The study aims to assess the prognostic value of risk factors for tuberculosis infection. Material and methods. A total of 310 children with and without tuberculosis infection are prospectively examined. A comparison of the risk factors for the development of tuberculosis, already used in practice, with the results of a specific study, is carried out. Results. The significance of biomedical risk factors for the development of tuberculosis at the stage of latent tuberculosis infection, such as past chickenpox, untimely vaccination, the presence of allergic diseases, respiratory diseases (bronchial asthma), and recurrent episodes of viral respiratory infections, has been established.

The study aims to investigate the clinical, epidemiological, and etiological characteristics of communityacquired pneumonia at inpatient healthcare delivery in persons living on the territory of the Khanty-Mansi Autonomous Okrug – Ugra. Material and methods. A prospective analysis of hospital pneumonia morbidity in 2011–2020 by the method of continuous sampling of cases in the Surgut Regional Clinical Hospital is carried out. The data is also compared with the parameters of the official incidence of pneumonia in the country and the region. Evaluation of the etiology and outcomes of pneumonia allows forming risk groups for its development and plan preventive measures, including vaccine prophylaxis. Results. Pneumonia, mainly community-acquired, accounts for 1.3% of cases of all hospital patients and 2.8 % of cases of patients of a therapeutic profile. During the fight against the novel coronavirus infection in this Clinical Hospital, 26.9% of patients with SARS-CoV-2 were treated. The dynamics of the frequency of occurrence of both bacterial pneumonia and pneumonia complicating influenza is characterized by a progressive rate of increase in the frequency of cases requiring inpatient admission. Bacterial, viral, and fungal flora play their role in the etiology of community-acquired pneumonia, whereas lung lesions in SARS-CoV-2 infection are characterized by the complexity and staging of pathogenesis: from a cytokine storm to viral and viral-bacterial lesions of not only the lung parenchyma but also pleura. The fatal outcome of communityacquired pneumonia in patients with SARS-CoV-2 occurs 3.54 times more often than in patients with pneumonia of a different etiology (8.51% versus 2.4% (p = 0.0000)).

The study aims to evaluate the signs and extent of lung damage in patients with pneumonia affected by COVID-19, associated with end-stage renal disease (ERSD) and without kidney disease, according to the data of computed tomography (CT) of the chest organs. Material and methods. The group of patients with pneumonia and ERSD had 53 people and the group without kidney disease consisted of 59 people. Despite the appropriate
treatment, all patients died. The autopsy confirmed the presence of pneumonia caused by COVID-19. The average age of the patients was 68.40 ± 14.63 years. All 112 patients had chest CT 2.12 ± 0.94 days before death. Results. The lethal outcome in patients with pneumonia caused by COVID-19 and long-term ESRD occurred when the extent of the lung damage equaled 40.64 ± 18.50% with fluctuations from 3 to 69%. Among the patients without
kidney disease, the extent of lung damage was 56.63 ± 19.17%, (p < 0.05) with fluctuations from 18 to 94%. According to CT data the ground-glass opacification, crazy-paving, and consolidation signs were observed in 100.0% of patients in both groups. These signs were referred to as the main ones for the purposes of the study. The frequency of other signs such as air bronchogram, pleural thickening, pleurisy, lymphadenopathy, atelectasis, local emphysema, nodules, reticulation, calcifications, fibrosis, bronchiectasis, and pulmonary edema ranged from 2 to 73%. There was no statistically significant difference in the frequency of the signs in both groups. The most frequent locations of pneumonia were the lower (94.4%) and posterior (98.2%) parts of the lungs, regardless of the group observed. The percentage of the severity of the main signs in the lungs was significantly lower among the patients with long-term ERSD.

The study aims to provide a scientific justification for the development and usage of regional standards of physical development of ethnic Khanty for an objective assessment of their health. Material and methods.
A continuous cohort comparative study of the anthropometric data of children aged 0–17 years was carried out. Among these children were 13,140 ethnic Khanty (1st group) and 22,660 newcomers born on the territory of
Khanty-Mansi Autonomous Okrug – Ugra (2nd group). Centile tables were compiled and the obtained indicators were compared with the World Health Organization (WHO) standards. Results. Based on the results of the study, the
authors have developed standards for indicators of the physical development of children of ethnic Khanty and the newcomer population of the Middle Ob region. The significant differences between the lower growth rates, body
weight, body mass index, and chest circumference of ethnic Khanty children obtained in almost all age groups from the existing WHO standards and indicators of the newcomer population can form the basis for a regional standard to exclude overdiagnosis of nanism and underdiagnosis of overweight and obesity in a given population cohort.

