Chronic heart failure is currently a global problem. Community-acquired pneumonia, which plays a major role in mortality from respiratory diseases, 
is equally important. Th e aim of the study is to review the literature on risk and progression factors, pathogenesis, and diagnostic features of chronic heart failure and community-acquired pneumonia, both separately and in combination. Th e review was conducted using eLibrary and PubMed databases. Th e retrospective period was 10 years with a predominant selection of material published over the past 5 years. Most sources describe the role of chronic infl ammation, but there is limited data on the eff ect of acute infl ammation on myocardial dysfunction, which determines the need to continue research on this problem.

n recent years, certain successes have been achieved in the fi ght against tuberculosis in the Russian Federation. Despite this, the current epidemic 
situation for tuberculosis remains tense. A certain role in this was played by the spread of the new coronavirus infection (COVID-19) in the period 2019-2022. A search for publications dated 2020-2023 on the problem of mutual infl uence of tuberculosis and COVID-19 was carried out in the Medline, Library (https://www.elibrary.ru), PubMed (https://www.ncbi.nlm.nih.gov/pubmed), Embase ( https://www.elsevier.com) and Google Academy (https://www.scholar.google.ru) 
databases using terms indexed by MeSH,.Th is review highlights the data on the pathophysiological and clinical aspects of the eff ect of COVID-19 on tuberculosis in their combination and in the post-COVID period. It has been established that the synergism of COVID-19 and tuberculosis contributes to an increased risk of reactivation of latent tuberculosis, severe clinical manifestations and complications associated with the system of haemostasis and fi brinolysis.

Acute pancreatitis is a severe disease of the pancreas, the number of cases of which increases by 3.4% annually. Both acute and chronic pancreatitis 
can become risk factors for the development of such a malignant neoplasm of the pancreas as ductal adenocarcinoma of the pancreas, although the degree of possible danger of malignant neoplasm development in diff erent researches varies. Search for studies was conducted using electronic databases from Google Scholar, Medline and PubMed. A total of 215 articles were reviewed and 50 articles were deemed relevant according to the inclusion criteria. Among the genes the activity of which may be modulated during the development of a malignant tumour of the pancreas is the catalase gene. Catalase is an antioxidant protection enzyme that plays a key role in ROS inactivation and prevention of oxidative stress, one of the most important pathogenetic factors in acute pancreatitis

Th e aim of the research. To study the relationship between the general morbidity and certain classes of diseases in children aged from 0 to 14 years and the quality of drinking water according to the data of sanitary and hygienic monitoring for 2007-2021 in the city of Astrakhan.
Material and methods. A mathematical and statistical analysis of offi cial data on the morbidity of children and sanitary and hygienic monitoring of drinking 
water was carried out using Microsoft Excel soft ware. Th e study of correlations was carried out by calculating the Spearman’s rank correlation coeffi cient at the level of signifi cance α≤0.05 using an online calculator service on the Internet.
Results. Th e presence of a notable and direct statistically signifi cant relationship between diseases of the blood, hematopoietic organs and certain immune disorders in children aged 0 to 14 years has been established with the indicator “Proportion of drinking water samples from the water supply network that do not meet hygienic standards for sanitary and chemical indicators” (rs = 0.64; p = 0.014). Th e absence of statistically signifi cant links between general morbidity, respiratory diseases, neoplasms, endocrine pathology in children (0-14 years old) with water quality indicators in the centralised water supply source of Astrakhan has been 
revealed (according to sanitary and chemical indicators of water, the relationship is weak, direct: rs = 0.10, p = 0.723, according to microbiological indicators, the relationship is moderate, direct: rs = 0.323, p = 0.240). Essential regional elements that need special sanitary and hygienic control to prevent diseases of the blood, hematopoietic organs and certain disorders of the population’s immunity (copper, iron, manganese and nitrates) have been identifi ed.
Conclusion. A notable direct statistically signifi cant correlation between blood diseases of hematopoietic organs and certain immunity disorders in children 
(0-14 years old) and the quality of drinking water from the water supply network has been established. Th e results of this study may be applied for prediction and prevention of environmental pathology in the region.

