The article reviews the literature on fundamental and clinical studies devoted to the problems of molecular mechanisms of endothelial dysfunction
formation of pulmonary embolism (PE). Despite the sufficient scientific justification of the role of discoordination of endothelial cell functions in the
development of thrombotic processes, only some aspects of molecular genetic mechanisms of its realization have been studied. The main attention is paid
to the less studied predictors of PE among the biologically active substances that are involved in the process of maintaining vascular homeostasis. Candidate molecular genetic markers of genes E- and P-selectin, Endothelin-1, with scientific substantiation for their use as prognostic factors while treating patients with PE, are revealed.

The article contains a review of the research works, studying the influence of macro- and micronutrients on the state of reproductive health and their
potential impact on subsequent cardiometabolic risk, starting from prenatal development. Unique actions, biological effects and synergism or antagonism of macro- and micronutrients determine their correlation with other regulators of reproductive function of the whole organism. It is significant to compensate the deficit of macro- and micronutrients, which are important preventive and curative options in the framework of modern strategies, aimed at improving the reproductive health. One of the promising areas, that allow to solve the problem of public health, is the enrichment of food with vitamins and microelements

The review presents modern ideas concerning the discovery, characterization, molecular structure, features of expression in cells of different nature, biological functions and CD147 regulatory mechanisms in humans in physiological and pathological conditions. The role of CD147 in the regulation of central nervous system cells activity in normal conditions and in neurodegeneration is discussed. The participation of CD147 in the pathology of central nervous system, in the pathogenesis of Alzheimer’s disease, in particular, is considered. The mechanisms, regulating the level of beta-amyloid by CD147 are described. Data on the possibility of CD147 use as a target for pharmacotherapy of central nervous system diseases are presented.

