Aim. To conduct an assessment of the quantity, qualitative composition, and proliferative potential of blood ECs taken from the coronary artery (CA), internal mammary artery (IMA), radial artery (RA), and venous bed in patients with ASC and IHD.

Materials and methods. The study examined eight biological blood samples obtained from two male patients: a 72-year-old with ACS and a 63-year-old with stable IHD. Each patient had 20 ml of venous blood obtained from the cubital vein and 20 ml of arterial blood obtained from the internal thoracic, radial, and coronary arteries. The mononuclear fraction was isolated from the blood, the cells were counted, cultured in vitro.

Results. During 26 days of cultivation, cells in the vials were counted. The highest proliferative activity of ECFC was observed in a patient with ACS: the doubling time of the population was 2.17 days for cells isolated from blood of CA and 2.38 days for cells isolated from blood of IMA. In a patient with chronic IHD, the doubling time of ECFC cells obtained from venous blood was higher – 2.54 days. The highest concentration of ECFC was detected in a patient with ACS in the blood of the infarct-related artery.

Conclusion. An analysis of endothelial cells isolated from the blood of CA and conductive vessels in CS revealed differences depending on the form of IHD. In patients with ACS, similarities in the characteristics and growth of CA and IMA ECs were noted, which may reflect the unidirectionality of reparative processes and increased stability of the MFS of conduit arteries when using these autoarterial grafts.

Chronic rhinosinusitis is a heterogeneous and multifactorial inflammatory disease of the nasal mucosa and paranasal sinuses.

Aim. To evaluate the morphological and some immunological features of nasal polyps in individuals suffering from chronic rhinosinusitis with various comorbid backgrounds.

Materials and methods. The study included 76 patients with chronic polypous rhinosinusitis and comorbidities such as bronchial asthma(, hypertension, chronic obstructive pulmonary disease (COPD). The control group consisted of patients without chronic rhinosinusitis or associated comorbidities, operated on for septoplasty. We analyzed the quantitative and qualitative cellular composition of polyp biopsies and mucosal samples from the control group. The concentration of cytokines (IL- 8, IP-10, MCP-1) was determined in blood serum and tissue homogenates using the multiplex analysis system "Human Essential Immune Response Panel" by BioLegend (USA).

Results. The total number of cells per 1 mm2 in polyp tissue was maximum in patients with a history of bronchial asthma and hypertension. In individuals with bronchial asthma, eosinophils and neutrophils prevailed in polyp preparations. In patients with hypertension and without comorbid conditions, lymphocytes prevailed. Biopsy specimens of nasal polyps in patients with COPD had approximately the same number of eosinophils and lymphocytes, with the maximum number of plasma cells. The concentration of IP-10 did not differ significantly in blood serum and tissue homogenate and was maximum in individuals with bronchial asthma. The maximum concentration of IL-8 was recorded in patients with bronchial asthma, and in tissues - in individuals with hypertension. The highest concentration of MCP-1 in both blood serum and polyp tissue homogenates was found in patients with bronchial asthma.

Conclusions. The induction of polyp formation and their cellular composition are influenced by the patient’s comorbid background.

Aim. To determine the participation of estradiol and progesterone (E2 and Pg), hormone-specific idiotypic and antiidiotypic antibodies and antibodies against benzo[a]pyrene (Bp) in the regulation of tumor metastasis in breast cancer patients (BCP).

Materials and Methods. There were studied 475 BCP II stage (254 – without metastases and 221 – with metastases). Test-systems “ImmunoEA-Estradiol” and “ImmunoEA-Pg” (Immunotech, Moscow) were performed for blood serum E2 and Pg concentration analysis before antitumor treatment. Enzyme-linked immunosorbent assay was used for study of IgA1 and IgG1 antibodies against E2, Pg and Bp and antiidiotypic antibodies (IgG2). Associations of these serum factors with tumor metastasis were studies by CART-analysis.