Th e aim of the research. To study the associations of recurrent pain syndromes with smartphone addiction among Russian and foreign medical students.
Material and methods. Using an online questionnaire, 239 medical students were surveyed: 162 Russian citizens (main group) and 77 foreigners (comparison group); 98 (41.0 %) males and 141 (59.0%) females, median (Me) age was 20 [18; 21] years. Th e survey programme for the compared groups included: analysis of the prevalence of problematic smartphone use; association of recurrent pain (headaches, abdominal pain, back pain) with addiction to a smartphone and consumed content, with features of online behaviour: adaptive (АIU), non-adaptive (NIU) and pathological (PIU) use of the Internet, with specifi c forms of PIU (problematic use of computer games and social networks, mixed and undiff erentiated forms of PIU); assessment of the total score of the smartphone addiction questionnaire scale; analysis of correlations of the studied parameters. Th e indicators were compared in the general sample of the examined, in groups of Russians and foreigners, including taking into account gender, characteristics of online behaviour, the presence or absence of smartphone addiction, using the “Statistica 12 for Windows” program (StatSoft Inc., USA).
Results. A total of 14.2 % among the total number of the surveyed are smartphone-dependent students; there are more such people in the group of foreigners (27.3 % and 8.0 %). 16.3% have frequent cephalgia, 43.9 % have rare cephalgia, 17.9 % have verifi ed tension headache (TH), its frequency is higher in addicted users (30.8 % and 16.8 %). Th e presence of migraine was detected in 25.3 % of all examined. Rare (episodic) abdominal pain is more typical for smartphone-dependent users, more oft en Russians than foreigners. 28.4 % of students suff er from dorsalgia; their frequency is higher among addicted Russian users (69.2 %) than foreigners (23.8 %). The most common location of dorsalgia in addicted users is the cervical and lumbar spine. Th e total score on the smartphone addiction questionnaire scale is higher among foreigners (males + females) and among foreign males than among Russian males. Regardless of citizenship, students with PIU had higher values for this parameter. A larger number of correlations was found for dorsalgia and fewer for recurrent cephalgia.
Conclusion. Using the sample surveyed as an example, the prevalence of problematic smartphone use among Russian and foreign medical students has been determined, and associations and correlations of recurrent pain with smartphone addiction and other forms of PIU have been identifi ed. Th e results obtained indicate the need for further research aimed at solving an urgent medical and social problem: timely diagnosis of smartphone-dependent behaviour and prevention of the associated somatic and neuro-mental health disorders in the younger generation. Along with functional somatic disorders (pain syndromes), the range of indicators for studying in people with problematic smartphone use should also include an analysis of the characteristics of psychosocial characteristics, taking into account age-sex and ethno-geographical diff erences in users of electronic gadgets.

Th e aim of the research. To study the frequency of pregnancy complications detected by ultrasound (US) and Doppler (DP) examinations at screening dates in patients whose pregnancy ended in preterm birth.
Material and methods. A retrospective clinical study involving 529 pregnant women with a gestational age of 220-336 weeks whose pregnancy ended in 
preterm birth was conducted. All patients were divided into 4 groups according to the gestational age: Group 1: 22-24 weeks; Group 2: 25-27 weeks; Group 3: 28-31 weeks; Group 4: 32-33 weeks. Th e structure and frequency of detection of pregnancy complications using ultrasound and DP were analysed.
Results. According to ultrasound data, the most frequent pathologies in the fi rst trimester of pregnancy were retrochorial haematoma (5.3 %) and uterine 
leiomyoma (4.2 %). Th erewith, the most frequent diagnoses among all patients in the second trimester were short cervix (less than 25 mm) – 32.9 %, oligohydramnios – 16.2 %, low placentation and placenta previa – 9.8 %. Oligohydramnios was more frequently diagnosed in group 1 and 2 patients, 27.1 % and 25.0 %, respectively (p<0.05), compared with group 3 and 4 patients, 9.7 % and 3 %, respectively. Short cervix in the second trimester was more frequently diagnosed in patients of Group 1 and Group 2 (46.3 % and 42.0 %, respectively) compared patients of Group 3 and Group 4 (26.1 % and 19.8 %, respectively). 
The data of the DP examinations demonstrated a higher frequency of haemodynamic disorders in patients of Group 2: 20.4 %, while among the other patients it did not exceed 14.6 %.
Conclusion. Th e high frequency of retrochorial haematoma in the fi rst trimester and short cervix in the second trimester of pregnancy are associated with the development of very early and early preterm labour. Th e frequency of cervical shortening and haemodynamic abnormalities in groups of patients with diff erent gestational age at the time of delivery was determined based on ultrasound and Doppler studies. In particular, short cervix was statistically signifi cantly more oft en diagnosed in patients with very preterm (29-32 weeks) and extremely preterm (22-28 weeks) birth, and haemodynamic abnormalities according to DP were more oft en detected in patients with very preterm (29-32 weeks) birth.

