The verification of the diagnosis of “myocarditis”, despite the active introduction of modern survey methods, is still complicated, which leads not only to late diagnosis, but also to worsening the prognosis of patients. The purpose of this study was to identify the causes of late diagnosis of inflammatory diseases of the myocardium, evaluate the factors influencing the course of the disease, and the effectiveness of the therapy in patients with morphologically documented myocarditis. The study involved 50 patients with morphologically documented myocarditis. The duration of follow-up was 3.5±1.6 years. In 59% of cases, myocarditis was diagnosed within a period exceeding 6 months of the first clinical and instrumental manifestations. Long-term prognosis of patients with regard to global contractility of the left ventricle depended on the timing of verification of the diagnosis (c² = 6.9, p <0.05) and the clinical variant of the debut of the myocarditis (c² = 13.7, p <0.01). There was a significant deterioration in the prognosis in  patients who have a heart failure clinic and rhythm disorders in the onset of the disease, as well as in patients with late diagnosis of the disease due to erroneous treatment. It was concluded that the presence of idiopathic rhythm disturbances should be considered as an excuse for excluding myocarditis in patients with already diagnosed heart diseases. The study proved an improvement in the prognosis on the background of combined therapy for heart failure (ACE inhibitors, beta-blockers and diuretics) (c² = 9.28, p <0.01), and statin therapy (c² = 6.04, p <0.05).

Background. Dissatisfaction with the results of drug and non-drug therapy of atrial fibrillation causes clinicians and scientists to seek new methods for treatment of this arrhythmia.

Objective. The paper aims at studying the features of cardiac remodeling and morphological changes of myocardium in chronic heart failure patients with atrial fibrillation.

Materials and methods. The features myocardial remodeling and the morphology of the myocardium of a right atrial auricle segment were studied, respectively, by echocardiography and by microscopy in chronic heart failure patients with and without atrial fibrillation.

Results. Compared to patients without cardiac arrhythmia, patients with chronic heart failure, with atrial fibrillation, revealed more pronounced hypertrophy of the walls of the myocardium of the left and right ventricles, increased myocardial mass index, dilatation of both right and left atria, increased pressure in the pulmonary artery and veins. With a constant form, unlike paroxysmal atrial fibrillation, structural disorders of the walls and chambers of the heart were more pronounced. The interstitial edema of the myocardium of the auricle of the right atrium was detected in patients with atrial fibrillation compared to patients without arrhythmias.

Conclusion. More pronounced atrial dilatation in heart failure patients with atrial fibrillation is accompanied by interstitial myocardial edema, which, perhaps, is one of the reasons for the emergence and maintenance of atrial fibrillation.

Background. Navigation systems can perform anatomical reconstruction of the heart, build activation maps and perform accurate radiofrequency ablation (RFA). But they are ineffective because of the anatomical location of the arrhythmogenic focus. The method of surface non-invasive mapping, allows you to determine the prognosis, evaluate the scope and treatment tactics.

The goal is to assess the accuracy and effectiveness of eliminating surface and invasive endocardial mapping using the Russian systems «Amycard» and «Astrocard».

Material and methods. The study included 23 patients (m – 16, f – 7) with ventricular rhythm disturbances of non-ischemic origin. Patients underwent non-invasive pre-operative mapping using the «Amycard» system and invasive mapping using the «Astrocard» complex and subsequent RFA.

Results. In 22 patients, the early activity zone was verified from the endocardial ventricular surface, with the epicardial surface in 1 case. Efficiency RFA was 82,6% (19). The accuracy of the coincidence of noninvasive and endocardial invasive mapping was 98%.

Conclusion. Use of non-invasive preoperative mapping makes possible to accurately verify the arrhythmogenic focus in the heart, as evidenced by the results of invasive mapping. It increases the effectiveness of RFA, reduces the duration of the procedure and fluoroscopy, and determines the tactics of treatment.

The purpose was to analyze clinical features of epilepsy in a neurosurgical department.

