I n t r o d u c t i o n .  According to clinical observations, depressive states in the structure of bipolar disorder (BD) are observed in 23.8% of the examined patients. Most studies show that compared with the general population, the standardized mortality rate in patients is about 30%; BD patients account for 1.4% of total deaths.

A i m .  To assess the risk of suicidal behavior in depression in the structure of BD complicated by plant cannabinoid addiction.

M a t e r i a l s   a n d   m e t h o d s .  For this research, 58 patients with diagnosed BD associated with the syndrome of cannabinoid addiction were selected – the main group (mean age 34 ± 4 years). The control group consisted of 100 individuals with BD without associated pathology (mean age 32 ± 3 years). The duration of the disease in both groups ranged from 1 to 5 years. The following methods and scales were used in the study: clinical method – mental status assessment, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the SAD PERSONS Scale – a scale for suicide risk assessment.

R e s u l t s .  The study showed that the risk of suicidal behavior in depression in the structure of BD complicated by plant cannabinoid addiction increases significantly, which is confirmed by the results of assessment using psychometric scales (after 6 months since the beginning of the study in the main group, a high risk of suicide was diagnosed in 8% of cases, after 12 months – in 11%, very high risk – in 4% of cases). The deterioration of the mental state was confirmed by the frequency and longer duration of hospitalizations in a psychiatric hospital: in the main group, the average duration of hospitalization in a psychiatric hospital after 6 months since the beginning of the study was about 5.3 ± 2 months (67% (p < 0.005)), after 12 months – about 5.9 ± 1 months (72% (p < 0.005)). In the treatment of this category of patients, high drug resistance was noted (73–86% (p < 0.05)).

C o n c l u s i o n .  The use of plant cannabinoids increases the risk of suicidal behavior. Depression in the structure of BD associated with plant cannabinoid addiction was characterized by resistance to therapy. An increase in anxiety levels led to compulsive suicide attempts which is a key risk factor for completed suicide.

I n t r o d u c t i o n .    The availability of drugs for the treatment of diabetes mellitus in pharmacies requires special attention and is an important indicator of the quality of pharmaceutical care provided to patients with diabetes mellitus on an outpatient basis.

A i m . To assess the availability of oral drugs for the treatment of type 2 diabetes mellitus (T2DM) in  Novosibirsk pharmacies.

M a t e r i a l s   a n d   m e t h o d s . The objects of the study were current databases of  Novosibirsk pharmacies, data from the State Register of Medicines. The retail availability and affordability of drugs for the treatment of T2DM were assessed. We used the content analysis, statistical method, and comparison method.

R e s u l t s . The retail availability of the majority of drugs for the treatment of T2DM was low. Among the drugs with low availability, the largest part  is occupied by combinations of oral hypoglycemic drugs (31.91%). More than half the drugs were unaffordable. The least affordable medications were combinations of oral hypoglycemic drugs (35% of the amount of unaffordable medicial products) and renal glucose reabsorption inhibitors (11.67% of the total amount of unaffordable drugs).

C o n c l u s i o n . The results obtained, which revealed the insufficient retail availability and affordability of oral drugs for the treatment of type 2 diabetes mellitus, may serve as a basis for further research to improve pharmaceutical care for patients with diabetes mellitus.

I n t r o d u c t i o n . Ovarian tumors (OT) are the leading cause of death from gynecological cancer.

A i m .   Studying of epidemiological, histopathological, and immunohistochemical profile of OT in the North-Central region of Algeria.

M a t e r i a l s   a n d   m e t h o d s .  An epidemiological and histopathological analysis of OT that were diagnosed over a period of 32 months from January 2018 to August 2020 in Algiers was carried out. It grouped all the histologically confirmed cases in the Pathological Anatomy and Cytology Department of the Hussein Dey Hospital during the study period. Through this work, we collected 110 cases of OT. Among this total, 26 cases (23.63%) were represented by functional cysts and 7 cases (6.36%) by borderline epithelial tumors excluded from our work. Only OT (benign and malignant) were studied. On the epidemiological level, we were interested in the age factors and distribution by year of study, and on the anatomopathological level, we dealt with the topography, macroscopic and histological aspects of these tumors.

R e s u l t s .  An average age of the patients with OT was 39.99 years, with extremes of 16 years and 88 years, and the most affected age was that of 15–30 years with 29 cases. Both ovaries were affected in 4.47% of cases. The study revealed that 79% of OT were benign, and epithelial tumors were more frequent (69% of cases). In this type, serous cystadenoma was most common among benign epithelial tumors (70.45%), and cystadenocarcinoma was most dominant among malignant epithelial tumors (80%). Mature teratoma represented 85.71% of germ cell tumors in our series, and fibrothecoma represented 55.55% of sex cord-stromal tumors cases. The latter predominated in older patients (46–60 years.

