Background. The system of insulin-like growth factors (IGF) is involved in carcinogenesis. Objective. Studying the dynamics of the IGF system components in the lungs of rats with antitumor effect of 1,3-diethylbenzimidazolium triiodide (Stellanin). Design and methods. The main group included male (n = 27) and female (n = 27) white outbred rats with sarcoma 45 (s45) inoculated into the subclavian vein but not developed in the lungs (2 × 10⁶ cells) due to Stellanin administration (intragastrically, 0.4 mg/kg once a day according to the regimen: administration for 5 days with a 2-day interval). Control group included males (n = 14) and females (n = 14) with s45 growing in the lungs without treatment. Levels of IGFI-II and IGFBP1-3 were measured by ELISA in 10 % lung homogenates obtained at weeks 4–8. Results. The s45 development in the lung was accompanied by the IGF-I increase by 2.4–3.0 times in males and by 4.3 times in females, and the opposite IGF-II dynamics: an increase in males (by 4.6 times) and decrease in females (by 4.3 times), together with the IGFBP decline. Stellanin upregulated IGF-I levels in the lungs of all rats on average by 1.3 times (p < 0.05) and normalized IGF-II in males, while increasing it in females by 1.6 times (p < 0.05), together with higher (compared to controls) IGFBP levels. Conclusion. Preventive anticancer effect of Stellanin is based on the stabilization of the IGF system grossly altered during the malignant process development in the lung.

Background. Abdominal obesity (AO) is a key factor of metabolic syndrome (MS) and risk factor of cardiovascular diseases (CVD). The level of physical capacity (PC) is an important diagnostic and prognostic criteria and a risk stratification factor in healthy individuals and patients with CVD. Objective. To evaluate the effect of changes in the level of PC on the course of MS in patients with AO on the background of non-drug correction of body weight. Design and methods. A 3-year prospective study was conducted on weight loss by non-drug methods in 153 patients with AO and MS and /or CVD risk factors. The dynamics of MS, indicators of carbohydrate and lipid metabolism, and blood pressure levels were evaluated depending on changes in the level of PC. Results. The favorable course of the MS was more common in patients with an increase in the level of PC than in patients with a decrease in this indicator (82.3 and 37.5 %, respectively; p = 0.0001). When increasing VO_2peak > the 5 % to 15 % chance of a favorable course of MS increases by 5.8 (1.5–22.3) and 15.1 (5.7–39.9) times, respectively. Conclusion. An increase in the level of PC is associated with a favorable MS dynamic.

Assessment of systolic and diastolic ventricular function is one of the main goals of echocardiography. Nevertheless, some patients require data beyond standard echocardiographic protocol for making more precise clinical decision and prognosis determination. The spectrum of novel parameters, including myocardial strain and strain rate, provides more comprehensive evaluation of the initial changes in myocardium in a variety of clinical conditions. New methods of quantifying the systolic function of left and right ventricles can be applied in patients with arterial hypertension, coronary heart disease, hypertrophic and dilated cardiomyopathies, also in patients with valvular heart disease such as aortic stenosis, aortic and mitral insufficiency. Besides strain analysis in patients with myocardial storage diseases, patients on cardiotoxic chemotherapy and patients with heart transplant turned out to be a specific niche for the method. Here, we provide the possibilities of strain analysis in variable heart pathologies in clinical practice.

Russia is on the second place among European countries in the number of completed cycles of assisted reproductive technologies (ART). The proportion of children conceived using ART becomes annually higher. The present review summarises data on the impact of new reproductive technologies on the risk of developing cardiovascular diseases are presented. Potential health risks in the introduction of ART in babies born are discussed in numerous studies, the impact on all stages of embryo- and organogenesis is noted. The greatest problem is a possible increase in the incidence of congenital malformations (CM) in children after ART compared to the latter in the natural population. The frequency of CM is due not only to the use of APT, but also to factors such as genetic characteristics, age and state of health of the mother, aggravated obstetric-gynecological history, multiplicity, low birth weight of the fetus. In children conceived with ART, often appear early symptoms of systemic endothelial dysfunction, metabolic disorders (lipid metabolism, glucose level), congenital heart defects (interventricular septum defect, small cardiac development abnormality (false chord), open arterial duct, open oval window). There is a need to improve prenatal diagnostics of CM in early pregnancy and regular medical examinations of children conceived with ART.

