Th e purpose of the study was to review papers devoted to pathogenetic links of external and internal endometriosis and to form a common
understanding of key similarities and diff erences in development of the diseases. Th e analysis of literatures for the last 7 years was carried out using PubMed,
Cochrane Library and Google Scholar. Consistent features of all endometriosis forms are hormonal imbalance, tissue proliferation, neuroangiogenesis,
dysfunction of immune cells and excessive synthesis of pro-infl ammatory cytokines. However, the diff erence in triggers, points of application, features
of proliferative processes, as well as the severity of immunological changes make it possible to distinguish between the concepts of external and internal
endometriosis. Discovering all pathogenesis aspects will allow finding effective methods of treatment and non-invasive diagnostics

Dysbiotic disorders account for approximately 35 % in the structure of gynaecological pathology. Th e aim of the research: to analyse literature on
the role of vaginal microbiome in preventing reproductive losses. Materials and methods: analysis of literature data containing information on the role of
vaginal microbiome in reduction of reproductive losses (PubMed, E-library, Scopus). Results: a worldwide trend toward the increase in vaginal dysbiotic
disorders incidence has been established. New diagnostic methods allow us to obtain reliable information about the state of the microbiome. Conclusion:
the increased interest to the problem from the global professional community demonstrates and emphasises the high importance of vaginal microbiome in
preventing reproductive losses.

Th e article provides information on the functionality of the ovaries, characterised by the indicator of ovarian reserve, as well as factors affecting the rate of its depletion. Both physiological reasons for the decrease in follicular potential and pathological ones are considered. The article presents such factors influencing the ovarian reserve as pelvic inflammatory disease, intoxication, prematurity, obesity, the infl uence of radiation and chemotherapy, alcoholism and smoking addiction as well as occupational factors that a woman is exposed to in the workplace. All these data show the need to continue research in this area and the high need to organise educational activities for expectant mothers

Anastomotic leakage is a serious complication of surgical treatment of colorectal cancer. In addition to aff ecting short-term treatment outcomes,
anastomotic leakage has also been found to increase the likelihood of colorectal cancer recurrence. Th e purpose of this study is to analyse the pathogenetic links in the influence of anastomotic leakage on the recurrence of the oncological process. A review of the literature was carried out using the following databases: PubMed, MEDLINE for the period from 2017 to 2022. Particular attention was devoted to the infl uence of infl ammatory mediators, NETosis, mean platelet volume and platelet distribution width. Detailed understanding of these mechanisms will allow optimising the tactics of treatment and postoperative management of colorectal cancer patients.

Th e aim of the research. To study the interrelations between CD38, CD31 lymphocytes and development of critical ischaemia of the lower extremities.
Material and methods. Th e 1st group included 75 patients with the ΙΙВ degree of ischaemia and the 2nd group included 75 patients with critical ischaemia.
Th e control group consisted of 75 healthy subjects. We measured anklebone arterial blood pressure, the ankle-brachial index, toe arterial blood pressure,
the transcutaneous tension of oxygen, used ultrasonic Doppler sonography and the CT-angiography. Th e CD38, CD31 level was determined using
immunofl uorescence. Th e data are presented as median and quartiles – Me (LQ, UQ).
Results. Th e anklebone arterial blood pressure in the 1st group did not diff er from the controls while it was 56 [34; 69] mmHg in patients with critical
ischaemia. Th e toe arterial blood pressure in patients of the1st group did not diff er from the controls, and in the 2nd group, this index was signifi cantly below
41 [33; 46] mmHg. Transcutaneous tension of oxygen in the 1st group was normal, in the 2nd group it was 38 [28; 53] mmHg, (р2<0.001). Th e damage to
arteries was multifocal. Th e most expressed stenosis up to full occlusion was revealed in shin arteries. CD31 in the 1st group was 31.53 [29.11; 45.74] %, and
in the 2nd group it was 68.14 [57.55; 79.64 %] (р2<0.001)
Conclusion. High and average correlations have been found between CD31, CD38 and ischaemia, high and very high correlations were revealed between
CD31 and the arterial blood fl ow parameters in the lower extremities, and the preserved lumen of arteries.