1. Jiang JL, Zhou Q, Yu MK, Ho LS, Chen ZN, Chan HC. The involvement of HAb18G/CD147 in regulation of store-operated calcium entry and metastasis of human hepatoma cells. The Journal of Biological Chemistry. 2001;276(50):46870-7. 
2. Miyauchi T, Masuzawa Y, Muramatsu T. The basigin group of the immunoglobulin superfamily: Complete conservation of a segment in and around transmembrane domains of human and mouse basigin and chicken HT7 antigen. Journal of Biochemistry. 1991;110(5):770-4. 
3. Fossum S, Mallett S, Barclay AN. The MRC OX-47 antigen is a member of the immunoglobulin superfamily with an unusual transmembrane sequence. European Journal of Immunology. 1991;21(3):671-9. 
4. Seulberger H, Unger CM, Risau W. HT7, Neurothelin, Basigin, gp42 and OX-47 – many names for one developmentally regulated immuno-globulin-like surface glycoprotein on blood–brain barrier endothelium, epithelial tissue barriers and neurons. Neuroscience Letters. 1992;140(1):93-7. 
5. Biswas C, Zhang Y, DeCastro R, Guo H, Nakamura T, Kataoka H, Nabeshima K. The human tumor cell-derived collagenase stimulatory factor (renamed EMMPRIN) is a member of the immunoglobulin superfamily. Cancer Research. 1995;55(2):434-9. 
6. Liang L, Major T, Bocan T. Characterization of the promoter of human extracellular matrix metalloproteinase inducer (EMMPRIN). Gene. 2002;282(1-):75-86. 
7. Yang H, Zou W, Chen B. Overexpression of CD147 in ovarian cancer is initiated by the hypoxic microenvironment. Cell Biology International. 2013;37(10):1139-42. DOI: 10.1002/cbin.10131 
8. Zhou S, Zhou H, Walian PJ, Jap BK. CD147 is a regulatory subunit of the gamma-secretase complex in Alzheimer’s disease amyloid beta-peptide production. Proceedings of the National Academy of Sciences of the United States of America. 2005;102(21):7499-504. DOI: 10.1073/pnas.0502768102 
9. Tang J, Wu YM, Zhao P, Yang XM, Jiang JL, Chen ZN. Overexpression of HAb18G/CD147 promotes invasion and metastasis via alpha3beta1 integrin mediated FAK-paxillin and FAK-PI3K-Ca2+ pathways. Cellular and Molecular Life Sciences. 2008;65(18):2933-42. DOI: 10.1007/s00018-008-8315-8 
10. Dai JY, Dou KF, Wang CH, Zhao P, Lau WB, Tao L, Wu YM, Tang J, Jiang JL, Chen ZN. The interaction of HAb18G/CD147 with integrin α6β1 and its implications for the invasion potential of human hepatoma cells. BMC Cancer. 2009;(9):337. DOI: 10.1186/1471-2407-9-337 
11. Zhu Y, Wu J, Yuan SY. MCT1 and MCT4 expression during myocardial ischemic-reperfusion injury in the isolated rat heart. Cellular Physiology and Biochemistry. 2013;32(3):663-74. DOI: 10.1159/000354470. 
12. Biegler B, Kasinrerk W. Reduction of CD147 surface expression on primary T cells leads to enhanced cell proliferation. Asian Pacific Journal of Allergy and Immunology. 2012;30(4):259-67. 
13. Cui HY, Guo T, Wang SJ, Zhao P, Dong ZS, Zhang Y, Jiang JL, Chen ZN, Yu XL. Dimerization is essential for HAb18G/CD147 promoting tumor invasion via MAPK pathway. Biochemical and Biophysical Research Communications. 2012;419(3):517-22. DOI: 10.1016/j. bbrc.2012.02.049 
14. Redzic JS, Armstrong GS, Isern NG, Jones DN, Kieft JS, Eisenmesser EZ. The retinal specific CD147 Ig0 domain: from molecular structure to biological activity. Journal of Molecular Biology. 2011;411(1):68-82. DOI: 10.1016/j.jmb.2011.04.060 
15. Adithi M, Nalini V, Kandalam M, Krishnakumar S. Expression of matrix metalloproteinases and their inhibitors in retinoblastoma. Journal of Pediatric Hematology/Oncology. 2007;29(6):399-405. 
16. Huang Z, Tan N, Guo W, Wang L, Li H, Zhang T, Liu X, Xu Q, Li J, Guo Z. Overexpression of EMMPRIN isoform 2 is associated with head and neck cancer metastasis. PLoS One. 2014;9(4):e91596. DOI: 10.1371/ journal.pone.0091596 
17. Yang SH, Li YT, Du DY. Oxidized low-density lipoprotein-induced CD147 expression and its inhibition by high-density lipoprotein on platelets in vitro. Thrombosis Research. 2013;132(6):702-11. DOI: 10.1016/j.thromres.2013.10.003 
18. Spring FA, Holmes CH, Simpson KL, Mawby WJ, Mattes MJ, Okubo Y, Parsons SF. The Oka blood group antigen is a marker for the M6 leukocyte activation antigen, the human homolog of OX-47 antigen, basigin and neurothelin, an immunoglobulin superfamily molecule that is widely expressed in human cells and tissues. European Journal of Immunology. 1997;27(4):891-7.
19. Seizer P, Gawaz M, May AE. Cyclophilin A and EMMPRIN (CD147) in cardiovascular diseases. Cardiovascular Research. 2014;102(1):17-23. DOI: 10.1093/cvr/cvu035 
20. Kanyenda LJ, Verdile G, Martins R, Meloni BP, Chieng J, Mastaglia F, Laws SM, Anderton RS, Boulos S. Is cholesterol and amyloid-β stress induced CD147 expression a protective response? Evidence that extracellular cyclophilin a mediated neuroprotection is reliant on CD147. Journal of Alzheimer’s disease. 2014;39(3):545-56. DOI: 10.3233/JAD-131442 
21. Agrawal SM, Williamson J, Sharma R, Kebir H, Patel K, Prat A, Yong VW. Extracellular matrix metalloproteinase inducer shows active perivascular cuffs in multiple sclerosis. Brain. 2013; 136(Pt 6):1760-77. DOI: 10.1093/brain/awt093 
22. Zhang DW, Zhao YX, Wei D, Li YL, Zhang Y, Wu J, Xu J, Chen C, Tang H, Zhang W, Gong L, Han Y, Chen ZN, Bian H. HAb18G/CD147 promotes activation of hepatic stellate cells and is a target for antibody therapy of liver fibrosis. Journal of Hepatology. 2012;57(6):1283-91. DOI: 10.1016/j.jhep.2012.07.042 
23. Zhao S, Chen C, Liu S, Zeng W, Su J, Wu L, Luo Z, Zhou S, Li Q, Zhang J., Kuang Y, Chen X. CD147 promotes MTX resistance by immune cells through upregulating ABCG2 expression and function. Journal of Dermatological Science. 2013;70(3):182-9. DOI: 10.1016/j. jdermsci.2013.02.005 
24. L, Lam MP, Lam KK, Leung CO, Pang RT, Chu IK, Wan TH, Chai J, Yeung WS, Chiu PC. Identification of CD147 (basigin) as a mediator of trophoblast functions. Human Reproduction. 2013;28(11):2920-9. DOI: 10.1093/humrep/det355. 
25. Richard V, Pillai MR. The stem cell code in oral epithelial tumorigenesis: ‘the cancer stem cell shift hypothesis’. Biochimica et Biophysica Acta. 2010;1806(2):146-62. DOI: 10.1016/j.bbcan.2010.06.004. 
26. Kanyenda LJ., Verdile G, Boulos S, Krishnaswamy S, Taddei K, Meloni BP, Mastaglia FL, Martins RN. The dynamics of CD147 in Alzheimer’s disease development and pathology. Journal of Alzheimer’s Disease. 2011;26(4):593-605. DOI: 10.3233/JAD-2011-110584 
27. Jin A, Chen H, Wang C, Tsang LL, Jiang X, Cai Z, Chan HC, Zhou X. Elevated expression of CD147 in patients with endometriosis and its role in regulating apoptosis and migration of human endometrial cells. Fertility and Sterility. 2014;101(6):1681-7. DOI: 10.1016/j.fertnstert.2014.02.007 
28. Pistol G, Matache C, Calugaru A, Stavaru C, Tanaseanu S, Ionescu R, Dumitrache S, Stefanescu M. Roles of CD147 on T lymphocytes activation and MMP9 secretion in systemic lupus erythematosus. Journal of Cellular and Molecular Medicine. 2007;11(2):339-48 
29. Wang ZZ, Wang Y, Li JM, Mou FX, Wu H. Significance of serum MMP-3, TIMP-1, and monocyte CD147 in rheumatoid arthritis patients of damp-heat Bi-syndrome and of cold-damp Bi-syndrome. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013;33(6):770-3. 
30. Maeda-Hori M, Kosugi T, Kojima H, Sato W, Inaba S, Maeda K, Nagaya H, Sato Y, Ishimoto T, Ozaki T., Tsuboi N, Muro Y, Yuzawa Y, Imai E, Johnson RJ, Matsuo S, Kadomatsu K, Maruyama S. Plasma CD147 reflects histological features in patients with lupus nephritis. Lupus. 2014;23(4):342-52. DOI: 10.1177/0961203314520840 
31. Wang M, Huang ZX, Pan YF, Zhang FC, Zheng BR, Deng WM, Li TW, Gu JR. Expressions of CD147 in peripheral monocytes and T lymphocytes of patients with ankylosing spondylitis. Zhonghua Yi Xue Za Zhi. 2010;90(41):2902-6. 