C o n c l u s i o n .  The authors recommend to broaden this study over several hospital structures with the inclusion of other parameters for a better understanding and determining the criteria of this disease.

I n t r o d u c t i o n .  Low-intensity pulsed electric stimulation of the affected joints activates microcirculation and trophism, release of opioid neuropeptides into the vascular bed, which determines the use of transcutaneous electric nerve stimulation as an effective and low-cost method for the rehabilitation of occupational knee osteoarthritis.

A i m .  To study the state of the arteries of the lower extremities in patients with occupational knee osteoarthritis (OKO) and substantiate the use of dynamic electric nerve stimulation (DENS) for the correction of microcirculatory disorders.

M a t e r i a l s   a n d   m e t h o d s .  The study included 55 men with occupational OKO (mean age 49.3 ± 3.6 years, mean work experience 22.3 ± 3.6 years) – the main group. The control group consisted of 20 apparently healthy men working in allowable job conditions. Doppler ultrasound of vessels of the lower extremities and laser Doppler flowmetry were performed. To assess the non-drug correction of microcirculatory changes, the patients of the main group were randomized into two groups: the 1st group (35 individuals) received a conventional treatment in combination with DENS for 14 days. Patients of the 2nd group (20 individuals) received only conventional therapy.

R e s u l t s .  Doppler ultrasound for the posterior tibial arteries in patients with OKO showed an increase in the systolic-diastolic ratio by 11.48% from the baseline values, the resistivity index – by 6.9%, the pulsatility index – by 8.8%, and an increase in intima-media thickness by 1.46 times as well. In patients with OKO, a decrease in the microcirculation indicator by 1.3 times was revealed, relative to the indicators of the control group; the amplitude of vasomotor (Av) and pulsatile (Ap) oscillations – by 1.6 and 2.4 times, respectively. When performing the breath-holding and occlusion tests in patients with OKO and the control group, an increase in capillary blood flow reserve (CBFR) by 1.2 and 1.3 times, respectively, was revealed; as well as the biological zero values – by 1.4 times and a decrease in the half time of blood flow recovery – by 1.2 times. In patients after treatment with DENS, the microcirculation indicator increased by 1.2 times compared to the baseline values, the amplitudes of slow Av and Ap oscillations increased by 1.2 and 1.9 times, respectively, BFR in the breath-holding test decreased by 1.3 times, and in the occlusion test increased by 1.16 times, which was not observed in the 2nd group.

C o n c l u s i o n .  In patients with OKO, the significant remodeling of the popliteal and posterior tibial arteries, impaired microcirculation processes with a simultaneous decrease in the vascular reactivity and congestion in venous microvessels are revealed. Optimization of the comprehensive treatment of knee osteoarthritis by low-intensity pulsed electric stimulation has a positive effect on microcirculation, contributing to an increase in tissue perfusion and a decrease in venular congestion.

I n t r o d u c t i o n .  Currently, a new pharmacological technology of thrombolytic therapy using immobilized subtilisins (ISs) has been introduced into clinical practice. Experimental and clinical studies have shown the high efficacy and safety of the treatment of thrombotic diseases using the drug Thrombovasim®, created on the basis of ISs. Although this drug has been widely studied as a thrombolytic, its pluripotent pharmacological properties have not been studied in detail.

A i m .  To study the performance of an isolated rat heart under the coronary perfusion with ISs.

M a t e r i a l s   a n d   m e t h o d s .   The Langendorff’s perfused heart model was used in the study. The experiment included 50 Wistar rats. Animals were divided into 5 groups (10 animals each): group 1 – control (hearts perfused with Krebs-Henseleit solution) and 4 experimental groups – hearts perfused with ISs at 4 concentrations of 170, 340, 510 and 1020 IU/l respectively. The performance indicator of an isolated heart was assessed, reflecting the actual work of the heart muscle and expressed as the product of the heart rate and the strength of its contractions in the form of the pressure developed by the left ventricle.

