The studies conducted on human cell lines demonstrated that even moderate alcohol consumption caused the shortening of telomeres – structures that play a key role in of cellular aging. Nevertheless, published data on the effect of chronic alcohol intake on the changes in the relative leukocyte telomere length (LTL) in humans remain ambiguous. Such ambiguity may be attributed to the differences in the clinical symptoms of individuals with alcohol dependence. In this regard, the present study aimed to test for the hypothesis, which suggests the association of shorter telomeres with manifesting chronic alcoholism and to identify clinical and anamnestic characteristics associated with individual variance in relative telomere length in subjects with alcohol dependence. LTL assessment has been carried out via real-time PCR in patients diagnosed with alcohol dependence syndrome (ICD-10) (N = 272) and in control group (N = 254). Linear regression analysis demonstrated statistically significant effect of age in the total sample (βstand = -0.153, Р = 0.009) and in men (βstand = -0.143, Р = 0.026) on variance in LTL. Moreover, age-dependent telomeres shortening was characteristic only for patients’ group (βstand = -0.217, Р = 0.017). The inclusion of clinical and anamnestic characteristics in the model resulted in a significant negative effect of age at onset of withdrawal syndrome on LTL (βstand = -0.343, Р=0.001). The findings obtained are congruent with the data on the toxic effect of acetaldehyde and increased allostatic load accompanied by prolonged alcohol consumption, and confirm the presence of a compensatory effect in the cells, which is associated with regulated expression of genes responsible for maintaining telomere length.

Many environmental and genetic factors are involved in asthma development, among which an important role in the disease formation and response to antihistamine therapy belongs to genes involved in the histamine metabolism (HRH1, HRH2, HRH3, HRH4, HDC, HNMT, AOC1, MAOB, ALDH7A1, etc.). Histamine is a central mediator of allergic inflammation the release of which leads to contraction of the bronchial smooth muscles, bronchial secretion and edema of the respiratory mucosa. The use of antihistamines performing competitive blockade of histamine receptors leads to inhibition of histamine effects. The aim of this study was to assess the role of polymorphic variants of aldehyde dehydrogenase 7 family member A1 ALDH7A1 (rs13182402), amine oxidase copper containing 1 AOC1 (rs1049793), prosaposine PSAP (rs11000016), adenylate cyclase activating polypeptide 1 ADCYAP1 (rs2231187) genes involved in the histamine metabolism in asthma development in individuals from the Republic of Bashkortostan. DNA samples of 846 unrelated individuals of different ethnicity living in the Republic of Bashkortostan were used as the study material. Genotyping of polymorphic variants was performed by real-time PCR and RFLP analysis. The statistically significant association of the rs2231187*AA genotype and the rs2231187*A allele of the ADCYAP1 gene with asthma, the rs2231187*A allele of the ADCYAP1 gene with disease manifestation in childhood, the rs2231187*AA genotype of the ADCYAP1 gene and the rs13182402*G allele of the ALDH7A1 gene with severe and moderate asthma was established in Bashkirs. The rs1049793*CC genotype and the rs1049793*C allele of the AOC1 gene were associated with asthma in Russians. The results of this study are complementary to the previously published data regarding genetic aspects of asthma pathogenesis that suggest the involvement of ALDH7A1, ADCYAP1 and AOC1 gene polymorphisms in asthma development.

Nowadays, control of bronchial asthma (BA) can be achieved only in 2/3 of cases, even in a controlled population with direct daily supervision of a doctor ensuring full compliance with standard treatment regimens. In this regard, factors that can affect the course of asthma, but those which are not taken into account in standard treatment regimens, are of particular importance. Interest in vitamin D as a modifier of atopic inflammation in BA is due to its noncalcemic effects realized through the VDR receptors of immune cells. 78 patients suffering from asthma were examined. The diagnosis of the disease and the degree of control over it were established based on the GINA 2020 criteria. The levels of vitamin D and interleukins in the blood serum were determined by ELISA. The level of immunocompetent cells was determined by flow cytometry. The presence of persistent infection was determined by PCR method. It was found that children with uncontrolled AD have more than two times (29.8 vs 64.5 ng/ml) lower level of vitamin D than patients who control the disease. Children with vitamin D deficiency have three times higher levels of one of the inducers of atopic inflammation – IL5 (0.62 vs 0.22 pg/ml) and require a higher dose of topical glucocorticosteroids (TGC) (347.3 vs 285.5 mcg) to control the disease. Thus, vitamin D has a significant impact on the level of asthma control in children, the immune status and the likelihood of persistence of the herpes virus type 6. Determination and correction of vitamin D deficiency should be recommended, since it influences on pathogenetically significant parameters of atopic inflammation in uncontrolled bronchial asthma in children.

In order to verify the assumption that changes in the content of osmiophilic bodies (OB) in pinealocytes in rats are a morphological marker not only of shifts in secretory activity and cal-cification of the pineal gland responding to round-the-clock lighting, but also reflect violations of pineal biorhythm, by methods of light and transmission electron microscopy, microrentgenospec-tral analysis in an experiment on rats, exposed to 48- hour exposure to bright light, the numerical density of single and grouped OB, their chemical composition was estimated. It is concluded that the grouped OB with the material of disposed mitochondria and calcifications are a residual manifestation of desynchronosis. Their content increases at an earlier time after exposure than the total content of various types of OB.

