The study aims to evaluate the diagnostic value of fetal movements counting for labor outcomes based on the literature review. Materials and methods. The scientific literature was searched in the Web of Science, Medline, PubMed, and RSCI databases. Results. Despite being an indirect diagnostic method, fetal movement counting improves pregnancy outcomes and lowers the stillbirth rate.

The study aims to investigate the modern possibilities for psoriasis therapy using genetic engineering biological drugs. Materials and methods. The main meta-analyses on modern methods of treating moderate and severe psoriasis over the past 10 years have been examined. The most effective and safe biological drugs, as well as the features of their prescriptions for various concomitant conditions, have been identified. Results. Long-term use of biological drugs was evaluated and found to be relatively safe. Due to the potentially higher risks of malignancy and infection in biological therapy, biological drugs must be prescribed strictly according to concomitant conditions. There is insufficient evidence that biological drugs have a negative impact on the progression of concomitant diseases.

The study aims to propose management strategies for patients with spontaneous pneumomediastinum comorbid with coronavirus pneumonia. Materials and methods. 70 patients with spontaneous pneumomediastinum comorbid with coronavirus pneumonia were examined. Results. Spontaneous pneumomediastinum often develops in more than 75 % of lung tissue damage. Spontaneous pneumomediastinum occurred in 3.6 % of COVID-19 pneumonia patients admitted to Khanty-Mansiysk District Clinical Hospital. There was no statistical significance in correlation between disease outcomes and patient management strategies (non-surgical or surgical one). Therefore, patients with spontaneous pneumomediastinum associated with COVID-19 pneumonia do not require anterior mediastinum drainage.

The study aims to detect features of autonomic regulation in women living in the subarctic region following pregnancy losses in order to improve the outcomes of subsequent pregnancies. Materials and methods. A prospective study of heart rate variability in women with pregnancy losses in anamnesis was conducted using a head-up tilt-table test. The main group consisted of 36 women who had recurrent miscarriages, the control group included 29 women who had one pregnancy loss (non-developing pregnancy or spontaneous miscarriage before 21 + 6 weeks of pregnancy). Statistical analysis was carried out using the StatTech 2.8.3 (by Stattech LLC, Russia). Results. Sympathicotonia is common in women who live in the Middle Ob area following pregnancy losses. Moreover, the shift in the autonomic balance is balanced and compensated according to the active head-up tilttable test. The data obtained enables personalized rehabilitation and pre-gravid preparation for the next pregnancy.

The study aims to analyze and advance the diagnostic algorithm used at city hospital admission offices to improve surgical pathology outcomes. Materials and methods. A retrospective analysis of patients examined at the admission office in City Hospital No. 6 named after G. A. Zakharin was conducted. Pancreatic diseases were analyzed in children and adults living in Penza Oblast from 1998 to 2017. The analyses aim at optimizing the diagnostic algorithm for admission offices that provide emergency care to patients with abdominal pathology. Results. To optimize the diagnostic algorithm at admission offices, both the examination methods of the patients’ organs and systems and the equipment must be upgraded. When patients refuse to be admitted to the hospital and are discharged with recurrent pain syndromes, general practitioners must be directed to use more informative methods that cannot be implemented in an in-patient hospital.

The study aims to present the results of diagnosis and treatment of recurrent bullous erythema multiforme associated with opisthorchiasis invasion. Materials and methods. The clinical observation of recurrent erythema multiforme of infectious and allergic origin is described. Clinical and anamnestic data, as well as examination and therapy results are presented. Results. A female patient with erythema multiforme was examined. During traditional therapy, dermatovenereologists observed a worsening of clinical manifestations and negative dynamics of the pathological skin process. Opisthorchiasis, which induced the development of dermatosis, was detected during thorough examination. Throughout dynamic observation, the appearance of skin rashes regressed after helminthiasis debridement. The study emphasizes the importance of conducting a fullfledged examination of patients with erythema multiforme in order to identify the trigger factor.

