Th e number of patients in need of hip replacement is steadily increasing, which makes the problem of assessing the outcomes of this intervention
quite relevant. Currently, when choosing assessment tools, preference is given to scales and questionnaires that allow the patient to evaluate the eff ectiveness
of treatment from the standpoint of changing the quality of their health personally. Literature search was conducted in RSCI, Google Scholar, Scopus and Web
of Science databases for the period from 2005 to 2023, considering scales and questionnaires for assessing the outcomes of hip replacement by the patients.
Th is review examines the main requirements that apply to such scales and questionnaires. It is recommended to use at least one specifi c and one general
questionnaire, supplemented by a single-item question on patient satisfaction with treatment results. A brief description of specifi c and general instruments
that are recommended for use to determine the outcomes of hip replacement by international and national recommendations is given. Th e tools (specifi c
scale – OHS and general questionnaires - SF-36 and EQ-5D-3L) that currently have a Russian-language version and have undergone the procedure of cultural
adaptation and validation are indicated.

One of the main problems of modern colorectal surgery remains the high frequency of postoperative infectious complications. Th e gut microbiome
is a complex system of interaction between the human body and a complex of bacteria, which has a signifi cant infl uence on health and participates in many processes. At present, there is a huge amount of research in the scientifi c literature aimed at studying the gut microbiome and its relationship with colorectal cancer at diff erent stages of treatment. However, there is still no consensus regarding the use of mechanical bowel preparation or antibiotic prophylaxis. Th is work presents a review of the results of studies evaluating the infl uence of preoperative bowel preparation and the use of antibacterial agents on the frequency of postoperative infectious complications in patients with colorectal cancer.

Analysis of literature data was performed using the PubMed/MEDLINE, Scopus, Web of Science, Embase, SciELO and eLibrary databases. Studies
evaluating the interaction between human papilloma virus (HPV) infection and its infl uence on preproduction and obstetrical outcomes were the object of
interest. Th e frequency of HPV infection in the population is 29.4%, and is 15% among pregnant women. Persistent HPV infection in men and women is not
only the risk of developing genital neoplasia, but also a risk factor for infertility, miscarriage and prematurity, the formation of primary placental insuffi ciency,
which assumes the form of intrauterine growth restriction, as well as increased perinatal morbidity and mortality rate.

Th e aim of the research. Analysis of the prevalence of Helicobacter pylori (HP) among residents of the Transbaikal region in diff erent age groups, in men and women, and in medical staff . Assessment of the role of gender, age and medical profession as risk factors for HP infection.
Material and methods. A total of 421 residents of the Transbaikal region aged 18 to 80 years were examined, of which 328 were women and 93 men, 105 were medical staff and 316 were non-medical specialists. HP was diagnosed by detecting the antigen (Ag) in the stool.
Results. A total of 37 % of the subjects were HP-positive. In medical staff , HP-Ag was detected in stool in 60 % of cases, in non-medical controls – in 29.4 % (p<0.001). Th e risk of HP infection among medical staff was 3.6 times higher (OR: 3.597; 95 % CI: 2.272 – 5.694). No gender diff erences were found: women were infected in 36.0 %, men – in 41.0 % (p=0.390). Female medical staff were associated with a signifi cantly higher risk of infection than female non-medical (OR: 4.220; 95 % CI: 2.535 – 7.023; p<0.001), as well as men in the same subgroup (OR: 2.495; 95 % CI: 1.344 – 4.634; p=0.004). Young people aged 18 to 40 years were most oft en infected (41.5 % - 41.1 %). With increasing age, the proportion of people infected with HP decreased and amounted to only 16.7 % in 70-80 years old (p>0.05). Medical profession increased the chances of having HP infection in each decade of life: 18-29 years – OR: 4.673 (95 % CI: 1.210 – 18.043; р=0.02); 30-39 years – OR: 2.068 (95 % CI: 0.802 – 5.330; р=0.13); 40-49 years – OR: 4.071 (95 % CI: 1.687 – 9.827; р=0.002); 50-59 years – OR:
3.252 (95 % CI: 1.044 – 10.130; р=0.037); 60-69 years – OR: 7.200 (95 % CI: 2.178 – 23.805; р<0.001).
Conclusion. Th e prevalence of HP in the Transbaikal region equals 37%. A trend towards a decrease in the number of infected with age has been noted. Risk factors for HP infection include medical professions, which increase the probability of infection by 3.6 times at any age. Female medical specialists are most at risk.

