The aim of the study was to search for seasonal variations in the levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) in young men in Yakutia, where there are strong changes in climatic parameters in the winter-spring period (from -41.8°C to -0.2°C). Seasonal variations between winter and spring were found for fT3, where in winter its levels were lower – 6.48±0.31 pmol/L than in spring 6.88±0.1 pmol/L (p=0.005). There were no statistically significant seasonal variations for TSH (U=97; p=0.914) and sv.T4 (U=47; p=0.112). Winter-spring seasonal variations of fT3 detected in this study there are signs of polar T3 syndrome in young men in Yakutia. To search for the causes of the detected seasonal variation, a correlation analysis of the levels of TSH, fT3 and fT4 was carried out depending on daylength and atmospheric air temperature. As a result, a correlation between fT3 and fT4 with the daylight (fT3: R=0.339, p=0.03; fT4: R=-0.346, p=0.01) and with air temperature (fT3: R=0.295, p=0.05; fT4: R=-0.296, p=0.04). No correlations were found with TSH levels (daylight: R=-0.06, p=0.69; air temperature: R=-0.09, p=0.559). Thus, the residents of Yakutia have signs of polar T3 syndrome, which can be associated with both a short light day and low atmospheric temperatures in winter. The results obtained may indicate an increase in the absorption of T3 at the tissue level when exposed to cold. 

Pulmonary hypertension (PH) is an understudied but significant complication of myocardial infarction (MI). Currently, there are no diagnostic algorithms that can predict the development of PH in the setting of myocardial infarction, which requires the development of prediction models based on the results of routine examination, for example, lipid profile. The purpose of the research was to study the parameters of lipid metabolism in men with PH that developed against the background of MI and their impact on the risk of developing PH. The results of examination of men aged 32-60 years with verified MI were studied. According to the level of mean pulmonary artery pressure (MPAP) determined by echocardiography, patients were divided into two groups: the study group (with a MPAP level of more than 20 mm Hg at the end of the third week of MI) and the comparison group (with a normal MPAP level at the end of the third week of MI). The studied indicators were compared based on the Mann-Whitney, Wilcoxon, and Chi-square tests; correlations were performed using the Spearman method. It was found that patients in the study group had lower levels of the atherogenic coefficient (AC) and the total cholesterol/high-density lipoprotein (TC/HDL) index at the end of the third week of MI. Levels of triglycerides (TG) < 1.3 mmol/l and very low density lipoprotein (VLDL) ≥ 1.2 mmol/l, TC/HDL indices < 6.0 and LDL/HDL < 3.2 in the first 48 hours, LDL <2.4 mmol/l, AC value <5.0, TC/HDL indices <6.0 and LDL/HDL <3.2 at the end of the third week of MI influence the risk of developing PH in the subacute period of MI. Correlations have also been established between the level of MPAP and lipid profile parameters. It is advisable to use the obtained results when developing a model for predicting the development of PH against the background of MI. 

Slow acetylation of substrate is associated with drug-induced liver damage and transformation of viral and alcohol hepatitis in cirrhosis. Increasing xenobiotic load is a significant factor in development of metabolic associated liver diseases. This interaction between genotype and environment should be studied to reveal disease pathogenesis. We analysed polymorphism rs1495741 genotypes in control group and in patients with cryptogenic liver cirrhosis and non-alcohol fatty liver disease to evaluate association of acetylation type with liver disease development. As part of the study, patients filled the questionnaire to assess xenobiotic load. The rs1495741 polymorphism was detected by real-time PCR. Significant differences were revealed in the criptogenic liver cirrhosis and non-alcoholic fatty liver disease groups in patients consuming fried and smoked foods (OR: 5,49 at p<0,05); in combination with older age (>55) the risk increases by 7.57 times (p<0,05). However, no association of the rs1495741 polymorphism with the development of liver diseases was identified.