32. Agrawal SM, Silva C, Tourtellotte WW, Yong VW. EMMPRIN: a novel regulator of leukocyte transmigration into the CNS in multiple sclerosis and experimental autoimmune encephalomyelitis. The Journal of Neuroscience. 2011;31(2):669-77. DOI: 10.1523/ JNEUROSCI.3659-10.2011 
33. Chen H, Lam Fok K, Jiang X, Chan HC. New insights into germ cell migration and survival/apoptosis in spermatogenesis: Lessons from CD147. Spermatogenesis. 2012;2(4):264-72. DOI: 10.4161/spmg.22014 
34. Wang B, Xu SS, Jiang JJ, Lu XB, Xue YS, Wang JC, Mi YF, Zhu M, Ge WL, Tang LJ. Expression of extracellular matrix metalloproteinase inducer in the unstable plaque of patients with acute coronary syndrome. Zhonghua Xin Xue Guan Bing Za Zhi. 2012;40(5):416-20. 
35. Tu Y, Fu J, Wang J, Fu G, Wang L, Zhang Y. Extracellular matrix metalloproteinase inducer is associated with severity of brain oedema following experimental subarachnoid haemorrhage in rats. The Journal of International Medical Research. 2012;40(3):1089- 98. DOI: 10.1177/147323001204000328 
36. Nishioku T, Dohgu S, Koga M, Machida T, Watanabe T, Miura T, Tsumagari K, Terasawa M, Yamauchi A, Kataoka Y. Cyclophilin A secreted from fibroblast-like synoviocytes is involved in the induction of CD147 expression in macrophages of mice with collageninduced arthritis. Journal of Inflammation. 2012;9(1):44. DOI: 10.1186/1476-9255-9-44. 
37. Burnett LA, Light MM, Mehrotra P, Nowak RA. Stimulation of GPR30 increases release of EMMPRINcontaining microvesicles in human uterine epithelial cells. The Journal of Clinical Endocrinology and Metabolism. 2012;97(12):4613-22. DOI: 10.1210/jc.2012-2098 
38. Singh M, Kindelberger D, Nagymanyoki Z, Ng SW, Quick CM, Yamamoto H, Fichorova R, Fulop V, Berkowitz RS. Vascular endothelial growth factors and their receptors and regulators in gestational trophoblastic diseases and normal placenta. The Journal of Reproductive Medicine. 2012;57(5-6):197-203. 
39. Mishra B, Kizaki K, Koshi K, Ushizawa K, Takahashi T, Hosoe M, Sato T, Ito A, Hashizume K. Expression of extracellular matrix metalloproteinase inducer (EMMPRIN) and its expected roles in the bovine endometrium during gestation. Domestic Animal Endocrinology. 2012;42(2):63-73. DOI: 10.1016/j. domaniend.2011.09.004 
40. Chen Y, Gou X, Ke X, Cui H, Chen Z. Human tumor cells induce angiogenesis through positive feedback between CD147 and insulin-like growth factor-I. PLoS One. 2012;7(7):e40965. DOI: 10.1371/journal.pone.0040965 
41. Menashi S, Serova M, Ma L, Vignot S, Mourah S, Calvo F. Regulation of extracellular matrix metalloproteinase inducer and matrix metalloproteinase expression by amphiregulin in transformed human breast epithelial cells. Cancer Research. 2003;63(22):7575-80. 
42. Capestrano M, Mariggio S, Perinetti G, Egorova AV, Iacobacci S, Santoro M, di Pentima A, Iurisci C, Egorov MV, di Tullio G., Buccione R., Luini A., Polishchuk RS. Cytosolic phospholipase A2ε drives recycling through the clathrin-independent endocytic route. Journal of Cell Science. 2014; 127(Pt 5):977-93. DOI: 10.1242/jcs.136598 
43. Mauris J, Woodward AM, Cao Z, Panjwani N, Argüeso P. Molecular basis for MMP9 induction and disruption of epithelial cell–cell contacts by galectin-3. Journal of Cell Science. 2014; 127(Pt 14):3141- 8. DOI: 10.1242/jcs.148510 
44. Kong LM, Liao CG, Fei F, Guo X, Xing JL, Chen ZN. Transcription factor Sp1 regulates expression of cancerassociated molecule CD147 in human lung cancer. Cancer Science. 2010;101(6):1463-70. DOI: 10.1111/j.1349- 7006.2010.01554.x 
45. Philp NJ, Ochrietor JD, Rudoy C, Muramatsu T, Linser PJ. Loss of MCT1, MCT3, and MCT4 expression in the retinal pigment epithelium and neural retina of the 5A11/basigin-null mouse. Investigative Ophthalmology & Visual Science. 2003;44(3):1305-11 
46. Yang JM, O’Neill P, Jin W, Foty R, Medina DJ, Xu Z, Lomas M, Arndt GM, Tang Y, Nakada M., Yan L, Hait WN. Extracellular matrix metalloproteinase inducer (CD147) confers resistance of breast cancer cells to Anoikis through inhibition of Bim. The Journal of Biological Chemistry. 2006;281(14):9719-27. 
47. Bi J, Li Y, Sun F, Saalbach A, Klein C, Miller DJ, Hess R, Nowak RA. Basigin null mutant male mice are sterile and exhibit impaired interactions between germ cells and Sertoli cells. Developmental Biology. 2013;380(2):145-56. DOI: 10.1016/j.ydbio.2013.05.023 
48. Muramatsu T. Basigin: A multifunctional membrane protein with an emerging role in infections by malaria parasites. Expert Opinion on Therapeutic Targets. 2012;16(10):999-1011. DOI: 10.1517/14728222.2012.711818 
49. Bernard SC, Simpson N, Join-Lambert O, Federici C, Laran-Chich MP, Maïssa N, Bouzinba-Ségard H, Morand PC, Chretien F, Taouji S., Chevet E, Janel S, Lafont F, Coureuil M, Segura A, Niedergang F, Marullo S, Couraud PO, Nassif X, Bourdoulous S. Pathogenic Neisseria meningitidis utilizes CD147 for vascular colonization. Nature Medicine. 2014;20(7):725-31. DOI: 10.1038/nm.3563 
50. Klawitter J, Klawitter J, Schmitz V, Brunner N, Crunk A, Corby K, Bendrick-Peart J, Leibfritz D, Edelstein CL, Thurman JM., Christians U. Lowsalt diet and cyclosporine nephrotoxicity: changes in kidney cell metabolism. Journal of Proteome Research. 2012;11(11):5135-44. DOI: 10.1021/pr300260e 
51. Venkatesan B, Valente AJ, Prabhu SD, Shanmugam P, Delafontaine P, Chandrasekar B. EMMPRIN activates multiple transcription factors in cardiomyocytes, and induces interleukin-18 expression via Rac1- dependent PI3K/Akt/IKK/NF-κB and MKK7/JNK/AP-1 signaling. Journal of Molecular and Cellular Cardiology. 2010;49(4):655-63. DOI: 10.1016/j.yjmcc.2010.05.007 
52. Philp NJ, Ochrietor JD, Rudoy C, Muramatsu T, Linser PJ. Loss of MCT1, MCT3, and MCT4 expression in the retinal pigment epithelium and neural retina of the 5A11/basigin-null mouse. Investigative Ophthalmology & Visual Science. 2003;44(3):1305-11 
53. Aït-Ali N, Fridlich R, Millet-Puel G, Clérin E, Delalande F, Jaillard C, Blond F, Perrocheau L, Reichman S, Byrne LC, Olivier-Bandini A, Bellalou J, Moyse E, Bouillaud F, Nicol X, Dalkara D, van Dorsselaer A, Sahel JA, Léveillard T. Rod-derived cone viability factor promotes cone survival by stimulating aerobic glycolysis. Cell. 2015;161(4):817-32. DOI: 10.1016/j.cell.2015.03.023 
54. Muramatsu T. Basigin (CD147), a multifunctional transmembrane glycoprotein with various binding partners. Journal of Biochemistry. 2016;159(5):481-90. DOI: 10.1093/jb/mvv127 
55. Wei M, Li H, Shang Y, Zhou Z, Zhang J. Increased CD147 (EMMPRIN) expression in the rat brain following traumatic brain injury. Brain Research. 2014;1585:150-8. DOI: 10.1016/j.brainres.2014.06.018 
56. Besse F, Mertel S, Kittel RJ, Wichmann C, Rasse TM, Sigrist SJ, Ephrussi A. The Ig cell adhesion molecule Basigin controls compartmentalization and vesicle release at Drosophila melanogaster synapses. The Journal of Cell Biology. 2007;177(5):843-55. DOI: 10.1083/jcb.200701111 
57. Kaushik DK, Hahn JN, Yong VW. EMMPRIN, an upstream regulator of MMPs, in CNS biology. Matrix Biology. 2015;44-46:138-46. DOI: 10.1016/j. matbio.2015.01.018 
58. Vetrivel KS, Zhang X, Meckler X, Cheng H, Lee S, Gong P, Lopes KO, Chen Y, Iwata N, Yin K-J, Lee J-M, Parent AT, Saido TC, Li Y-M, Sisodia SS, Thinakaran G. Evidence that CD147 modulation of β-amyloid (Aβ) levels is mediated by extracellular degradation of secreted Aβ. The Journal of Biological Chemistry. 2008;283(28):19489-98. DOI: 10.1074/jbc.M801037200 
59. Nahalkova J, Volkmann I, Aoki M, Winblad B, Bogdanovic N, Tjernberg LO, Behbahani H. CD147, a gamma-secretase associated protein is upregulated in Alzheimer’s disease brain and its cellular trafficking is affected by presenilin-2. Neurochemistry International. 2010;56(1):67-76. DOI: 10.1016/j.neuint.2009.09.003 
60. Higgins GA, Jacobsen H. Transgenic mouse models of Alzheimer’s disease: phenotype and application. Behavioural Pharmacology. 2003;14(5-