Results. There were revealed the correlation of IgA1-Bp with IgA1-E2 and IgA1-Pg (rs = 0.71 and rs = 0.60; p < 0.01), IgG1-Bp with IgG1-E2 and IgG1-Pg (rs = 0.75 and r s = 0.69; p < 0.01). Concentration of E2 and Pg were no correlated with studied idiotypic and antiidiotypic antibodies levels. There was revealed 5 groups of BCP with definite personal IgG2-Pg + IgA1-Bp combinations associated with metastases significantly. Metastatic tumors were revealed in 51 BCP (group 1.1) with low levels of IgG2-Pg ≤ 2.19 cu + IgA1-Bp ≤ 2.21 cu rarely than in 137 BCP (group 2) with IgG2-Pg ≤ 2.19 cu + IgA1-Bp>2.21 cu (21.6% vs 46.0 %; p = 0,004). Metastasis were detected in 15 BCP (group 2.1) with IgG2-Pg 2.19–3.6 cu + IgA1-Bp levels ≤ 1.41cu frequently than in 199 (group 2.2) with IgG2-Pg 2.19– 3.6 cu + IgA1-Bp>1.41cu (86.7 vs 53.3; p = 0,026). Metastases were found in 73 BCP (group 3) with high IgG2-Pg>3.6 cu rarely (38.4%), vs groups 2.1 (p = 0.002) and group 2.2 (p = 0.04).

Conclusion. IgG2-Pg may inhibit whereas IgA1-Bp may stimulate the tumor metastasis in BCP II stage with definite personal combinations.

Аim. To study the prevalence and structure of undifferentiated connective tissue dysplasia (UCTD) and joint hypermobility syndrome (JHS) in the Transnistrian population.

Materials and methods. 234 outpatients (68.4 % women, median age 49 [IQR 32;63] years) with ≥ 2 chronic diseases were examined. The information was collected through direct examination of the patients, use of the questionnaire, and the analysis of medical documents. UCTD was diagnosed with the involvement of ≥ 2 systems according to the Yakovlev’s criteria; Beighton score ≥ 4 was considered as JHS. p < 0.05 was considered significant.

Results. Signs of UCTD were observed in 53 %, JHS – in 9.4 %. The disorders of musculoskeletal system (58.1 %), gastrointestinal tract (GIT) (32.5 %), eyes (20.5 %) and skin (20.5 %) were the most common signs of UCTD. Involvement of 2 systems was observed in 30.6 %, 3– in 33.9 %, 4 – in 24.2%, ≥ 5–in 11.3 %. Patients with UCTD more often had back pain (p < 0.001). Women more often had signs of UCTD in the skin/muscles (p = 0.043) and nervous system (NS) (p=0.024); people under 60 years of age compared with the elderly, more often had changes in NS (p = 0.043) and cardiovascular system (p < 0.001). Group with JHS, compared with the group without JHS, more often had musculoskeletal and eye signs of UCTD (p < 0.001) and less often – symptoms from GIT (p = 0.014).

Conclusion. In outpatients in Transnistria, undifferentiated UCTD is widespread and characterized by a variety of clinical manifestations, gender and age heterogeneity, with a predominance of musculoskeletal disorders. JHS is more often diagnosed in women under 50 years of age with other manifestations of UCTD. No associations between presence of JHS and other musculoskeletal diseases have been identified.

Aim. To assess the significance of body composition indicators as predictors of the development of cognitive impairment in patients with CKD C5 receiving hemodialysis.

Materials and methods. 182 young and middle-aged CKD C5 patients receiving treatment with chronic hemodialysis were examined. Sarcopenia was diagnosed according to the criteria formulated by the European Working Group on Sarcopenia in Older People (EWGSOP2). To identify dementia and pre-dementia cognitive impairments, all patients were tested using the questionnaire MMSE (Mini-Mental State Examination). The software and hardware complex "Assessment of Nervous System Properties" was used as a tool for studying cognitive functions. The indicators of thinking were evaluated: "simple and complex analogies", linguistic "induction and abstraction".