Nowadays a high level of CTD is prevailed, which has local and general phenotypic signs. At the same time, despite its wide study, the problems of diagnosis, treatment, prevention and comprehensive rehabilitation of its manifestations in the oral cavity and maxillofacial region remain unresolved. In this connection the research aim is to solve these problems, which have an extremely important practical, scientific and theoretical significance in dentistry, and also in medicine. The research objective is to study the structure of dentoalveolar anomalies of schoolchildren due to the hard palate vault height at different degrees of connective tissue dysplasia severity. Materials and methods. A clinical and craniometric study was performed in 964 children and adolescents aged from 12 to 15 years old diagnosed with CTD. The CTD severity was determined by the method of T. Milkovska-Dmitrova and A. Karkashev (1985). In this case, anomalies of occlusion, dental deformities and anomalies in the teeth position were determined taking into account the height of the hard palate vault at different CTD severity. The vault height of the hard palate was determined by the method of Ushnitsky I.D. et al. (2018). Results. The examined patients most frequently revealed a medium degree of severity, then a mild degree and less often a severe degree in the CTD structure severity. At the same time, in the structure of occlusal anomalies associated with distal occlusion, deep traumatic incisal overlap and underdevelopment of the upper jaw, dental arch anomalies including occlusion of the maxillary and mandibular dental arches, shortening of the maxillary and mandibular dental arches, displacement of the upper and lower central tremes, dental position anomalies such as close position of incisors, vestibular position of upper canines, protrusion of upper incisors, retrusion of upper and lower incisors, primary adentia, dystopia of upper canines are determined by increasing their prevalence in school children due to the height of the hard palate vault depending on CTD severity. It should be noted that an opposite pattern to the previous pathologies was detected in some dentoalveolar anomalies, which is characterized by their decrease in the examined schoolchildren depending on the CTD severity. Thus, the occlusion anomalies trend was determined in reverse incisal occlusion, crossbite, mesial occlusion, retroposition of the mandible, as well as in some anomalies of tooth position, including palatine positioning of upper second incisors, tortoanomaly of the upper and lower jaws, inverse occlusion of upper incisors, macro dentition, disorders of the premolars eruption, lateropositioning of upper second incisors. Discussion. The comprehensive study revealed the main structural characteristics of anomalies of occlusion and position of teeth and dental deformities in schoolchildren due to the hard palate vault height at different degrees of CTD severity. Conclusion. The increase and decrease pattern in the prevalence of dentoalveolar anomalies in schoolchildren due to the height of the hard palate vault at different degrees of CTD severity has been established for the first time, which will allow taking timely measures to improve complex medical and social rehabilitation.

Background. Modern research requires access to tumor models for various types of studies on a single patient xenograft. Biobanks store tissue fragments and cell cultures for various studies, and it is necessary to form protocols for cryopreservation of various tumor fragments and create collections of biomaterial. Material and methods. The study was performed on tumor material from patients with malignant gastrointestinal tumors (esophagus, stomach, and colon). An experiment included 90 Balb/c Nude mice. The third generation of a PDX model was used for cryopreservation. The effectiveness of 3 protocols for cryopreservation of tumor tissue was evaluated using RPMI nutrient medium, fetal bovine serum (FBS), dimethyl sulfoxide (DMSO) and Mr. Frosty containers. 90 days after the freezing of the tumor nodes, the samples were thawed and implanted to animals; engraftment was noted, and the onset of tumor nodes in animals was recorded. At the end of the experiment, the data were analyzed statistically. Results. Protocol 1 was the least suitable for preserving fragments of esophageal, colon, and gastric tumors. Protocols 2 and 3 showed higher engraftment rates. The lowest engraftment rate was registered for reanimated gastric cancer PDXs. Conclusions. Protocols 2 and 3 with slow freezing of samples should be used for cryopreservation of human esophageal and colon cancer xenografts. Gastric cancer PDXs require other cryopreservation methods due to the low efficiency of the existing ones.

The problem of the formation of metabolic syndrome in children is becoming more and more urgent every year, which is associated with excess nutrition, physical inactivity, increased psycho-emotional stress, therefore, timely identification of immune and genetic markers of predisposition to the development of this pathology will allow identifying possible health risks at an early stage and preventing their implementation in adulthood. The aim of the study: To evaluate the indicators of immune status and genetic polymorphism of candidate genes as markers of the development of metabolic syndrome in school children (on the example of a secondary school in Perm). Materials and methods. The study involved 214 school-age children. Three groups were formed, ranked according to the body mass index criterion: observation group1 with metabolic syndrome (BMI SDS >2.0), observation group2 with excess body weight (BMI SDS >1.0 <2), comparison group – absence of excess body weight (BMI SDS <1.0) The evaluation of immune (IL 1B, IL 4, CD19+), neuroregulatory (leptin), metabolic (glucose, HDL, triglycerides), genetic (ADRB rs1042413, PPARA rs4253778) indicators was carried out. Results and discussion. It was found that the group of children with metabolic syndrome and excess body weight in relation to the comparison group was characterized by an increase in CD19+ expression by 1.3 times, a decrease in the content of anti-inflammatory cytokine IL4 by 1.5 times, overexpression of pro-inflammatory cytokines (IL1b by 1.9 times), leptin by 2.0 times, an imbalance of lipid-carbohydrate metabolism (reduction of HDL by 7%, against the background of an increase in triglyceride levels by 17% and glucose levels by 8%), significant changes in the frequencies of genotypes associated with metabolic syndrome (increased frequency by 2.7 times of the typical AA genotype of the ADRB2 gene rs1042713, OR=3.79 CI:1.25-11.47; p<0.05, as well as by 4.6 times of the variant CC genotype of the PPARA gene rs4253778 OR=5.00; CI:0.97-25.89; p><0.05). Conclusion. Candidate immunological (CD19+, IL 1b, IL4) and genetic (ADRB2 rs1042713, PPARA rs4253778) markers are recommended to be used as indicators for identifying early signs of metabolic syndrome in school-age children living in the Perm region> <0.05, as well as by 4.6 times of the variant CC genotype of the PPARA gene rs4253778 OR=5.00; CI:0.97-25.89; p <0.05). Conclusion. Candidate immunological (CD19+, IL 1b, IL4) and genetic (ADRB2 rs1042713, PPARA rs4253778) markers are recommended to be used as indicators for identifying early signs of metabolic syndrome in school-age children living in the Perm region.

