The study aims to analyze the contemporary scientific literature on the topic of vitamin D insufficiency and deficiency role in the development of immunopathological conditions, formation of acute and chronic diseases of nasopharynx in children. Material and methods. The search was carried out using keywords combined in groups to identify various aspects of vitamin D effect on the organism. The analysis of scientific papers of Russian and foreign literature, including the reviews of randomized controlled clinical researches, was carried out in PubMed database with data from Medline, PreMedline, and in eLibrary platform. The search depth was 10 years. Results. The
vitamin D is one of the key factors that links innate and adaptive immunity. The review presents evidence of vitamin D active metabolite (calcitriol) participation in the process of inflammation and in anti-infective immunity, as well as of protective effect of vitamin D sufficiency in relation to the risk factor of formation of inflammatory and bacterial infections of respiratory tract in children.

The study aims to generalize and systemize the modern approaches to assess and monitor the level of bronchial asthma control in children. Material and methods. In the course of the study, the scientific publications of foreign and Russian authors, including reviews of randomized controlled studies, were analyzed in such databases as PubMed, Cyberleninka, eLibrary, Google Scholar, etc. The search depth was 10 years. The search was carried out using the following keywords: bronchial asthma, level of control of bronchial asthma, monitoring of bronchial asthma, children. Results. Monitoring of bronchial asthma can improve the quality of therapeutic and diagnostic approaches, makes it possible to objectify the severity of the disease, and to establish the reasons for withdrawal, continuation or modification of basic therapy, which substantiates the necessity of daily control of bronchial asthma, including remote control.

The study aims to detect the main methods and means for modern pharmacotherapy for patients with short bowel syndrome. Material and methods. The search was carried out in the following databases: PubMed, eLibrary, and Clinical Trials, using such keywords as intestinal failure, parental nutrition, short bowel syndrome. Results. Based on the analysis of published works, it was found that the analog of glucagonlike peptide-2, teduglutide, can reduce the parental nutrition, infusion duration, and provide full enteral autonomy, which makes the treatment method with such drug the most promising one for patients with short bowel syndrome.

The study aims to assess the phenotype and specifics of inflammatory response in myocardial infarction in patients with type 2 diabetes mellitus in different age groups. Material and methods. The study examined 121
patients with type 2 diabetes mellitus and myocardial infraction. The patients were divided into 3 clusters by the K-means clustering. The 1st cluster included 29 patient (with the age of 56.2 ± 5.3 and body mass index of 31.1 ±
4.1 kg/m2). The 2nd cluster included 48 patients (with the age of 69.0 ± 4.0 and body mass index of 30.3 ± 4.5 kg/m2). The 3rd cluster included 44 patients (with the age of 81.5 ± 4.8 and body mass index of 28.2 ± 4.8 kg/m2). Apart from the regular examination, on the 1st, 3rd, 5th and 12 ± 1 day the patients were examined for the number of monocytes, lymphocytes and their subpopulations, and neutrophils with the flow cytometry method. Results. In comparison with the 1st cluster, the patients from the 3 cluster were noticed to have lower body mass indexes (28.35 (24.69; 31.25) kg/m2 vs 31.13 (27.89; 34.11) kg/m2, p = 0.019), and lower glycated hemoglobin (6.73 (5.69; 7.54) % vs 8.42 (6.66; 10.69) %, p = 0.032). They atherogenic index was lower in comparison with the 1st and 2nd clusters: 3.45 (2.6; 4.55) vs 5.3 (4; 6.1) and 4.6 (3.5; 6.0), p = 0.003, accordingly. The patients from the 3rd cluster had lower general number of leucocytes in the 1st day than the patients from the 2nd cluster had: 8.7 (7.6; 10.6) × 109/L vs 10.95 (9; 13.4) × 109/L, p = 0.009. They lowest indexes of lymphocytes and CD16(-)T-lymphocytes and NK-cells were determined. On the 12th day CD16(+)monocytes level were higher in patients from the 3rd cluster than from the 1st cluster: 60.42 (35.445; 96.51) cells/μL vs 39.65 (25.11; 50.32) cells/μL, р = 0.039. The patients from the 2nd cluster had higher number of monocytes during the whole examination than the patients from the 1st and 3rd clusters. The patients from the 1st cluster were noticed to have the maximum of CD16(-)monocytes on the 3rd day and CD16(+)monocytes on the 5th day, in comparison with the 2nd and 3rd clusters.

