The scientifi c review considers the problem of habitual loss of the fetus due to the carriage of genes associated with thrombophilia. Physiological
and anatomical aspects that allow attributing pregnancy to thrombogenic risks are briefl y described, a review of genetic polymorphisms determining
the propensity to thrombophilia is given. Th e data on the positive and unsuccessful results of IVF in women with the carriage of genes associated with thrombophilia are indicated. A literature review on the topic was carried out, intermediate results of author’s studies on the presented issue in the Kaliningrad region, comparison of the obtained data are given. The assumptions about the patterns of the distribution of certain polymorphisms in the Kaliningrad region are given.

Th e aim of the research. In persons infected with the human immunodefi ciency virus, infections caused by Staphylococcus aureus have a signifi cant
proportion, and particularly alarming are the cases of detection in these persons methicillin-resistant S. aureus (MRSA), because can cause serious damage to organs and systems. It is necessary to to reveal frequency of carriage S. aureus, MRSA among HIV-infected people, incl. located in the penitentiary institution in the Krasnoyarsk Region, as well as to study the molecular genetic features of the MRSA. Th e goal is to study the molecular genetic features of MRSA from HIV-infected people in the penitentiary institution.
Material and methods. To determine the frequency of carriage of S. aureus, MRSA, the bacteriological method was used. For genotyping and determination of molecular genetic features – PCR, M-PCR, sequencing. Th e results were processed using the computer program WHONET(WHO).
Results. The frequency of carriage of S. aureus, MRSA in HIV-infected in the penitentiary institution in 2016-2017 amounted to 52.6% and 5.3% respectively. The frequency of carriage of S. aureus, MRSA of practically healthy persons in the penitentiary institution was 50% and 0%, respectively. When studying the molecular genetic features of strains of MRSA, it was established that there is one SCCmecIV clone having lukED genes; genes encoding adhesins, except cna and
bbp; hemolysins. Th e MSSA strain belonged to variant ST1, the presence of lukED genes, hemolysins was established; genes that encode sea and sek toxins, seq.
Conclusion. Th us, a higher level of colonization of MRSA among HIV-infected in the penitentiary institution was established. Th e strains from HIV-infected
MRSA corresponded to the genetic variant of SCCmecIV.

The aim of the research. To assess cardiovascular risk in COPD patients based on traditional assessment factors and spirometry parameters.
Material and methods. A total of 75 patients with COPD of I-IV degree GOLD (36 males and 39 females) aged 54.81 ± 8.36 years were examined. A 10-
year prognosis of fatal cardiovascular events was determined on the SCORE scale. Factors of reclassifi cation of cardiovascular risk - body mass index, waist circumference, triglycerides and LPNP were studied. Th e thickness of the intima-media complex and atherosclerotic plaques in the common carotid arteries was assessed for evaluation of subclinical vascular lesions.
Results. Th e relationship between subclinical atherosclerosis and such traditional risk factors as sex, smoking, the level of total cholesterol, triglycerides, LDL, body mass index, waist circumference and blood pressure has been revealed. In COPD, the use of the SCORE scale to assess cardiovascular risk was not suffi ciently informative, especially in low- and moderate-risk groups. In these patients, to clarify the information on the degree of risk, it is advisable to use additionally ultrasound imaging of the carotid arteries. More than half of patients with a low and moderate risk of cardiovascular disease have atherosclerotic plaques in the carotid arteries, which is an unconditional confi rmation of atherosclerosis and requires a change in the degree of risk to a higher one. In analyzing other possible factors, it turned out that the greatest relationship can be noted not so much to traditional risk factors as to the degree of airfl ow limitation at GOLD III-IV level.
Conclusion. Assessing the cardiovascular risk in COPD patients, it is necessary to take into account not only the contribution of traditional risk factors, but
also the importance of postbronchodilation FEV1.

