Introduction. Xanthelasma palpebrarum is a marked cosmetic defect and leads to reduced quality of life in patients. Non-selective technologies (for example, radiofrequency exposure and the use of ablative lasers) can lead to scarring, eyelash loss and severe functional disorders of the eye (including incomplete eyelid closure) because of insuffi cient skin thickness.
Aim . To evaluate the eff ectiveness of xanthelasma palpebrarum treatment with copper vapor laser radiation under dermatoscopy control.
Materials and methods. Treatment of grade I–IV xanthelasma palpebrarum was performed in 47 fairskinned women and men aged 28–72 years. The procedures were performed using a copper vapor laser at an average power of 0.6–0.8 W, wavelength 578 nm, exposure time 0.2 s, and spot diameter 1 mm. The maximum discoloring to gray of the xanthelasma surface was the criterion for laser pulse energy selection. The treatment was performed in one session under dermatoscopy control of treatment uniformity.
Results. Treatment with a copper vapor laser allowed complete removal of xanthelasma palpebrarum areas in all patients, including IV degree, without recurrence within 24 months after the treatment.
Conclusion. The use of copper vapor laser radiation at a wavelength of 578 nm provided excellent results for the xanthelasma palpebrarum treatment without side effects. The use of dermatoscopy improved the result of laser application and prevented treatment recurrences.

Introduction. Exposure to heavy metals is an important and underestimated risk factor related to the development of atherosclerosis and its consequences. However, data on hematological changes in atherosclerosis under exposure to heavy metals could not be found in the literature, which was the reason for carrying out this study.

Aim. Study of changes in hematological parameters under chronic exposure to various heavy metals in experimental atherosclerosis.
Material and methods. The experiments were conducted on 110 outbred male albino rats which, after modeling atherosclerosis, were exposed to chronic heavy metals through drinking water for 60 days. The model of atherosclerosis was created according to I.V. Savitsky et al., based on the multifactorial theory of the development of atherosclerosis and its consequences. Cadmium sulfate, nickel nitrate and cobalt nitrate were used as toxicants. The measurement of hematological parameters was carried out using an automatic hematology analyzer.
Results. After intoxication with various heavy metals under conditions of experimental atherosclerosis, an aggravation of changes in hematological parameters, that occurred after modeling atherosclerosis, took place. The increased count of leukocytes, lymphocytes, platelets and erythrocytes in experimental atherosclerosis after chronic intoxication with heavy metals began to decrease, with the exception of the platelet count which continued to increase. The increased level of hemoglobin and mean corpuscular hemoglobin, which occurred in experimental atherosclerosis, continued to decline after intoxication. Maximum disturbances were observed by the 60th day of intoxication, and the most pronounced changes were noted under exposure to cadmium sulfate, then nickel nitrate and cobalt nitrate.
Conclusion. The presence of hematological disorders following the long-term exposure to heavy metals in experimental atherosclerosis necessitates to take these disorders into account in the comprehensive treatment of heavy metal poisoning, especially in older patients with atherosclerotic damage to the vessels. Keywords: experimental atherosclerosis, heavy metals, hematological parameters.

Introduction. The development of gastrointestinal complications of chemoradiotherapy in patients with hematologic malignancies is based on dysbiotic processes characterized by suppression of normal intestinal microfl ora, activation of opportunistic microorganisms, high risk of their translocation to non-specifi c biotopes, and endogenous infection. Another etiological factor in the development of intestinal dysbiosis in patients with hematologic malignancies  is the use of antibacterial therapy (ABT) amid febrile neutropenia. Thus, the relevance of searching for therapeutic and preventive measures to reduce the number of gastrointestinal complications that arise in antitumor treatment is beyond doubt. The solution to this problem is rational ABT and maintenance therapy with probiotics.

Aim. To evaluate the eff ectiveness of probiotics in patients with lymphomas at the onset  of the disease in order to correct dysbiosis and endogenous intoxication (EI).