The study aims to analyze the efficacy of prescribing losartan or telmisartan in combination with atorvastatin and ursodeoxycholic acid during the comprehensive treatment of patients with arterial hypertension and
comorbid non-alcoholic fatty liver disease. Material and methods. 65 patients with arterial hypertension and comorbid non-alcohol fatty liver disease were divided into 2 groups. The first group consisted of 26 patients who were prescribed with 50 mg of losartan combined with 20 mg of atorvastatin and 10 mg/kg of ursodeoxycholic acid. The second group consisted of 39 patients who were prescribed with 20 mg of telmisartan combined with 20 mg of atorvastatin and 10 mg/kg of ursodeoxycholic acid. All patients underwent routine physical and laboratory examinations, electro- and echocardiographic diagnostics. Results. It was found that combination of both telmisartan and losartan with atorvastatin and ursodeoxycholic acid in patients with comorbid pathology reduced the level of systolic and diastolic blood pressure, increased left ventricle ejection fraction, decreased the size of the left heart, myocardial mass and left ventricle myocardial mass index. Moreover, the level of proinflammatory interleukin-6 was reduced and the level of adiponectin was increased due to the use of these drugs combinations.

The study aims to find the patterns of biliary complications formation following hepatectomy in patients with parasitic invasion, Opisthorchis felineus, to analyze the efficacy of application of bile ducts drainage as a way of preventive measures for the aforementioned complications. Material and methods. The retrospective analysis of disease records of 241 patients, who got surgical treatment with different hepatectomy in the District Center of Liver and Pancreas Gland Surgery for the period of 2008–2019, has been carried out. 134 clinical cases were selected for the study and divided into 2 groups. The first group included 37 patients with the opisthorchiasis invasion, the second group included 97 patients without diagnosed opisthorchiasis invasion. External drainage of bile ducts has been used as an option of temporary biliary decompression after hepatectomy in patients with signs of parasite cholangitis. Results. The statistically significant increase of risk of the complication in patients with opisthorchiasis invasion has been substantiated by the bile leakage examined in 22.4 % (30) patients who underwent surgery.

The study aims to compare the efficacy and safety of endovenous laser ablation and radiofrequency ablation, as
well as preferences for use of each method based on the survey of phlebologists. Material and methods. The survey of 235 respondents, members of Russian Phlebologists Association, has been carried out. The results of obtained data processed with descriptive statistics are presented. Results. It was found that endovenous laser ablation is the most preferable method for 54.2 % out of 177 interviewed. At the same time, 19.4 % of interviewed use both radiofrequency ablation and endovenous laser ablation. Deterministic complications associated with endovenous laser ablation, such as pigmentation and neuropathy, were reported by 33.3 and 22.2 % of interviewed, accordingly. The most frequent stochastic complications, thrombophlebitis and deep vein thrombosis, were reported by 33.3 and 22.2 % of interviewed, accordingly. Compared to radiofrequency ablation, endovenous laser ablation is a more
preferable method for phlebologists. At the same time, both methods are quite similar in efficacy and safety.

The study aims to assess the level of women’s satisfaction in using a menstrual cup during menstruation (in comparison with other means of feminine hygiene). Material and methods. 30 patients participated in the
study. The majority of women, 89.7 % (27), agreed to continue using the menstrual cup. However, 10.3 % (3) of women refused to use it afterwards due to the difficulties in use and unpleasant odor from the vagina. The results of the survey and bacterioscopical examination were compared before and after using the menstrual cup for 3 months. The package Microsoft Excel was used for statistical analysis. The Pearson’s Chi-squared test was used to compare the qualitative properties. The Shapiro-Wilk test was used to examine the quantitative properties for the normality of distribution. The data with normality of distribution are shown as the arithmetic mean (M) and standard deviation (SD). The Wilcoxon test was used to carry out the comparative analysis of quantitative properties. The value of p < 0.05 was used as the level of the statistical significant difference. Results. An extraneous body in the vagina for 3–4 days can create preconditions for bacterial vaginosis formation, which should be considered while consulting the patients on the matter of suitable hygienic means.