Th e aim of the research. To study risk factors, features of diagnosis and treatment of tubo-ovarian formations of the lesser pelvis in women in order to 
improve approaches to preserving their reproductive potential.
Material and methods. A comprehensive retrospective analysis of registration form 003/u “Medical record of a patient receiving medical care in an inpatient 
setting, in a day hospital” was carried out for women who received medical care for purulent-destructive diseases of the uterine appendages in 2021-2022. A total of 42 cases of tubo-ovarian formations of the lesser pelvis organs were identifi ed and one female aged 53 years was excluded from the study. Statistical data analysis was carried out using the statistical package IBM SPSS Statistics v.19.
Results. A retrospective analysis of the medical history of women with purulent-destructive diseases of the uterine appendages revealed that this pathology is more oft en registered in women of active reproductive age, the average age of patients is 34,0 [29.5; 41.0] years (from 18 to 45 years). Most of the women lived in the city (75.6 %), were married (63.4 %), did not work (53.6 %) and almost all had a burdened obstetric and gynaecological history. Every second patient had at least one abortion and one third of the women had spontaneous pregnancy losses in the past. Th e method of contraception in 43.9 % of women was an intrauterine device (IUD), the average period of continuous use of the IUD was 9.0 [5; 12.0] years. All patients underwent surgical treatment, half of them on the day of admission to the hospital (53.6 %); radical surgical intervention with removal of the uterus (total hysterectomy of the uterus with or without appendages and subtotal hysterectomy of the uterus with or without appendages) was performed in 46.3 % of the women due to a complicated form of infl ammation. In 14.6 % of cases, complications arose aft er surgical treatment (peristump infi ltration, adhesions in the abdominal cavity, infi ltration in the postoperative suture area, pelvic haematoma, small intestinal obstruction, interintestinal abscess, sepsis, multiple organ dysfunction, pericarditis, pleurisy, 
hepatosplenomegaly). One-fi ft h of the women (19.5 %) had the uterus preserved but both tubes are missing, and pregnancy is subsequently possible in such patients with the use of assisted reproductive technologies; their average age was 33.0 [33.0; 34.0] years.
Conclusion. Tubo-ovarian formations of the less pelvis are more common in women of active reproductive age, with a burdened obstetric history, and 
the presence of gynaecological and somatic pathologies. A particular risk factor is long-term use of intrauterine contraception. Timely diagnosis and 
organ-sparing principles of treatment, eff ective prevention, adequate contraception, competent regular medical checkup supervision will help preserve the reproductive potential of this category of patients.

The aim of the research. To evaluate the effi cacy of ultrasound-guided vacuum-assisted biopsy (VAB) in focal changes of mammary glands.
Material and methods. A total of 40 clinical cases of women aged 22 to 78 years (mean age 43.25±13.65) with complaints of discomfort in the area of the mammary glands and/or the presence of lumps who sought medical attention from 09.2019 to 09.2020 were studied. According to ultrasound imaging, focal breast lesions were visualised in the patients assessed as 3-4 by BI-RADS (56 in total). VAB and subsequent histological examination were performed.
Results. Out of the 56 focal lesions, 51 lesions (91.07 %) were benign and 5 (8.93 %) were malignant according to the histological analysis. Histologically: 
fi broadenoma (FA) (n=19; 33.93 %), sclerosing adenosis (n=3; 5.36 %), a combination of these types (n=11; 19.64 %), fi brocystic changes (n=6; 10.71 %), a simple cyst (n=7; 12.5 %), a cyst with infl ammation (n=3, 5.36 %), infl ammatory changes (n=1, 1.79 %), lipoma (n=1, 1.79 %), invasive carcinoma – 5 (8.92 %). FA was suspected using ultrasound imaging in 31 cases (55.36 %), diagnosed histologically in 30 cases (53.6 %) and in 11 cases FA was combined with sclerosing adenosis, which was not revealed by ultrasound imaging. On ultrasound, the probability of a malignant neoplasm was assessed as high in 8 cases; on histological examination, invasive carcinoma was diagnosed in 5 (8.93 %) cases: 2 of them were assessed as BI-RADS 3, and 3 were assessed as BI-RADS 4. Th e effi cacy of VAB was assessed as 98.21 %, and the accuracy, sensitivity and specifi city as 100 %.
Conclusion. Th erefore, VAB has a high potential for widespread use in routine practice, and suspicion of breast cancer is a direct indication for VAB.

