Introduction. Endovascular treatment is currently the main treatment method of patients with peripheral arterial disease. The main disadvantage of this treatment method is the frequent development of restenosis in the long-term postoperative period, which necessitates the development of more advanced devices aimed at preserving the integrity of the inner layer of the artery. Objective. To study the effect of a new self-expanding nitinol stent on changes in the architecture of the vascular wall and cellular components of tissues adjacent to the implantation site by analyzing the vascular condition in laboratory pigs. Material and methods. Two Landrace pigs had stents with 5–20 % oversizing implanted in the common iliac artery. Vital signs were monitored during the follow-up; 3 days before the procedure and thereafter, dual antiplatelet therapy was used. After 3 months, angiography and ultrasound of the iliofemoral segment were performed, then the animals were euthanized. The extracted sections of the arteries with implanted stents were subjected to a thorough macroscopic and histological analysis. Results. For 3 months, the vital signs remained within the normal range. Angiography and ultrasound revealed patency of the stented area without significant restenosis. Morphological examination of the tissues demonstrated the integrity of the internal elastic membrane of the arteries. Conclusion. The implantation of the new domestic self-expanding nitinol stent caused a favorable reaction of the common iliac artery wall with minimal myointimal hyperplasia in the postoperative period. Thus, the new domestic self-expanding nitinol stent developed by us has successfully passed the stage of preclinical animal testing.

Genetic studies have shown associations between polymorphic regions of genes that determine the metabolic processes of xenobiotics, transcription factors, signaling pathways, membrane receptors and cytokines with a pleiotropic effect, as well as antigen-presenting molecules, with congenital heart defects (CHD). A significant problem in assessing the impact on the formation of congenital heart disease of a wide set of polymorphic variants of genes unrelated to each other by signaling pathways is their complex, combined interaction, which requires the use of a developed scheme for analyzing data from the binary system “sick — healthy”. Aim of the study: to assess the significance of a wide set of genes for the formation of congenital heart defects. Materials and methods. Genotyping of polymorphic loci of immune response genes, xenobiotic metabolism genes, and signaling pathway genes was performed and comparison of genetic profiles in children with sporadic (without family history) septal congenital heart disease with the absence of chromosomal pathologies with a control conditionally healthy group of children using various classifiers. Data analysis was performed on a wide range of polymorphic gene variants according to a developed scheme: assessment of the data structure; selection of significant polymorphic variants of genes associated with congenital heart disease; training and testing of nonlinear classifiers; repeated selection of associative variants of polymorphic gene regions with optimization of nonlinear classifiers; construction of a linear classifier. Results. The most significant polymorphic variants of genes that determine the formation of congenital heart defects were identified: GSTP rs1871042, GSTP rs1695, CYP1A2 rs7622551, GATA6 rs10454095, TREM1 rs4711668, TLR1 rs5743551, IL6R rs2228145, IL6R rs222923 8, IL8 rs4073, HLADRB1*. Models such as random forest (RF), support vector machines with a polynomial kernel (PSVM) and Gaussian processes for classification (GPC) were obtained with good accuracy both for individual classes and average accuracy. A method has been tested to increase classification accuracy by combining models into a simple voting system, which may be of (applied) practical interest for pilot studies of a wide range of polymorphic variants of genes with unrelated signaling pathways.

Chronic heart failure with preserved ejection fraction (CHFpEF) is a multifactorial condition with various pathophysiological causes and morphological manifestations, which largely determines the use of therapeutic approaches adapted to the patient’s clinical phenotype. In recent years, CHF has been increasingly replacing chronic heart failure with a reduced ejection fraction (CHFrEF), and is an equally serious condition that reduces the quality of life of patients on a par with CHFrEF. Currently, CHFpEF affects approximately 9 % of individuals over the age of 60, and the 5-year survival rate for this form of heart failure is roughly 35 %. The contemporary pharmacological armamentarium for managing CHFpEF symptoms remains notably limited. One promising therapeutic avenue involves targeting the modification processes — and consequently the mechanical properties — of titin, a major protein of the muscle sarcomere. Active research is currently underway on the development and application of agents that influence titin modification, with ongoing preclinical and clinical trials. This review examines the structure and post-translational modification (predominantly phosphorylation) of titin. It also explores the various signaling pathways whose dysregulation is associated with CHFpEF pathogenesis, as well as data from studies investigating drugs that target these pathways in both animal models and human subjects. The review presents an analysis of domestic and international literature published between 2000 and 2026, sourced from platforms including PubMed, Elsevier, and Google Scholar. Current evidence indicates that modulating titin modification is a potentially effective strategy for treating chronic heart failure. These findings underscore the need for further investigation in this field. The ultimate goal is to identify novel pharmacological solutions and integrate them into clinical practice to enable personalized management of CHFpEF syndrome.

