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 with primary skin involvement. The diagnosis of CTCL is often challenging because, in the early stages, malignant lymphoma can have clinical and morphological features that are similar to benign dermatological conditions such as chronic eczematous dermatitis, psoriasis, pityriasis rubra pilaris, or fungal skin infections. Additionally, unlike B-cell non-Hodgkin’s lymphomas, T-cell tumor proliferation often lacks specifi c immunophenotypic markers, characteristic chromosomal aberrations and tends to be polyclonal, which signifi cantly complicates the use of immunohistochemical and molecular genetic methods in diff erential diagnosis. However, both genetic and epigenetic factors, microRNAs (miRNAs) in particular, are involved in the pathogenesis of CTCL.

A i m . To identify a specifi c miRNA profi le of the tumor substrate that can diff erentiate CTCL from benign skin lesions and determine their role in the pathogenetic mechanisms of disease development. Materials and methods. Using real-time reverse transcription polymerase chain reaction levels of expression of miRNAs-126, -145, -125b, -203a, -99, -23a, -146a, and let-7g were analyzed in 10 formalin-fi xed paraffi nembedded skin biopsy samples from patients with CTCL, 10 skin biopsy samples from patients with psoriasis, and 20 skin biopsy samples from patients with eczema.

R e s u l t s . Comparative analysis of miRNA expression levels between CTCL and benign skin samples showed a statistically signifi cant decrease in the miRNA-203a expression and an increase in the miRNA-146a and let-7g expression in tumor samples (p < 0,05). ROC analysis demonstrated that the let-7g level and the composite biomarker, i.e. the ratio of miRNA-203a/miRNA-146a, are the highly sensitive and specifi c markers for CTCL diagnosis.

C o n c l u s i o n . The analysis of miRNA expression levels serve a promising tool for the diff erential diagnosis of dermatotropic T-cell lymphoid hematologic malignancies and non-hematopoietic skin diseases.

I n t r o d u c t i o n. The high prevalence and medical social signifi cance of benign uterine tumors, particularly uterine leiomyoma (UL), with a frequency reaching 70% in the structure of gynecological diseases, requires close attention in terms of the organization and provision of medical care, especially on an outpatient stage.

A i m. Based on the results of a survey of patients with UL and obstetrician- gynecologists of antenatal clinics, to evaluate the eff ectiveness of providing outpatient medical care for this group of patients and identify ways to optimize further work.

M a t e r i a l s a n d m e t h o d s . A survey of patients with LM (n = 100) which sought medical care at antenatal clinics in Yekaterinburg in the period 2023–2024 was conducted using the “Questionnaire on the analysis of satisfaction with the quality of outpatient medical services”, posted on the website of the Ministry of Health of the Russian Federation, as well as 100 obstetrician-gynecologists from antenatal clinics (we used own questionnaire) on the organization and provision of outpatient medical care to women with UL

R e s u l t s . In general, 92% (n = 92) of patients with UL were satisfi ed with the quality of medical care. 72% (n = 72) of patients positively assessed the doctor’s consultation. Half of the patients noted the kindness, politeness and carefulness of the medical staff at the antenatal clinic, while the other half of the patients pointed out the lack of courtesy and carefulness of the staff . Other main problems identifi ed during the survey were the long wait for a doctor’s appointment, delayed start of an appointment, non-adherence to clinical recommendations, and insuffi ciently comfortable conditions at the antenatal clinic. However, the majority of respondents (62% (n = 62)) were satisfi ed with the methods of examination, treatment, and outpatient follow-up. All the obstetrician-gynecologists consider it necessary to increase the availability of ultrasound (US) examinations for gynecological patients; 30% (n = 30) indicated non-adherence to doctor’s prescriptions; 15% (n = 15) of doctors noted diffi culties in interpreting US results due to the heterogeneity of data in examination records.