Results. In patients with CKD C5 receiving hemodialysis, when analyzing the function of thinking, a decrease in the indicator "simple analogies" was recorded in 23 (12.6 %); "complex analogies" in 120 (65.9 %); "language induction" in 173 (95 %) and "language abstraction" in 161 (88.5 %) patients. Patients with CKD C5 and sarcopenia have worse performance of the "language induction" indicator 6 [5; 7] responses, compared with 6 [6; 8] responses in the CKD C5 group and without sarcopenia (p = 0.0434).

Conclusion. Patients with CKD C5 and sarcopenia have cognitive impairment. According to the results of a multivariate regression analysis, sarcopenia indicators, along with age, hemodialysis duration, and biochemical parameters, are the main factors leading to the development of cognitive impairment.

Aim. To present a clinical observation of paraduodenal pancreatitis with an analysis of differential diagnosis, patient management features, and justification of treatment tactics.

Materials and methods. A clinical case of a 48-year-old man with recurrent epigastric pain syndrome over a period of five years was analyzed. The study used general clinical and laboratory methods (including the examination of cancer markers and pancreatic elastase-1), methods of radiological and endoscopic diagnostics (endoscopic ultrasound, computed tomography and magnetic resonance imaging, fibrogastroduodenoscopy), histological examination of surgical material, and dynamic observation over a period of 5 years. The patient provided written voluntary informed consent for the publication of the data.

Results. The patient was diagnosed with segmental cystic para-duodenal pancreatitis with thickening of the medial wall of the duodenum, cystic inclusions, and narrowing of the duodenal lumen. The normal level of cancer markers, the results of the histological examination (chronic pancreatitis with fibrosis), and the stability of the process during dynamic observation allowed for the exclusion of adenocarcinoma. An organ-preserving surgery (resection of the pancreatic head with pancreatojejunostomy) was performed, and subsequent conservative therapy proved to be effective without the development of exocrine insufficiency.

Conclusion. Paraduodenal pancreatitis remains a diagnostic challenge due to its rarity and similarity to pancreatic head tumors. The key elements of diagnosis verification include the integration of imaging techniques, the level cancer markers, and morphological studies. Organ-preserving surgical interventions, combined with conservative therapy, can be an effective alternative to pancreatoduodenectomy in cases where the process is confirmed to be benign. Given the lack of standardized protocols for managing patients with this type of pancreatitis, treatment decisions should be made on a case-by-case basis.

Aim. To present a clinical case of observation and treatment of a patient with type 1 diabetes mellitus and suspected pancreatic neuroendocrine tumor (clinically VIPoma).

Materials and Methods. Description of a clinical case of severe type 1 diabetes mellitus.

Results. The gastrointestinal form of diabetic autonomic neuropathy is manifested by hypo- and atony of the esophagus (in 2-27% of patients with diabetes) and stomach (7-29%), intestinal hypomotility, diarrhea (0-22%), gallbladder atony and biliary dyskinesia with a tendency to cholelithiasis and reactive pancreatitis. There is a direct relationship between the incidence of diabetic autonomic neuropathy and the duration and degree of compensation of diabetes. Diabetic diarrhea results from impaired innervation, bacterial overgrowth syndrome, pancreatic insufficiency, bile acid metabolism disorders due to biliary dyskinesia, impaired colonic motility, anorectal dysfunction, microangiopathy and atrophy of the intestinal mucosa, and vitamin deficiency. The prevalence of diarrhea in patients with diabetes ranges from 4% to 22%. In 20-44% of cases, diabetic diarrhea associated with autonomic gastropathy may alternate with constipation. Timely treatment of gastrointestinal complications of diabetes can increase the active life expectancy of patients. The primary goals of diabetic gastropathy therapy are glycemic control and reduction of dyspeptic symptoms. Glycemic control is crucial in preventing the development of autonomic gastropathy.