A one-stage study of the working non-indigenous population of South Yakutia was conducted. A high incidence of abdominal obesity, lipid-metabolic disorders has been shown. Dyslipidemia, arterial hypertension and metabolic syndrome, mainly represented by a three-component, were most often registered in men compared to women. The relationship of blood pressure with triglyceride and glucose levels was obtained.

Functional endoscopic sinus surgery (FESS) provides not only optimal access with a sufficient overview of the surgical field, but also allows to preserve with minimal trauma the functionality of the ostiomeatal complex zone, to provide ventilation and drainage through the natural respiratory tract. To perform FESS procedures it is important to minimize bleeding in the surgical area, since even a small amount of blood can deteriorate the endoscopic view.

The aim of the study: to evaluate the effects of beta-blockers as component of general anesthesia in functional endoscopic sinus surgery.

Materials and methods: 110 patients were included in a single-center prospective cohort study. FESS procedures were performed under general anesthesia. 3 groups of patients were intraoperatively isolated: without administration of beta-blockers (BB) (control group, C) (n=40); with intravenous metoprolol (M) (n=35) 1-2 mg each until a heart rate of 50-60 beats /min, but no more than 15 mg; with intravenous esmolol (E) (n=35) with loading dose of 0.5 mg/kg during 1 min., then 0.05 – 0.15 mg/kg/min. The same type of general anesthesia was performed in all groups The intraoperative intensity of bleeding (IB), heart rate (HR bpm), noninvasive systolic (SBP), diastolic (DBP) and mean blood pressure (MBP) (mm Hg.), perfusion index (PI) were assessed. The study points were the 10th, 30th and the 60th minute of the procedure.

Results and discussion: HR in group C at all points of the study was statistically significantly higher compared to group M and E. MBP significantly differed at the 10th minute of the procedure between the groups, at the 30th minute the levels of MBP were the same in all compared groups, and at the 60th minute in the group M recorded high MBP compared to group E. At the 30th and 60th minutes of the procedure, PI was lower in groups M and E compared to group C. The IB was convincingly lower at all points of the study in groups M and E compared to group C and did not differ between groups M and E. In the prognostic model when assessing factors that may affect the development of intraoperative bleeding the fact of the use of BB in groups M and E leads to a decrease IB at all points of the study. An increase in IB is predicted with an increase in HR and SBP at the 10th and 60th minutes of the procedure.

Conclusion: 1. Intraoperative use of beta-blockers in addition to reduction of the heart rate leads to a moderate decrease in mean blood pressure and a decrease in intraoperative bleeding during functional endoscopic sinus surgical procedures under general anesthesia. 2. Metoprolol and esmolol have the same effectiveness for reducing the intensity of bleeding during FESS procedures. 3. The use of esmolol causes a more expressed decrease in heart rate and mean blood pressure compared to metoprolol.

Short summary. The effects of beta-blockers as component of general combined anesthesia in functional endoscopic sinus surgery were studied. It was found out that intraoperative use of beta-blockers in addition to decreasing heart rate leads to a moderate decrease in mean blood pressure and a decrease in intraoperative bleeding. Metoprolol and esmolol are equally effective, but the use of esmolol causes a more significant decrease in heart rate and mean blood pressure compared to metoprolol.

The aim of this study was a clinical assessment of the diagnostic value of determining changes in the fatty acid composition and values of the surface tension of blood serum in patients with peritonitis in the light of assessing the severity of the course of the infectious and inflammatory process. In the course of the study it was found that the most informative indicator of the severity of the course of an infectious-inflammatory process is a sharp and prolonged decrease in the blood serum of patients with CCP in the level of γ-linolenic, dihomo-γ-linolenic fatty acids, as well as a persistent decrease in STC values. The results of the clinical study presented by us allow us to recommend, as a method of choice, to assess the severity of the course of peritonitis with the help of a comprehensive assessment of changes in the fatty acid composition and STC values of blood serum.