The review discusses the possibility of application, for the purposes of regenerative medicine, of nanoparticles of metals and their oxides, as well
as selenium. It is shown that nanoparticles of silver, gold, platinum, selenium and copper, as well as oxides of zinc, tantalum, iron and titanium dioxide
have potential therapeutic effect. Perspectives of silver application in nanoscale form for wound healing are outlined. It has been shown that noble metal nanoparticles, such as gold, palladium and platinum, act as antioxidants due to their high catalytic activity. A significant influence of matrix on the properties of nanocomposite material, on its toxicity and bioavailability in particular, is demonstrated. Thus, pharmaceutical nanotechnologies with application of metal nanoparticles are promising for the use in regenerative medicine in the nearest future.

The epidemiological situation regarding tuberculosis in the Russian Federation can not be considered absolutely safe. Patients with chronic processes in pulmonary tissue and with multiple drug resistance of the pathogen worsen the epidemiological situation on tuberculosis, which creates additional reservoir of tuberculosis infection.
The aim of the research was the analysis of morbidity with all forms and extra pulmonary tuberculosis in Omsk Region in comparison with the indicators of Siberian Federal District and Russia for forecasting the situation.
Material and methods. The main statistical report forms were used.
Results. The morbidity rate on tuberculosis in Omsk Region tends to decline from 2010, that is 9 years later than totally in Russia. The influence of the released from penitentiary institutions on tuberculosis morbidity was established, especially nowadays due to the high frequency of patients with HIV-infections registration. In some years, every fourth patient with tuberculosis in the Omsk Region fell ill with the specific process in places of liberty deprivation. In 2015, one out of five fell ill with tuberculosis in corrective labour colonies. Before 2005 morbidity of extra pulmonary forms of tuberculosis in Omsk Region was high. Subsequently, morbidity decrease was noted, but without any stable tendency, which indicates the lack of stability in this parameter. On the background of the decrease in tuberculosis morbidity in Omsk Region, the increase in tuberculosis morbidity with multiple drug resistance of pathogen has been revealed.
Conclusion. Therefore, while analysing pulmonary and extra pulmonary tuberculosis morbidity, a tendency for their reduction has been registered, but, meanwhile, the forecast indicates the increase in the number of newly diagnosed forms of multidrug-resistant tuberculosis as well as the ones combined with HIV- infections among newly diagnosed patients.