Material and methods. A total of 40 patients with lymphomas were included in a prospective randomized study. The average age of the patients was 45 (34; 54.5) years. The distribution of patients by gender was as follows: 4 men (10%), 36 women (90%). Among the subjects, patients with stages III and IV of the disease predominated (n = 26, 65%). In order to evaluate the effi  cacy of a probiotic, the patients were randomly divided into 2 groups: 20 people who, in addition to polychemotherapy (PCT), received the probiotic orally in combination with a metabiotic, and 20 patients with lymphomas from the control group who received only conventional therapy. A comprehensive assessment of the state of the intestinal microbiome was performed using  real-time polymerase chain reaction. Statistical data processing was performed using IBM SPSS Statistics 26.0 program.

Results.  At the disease onset, a pronounced defi ciency of the total bacterial load was observed in 7 patients (17.5%), a defi ciency of bifi dobacteria – in 29 patients (72.5%), a decrease in the  lactobacilli count – in 34 (85%) patients.  An imbalance in anaerobic fl ora prevailed in patients with aggressive B-cell lymphomas compared to patients with  indolent  tumor (χ² = 4.1, p = 0.04). The microbiome  with abundance of E. coli was more often diagnosed in patients with  localized tumors compared to those with stages III and IV of the disease (χ² = 4.6, p = 0.03). Clinical manifestations of intestinal dysbiosis at the onset of the disease were characterized by the following symptoms: abdominal pain (n = 4, 10%), fl atulence (n = 6, 15%), a feeling of incomplete evacuation (n = 2, 5%), diarrhea (n = 8, 20%). In patients receiving probiotics as maintenance therapy, the count of Bifi dobacterium spp. (p = 0.000005), Lactobaccilus spp. (p = 0.00007) and Faecalibacterium prausnitzii (p = 0.003) was signifi cantly higher compared to the results of patients who received only standard courses of polychemotherapy. Comparative assessment of median concentrations of biochemical parameters demonstrated that in patients receiving the probiotic, the concentration of lactate dehydrogenase (p = 0.000001) and C-reactive protein (p = 0.04) was signifi cantly lower compared to the control group who did not receive pro- and metabiotics. More  pronounced leukocytosis (p = 0.0005) and accelerated erythrocyte sedimentation (p = 0.002) were noted in patients from the control group. At the same time, it was found that in the group of patients who received the probiotic before the start of antitumor treatment, nausea (χ² = 10.9, p = 0.0009), fl atulence (χ² = 4.3, p = 0.03), and diarrhea (χ² = 4.2, p = 0.04) associated with chemotherapy were signifi cantly less common.

Conclusion. Intestinal dysbiosis in patients with hematologic malignancies has a multifactorial nature, caused by destructive processes in the body due to growth and spread of tumor, disorder of the functional state of various organs, empiric antibacterial therapy and the administration of high doses of cytostatic drugs. The use of probiotics as part of combined therapy for patients with lymphomas will signifi cantly reduce the severity of intestinal dysbiosis and improve  polychemotherapy results.