The aim of the research. To investigate the possibilities of electrochemical detection of COVID-19 pathogens in biological samples using biosensors based on DNA aptamers and to create an electrochemical aptasensor for this disease based on them.
Material and methods. Th e objects of the study were the spike S-protein of the RBD domain of the coronavirus, artifi cial saliva, and swabs from the 
oropharyngeal mucosa of healthy people and those infected with COVID-19. Th e aptasensor was produced by creating a monolayer of Apt31 aptamers on 
the surface of the gold electrode. Cyclic voltammetry and diff erential pulse voltammetry were used as the main electrochemical methods.
Results. Th e change in the electrochemical signal of the aptasensor based on the DNA aptamer Apt31 affi ne to the COVID-19 coronavirus pathogens upon 
binding of the target S-protein RBD domain has been studied. The aptasensor was tested on clinical samples of swabs from the oropharyngeal mucosa of 
healthy people and subjects infected with COVID-19. Th e presence of COVID-19 pathogens in the samples was confi rmed using a PCR test. The research results showed that an electrochemical aptasensor based on a gold electrode with an active sensor layer based on the Apt31 aptamer specifi c to the RBD protein of the Wuhan strain of SARS-CoV-2 makes it possible to diff erentiate between smear samples of healthy and COVID-19 patients in diff erential pulse voltammetry (DPV) mode.
Conclusion. Th e electrochemical aptasensor is potentially applicable for detection of COVID-19 pathogens in biological samples (oropharyngeal swabs).

Th e aim of the research. Assessment of iron metabolism in donors of blood and its components, including those who have had the new coronavirus infection (COVID-19).
Material and methods. A comprehensive study of hemogram parameters, iron metabolism in donors of blood and its components was carried out depending 
on the type of donation, the time donorship and history of COVID-19. In donors who had had COVID-19, the level of C-reactive protein and IgG antibodies to the SARS-CoV-2 antigen was determined using enzyme-linked immunosorbent assay.
Results. Th e article presents data from our own studies of iron metabolism in donors of blood and its components. Ferritin levels below the reference values 
were detected in 32.2 % of male and 21.4 % of female donors. Th e group at increased risk of iron defi ciency included male and female donors who have been donating blood for more than four years, including those who have had COVID-19. Th e average ferritin level in male donors was 27.56 μg/L (p<0.01) which is lower than the reference values. With revealed risk of iron defi ciency, it is advisable to begin the development of personalised preventive measures.
Conclusion. COVID-19 history did not aff ect the metabolism of iron in donors; the time in donorship and the borderline permissible values of haemoglobin and (or) haematocrit before donation were of greater importance.

Th e aim of the research. To determine the role of chymase and tryptase of mast cells in COVID-19 lung damage pathogenesis.
Material and methods. Th e study included 55 patients diagnosed with COVID-19 accompanied by community-acquired bilateral polysegmental pneumonia and acute respiratory distress syndrome. Th e control group included 30 people without COVID-19 who died from external causes. General blood test and coagulogram were assessed in the main group. Microscopic slides of post-mortem lung biopsies were analysed in both groups to determine the representation of mast cells, analysis of the protease profi le and degranulation activity. A comparative analysis of the representation of mast cells in both groups and a correlation analysis to identify connections between mast cell parameters and laboratory data were performed.
Results. An increased content of tryptase-positive mast cells was found in the lungs of patients with COVID-19 (p=0.033) compared to controls and their 
reduced degranulation activity. Th e representation of chymase-positive mast cells in patients with COVID-19 was signifi cantly lower (p=0.013). Correlations between the content of tryptase-positive mast cells and the degree of their degranulation activity in the lung tissues with the levels of band neutrophils, basophils, eosinophils in the peripheral blood, ESR, APTT, INR and fi brinogen have been established.
Conclusion. Th e content of chymase-positive MCs in the lungs of patients with COVID-19 is signifi cantly lower compared to controls, and tryptase-positive MCs are signifi cantly higher. At the same time, a reduced degranulation activity of tryptase-positive MCs has been noted. Correlations have been noted between the content of tryptase-positive MCs and the degree of their degranulation activity in the lungs with the level of band neutrophils in the blood, indicating the pro-infl ammatory eff ects of MCs. Numerous correlations between the parameters of coagulation haemostasis and diff erent mast cell parameters indicate a possible infl uence of mast cells on systemic coagulation status.

