The aim of the study is to assess the current state of the incidence of thrombosis of arteriovenous fistulas in the early and late postoperative period in patients receiving hemodialysis according to the literature. Material and methods. The scientific literature is studied using the PubMed, MEDLINE and Medscape databases, with a search depth of 8 years to identify all published reports of thrombosis of arteriovenous fistulas in Russian and English. The 112 modern publications were identified, of which 28 were included in the analysis (they describe 7 prospective and 23 retrospective studies). Results. Thrombosis of arteriovenous fistulas remains an unresolved problem in the surgery of vascular access and is the most frequent complication of the fistula failure. The frequency of thrombosis of fistulas ranges from 1.7 % to 56.1 %.

The aim of the study is to give an objective assessment of the possibilities for detection and staging lung cancer without contrast magnetic resonance imaging of the chest organs in comparison with the X-ray computed tomography method. Material and methods. The study included 204 patients with lung cancer who underwent contrast-free (according to medical contraindications) X-ray computed tomography on the low-dose scanner Hitachi Pronto and 42 patients diagnosed with lung cancer who underwent magnetic resonance imaging of the chest organs. Results. The possibilities of magnetic resonance tomography in the diagnosis and staging of lung cancer in comparison with the contrast-free X-ray computed tomography are presented.

The aim of the study is to develop and estimate the efficiency of the new surgical treatment of venous trophic ulcer with afferent vein excision combined with other remedial procedures. Material and methods. The 114 cases of patients with venous ulcer aged from 20 to 75 years are analyzed. All patients received different combined remedial procedures. Results. The surgical treatment of venous trophic ulcer with afferent vein excision combined with other remedial procedures is proposed. This method was used on the main group of patients (88 people). The control group (26 patients) received other treatment. Obtained results show high efficiency of the proposed surgical treatment. The ulcer recurrence during observation for 5 years is present in 2.3 % of cases (the main group) and in 19.2 % (the control group). Application of the new surgical treatment of venous ulcer favors healing process
and reduces ulcer recurrence.

The aim of the study is to carry out the analysis of the clinical course for the first time revealed stomach ulcers in patients after situational alcohol intake affected by the action of ulcerogenesis comorbid factors. Materials and methods. In 86 patients with newly diagnosed gastric and duodenal ulcers, the frequency of manifestations of dyspepsia and complicated course of the disease was analyzed. Results. The newly diagnosed peptic ulcer in patients with situational alcohol intake is associated with comorbid factors of ulcerogenesis: invasion of Helicobacter pylori (71 %) and ingestion of nonsteroidal anti-inflammatory drugs (36 %). Nausea and abdominal pain are the most common symptoms, and bleeding from gastric ulcers is the most common complication in patients with newly diagnosed peptic ulcer affected by the situational alcohol intake.

The aim of the study is to present an analysis of patients’ management with Boerhaave syndrome and the outcomes of surgical treatment within the first 12 hours after the occurrence of esophageal rupture to reduce the mortality associated with the development of this disease. Material and methods. A retrospective analysis of seven patients
with spontaneous esophageal rupture who were treated in Surgut Clinical Traumatological Centre is conducted. Results. Application of a left-sided thoracotomy, despite the late admission and execution of the operation 24 hours after the rapture affected by mediastinitis and sepsis in 50 % of cases, allows for a full recovery of 71.4 % of patients.

The aim of the study is to summarize the literature data on the monitoring of genetic diseases and congenital malformations in children. Material and methods. We studied publications of foreign and domestic authors, reviews of randomized controlled studies from various sources of scientific literature, including platforms PubMed, CyberLeninka, etc. The search depth was 20 years. A literature search was conducted by keywords: genetic diseases, monitoring, children. Results. There is an urgent need for a differentiated approach to the organization of monitoring for chromosomal, gene-related diseases and congenital malformations since this is about increased mortality, disability of children, and a decrease in the quality of family life. There are features of the population genetics of various types of genetic diseases, malformations, which determines the validity of creating registers of
patients with these diseases.

