Visualization is one of the key factors for successful operation in endovideosurgery. Aspiration and irrigation play a critical role in ensuring adequate visualization at all stages of operations in general surgery, urology, gynecology and other areas of surgery. It is almost impossible to imagine any minimally invasive surgery without the use of an aspirator-irrigator. It is necessary to protect the intra-abdominal space from contamination and/or removal of blood, clots or other fluid during surgery, which in turn is essential to ensure adequate visualization of the surgical area. This article identifies the main historical stages in the introduction of aspiration and irrigation in minimally invasive surgery, as well as the main devices for removing biological fluids during laparoscopic and robotic operations, used in modern surgery.

Background. Osteoporosis is one of the most common diseases, which, along with myocardial infarction, stroke, cancer, and sudden death, occupies a leading place in the structure of morbidity and mortality of the population. Postmenopausal women are most vulnerable and are approximately 4 times more likely to be affected than men (80 % of all patients), and osteoporosis-related fractures are responsible for a significant increase in morbidity, disability, and mortality, especially in the elderly.

Objective. To study the acute toxicity of the new drug “Antiosteoporosis drug” (patent No. 02-04-16643/15-0 dated February 26, 2015) with a single intragastric administration to mature outbred rats of both sexes.

Design and methods. The study was conducted on outbred rats of both sexes according to protocol OECD 420, GOST 32296-2013. The development of a toxic effect was concluded based on behavioral tests, clinical examinations, changes in body weight, the results of pathomorphological examination of organ tissue and biochemical parameters of blood and urine.

Results. According to the results of the study, the tested drug was classified according to the active substance into category 5 according to the GHS classification (2000<LD50 (i/g)<5000 mg/kg). An assessment of the dynamics of body weight in experimental animals showed that a single intragastric administration of the test drug had no effect on this indicator. The study of individual behavior as part of the main study on the 14th day after a single intragastric administration of the test drug showed that a single intragastric administration of the test drug at a dose of 2000 mg/kg did not have a delayed effect on the general condition and indicative research activity of experimental animals. Autopsy and pathological examination of animals on the 15th day after a single intragastric administration of the test drug did not reveal the presence of any residual effects associated with the administration of the test drug. The tested drug did not have a local irritant effect on the injection site — the gastrointestinal tract. In all tests, the degree of change in indicators caused by the test drug was the same: there were no statistically significant differences in the recorded parameters between the test drug and the control group.

Background. Derivatives of diterpenes, in particular, resin acids, are of interest for the creation of pharmacological substances with a wide spectrum of action.

Objective. To perform a predictive assessment of the biological activity of oxidation products of fluorinated esters of resin acids.

Design and methods. Predictive assessment of the biological activity of the oxidation products of fluorinated esters of resin acids (I–VIII) was carried out using the PASS-online software. The prediction of physico-chemical and pharmacological properties of the studied compounds was carried out using the SWISS-ADME web server and SwissTargetPrediction.

Results. A predictive assessment of the spectrum of biological activity, physico-chemical and pharmacological properties of oxidation products of fluorinated esters of resin acids was carried out using PASS-online modeling and the SWISS-ADME and SwissTargetPrediction web server. All the studied compounds (I–VIII) are capable of exhibiting antiviral, antitumor, and dermatological activity. These results indicate the potential of using oxidized fluorinated esters of resin acids as a platform for the creation of pharmacological substances. Using SwissTargetPrediction, it was demonstrated that the most likely target (92 %) for compound (I) is a cholesterol ester transporter protein.

Conclusion. Based on the results of a predictive assessment of the spectrum of biological activity using the PASS-online and SWISS-ADME programs, the possibility of using oxidation products of fluorinated esters of resin acids as pharmaceutical substances was revealed.

The paper proposes a new mathematical model of dynamic processes in a typical spatially non-uniform biological system. The mathematical problem of modeling the dynamics of the neurovascular units of the brain under conditions of ischemic stroke is formulated and solved. An investigation of this model is conducted, and a numerical and programmatic implementation of the corresponding mathematical problem is proposed.

Medicine is one of the most promising and essential fields for the application of modern nanotechnologies. Targeted drug delivery, providing prolonged drug action, diagnostics, and the manufacturing of medical devices are among the promising applications of nanomaterials. The excellent electrical, mechanical, and optical properties of carbon nanoparticles, along with their ease of functionalization, have made them attractive candidates for the development of new materials for biomedical applications. As analyzed from contemporary literature, a significant amount of research in experimental oncology has been dedicated to the development of methods for targeted delivery of antitumor agents to biological targets, including the use of nanoparticles. Thus, the creation of antitumor drugs based on conjugates of cytostatic drugs with carbon nanostructures is one of the actively developing directions in medicinal chemistry. This review discusses scientific achievements in the synthesis and study of properties of nanocomposites based on graphene oxide and fullerenes with cytostatic drugs (such as paclitaxel, carboplatin, cisplatin, doxorubicin, gemcitabine, etc.), their mechanisms of action, and practical applications in biomedicine. Special attention is given to the requirements imposed on nanocarriers, methods of targeted delivery of nanocomposites to biological targets, and the advantages of using antitumor agents in the composition of nanoconjugates based on carbon nanostructures. Additionally, the review summarizes and iden- tifies the current challenges in the application of carbon nanostructures in biomedicine.