Conclusion. Patients with diabetes mellitus should achieve target carbohydrate metabolism values and avoid hypoglycemia to prevent the development of diabetic complications. Autonomic gastropathy presents challenges in patient management for the practitioner and significantly reduces the patient's quality of life. A neuroendocrine tumor (VIPoma) may be suspected in the presence of prolonged intermittent diarrhea.

Aim. The purpose of this review is to analyze modern approaches to rehabilitation and evaluate the possibilities and prospects of using the method of interval hypoxic-hyperoxic training (IGTT) in patients with CHF.

Materials and methods. Analysis of scientific publications presented in databases elibrary.ru PubMed was conducted for the period from 2014 to 2024 on keywords such as "hypoxic effects, interval hypoxic training, hypoxic-hyperoxytherapy, re-oxy therapy, pathophysiological mechanisms of hypoxia, cardiorehabilitation." The inclusion criteria were the results of randomized trials, systematic reviews, as well as original articles with a control group.

Results. It has been shown that the IGTT method is a promising direction that has a pathophysiological basis and demonstrates positive results in clinical trials.

Conclusions. Further development and practical integration of this method require large randomized trials to confirm its clinical efficacy and safety.

Aim. To audit the maternal mortality rate in the Altai Region, an agrarian region of southern Siberia, for the period 2015−2024 and assess the contribution of extragenital pathology and direct obstetric causes to its structure.

Materials and methods. A retrospective comparative analysis of the dynamics and structure of causes of maternal mortality for the period 2015−2024 was carried out in the number of 58 sectional observations in the Altai Region, characterized by a large territory, a population density below average and a predominance of women of fertile age living in rural areas (40.2 %).

Results. The maternal mortality rate in the large agricultural region of southern Siberia over the 10-year period under study was unstable. The sharp increase in its level in 2021 (73.7 per 100,000 live births) was due to COVID-19 and its consequences in the form of thromboembolic complications. The leading causes of maternal mortality in the post-pregnancy period are complications of cardiovascular diseases, HIV- infection, and cases of direct obstetric causes are determined by the social factor.

Conclusion. To achieve the goals of sustainable development at the regional level, interdisciplinary interaction and coordination of the efforts of specialized specialists for the correction of cardiovascular pathology, HIV-infection, effective social and psychological work with patients at high social risk is necessary.

Group B Streptococcus as a commensal can cause severe infectious diseases in newborns, posing a serious danger to their lives.

The aim of the study was to evaluate the frequency of registration of group B streptococcus in pregnant women, mothers and newborns Using a mini-laboratory – the analytical system «LifePad» Analyzer.

Materials and methods. The study was conducted in a group of pregnant women examined at 35−37 weeks of pregnancy, intranatally in the delivery room, as well as in newborns. Microbiological data were compared with clinical manifestations of newborns.

Results. Among pregnant women, S. agalactiae carriage was 4.4 %. In women examined in the delivery room, S. agalactiae was detected in 7.8 % of cases with a predominance of colonies in the vaginal contents and from the cervix. Every second pregnant woman had registration of polymicrobial associations. The use of the analytical system of the LIFEPAD analyzer in combination with reagents reduced the time for obtaining results on the presence of S. agalactiae to 60 minutes. When examining newborns, in 75.0 % of cases, streptococcus was seeded from the skin of the axilla. Generalized streptococcal infection was reported in 8.3 % of cases, localized in 16.7 % of newborns. Among the newborns of the second stage of nursing, generalized bacterial infection caused by S. agalactiae was reported in 8.0 % of cases, and localized in 40.0 %. The results of determining the sensitivity of S. agalactiae to antibacterial drugs revealed high resistance to tetracycline drugs, moderate to fluoroquinolones, macrolides and lincosamides. Some strains had a constitutive and inducible MLSb phenotype of antibiotic group resistance.