Th e aim of the research. To assess the severity of atherosclerosis of the carotid arteries in smoking patients suff ering from cardiovascular diseases and to analyse lipid-lowering therapy.
Material and methods. Th e study involved 444 patients who were divided into 2 groups based on the smoking status. Patients with a negative smoking
status formed the fi rst group (n=320 (72 %), smoking patients formed the second group (n=124(28 %). Th e fi rst group was divided into 4 subgroups: 1a – relatively healthy individuals (n=45 (32 %), 1b – patients with coronary heart disease (CHD), (n=38(12 %), 1c – patients with hypertensive disease (HD), (n=135(42 %), 1d patients with grade 2 dyscirculatory encephalopathy (DEP) (n=102 (32 %). Subgroups 2a, 2b, 2c and 2d consisted of relatively healthy individuals (n=33(27 %), CHD patients (n=29(23 %), stage 3 HD (n=23(19 %), grade 3 DEP (n=39 (31 %), respectively. All patients underwent ultrasound duplex scanning of the carotid arteries, the lipid profi le was determined, and lipid-lowering therapy was studied.
Results. According to the results of the study, haemodynamically insignifi cant carotid artery stenosis was registered in patients, most pronounced in patients with a positive smoking status, the target level of LDL cholesterol was not reached against the background of statin therapy.
Conclusion. A direct relationship was established between smoking and carotid artery stenosis, as well as the failure to achieve the target values of low-density lipoproteins during statin therapy.

Th e aim of the research. Th e need to improve the approaches to increasing the effi cacy of treatment for patients with destructive pulmonary tuberculosis
with MDR/XDR pathogen.
Material and methods. Th e study enrolled 64 patients with destructive MDR/XDR pulmonary tuberculosis. Two groups of patients were formed, comparable
in basic age-gender and clinical-radiological characteristics. In group 1, conservative methods of treatment were used in 32 patients; in group 2, surgical
methods were used in the treatment complex in 32 patients. All observed patients excreted the bacteria with MDR of the pathogen, while 37/64-57.8 % of
the patients had pre-XDR, and 9/64-14.1 % had XDR-MBT (as defi ned until 2021). According to their medical history, surgical treatment before admission
to the clinic of the FSBI “CTRI” was carried out in 9/64-14.1 % of patients, including 6/32-18.8 % of patients of group 1 and 3/12-9.4 % of group 2. Th e main
criterion of effi cacy was the successful completion of treatment by the 24th month of chemotherapy (or earlier when the necessary indicators were reached),
characterised by the cessation of bacterial excretion and the closure of the destruction cavities.
Results. It has been found that the effi cacy of treatment for patients with destructive MDR/XDR tuberculosis when using surgical methods in the treatment
complex allows to achieve signifi cantly high results in the dynamics of sputum culture conversion and closure of decay cavities compared with patients in the
treatment of which only conservative methods were used. Th e cost of treatment of all patients using only conservative methods amounted to 44.07 million
rubles, while the use of surgical methods in the treatment complex in a group of patients comparable in all clinical and radiological parameters reduced the
cost of treatment by 12.69 million rubles. 
Conclusion. Th e indicator of the eff ectiveness of chemotherapy and pharmacological and economic indicators in the group of patients with destructive MDR/XDR pulmonary tuberculosis, in the complex treatment of which surgical methods of treatment were used, is higher than in patients who used only conservative methods. By the end of 24 months of treatment, an eff ective course of chemotherapy was recorded in all patients using a complex of surgical methods. Th e surgery also made it possible to avoid ineff ective chemotherapy courses and deaths in this group of patients, while the indicators of eff ective treatment outcomes between the groups had statistical signifi cance (p<0.01). According to calculations, it has been shown that the use of surgical methods in the complex treatment of patients with destructive pulmonary tuberculosis with MDR/XDR pathogen reduces the cost of treatment.