The aim of the research. To study the association of genotypes and alleles of SCN5A gene rs11720524 polymorphism with lipid profi le parameters, presence of stenoses in coronary and carotid arteries in patients with chronic coronary artery disease (CAD) combined with type 2 diabetes mellitus (DM).
Material and methods. We examined 220 patients with chronic CAD, including 120 patients with type 2 DM and 100 patients without carbohydrate 
metabolism disorders. Total cholesterol (TC), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides (TG) levels were evaluated. Selective coronary angiography and ultrasonography of carotid arteries were performed. Genetic polymorphism rs11720524 (C>G) of SCN5A gene was determined by real-time polymerase chain reaction. The associations of genotypes and alleles of the gene polymorphism with the studied traits were determined within groups. Methods of nonparametric statistics were used.
Results. In the group with CAD and type 2 DM, carriers of the GG genotype had higher values of TC compared to carriers of the GC genotype (p=0.022) and CC genotype (p=0.029), TG levels in carriers of the GG genotype were also higher than in carriers of the CC genotype (p=0.003). Type 2 DM patients with stenosis in common carotid arteries (CCA) were more likely to have the GG genotype (p=0.027), OR 2.58, (95% CI: 1.09-6.05); the presence of the G allele increased the likelihood of stenosis in CCA (p=0.01), OR 2.11, (95% CI: 1.17-3.82). Atherosclerotic plaques in the right coronary artery (RCA) in patients with DM were also more frequently detected in carriers of the GG genotype (p=0.009), OR 4.33 (95% CI: 1.35-13.87). No associations of rs11720524 SCN5A polymorphism with lipid profi le parameters and atherosclerosis were found in patients with CAD without carbohydrate metabolism disorders.
Conclusion. Associations of SCN5A gene rs11720524 polymorphism with lipid spectrum parameters and the presence of stenoses in CCA and RCA in 
patients with CAD combined with type 2 DM were revealed.

The aim of the research. To evaluate echocardiographic features in patients aft er COVID-19 infection and CABG.
Material and methods. A total of 80 patients aft er CABG in the State Budgetary Healthcare Institution “Research Institute - Specialized clinical hospital of cardiovascular surgery by academician B.A. Korolyev” in 2019 were enrolled in the study. Th e research was conducted in compliance with the Declaration of Helsinki. Informed written consent was obtained from all participants. Th e distinguishing of COVID-19 positive or negative patients was performed based on the results of nasal and pharyngeal swabs using reverse transcriptase-polymerase chain reaction (RT-PCR) or positive serum COVID-19 antibodies. 
Statistical analysis was performed using Jamovi soft ware version 2.3.28.
Results. According to EchoCG data, COVID-19 positive patients compared to COVID-19 negative patients demonstrate: a larger longitudinal right atrial 
size: 42 [36.5; 47] vs 39 [37; 42] mm, р = 0.034; OR = 0.922 [0.853; 0.996] 95 % CI, p ratio = 0.039; a longer mitral valve deceleration time (DT): 191 [171; 215] vs. 177 [159; 190] ms, р = 0.009; OR = 0.988 [0.976; 1.00] 95 % CI, p ratio = 0.077; a higher ratio of peak velocities of early transmitral fl ow and early diastolic motion of the mitral annulus (E/e’): 8.90 [6.59; 9.30] vs. 6.20 [4.90; 8.20], р = 0.004; OR = 0.786 [0.647; 0.955] 95 % CI, p ratio = 0.015; a higher occurrence of 1st degree tricuspid regurgitation: 34 (42.5 %) vs. 28 [35 %], р = 0.043; OR = 0.317 [0.101; 0.997] 95 % CI, p ratio = 0.049.
Conclusion. In patients with CAD and a history of CABG who have had COVID-19, a more pronounced impairment of myocardial diastolic function has been noted. Th is is manifested by a greater DT value, the ratio of peak velocities of early transmitral fl ow and early diastolic motion of the mitral annulus (E/e’) and a larger longitudinal size of the right atrium (RA). Th e available data suggest that the management strategy for patients with CAD who have had COVID-19 should include an extended EchoCG protocol using tissue Doppler imaging to assess left ventricular diastolic function, in order to timely identify the adverse eff ects of COVID-19 and prevent the progression of the existing cardiovascular pathology.