The aim of the research is to study clinical characteristics of pregnant women with compromised obstetric history, to analyse perinatal terminations and the
state of the new-borns.
Material and methods. In general, data on 716 pregnant women were included in the analysis, two groups were identified for the study: the 1-st group with compromised obstetrical history (COH) – 46.6 % (334 women) and the 2-nd group with non-compromised obstetrical history – 53.4 % (382). The age of women, obstetric-gynaecological history, number of pregnancies, objective examination data, laboratory and instrumental examination data, revealed or available somatic pathology, pregnancy terminations and methods of delivery, the condition of the new-borns were taken into consideration.
Results. Pregnant women with COH were in 7 times more likely to have infectious diseases, including HIV, sexually transmitted diseases – in 2.3 times, TORCH infections – in 13.5 times, blood diseases – in 1.3 times against the comparison group, as well as obesity and smoking. Extra genital pathology was diagnosed in half of pregnant women in both groups. Differences in ultrasound characteristics, assessing the condition of fetus and placenta concerning the development of fetoplacental insufficiency and the threat of its occurrence, violation of utero-placental blood flow and the delay in intrauterine development of the fetus have been determined. In regard with pregnancy terminations and methods of delivery, women with compromised obstetrical history more often had indications for Cesarean operation and the risk of premature birth.
Conclusion. The analysis justified allocation of a particular risk group of pregnant women belonging to the category of the ones with compromised obstetrical history. The information obtained will be mostly useful for general practitioners (family doctors) and therapists, providing medical care for pregnant outpatients along with gynaecologists.