Th e aim of the research. To study, in a comparative aspect, the level of markers of the state of haemostasis and fi brinolysis systems, indicators of clinical blood analysis and C-reactive protein (CRP) in patients with previously treated bronchial asthma (BA) of moderate severity who have and have not had an infection caused by SARS-CoV-2.
Material and methods. A prospective cohort study of 42 patients with bronchial asthma of moderate severity at the acute stage who were on inpatient treatment at the Central TB Research Institute in 2022 was conducted. Th e patients were divided into two groups. Th e fi rst group included 21 patients with bronchial asthma who had an infection caused by SARS-CoV-2, the second group included 21 patients with bronchial asthma who did not have infection caused by SARS-CoV-2. Th e indicators of haemostasis and fi brinolysis systems, clinical blood analysis and CRP were evaluated.
Results. It has been found that in patients with previously treated bronchial asthma of moderate severity, who had an infection caused by SARS-CoV-2,
a hypercoagulation shift was more oft en observed compared to patients who did not have COVID-19. Th is was evidenced by the most frequent shortening of activated partial thromboplastin time, prothrombin time and an increase in fi brinogen levels. Analysis of ESR and CRP indicators showed that the partially detected hypercoagulation shift was associated with the severity of the systemic infl ammatory response, which was also more pronounced in the group of patients with BA who had an infection caused by SARS-CoV-2.
Conclusion. In patients with previously treated moderate-severity BA at the acute stage who have undergone COVID-19, a hypercoagulation shift is more
oft en detected, partly associated with the greatest severity of the infl ammatory reaction, compared with BA patients who have not had COVID-19.

Th e aim of the research. To investigate the association between the gene polymorphism of cytokines and the level of their production during the intensive
phase of chemotherapy.
Material and methods. Th e study included 100 patients with pulmonary tuberculosis who underwent an intensive phase of chemotherapy. Th e patients
underwent genotyping of cytokine gene polymorphisms (IL1 (B-31C>T (rs1143627), IL4 -589C>T (rs2243250), IL10 (-592C>A (rs1800872), IL10 (-1082A>G
(rs1800896), TNF (-308G>A (rs1800629) as well as quantitative assessment of cytokines. Statistical data processing included checking the data for the
normality of distribution (Kolmogorov-Smirnov test), nonparametric Spearman correlation coeffi cient, Wilcoxon test for related samples.
Results. In the course of the study, a statistically signifi cant correlation between cytokine gene polymorphisms and the level of their production has been
established. It has been found that patients with the IL4 - 589CC genotype have higher levels of IL-4 production compared to the IL4 -589CT+TT genotype.
Patients with pulmonary tuberculosis with the IL 10-592 CA+AA genotype have higher IL10 production compared to patients with the IL10-592CC genotype.
Patients with pulmonary tuberculosis with the IL4 -589CC genotype have an unfavorable course of the disease, in contrast to the IL4 -589CT+TT genotype.
While patients with the IL10-592CA+AA genotype have an unfavorable course of the disease than patients with the IL10-592CC genotype.
Conclusion. Th us, it can be assumed that higher levels of IL-4 and IL10 may have an adverse eff ect on the course of pulmonary tuberculosis. Genotyping of polymorphisms of cytokine genes IL4 -589C>T (rs2243250) and IL10 (-592C>A (rs1800872) in patients with pulmonary tuberculosis can identify risk groups for the adverse course of tuberculosis infection and form preventive measures for contact persons in the foci of tuberculosis infection.

Th e aim of the research. Conduct a comparative analysis of the eff ectiveness of surgical methods for correcting pelvic organ prolapse using a mesh implant.
Material and methods. A retrospective analysis of the medical history of patients with stage III-IV pelvic organ prolapse was carried out. according to the POP-Q classifi cation who underwent surgical correction using mesh implants. Next, a prospective study was carried out to evaluate the long-term results of the operation and questioning using specialised questionnaires. Statistical processing of the obtained data was carried out using the computer program Microsoft Excel (Microsoft Corporation, USA), SPSS Statistics 24.0.
Results. It has been found that laparoscopic pectopexy is the least time-consuming operation (90 ± 25 minutes) compared to laparoscopic sacropexy (150 ± 36 minutes). When assessing postoperative complications, it was revealed that aft er laparoscopic sacropexy, patients experience dyspareunia in 37.4% of cases, pain syndrome in 20.8 %, and de novo stress urinary incontinence in 4.1 %. Aft er laparoscopic pectopexy, pain was observed in 18.3 % of cases, dyspareunia in 6.1 %, and there were no cases of de novo stress urinary incontinence. A statistically signifi cant diff erence was revealed in such a complication as obstipation: 87.5 % of patients aft er laparoscopic sacropexy in the fi rst 2 months aft er surgery noted symptoms that persisted in 22.9 % of cases up to 6 months. Th is complication was not recorded in patients who underwent laparoscopic pectopexy. In addition, there was a statistically signifi cant improvement in quality of life indicators aft er surgery in both groups of patients.
Conclusion. Th us, laparoscopic pectopexy is an eff ective and safe method for surgical treatment of pelvic organ prolapse as compared with laparoscopic
sacropexy, due to such factors as: shorter duration of the operation, low risk of damage to anatomical structures, as well as a lower rate of complications due to the location of the implant.