C o n c l u s i o n. Aspects identifi ed during the study that require improvement (convenience in arranging an obstetrician and gynecologist’s appointment; the start of a doctor’s appointment in a timely manner; convenience of waiting conditions for a doctor’s appointment; kindness and politeness of medical staff ) will help to optimize the delivery of outpatient care to women with UL, which will contribute to a high adherence to follow-up and timely treatment, and, thus, to the maintenance of fertility and improvement of quality of life.

I n t r o d u c t i o n. Biologic therapies have emerged as a signifi cant treatment for the patients with the psoriasis ranging from the moderate to severe infl ammatory condition featured by the silvery scales and erythematous plaques.

A i m. To evaluate the long-term eff ectiveness of various biologic therapies in reducing psoriasis severity; to investigate the impact of biologic therapies on patients’ quality of life (QoL); to analyse the eff ect of demographic and clinical characteristics (age, sex, baseline disease severity, comorbidities, and adherence to therapy) on treatment outcomes.

M a t e r i a l s a n d m e t h o d s . A quantitative methodology research approach was applied, and data were collected from 200 psoriasis patients using a purposive sampling technique with the aid of a structured questionnaire. The quantitative data were analyzed using the SPSS tool version 23 package through performing ANOVA, frequency, and regression analysis.

R e s u l t s. The outcomes of the study revealed that long-term eff ectiveness of biological therapies has signifi cant impact on the psoriasis severity. Furthermore, the biologic therapies improve the QoL of the patients. Ixekizumab had the highest proportion of complete skin clearance (PASI 100) at 24 weeks (60,1%), as compared to adalimumab (46,6%), with statistically signifi cant diff erences found (p < 0,001). Long-term biologic therapy dramatically decreased the severity of psoriasis (ANOVA, p < 0,001) and enhanced the QoL (regression, R² = 0,305, p < 0,001). Older age (β = 0,881, p < 0,001) and male sex (β = 0,225, p = 0,009) were related to more positive treatment experiences, with comorbidities not having a signifi cant association. The demographic and clinical characteristics like age, gender, and therapy adherence positively impacts on the treatment outcomes. On contrary, the existence of other illnesses does not have a signifi cant impact on the overall rating of treatment experience.

C o n c l u s i o n. Biologic treatments – in particular ixekizumab – provide signifi cant and sustained gains in both clinical and QoL outcomes for moderate to severe psoriasis patients. Tailor-made treatment regimens taking clinical and demographic characteristics into consideration can also maximise patient satisfaction and compliance. Overall, the results of the study demonstrate the eff ectiveness of integration of biologic therapies in the management of psoriasis to alleviate the symptoms and thereby improving the QoL of the patients.

I n t r o d u c t i o n. Plants of the Boraginaceae family are insuffi ciently studied. One of its representatives is Brunnera (B.) sibirica Steven, a perennial herbaceous plant that can be found in Western Siberia, is easily introduced into cultivation and has a fairly large biomass. There are no data on the chemical composition of B. sibirica in the literature, but it is known about the use of B. macrophylla (Adams) I.M.Johnst. in traditional medicine as an antibacterial and antimicrobial agent. Considering the principle of phylogenetic affi nity, it can be assumed that B. sibirica has similar properties.

Aim. Phytochemical analysis and detection of microdiagnostic signs of B. sibirica.

Materials and methods. The objects of the study were the leaves, reproductive shoots and rhizomes of B. sibirica harvested in the Novosibirsk region. The total extracts from the raw materials obtained using purifi ed water, water-ethanol mixtures and 2% hydrochloric acid as extractants were used for qualitation and quantitation of the components of the plant raw materials using spectrophotometric and gravimetric methods. The micromorphology of leaves and rhizomes was studied using microscopy.

Results. The main groups of biologically active compounds (BAC) were found in the raw materials and their quantitative content in plant organs was determined. Thus, the largest amount of fl avonoids and hydroxycinnamic acids is extracted from reproductive shoots, leaves are more rich in chlorophyll, and reproductive shoots are more rich in anthocyanins; water-soluble substances (polyfl avan compounds and polysaccharides) are extracted in large amount from rhizomes. Using microscopic analysis of the leave morphology and transversal sections of the rhizomes, signs for identifi cation of the raw materials were established.