The study aims to analyze the effect of the combination of Mexicor and Polyoxidonium on the cardiovascular system in patients with chronic obstructive pulmonary disease (COPD) and concomitant coronary heart disease (CHD). Material and methods. We examined 94 patients with stage 3 COPD in the acute phase with concomitant stable CHD, stable effort angina class I–II, and congestive heart failure of the I–II functional class. The main group consisted of 43 patients (35 men, 8 women, average age 62.0 ± 4.3 years), who received, in addition to basic therapy, the immunomodulator Polyoxidonium (tablet form, 12 mg daily, half an hour before meals, 2 times a day for a month) and the cytoprotector Mexicor (1 capsule (100 mg) 3 times a day for a month). The comparison group included 51 patients (42 men and 9 women, average age 58.0 ± 4.1 years) who received only basic therapy, which
was based on the recommendations of the Ministry of Health of the Russian Federation. Before and after treatment, patients underwent 24-hour electrocardiography, bicycle ergometry, with an analysis of the total exercise,
assessment of changes in peak values of systolic and diastolic pressure, and peak heart rate. Results. A group of patients taking a combination of Polyoxidonium and Mexicor in addition to basic therapy showed a significant
decrease in the frequency of chest pain, a decrease in the daily, night, and 24-hour heart rate. In the main group, there was a statistically significant decrease in the average heart rate at rest (p < 0.001), an improvement in bicycle ergometry, and an increase in exercise tolerance. The indicator of total work performed increased by 26.8% (p < 0.05). A statistically significant increase in the time of performing the load until the manifestation of ST segment depression on the electrocardiogram (p <0.05) was noted.

The study aims to examine the course of multiple and singleton pregnancies and their outcomes associated with gestational diabetes mellitus. Material and methods. A retrospective analysis of 131 cases of the course and outcomes of labor in patients with multiple and singleton pregnancies, complicated and not complicated by gestational diabetes mellitus was performed. Results. Multiple and singleton pregnancies with gestational
diabetes mellitus were typically complicated by placental insufficiency and preterm birth (p < 0.01). The neonatal period in twin children whose mothers had gestational diabetes mellitus was statistically significantly more likely
to be complicated by hypoglycemia, neonatal jaundice, extreme immaturity, which required inpatient treatment and intensive care. Most likely, these complications in multiple pregnancy are caused by hyperinsulinism, which
developed in the fetus in the II and III trimesters of gestation affected by hyperglycemia in uncompensated gestational diabetes mellitus in a woman.

The study aims to analyze the results of surgical treatment of patients with end-stage renal disease in the Surgut Regional Clinical Hospital for the period from 2009 to 2019. Material and methods. A retrospective analysis of the
results of arteriovenous fistula formation in 358 patients with end-stage renal disease is carried out. A search for the results of studies on the complications structure in the postoperative period in hemodialysis patients with permanent
vascular access in the scientific literature is made. The results of this study are compared with findings from the literature. Search depth is 8 years. Results. Within 11 years, permanent vascular accesses (arteriovenous fistulas)
were formed in 358 patients at the Dialysis Center of the Surgut Regional Clinical Hospital. Among those patients are 139 (38.8%) women and 219 (61.2%) men. The duration of receiving substitution therapy was on average 7.84 years.

The study aims to show the result of successful treatment of giant-cell tumor of the epimetaphysis of the right femur in a child. Material and methods. The paper presents a rare clinical and diagnostic case of giant-cell tumor of the epimetaphysis in a 5-year-old girl and its results of diagnosis and surgical treatment. Results. The patient first came to see a Trauma Surgeon and a Pediatric Surgeon for pain in the right knee joint 2 weeks after the injury. As a result of the diagnostic search and morphological examination of the tumor, a giant-cell tumor of the epimetaphysis of the right femur and a fracture of the femoral neck were diagnosed. The resection of the upper third of the femur, osteosynthesis, followed by reduction of the fracture were performed. Oncological alertness should always be present regarding prolonged bone pain in patients, especially when they occur at night, considering the results of the histologic examination and despite their age.

The study aims to analyze the contemporary scientific literature on the influence of polyphenols and flavonoids on the course of pregnancy and its outcomes. Material and methods. In the course of the work, literature was
searched in the MEDLINE, PubMed, eLIBRARY.RU, and RSCI databases through the following keywords: polyphenols, flavonoids, preeclampsia, placental insufficiency, intrauterine growth restriction. The analysis of 120 publications was carried out. As a result, 41 literature sources were selected. The search depth was ten years. Results. Analysis of the information currently available indicates a large gap in the knowledge regarding the safety of these compounds for reproductive processes. Thus, it is necessary to conduct additional studies of the safety profile of active polyphenolic compounds in experimental conditions and it is essential to monitor the data on the situation in clinical practice.