Introduction. The cervical spine has a high mobility and is prone to the development of degenerative and dystrophic changes (DDCH). Expanding the range of clinical diagnostic capabilities requires the active development of algorithms for specialized information analysis tools. Data on individual variability of the skeleton are in demand when planning minimal invasive surgical interventions. The comparison of such information with clinical practice data has become an important task for researchers. The study of anatomical variability is relevant in the search for more effective ways of performing neurosurgical interventions.
Aim. A comparative analysis of transverse dimensions of the cervical vertebral bodies and transverse foramina in relation to the course of the vertebral arteries (VA) and manifestations of spinal DDCH.
M a t e r i a l s  a n d  m e t h o d s . A total of 214 magnetic resonance images were studied. The transverse size (width) of the cervical vertebral bodies and the average transverse size (width) of the transverse foramina (the distance between the medial and lateral walls of the transverse foramina) were determined. To assess the proportionality of the relationship between the abovementioned parameters, the average ratio of the transverse foramen width to the width of the body of the corresponding vertebra was calculated. Considering the DDCH of the cervical spine and the course of VA, 4 groups were identified: 1st group – without signs of DDCH and indirect VA (n = 20); 2nd group – without signs of DDCH and direct VA (n = 89); 3rd group – with signs of DDCH and indirect VA (n = 49); 4th group – with signs of DDCH and direct VA (n = 56).
Results. The width of the transverse foramina of the C4–C6 vertebrae differed by 0.29–0.78 mm when comparing the 1st and 2nd groups, by 0.24–0.58 mm when comparing the 1st and 3rd groups (foramina on the left side were wider). The width of the C3, C6, C7 vertebral bodies when comparing the 1st and 4th groups diff ered by 0.8–1.2 mm; at the level of C3, C7 when comparing the 2nd and 3rd groups – by 0.35–0.53 mm. The mean values of the transverse foramina width/vertebral body width ratio in all groups ranged from 0.2 to 0.29. Signifi cant differences were found for the C4–C6 vertebrae when comparing the 1st and 2nd groups; for the C4, C6 vertebrae – the 1st and 3rd groups; for the C5, C6 vertebrae – the 1st and 4th groups.
C o n c l u s i o n . In the diagnosis of spinal DDCH and the diff erent course of VA, significant differences were found for the vertebral body width at the level of C6, C7. No significant differences were noted for the vertebral body width in groups differing only in the course of VA. In the absence of DDCH, diff erences were revealed for the transverse foramina width of the C4–C6 vertebrae and the ratio of the width of transverse foramina to vertebral body width. With the direct course of the vessels, there were no statistically significant differences associated with the detection of DDCH for the vertebrae and transverse foramina.

I n t r o d u c t i o n . Currently, immunological research is one of the priorities in the field of tuberculosis, since the effectiveness of treatment and, consequently, the outcome of the disease in most cases are determined by the immune and genetic characteristics of the macroorganism.

A i m . To study the dynamics of cytokines (IL-6, IL-8, IL-4, IL-10, TNF-α, IFN-γ) in patients with  pulmonary disseminated tuberculosis (DST) and fi brous-cavernous tuberculosis (FCT)  after 2 months of specific chemotherapy.

M a t e r i a l s a n d m e t h o d s . The study group consisted of 100 patients with pulmonary tuberculosis (DST – 48 people, FCT – 52 people) aged 40 to 69 years who received specific chemotherapy in the intensive phase.  The concentration of  cytokines (IL-6, IL-8, IL-4, IL-10, TNF-α, IFN-γ) was determined at baseline and after 2 months of chemotherapy, as well as  the cytokine balance (IL-6 + IL-8/IL-4 + IL-10) at baseline and after 2 weeks of chemotherapy. R e s u l t s . After 2 months of chemotherapy, patients with DST showed a signifi cant decrease in the level of IFN-γ, TNF-α, IL-6, IL-10, and the level of IL-8 tended to increase, however, this dynamic was not statistically significant; in patients with FCT, there was a significant decrease in the level of IFN-γ, IL-8, IL-6, as well as IL-4 – from 5.6 to 5.11 pg/ml, TNF-α – from 3.6 to 3.1 pg/ml, however, this trend was not statistically significant. The cytokine balance values tended to decrease: in patients with DST – from 7.7 to 7.48, and in patients with FCT – from 7.69 to 4.97.

C o n c l u s i o n . The cytokine system plays an important role in the regulation of infl ammatory processes in patients with DST and FCT of lungs.

In t r o d u c t i o n . The extreme physical exertion in athletes is a powerful stress factor for the organism and causes an increase in the level of stress hormones, vasoconstriction thus resulting in the microcirculation system disorders, which are largely infl uenced by erythrocytes. In turn, the movement of erythrocytes through the microcirculatory bed is determined by the state of the physicochemical properties of their membrane depending on the type of lipid phase fatty acids. At the same time, it has been shown that professional athletes have a defi ciency of omega-3 polyunsaturated fatty acids (n-3 PUFAs). The content of n-3 PUFAs in fi sh oil (FO) determines its use in practice of sports medicine. At the same time, the eff ectiveness of FO and its ozonated form on the state and functioning of erythrocytes under conditions of temporary homeostasis imbalance due to the extreme physical exertion remains unclear.