The cellular plasma membrane functions not only as a structural barrier but also as a dynamic regulatory platform, integrating stress, mechanical, and metabolic signals and coordinating intracellular and intercellular adaptive responses. It ensures the spatial organization of signaling complexes, promotes compartmentalization of biochemical processes, and creates conditions for rapid and selective reorganization of the cellular response to microenvironmental changes. This review proposes the concept of a membrane-associated epichaperome, organized in functional association with lipid microdomains and forming an epichaperome-lipid interface — a structurally and functionally integrated platform that unites proteostasis, membrane biophysics, and adaptive signaling.

The membrane heat shock proteins HSP70 and HSP90 coordinate intracellular signaling cascades, serving as platforms for the assembly and stabilization of multiprotein complexes, including receptors and kinases. They support the activity of signaling pathways and regulate intercellular communication via exosomes, extracellular vesicles, and tunneling nanotubes. Furthermore, these proteins participate in the remodeling of the lipid environment, influencing the organization of lipid rafts and ensuring the functional plasticity of membrane domains, which facilitates cellular adaptation to changing conditions. In pathological conditions, including tumors, chronic inflammation, and neurodegenerative diseases, the epichaperome-lipid interface forms pathologically adaptive signaling platforms that promote cellular plasticity, drug resistance, invasion, and cooperative behavior. The proposed theory of the membrane-associated epichaperome expands the traditional understanding of cytoplasmic chaperone networks and provides a new conceptual basis for the development of diagnostic markers and translational therapeutic strategies aimed at the selective disruption of pathological membrane platforms. The aim of the work is to summarize modern data on the molecular organization and functions of the epichaperome-lipid interface and discuss its importance in the pathogenesis of socially significant human diseases.

The period of the Special Military Operation (2022–2026) marked an era of profound and comprehensive transformation for Russian military medicine, driven by unprecedented challenges: the high intensity of combat operations, the predominance of mine-blast trauma and polytrauma in the structure of sanitary losses, and the need to provide care under conditions of mass and irregular influx of the wounded. An analysis of 78 scientific publications demonstrates that the response to these challenges was not merely adaptation, but a fundamental restructuring of the entire medical evacuation and treatment system. The classical linear staging gave way to a network-centric model, where mobile forward medical groups and aeromobile units play a key role, while “vertical” evacuation by air ambulance has reduced the time for delivering severely wounded patients to multidisciplinary hospitals to 60–90 minutes. In clinical practice, a true technological breakthrough occurred: the principles of Damage Control Surgery became the standard for treating polytrauma, and in vascular surgery, priority shifted to endovascular and hybrid methods, fundamentally changing approaches to treating traumatic pseudoaneurysms and arteriovenous fistulas. Concurrently, massive transfusion protocols were standardized, becoming a key factor in reducing mortality from acute blood loss, and modern multimodal analgesia protocols were introduced, including the legalized use of narcotic analgesics at the pre-hospital stage. A continuous system of staged medical and psychological rehabilitation has been established, integrating high-tech prosthetics, including myoelectric prostheses, methods for managing phantom limb pain (botulinum therapy, mirror therapy), and robotic exoskeletons. The accumulated experience, grounded in the close integration of military and civilian medical services, has not only forged a new “gold standard” for managing severe combat trauma but has also acted as a powerful catalyst for innovation, with outcomes that hold strategic significance for the development of the entire healthcare system, particularly in the field of disaster medicine.