The aim of the research is to study correlation of testosterone with various indicators of mineral-bone metabolism disturbance and metabolic syndrome
markers in male patients with IHD.
Material and methods. The study included 111 men with stable angina of II-III functional class without clinically significant concomitant pathology and
planned open myocardial revascularization by coronary artery bypass grafting. Along with general clinical methods, all patients underwent blood sampling on an empty stomach prior to surgery. The following biological markers (total testosterone and estradiol, calcitonin, osteocalcin, parathyroid hormone (PTH), osteoprotegerin, osteopontin and bone isoenzyme of alkaline phosphatase) were determined from the obtained plasma or serum, in addition to a number of standard biochemical indices (lipidograms, ionized calcium, phosphorus, alkaline phosphatase, glycaemia, insulin):
Results. When analysing biochemical markers described above, a correlation has been established between the levels of total testosterone, on the one hand, and insulin (r = -0.20, p = 0.047), PTH (r = 0.34, p = 0.0002), on the other. From all lipidogram parameters, a significant negative bond of total testosterone concentration was found only with the level of triglycerides (TG): r = -0.19; p = 0.047. In patients younger than 60, and having neither obesity nor type 2 diabetes, the correlation of total testosterone with insulin and TG increased significantly: r = -0.38 (p = 0.017) and r = -0.33 (p = 0.046). At the same time, there was no correlation with other investigated parameters in this subgroup, and the correlation with PTH became unreliable (p = 0.29). However, in a particular correlation analysis with consequent introduction of age, body mass index, diabetes corrections reliable bond of total testosterone with PTH has remained: correlation coefficient (r) varied from 0.30 to 0.29 at p = 0.002.
Conclusion. In the present study, it was found that in men with IHD there is a positive bond between concentration of total testosterone with the level of PTH and negative one with insulin and TG.

The aim of the research is to study the function of the left atrium (LA), left ventricular twist (LV) and to establish their possible correlation in cases of
intraventricular conduction without obvious cardiac diseases.
Material and methods. 52 patients without known cardiac diseases were examined. All patients were divided into BLLBG group with average duration of QRS 153 ± 24 ms and a control group with normal intraventricular conduction. BLLBG group included 34 patients (14 (41%) men and 20 (59%) women), 18 persons (8 (44%) men and 10 (56%) women were included in control group. Coronary ventriculography, echocardiography (echocardiography) with determination of hemodynamic parameters, longitudinal deformation of LV and LP, rotation and LV twisting at rest and after the loading test were performed in all patients.
Results. In BLLBG group, there was noted a decrease in global longitudinal deformation of the LV (-15.6 ± 4.7% and -18.4 ± 3.1%, p = 0.037), global
longitudinal deformation of the LA “εtotal” (31,8 ± 15,1% and 44,3 ± 11,7%, р = 0,0086) and LV twisting (9,08 ± 4,59 º and 13,96 ± 4,61 º, р = 0.0156), whereas differences in the parameters of the ejection fraction, end systolic and terminal diastolic LV volume were absent. After conducting loading test in BLLBG group, there was no increase in torsion of LV Δtorsion (respectively, 2.05 ± 8.35% and 4.66 ± 8.49%, р = 0.0463) in comparison with the control one. The described changes in the LV twist during loading test were obtained against the background of persistent changes in the global longitudinal strain of LA (43.5 ± 13.3% and 56.9 ± 14.7%, p = 0.0286) and changes in the systolic fraction of the pulmonary veins (57.6 ± 4.4% and 66.5 ± 4.2%, p = 0.0127).
Conclusion. Decrease in LV twisting at rest and lack of adequate growth during stress test in BLLBG can be accompanied by changes in pulmonary veins flow and LA properties deformation.