A video-polysomnographic study of the structural characteristics of night sleep was carried out in 157 patients with a first-time unprovoked tonic-clonic seizure. The main group included patients with remote symptomatic seizure (RSS). Over the course of three years, 60 individuals had recurrent attacks; 38 patients had no recurrence of attacks during the observation period. The comparison group included 59 MRI- and EEG-negative patients. Patients with recurrent RSS had lower sleep efficiency, longer rapid eye movement phase, sleep fragmentation, wake after sleep onset, and more frequent awakenings from sleep (number of awakenings) versus patients with a single RSS and the comparison group. The identified changes demonstrate deeper disturbances in sleep architecture in patients with recurrent RSS and can be taken into account in prognostic counseling of this category of patients.

Aim. To study and compare indicators of quality of life in schoolchildren with abdominal pain in the assessment of children and their parents in the ethnic populations of the Republic of Tyva.

Material and Methods. In the Republic of Tyva, schoolchildren aged 7-18 years of the indigenous population (312 Mongoloids - Tuvans) and alien population (136 Caucasians) were examined using a cross-sectional method. Gastroenterological complaints and demographic information were recorded. To assess the quality of life of children, adapted Russian parent (CHQ-PF28) and child (CHQ-PF45) versions of the Child Health Questionnaire (CHQ) were used. The questionnaire allows you to assess various areas of a child’s life. The studies were approved by the ethics committee and the consent of the patients (their parents) was obtained.

Results. A decrease in the quality of life was established in schoolchildren of both ethnic populations in the presence of abdominal pain, both in their own assessment and by their parents. This applies to the general state of health, and specifically to the state of physical, mental health, as well as the emotional sphere. At the same time, in the Tuvan population, when schoolchildren assessed their quality of life, in contrast to their parents, a decrease was noted on scales related specifically to indicators of mental and physical health. It is noteworthy that the decrease in quality of life indicators in the assessment of children is more significant than in the assessment of parents, and affects a wide range of questionnaire scales in both ethnic populations of schoolchildren in Tyva. At the same time, children with abdominal pain are severely limited in communication with peers, both due to emotional and physical problems, and often experience a constant feeling of anxiety and depression. The latter is not properly reflected in the results of the analysis of parental quality of life questionnaires.

Conclusion. The peculiarities of the frequency of family deprivation in ethnic populations have been established.

Biologically active substances in lingonberry leaves (Vaccinium vitis-idaeae L.) have antioxidant properties. This study selected the optimal extraction method to obtain extracts with a high content of biologically active components with antioxidant activity from the leaves of Vaccinium vitis-idaeae growing in Yakutia. The data obtained allow us to conclude that biologically active substances isolated by alcoholic extraction from the leaves of Vaccinium vitis-idaeae can be used in medicine to find approaches to regulating pro-oxidant processes in the human body under various pathological conditions.

In the world the role of pathogenic variants of the MYO15A gene in the etiology of hearing loss has not been sufficiently studied, since the large size of the gene (66 exons, 71 kb) suggests the search for pathogenic variants using NGS technologies, which are not yet sufficiently used in routine practice. In this regard, it is relevant to study the role of pathogenic variants of the MYO15A gene in the etiology of non-syndromic forms of hearing impairments. The purpose of this work is to describe the rare pathogenic variant c.7636C>T p.(Gln2546*) in the MYO15A gene, found in a homozygous state in two siblings with prelingual profound sensorineural hearing loss from a Buryat family. Previously, this variant was found only in one patient in a compound-heterozygous state with another nonsense variant in the MYO15A gene in Brazil and described as pathogenic. Detection of variant c.7636C>T p.(Gln2546*) in a homozygous state in Buryat siblings may indicate either a rare case of endogamous marriage or a wider distribution of this variant in the Lake Baikal region.

The aim of the study. To evaluate the results of the introduction of a system for the prevention of sternal infectious complications at the Federal Center for Cardiovascular Surgery in Khabarovsk in comparison with the traditional method of cardiac surgery.

Materials and methods. The authors conducted a comparative analysis of two treatment groups of cardiac surgery patients operated with sternotomy median access. The first group, 2712 patients operated according to the traditional method (2016-2018); the second group of patients, 2991 people, were treated using the method of prevention of sternal infectious complications (2019-2021). Attention was paid to the performance of bimammary bypass surgery, which is one of the leading risk factors for complications, while performing this type of bypass surgery increased in the second group.