Based on a retrospective analysis of the treatment results of 23 patients of the coloproctology department of the Surgut District Clinical Hospital for the period from 2018 to 2021, the effectiveness of transanal endoscopic resection of rectal benign tumors was evaluated. The study found that the technique of transanal resection of large tumors of the rectum has a number of advantages in comparison with traditional approaches: preservation of the function of the rectal closure apparatus, a small number of postoperative complications and preservation of the patient's quality of life at a high level. The results of the study indicate the effectiveness of using the technique of transanal endoscopic surgery in patients with malignant rectal tumors. The feasibility study ensured the radical removal of the formations of the TisN0M0 and T1N0M0 stage with minimal invasiveness of the procedure and the absence of early signs of recurrence of the disease.

The purpose of the study was to evaluate the content of endothelial vascular growth factor in the tissues of the kidney parenchyma, in the thickness of the tumor and in the blood serum of a patient during partial nephrectomy with intra-arterial administration of an anti-angiogenic drug.

Materials and research methods. The present study was carried out on the basis of an analysis of the results of surgical treatment of patients with kidney cancer. 8 patients with renal cell carcinoma in stage T 1 a N 0 M 0 organ-preserving surgery was performed in the amount of kidney resection with intra-arterial injection of the targeted drug Bevacizumab into the kidney artery. The concentration of vascular growth factor in the tumor, in the renal parenchyma, and in venous blood from the kidney was studied before the renal artery was clamped, during renal ischemia, and after the injection of Bevacizumab into the renal artery.

Results and discussion. With a sudden cessation of blood flow, the tumor releases the amount of vascular growth factor several times higher than the initial values: an increase in the concentration in the thickness of the tumor by 3 times, in the kidney parenchyma - 1.5 times, and in the venous blood - 3.5 times higher than before ischemia. Inactivation of the growth factor by the targeted drug caused a decrease in its level in the tumor tissue by 25%, in the kidney parenchyma by 10% and in the blood serum by 85.35%.

Conclusion. Intraoperative administration of a targeted drug at the time of acute tumor ischemia irreversibly binds the vascular growth factor released during hypoxia, and thus prevents neoangiogenesis in potential metastatic foci.

In the Republic of Sakha (Yakutia) for the period 2015-2020, an increase in mortality and a decrease in fertility were noted, as well as higher rates of primary morbidity, including in the class of respiratory diseases, 1.4 times higher than in the Russian Federation, while the incidence rate of COVID-19 was higher; also, higher incidence of digestive diseases was noted (1.7 three times higher than in the Russian Federation). Indicators of primary morbidity of children and adolescents are higher than those of the total population in almost all classes of diseases for all 6 years of analysis (2015-2020). Differences in the indicators of primary morbidity in uluses (regions) of the Republic of Sakha (Yakutia) are higher by 3.3 times, which is associated with difference in availability of medical care in different areas of residence. The information obtained is important for development of management decisions at the regional level.

Relevance. The development of preventive measures and the improvement of the system of medical care for the treatment of zoonotic infections depend on the identification of the incidence rate and important risk factors. The present study aims to determine some epidemiological indicators and trends in the incidence of brucellosis among people in Azerbaijan from 2017 to 2021.

Methods. Descriptive cross-sectional retrospective study was carried out on the basis of the Electronic Surveillance System for Infectious Diseases of the Ministry of Health of the Republic of Azerbaijan for 2017-2021. Epidemiological reports on each case of the disease were used to collect data on demographic and background characteristics, risk factors, laboratory test results.

Results. In total, 1,711 newly reported cases of brucellosis have been registered in Azerbaijan from 2017 to 2021. The highest (5.3) and lowest (2.2) incidence rates per 100,000 population were observed in 2019 and 2021, respectively. The highest rates during the observation period were in the cities of Baku and Sumgayit, Shemkir region. The cumulative percentages of the disease were estimated for various variables by the following indicators: by sex: 70.6% for men; by age groups: 10.7% for the age group 26-30; by occupation: unemployed 45.8%; by place of residence: 81.6% for residents of districts and villages.

Conclusions. Despite the general decrease in the number of newly reported cases of brucellosis by years and cumulative characteristics, a detailed descriptive analysis revealed epidemiological features of the spread of cases by years depending on risk groups.

Biological environments of the body serve as a reliable bioindicator reflecting the state of human health and its environment. The aim of the study was to study the accumulation of trace elements in the hair of children from birth to 6 years old, living in areas with different types and degrees of anthropogenic pressure. The content of (Ca, Mg, Fe, Zn, Cu, Cr, Ni, Mn, Pb, Cd) in the hair of newborns was determined by atomic absorption spectrometry; the dynamics of the content of heavy metals in the hair of children from birth to six years of age was assessed; a comparative analysis of the level of trace elements in the hair of preschool children living in different regions of the Republic of Bashkortostan was carried out. By the age of six, the hair of Ufa children revealed a reduced content of essential elements: Fe, Mn and Zn; toxic metals: Pb and Cd; conditionally essential: Ni and Cr compared with the average physiological level. In the hair of children living in a region with a developed mining industry, on the contrary, there is an accumulation of essential elements: Fe and Mn; conditionally essential element - Cu and Ni and toxic - Pb.

The aim. Investigation of nasopharyngeal SARS-CoV-2 viral load in newborns with COVID-19 of different severity.

Materials and methods. The main group was composed of 44 newborns with RT-PCR confirmed COVID-19. 168 children aged from 1 month to 17 years old with RT-PCR confirmed COVID-19 were included in the group of comparison. SARS-CoV-2 viral load was measured as amount of viral RNA copies in 1 ml of nasopharyngeal mucosa using the regression model and presented as lg of the amount. The results presented as Me[Q1;Q3].