Conclusion. The relatively high incidence of infectious disease manifestation in newborns at risk requires attention to the diagnosis of Group B Streptococcus carriage in pregnant women.

Endometriosis is a chronic, estrogen-dependent inflammatory disease that affects approximately 10% of women of reproductive age worldwide and is associated with pelvic pain, infertility, and significant comorbidity. Despite more than a century of research, its pathogenesis, optimal diagnostic pathways, and long-term management strategies remain incompletely understood.

Aim. To summarize and critically appraise recent advances in the understanding, diagnosis, and management of endometriosis, based on key findings presented at the 13th Congress of the Asian Society of Endometriosis (ACE- 2025).

Materials and Methods. This mini-review is based on an analysis of scientific presentations, program abstracts, and selected recent publications discussed during ACE-2025, with integration of epidemiological, genetic, molecular, diagnostic, and therapeutic evidence.

Results. Recent data reinforce the concept of endometriosis as a systemic, inflammatory, and fibrotic disorder with substantial heterogeneity. Large population studies confirm prolonged diagnostic delay, high multimorbidity, and significant reproductive impact. Advances in genomics, including genome-wide association studies and polygenic risk score analyses, demonstrate shared genetic architecture with several comorbid conditions. Pathophysiological insights highlight the central roles of estrogen dominance, progesterone resistance, immune dysregulation, and fibrosis. Diagnostic progress includes expert-guided ultrasound, MRI, and emerging multimarker approaches. Therapeutically, long-term medical management has become central, with extended GnRH analogue therapy using add-back regimens and dual progestin systems providing effective options for refractory pain. Special considerations in adolescents and infertility management emphasize early intervention and fertility preservation.

Conclusion. Endometriosis care is undergoing a paradigm shift toward personalized, multidisciplinary, and long-term management. Continued integration of molecular research with clinical practice is essential to improve outcomes and quality of life for affected women.

The patient with confirmed hereditary cancer risk was admitted to the A.V. Vishnevsky National Medical Research Center of Surgery. A comprehensive genetic analysis revealed heterozygous germline mutation, located in coding exon 10 of the BRCA2 gene, associated with breast-ovarian cancer. Considering the patient’s young age, the cancer team referred her on immediate breast reconstruction after skin-preserving mastectomy. Histological examinations did not reveal any pathological changes indicative of malignant transformation. This case report emphasizes the significance of personalized treatment approach aimed at preventing BRCA-associated breast cancer in patients carrying hereditary mutations. Preventive surgery substantially reduces the risk of cancer, even in patients with genetically determined risks, and ensures a high quality of life.

Aim. Study the Structure of the Internal Picture of Disease in HIV-Infected Patients Depending on Clinical and Epidemiological Characteristics.

Materials and methods. 86 HIV-infected patients aged 19 to 59 years were examined, with varying duration of infection and severity of disease progression. The pilot study was conducted at the Kuzbass AIDS Center. Research methods: questionnaire "Short questionnaire of E. Broadbent disease perception in Russian adaptation; "Personal meaning of the disease" (Z.L. Lipowski); "Emotional Response Questionnaire"; Student's t-test for independent samples; descriptive statistics; factor analysis was performed by principal component method by Varimax rotation taking into account Kaiser test; cluster analysis. As part of the study, the results of studies of the subjective response of the individual to HIV infection as a chronic incurable life-threatening disease are systematized.

Results. The study systematized research findings on subjective responses to HIV infection as a chronic, incurable, life-threatening disease. The internal picture of disease in HIV-positive patients is determined by disease severity. The duration of infection correlates with cognitive assessment of disease threat but has less impact on subjective response. Cognitive assessment aligns with HIV infection severity. In patients in remission with over 10 years of infection, the cognitive level of the internal picture of disease (IPD) dominates. Emotional representations show ambivalence (self-stigmatization combined with hope, optimism, and joy from overcoming difficulties). The motivational-meaning level of IPD is characterized by predominance of positive personal meanings. In patients with progressive forms of HIV infection, regardless of infection duration, all IPD components reflect acute stress impact. Emotional level of IPD shows depression (despair and helplessness as leading emotions). Negative personal meanings dominate («disease as threat», loss of health, weakness).