The study aims to review the scientific literature on the pathogenetic mechanisms of ionizing radiation damage to endotheluim during radiation therapy in cancer patients. Materials and methods. The scientific literature was searched in the Web of Science, Scopus, MEDLINE, PubMed and RSCI databases using such keywords as endothelium, radiation, and radiation therapy. The search depth was 10 years. Results. Most of the negative effects of radiation exposure are associated with the development of endothelial dysfunction. Thus, a disruption in endothelial homeostasis results in the development of a pro-inflammatory phenotype, which is followed by the inclusion of a number of pathogenetic mechanisms that cause the emergence of a variety of clinical conditions, including cardiovascular pathology. This problem occurs due to the progression of cardiovascular diseases in cancer patients, which worsens the course of the underlying disease and often leads to death. This article reviews and summarizes the latest data on the mechanisms and pathogenesis of radiationinduced endothelial damage, as well as the consequences of endothelial dysfunction. The data obtained will help develop a preventive strategy for patients undergoing radiation therapy.

The study aims to evaluate the association of polymorphic variants of the brain-derived neurotrophic  factor gene (rs6265) with the severity of cognitive dysfunction in military personnel with hypoxia. Materials and methods. 295 male military personnel (100 men serving in the Arctic belt, 100 men – in the Middle belt, and 95 men – in the subtropical belt’s middle mountains), with an average age of 34, were examined. They underwent general checkup, gathering and detailing of complaints, recording of anamnesis, assessment of personal sleep characteristics. The results of the genotyping analysis of brain-derived neurotrophic factor (rs6265) were divided into three types as follows: allele1, heterozygote, and allele2. The statistical analysis of data was conducted using IBM SPSS Statistics 26. The distribution normality of quantitative indicators was assessed with Shapiro–Wilk test. The significance of differences in quantitative indicators that have normal distribution in more than two groups was assessed with the analysis of variance and Kraskal–Wallis, which is used for variables with abnormal distribution. Results. In the course of the study, statistically significant differences in the distribution of genotypes of the brainderived neurotrophic factor gene (rs6265) were registered in 295 men serving in various climatic and geographic zones (A/A – 5.76 %, G/A – 29.49 %, G/G – 64.75 %) and 100 men serving in the Arctic belt (A/A – 52.9 %, G/A – 43.7 %, G/G – 27.7 %). The study shows that the G/G gene is the most protective of the brain-derived neurotrophic factor gene (rs6265) genotypes studied and provides less cognitive dysfunction and more possibilities for longlasting military service in the Arctic conditions.

The study aims to analyze the features of the functional connectivity structure of the motor system in patients after traumatic brain injury according to functional magnetic resonance imaging. Materials and methods. The study included 53 people: 40 patients with traumatic brain injury and 13 healthy people. A comprehensive clinical study was carried out, including an assessment of the patients’ neurological state and a functional magnetic resonance imaging study followed by an analysis of functional connectivity. At rest and with their eyes closed, patients underwent functional magnetic resonance imaging for 10 minutes and 12 seconds. Masks, which described the brain areas interactions, their dependence on the experimental conditions (at rest or active) and on behavior, were generated in CONN using the WFU Pick Atlas package to analyze the regions of interest connectivity. Results. The study shows that neuroplastic changes in patients include the cortical and subcortical parts of the motor functional system. The highest indicators of functional connectivity are found in the norm and mild hemiparesis. With an increase in the motor deficit, the indicators progressively decrease. The regulation of an arbitrary resting position is determined by functional connectivity of functional magnetic resonance imaging between symmetrical areas of the subcortical network (shell, globus pallidus, caudate nucleus). The study found that the most important factors in the neuroplasticity of the cerebral motor system in patients with severe traumatic brain injury are qualitative nonlinear changes in the network patterns of connectivity.