Background. Essential arterial hypertension (AH) is a global problem of the healthcare system. Kidney damage could aggravate the course of the disease, and genetic factors play an important role in the development of hypertensive nephropathy: approximately 50% of patients are carriers of genetic polymorphisms that predispose to the occurrence of hypertensive nephropathy. Objective. Studying the relationship between genetical disorders and features of intrarenal blood flow among patients with AH. Design and methods. 114 patients (49 men and 65 women) aged 35 to 58 years with stage I–II hypertension and 1–3 degrees of arterial hypertension were examined. Duplex scanning of renal arteries was performed using a Vivid-7 Dimension ultrasound scanner, genotyping of the Т786С polymorphism of the NOS3 gene using a real-time polymerase chain reaction; the calculated glomerular filtration rate (using the CKD-EPI formula) was analyzed. The examined patients were divided into 2 groups: the 1st group included individuals with glomerular filtration rate (GFR) greater than or equal to 60 ml/min/1,73 m² (32 men and 40 women), the 2nd group — with GFR 45–59 ml/min/1,73 m² (17 men and 25 women). Results. In patients with hypertension with GFR 45–59 ml/min/1,73 m2 , the predominance of the CC genotype and allele-C was found, and among patients with GFR greater than or equal to 60 ml/min/1,73 m², the TC genotype and allele-Т prevailed. In the second group, higher values of peripheral resistance indices were observed in comparison with the first group. It was also found that individuals with TC and CC genotypes had higher indices of peripheral resistance of intrarenal blood flow compared to patients with TT genotype. Conclusion. The presence in the genotype of patients with arterial hypertension of the 786C allele and the CC genotype of the NOS3 gene can predispose to early kidney damage, and an increase in the indices of peripheral resistance of blood flow in the interlobar renal arteries can serve as a criterion for the development of hypertensive nephropathy in patients with arterial hypertension.

Background. Hippocampal sclerosis is one of the most common structural lesions associated with epilepsy. The standard medical care in the treatment of drug-resistant temporal lobe epilepsy associated with hippocampal sclerosis is surgery with anterior temporal lobectomy. The extent of resection depends on the involvement of hippocampal sclerosis in the epileptic system. Objective. Determine the relationship between the involvement of the hippocampus in the epileptic system (on the basis of the results of intraoperative electrocorticography (ECoG)) and the presence of structural changes in it, found on the basis of MRI data. Materials and methods. The present article presents an original retrospective study of the dependence of the signs of hippocampal sclerosis according to neuroimaging data and the formation of epileptiform activity in 36 patients treated at the Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre in 2015–2018. Results. Depending on the presence of hippocampal sclerosis and epileptiform activity, patients were divided into 4 groups: 1) patients with the presence of both hippocampal sclerosis and epileptiform activity in the mesiobasal structures (n = 15); 2) patients with identified sclerosis of the hippocampus, without registration of specific activity according to the results of ECoG (n = 8); 3) patients with epileptiform activity, while MR-negative (n = 10); 4) patients without epileptiform activity and without signs of hippocampal sclerosis according to MRI (n = 3). After a statistical check of the distribution of patients, it was found that the distribution was random. Conclusion. The fact of the presence of structural changes in the hippocampus could not be a pathognomonic sign of the inclusion of the hippocampal-entorial complex in the epileptic system.