Th e aim of the research. To evaluate the eff ect of implanted surgical suture material modifi ed with metal-substituted calcium hydroxyapatite on morphological
changes in the skin.
Material and methods. In order to assess morphological changes in the tissue, an experimental study was conducted, in which 40 white laboratory rats
were implanted with the suture material. Th e animals were divided into 4 equal groups depending on the composition of the fi laments (modifi ed with Ag-,
Zn-, Cu-substituted calcium hydroxyapatite and a comparison group), and a macroscopic assessment of the wound condition was performed during the
experiment. Th e animals were withdrawn from the experiment on the 10th day by injection of a combination of anesthetic agents, aft er which the material
was collected. Morphological examination assessed the area of granulation tissue and its cellular composition and the presence of infl ammatory infi ltrate.
Results. Macroscopically, less pronounced symptoms of postoperative infl ammation were observed in groups of modifi ed fi laments as compared with
unmodifi ed ones. In morphometric analysis, the area of granulation tissue in the experimental groups turned out to be smaller than that in the comparison
group, while the values in the group with Zn-substituted calcium hydroxyapatite were 47 % lower than the corresponding indicators of the comparison group.
In the groups with Zn- and Ag-substituted material, there was no infl ammatory infi ltrate, the tissue was abundantly vascularised.
Conclusion. In-vivo application of modifi ed surgical fi laments creates an anti-infl ammatory eff ect, which is most pronounced when using suture material
modifi ed with Zn-substituted calcium hydroxyapatite. Th e antibacterial effect of the developed material is able to provide prevention of postoperative
complications of the wound, which is a relevant task in surgical practice.

Th e aim of the research. To study the associations between characteristics of low socio-economic status (SES) and anxiety symptoms (AS) according to HADS
on the example of open population of Krasnoyarsk.
Material and methods. Within the framework of the multicentre study “ECVD RF-2012”, a one-stage epidemiological screening was carried out for 1,123
residents of Krasnoyarsk (409 men and 714 women) aged 25 to 64 years. Th e socioeconomic status (educational background, marital status, employment,
family income level, disability) was assessed based on a standardised questionnaire and anxiety symptoms were evaluated through the HADS subscale of
anxiety. To study the associations between the investigated parameters, adjusted for the age and sex, mathematical models of the “classifi cation tree” and of
the multiple logistic regression were built.
Results. According to the results of multivariate analysis, the female gender, absence of higher education, low family income and absence of a family showed
an independent predictor value in relation to the risk of developing a high level of anxiety (HLA). Gender-adjusted predictors of HLA among men were
unemployment (OR=3.701; 95 % CI 1.141–12.003) and low income (OR=2.537; 95 % CI 1.178–5.467); among women – absence of higher education
(OR=1.613; 95% CI 1.186 – 2.194), the “single” marital status (OR=1.588; 95 % CI 1.082 – 2.330) and low family income (OR=1.955; 95 % CI 1.163 – 3.286).
Conclusion. In the open population of Krasnoyarsk, gender diff erences for the association between separate characteristics of low SES and AS have been
established.

Th e aim of the research. To assess the impact of a comprehensive perioperative programme for accelerated recovery on postoperative outcomes in patients
undergoing pancreatic surgery.
Material and methods. A two-centre, prospective, randomised controlled study was conducted. Th e study included 49 patients, including 25 (51 %)
men and 24 (49 %) women. All patients enrolled in the study underwent surgery. Patients were randomised into two groups. Th e control group (CG,
24 patients) underwent perioperative management according to the default method. In the main group (MG, 25 patients), the patients were managed
using a comprehensive perioperative accelerated recovery programme, including prehabilitation, accelerated recovery protocols as well as personalised
perioperative prevention of postoperative pancreatic fi stula.
Results. Among patients in the compared groups, there were no statistically signifi cant diff erences in age, gender, ASA score, and body mass index. When
assessing postoperative complications, a statistically signifi cant decrease in “major” complications (Clavien-Dindo III-IV) in the MG of patients compared with the CG (16 % vs. 37.5 %, respectively, p = 0.037), as well as the frequency of delayed gastric emptying was revealed (8 % vs 33.3 %, p=0.02). In the MG,
the function of the gastrointestinal tract was restored faster, which was manifested by a decrease in the time until the fi rst gases passed, and a faster onset of
solid food intake (p<0.01). Postoperative stay length was signifi cantly less in the MG (11.1 ± 2.8 versus 14.9 ± 4.6 days, p<0.01).
Conclusion. Th e developed comprehensive perioperative programme for accelerated recovery during operations on the pancreas makes it possible to reduce
the frequency of “major” postoperative complications, accelerate the recovery of the function of the gastrointestinal tract, reduce the frequency of delayed
gastric emptying and also reduce postoperative stay length.