A i m . Study of the eff ect of FO and ozonated FO (OFO) on the functional indices of erythrocytes in rats under the extreme physical exertion.

Ma t e r i a l s a n d m e t h o d s . The eff ect of FO and OFO on metabolic and oxidative indices of erythrocytes, erythrocyte electrophoretic mobility (EEM) and their aggregation during modeling of physical activity in rats was studied. Extreme physical exertion in animals was modeled with forced swimming with a load equal to 10% of their body weight. The weight-loaded forced swimming (stress) test was performed 4 times; during the post-exertion recovery, the rats received FO, OFO (with an ozonide number of 3000 or 1500 – OFO-3000 and OFO-1500, respectively) depending on the group. The animals were tested 6 times: parameters were determined at baseline, after the stress test (4 times) and after substance withdrawal (on the 3rd day). The concentration of malondialdehyde (MDA), adenosine triphosphate (ATP), 2,3-diphosphoglycerate (DPG), EEM and erythrocyte aggregation was measured.

R e s u l t s . The extreme physical exertion (control group) caused an increase in the MDA concentration, a decrease in EEM and the concentration of ATP and 2,3-DPG in erythrocytes, which was accompanied by an increase in erythrocyte aggregation. The administration of FO during physical exertion determined less pronounced lipid peroxidation, while the administration of OFO-3000 determined induced the most pronounced lipid peroxidation compared to the control group. The lowest oxidative eff ect during physical exertion was recorded with the administration of OFO-1500. A decrease in lipid peroxidation was accompanied by an increase in the ATP concentration, a decrease in 2,3-DPG, an increase in EEM and a decrease in erythrocyte aggregation.

Co n c l u s i o n . The use of OFO-1500 most eff ectively eliminated the processes in rat erythrocytes induced by stress caused by extreme physical exertion.

I n t r o d u c t i o n . Lambda interferons (IFN-λ), known as type III interferons (type III IFN), demonstrate significant prospects in the field of antivirus defense. IFN-λ are similar in their antiviral activity to type I IFN, but have unique mechanisms of induction and functioning because of the specific location of their receptors. Type I receptors are expressed in most nucleated cells, IFN-λ receptors (IFN-λR1 or IL-28Rα) are mainly found in epithelial cells. IFN-λ are considered as the first line of defense against microbial attacks, therefore, the development of IFN-λ-based drugs seems very promising. A prototype of an IFN-λ-based drug for enteral administration, PEGylated (polyethylene glycol) using electron beam synthesis technology, has already been developed.

A i m . To study the common toxic properties of the  intragastrically administered IFN-λ1-based drug in experiments in vivo.

M a t e r i a l s a n d m e t h o d s .  The IFN-λ1-based drug was administered daily intragastrically at doses of 2.6, 13.0 and 26.0 μg/kg (1 therapeutic dose (TD), 5 TD and 10 TD, respectively) to rats and 2.6 and 13.0 μg/kg (1 TD and 5 TD) to rabbits once a day for 180 days. The doses of the drug were calculated for each animal individually, based on body weight. Rabbits were followed-up during the drug administration (180 days), and rats – additionally for 30 days after the end of administration (210 days). In animals, vital signs, behavioral reactions, laboratory parameters of cellular and biochemical composition of blood, electrocardiography data, hematopoiesis parameters, pathomorphological signs were assessed.