The study aims to analyze the occurrence of the IL-2 (T330G) gene promoter polymorphism and evaluate its clinical and predictive role in adults with chickenpox. Materials and methods. The article presents the results of a comprehensive survey of young Europid men aged 19 to 24 years who were born in Zabaykalsky Krai and now do mandatory military service there. Biological data of 201 military personnel, with 105 men admitted to the military hospital with chickenpox, was analyzed. Results. The TG genotype of the IL-2 (T330G) gene is a risk factor for chickenpox development, as this genotype is found 1.4 times more frequently in the group of men with chickenpox than in the control group. The GG genotype of the IL-2 (T330G) gene plays a protective role against chickenpox, as it occurs 4.9 times more frequently in healthy men. The IL-2 (T330G) TG/GG polymorphism’s insignificant specificity (Sp _{IL-2 (Т330G) TG/GG} = 0.19) and insignificant sensitivity (Se _{IL-2 (Т330G) TG/GG} = 0.79) along with the relative risk value (RR = 0.94) determine the minimal contribution of IL-2 (T330G) to the development of chickenpox. Alleles T and G occur almost equally in men with various stages of chickenpox – χ² = 0.07; df = 2 (p > 0.01). The TT genotype occurs in 14.3 % (2/14) of cases with mild chickenpox, in 23.8 % (19/80) of cases with moderate chickenpox, and in 9.1 % (1/11) of cases with severe chickenpox. The TG genotype is found in 85.7 % (10/14) of mild chickenpox cases, in 67.5 % (54/80) of moderate chickenpox cases, and in 90.9 % (10/11) of severe chickenpox cases. The GG genotype only occurs in 8.7 % (7/80) of moderate chickenpox cases. The text statistics are as follows: χ² = 4.65; df = 4 (p = 0.32).

The study aims to analyze the urine amino acids level in children with undifferentiated connective tissue dysplasia. Materials and methods. The study included 105 children divided into two groups: the main group (57 children with undifferentiated connective tissue dysplasia) and the control group (48 children). The level of urine amino acids was assessed using a gas chromatography-mass spectrometric detector (Agilent GC 7820/MSD 5975). Statistical analysis was performed using SPSS Statistics 22. Results. As a result of the study, increased hydroxyproline in free amino acids and bound acids in urine proteins was found in children with undifferentiated connective tissue dysplasia, which may indicate nutritional and metabolic disorders.

The study aims to evaluate the association of polymorphic variants of the angiotensin-converting enzyme gene (rs4646994) with a decrease in physical performance in servicemen of the Aerospace Forces of the Russian Federation with hypoxia. Materials and methods. 295 male military personnel serving in various climatic and geographic zones were examined. Polymorphisms of the gene were determined by polymerase chain reaction. The DT-Prime amplifier enabled real-time genotyping of gene samples. The significance of the differences in the mean values of quantitative indicators with normal distributions was assessed in three independent groups by the analysis of variance. The non-parametric Kraskal–Wallis test assessed those variables with abnormal distributions. Results. The I/I homozygous genotype of the angiotensin-converting enzyme gene (rs4646994) association with a decrease in the physical performance of servicemen of the Aerospace Forces of the Russian Federation was registered as 17.1 %, in particular: 9.1 % of servicemen with the I/I genotype and less than 5-year service; up to 60 % of those with the D/D genotype and more than 10-year service. The D/D genotype was found to be the most advantageous of the angiotensin-converting enzyme gene (rs4646994) genotypes studied, with less decrease in physical performance and more possibilities for long-term military service in hypoxic conditions.

The study aims to analyze the surface-active agent system, water balance, and free-radical reactions in pulmonary tissue in the early and late periods of cerebral blood flow restoration after ischemic brain damage. Materials and methods. Bilateral ligation of the common carotid arteries caused acute cerebral ischemia in rats. The cerebral ischemia/reperfusion model consisted of clipping the common carotid arteries for 10 minutes, followed by reperfusion. The ischemia/postconditioning model consisted of 10 minutes of reversible cerebral ischemia, followed by five repetitions of ischemia/reperfusion sequence for 15 seconds each. A comprehensive study included an assessment of neurological deficiency in survived rats according to McGraw scale, as well as determination of alveolar phospholipids and their surface activity using Wilhelmy method, and detection of the lipid peroxidation intensity and pulmonary catalase activity, water balance, blood filling in lungs by the gravimetric method. Results. Both ischemia/reperfusion and ischemia/postconditioning are accompanied by the same changes in surface-active agent 24 hours after reocclusion, particularly, a decrease in phospholipid fractions in the composition and in surface activity. These changes are associated with high lipid peroxidation activity during the early (3 hours) and late (24 hours) periods of cerebral blood flow restoration. In
the dynamics of ischemia/reperfusion, the neuroprotective effect of ischemic postconditioning was manifested by an increase in the activity of antioxidant defense enzymes while maintaining the risk of developing hyperhydration of the lung tissue.