Materials and methods. The study was retrospective. Primary documentation from epilepsy database since 2012 for 2017 was analyzed. The cohort consisted of 91 case histories of patients with drug-resistant epilepsy. Demographic indicators, clinical features of epilepsy, results of neurovisualisation and neurophysiologic dates were analyzed. Comparison of the obtained data was carried out with average data for epilepsy.

Results: Average age of the hospitalized patients was 32 y.o. The average duration of an epilepsy – 19 y. 77% of the patients suffered from epilepsy for more than 10 years, 41% – more than 20 y. Focal epilepsy was diagnosed in all cases (100%): temporal localization -71%. extra temporal – 29%. 37,4% patients had clustered seizures. Epileptic status had 3.4%. In the group of patients with epilepsy duration more than 10 years bilateral epileptic activity was observed.

Conclusions: The epilepsy in patients in neurosurgical hospital was presented by focal drug-resistant forms, frequent seizures and late administration to a neurosurgeon. Now Polenov Russian Scienific Research Institute of Neurosurgery became a center of surgical treatment of drug-resistant epilepsy. The high duration of a disease in a neurosurgical department demands search for a solution.

Background. Chronic pain is a pathologic process changing the whole body metabolism.

Objective: determination of plasminogen regulators in tissues of cutaneous melanoma and in the skin tissues not associated with the tumor in female mice in the dynamics of the growth of experimental melanoma with chronic neurogenic pain.

Design and methods. в16/F10 melanoma with chronic pain was reproduced in female С57вL/6 mice. Plasmin-alpha2-antiplasmin complex (PAP), urokinase (pro-uPA and uPA) and tissue (pro-tPA and tPA) plasminogen activators, the uPA (uPAR) receptor and serpin-1 (PAI-1) were determined by ELISA using standard test systems. Results were analyzed using the Statistica 10 program.

Results. Chronic neurogenic pain was accompanied by significant changes in the fibrinolysis components in the skin of female С57вL/6 mice. After the в16/ F10 melanoma transplantation (1-3 weeks), skin and tumor tissues showed higher levels of рар and the uPAR receptor (p<0.05), decreased levels of pro-uPA and uPA, pro-tPA and tPA, and PAI-1 (p<0.05), compared to the comparison group (standard melanoma model).

Conclusion. Analysis of the state of the tissue fibrinolysis in the skin and tumors of female С57вL/6 mice demonstrated that during the tumor formation with chronic neurogenic pain, plasmin, tPA, uPA, uPAR and PAI-1 play a leading role in the rapid growth and increased malignancy of melanoma. The study of the proposed model will make it possible to clarify many questions of carcinogenesis and the generalization of the malignant process. Studying the model can clarify many issues of the carcinogenesis and progression of the malignant process.

Epigenetic changes are defined as inherited/non-inherited modifications that control alterations in gene expression without any structural changes in their nucleotide sequence. Epigenetic mechanisms include DNA methylation, methylation, phosphorylation, ubiquitination, acetylation and glycosylation of histones. These processes are associated with the adaptation of the structural and functional organization of chromatin to the local physiological and metabolic changes in response to environmental conditions. It is known by now that the number of diseases is associated with disruptions in the mechanisms of epigenetic regulation; however, epigenetic changes are dynamic and their potential reversibility makes them the promising targets for pharmaceutical interventions to correct alterations associated with epigenetic reprogramming.

Experimental approaches to the investigation of epigenetic mechanisms may seem complicated, since they all are time-consuming and require experience in performing complex experimental tasks. In our work, we present the protocols for the preparation of samples for the study of DNA methylation and histone modifications that are the result of integration and adaptation of the methodological approaches described in various scientific publications. All experimental procedures we tested on the cellular models of adipogenic differentiation of mesenchymal stem cells. These protocols will be useful for those who plan to study the mechanisms of epigenetic regulation of specific genes, or for full-genome mapping of certain epigenetic modifications; these protocols can also be adapted for immunoprecipitation of any regulatory DNA-protein complexes.