R e s u l t s .  No negative ISs effect on the performance of the isolated rat heart was found. A tendency to increase the performance in the first 5 minutes of using ISs was revealed. The achievement of the maximum and the duration of this effect depend on the ISs contents in perfusate. At a concentration of 170 IU/l, an obvious increase in the effect is found from the 10th minute, at higher concentrations – from the 5th minute. The duration of the increasing performance effect when using doses of 170–510 IU/l is maintained up to the 20th minute, when using ISs at a dose of 1020 IU/l – up to the 30th minute. The return of the performance indicators to the baseline values is observed at the 30th minute, at a dose of 340 IU/l – at the 40th minute. When perfused with a solution of ISs at concentrations of 510 and 1020 IU/l, by the 40th minute, the effect of increasing performance weakens, but the parameters still remain at higher levels as compaired to those at baseline.

C o n c l u s i o n .  The experimental data obtained show that ISs increase the performance of the heart. This circumstance will allow expanding the use of the drug Thrombovasim® in a catastrophe of the coronary circulation.

I n t r o d u c t i o n .  Recent studies have shown that in tumor cells of various types of malignant neoplasms, in carriers of the heterozygous variant rs1042522 of the TP53 gene, most of the point mutations are detected in the G allele of the gene, while the C allele was lacking as a result of loss heterozygosity (LH). At the same time, the association of the G allele of the rs1042522 gene with a decrease in the effectiveness of therapy in patients with malignant neoplasms was described. Previously, the study of rs1042522 on samples of patients with lymphomas was carried out only in healthy tissues; in the tumor tissue of diffuse large B-cell lymphoma (DLBCL), this single nucleotide polymorphism was not studied. Given the propensity of B-lymphocytes to p53-mediated apoptosis, the study of the rs1042522 genotype in combination with somatic aberrations, such as mutations or LH of the TP53 gene in the tumor tissue of DLBCL is of particular interest.

A i m .  To describe the frequency of occurrence of somatic mutations and LH in the TP53 gene depending on the rs1042522 genotype in the tumor tissue of patients with DLBCL.

M a t e r i a l s   a n d   m e t h o d s .  The study included 150 patients with a diagnosis of DLBCL confirmed histologically and immunohistochemically. DNA was isolated from paraffinized blocks of tumor lymph nodes and extranodal lesions by phenol-chloroform extraction using guanidine. Genotyping according to rs1042522 and detection of cases of loss of heterozygosity in the TР53 gene was carried out by PCR with the analysis of polymorphism of the lengths of restriction fragments. Confirmation of LH and the search for mutations in the TP53 gene were carried out by direct Sanger sequencing.

R e s u l t s .  In the study group, almost a third (28.6%) of patients with DLBCL at the stage of tumor diagnosis had genetic anomalies in the structure of the TР53 gene (LH and mutations). The combination of LH and the mutant status of this gene in patients with heterozygous Arg/Pro genotype of the tested polymorphism in the tumor tissue was not revealed. At the same time, it was noted that in a subgroup of 73 samples with a homozygous G/G genotype, mutations were detected in 20 cases (27.3%). In the subgroups of C/C homozygous and G/C heterozygous samples, the mutation was detected only in 1/13 (7.7%) and 4/64 (6.25%) cases, respectively. The significance of differences in the frequency of detection of mutations between G/G homozygous patients and other patients with DLBCL (genotypes C/C+G/C) was p < 0.001, and the probability of detecting mutations in the TР53 gene in carriers of the G/G genotype was more than 5.4 times higher than that in carriers of other genotypes (odds ratio – 5.4, 95% confidence interval – 1.9; 15.4).

C o n c l u s i o n .  In order to increase the probability of identifying of combined detection of LH and mutations in TP53 with different rs1042522 genotypes, it is possible to increase the number of lymphoma samples, as well as the use of high-performance sequencing and methods for searching for allelic imbalance, which will allow registering the loss of heterozygosity in homozygous samples as well. A possible direction for further research may also be the analysis of the clinical significance of the combined detection of the homozygous genotype G/G of the marker and LH or/and somatic mutations in the TP53 gene in the tumor tissue of patients with lymphoma.

I n t r o d u c t i o n .  Nonea rossica Steven is a widespread in Western Siberia herbaceous plant of the Boraginaceae family. It is used in folk medicine as an antimalarial, antibacterial, analgesic, anti-inflammatory and anticoagulant agent, and in this regard, the plant is promising for study with a view to introducing it into practice as an officinal medicine.

A i m .  Phytochemical and morpho-anatomical study of aboveground and underground organs of Nonea rossica Steven.

M a t e r i a l s   a n d   m e t h o d s .  A phytochemical analysis was performed using conventional methods. The anatomical structure of plant organs was reveal using microscopic analysis.