Th e aim of the research. Th e aim of our study was to analyse and study markers in premature abruption of a normally located placenta.
Material and methods. In the course of our work, a study was conducted at the Simferopol Central Regional Clinical Hospital in Simferopol on a complex
of embryotropic antibodies as well as immunohistochemistry of the placenta for women hospitalised with the diagnosis of premature abruption of normally
located placenta in 2018-2022.
Results. Th e mean age in the group with premature abruption of a normally located placenta (60) was 28.8±4.5 years. In the control group (10), it was 27.2±3.0 years. Th e delivery of patients with clinical picture of PANLP was carried out by caesarean section in 100 % of cases, complete abruption of the placenta was not observed. According to the morphological analysis, dystrophic changes in the foetal membrane were revealed in all cases, which corresponded to the picture of acute placental insuffi ciency. We revealed a signifi cant increase in C4 (0.27±0.01 g/l). According to the literature, the complement system plays an important role in the process of rejection.
Conclusion. In women with premature abruption of a normally located placenta, antibodies to beta-2 glycoprotein and S100 protein in blood serum were signifi cantly increased, thus they can be attributed to embryotropic markers of the humoral link of the immune response in PANLP. An increase in the HIF1α protein in the placenta has been noted. An increase in the expression of this protein in the cytoplasm of cells in late pregnancy may indicate hypoxic conditions, which we observed in the group with placental abruption.

Th e aim of the research. To evaluate the eff ectiveness of ultrasound transvaginal cervicometry (UTVC) in pregnant women to identify the risk group for spontaneous preterm birth (spPB).
Material and methods. UTVC was performed in 1,832 pregnant women at weeks 11-14 and 18-21. Group 1 (main) included patients with a cervical length (CL) of 25 mm or less (n = 53 people): 1a – 18 patients with CL of 25 mm or less at weeks 11-14; 1b – 35 people with CL of 25 mm or less, fi rst detected at weeks 18-21. Group 2 (control) included 1543 people with a CL of 26 mm or more.
Results. Every third spPB and every second extremely preterm birth occur in patients with a short cervix. Shortening of the cervix at 11-14 weeks increases the risk of spPB, in terms of weeks 22-27 and 29-33. It was determined that the risk of spPB increases with a CL of 20 mm or less at weeks 18-21 (10-15 mm – relative risk (RR) 22.042; 95 % CI 9.835-49.397; 16-20 mm – RR 20.636; 95 % CI 8.227-51.764). Shortening of the cervix at weeks 18-21 increases the risk of all spPB.
Conclusion. UTVC at 18-21 weeks allows better prediction of SpPB probability. However, the results are improved when cervicometry data are combined
with maternal factors at the term of 11-14 weeks.

Th e aim of the research. Assessment of clinical and metabolic parameters and comorbidities in hospitalised geriatric patients with normal and reduced
muscle mass, as a necessary factor for prescribing targeted eff ective treatment and methods of further rehabilitation.
Material and methods. Th e study was conducted with inpatients of the geriatric department aged 65-91 years who were divided into 2 groups: the main (sarcopenia) and the control one. Demographic data collection and screening tests were performed to assess patients’ quality of life and severity of sarcopenia.
Initial screening for decreased muscle strength and/or function was performed using hand dynamometry and 4-meter walking speed assessment, balance testing, and chair-rising speed. Th e last stage of the patient study was bioimpedansometry using the Inbody 770 device (Korea), based on the data of which the appendiceal skeletal mass index was calculated. Th e fi nal data were statistically processed using Statistica IBM soft ware (Russian version).
Results. In both groups, there was a decrease in SPPB test results, but to a greater extent in the group with sarcopenia: 3 (out of 10 points) versus 6 points in patients with normal muscle mass. Th e body mass index (BMI) in the main and control groups was 24 and 31, respectively. In the main group, indicators of vital activity, functionality, BMI, appendicular lean mass (ALM) and appendicular skeletal muscle index (ASMI) were reduced to a greater extent, and parameters of the pain intensity and psychological state were increased. Analysis of the results also has shown 36 more signifi cant correlations between the indicators recorded in the group of all patients of the geriatric department. Diff erences were considered signifi cant at p<0.05 and |R|>0.5.
Conclusion. In the age group over 65 years, people with normal muscle mass are more likely to be overweight, and patients with sarcopenia are more likely to have normal or underweight. Th e studied hospital patients can be characterised by a signifi cant number of concomitant pathologies, medications taken, and a psychological (anxiety) and physical state (pain) specifi c to those hospitalised with a particular disease.