Results. SARS-CoV-2 viral load in newborns was detected significantly higher as compared to children aged 1-17 years: 3,2×106[5,7×104; 7,8×107] and 1,3×105[2,6×104; 1,2×107] respectively and no association has been revealed between nasopharyngeal SARS-CoV-2 viral load and disease severity, lung injury and the type of feeding.

Discussion. Nasopharyngeal SARS-CoV-2 viral load presumably reflects epidemiological circumstances and tends to decrease as the disease develops. It can be due to virus dissemination to lung tissue, vessel walls and other organs that followed by fall of number of viral particles in upper respiratory tract. While elimination of virus from mucosa on the early stages after infection probably depends on efficiency of innate immunity (which mechanisms can kill and/or impede virus invasion before immune response develops), viral load in blood and internal organs tissues, as well as favorable course of the disease, mainly depends on ‘proportionate’ immune response. So that, assessing the viral load and its significance for disease development should be performed considering the day after infection.

Conclusions. High level of nasopharyngeal SARS-CoV-2 viral load in newborns along with mostly mild COVID-19 course can be based on age-correlated features such as: immature immunity mechanisms, low expression of ACE2 receptors, the absence of comorbidity and intake of innate immunity factors while breastfeeding.

With an aim to study the impact of restrictive measures against COVID-19 pandemic on epidemiologic situation with tuberculosis (TB), we analyzed key epidemiological data and distribution of clinical forms of newly detected pulmonary TB (PTB) among adult population of the Sakha Republic (Yakutia), with a separate analysis for the Arctic zone, as an example of a territory with low population density and limited transport accessibility.

For the study purpose, we used data from federal statistical recording and reporting forms, and data from TB medical patient database of the Sakha Republic (Yakutia). Rates for adult newly diagnosed PTB cases were analyzed for two pandemic years (2020-2021) against two pre-pandemic years (2018-2019). Statistical methods of choice were Pearson’s correlation coefficient and data weighing by chest x-ray coverage trend.

Study findings showed that the period of strengthened anti-epidemic and sanitation measures against novel coronavirus infection (COVID-19) was followed by substantial decrease in epidemiologic rates for TB, but, at the same time, profoundly deteriorated situation with delays in TB detection.

In the Arctic zone of Yakutia, epidemiologic rates for TB were showing decrease during restrictive measures, but generally remain higher than mean republic rates.

Increase in proportion of new adult patients with advanced disease forms was observed, together with the fact the TB detection rates in the Arctic zone were lower compared to mean republic detection rates.

The scope and quality of preventive checkups for TB correlated in a statistically significant way with the distribution of clinical forms of TB among newly diagnosed patients.

In conclusion, to reduce the rate of detections of MTB-positive destructive TB forms, prevention and detection measures will need to be strengthened, and should include universal annual chest x-ray screening of the population aged 15 and above.

A feature of the SARS-CoV-2 virus, unlike other respiratory infections affecting the human body, is a rather high virulence and mortality. It has been established that severe forms of the disease are more common in elderly people with concomitant diseases. It has been established that free radical lipid oxidation plays an essential role in the pathogenesis of COVID-19. The body's antioxidant defense system prevents damage to cells and tissues from initiating free radical reactions. The family of enzymes glutathione-S-transferase (GST; EC 2.5.1.18) is interesting for research. The aim of this work was to analyze the association of polymorphisms of the GSTM1 and GSTT1 genes with the degree of lung damage in elderly people who had COVID-19. A survey of 51 elderly volunteers who had coronavirus infection aged 60 to 75 years (average age: 64.470± 0.602 years) was conducted. Informed consent to the study was obtained from all participants of the study (according to the protocol of the Ethics Committee of the YSC CMP No. 52 dated March 24, 2021, decision 1). Identification of samples by the GSTT1 and GSTM1 genes was carried out using polymerase chain reaction (PCR) according to the method described in the work of Zehra et al. (2018). According to the data obtained by us, 74.50% of all surveyed elderly people suffered a coronavirus infection with a mild degree of lung damage, and 25.49% with a severe degree. The results of our study show that the combination of zero deletion genotypes GSTM1 and GSTT1 are a risk factor for the development of severe lung lesions in elderly people in Yakutia.

Relevance. The consequences of COVID-19 are a serious problem and a cause of health problems for children. Identifying post-COVID-19 health problems to develop rehabilitation and treatment options is an important public health challenge. One of the urgent problems is the violation of the functional parameters of the cardiovascular system in children.

Material and methods. The functional state of the cardiovascular system of children who had COVID-19 in school conditions at the age of 8-12 years was studied. A total of 64 children (32 girls and 32 boys) were studied, 3-6 months after suffering COVID-19. The children were examined by copy-pairs. The study included children in the age range (8-12 years), in which functional indicators have the same reference values according to the methods used. The functional indicators of the cardiovascular system were studied according to the electrocardiogram data using the analysis of heart rate variability according to R.M. Baevsky, as well as with the help of the Martinet-Kushelevsky functional test. The following were studied: adaptive potential, response quality index, Kerdo autonomic index, coefficient of variation, systolic and diastolic blood pressure, pulse pressure, heart pumping function by assessing the stroke and minute volume of the heart, the index of functional changes, the stress index, the total power of the spectrum.