The aim of the research. To study the control level in patients with bronchial asthma (BA) of a young age, depending on the body mass index and the
identifi cation of the most signifi cant risk factors that aff ect to the achievement of a controlled course of the disease according to the data of the Regional Pulmonary-Allergology Center.
Material and methods. 213 people were examined: 173 patients with BA of various severity degrees at the age from 18 to 44 and 40 practically healthy people. In accordance with the value of BMI, the patients were divided into two groups: the 1st BA and BMI to 24.9 kg / m2, the 2nd BA with a BMI from 30 to 34.5 kg / m2. To quantify the level of control over the symptoms of asthma, ACQ-5 (Asthma Control Questionnaire 5) was used.
Results. Th e results of the study showed that in synthropy BA and obesity, even at a young age and with a shorter duration of the disease, patients with a severe course of the disease are more common. In the group of patients with obesity, the severity of bronchial obstructive syndrome was more signifi cant. In a signifi cant proportion of patients in both study groups, regardless of the severity of asthma, there is no control over the disease, and this is primarily due to
the lack of basic therapy volume.
Conclusion. Even at a young age and a mild course of the disease, obesity signifi cantly exacerbates the clinical picture. Th e most signifi cant factors that negatively aff ecting the achievement of a controlled course of asthma in obese patients are: the thickness of the epicardial adipose tissue more than 7 mm, the decrease in adiponectin more than 30 μg / ml, the severe course of asthma, the concentration of TNF-α more than 10 pg / ml, BMI, the FEV1 value is less than 70%, the value of the resonant frequency (fres) is more than 14 Hz.

The aim of the research. To study the degree of infl uence of multiple drug resistance and the viability of mycobacterium tuberculosis on the clinical and X-ray manifestations of infi ltrative pulmonary tuberculosis.
Material and methods. The data on 235 newly diagnosed of infi ltrative pulmonary tuberculosis of bacterioviruses were used, which were in the stationary stage of treatment at the Krasnoyarsk Regional TB Dispensary No. 1. Clinical and radiological and laboratory features of infi ltrative pulmonary tuberculosis were studied depending on the biological properties of the pathogen.
Results. It was established that the degree of viability of mycobacteria tuberculosis in a much greater extent determines the clinical and radiological picture of infiltrative pulmonary tuberculosis than the presence of multiple and broad drug resistance of the pathogen. Th us, a specifi c process caused by mycobacteria with high viability was characterized by a greater prevalence of lesions, a high incidence of pulmonary tissue disintegration and bronchogenic colonization
and, as a result, a brighter clinical picture of the disease and more pronounced changes in the hemogram.
Conclusion. Based on the results of the study, it was concluded that the biological properties of mycobacterium tuberculosis exert a signifi cant infl uence on the clinical and radiological manifestations of infi ltrative pulmonary tuberculosis, while the viability of the pathogen to a much greater extent determines the clinical and X-ray picture of the specifi c process than the presence of multiple and broad drug resistance.

Th e aim of the research. To study the mechanisms of infl ammation in professional chronic obstructive pulmonary disease (COPD) under the infl uence of toxic gases or inorganic dust.
Material and methods. Design is a one-center, prospective cohort observational study of patients with professional COPD from toxic gases (n = 55) and inorganic dust (n = 101). Comparison group - patients with COPD, tobacco smokers (n = 103), control group - conditionally healthy persons (n = 99). Diagnosis of COPD - criteria GOLD 2011-2017. Concentrations in the systemic circulation of proinfl ammatory cytokines, growth factors, molecules of proteinase-antiproteinase systems, oxidant-antioxidant, endothelial factors, D-dimers were determined by the method of solid-phase immunoenzymatic
test. The eff ect of the production factor on the lavage liquid cell composition and serum concentration of the molecules for the biomechanism of COPD
development was established by the method of covariance variance analysis.
Results. In COPD, the eff ect of toxic gases was dominated eosinophilic type of infl ammation (in 58% of patients), from the action of dust - pausigranulocyte (in 70% of patients). The molecular pattern of infl ammation in COPD due to toxic gases was marked by an increase in the systemic circulation concentrations of IL1β, MIF, TGFβ1, MMP1 and MMP9, a decrease in VEGF A and nitric oxide, and in COPD due to inorganic dust, an increase in FGF2 and 8-iso-PGF2α. In the multiple regression model in COPD from the eff ects of toxic gases, FEV1 is associated with MCP1 and TGFβ1, from dust action with IL1β. The revealed diff erences allow to speak about the infl uence of the production etiological factor on the phenotype of COPD due to the modifi cation of the endotype. Markers of COPD from the action of toxic gases - a combination of serum concentrations of IL1β (B = 0.027), TGFβ1 (B = 0.00009), VEGF A (B = -0,0003) and inorganic dust – IL1β (В = 0,017), FGF2 (В=0,045).
Conclusion. Th e production factor infl uences to the features of the biomechanism for professional COPD development.