Results. As a result of the introduction of systemic prevention of complications during cardiac surgery, the number of superficial complications, such as divergence of wound edges, skin necrosis, osteomyelitis of the sternum significantly decreased from 1.18±0.207 to 0.43±0.120% (t=3.11), there was also a tendency to decrease deep complications, namely sternomediastinitis - from 0.55± 0.142 to 0.23±0.088% (t=1.90).

Conclusion. The introduction of a system for the prevention of sternal complications in the work of cardiac surgeons during median sternotomy has reduced the incidence of postoperative sternomediastinitis and superficial complications. Therefore, in order to reduce infectious complications after cardiac surgery, it is advisable to introduce systemic prevention of sternal infection more widely into clinical practice.

Objective: to study the immunological characteristics of patients with systemic lupus erythe- matosus and Sjogren's syndrome by determining antinuclear antibodies using immunoblotting.

Materials and methods. We observed 69 patients whose average age was 38.9 years [23.2- 62.9], of which 63 (91.30%) were women and 6 (8.69%) men. BMI was 27.3 kg/m2 [21.8-49.2]. Inclusion criteria: age from 18 to 70 years, presence of a reliable diagnosis. To study the di- agnostic value of determining the ANA profile, patients were divided into 3 groups: 1st group 15 patients with systemic lupus erythematosus (SLE), 2nd – 21 patients with the disease and Sjögren’s syndrome (SS), 3rd (control) group – 33 patients with osteoarthritis. The control group was comparable to the study groups by gender and age.

Results. The determination of anti-SS-A in SLE has good quality (area under the ROC curve - 0.66). A cut-off value was determined with 79.6% specificity and 53.3% sensitivity. Anti-RNP/SM, anti-Sm, anti-dsDNA and anti-HI were somewhat less sensitive (30%), with a specificity level of 91% for anti-dsDNA and anti-Sm and 100% for anti-RNP/Sm and anti -HI. The most informative diagnostic tests for the disease and Sjogren's syndrome are anti-Ro-52 recombinant (sensitivity 57.1%, specificity 96%), anti-SS-Anative (sensitivity 52.4%, specificity 86%). The determination of anti-Ro-52 in SS is of good quality, which confirms the value of the area under the ROC curve (>0.7). The optimal cut-off value corresponded to 99.6% specificity and 57.1% sensitivity. Some- what less sensitive (28.6%) were anti-Sm (specificity - 92%), anti-dsDNA (specificity - 92%) and anti-RIB (specificity 100.0%).

Findings. The laboratory tests studied, as a rule, had high specificity, but rather low sensitivity. The most specific tests for diagnosing SLE are antibodies to the antigens RNP/Sm, SS-Ana- tive, antibodies to histones, for SS - anti-SS-Anative, anti-Ro-52 recombinant, anti-RIB.

The aim of this study was retrospective assessment of the effectiveness of surgical treatment tactics in the treatment of Mallory-Weiss syn- drome in a specific surgical hospital. Material and methods. The material is based on a clinical analysis of the results of observations of 73 patients with MWS who were treated in surgical hospitals of the of the Republican Hospital №2 ‒ Center for Emergency Medical Care (CEMC) of the Republic of Sakha (Yakutia) in the period from in the period from 2019 to 2023. Results. In the course of the study, it was established that the widespread use of endoscopic methods of stopping bleeding in MWS in clinical practice of multidisciplinary surgical hospitals can improve the immediate results of treatment, reduce the number of complications and reduce mortality. Conclusion. The results of the study we presented allow us to recommend the use of endoscopic methods of hemostasis for MWS as the method of choice.

The aim of the study was to study the nutritional habits of secondary school students living in the territory of the Republic of Bashkortostan. Analysis of the actual nutrition of the child population is an urgent task, since the preservation of the health and development of the child deter- mines the health of the nation in the future. The paper examined the actual nutrition of children on school and weekend days. The survey involved students of grades 5-9, from 16 educational institutions of the city of Salavat (Republic of Bashkortostan), aged 11-16 years. By the method of daily reproduction of the diet, the intake of macro- and micronutrients with food was studied. To assess the chemical composition of the diets, the results were compared with the norms of physiological needs (NPN) for children and adolescents.