Modern clinical medicine with its achievements has helped a person to get rid of many infectious and non-communicable diseases, restore health, preserve and improve the quality of life of people with chronic dis- eases. Tens of thousands of medicines are used in medical practice. However, paradoxical as it sounds, having created medicines for almost all diseases, humanity has not become healthier and the need for medicines is only growing every year. More than 20 % of people receiving medications during therapy have various complications. Therefore, the search for medicines does not stop, but only increases at the present time. Another important problem is the detecting drugs in environmental objects and food products. Most drugs that get into wastewater from pharmaceutical factories and farms, even after treatment at wastewater treatment plants, are still diagnosed in the water. The method of fluorescence polarization is extremely widespread in clinical and biomedical fields. Thanks to the introduction into laboratory diagnostics of devices capable of measuring the signal of fluorescence polarization on microplates, polarization fluorescent analysis is used not only in the traditional format: the detection of drugs in human physiological fluids, environmental objects and food, but also in high-tech screening of drugs, significantly speeding up and facilitating the process of identifying new drugs.

A scientific study is devoted to the problem of burnout of medical workers providing primary health care. The presented protocol is aimed at creating promising personalized rehabilitation programs, the development of which will be based on the data of laboratory and instrumental examinations of a particular medical worker and will include not only psychotherapeutic assistance, but also comprehensive counseling by specialized specialists, as well as a variety of physiotherapeutic treatment. With the help of quality of life and burnout questionnaires, a comparison will be made between employees of the inpatient and outpatient departments of medical institutions, as well as a comparison of the effectiveness of the developed personalized rehabilitation programs. It is planned that as a result of the study, the created rehabilitation programs will reduce the level of professional burnout and will be aimed at overcoming professional adaptation, which will improve the climate of the professional environment and maintain mental and physical health, as well as increase the professional prestige of medical specialties and ensure a decrease in the outflow of personnel from medical institutions.

Background. To date, the influence of genetic variants in the titin gene on the development of all types of cardiomyopathies has been proven, and this primarily applies to TTNtv, however, the high frequency of these variants in the control population (1–3 %) significantly complicates the determination of the pathogenicity of the detected variants. In addition, due to a significant population frequency (1–3 %) in patients with CMP, variants in the titin gene are often combined with causal variants in other genes, and thus can act as modifiers of the clinical course of the disease and myocardial remodeling.

Objective. To study the effect of shortening variants in the titin gene on the clinical course of cardiomyopathies in the presence of causative variants in other genes or etiological factors of the disease.

Design and methods. This article will consider three clinical cases of patients diagnosed with CMP who were treated at the Almazov National Medical Research Center. To conduct a genetic examination, next generation sequencing was used with a target cardiopanel to check 108 genes associated with the development of cardiomyopathies, as well as Sanger sequencing to exclude false positive results.

Results. During a genetic examination of the studied patients, identified genetic variants in the titin gene led to the syn- thesis of a truncated protein: in all cases, the reason for this was frameshift deletions located in exons with a PSI (Percent Spliced-In) level of 100%. According to the American College of Medical Genetics and Genomics pathogenicity classification, two genetic variants are classified as pathogenic and one is classified as probably pathogenic.

Conclusion. In these patients, we found shortening variants (frameshift deletions) in the titin gene, which acted as modifiers of myocardial remodeling.

Intestinal cystous pneumatosis is a rare pathology in pediatric practice, accompanied by a nonspecific clinical picture, which greatly complicates the diagnosis. The literature describes isolated cases of the development of this condition in oncohematological patients of childhood. Intestinal cystous pneumatosis in them can be complicated by life-threatening conditions, and therefore the choice of the correct tactics for managing these patients significantly affects survival. This article describes 2 clinical cases when cystic pneumatosis of the intestine developed during the treatment of an oncological disease.

Background. Magnetic resonance pelviophetometry is a highly informative, non-invasive and safe method for assessing the size of the pelvis of a pregnant woman and the fetal head, but it has several disadvantages — a long scanning time, heating of the tissues of the pregnant woman and the fetus, and operator dependence.

Objective. Evaluation of the capabilities of the three-plane 3D Dixon MR-pelviophetometry (3D MR-PFM) technique, its comparative analysis with the generally accepted method of two-plane 2D MR-pelviophetometry (2D MR-PFM).

Design and methods. A retrospective analysis was perormed out in 26 pregnant women with risk for the development clinically narrow pelvis for various reasons. Results. The data obtained using the Dixon pulse sequence is comparable to the data obtained during the standard technique.

Conclusion. The Dixon sequence can be used for the developed 3D method of MR pelviophetometry, since it allows to reduce the scanning time and, according to statistical analysis, show comparable results.