Th e aim of the research. To evaluate the technological capabilities of the developed method and device for polyaxial distal locking of an intramedullary nail in a clinical setting.
Material and methods. Th e results of application of technique and device for polyaxial distal locking of tibial intramedullary nail in 42 patients with
infraisthmal tibial fractures were studied. Th e main group included 22 patients on which the locking was done using the developed method. In the control group 20 patients the “free hand” method was used. Th e study evaluated the following parameters: the duration of locking, the time of X-ray exposure, the number of locking attempts.
Results. In the main group, duration of distal locking procedure and time of X-ray exposure was signifi cantly shorter than in the control group. Th e number of locking attempts in the control group was higher than in the main group. Th e diff erences were statistically signifi cant.
Conclusion. Th e developed method and device have shown their eff ectiveness due to simplifi cation of the procedure of distal locking which made it possible to signifi cantly reduce the duration of this stage of the operation, make it safer for the patient and medical personnel.

One of the treatment methods aimed at improvement of the prognosis, quality and expectancy of life in patients with coronary artery disease is
the surgical method of myocardial revascularisation. Today, the “gold standard” of coronary bypass graft ing is considered the obligatory use of the internal thoracic artery (ITA) as the conduit. In patients with aortic occlusion, ITA oft entimes participates in formation of a collateral blood supply pathway to the lower limbs: the Winslow pathway. In case of its liquidation, there is the possibility of acute arterial failure in the ipsilateral lower limb. Th is article
demonstrates a clinical case of a successful coronary artery bypass surgery in a patient with abdominal aortic occlusion. Aft er complete preoperative diagnosis of the vascular impairments, we made a collective decision on stagewise surgical treatment: the fi rst stage was myocardial revascularisation without using ITA and the second stage was aortic bifemoral bypass. Aft er the mentioned surgical interventions with consideration for the anatomical features, development of acute myocardial infarction was prevented as well as the complications associated with critical lower limb ischemia.

According to the literature, the incidence of acute perioperative myocardial infarction in patients with multivessel coronary lesion who are planning
myocardial revascularization totals 5-30%. Currently, the issue of optimal choice of the revascularisation method for patients with the development of this complication remains unresolved with the choice between open and X-ray endovascular surgery. Th is clinical case is devoted to a successful two-stage hybrid revascularisation combining endovascular intervention and minimally invasive coronary artery surgery for a patient with a multivessel lesion against the background of acute perioperative myocardial infarction at the stage of anaesthesia induction.

It is believed that diaphragmatic-intercostal hernia is a rare pathology and is characterised by the formation of a defect in the chest wall involving the
costal arch, diaphragm and intercostal muscles. However, existing publications contain taxonomic discordances that do not allow generalising the material and standardising the treatment. In most cases, surgical approaches are aimed at eliminating the defect and strengthening the tissues of the diaphragm and chest wall with synthetic implants. We present two clinical observations: in the fi rst case, there was a rupture of the costal arch with an intercostal hernia on the left without violating the integrity of the diaphragm with a pseudarthrosis of the 9th rib; in the second case, a left -sided diaphragmatic-intercostal hernia was diagnosed without a rupture of the costal arch with a pseudarthrosis of the 8th rib. In both cases, original surgical solutions were used using alternative materials based on titanium nickelide.

Th e article presents the effi cacy of the proctocolectomy (PCE) prediction model developed in clinical practice for patients with ulcerative colitis
(UC), created as a result of a study of intestinal integrin gene polymorphism. According to calculations, two clinical examples revealed a high risk of PCE.
Th e absence of targeted therapy in the fi rst case in a patient with total colon lesion, severe course of UC resulted in PCE. Timely administration of the integrin a4β7 inhibitor in a patient with total colitis, severe chronic recurrent course of the disease allowed to avoid surgery and achieve long-term remission of UC. Th e PCE forecasting model demonstrates its eff ectiveness in practice, which will make it possible to prescribe targeted therapy during the onset of UC.
Further research in this direction seems promising and socially signifi cant in solving the problems of UC treatment.