The aim of the study is to investigate the structure of multimorbid pathology under compliance to treatment of patients with acute coronary heart disease, based on the data analysis of domestic and international authors and clinical guidelines. Material and methods. Analysis of literature in databases: Scopus, PubMed, Lancet, CyberLeninka, etc. over the last 15 years is made. Results. The necessity of rating scales development for estimation
of multimorbidity and comorbidity in patients with acute coronary syndrome accounting their regional features is shown

The aim of the study is to evaluate the effectiveness of the psoriatic onychodystrophies treatment using local photochemotherapy, in combination with an external photosensitizer. Material and methods. The study included 34 patients with a diagnosis of psoriasis in a common plaque form and advanced stage. Psoriatic onychodystrophy was observed in 23 male patients (67.7 %) and 11 women (32.3 %). The patients were divided into 3 groups depending on the severity of onychodystrophy. The treatment efficacy of the pathology with photochemotherapy was analyzed. Results. The results of symptomatic treatment using local photochemotherapy without oral or intravenous drug administration are presented. This type of treatment is medically fit and requires no aftercare. As a result, clinical outcomes of varying degrees of improvement of different onychodystrophies are obtained.

The aim of the study is to evaluate the current state of the incidence of pneumonia and otitis in children living in the city of Surgut. The study is done in the context of awareness about pneumococcal infection and pneumococcal vaccination. Material and methods. The practice guidelines of pneumococcal vaccines usage in the Russian Federation and the Khanty-Mansi Autonomous Okrug – Ugra are analyzed. More than 35 articles from the eLIBRARY.RU database are viewed. Based on statistical materials of the Russian Federal State Statistics
Service, a statistical analysis of childhood vaccination and incidence of acute pneumonia and otitis media in Surgut for 2015–2017 is carried out. Results. During active vaccination against pneumococcal infection, the incidence of pneumonia in children in 2016 decreased to 3.4, and in 2017 this indicator was 2.2 per 1000 children with respect to 2015.

The aim of the study is to review the literature to determine the main exogenous and internal factors affecting the aging of human skin and evaluate the mechanisms that occur in the skin during aging. Material and methods. The search is conducted using the MEDLINE, PubMed and RSCI databases. The keywords used are skin aging, factors, atrophy, “exposome”, ultraviolet rays, phototypes, matrix metalloproteinases. Results. Adverse environmental factors, a certain lifestyle, an increase in the number of comorbid pathologies in the elderly
contribute to the development of skin pathology, determine the need for further study of this issue and require close attention of the dermatologists.

The aim of the study is to determine the role of microchimerism in the pathogenesis of systemic autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma) according to the analysis of evidence-based medicine data and literature review. Material and methods. The study of scientific Russian and foreign literature in such databases as Springer, Scopus, eLIBRARY.RU, Web of Science, MEDLINE, PubMed
Central, BioMed Central for the last 8 years is made. The following keywords were used in the literary search: microchimerism, graft-versus-host disease, systemic lupus erythematosus, rheumatoid arthritis, systemic scleroderma. The 35 current publications have been identified; information from 22 resources was included in the analysis; there are 6 prospective and 12 retrospective studies among them. Results. Fetal microchimerism is insufficiently studied. It is still unclear how fetal cells undergo differentiation within the mother and affect organs
and tissues in systemic diseases. The role of microchimeric cells in the pathogenesis of immunological reactions of systemic diseases proceeding in a “graft-versus-host” type and their manifestation has not been identified yet.

The aim of the study is to estimate the role of the pathogenic microbiota in the development of the systemic inflammatory response. Material and methods. The study included 30 women with physiological puerperium (control group) and 80 women with postpartum endometritis (main group). We determined the cytokines levels of blood: interleukin-1-beta (IL-1β), tumor necrosis factor alpha (TNFα), interleukin 10 (IL-10), acute phase proteins on the 1st and 5th day of postpartum endometritis. The correlation with the results of detected microbiota of the uterus with postpartum endometritis was studied. Results. A direct dependence was revealed between the microorganism resistance and the α-1 globulin and IL-1β in the blood by the 5th day. It is proved that the determination of the level of IL-1β in the blood by the 5th day from the onset of the disease has the most predictive value for determining the further tactics of the treatment.

The aim of the study is to analyze postmortem cases of alcohol detection in children’s blood for the definition of toxic effects of ethyl alcohol on a child’s body. Material and methods. The paper analyzes 34 cases of postmortem detection of ethyl alcohol in children who underwent forensic investigations in the Khanty-Mansi Autonomous Okrug – Ugra over the past five years. The concentration of ethyl alcohol in a forensic study was determined in 4 age groups: in early childhood (1–3 years), in preschool age (4–6 years), in primary school age (7–10 years) and middle school age (11–14 years). Results. Every single case of postmortem detection of alcohol in children under the age of 14 corresponded to a mild degree of intoxication.