Conclusion. The presence of BAC with anti-infl ammatory, bactericidal and regenerating eff ects creates prerequisites for a more detailed study of B. sibirica as a promising source of plant raw materials.

I n t r o d u c t i o n. Heart failure is a clinical syndrome associated with various metabolic disorders, many of which can adversely aff ect the musculoskeletal system. Pro-infl ammatory cytokines, playing an important role in the pathogenesis of chronic heart failure (CHF), can also alter bone metabolism.

A i m. To study the prognostic signifi cance of soluble ST2 as a biomarker of bone mineral density (BMD) decline progression and the risk of osteoporotic fractures in patients with CHF and type 2 diabetes mellitus (T2DM).

M a t e r i a l s  a n d  m e t h o d s. A 12-month prospective, clinically controlled study of 75 women with CHF and T2DM was conducted. Bone tissue characteristics were analyzed taking into account ST2 levels in 3 tertiles. The selective sample of the 1st tertile (n = 25) included patients with a minimum ST2 level of less than 21,3 ng/ml; in the 2nd tertile (n = 25) – patients with an ST2 level of 21,3–32,8 ng/ml; in the 3rd tertile (n = 25) – patients with a ST2 level is over 32,8 ng/ml. ST2 concentration was determined by enzyme immunoassay. BMD was assessed using the densitometric method using dual energy X-ray absorptiometry (DXA).

R e s u l t s. After 12 months, the frequency of the combined endpoint was assessed: a decrease in BMD according to DXA and/or development of osteoporotic fractures. The frequency of adverse events gradually increased from the 1st tertile to the 3rd tertile (p = 0,001). In women with comorbidities having a median ST2 of over 25,3 ng/ml and BMD (according to T-score) of less than –2,5, the highest frequency (52,6%) of adverse osteoporotic events was identifi ed. There was a moderate negative correlation of ST2 levels with BMD (r = –0,48; p = 0,001).

C o n c l u s i o n. Elevated ST2 levels are associated with the progression of BMD loss and the risk of osteoporotic fractures. It seems appropriate and informative to study the serum level of ST2 in women with CHF and T2DM to assess the risk of osteoporotic fractures.

This literature review includes an analysis of data from epidemiological studies, meta-analyses, and scientifi c publications on type 1 DM (T1DM). The results of studies assessing the prevalence and incidence of T1DM in various regions of the world, including Russia, are considered. A widespread increase in these indicators in all age groups over the past 10 years was found. An analysis of data on genetic and environmental risk factors for the development of T1DM, including maternal age, obesity, infections, and vitamin D defi ciency is presented. A classifi cation of T1DM stages is considered, refl ecting the continuum of disease development from the appearance of autoantibodies to clinical symptoms. The emphasis is on the preclinical stages of T1DM and the importance of their early diagnosis for potential prevention and delay of disease progression. The need for an integrated approach to the study of T1DM, taking into account the genetic, environmental, and immunological aspects of the disease, is emphasized. Knowledge of risk factors and stages of development of T1DM allows us to develop strategies for early diagnosis and prevention aimed at delay in the progression of the autoimmune process and development of clinical manifestations of T1DM.

This review presents the available data on possible variants of cutaneous toxicity of antitumor therapy for hematologic malignancies. The existing methods of prevention and treatment of manifestations of dermatological toxicity are described. Cutaneous lesions in patients with hematologic malignancies can be caused by a toxic-allergic reaction, chemotoxicity, and – in case of hematopoietic stem cell transplantation – by immune infl ammation. Adverse skin reactions can occur at diff erent stages of antitumor therapy. Each type of therapy has its own characteristics and manifestations of cutaneous toxicity. At the moment, it is impossible to completely avoid the occurrence of toxic dermatological reactions when using any type of therapy in oncohematology. In this regard, the key factor in improving the tolerance of antitumor treatment is timely adequate prevention and therapy of adverse toxic reactions.