Background. Experimental and clinical evidence of the effectiveness of surfactant application in treatment of influenza A/H1N1 became prerequisites for the use of surfactant in the treatment of patients with COVID-19. Objective. To analyze the results of the application of a surfactant inhalation therapy in the SARS-CoV-2 severe pneumonia treatment. Design and methods. The present study represents retrospective controlled study, including 68 patients with severe viral pneumonia. Inclusion criteria: confirmed SARS-Cov-2 infection; bilateral polysegmental COVID-19 pneumonia with a lesion of at least 2 deg. according to CT data; SpO2 less than 92 % with face mask oxygen supplementation ≥ 6 l/min flow. Exclusion criteria: wrong in-closure administration of Surfactant-BL; invasive mechanical ventilation. Twenty-eight patients received traditional therapy (antiviral, anti-inflammatory, anticoagulant) combined with inhalation of Surfactant-BL at a dose of 1 mg/kg, 2–3 times a day, for 3–5 days. Forty patients from the control group received only traditional therapy. Results. In the group of patients who were treated in the infectious diseases department (16 patients received surfactant, 20 — traditional therapy), a significant increase in SaO2 after 24 h of therapy, a lower risk of transfer to the ICU (6.25 % when using surfactant, 45 % — in control cases, p = 0.011), a tendency towards lower mortality (6.25 % when using a surfactant, 30 % in control, p = 0.084) were found. In the group of patients treated in the ICU and receiving non-invasive respiratory support (non-invasive mask mechanical ventilation or high-flow oxygen therapy, 12 patients received surfactant, 20 — traditional therapy), a significant increase in SaO2 was found after 24 h of therapy, a significantly lower risk of transfer to invasive mechanical ventilation (25 % with surfactant therapy and 75 % — in control group, p = 0.008) and significantly lower mortality (25 % with surfactant therapy and 75 % in control cases, p = 0.008). In the combined group of inhalation surfactant therapy, 4 out of 28 patients (14.3 %) died, in the control group 21 out of 40 patients (52.5 %) died, p = 0.001. Conclusion. The inclusion of surfactant therapy in the treatment of severe SARS-CoV-2 pneumonia made it possible to improve oxygenation, significantly reduce the need in invasive mechanical ventilation, and reduce mortality. Considering the limitations of the study, this technique effectiveness confirmation requires multicenter randomized controlled trials.

In 2020, a pandemic of the new coronavirus infection (COVID-19) began. Treatment of this infection is limited by the lack of effective etiological treatment, which requires the selection of empirical and symptomatic therapy. The obtained some effectiveness of the use of antimalarial drugs, antiretroviral drugs in combination with antibacterial therapy made it possible to recommend it for use in the treatment regimen for patients with COVID-19. However, these drugs provoke the development of undesirable side reactions that require correction to continue treatment. Considering the need to use complex therapy in the treatment of patients with COVID-19 and the direct effect of the virus on liver cells, the likelihood of developing hepatotoxicity is quite high. The described cases of liver damage are characterized by impaired functional activity, an increase in the level of liver function tests, the development of small-drop fatty infiltration and a mild inflammatory reaction in the liver lobules. The development of these complications requires the hepatoprotective drugs, which increase the liver’s resistance to the damaging effects of various pathogens and help restore the functional activity of hepatocytes. According to the conducted studies, hepatotropic drug inosine+ + meglumine + methionine + nicotinamide + succinic acid and reamberin contribute to the normalization of lipid metabolism, a decrease in the level of enzyme markers of liver damage. The article presents the complex treatment with lopinavir + ritonavir. Thanks to hepatoprotective therapy, a week later, a decrease in ALT, alpha-amylase, blood counts to normal values was achieved.

Background. Magnetic nanoparticles (MNPs) are considered as a means of targeted delivery, diagnosis and treatment, the main route of administration for them is intravascular, so it is important to evaluate their interaction with blood. We previously studied the effect of two samples of MNPs (MNP1 and MNP2) on the viability of human umbilical vein endothelial cells and hemocompatibility on human heparinized whole blood. Objective. The aim of the present study is to evaluate the effect of MNP1 and MNP2 on hemostasis. Design and methods. MNP1 and MNP2 suspensions were administered intravenously in outbred Wistar rats once and repeatedly (7 days); prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), and fibrinogen concentration were evaluated before administration, on the 15th and 31st days after the last administration. Results. It was shown that MNP1 and MNP2 decreased in TT and an increased in APTT (in the MNCH1 and MNCH2 groups) as well as its increased in the fibrinogen concentration (in the MNCH2 groups) after a single dose (400 mg/kg) on day 31. Repeated administration of 60 mg/kg MNCH1 led to decrease the fibrinogen concentration (day 15) and to increase in APTT (day 31) in females. Repeated administration of 10 mg/kg MNCH2 caused an increase in APTT (males and females) and a decrease in fibrinogen concentration (females) on the 15th and 31st days. Conclusion. Thus, a single administration of 400 mg/kg MNPs caused an imbalance in the blood coagulation system, changes were independed on the sex of animals, but depended on the time after administration. Repeated administration of MNPs caused gender-dependent hypocoagulation changes (more pronounced in females).