The aim of the research is to study daily profile of arterial pressure (DPAP) in workers with arterial hypertension (AH) combined with chronic obstructive
pulmonary disease (COPD) who contact industrial aerosols (IA).
Material and methods. 210 men diagnosed AH I-II degree, risk 1-2 were examined. Among them, 160 people had industrial contact with IA of toxic and chemical action and were divided into 2 subgroups, 80 of whom were diagnosed with only AH, the remaining 80 had AH combined with COPD, stage I, categories A and B (Groups 1 and 2). The comparison group (group 3) comprised 50 people with AH I-II degree, risk 1-2, having no contact with IA. Distribution of patients by AH degree in all three groups did not differ significantly. All patients were comparable in age (average age – 42.8 ± 4.4 years) and smoking experience (average length of smoking – 9.7 ± 3.5 years). Work experience with IA exposure varied on average 9.3 ± 3.2 years, AH duration lasts 7.9 ± 2.8 years. AH was diagnosed in accordance with clinical recommendations of the RSC 2013, ESH / ESC 2013. Daily monitoring of blood pressure (DMBP) was performed on BPLab (“Petr Telegin”, Russia). COPD diagnosis is based on the criteria of Global Strategy for Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2016). Spirography was performed in patients with COPD (group 2) on microprocessor-based spirograph “SMP-21 / 01-”R-D”.
Results. The results of SMAD showed that in patients with AH and with combined pathology in day time, parameters of average systolic AP (SAP) were 127.43 ± 0.63 mm Hg. Art. and 128.31 ± 0.74 mm Hg. Art. statistically exceeded significantly the values of the comparison group (p <0.05). The indices of diastolic AP (DAP) in the group of people with comorbid pathology had significant differences from the values of the comparison group (81.22 ± 0.58 mm Hg). The time index (TI) of SAP and IV DAP (indicators, characterizing the percentage of time during which the AP exceeds the critical level for certain period of time), that was also statistically significant (p <0.01 and p <0.05), were increased in people with AH and with a comorbid pathology. The parameters of TI of SAP and TI of DAP combined with pathology were mainly increased in reference to the values of comparison group (p <0.01; p <0.05). In patients of all three groups, variant of SMAD Non-dippers prevailed.
Conclusion. SMAD data in patients with AH, combined with COPD with IA contact, showed more significant increase of average SAP and DAP, time index of SAP and time index of DAP, SAP and DAP variability, morning SAP and DAP rise, high speed of morning SAP and DAP increase, as well as high frequency of increased variability of SAP and DAP. With the combined pathology, the pathological types of SMAD Non-dippers prevail.

The aim of the research. To reveal occurrence frequency, structure and features of clinical manifestations of recurrent headaches in children and adolescents with asthenic syndrome (AS).
Material and methods. 785 patients of children’s somatic department, aged 7-17 years (386 boys and 399 girls) were examined by method of questioning.
Comparison of indicators was carried out in 2 groups – the main one (with AC, n = 344) and the comparison group (without AC, n = 441). Cephalalgia type was verified in accordance with the criteria of International Classification of Headache (2005). Presence of asthenic syndrome and the degree of asthenia severity were assessed according to the Scale of Asthenic State (SAS) by L.D. Malkova and T.G Chertova.
Results. It was established that recurrent headaches, in most cases, are recorded in children and adolescents with asthenic syndrome: they are characterized by high incidence of infrequent episodic and chronic tension headache (TH). The proportion of girls in the group with asthenic syndrome is greater than in the group without this syndrome. In overwhelming majority of children with asthenic syndrome, the severity of asthenia was weak and the minority had moderate severity. Episodic TH (mostly infrequent) was the prevailing form of cephalalgia in the examined patients. Chronic TH was significantly more frequent in girls than in boys, and more often in older age group (12-17 years) than in younger one (7-11 years).
Conclusion. The study established the fact of more frequent occurrence of asthenic syndrome in girls in comparison with boys, and higher frequency of the syndrome in older age group relatively younger one. It is shown that the presence of asthenic syndrome in children and adolescents is associated with greater incidence of infrequent episodic and chronic tension headaches

The aim of the research is to study peculiarities of coronary bed in patients with coronary heart disease (CHD) combined with gastroduodenal pathology
(GDP) depending on Helicobacter pylori infection.
Material and methods. The study consistently included 68 patients with stable angina combined with CHD. During the study, groups of patients were formed
on the basis of H. pylori infection and the intensity degree of serological test (the level of antibody titer to H. pylori). Group I (n = 26) consisted of patients who had up to 1: 699 titers of antibodies to H. pylori, group II (n = 23) – patients who had more than 1: 700 antibody titers, III (control) group (n = 19) – patients who are not infected with H. pylori.
Results. Patients with stable angina combined with CHD, associated with H. pylori, compared to patients with stable angina without H. pylori – associated
CHD, have more evident changes in brachiocephalic arteries (BCA), and the severity of the atherosclerotic process is more significant in patients with higher value of antibody titers to H. pylori. Patients with stable angina infected by H. pylori, have more evident and increasing lesion of the coronary arteries, that is worsened by extended number of antibody titers. An increase value of antibody titers to H. pylori in patients with stable angina, combined with CHD, is accompanied by a more evident level of uric acid, fibrinogen and a decrease in glomerular filtration rate (GFR).
Conclusion. Patients with stable angina combined with CHD, associated with H. pylori, have more evident significance of atherosclerotic process, which is
mainly manifested by vascular lesions both of coronary bed and brachiocephalic arteries