Th e aim of the research. To study the association between the risk of severe preeclampsia developing and acute infectious processes in mothers-carriers of
pre-eclampsia predictor genes AGTR1-1166CC and NOS3-894ТТ.
Material and methods. A retrospective case-control study included 50 women with severe preeclampsia and 50 women in the comparison group. All patients were carriers of genetic polymorphisms AGTR1-1166CC and NOS3-894TT, which are predictors of preeclampsia. Th e average age of pregnant women ranged from 20 to 35 years old. All women had a single-stage pregnancy, had no previous hypertension, kidney disease, cardiovascular, autoimmune, metabolic
diseases, pre-eclampsia in the anamnesis. Genetic polymorphisms were studied by polymerase chain reaction with the detection of the amplifi cation product in real time. Statistical analysis included the calculation of χ2, the odds ratio with its 95% of confi dence interval (95% CI).
Results. Th e risk of severe preeclampsia was signifi cantly higher in women with asymptomatic bacteriuria (OR = 17.0, 95% CI 4.66-61.81), acute gestational pyelonephritis (OR = 5.4, 95% CI 1.69-10.54 ), acute nonspecifi c bacterial vaginitis (OR = 6.7, 95% CI 1.90-11.02), acute candidal vulvovaginitis (OR = 4.3, 95% CI 1.45-9.99). Acute cytomegalovirus infection, toxoplasmosis, bacterial vaginosis were registered only in a group of patients with preeclampsia. Systemic infectious diseases increase the probability of developing the severe preeclampsia in a greater extent (OR = 49.6, 95% CI 13.05-188.64) than local infectious processes (OR = 4.5, 95% CI 1.49-6, 71).
The conclusion. Our data confi rm that acute infection in a mother increases the risk of developing pre-eclampsia more signifi cantly than a genetic
predisposition, associated with polymorphisms of candidate genes of pre-eclampsia AGTR1-1166CC and NOS3-894TT. Thus, infectious diseases during
pregnancy can be considered as an epigenetic risk factor for the development of severe preeclampsia. Further research is needed to fi nd out the mechanisms of this association

Th e aim of the research. Evaluation of the association of polymorphism of interleukin IL-1β T31C, IL-2 T330G and cytokine TNFα G308A genes in women with preterm birth.
Material and methods. The study voluntarily participated 132 patients with preterm birth in history, including very early and early periods. Women who gave birth on time (30 people) made up a control group. Women of both groups are comparable in parity and age. All patients underwent molecular-genetic typing of polymorphism of cytokine genes IL-1β T31C, IL-2 T330G and TNFα G308 on DNA obtained from peripheral blood leukocytes (DNA Express Blood, Litekh, LTD, Moscow). As a research method, a polymerase chain reaction was used with the detection of the results by gel electrophoresis in transmitted ultraviolet light.
Results. An increased incidence (odds ratio 7.75) of the mutant homozygous genotype IL-2 330GG in patients with preterm birth (21.1% vs. 3.3% in pregnant women who gave birth on time) was noted. The mutant homozygous carriage of IL-1β 31CC can be considered as a predictor of the PR at very early and early times. It may be noted that in women whose pregnancies ended in very early and early periods, the birth of newborns with a critically low body weight, the mutant genotype (-31CC) of the IL-1β gene occurred in 16% of cases. In healthy women who gave birth on time, this genotype was not found.
Conclusion. Th e presence of mutant homozygous genotypes IL-2 330GG and IL-1β 31CC in patients can be associated with premature birth.