The problem of reducing mortality from diseases of the circulatory system in the Russian Federation is the most relevant for the healthcare system and requires an integrated approach to its solution. Th e successes of the last two decades in this work have been associated with the creation of an 
X-ray vascular diagnostics and surgery service. Th is article analyses the second important stage of work: the implementation and development of a system of primary prevention of cardiovascular diseases (CVD), successfully used in a number of regions of Russia and in Western European states. Th is stage is aimed at identifying individuals with familial hypercholesterolemia who are at particularly high risk. Leading medical institutions of the Krasnoyarsk Region present their own experience of interaction between paediatric and adult cardiologists in identifying patients at very high risk of cardiovascular diseases using cascade screening. Th e essence of this screening is the search for sick relatives of the index patient who suff ered early acute CVD. Th e authors have shown a high percentage of molecular genetic confi rmation of the diagnosis of familial hypercholesterolemia in childhood, the possibility of early initiation of lipidlowering therapy, as well as the advantages of multidisciplinary hospitals for the diff erential diagnosis of familial forms of dyslipidaemia and the organisation of observation and treatment of patients.

Neuromyelitis optica spectrum disorders are immune-mediated infl ammatory diseases of the central nervous system which oft en aff ect the optic 
nerves and spinal cord with relatively low involvement of cerebral structures and are characterised by a relapsing course and a high risk of disability. Diagnosis of this pathology may be especially diffi cult when there are symptoms associated with damage to the brainstem or hemispheres of the brain at the onset. 
Th e article presents a clinical case of neuromyelitis optica spectrum disorder seropositive to aquaporin-4 immunoglobulin G antibodies with late onset, two 
relapses with a short interval and further remission for 3 years. Th e disease manifestations were bilateral optic neuritis, cognitive impairment, pyramidal 
syndrome and ataxia. Stabilisation of the condition was achieved aft er short course of intravenous methylprednisolone in high doses; mycophenolate mofetil was used for preventing relapses. Th e features of diff erential diagnosis of neuromyelitis optica spectrum disorders with vascular lesions of the eye and other infl ammatory diseases of the central nervous system are discussed.

Eosinophilic lesion of the gastrointestinal tract (GIT), including the oesophagus, is of considerable interest to doctors in a wide range of specialties, being an interdisciplinary problem. Th e insuffi ciently studied epidemiology of the disease, the complexity of etiopathogenetic mechanisms of development, the lack of physicians’ focus on this pathology and clear treatment protocols predetermine the need for considerable research in the fi eld of eosinophilic lesions of the GIT taking into account the possible development of severe complications. Until recently, eosinophilic oesophagitis (EoE) was considered one of the manifestations of GERD. However, as a result of studies conducted approximately 30 years ago, it was revealed that this is a separate nosology, since the oesophagus is an active 
immunogenic organ. Th is article presents a brief review of the literature on EoE in children with a description of a clinical case of the disease in a teenage girl, which caused widespread oesophageal stenosis. A long path from the fi rst symptoms of the disease in the patient to verifi cation of the diagnosis, the absence of specifi c symptoms and the alertness of physicians to this pathology were noted, which possibly led to the development of complications.

In recent years, the frequency of placenta accreta has increased signifi cantly, corresponding to the increase in the frequency of caesarean sections, 
and there has also been a paradigm shift in the treatment of this pathology while organ-preserving surgical interventions are now increasingly performed. 
This article describes a clinical case of a pregnant woman with three scars on the uterus aft er a caesarean section and accretion of the placenta to the 
myometrium. The patient underwent successful metroplasty with preservation of organ function. This method has not yet found widespread use in the 
Republic of Crimea, and therefore the presented clinical case and metroplasty are generally relevant for our region.