mass compression on the vital mediastinal organs. Diagnosis is usually made during routine pregnancy checkups by ultrasonography, and differential diagnosis with other mediastinal masses such as congenital cystic-adenomatous lung malformation, pulmonary sequestration, intrapericardial malformations is crucial. We report a new case of 34 year old woman’s pregnancy complicated by non-mature Grade 3 mediastinal teratoma of fetus, who therefore was diagnosed death on the 6th day postnatally.