R e s u l t s . No deaths were observed during the study. The animals showed a stable state of health, the absence of visible changes in an appetite, appearance, and behavior. During a pathomorphological examination, no abnormalities were found that could indicate a negative effect of the substance. A significant decrease in the mass and mass coefficient of the thymus and spleen was revealed in rats receiving the drug at a dose of 26.0 μg/kg after 180 days of administration compared with the corresponding control.  The thymus and spleen mass and the mass coefficient of the thymus and spleen normalized 30 days after drug withdrawal in all groups, where abnormalities were observed. A microscopic examination of the internal organs of rats receiving the highest dose of  the IFN-λ1-based drug (26.0 μg/kg) for 180 days revealed specific changes in the thymus and spleen, while analysis of the thymus and spleen in rats receiving a lower dose of  the drug (13.0 μg/kg) did not reveal similar pathological changes. This indicates the possibility of dose-dependent toxic effect of the drug. 30 days after the IFN-λ1-based drug withdrawal, the mass and mass coefficient of the thymus and spleen of rats receiving the highest dose of the drug returned to the reference values and did not differ from the corresponding control. Both in rats and rabbits, the indicators of body weight gain, peripheral blood and bone marrow, biochemical parameters of the blood serum in both males and females in the experimental and control groups did not differ significantly throughout the study. The pathomorphological examination found no changes in such crucial organs as the brain, heart, lungs, liver, etc., which indicates the absence of negative effect of the drug on the health and condition of the tissues of rabbits.

C o n c l u s i o n . Based on in vivo experiments to study the common  toxic properties of IFN-λ1-based drug in the intragastric route of administration, it can be argued that the drug belongs to the 4th hazard  class (GOST 12.1.007-76). 

I n t r o d u c t i o n . In Russia, as of 2021, 5 million 168.8 thousand patients with diabetes mellitus (DM) were registered. Ophthalmologic late complications of DM (cataract, retinopathy, glaucoma) lead to a progressive decline in vision up to blindness, and, consequently, to a decrease in the quality of life of patients with DM. Prevention of DM complications is directly related to glycemiс control, which is not always possible, therefore, the search for new pharmacological agents for correction of the consequences of DM is an urgent task. In previous studies, among melatonin isosteres, the compound K-165 was synthesized, which has ophthalmic hypotensive properties.

A i m . To study the eff ect of a new melatonin bioisostere, a 3-arylidene-2-oxindole derivative, on diabetic cataractogenesis, intraocular pressure (IOP), retinal microcirculation and functional activity of the retina in streptozotocin-induced DM.

M a t e r i a l s a n d m e t h o d s . DM was modeled by administering streptozotocin (45 mg/kg, DM group) into the tail vein of male Sprague Dawley rats weighing 260–280 g. Throughout the experiment, for 60 days, to reduce the risk of death from ketoacidosis, the experimental animals subcutaneously received biphasic insulin, Humulin M3 (Eli Lilly, France). Since the 61st day of the experiment, the animals were instilled 0.4% solutions of K-165 and melatonin (experimental group and reference drug group). During the experiment, intravital measurements of IOP, ocular microcirculation level and electroretinography were carried out to evaluate the effectiveness of the studied compound. After euthanasia of the animals, the enucleated eyeballs were used for pathomorphological examination and determination of advanced glycation end products and carboxymethyllysine in the lens structures.

R e s u l t s . The compound K-165 in streptozotocin-induced DM reduces the severity of pathomorphological signs of cataract by 32% (defragmentation, swelling in lens fibers, appearance of Morgagni globules) and the level of IOP by 24%, increases the level of ocular blood microperfusion by 37.5% and shows a tendency to increase the combined response of rods and cones.

C o n c l u s i o n . A new derivative of 3-arylidene-2-oxindole, the compound K-165, exhibits a pronounced anti-cataract effect, reduces the level of IOP in animals with experimental DM, improves microcirculation parameters and demonstrates a tendency to normalize the bioelectrical activity of the retina, and has a neuroprotective eff ect on the retina.