It was revealed that the nutrition of the respondents meets the standards for energy value, protein and fat intake. The amount of carbohydrates ingested with food is reduced relative to NPN by 28%, but the proportion of intake of mono- and disaccharides exceeds the norm. An increased consumption of added salt by 1.8 times was found. The daily diet of schoolchildren is adequately provided with vitamins. The content of calcium is deficient (68% of the norm), the intake of sodium is almost 5 times excessive. The analysis of the diet revealed a reduced share of the calorie content of breakfast and lunch both on school days and on weekends.

The main violations in the nutrition of middle school children are expressed in the increased consumption of SFA, simple carbohydrates and added salt. Combined with a calcium deficiency and an excess of sodium, this imbalance, in the future, can cause the risk of developing nutritional diseases.

The aim of the study was to analyse the indicators characterising the quality of life and health of the population in the subjects of the Far East- ern Federal District (FEFD). Official data of the Federal State Statistics Service and the Analytical Centre under the Government of the Russian Federation were used as sources of information. It was found that despite the fact that most of the Far Eastern territories have a high level of human development, they are significantly inferior to the Russian Federation in terms of some indicators characterising the social well-being of the FEFD residents (life expectancy, mortality from certain causes, crime and suicide rates, etc.). In some constituent entities of the FEFD there is still a high level of mortality from "injuries with uncertain intentions", which may include a part of socially caused and socially significant incidents; the quality of official statistics on mortality from external causes in these territories is highly questionable. In order to achieve sustainable growth in the well-being of the residents of the Far Eastern Federal District, it is necessary to implement a comprehensive regional policy aimed at realizing the development potential of each region, overcoming infrastructural and institutional limitations, creating equal opportunities and promoting human development.

In order to study the timeliness of medical evacuation of the patients with severe novel coronavirus from the districts of the Sakha Republic (Yakutia), a retrospective analysis of data from the Republic’s Center for Disaster Medicine (RCDM) for 2019-2022 was carried out. To compare the treatment results of patients living in the city of Yakutsk and patients evacuated from the districts of the republic (“city”, “district”), we conducted a prospective observational case-control study of 600 patients with severe COVID-19 in the specialized anesthesiology, resuscitation and intensive care unit (ARICU) of the Sakha Republic Clinical Hospital in 2020-2022. Lethal outcome (n=397) was chosen as the studied criterion. It was found that the study groups had statistically significant differences in age (p=0.002), body mass index (BMI) (p=0.001), saturation (SaO2) of mixed blood upon admission to the ARICU (p=0.003), oxygenation index (p=0.011), and the severity of the condition according to the SOFA (Sequential Organ Failure Assessment) score. The patients evacuated from the districts were characterized by younger age, higher body mass index, and greater damage to lung tissue. City residents were more prone to experience brain failure, acute kidney injury, and the development of multiple organ dysfunction. The mortality rate for the district patients with severe COVID-associated community-acquired pneumonia was 65.8%; for urban patients it made 66.3%, with no statistically significant differences established (p=0.906). Thus, the arrangement of medical evacuation for COVID-19 patients to a specialized institution during the pandemic ensured the availability and timeliness of specialized care provided to them.