Results. It was shown that one of the mechanisms of functional disorders of the cardiovascular system in the period from 3 to 6 months after COVID-19 is a syndrome of autonomic dysfunction. The manifestations of autonomic dysfunction in children are hypertensive changes in the cardiovascular system in the absence of pronounced clinical manifestations, the presence of functional tension of regulatory systems, unsatisfactory functional status, decreased rates of increase in heart rate power in response to load, low values of sympathetic regulation mechanisms and centralization of the cardiovascular system regulation circuit, a large proportion of the influence of the peripheral regulation circuit.

Conclusion. One of the pathogenetic mechanisms for reducing the functional parameters of the cardiovascular system in children who have had a coronavirus infection is endothelial dysfunction syndrome.

The frequency of extremely early preterm birth (ERPR), their obstetric and perinatal outcomes, morphological features of the placenta in pregnant women in the city of Chelyabinsk and the Chelyabinsk region (CO) with a new coronavirus infection (NCI) in periods 1-2 and 3-4 waves of the COVID pandemic were studied. -19. The results obtained indicate that there is no increase in the frequency of ERPR in pregnant women with NCI. Delivery by caesarean section is associated mainly with the increase in acute respiratory distress syndrome (ARDS) of the mother. In the period of waves 3-4 of the COVID-19 pandemic, an increase in the perinatal mortality rate was noted compared to the period of waves 1-2 without statistical significance of these indicators. At the same time, antenatal fetal death during the 3rd-4th wave of the NCI pandemic was observed statistically significantly more often (p=0.033). The features of placental damage to the placentas in patients with NCI with ERPR and antenatal fetal death during the 3rd-4th wave of the pandemic are severe maternal and fetal vascular malperfusion and severe acute inflammatory lesions of the placenta (2,3 stages and 2,3 degrees).

Currently, a promising study is the identification of changes in the level of expressed proteins (omic markers) in the body under the influence of adverse factors, including climatic ones, reflecting the destabilization of homeostasis. The purpose of the study was to identify protein markers of negative effects in children living under the influence of adverse factors of the subarctic climate.

Materials and methods. A study of the proteomic profile of the blood plasma of children was carried out; statistical evaluation of the values of the relative volume of identified protein spots; establishing and evaluating a probable relationship between the change in the relative volume of identified protein spots and the impact of adverse factors of the subarctic climate.

Results and discussion. Under the influence of adverse factors of the subarctic climate in children of the observation group, relative to the indicators in children of the control group, there was a significant change in the volume of proteins (prothrombin, vitronectin, hemoglobin beta subunit, apolipoproteins A1, C-II and C-III, amyloid proteins A-1 and A- 2, P2Y purinoreceptor 12, transthyretin), the expression or decrease in production of which can cause a violation of the cascade of reactions of the blood coagulation system, a change in the development of mature forms of erythrocytes, a violation of the regulation of reverse cholesterol transport, and damage to endothelial cells.

Conclusion. The study made it possible to establish a relationship between the impact of adverse factors of the subarctic climate and the expression of proteins (apolipoprotein C-III, transthyretin, prothrombin, vitronectin, and hemoglobin β-subunit) identified in the blood plasma of children exposed to this effect. The established omic markers make it possible to predict the development of negative effects in the form of impaired hemostasis mechanisms, intracellular cholesterol esterification, insufficient oxygen supply to tissues, and endothelial dysfunction. The obtained results should be used for predicting, early detection and prevention of the development of possible diseases of the cardiovascular system, blood and hematopoietic organs associated with prolonged exposure to natural cold.

The immunological results of 242 people with bronchitis and 198 people with colitis, as well as 47 practically healthy people aged 21 to 55 years at the time of examination were analyzed in order to study intercellular interactions and the relative proportion of neutrophil aggregation in the area of inflammation in people living in the North. Against the background of neutropenia in the area of inflammation, the level of migration of monocytes and lymphocytes is less pronounced. In conditions close to physiological, in the exudate of the "skin window", no significant differences in the level of leukocyte migration were revealed. With neutropenia in peripheral venous blood, the content of neutrophil aggregates in the area of inflammation is higher. Aggregation of neutrophils leads to significantly more active exosecretion, degranulation and lysis of aggregate cells, which may be one of the mechanisms for the formation of neutropenia in people living in the North.

The Evenks are an indigenous people of the North of Russia. The study included 103 Evenks living in the rural area of Jilinda in the Oleneksky district of Yakutia. The concentration of 4 major elements was determined in the blood serum by mass-spectrometry: sodium (Na), magnesium (Mg), phosphorus (P), calcium (Ca). The study revealed a reduced level of calcium (72.8 mg/L) and an increased concentration of phosphorus (130.3 mg/L) in the serum of Evenks compared to the literature data, which may affect the development of diseases in this ethnic group.

The paper analyzes the relationship of traditional lipid indicators and lipid indices with the level of blood pressure in men living in the European North of Russia. In apparently healthy middle-aged men, normal high blood pressure, abdominal pre-obesity, and compliance of traditional lipid indicators with reference values were revealed. At the same time, a number of lipid indices (atherogenicity coefficient (AC), the ratio of total cholesterol (TC) to high-density lipoprotein cholesterol (HDL-C), atherogenic plasma index (AIP), triglyceride/HDL-C ratio and lipid accumulation index (LAP)) appeared to be elevated.