The study aims to evaluate the effectiveness of the developed method for treating skin proliferation induced by human papillomavirus using the cytokine-like peptide (alloferon) and radio wave excision. Material and methods. The study included 109 patients. Among them were 46 people with plantar warts, 16 people with genital warts, and 47 people with papillomas and keratosis (senile and seborrheic). The patients were divided into two groups. The main group was represented by 65 patients who had the removal of proliferation with the administration of alloferon. The 44 patients in the comparison group had only the removal of the skin proliferation induced by the human papillomavirus. Results. During 12 months of observation relapses of plantar warts were noted in 26.3 % of patients in the comparison group and only in 3.7 % of patients in the main group. Relapses of genital warts were observed in two patients (28.6 %) in the comparison group and none of the nine patients in the main group. Spontaneous regression or a significant decrease in the size of more than a third of the papillomas and keratosis was observed in 65.5 % of patients in the main group after the 3rd course of allokin-alpha. None of the 18 patients in the comparison group had a similar effect.

The study aims to investigate the system of hemostasis and fibrinolysis in venous and arterial blood, the features of blood filling and lung water balance, as well as the activity of lipid peroxidation (LPO) processes in
the lung tissue iduring the acute cerebral ischemia. Material and methods. The experiments were performed on non-pedigree male rats, including control and sham operated ones. Acute cerebral ischemia was modeled
by the bilateral occlusion of the common carotid arteries. Survived animals were assessed according to the degree of neurological deficit using the McGraw scale. Complex studies included determination of activated
partial thromboplastin time, prothrombin time, time of XIIa-dependent fibrinolysis of arterial and venous blood, LPO intensity by the content of thiobarbituric acid active products and catalase activity in the lung
tissue, the number of circulating endothelial cells; assessment of the lung blood filling and water balance by the gravimetric method. Results. In 24 hours after cerebral ischemia we found that the coagulation
potential of blood increased in the systemic circulation and the pulmonary circulation affected by inhibition of the fibrinolysis system. On the 21st day of cerebral ischemia, dysregulation of hemostasis mechanisms in the pulmonary bloodstream was revealed in the form of hypercoagulation of blood and hyperfibrinolysis. At the same time the increase of malondialdehyde, blood circulation, and the content of the extravascular fluid in the lungs were noted. The correlation between the intensification of LPO processes with an imbalance of pro- and anticoagulants and hyperhydration of the lung tissue has been shown. The obtained results indicate a progressive course of disorders of the non-gas exchange functions of the lungs in the dynamics of acute experimental cerebral ischemia.

The study aims to research the protective effect of lithium chloride solution on endotheliocytes in cell culture under conditions of incubation with the blood serum of patients suffering from systemic inflammatory response
syndrome (SIRS) secondary to severe concomitant injury. Material and methods. We used serum of five patients with SIRS, which occurred in presence of severe concomitant injury, and blood serum of five healthy donors. Endothelial cells of the EA.hy926 line were incubated with the blood serum of healthy and sick patients. Lithium chloride was added to the cell samples at a concentration of 0.01, 0.1, 1, and 10 mmol/l. After incubation, the cells were removed with a Trypsin-Versene Solution, fixed with 70% ethanol, and stained with propidium iodide. Cells containing fragmented genomic DNA were analyzed using flow cytometry. Results. It was found that toxic serum inhibited phosphorylation of glycogen synthase kinase 3β (GSK-3β) in endotheliocytes, caused cleavage of Vascular endothelial (VE)-cadherin and a decrease in the amount of claudine and actin, which caused the destruction of
intercellular contacts of the endothelial monolayer and an increase in endotheliocyte apoptosis. Incubation of a monolayer of endothelial cells of the EA.hy926 line with lithium chloride at concentrations of 1 and 10 mmol/l
significantly prevented the disassembly of claudine, actin, and (VE)-cadherin, halved the intensity of endotheliocyte apoptosis, and stimulated the phosphorylation of GSK-3β.

The study aims to present an analysis of the late diagnosis of achondroplasia in an 8-year-old child. Material and methods. A clinical case of achondroplasia in a girl with partial growth hormone deficiency is presented.
Anamnestic data and the results of a large block of examination, which did not lead to timely diagnosis of pathology, are analyzed. Results. In the process of dynamic observation, a rare genetic disease with characteristic typological manifestations was revealed in a child of 8 years. The isolation of individual clinical signs of growth retardation, isolated from other manifestations, led to an underestimation of the clinical situation and late diagnosis.