The Republic of Sakha (Yakutia) is the largest administrative-territorial unit in the world, more than 40% of its territory is located beyond the Arctic Circle. At the same time, the population of the republic is the lowest among all subjects of the Russian Federation (0.32 people/km2). All this together significantly distinguishes this region from other territories of Russia. The purpose of this study: to assess the main manifestations of the epidemic process of chronic hepatitis C on the territory of the Republic of Sakha (Yakutia) at the stage of implementation of the national program for the elimination of viral hepatitis. Materials and methods. An epidemiological analysis of chronic hepatitis C and liver cancer was carried out for the period from 2000 to 2019. The incidence of liver cancer was assessed according to ICD-10, in which malignant neoplasms of the liver and intrahepatic bile ducts are summarized under code C22. Statistical analysis was carried out in the application package R. The study of differences in the distribution of incidence rates of chronic hepatitis C and malignant liver diseases between the Russian Federation and the Republic of Sakha (Yakutia) was carried out using the method of nonparametric assessment of the weighted average median of the Mann-Whitney test. Results and discussion. The decrease in the intensity of the incidence of acute and chronic hepatitis C in Russia was unidirectional in nature with a fairly close manifestation of their longterm movement. In contrast, in the Republic of Sakha (Yakutia) there was a significantly less pronounced decrease in the incidence of acute hepatitis C (4.9 times, rate of increase -6.2%), and the incidence of chronic hepatitis C in general for the entire analyzed period was cyclical and had a pronounced upward trend (2.4 times growth, rate of increase +2.6%). It was shown that there are statistically significant differences (p<0.01) between the median incidence rates of chronic hepatitis C and malignant liver diseases between the Russian Federation and the Republic of Sakha (Yakutia). Conclusion. To achieve the appropriate targets for hepatitis C elimination in the country, it is necessary to take into account the specific natural, climatic, social and ethnic characteristics of the Republic of Sakha (Yakutia). 

The analysis of fertility, morbidity (primary and general) and mortality in the Republic of Sakha (Yakutia), in dynamics, over a 10-year period (2013-2022). Differences in the structure of morbid- ity in the Republic of Sakha (Yakutia) and in the Russian Federation as a whole were revealed. The peak of mortality rates of the urban and rural population of the Republic of Sakha (Yakutia), caused by the COVID-19 pandemic, has been determined. Problematic aspects of rural health care have been identified, as well as diseases complicated by the pandemic that require rehabili- tation. The results of the study should be taken into account by health authorities and institutions for management decisions on countering challenges and threats to the health of the population of the Republic of Sakha (Yakutia) caused by a new coronavirus infection.

The article presents certain aspects of the epidemiological situation regarding HIV infection in the Irkutsk region: morbidity in adults, children and adolescents, dynamics of transmission routes and age groups at risk. According to the results of the sociological study, a satisfactory level of awareness of the region's residents on HIV infection issues has been shown, with significant differences by gender and age groups. The results obtained are necessary to increase the effectiveness of information and educational work among the population, with an individual approach to each gender and age group.

The features of diagnosis and treatment of biliary tract diseases in patients with COVID-19 were studied. An increase in the number of non-calculous cholecystitis and gallbladder gangrene in severe cases of COVID-19 was revealed. The immunosuppressive effect of SARS-CoV-2, anti-inflammatory and antibacterial therapy, and multiple organ failure led to a decrease or complete absence of local symptoms and leukopenia in acute cholecystitis. In severe cases of COVID-19, the basis for diagnosing acute cholecystitis was dynamic ultrasound examination of the abdom- inal cavity, diagnostic laparoscopy and laparotomy in patients with the highest levels of leukocytosis, CRP and PCT. The greatest number of postoperative complications and deaths were observed in patients with severe COVID-19. In patients with malignant neoplasms of the biliary tract, the main symptom was “painless” jaundice. The diagnosis was confirmed by abdominal CT scan. All patients underwent minimally invasive ultrasound and endoscopic drainage operations.