Stroke is a pressing medical problem that causes signifi cant socio-economic losses. Post-stroke cognitive impairment negatively aff ects rehabilitation outcomes, increases the likelihood of recurrent stroke and premature death. In the management of post-stroke cognitive impairment, signifi cant attention is paid to the use of non-invasive physical brain stimulation – audiovisual stimulation, transcranial magnetic stimulation (TMS) and transcranial direct or alternating current electrical stimulation. The mechanism of audiovisual impact on the state of the brain is due to the formation of a dominant rhythm of electrocortical activity, the biological eff ects of weak magnetic fi elds are determined by chemical processes responsible for enzymatic DNA synthesis, which can stimulate processes of neuroplasticity in stroke patients and aff ect the cognitive functions. The most promising in the treatment of post-stroke cognitive impairment are considered to be modern directions of TMS: high-frequency or low-frequency repetitive TMS (rTMS), intermittent theta pulse stimulation, which have demonstrated safety and eff ectiveness. In recent years, in the set of rehabilitation programs for the recovery of poststroke cognitive defi cit multimodal interventions have been widely used, including physical exercises, walking, cognitive and aerobic training.

The data presented in the review indicate that the inclusion of transcranial low- and high-intensity pulsed magnetic fi eld therapy, audiovisual stimulation of brain structures into rehabilitation programs for post-ischemic stroke patients contributes to the improvement of attention, speech, gnosis, delayed memory and orientation, and increases the functional level of the central nervous system.

The historical aspects of the origin and evolution of ideas about fl uid fl ow pathways (prelymphatic pathways) in the interstitium are examined in this review. In the 16th–18th centuries, the hypothesis of communication between the arterial and lymphatic vessels evolved from ideas about the existence of arterial lymphatics (later vasa serosa, juice canals), which are the thinnest vessels, to non-vascular prelymphatic pathways, which include not only tissue channels, but also parafi brillary, para(peri-)vascular and perineural pathways according to advanced studies. The literature also describes pores and nanochannels of the interstitium. This evolution of views occurred due to numerous researches aimed to identify prelymphatic pathways using tracer injections of the lymphatic pathways and interstitium, the implantation of Guyton capsules of various shapes with orifi ces opened into the interstitium and subsequent electron microscopy. These studies showed that interstitial pathways have indirect communication with the vascular bed, and they lack the endothelial lining. This allowed prelymphatic pathways to be considered independent entities that do not relate to either the blood circulatory or lymphatic systems. But historically, they have been called prelymphatic pathways, and they are studied together with the lymphatic system. The paper also concerns another terminological issue about the roots of the lymphatic system to which the vast majority of scientists attribute lymphatic capillaries, but not prelymphatic pathways.

The prevalence of type 1 diabetes mellitus (T1DM) continues to grow, and despite the advances in insulin therapy, the optimal control of T1DM is not achieved yet. Its clinical onset is often associated with diabetic ketoacidosis, which determines a high risk of recurrent events and early development of severe complications, determining the disease burden and necessitating the development of a set of specific arrangements for early detection of preclinical stages of the disease.

On March 20, 2025, a scientific and practical conference “Pediatric and Adolescent Endocrinology: Opportunities, Challenges, and Mistakes” was held in Novosibirsk, which included an Expert Board of pediatric endocrinologists from the Siberian Federal District. The conference focused on scientific advances in the study of T1DM and implementing strategies for its early detection and monitoring in real-life endocrinologic practice. Based on the results of scientific reports and discussions held during the Expert Board meeting, experts decided on the need to implement a socially significant initiative for the timely diagnosis of T1DM before its clinical manifestation in order to prevent its onset with ketoacidosis, which significantly worsens the disease prognosis, and to reduce the risk of complications.