I n t r o d u c t i o n . Primary cutaneous T cell lymphomas (CTCL) are a heterogeneous group of extranodal nonHodgkin’s lymphomas that are locally limited to the skin at diagnosis. The diagnosis of CTCL is often diffi  cult, since at certain stages of development, this hematological malignancy has clinical similarities with non-neoplastic dermatological diseases such as chronic eczematous dermatitis, psoriasis, lichen ruber, or fungal infections. Both genetic and epigenetic factors, in particular microRNAs (miRNAs), are involved in the pathogenesis of CTCL.

A i m . To identify the miRNAs that diff erentiate CTCL from benign skin lesions (BSL) and determine their role in genetic pathways involved in the development of CTCL.

M a t e r i a l s a n d m e t h o d s . Real-time reverse transcription PCR was used to analyze the expression levels of miRNA-181a, -155, -574, -148b, -191, -26a, -21, -124, -221, -200b, -20a, -92a, -145, let-7a, and let-7d in 5 formalin-fi xed paraffi  n-embedded skin biopsy samples from patients with CTCL and 20 skin biopsy samples from patients with psoriasis (control group).

R e s u l t s . Comparative analysis of miRNA expression levels between CTCL and BSL samples showed a statistically signifi cant increase in the levels of miRNA-181a, -155, -574, -148b and -191 in tumor samples (p < 0.05). ROC analysis showed that miRNA-155 and miRNA-181a are highly sensitive and specifi c markers for the diagnosis of CTCL.

C o n c l u s i o n . Analysis of miRNA expression levels may be a promising tool for the diff erential diagnosis between dermatotropic lymphoid hematological malignancies and non-hematological skin diseases. 

I n t r o d u c t i o n . Infertility in women is being a difficult social and medical problem for resolving, especially in the case of a chronic endometritis diagnosis with a variant of so called “thin” endometrium.

A i m . To study the clinical and morphological features of the endometrium in infertility in women referred for in vitro fertilization (IVF).

Ma t e r i a l s a n d m e t h o d s . The clinical data and results of immunohistochemical examination of the endometrium were studied in 181 women aged 30 [22; 38] years who were referred for IVF and gave birth. The causes of reproductive dysfunction were thin endometrium (group 1, 64 patients), fallopian tube obstruction (group 2, 55 women) and male factor infertility (group 3, 62 cases). The examination of patients included ultrasound imaging. In Pipelle biopsies of the endometrium before the IVF procedure, the number of pinopodia in the epithelium was assessed, the expression of HLA-DR and estrogen and progesterone receptors (ERs and PRs, respectively) was measured using immunohistochemistry. Nonparametric statistical tests were used.

R e s u l t s . In women with infertility referred for IVF, a low percentage of endometrial pinopodia in the epithelium was detected in the secretory phase of the cycle. The lowest expression rates of HLA-DR, ERs and PRs were found in the endometrium of patients with tubal obstruction. At the same time, patients with thin endometrium had relatively high expression rates of ERs and PRs in the epithelium. The expression of ERs and PRs in endometrial stromal cells did not have statistically significant differences in pairwise comparisons.

Сo n c l u s i o n . In patients with thin endometrium, the formation of pinopodia has a high diagnostic significance for the receptive status confirmed by the ERA test, and does not depend on the PRs expression in the epithelium and stroma

I n t r o d u c t i o n . Right ventricular (RV) thrombosis is a rare life-threatening complication of right heart failure developing amid venous thromboembolic complications and severe lower respiratory tract infections.

A i m . Exchange of experiences in the diagnosis and treatment of patients with RV thrombosis associated with severe pneumonia.

M a t e r i a l s a n d m e t h o d s . We studied a history of the inpatient and the archive of medical records, including the results of lab tests, functional diagnostics and radiologic imaging.

R e s u l t s . The article presents a case report of a 19-year-old female patient, in whom the clinical picture of acute right heart failure and RV thrombosis occurred amid severe pneumonia.

C o n c l u s i o n . Timely diagnosis and treatment of acute right heart failure, pulmonary thromboembolism, and RV thrombosis can improve outcomes and reduce mortality in patients with severe pneumonia.