Th e aim of the research. To determine the acute toxicity and cytotoxicity of sterile samples of bacterial cellulose (BC) in vivo when applied to the skin and to
study the morphological changes in the structure of the material when used as a wound dressing.
Material and methods. A comparative analysis of experimental studies on acute toxicity of wound dressings based on BC in cutaneous application to 10
Wistar rats is presented. Th e skin condition (redness, swelling, cracking, ulceration, haemorrhage) was taken into account within the initial 72 hours and
within 14 days. Th e general condition was assessed with consideration for changes in behavioural response. Cytotoxicity was determined via qualitative
microscopic evaluation of human fi broblasts aft er the addition of extracts of the proposed material. Morphological properties were studied aft er 3, 5 and
7 days of exposure to BC as a wound dressing for long-term non-healing wounds.
Results. Aft er a single skin application of sterile BC samples, 2.5x2.5 cm in size, to experimental animals and subsequent observation within the fi rst 72 hours
and within 14 days to reveal any local skin changes, clinical manifestations of intoxication and changes in behavioural reactions (nutrition, movement, act
of defecation, diuresis) was not detected. In the study of acute cytotoxicity, the fi broblasts of the experimental groups had a common morphology with the
control group, which was confi rmed by the presence of spindle-shaped cells and their parallel arrangement to each other. Th e nuclei were of medium size, oval
in shape, located in the centre and had fi ne-grained chromatin. No changes in the cytoplasm were detected. A morphological study found that the material
acquires a fi brous-cellular structure fi lled with degenerative segmented neutrophils with the formation of lacunar type “vascular” gaps with a decrease in
bacterial contamination of the wound and a longer presence of BC (7 days).
Conclusion. It has been found in experimental studies that BC samples belong to the IV hazard class of chemicals (low-hazard substances) since they neither
feature acute toxicity due to the absence of skin changes and general clinical pathological symptoms nor cytotoxicity due to the absence of morphological changes
in human fi broblasts. In high contamination of soft tissue wounds, partial lysis and fragmentation of BC are observed and, as microbial contamination decreases,
there is an increase in fixation of BC plates to the wound surface with the formation of structures resembling neovessels in them in cases of longer material exposure.

Th e aim of the research. To research the association of genotypes and alleles of the rs2072100 polymorphic locus of the substance P (TAC1) gene with the
course of bronchial asthma (BA).
Material and methods. To fi nd an association of the polymorphic locus rs2072100 with clinical manifestations of BA, 104 patients were examined, of which
two groups were formed: patients with severe BA (SBA) – 48 people and with moderate BA (MBA) – 56 people. Th e patient groups were selected by ethnicity
and gender. DNA was sampled from the patients’ peripheral venous blood lymphocytes. Genotyping of the polymorphic locus rs2072100 of the TAC1
gene was performed by real-time polymerase chain reaction. Th e diff erence in the frequency distribution of alleles and genotypes between the groups was
calculated using the χ2 test with Yates correction for continuity (with fewer than 10 observations) in the SPSS Statistica v.21 program.
Results. Molecular genetic analysis has shown a statistically signifi cant association of the AG genotype of the TAC1 gene with the risk of severe BA (χ2=7.11;
p=0.009; OR=3.24), and the AA genotype, on the contrary, was a protective marker (χ2=7.42; p=0.007; OR=0.19). Also, during statistical processing, it was
revealed that the AA genotype of the TAC1 gene is a protective marker for the deterioration of respiratory symptoms during physical load (χ2=4.73; p=0.030;
OR=0.12).
Conclusion. Th e infl uence of polymorphic variants of the rs2072100 locus of the TAC1 gene in development of severe BA has been shown. Th e association
between this locus of the TAC1 gene and aggravation of respiratory symptoms during physical load has been determined as well

Th e aim of the research. To study the effi cacy in the near and long-term follow-up and safety of the treatment regimen according to the bedaquiline,
pretomanid and linezolid (B-Pa-L) regimen in patients with pulmonary tuberculosis with MDR, pre-XDR and XDR of the causative agent.
Material and Methods. Th e study enrolled 36 patients with MDR/XDR pulmonary tuberculosis (2021 defi nitions) who had not previously received bedaquiline
and linezolid. Th e main group consisted of 18 patients randomised into the study, who underwent a full course of treatment with bedaquiline, pretomanid
and linezolid (B-Pa-L) chemotherapy regimen, which lasted 26 weeks. Th e follow-up period for those patients was 1.5 years. Th e control group consisted
of 18 patients selected retrospectively according to the “case-control” method. Th e control patients received chemotherapy consisting of pyrazinamide,
moxifl oxacin, linezolid, bedaquiline, cycloserine and capreomycin (Z-Mfx-Lzd-Bq-Cs-Cm) for 6 months followed by Z-Mfx-Lzd-Cs (12 months). Th ese
patients were also followed up for 1.5 years aft er completion of treatment.
Results. It has been found that the effi cacy of treatment of patients with MDR/XDR tuberculosis using the 6-month, B-Pa-L chemotherapy regimen makes
it possible to achieve signifi cantly high results in the dynamics of the disappearance of clinical manifestations of pulmonary tuberculosis, as well as in terms
of sputum conversion by seeding and closing of decay cavities at earlier stages of treatment compared with patients who received -Mfx-Lzd-Bq-Cs-Cm for
6 months and then Z-Mfx-Lzd-Cs for 12 months. Undesirable adverse reactions occurred in a limited number of patients in both groups, were clinically insignificant and did not require drug withdrawal. Ototoxicity was only observed in patients in the aminoglycoside group. At the same time, there were no recurrences of the tuberculous process in the group of patients who received completely oral chemotherapy.
Conclusion. Th e 6-month B-Pa-L chemotherapy regimen is eff ective and safe for treatment of MDR/XDR pulmonary tuberculosis patients. Th e indisputable
advantage of the new chemotherapy regimen is the completely oral administration of chemotherapy drugs and the shortened duration of chemotherapy, which increases the patients’ adherence to treatment.