"Polar stress syndrome" is the result of a negative extreme climatic and geographical conditions impact in the circumpolar territories with the subsequent formation of maladaptation disorders of immune and nervous regulation. There is no doubt the relevance of studying the SNP features of candidate ANKK1/DRD2 (rs18004976) and TNF (rs1800629) genes in the aspect of identifying probable predisposition markers to the "polar stress syndrome" development in the circumpolar territory population. The aim is to study the features of polymorphism of immune and nervous systems regulatory genes as possible markers of predisposition to the "polar stress syndrome" formation in the children population of circumpolar territory by the example of the dopamine receptor ANKK1/DRD2 (rs18004976) and the tumor necrosis factor TNF (rs1800629) genes. Materials and methods. 717 children aged 7-13 years were examined. 136 people live in conditions conducive to the formation of "polar stress syndrome" (circumpolar territory); 581 people live in the middle latitude territories. The identification of apoptosis receptors CD3+CD95+ and TNFR was carried out by flow cytofluorometry, dopamine production was analyzed by ELISA. The SNP of ANKK1/DRD2 (rs18004976) and TNF (rs1800629) genes were identified by real-time PCR. Results. The results of children genotyping established the reliable association of the T-allele and TT-genotype of the ANKK1/DRD2 gene (rs18004976) with dopamine hyperproduction and the similar relation of the G-allele and GG-genotype of the TNF (rs1800629) gene with an excessive content of TNFR and CD3+CD95+ lymphocytes (p<0.05). Overexpression of TNFR, CD3+CD95+ and dopamine in children was significantly associated with T-allele and TT-genotype of the ANKK1/DRD2 gene (rs18004976) and G-allele and GG-genotype of the TNF gene (rs1800629) relative to the CC-genotype of the ANKK1/DRD2 (rs1800497) gene and AA-genotype of TNF (rs1800629) gene independently of the analyzed sample (p<0.05) and reached the maximum values in carriers of the TT-genotype of the ANKK1/DRD2 (rs18004976) gene and GG-genotypes of TNF (rs1800629) gene in the observation group. Moreover, the difference in the allele and genotype frequency distribution of candidate genes between analyzed groups was significant (TT-genotype of the ANKK1/DRD2 gene (rs18004976) (OR=2.43; 95% CI=1.43-4.15; p=0.04); GG-genotype of the TNF gene (rs1800629) (OR=1.66; 95% CI=1.02-2.70; p=0.03)), which verified the contribution of genetic predisposition to the development of "polar stress syndrome" in children in extreme climatic and geographic conditions of the circumpolar territory.

An analysis of data on suicides in the Arctic zone of the Republic of Sakha (Yakutia) from 2000 to 2021 is presented, as well as their relation- ship with the prevalence of alcoholism and mental disorders. Official data show that during this period, 8,160 people, mostly men of working age, committed suicide in Yakutia. The overall suicide rate in the region has decreased, but is still significantly higher than the Russian average. Alcohol abuse is considered a leading cause of suicide, especially among indigenous people. There is a direct correlation between the prevalence of alco- hol dependence and suicide, as well as the incidence of alcoholism and mental disorders. However, the connection between these indicators and mortality from suicide in the Arctic zone has not been established. The problem is caused, among other things, by insufficient diagnosis of mental and addictive disorders due to a shortage of qualified doctors in the region. The authors of the article come to the conclusion that it is necessary to strengthen the prevention of alcoholism and suicidal behavior, as well as improve the quality and availability of psychiatric care in the Arctic zone.

Aim: to evaluate the results of clinical studies devoted to the study of the role of endothelial glycocalyx (GC) in the pathogenesis of critical conditions.

Materials and Methods. Scientific information was searched in domestic (E-Library) and foreign databases (PubMed, Scopus, Oxford University Press, Springer, Web of Science Core Collection). 120 publications were analysed, 42 of them were selected to meet the requirements of the review.

Results. GC is a gel-like polysaccharide-protein layer covering the surface of vascular endothelial cells. GC maintains homeostasis of the vascular network, including controlling vascular permeability and microvascular tone, preventing microvascular thrombosis, and regulating leukocyte adhesion. Endothelial GC damage is a universal link of pathogenesis in various pathological processes. The proposed review considers the structure and functions of GC, its participation in the pathogenesis of such diseases as diabetes mellitus, sepsis, covid-19, poly- trauma, pre-eclampsia, epilepsy and others. A decrease in GC thickness in patients with diabe- tes mellitus has been described. The effect of hyperglycaemia on GC structure has also been noted. In sepsis, GC is damaged by free oxygen radicals, which are released by circulating leukocytes, which in turn triggers a cascade of reactions that lead to systemic oedema, hypovo- laemia with further development of organ and tissue damage. In severe trauma, damage to GC is noted, which is accompanied by the release of syndecan, heparan sulfate, hyaluronic acid into the bloodstream. Preeclampsia is also associated with GC damage, which can be detected by elevation of specific markers. Epilepsy and many other neurological diseases are associated with disruption of the blood-brain barrier, whose dysfunction is associated with GC dysfunction.