Th e aim of the research. To compare the factors associated with the positive results of the stress test in single-photon emission computed tomography
(SPECT) and the presence of hemodynamically signifi cant stenoses of the coronary arteries (CA) in invasive coronary angiography (CAG).
Material and methods. Th e retrospective analysis includes 107 histories of patients who were on the examination and treatment in the clinic of the Research Institute of the CPSU in the period 2012-2015. with a previously established diagnosis of coronary heart disease (CHD) or hospitalized for its exclusion. For detect hemodynamically signifi cant CA stenoses, all patients underwent CAG and SPECT, the time interval between studies did not exceed 3 months.
Results. In the analysis of the study sample, the prevalence of males was noted, the average age was 61 years old. A quarter of patients are smokers, most suffer from hypertension, have angina pectoris. A typical clinical picture of angina was more common than atypical and cardialgia, and angina of functional class II (FC) predominated. Myocardial infarction (MI) in the history was noted in 56.1% of patients, chronic heart failure at 91.6%. 51.4% of patients underwent coronary revascularization of the myocardium as a whole in the group. The mean pre-test probability of having an ischemic heart disease was quite high (77 [58, 84]). A positive result of the pharmacological stress test in SPECT was revealed in 28% of cases, obstructive lesions of CA with invasive CAG - in 56% of patients. The independent clinical predictors of a positive stress test in SPECT and signifi cant CA lesions were male gender and angina pectoris (in the case of SPECT - angina pectoris clinic II FK, and with CAG-angina pectoris IV FK).
Conclusion. Th e results of this study should be considered when developing diagnostic approaches in the detection of obstructive coronary artery disease, in particular when using a stress test with SPECT.

The aim of the research. Th is article is devoted to determination of distribution peculiarities in the alleles and genotypes of some components at the hemostasis system in patients with stable coronary heart disease aft er myocardial infarction.
Material and methods. Th e study included 260 patients diagnosed with stable ischemic heart disease living in the territory of Western Siberia, RF, which were divided into 2 groups, depending on the presence of myocardial infarction. The first group included 182 patients (70%) who had a history of myocardial infarction, and the second group included 78 (30 patients without this diagnosis.). Genomic DNA was distinguished by phenol-chloroform extraction from the blood. Genotyping was performed on six polymorphic variants of fi ve genes: FII (rs1799963), FV (rs6025, rs6027), FVII (rs6046), F13A1 (rs5985), ITGB3 (rs5918). Th e genotypes and alleles were determined using the polymerase chain reaction system ViiATM 7 RealTime PCR System (LifeTechnologies, USA).
Results. Th e study showed that reduces the risk of developing myocardial infarction the presence in patients with stable coronary heart disease the minor allele C (OR = 0.48, 95% CI 0.24-0.95) ITGB3. It was noted that the protective eff ect is related to the number of copies of alleles in the genotype, as for the C / T genotype (OR = 0.46, 95% CI 0.24-0.87), and for the C / C genotype (OR = 0, 15, 95% CI 0.03-0.86). It was also found that the combination of CGCTGC alleles (rs5985-rs1799963-s6025-rs6027-rs6046-rs5918) has a protective eff ect, reducing the risk of myocardial infarction (OR = 0.27, 95% CI = 0.11-0.64).
Conclusion. Polymorphic marker rs5918 ITGB3 makes a signifi cant contribution to determining the risk of myocardial infarction in patients with stable ischemic heart disease belonging to the population of Western Siberia, RF.

The aim of the research. To compare the nature of lesions of coronary and brachiocephalic arteries (BCA), the content of matrix metalloproteinase-9 (MMP9), the relative length of telomeres and the rigidity of the vascular wall in patients with stable coronary heart disease (CHD) of diff erent age groups.
Material and methods. In the study, men with stable angina pectoris of the various functional classes (FC) participated. Th e fi rst group consisted of patients of young and middle age, the second-old. Th e anamnestic data, the results of coronary angiography, metabolic parameters, the data of the ultrasound of the heart and the BSA, direct and indirect vascular wall stiff ness markers, and the relative length of the telomeres were evaluated.
Results. In young and middle-aged patients, the rates of low-density lipoprotein (LDL) and triglycerides (TG) were signifi cantly more oft en increased, as was the incidence of obesity and smoking. According to coronary angiography, single-vessel lesions were more common in young patients, and multivessel lesions in elderly patients; the ultrasound exam of the heart and the frequency of atherosclerotic lesion of the BCA were not diff erent in groups. The content of MMP-9 as an indirect marker of vascular wall stiff ness was signifi cantly higher in the second group than in the fi rst group, as well as the value of the arterial wall stiff ness marker - Cardio-Ankle Vascular Index (CAVI). Th e relative length of telomeres was comparable in both groups.
Conclusion. The results suggest enough high frequency of early vascular aging syndrome in young and middle-aged patients, as well as the likelihood of a more severe course of IHD and atherosclerosis in this group of patients.