The study aims to present the clinical case of a long-term undiagnosed necrobiosis lipodica in a patient with endocrine pathology to discuss the clinical and morphological picture of the disease, as well as its differential diagnosis. Material and methods. A 48 years old man made complaint on changes of the skin on his left shin, which occurred about 10 years ago. Earlier, the dermatologist diagnosed it as psoriasis, the prescribed treatment was not effective. With anamnesis collected, it was found that the patient has undergone substitutive therapy for
hypogonadism for a long period. The examination of lesion led to suggestion of diagnosis “necrobiosis lipoidica”. Results. In the course of diagnostic actions, the diagnosis “necrobiosis lipodica” was confirmed. The presented clinical case shows the significance of thorough differential diagnosis of diseases in patients with background pathologies of endocrine system.

The study aims to review the scientific literature devoted to the analysis of leading pathogenetic factors of intestinal syndrome formation in novel coronavirus infection. Material and methods. The search of scientific literature was carried out in the following databases: Web of Science, Scopus, PubMed and RSCI using such keywords as coronavirus infection, intestinal syndrome. The search depth was 3 years. Results. As analysis of Russian and
foreign publications has shown, the pathogenesis of intestinal syndrome in COVID-19 is determined by the complex of such interconnected pathogenetic factors as cytokine storm, damage of microcirculatory bloodstream vessels with the development of microthrombosis, oxidative stress, hypoxia of mixed type, inflammation, and infectious intoxication.

The study aims to analyze the current state of the problem of pathogenetic significance of vitamin D deficiency and its clinical manifestations in metabolically associated comorbidity and non-alcoholic fatty liver disease.
Material and methods. The analysis of scientific literature, inter alia reviews of randomized controlled clinical trials, was carried out using such databases as PubMed, eLibrary, CyberLeninka, etc. The search depth was 10 years.
The current state of the problem of vitamin D deficiency in metabolic syndrome and non-alcoholic fatty liver disease was analyzed. Results. The extreme relevance of the problem has been substantiated by the analysis of the current state of the correlation of vitamin D deficiency with metabolic syndrome and metabolically associated therapeutic comorbidity, cardiovascular and non-alcoholic fatty liver disease, and has been determined by the epidemic of these diseases. The pathogenetic role and significance of obesity in forming metabolic syndrome, non-alcoholic fatty liver disease, and vitamin D deficiency syndrome have been presented. The correlation of metabolic syndrome, its components and vitamin D deficiency has been substantiated. The protective role of vitamin D in preventive measures from primarily cardiovascular complications has been determined. The study creates preconditions for the further analysis of the problem in order to improve both epidemiologic indicators and the life quality of people

The study aims to analyze the platelet volume and screening coagulogram in nonneoplastic pathology and cervical cancer, associated and non-associated with systemic non-differential dysplasia of connective tissue. Material and methods. The comparative statistical analysis (with Mann-Whitney test and Сhi-squared test with p < 0.05) of platelet volume, their quantity and screening coagulogram in 204 women with nonneoplastic pathology of cervix and cervical cancer with (1st and 3rd groups, accordingly) and without (2nd and 4th groups) dysplasia of connective tissue has been carried out. Results. Disturbances in the blood system prevailed in both groups with dysplasia of connective tissue: thrombocytosis and increase in prothrombin ratio that characterize tendency for hypercoagulability were statistically significantly higher in the 1st group than in the 3rd group and twice as frequent in the 1st group than in the 2nd group. Anemia and hyperfibrinogenemia prevailed in both groups with cervical cancer, with or without dysplasia of connective tissue. Statistically significant increase in platelet volume in groups with dysplasia of connective tissue is recorded not only in comparison with corresponding groups without dysplasia but also in groups with cervical cancer. Detected tendencies for hypercoagulability and increase in platelet volume (both in dysplasia of connective tissue and in cervical cancer) can possess significance for assessment of connection with features of pathological process flow and its treatment, which requires the further research.