R e s u l t s .  The presence and content of the main groups of biologically active substances was established: the content of flavonoids in the aboveground part in terms of rutin was 0.2%; tannins of the condensable group in aboveground parts of plant – 3.8%, in roots – 0.6%; xanthones in terms of mangiferin in roots – 0.01%, in herb – 0.008%; polysaccharides in herb – 4.37%. Microscopic analysis allowed to establish the main microdiagnostic signs of vegetative and reproductive organs of Nonea rossica Steven.

C o n c l u s i o n .  The diverse chemical composition of Nonea rossica Steven allows us to conclude that it is promising to study the plant in order to create new medicines based on it. As a result of micromorphological examination of the aboveground and underground organs of Nonea rossica Steven, it was possible to identify diagnostic signs for the identification of raw materials, which will become the basis for the draft of a monograph.

I n t r o d u c t i o n .  Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-dependent side effect of anticancer therapy that affects the patient’s quality of life. Currently, the problem of effective and reliable diagnostics for CIPN remains unresolved. Therefore, it is critically important to develop recommendations for a comprehensive assessment of peripheral neuropathy based on simple tests for vibration, tactile, pain sensitivity together with questionnaires.

A i m .  A prospective comprehensive assessment of the incidence and severity of CIPN using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) and the Patient Neurotoxicity Questionnaire (PNQ) in patients with breast cancer treated with taxanes.

M a t e r i a l s   a n d   m e t h o d s .  Symptoms of CIPN were prospectively assessed in 60 patients using the PNQ, the NCI-CTCAE and the Eastern Cooperative Oncology Group (ECOG) Performance Status scores at baseline, 1 week after and 13 weeks after the start of chemotherapy.

R e s u l t s .  The CIPN scores according to the PNQ were widely distributed among patients compared to the NCI-CTCAE scores for both sensory and motor neuropathy. There was a marked increase in symptoms of motor neuropathy in patients who were identified only on the basis of PNQ data. The PNQ was used to formally assess the impact of neuropathy on the patient’s activities of daily living.

C o n c l u s i o n .  A comprehensive methodology based on a neurological examination together with the NCI-CTCAE and the PNQ will allow a more detailed assessment of the severity of СIPN, and in the future will provide an opportunity to develop a more effective patient management plan. The PNQ has shown itself to be a more sensitive tool compared to the NCI-STCAE, especially in  assessing sensory neuropathy. Thus, it is reasonable to include patient-reported data in the evaluation of СIPN in order to provide a more accurate identification of the frequency and severity of neuropathy.

I n t r o d u c t i o n .  Bacterial vaginosis (BV), being one of the most common diseases of the female genital organs, is still of interest to a practitioner. In modern conditions, requiring a short time to make a diagnosis and start treatment, it is often necessary to prescribe treatment empirically. Given the variety of regimens for the treatment of BV, it is advisable to identify the most effective for empirical therapy.

A i m .  To determine the most effective treatment regimen for BV among those common in the Russian Federation.

M a t e r i a l s   a n d   m e t h o d s .  The study involved 120 women aged 18 to 45 years who met the inclusion criteria: applying to the antenatal clinic with complaints of abnormal vaginal discharge, the presence of BV, confirmed by the Amsel criteria at the initial admission. The follow-up was carried out during 4 consecutive visits. At the first visit, a clinical investigation was carried out: sampling for bacterioscopic and bacteriological studies, pH-metry of the posterior vaginal vault secretion, the amine whiff test, sampling for the Femoflor 16 real-time polymerase chain reaction (RT-PCR). At the second visit, all women were divided into 4 representative groups depending on the treatment regimen (group 1: metronidazole (gel) + Lactogynal (vaginal capsules); group 2: clindamycin (cream) + Lactogynal; group 3: chlorhexidine gluconate (vaginal tablets) + Lactogynal; group 4: Elzhina (vaginal tablets) + Lactogynal). At the third visit, on the 7th day of treatment, the intermediate efficacy of the studied regimens was evaluated, and side effects were identified. The fourth visit was scheduled 10–14 days after the end of treatment, during which the final result of treatment and treatment complications were assessed.