The aim of the research is to study the possibility of applying uncut Roux technique in patients with disseminated gastric cancer.
Material and methods. 269 people participated in the study, who were divided into 2 groups, being operated on in State Budget Institution of Healthcare “Regional Oncological Clinic” in 2010-2017. Control group included 164 patients. In this group, standard esophagus-enteroanastomosis on a long loop with Brownian anastomosis was applied. The main group included 105 patients. In this group, standard esophagous enteroanastomosis on a long loop with a Brownian anastomosis was also applied, reconstructive stage was followed by application of uncut Roux technique.
Results. In control group, 19 patients, which amounted to 11.7 %, had complications. In the main group, 15 people, which was 14.4 %, had complicated period There were two lethal outcomes in control group, so postoperative mortality was 1.2 %. In the main group, postoperative mortality was 0.9 %. The frequency of reflux esophagitis in control group was 56.8 %, in the main group –21.1 %. In the control group, 19 patients had reflux esophagitis of C and D degree.
Conclusion. Application of uncut Roux technique can reduce the amount and severity of esophagitis reflux to a great extend, that, in turn, helps to improve the quality of life significantly.

The aim of the research is evaluation of immediate and long-term results of esophago-cardio-fundoplastics with fundoplication according to Hill in stage
III-IV achalasia cardia.
Material and methods. Retrospective and prospective analysis of 51 cases of stage III-IV achalasia cardia according to the results of endoscopy, fluoroscopy, esophagus manometry and histology of the esophageal mucosa. Statistical processing is performed to determine the norm of distribution. Comparative analysis is the assistance of Wilcoxon and Friedman criteria.
Results. The duration of patients monitoring varied from 1 and 14 years. The relief of dysphagia occurred in 92.16 % of cases. Gastroesophageal reflux
appearance was noted in 7.84 %. The cause of recurrence of 4 case of dysphagia from 5 (9.8 %) was the absence of peristalsis of the esophagus under stage IV. In one case, it happened due to evident adhesive process in the subdiaphragmatic space. The patient was reoperated in the volume of adhesiolysis and the weakening of the fundoplication cuff with good effect. Restoration of esophagus patency is confirmed by the increase in patients’ body mass index from 22.9 ± 0.6 to 24.7 ± 0.6. The reduction of esophagus diameter, independently from the degree of esophagus expansion prior to surgery and the duration of history of the disease was demonstrated. Normalization of the resting pressure and residual pressure of the lower esophageal sphincter were noted. Cases of esophageal cancer or lethal outcomes were not reported.
Conclusion. Esophago-cardio-fundoplastics with fundoplication according to Hill has demonstrated long-term, stable result in dysphagia relief, even in
cases with advanced forms of cardiac achalasia. The number of dysphagia relapses or gastroesophageal reflux occurrence did not exceed 10% and is not related to the technical aspects of surgery. This circumstance makes it possible to recommend this operation as an alternative one to the existing cardioplastic operations, such as Heller myelotomy and to secure a patient against esophagus extirpation.

A clinical case of anomalous origin of anterior descending artery from pulmonary artery (ALCAPA syndrome) in an elderly woman is described. A peculiar feature of the presented clinical case is congenital heart disease manifestation in the elderly age. Clinical manifestations of coronary heart disease, risk factors allowed, first of all, to assume the presence of significant coronary atherosclerosis. Nevertheless, the data of modern visualization technologies indicate the possibility of diagnosing coronary artery anomaly in elderly patients. In the description and discussion of the clinical case, there are features of coronary arteries transthoracic visualization with determination of the direction and the velocity of blood flow along the main coronary arteries and intercoronary anastomoses, as well as the importance of conducting multispiral computer tomography of coronary arteries in order to identify “adult” type
of ALCAPA syndrome.

The article presents the history of the patient with transient myocardial ischemia in neonatal period against old perinatal hypoxia, while secondary
cardiomyopathy developed beyond the early neonatal period, and at the age of 2 months, infectious heart disease occurred. “Transient myocardial ischemia” is not often diagnosed in the practice of neonatology due to the lack of unified diagnostic criteria, but this condition can be masked and, as a result, worsen the course of respiratory pathology, which requires differential diagnosis and is important for choosing the right tactics for patients’ treatment.