Conclusion. The severity of disease progression and cognitive assessment of HIV infection influence the development of different variants of the internal picture of disease. The unique adaptation pattern of people living with HIV in remission (with high ART adherence, undetectable viral load, and long disease history) is characterized by belief in disease controllability as the leading adaptive resource in the IPD structure.

Aim. To determine HIV antibodies and viral load levels in cadaveric blood samples from individuals with undiagnosed HIV infection during their lifetime, and to propose measures to optimize the system of epidemiological surveillance and safety.

Materials and methods. A targeted screening of 710 cadaveric blood samples was conducted, received from the forensic medical examination bureau. Blood sampling was performed from the heart cavities or large vessels in accordance with the regulatory documents of the Russian Ministry of Health. The exact time of sample collection relative to the moment of death was not recorded, but it typically occurred within several hours after death was confirmed. The lifetime HIV status of the deceased was unknown. A total of 710 samples were analyzed; HIV was confirmed in 1.5 % of cases (n = 11). Primary detection of HIV-1/2 antibodies and p24 antigen was performed using the “MilaLab-ELISA-HIV-Ag+At” enzyme immunoassay test system. Seropositivity confirmation and antibody profile determination were performed using immune blot testing with the “MilaBlot-HIV” kit. To assess epidemiological risk in seropositive individuals, quantitative determination of HIV-1 RNA was performed using PCR (“AmpliSense HIV-MONITOR-FRT” kit). Viral load could not be determined in two samples due to hemolysis.

Results. Positive immune blot for HIV was detected in 1.5% of samples. Antibodies to gp160 and gp41 proteins were detected in 100 % of cases, to gp120, p31, and gag24 − in 91 %, to gp36 − in 27 % (3/11), to p51/66 and gag17 − in 64 % (7/11). Viral load results ranged from 48 to 390,000 copies/ ml. In the vast majority of cases (78 %), the viral load exceeded 1,000 copies/ml, indicating high risks of HIV transmission.

Conclusion. The obtained data indicate the need for validation of existing test systems for postmortem HIV diagnosis; development of an algorithm for epidemiological detection of HIV infection cases in cadaveric blood; examination of first-line contact persons; strengthening epidemiological safety measures for thanatologists and medical personnel when working with cadaveric material.

Aim. To substantiate the approximate population standards of the body roundness index for the adult population of the Russian Federation.

Materials and methods. The object of the study is the adult population of the Omsk region (1,470 thousand people). In 2023, a sample was formed, based on gender, age and place of residence (Omsk city and rural areas of the region) in the number of 506 people, representative by age and gender of the adult population of the region (231 men and 275 women) with The median age was 45 (32; 59) years. The subject of the study is somatometric parameters of the nutritional status of the adult population of the Omsk region: Body Roundness Index (BRI), body mass index.

Results. The parameters of descriptive BRI statistics for different sample groups are calculated. The comparative analysis shows the inapplicability of the ranges of BRI standards developed for various groups of the adult population in other countries of the world to the studied population. Based on the analysis of the literature, the most reasonable approach to determining the boundaries of the statistical norm of BRI has been determined: using the ranges of percentile values of the variational series of BRI values as boundaries: P2.3, P16, P84, P97.7. Using this approach, statistical normative ranges of the index for the adult population of the region are proposed: "high" values – above 6.75, "above normal" – ranging from 4.83 to 6.75, "average" – from 2.16 to 4.83, "below average" – from 1.39 to 2.15, "low" – less than 1.39.

Conclusion. In this study, based on the study of a representative sample, approximate population standards of the BRI index for the adult population of Russia are proposed.