Conclusion. Timely diagnosis of GC degradation can improve life prognosis and therapeutic outcomes in critically ill patients.

This review collects and summarizes the literature data accumulated over the past few years on the participation of microRNAs in the pathogenesis, progression and metastasis of ovarian cancer, as well as their role in the emergence of multidrug resistance, and considers their possibility of use as prognostic and diagnostic biomarkers.

The review is devoted to the study of humoral factors that directly affect the processes of non-contractile thermogenesis and the activity of brown adipose tissue. The review is based on research conducted in various research laboratories.

Applied bioethics is a field of knowledge, the subject of which is practical moral problems. The ethical principles that form the basis for applied bioethical research related to neurodegenerative disease in Yakutia are discussed. Applying the basic four ethical principles as starting points can lead to different answers regarding specific bioethical problems, in our case the moral problems of providing medical care to patients with neurodegenerative diseases.

Over the past decades, endometrial cancer has become the most common gynecological cancer worldwide. Its increasing incidence cannot be attributed only to the increasing age of women in socially secure countries. The leading risk factor for the endometrial cancer development is obesity, and its epidemic is gradually covering the female population of North Africa, Europe and Asia. Endometrial cancer is pathogenetically associated with hyperestrogenism, and this was the basis for the dualistic theory of clinical and pathological variants proposed by Ya.V. Bohman. The foundations of this theory about the hormonal dependence of endometrial cancer are now being actively supplemented by molecular genetic parameters of the TCGA classification. Recent studies show steroid dependence of endometrial cancer both on estrogens and, to a large extent, on androgens which are directly involved in the complex processes of transformation into estrogens. Published research data, rather contradictory and ambiguous, confirm the antiproliferative role of androgens in the pathogenesis of endometrial cancer. This review analyzes papers on the role of androgens in pathogenesis and their potential clinical antitumor application.

Acute cholecystitis undoubtedly remains an urgent problem of urgent abdominal surgery. The incidence of this nosology is 160 thousand cases per year. Postoperative mortality is in the range of 1,2-1,4%. Currently, the classification of acute cholecystitis, which is based on the Tokyo agreements, has received active distribution and use. However, this classification does not allow us to determine the degree of destructive process in the wall of the gallbladder. This often leads to a prolongation of the duration of conservative therapy and an increase in the percentage of intraoperative and postoperative complications. In this publication, we have tried to characterize the available classifications of acute cholecystitis, taking into account the advantages and disadvantages. And also, to propose a more rational classification from the point of view of a practical surgeon.

Studies of the effect of the use of preparations with microalgae C.vulgaris on the human body are important due to its wide distribution and the presence of a large number of biologically active substances. We investigated biochemical and hematologic indices of a group of persons after a course of microalgae suspension reception. There were immunomodulatory effects, expressed as an increase in LYM% and a decrease in ESR, cellular rejuvenation primarily among healthy men, and trends toward increased ALB and TP at younger ages. After 50 years of age, a tendency for GLU levels to decrease after the course was detected. There was an increase in CREA and UREA, which may be related to both improved availability of protein compounds and the composition of the microalgae growth medium, which requires further investigation.

Polymer products are widely used in the field of medicine in the form of implants, artificial vessels, heart valves, etc. However, the tasks of searching, developing and studying the proper- ties of polymeric materials for medical purposes remain relevant. This paper presents the results of biocompatibility research of PN-90 polytetrafluoroethylene implanted in the subcutaneous fat space of laboratory animals (Wistar rats). The implantation of the polymer was carried out under general anesthesia in the subscapular area. Histological sections of tissues from the control area and adjacent to the implant were studied. Around the implanted polytetrafluoroethylene there was is an intensive growth of new vessels of various calibers combined with severe fibroblasts proliferation. The polymeric material was also investigated by means of an IR spectrometer and a scanning electron before and after implantation. According to the results of IR spectroscopy the chemical composition of the polymer remained unchanged. The surface of polytetrafluoro- ethylene after implantation was practically identical to the surface of the initial polymer. Based on the data obtained, it can be concluded that polytetrafluoroethylene is biologically compatible and can be used in medicine as a base for implants.