The aim of the researh. Evaluation of the eff ectiveness of recovery the cognitive functions using authorial computer programs, the action of which is directed to the speech domains of the brain, in patients in the intermediate and residual periods of moderate to severe CCT.
Material and methods. In order to assess the dynamics of the cognitive status and the eff ectiveness of the described rehabilitation method, we examined 49 patients of young and middle age in the intermediate and residual periods of the middle-severe craniocerebral trauma. All patients were selected according to inclusion and exclusion criteria and had cognitive impairments in the stage of mild and easy dementia. Th e examined patients were randomized into two groups: the control group of patients received standard drug therapy, in the experimental group, in addition to drug therapy, cognitive training was conducted using the method of correction. Results of rehabilitation were assessed using brief psychometric scales.
Results. In the main group, where cognitive rehabilitation was conducted using computer programs aff ecting to speech domains, a statistically signifi cant advantage was found in restoring cognitive functions on the MMSE, FAB, «Schulte table», the «10 words» test with immediate and delayed reproduction, the «categorial associations». This indicates an improvement in the activating eff ect on the regulatory and neurodynamic processes of the brain, a decrease in the severity of the amnestic syndrome.

Th e aim of the research. To establish anatomical features of the extraorganic location of the venous branches of the lower hollow and lower portal veins of the abdominal esophagus and the cardiac section of the stomach of men, diff erent types of physique, mature and elderly ages.
Material and methods. 30 casts of the vessels of the of the lower hollow systems and portal veins of the abdominal part of the esophagus and the stomach cardial section of the male corpses of diff erent physique types mature and elderly ages were studied. To determine the branching types parallel to the vascular organ, V.N. Shevkunenko’s classifi cation was used, and a classifi cation according to Yu. M. Lopukhin was used to determine the type of branching of the direct organs of the vessels. Diagnosis of the body types of male corpses was carried out according to the method of J. M. Tanner.
Results. As a result of the study, the features of the branching types of the inferior vena cava and portal veins vessels were found, and their organometric features were described depending on the type of sexual dimorphism according to J. M. Tanner. The type of branching of the vessels parallel and direct to the organ of the vessels, their length, and the portal system of these organs are conjugated to the type of constitution. The type of branching of analogous vessels of the caval system, with statistically signifi cant diff erences in their length and diameter, does not depend on the type of the human body.
Conclusion. Th e results of the study suggest that in the representatives of the mesomorphic and andromorphic types of physique the syndrome of portal
hypertension will be more severe than in persons of the gynecomorphic type. Also, due to the features of the branching of the lower hollow and portal veins
vessels of the abdominal esophagus and cardiac stomach of mature and elderly age males, the risk of developing varicose veins of the rectum is higher in
meso-and andromorphic body types.

The article is devoted to a rather rare but highly lethal disease - peritoneal tuberculosis. Th e complexity of this pathology lies in the diffi culties of
diagnosis, since under abdominal tuberculosis many diseases of the gastrointestinal tract can be masked with a nonspecifi c, erased clinical picture. The article describes the case of peritoneal tuberculosis, diagnosed in a gynecological hospital.