R e s u l t s .  There were no significant differences in the studied groups in terms of the presence of complaints of vaginal abnormal discharge, the results of bacterioscopic examination, a positive amine whiff test, and the pH level (p > 0.05). In using the Femoflor-16 RT-PCR, normal state of vaginal biocenosis was determined in 26.67% of patients of each group (p = 1.0), moderate anaerobic dysbiosis – in 33.33% (p = 1.0), severe anaerobic dysbiosis – from 33.33% (in group 4) to 40% (in groups 1–3) (p > 0.05). The most effective was the treatment regimen with the use of Elzhina, its effectiveness was 80%. Also, according to the results of the Femoflor RT-PCR, the drug Elzhina showed the highest efficacy– 96.67%.

C o n c l u s i o n .  The most effective was the treatment regimen with the use of a combined drug with antibacterial, antiprotozoal, antifungal and anti-inflammatory action for topical administration – Elzhina. This drug is highly effective and can be recommended as an empirical treatment for BV.

I n t r o d u c t i o n .  Patients with stable coronary artery disease (CAD) and intermediate coronary artery stenosis are of great interest because, despite the absence of obstructive coronary artery lesion, the risk of cardiovascular complications is very high and is conditioned by a number of concomitant factors.

A i m .  Study of cardiovascular risk factors and assessment of clinical and angiographic picture in stable CAD patients with intermediate coronary artery stenosis of various clinical phenotypes.

M a t e r i a l s   a n d   m e t h o d s .  236 stable angina pectoris class I–III patients (190 men, 46 women, age 49–59 years) with intermediate (40–70%) coronary artery stenosis were examined. All patients underwent general clinical examination, ultrasound of the heart and coronary angiography. Based on the cardio-ankle vascular index (CAVI) values, the chronological age/biological age coefficient was determined. The study design is a comparative non-randomized descriptive study of four parallel groups.

R e s u l t s .  The prevailing phenotypes in CAD patients with intermediate (40–70%) coronary artery stenosis in a random sample turned out to be those with: CAD without a previous myocardial infarction (MI); CAD with MI > 6 months ago; CAD with metabolically unhealthy obesity (MUO) phenotype without diabetes mellitus (DM) and, finally, CAD with type 2 DM. In CAD patients with MUO and type 2 DM, the frequency of previous MI did not significantly differ. In addition, patients with CAD and MUO, who had previously had MI, differed in the earliest age of its onset. Despite the 100% presence of arterial hypertension (AH) in different phenotypes groups, CAD and type 2 DM patients had the highest values of the left ventricular mass index. They also had the most frequently recorded multivessel lesion during coronary angiography. Despite the ongoing outpatient year-long treatment, the values of lipid and inflammatory parameters (low-density lipoprotein cholesterol (LDL-C), triglycerides, C-reactive protein) were high, so, only in few patients the target values of LDL-C were reached; besides a large number of patients with insufficient blood pressure control were revealed. In more than half of the surveyed, the biological age prevailed over the chronological age.

C o n c l u s i o n .  Stable angina patients with intermediate coronary artery stenosis represent a rather serious group in terms of prognosis. Despite the absence of vascular obstructive lesions, the risk of cardiovascular complications is conditioned by almost 100% presence of hypertension, high body mass index values, a significant frequency of obesity, dyslipidemia, carbohydrate metabolism disorders, and high biological age.

Despite the fact that more than 70% of hereditary diseases can be considered rare, their prevalence in the population is 2%. Pompe disease (glycogen storage disease type II, glycogenosis type II) is a rare genetic disease that is accompanied with a damage to muscle cells and nerve fibers due to the accumulation of glycogen in them. The latter is due to a deficiency of the acid alpha-glucosidase enzyme. The relevance of Pompe disease is due to her rarity and the set of nonspecific symptoms, as well as the fact that it can manifest at any age. Depending on the onset, early infantile and late adult forms are distinguished. The early infantile form of Pompe disease manifests itself from the first months of life, the clinic includes generalized muscle weakness, frequent respiratory infections, macroglossia, hepato- and cardiomegaly.

The article describes a case of infantile Pompe disease in a child of the first year of life, which shows that without the results of specific tests, including genetic ones, the diagnosis will not be verified, and the way to a reasonable assignment of such tests often turns out to be long. A pediatrician, as well as subspecialist physicians, should be wary of infants with unusual combinations of symptoms, multiple organ lesions, since it is extremely important to transfer such a child for a consultation with a geneticist in a timely manner. Such actions will help not only save lives, but also preserve the quality of life of these patients. Due to the complexity of diagnosis, today it is promising to include Pompe disease in the list of diseases for newborn screening. In this case, the treatment will be preventive and will not allow the symptoms of the disease to develop. Preventive therapy will allow not only reduce the risk of fatal outcome in Pompe disease, but also significantly decrease the percentage of disability.