A one-stage population study was conducted in the working population in south Yakutia. The 174 people of non-indigenous nationality were examined. Increased uric acid (UA) levels were found in 27% of the individuals. The association of UA level with BMI, OT, lipid spectrum was revealed mainly in men, systolic blood pressure and blood glucose in women. Abdominal obesity was equally frequently recorded in both men and women, regardless of the presence or absence of hyperuricemia, Logistic regression showed satisfactory information content of the prognostic significance of the level of UA with hypertension only in the female population. Hyperuricemia was not an independent risk factor for the development of cardiovascular pathology.

The article presents the results of a study of the competitive endurance of servicemen of the airborne troops performing at the 3rd stage of the military field training competition "Airborne Platoon". The relevance of the work lies in the fact that a timely assessment of the functional state of military athletes will make it possible to adjust training plans in time and perform more effectively at the competition. The aim of the study was to assess the competitive endurance of military athletes according to heart rate variability data with different military accounting specialties. Based on the data of heart rate variability, the analysis of the state of the regulatory processes of the body was carried out, the assessment of the com- petitive endurance of the airborne troops before and after performing special tasks in the "Airborne Platoon" military field training competition was carried out. With the help of an orthostatic test, the latent capabilities of the functional systems of the body were evaluated. The body of military personnel serving as driver mechanics is characterized by a pronounced tension of regulatory systems during the orthostatic test, in soldiers of other accounting specialties, the body reacts adequately. It is presented that the physical load during the period of the competition was at the limit of the capabilities of the body of military personnel and almost led to the breakdown of adaptation mechanisms.

For the first time, the diagnosis of MELAS syndrome in a Yakut family was genetically verified using mitochondrial genome sequencing. The substitution of adenine for guanine at position 3243 (m.3243A>G) in the tRNALeu(UUR) gene (MT-TL1) was confirmed. The level of the mutant allele (heteroplasmia) in the patient was 38.5%, while in the mother only 9.8%, which is ex- plained by the selection of rapidly dividing blood cells with a low level of mutant alleles during life. It has been shown that the phenomenon of mtDNA heteroplasmy forms a significant clinical heterogeneity in the manifestation of the disease and demonstrates the complexity of diagnosing subclinical forms of MELAS.

The case of the current of two severe autoimmune diseases (Crohn's disease and juvenile rheumatoid arthritis) in a male Sakha adolescent is presented in the article.

The article presents a clinical case of combination of Miller Fisher syndrome and unspecified peripheral T-cell lymphoma, which is an aggressive disease with an extremely poor prognosis. The pathogenetic treatment of the identified syndrome did not cause an improvement in the pa- tient's condition and did not affect the expected unfavorable prognosis of the primary malignant disease, for which chemotherapy was not carried out due to the extremely serious condition of the patient. This case emphasizes the importance of an oncological search in patients with Miller Fisher syndrome and the mandatory determination of onconeural antibodies used in the diagnosis of paraneoplastic neurological syndrome, which occurs in malignant tumors of various histogenetic types.

The article presents a clinical case of congenital autosomal recessive cataract, first identified in a 3-year-old Sakha child. Congenital cataract is a relatively rare pathology found in children, but it is often the cause of visual impairment and blindness. The restoration of a child's eyesight depends on the early detection and treatment of the disease. Studies show that 30 to 50% of congenital cataracts are caused by genetic mutations.

The article presents a clinical case of a rare inflammatory myofibroblastic tumor of the abdominal cavity in a 6-year-old boy. The child had a high fever, laboratory tests revealed an increase in acute phase proteins, and according to instrumental studies - a large tumor of the abdominal cavity, without a clear organ affiliation. During laparoscopic revision, the possibility of total tumor removal was established; laparotomy was performed and the tumor was radically removed.