The aim of the research. To study of the relationship between anxiety-depressive disorders and cognitive dysfunction in patients with type 2 diabetes mellitus.
Material and methods. Th e study included 113 people with type 2 diabetes mellitus. Evaluation of disorders in the emotional-volitional sphere was carried out with the help of the Hospital Scale of Anxiety and Depression (HADS), the Montreal Cognitive Evaluation Scale (MoCA test) and the Frontal Assesment Battery were used to screen cognitive impairment.
Results. Our data showed that 53.1 ± 9.2% of patients with type 2 diabetes had cognitive dysfunctions, which were manifested by the difficulty of remembering new information, the diffi culty of concentrating and solving short-term problems. An analysis of the eff ect of gender differences and educational level on the state of cognitive functions in patients with type 2 diabetes showed no statistically signifi cant diff erences. According to the results of the FAB scale, moderate frontal dysfunction was detected in 37.2 ± 8.9% of patients with type 2 diabetes. Analysis of the HADS scale of patients with type 2 diabetes revealed the presence of anxiety-depressive disorders in 54.9 ± 9.2% of cases that were associated with the age of the patient (persons 65 years and older) and the duration of the disease (13 years or more). A negative correlation was established between anxiety disorders in patients with type 2 diabetes and FAB scale parameters, as well as between the alarm level (HADS scale) and the MoCa test values.
Conclusion. As a result of the study, a link was established between the presence of anxiety-depressive disorders and the severity of cognitive impairment in patients with type 2 diabetes mellitus.

Th e aim of the research. Development of measures to reduce the frequency and severity of early radiation reactions in patients with prostate cancer receiving radiotherapy.
Material and methods. Th e results of treatment of 88 patients with prostate cancer using diff erent radiotherapeutic approaches are analyzed. In the fi rst
group, patients were treated in the conventional mode of irradiation, in the second - in the conformal mode, in the third group - the conformal mode was
combined with the use of the sodium deoxyribonucleotide radioprotector. Evaluation of the degree of severity of radiation reactions was carried out in accordance with the criteria of RTOG, the eff ect on hemopoiesis - based on the study of the level of peripheral blood leukocytes, the severity of post-radiation cystitis - taking into account the IPSS scale and changes in urine analysis.
Results. Conformal radiotherapy reduces the number of radiation reactions by 1.6 times in comparison with the conventional regime. Th e use of conformal
mode in combination with intramuscular injection of sodium deoxyribonucleate reduces the severity of early radiation reactions (predominantly radiation lesions of the fi rst degree are 66.6%, the third and fourth degree are absent), the occurrence of uncomplicated RTOG events (16.7% ). In addition, the combined use of 3D-CRT with a radioprotector is characterized by minimal eff ect on hemopoiesis and lower urinary tracts (by 16.7%, the number of severe urination disorders on the IPSS scale decreased, and slight changes in the cellular urine sediment were noted).
Conclusion. The data obtained make it possible to recommend the conformal mode of radiotherapy in patients with prostate cancer in combination with
intramuscular injection of sodium deoxyribonucleate to reduce the frequency and severity of early radiation reactions.

Based on the analysis of published sources in experimental and pilot studies, the use of resveratrol in the treatment of endometriosis is shown: its
pro-apoptotic, anti-infl ammatory activity was evaluated, and angiogenesis inhibition in ectopic implants was proven on the basis of histological examination. In vivo studies it has been established that resveratrol causes inhibition of angiogenesis, the induction of apoptosis, and also results to a decrease in the size of endometriotic implants. In the study groups in women using the combination of COC + Resveratrol, in contrast to women using only COC, there is a marked decrease in the level of COX, aromatase

Dedicated to the 70th anniversary of the birth of Yuri Semyonovich Vinnik (10.03.1948) – Dr. Med. Sci., Professor, the Head of the Department of General Surgery, Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, from 2006 to the present. Since 2012, Yu. S. Vinnik, Chairman of the Dissertation Council D208.037.05 at KrasSMU, a member of the Russian Society of General Surgeons, a member of the International Association of Surgeons-Hepatologists, the Association of Endoscopic Surgeons of the Russian Federation. Th e results of scientifi c research and medical work are highly appreciated in Russia and abroad. Yu. S. Vinnik in 1986 was awarded with the badge “Excellent Worker in Public Health”. In 1999 Yuri Semyonovich was awarded the title “Honored Doctor of the Russian Federation”, in 2009 he was awarded the title “Honored Worker of Science”

Dedicated to the 80th anniversary of the birthday of Pavel Afanasyevich Samotesov – Dr, Med. Sci., Professor of the Department of Operative Surgery
and Topographic Anatomy, Honored Worker of the Higher School of the Russian Federation. The article presents the autobiographical information of Pavel Afanasyevich Samotesov relating to the period of his work at the Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University.