Th e aim of the research. To study the clinical and demographic indicators of the newly arrived and indigenous population living in the Far North (on the
example of the Khanty-Mansiysk Autonomous Okrug – Yugra).
Material and Methods. Th e study involved 626 patients permanently residing in the conditions of the Far North, of which 586 people (93.61 %) were
newcomers and 40 people (6.39 %) were native residents of the district (Khanty-Mansi). Th e number of male subjects was 238 (38.02 %): 227 (38.7 %)
newcomers and 11 (27.5 %) indigenous people. Th ere were 388 female subjects: 359 newcomers (61.3 %) and 29 indigenous people of the district (72.5 %).
According to the degree of AH, the groups are presented as follows, in the comparison of “newcomers” versus “indigenous”: 1st degree: 3 (0.51 %) – 0 (0.00 %);
2nd degree: 169 (28.8 %) – 9 (22.5 %); 3rd degree: 414 (70.6 %) – 31 (77.5 %), respectively. Th e following demographic indicators were analysed, in the
comparison of “newcomers” versus “indigenous”: the level of education, the level and degree of employment.
Results. In the course of the study, such clinical and demographic indicators as the level of education and social employment, the level of ABP, sodium content
in the blood and the degree of obesity were identifi ed and analysed. Leading positions in the oil and gas industry of the Okrug are occupied by newly arrived
inhabitants with higher professional education. An increase in body weight with development of one of the three degrees of obesity, increased content of
sodium in the blood, as well as a tendency to increase in blood pressure levels are noted among newcomers to the Okrug.
Conclusion. The data obtained reflect the demographic and clinical difference between the newcomers and the natives of Western Siberia

The paper presents a clinical case of Muckle-Wells syndrome in a 6-year-old child with allergy. Cryopyrin-associated periodic syndromes
are rare diseases, thus the primary care physicians’ awareness regarding this pathology is low. Aggravated personal and family history of atopy, disease
onset from an early age in the form of atopic dermatitis, allergic rhinitis and frequent infections of the respiratory tract contributed to the late diagnosis
of autoinflammatory disease. Relapses of urticarial rash were evaluated as manifestations of pseudo-allergy, changes in blood tests as markers of a viral
infection. Th e presented clinical observation demonstrates the course as well as the diffi culties in diagnosing Muckle-Wells syndrome, in children with
atopy, in particular.

Aneurysmal dilatation of the ascending aorta is a life-threatening condition due to the high risk of dissection and rupture. Aortic prosthesis is the
gold standard for surgical treatment of this pathology. However, there are diff erent views regarding the volume of resection of the changed area and the level
of formation of the distal anastomosis. Giant aneurysms with an expansion of the ascending aorta greater than 8cm are extremely rare. Th is article presents
a clinical case of successful replacement of a giant aneurysm of the ascending and proximal aortic arch with a maximum diameter of 10cm in a 70-year-old
woman using circulatory arrest and hypothermia.

Inversion of uterus is a rare complication of vaginal delivery. Th e reported occurrence of puerperal inversion varies from approximately 1 in 550
to 1 in several thousand normal deliveries. Maternal mortality has been reported to be as high as 15 %, mainly due to the associated life-threatening blood
loss and shock. Some obstetricians do not encounter this condition in their entire practice, but it may cause maternal mortality. Th erefore, it is necessary that
every obstetrician considers this possibility, knowing the risk factors and the therapeutic options in this critical situation. Th e uniqueness of the presented
case lies in the fact that in a woman who had a history of complete postpartum inversion of the uterus, subsequent births with a large fetus were completed
successfully and there was no recurrence of this complication.

One of the key problems of phthisiology currently is the growth in the number of patients with drug resistance. In this connection, works devoted
to the study of mechanisms of drug resistance development in Mycobacterium tuberculosis are timely and relevant. Th e purpose of this paper is to show the
formation of drug resistance in dynamics of the disease based on a real clinical case. Th e article describes the complexity of treating a patient with pulmonary tuberculosis due to her low adherence to treatment and the development of resistance to anti-tuberculosis drugs against this background.