The study aims to detect the patterns of electrolytes (sodium, potassium, calcium) content in the blood serum during the first week of life of infants with extremely low birth body weight, and to determine the effect
electrolyte disorders produce on their survival. Material and methods. 141 infants with gestational age up to 34 weeks have been examined for the electrolyte balance during the first week of life. The study was conducted in the Department of Reanimation and Intensive Therapy for Infants of the District Clinical Hospital in Khanty-Mansiysk for the period of 2015–2020. The main group included 79 infants with extremely low birth body weight of 480–998 g (Me = 795 [662.5; 923.0]) and gestational age of 23–29 weeks (Me = 26 [25; 27]). The comparison group included 62 infants with very low birth body weight of 1000–1500 g (Me = 1255 [1152.5; 1397.75]) and gestational age of 26–34 weeks (Me = 30 [28; 30]). The K+, Ca2+, Na+ ions content in capillary blood serum was assessed with the ionselective ionizer ABL800 FLEX RADIOMETER (Denmark). Results. Electrolyte imbalance in the blood during the first 72 hours of life in the form of severe hyponatremia (32 %), hypocalcaemia (16 %), and hyperpo-tassemia (7.8 %) were typical for infants with extremely low body weight. The next 4–7 days of life of these infants were noted with high occurrence of hypernatremia (30 %) with statistically significant decrease of occurrence of hyponatremia (23 %, p = 0.01), preservation of hyperpotas-semia, and absence of stabilization of electrolyte level by the 7th day of life. Water-electrolyte imbalance in these infants is due to the high loss of water and reduced kidney function. Severe hyponatremia and hyperpotassemia during the first week of life lead to the increased mortality among infants with extremely low birth body weight.

The study aims to assess in the early postoperative period the puerperae’s quality of life who underwent caesarean section, with various anesthesia applied. Material and methods. The quality of life of 310 patients after caesarean section has been assessed. Epidural anesthesia was used for patients in the main group (n =112). Combined spinal and epidural anesthesia and prolonged epidural anesthesia were used for patients in the comparison group (n = 95). Epidural anesthesia was used for patients in the control group (n = 103). Non-steroidal anti-inflammatory drugs were used for pain relief during postoperative period. The SF-36 questionnaire was used to assess the patients’ quality of life. The statistical data processing was conducted with Statistica 10.0. Results. In the course of the study, the most acceptable indicators of the quality of life have been recorded in the group of patients who received prolonged epidural anesthesia in caesarean section.

The study aims to assess the stress level and metabolic reactions in rats with various initial stress resistance during the early post-traumatic period of adaptation after myocardial contusion. Material and methods. Rats were ranged by the level of stress resistance with the Porsolt forced swimming test. Twenty four hours later, with simulation of isolated myocardial contusion performed, the rats were examined for the rectal temperature. The level of corticosterone, crude protein, albumin, triglyceride, glucose, and lactic acid in blood, and total antioxidant activity and reduced glutathione content in myocardium tissue were determined. Results. In comparison with the control, reliably higher levels of corticosterone, triglyceride, glucose, lactic acid in blood, as well as lower indicators of total antioxidant ability and reduced glutathione were registered in the early post-traumatic period after myocardial contusion. At the same time, the content of corticosterone, triglycerides, glucose in blood were reliably higher, and total antioxidant ability and reduced glutathione in myocardial tissue were reliably lower in
the groups of traumatized rats with low initial stress resistance compared with the ones with high stress resistance. Statistical data processing was carried out by the descriptive statistics method and method of samples comparison
(Mann–Whitney U test). The level of statistical value was set equal to 0.05. The data processing was carried out with IBM SPSS Statistics 23 program. The results are presented as median value and interquartile range.