Correlation analysis revealed the linear relationship of systolic pressure in the brachial artery with the content of Apo A-1, Apo B, TC, low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk (CVR); diastolic pressure with TC, CVR and the waist-hip circumference ratio; heart rate index with waist and hip circumferences and body mass index. More number and greater strength of significant correlations were found between indicators of central hemodynamics and lipid profile. The relationships between age and length of living in the North with peripheral and central hemodynamic parameters turned out to be obvius.

Thus, male northern residents with normal high blood pressure have abdominal pre-obesity, normolipidemia but elevated lipid indices. Apparently, lipid indices are of greater prognostic significance and may be more sensitive predictors of the risk of arterial hypertension at the normal level of traditional lipid profile indicators.

Correlation analysis revealed the linear relationship of systolic pressure in the brachial artery with the content of Apo A-1, Apo B, TC, low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk (CVR); diastolic pressure with TC, CVR and the waist-hip circumference ratio; heart rate index with waist and hip circumferences and body mass index.

More number and greater strength of significant correlations were found between indicators of central hemodynamics and lipid profile.

The interrelations between lipid parameters and pressure level were revealed: a) positive correlation of AC with peripheral systolic and diastolic pressure, systolic pressure in the aorta, diastolic and pulse pressure, b) TC-non-HDL with systolic and diastolic pressure in the aorta, c) negative correlation of LAP with peripheral pulse pressure.

These correlations indicate that in Arctic conditions, the presence of normolipidemia and pre-obesity may be a prerequisite for the formation of normal high pressure.

SARS-CoV-2 virus impairs cognitive functions during illness and in long-term periods: from 3 months (in 44% of patients) to one year (in 16.2% - 63% of patients) after recovery. Cognitive deficits are more common in patients with severe COVID-19, especially those treated in the intensive care unit, and with infection duration of more than 28 days. Such consequences are associated with direct impact of SARS-CoV-2 on the functioning of brain neurons and changes mediated by endothelial dysfunction due to impaired blood supply to the cerebral cortex. The long-term results of the viral effect on brain neurons are due to immune responses to the virus multiplying in cells and to changes in the epigenetic regulation of gene expression. The immune response leads to inflammation, which is expressed in the form of encephalitis, encephalopathy, anosmia, hypogeusia and is reflected in the development of cognitive deficit. Epigenetic changes are mediated by virus-induced activation of retroelements that have cis- and trans-effects on genes involved in neurogenesis. SARS-CoV-2 promotes the expression of miRNAs that silence the expression of many genes, thus impairing cognitive functioning. The mechanism of these changes is associated with the effect of the virus on retroelements, which are the sources of miRNAs. Reverse transcriptase and endonuclease of retroelements may be involved in the integration of SARS-CoV-2 into the human genome, which may also affect the change in the expression of genes necessary for cognitive development.

The review summarizes the studies of the role of the FADS gene in the metabolism of polyunsaturated fatty acids, as one of the mechanisms of human adaptation to the environmental conditions, in particular, a cold climate. A comparative analysis of the distribution of the most significant for circumpolar ethnic groups polymorphic variants rs7115739, rs174570 of the FADS 2-3 genes in various ethnic groups, including the Inuits and Yakuts, was carried out. The results of studies of the FADS polymorphic markers effect on lipid metabolism, the risk of cardiovascular diseases and type 2 diabetes mellitus in different world populations are systematized.

The article presents the results of the study of the association of some socio-demographic factors with risk of congenital heart disease in children in the Republic of Sakha (Yakutia). The analysis was carried out on the basis of the Perinatal Center of the Republican Hospital No.1-NCM). The study includes all cases of congenital defects among newborns born alive in two time periods – from 2001-2003 and 2011-2013. In the first period, 697 cases were registered, in the second period there were 1127 cases of congenital heart disease.

The first group included newborns with persistent fetal communications without signs of heart failure, without expansion of the heart cavities and without hemodynamic disorders. The second group was represented by newborns with congenital heart disease with signs of heart failure and functional class of various degrees. This group was divided by severity of heart failure and functional class stages into two subgroups which were 2A and 2B respectively.

The factors such as the education of parents, the number of births in the history, the presence of a full and incomplete family, were analyzed.

The compared groups were not statistically significantly different by age of the parents. The median values of the mothers’ age at the time of birth of a child with congenital heart disease were 27 years in the first group, 26 years in the 2A group, and 28 years in the 2B group. The median age of the father in all groups was 29 years.

The structure of categories of social status is represented mainly by employees, non-workers, workers and students. An analysis of the parents of the education factor as a possible predictor of the birth of a child with congenital heart disease was also conducted.

According to the results of the study, social factors affecting the risk of birth of children with congenital heart defects were an incomplete family without a sign of marriage (registered and unregistered marriage), the level of education of the mother in the case of simple heart defects, the number of births and the social status of the mother in complex diseases.

Functional systems, including the immune system in humans, adapt depending on the influencing environmental factors. Factor analysis is considered an important method for identifying latent operating parameters and their contribution to the overall process. The aim of this work is to assess the immune status of men aged 20-60 years old living in the subarctic and semi-arid regions using factor analysis. After determining the concentration of leukocytes by standard methods, and the concentration of lymphoid subpopulations by the method of indirect immunoperoxidase reaction using monoclonal antibodies, factor analysis was carried out by the method of the main component with the determination of coefficient scores of indicators to calculate the contribution of different stages of the immune reaction in the formation of the immune response. The processes of lymphoproliferation and apoptosis play a controlling role over other processes, regardless of the place of residence. The activity of the phagocytosis process increases under semi-arid conditions. The activities of the processes of differentiation and the acquired cellular response are intensified in the subarctic region. At the same time, the balance between the processes of proliferation and apoptosis is disturbed to a greater extent in the subarctic region. Thus, the formation of an adaptive immune response in men of the subarctic region is accompanied by excessive use of the reserve capabilities of immune homeostasis. In men of the semi-arid region, the adaptive immune response is formed more fluently, which contributes to the preservation of reserve capabilities of immune homeostasis and is the most optimal (beneficial) for the body.

The purpose of this work was to evaluate the biochemical parameters of blood in the mass-wrestler students during the training period. 28 students of the NEFU named after M.K. Ammosov, indigenous nationality of the Republic of Sakha (Yakutia), including 17 athletes - wrestlers, took part in the survey on the basis of informed voluntary consent. The biochemical parameters of blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), creatine kinase, alkaline phosphatase, gamma-glutamyltransferase (GGT), glucose, total cholesterol, HDL cholesterol, LDL cholesterol, VLDL cholesterol, triglycerides, uric acid, urea, creatinine, total protein, albumin by enzymatic method. Calculated indicators were determined: the de Ritis coefficient (AST/ALT), the index of muscle tissue damage (CPK/AST) and the atherogenicity coefficient. According to the results of the study, the excess of normal indicators of CPK, SCHF and the muscle damage index (CPK/ AST) of more than 10 units was revealed.

The problems of improving complex medical and social rehabilitation of children and adolescents with connective tissue dysplasia due to its degree of severity (DCT) have not been completely solved up to the present time. At the same time, insufficient information on the diagnosis of dentition anatomical changes depending on DCT severity has been identified in the research. Thus, we present clinical cases of upper dentition cconstriction in children and adolescents with connective tissue dysplasia at various degrees of severity, taking into account the arch height of the hard palate. The purpose of the research is to present clinical cases with pronounced upper dentition constriction in children and adolescents with different severity of connective tissue dysplasia based on the clinical and biometric studies. Discussion. We’ve obtained high values of the sum of the four upper incisors width, characterized as macrodentia in the examined children and adolescents with DCT, which has a direct impact on the deformation of the maxillary dentition. Thus, constriction of maxillary dental arches in mild DCT is 19,32+1,47%, moderate - 22,39+0,72 and severe - 28,52+1,70%, which have significant differences (p<0,05), and the average is at the level of 23,41+0,54%. A certain pattern of increased frequency of upper dentition constriction depending on DCT severity has been established. Conclusion. The research clinical results characterize local DCT manifestations of the maxillary dental row in the form of incisor macrodentia as well as its constrictions where the tendency of increasing the incidence> <0,05) , and the average is at the level of 23,41+0,54%. A certain pattern of increased frequency of upper dentition constriction depending on DCT severity has been established. Conclusion. The research clinical results characterize local DCT manifestations of the maxillary dental row in the form of incisor macrodentia as well as its constrictions where the tendency of increasing the incidence rate depending on its severity degree has been established in the examined age groups of schoolchildren of the North. The established data of the anomalies increase of the frontal teeth group shape and upper jaw narrowings depending on DCT severity in schoolchildren may become the basis for the improvement of treatment, prophylactic and rehabilitative measures.

The article presents observation of a clinical case of postoperative sternomediastinitis. The technique of using vacuum therapy in the treatment of purulent wounds is highlighted. The authors described the possibility of using vacuum therapy without performing the final reconstructive operation in a patient with severe concomitant pathology.

The article is devoted to a rare disease which is mastocytosis in a child. In Russia, this disease is registered with a frequency of 0.12–1 case per 1000. At the moment, the etiology and the pathogenesis of the disease are not fully understood. Mastocytosis is a rare disease with a favorable prognosis in children. Due to the small occurrence, diagnosis and treatment are often difficult. All children diagnosed with mastocytosis should be registered at a dispensary due to the possibility of transition to a systemic option at an older age. The article presents a clinical case of mastocytosis in a Sakha child.

Parkinson's disease (PD) – is a chronic neurodegenerative disease that ranks 2nd in prevalence in the world and has a steadily progressive course. It is clinically manifested by motor disorders in the form of hypokinesia, muscle rigidity and/or rest tremor. In addition, patients have non-motor symptoms, some of which may occur long before the development of typical motor manifestations. Cerebrovascular diseases are in the first place in terms of mortality and disability. A number of studies have revealed that PD reduces vascular risk factors due to low activity of the sympathetic part of the autonomic nervous system, disorders of the hypothalamic-pituitary-adrenal axis, as well as due to treatment with dopaminergic drugs. Contradictory results are expressed by a number of other authors, according to which PD is associated, on the contrary, with an increase in the risk of stroke. This article presents a clinical case of a patient with an established diagnosis of PD who has developed an ischemic stroke. The possible mechanisms of the combination of two diseases, the influence of the neurodegenerative process on the recovery processes and the timing of hospitalization are discussed.