Obesity is a global health problem whose incidence is steadily increasing. Modern lifestyles, characterized by changing dietary preferences and low levels of physical activity, are key factors in the development of obesity and overweight. Obesity increases the risk of numerous gastrointestinal (GI) diseases, such as gastroesophageal reflux disease, inflammatory bowel disease, functional digestive disorders, and others. The pathogenesis of these conditions includes chronic low-grade inflammation, increased intestinal barrier permeability, and changes in the intestinal microflora. The purpose of this article is to describe and systematize high-calorie diets and to study the morphological and pathophysiological mechanisms by which these diets influence the gastrointestinal tract. This review examines the main types of diets used to model obesity in laboratory animals: high-fat, high-carbohydrate, with a choice of fats or carbohydrates, combined (“cafeteria diet”, “Western diet”), and models of psychogenic overeating. Histological features of the gastrointestinal tract wall of obese rats are represented by changes in the mucosa (a decrease in the number of PAS-positive goblet cells) and the lamina propria (an increase in the number of neutrophils, lymphocytes, macrophages, and collagen fibers). In addition, increased concentrations of IL-1β, IL-6, IL-8, TNF and monocyte chemotactic protein (MCP-1), and malondialdehyde (MDA) were detected in the colon wall. Obesity and excess body weight have been shown to impact structural components of the nervous system (hyperactivation of enteric ganglia, disruption of the autonomic nervous system, etc.), leading to impaired gastrointestinal motility.

Experimental studies demonstrate that high-calorie diets alter the histological characteristics and motility of the gastrointestinal tract in laboratory animals, causing structural damage and disruption of innervation of the digestive organs. This indicates the need for further research to identify the mechanisms underlying the development of obesity complications and develop effective preventive measures.

The aim of the study was to quantify and compare the parameters of cerebral tumor blood flow in neuro-oncological neurosurgical patients with relapse-free course and recurrence of glial low-grade tumors using SPECT-CT with ^99mTc-Technetril as a tumorotropic radiopharmaceutical, and MRI in the arterial spin labelling (ASL) mode. Materials and methods. The study included 23 patients treated 2019-2020 with glial brain tumors (15 with grade 2‒4 anaplasia gliomas and 8 with glioblastomas). Of these, 16 with glial brain tumors (13 — gliomas and 3 — glioblastomas) after radical tumor removal followed by external gamma therapy, and 7 with inoperable formations were examined after chemoradiotherapy, without surgical removal. The patients were divided into groups 1 — with a relapse-free course, 11 people; of those who had a relapse/continued growth, 12 patients (group 2), five of them died during a two-year follow-up. All underwent MRI of the brain (MRI 3.0 T) in ASL mode with calculation of cerebral blood flow in absolute units — as ml/min/100 cm3, as well as SPECT-CT with ^99mTc-Technetril on a gamma camera with the ability to determine standardized uptake values (SUV), with calculation of blood flow in tumor formations (РКрОп_ОФЭКТ), using the method KML (Krivonogov-Minin-Lishmanov), as РКрОпОФЭКТ = СВП99mTc-Технетрил * (МО/Body Weight) * 100, where СВП99mTc-Технетрил is the standardized value of rfp uptake, MO is the minute volume, 100 is the conversion coefficient for representing the result in the usual units “ml/min/100 cm³ of tissue”. Results. ASL MRI and SPECT-CT with ^99mTc-Technetril methods significantly correlate with each other and are interchangeable in terms of the obtained values of blood flow of malignant tumors, both maximum and average in the studied regions. If there is a visual nodular structure in the area of the removed brain tumor, and blood flow anywhere within it is more than 23 ml/min/ 100 cm³, the presence of continued growth or recurrence of a low-grade glial neoplasm is likely. Conclusion. As follows from the presented visual-semiotic and computational data of ASL MRI and SPECT CT with ^99mTc-Technetril, these methods should reasonably be used as widely as possible for early monitoring of the postoperative condition in patients after radical removal of glial low-grade brain tumors. It is advisable to further their comparative and joint study, including in inter-center studies.

Relevance. Declining birth rates and the increasing prevalence of pregnancy complications remain major medical and demographic challenges in the Komi Republic, underscoring the need for continuous monitoring of maternal health indicators and evaluation of regional support measures. Objective. To analyze trends in key maternal health indicators in the Komi Republic in 2012–2024 and to assess the impact of organizational measures on maternal health and pregnancy outcomes. Materials and methods. The study was based on data from statistical reports of the Komi Republic Medical Information and Analytical Center and official data from the Federal State Statistics Service of the Russian Federation (Rosstat). A retrospective analysis was performed of birth rates, morbidity among pregnant women, complications of pregnancy, labor and the postpartum period, operative delivery rates, and the effectiveness of antenatal follow-up. Results. Over the past 12 years, the birth rate in the Komi Republic decreased by 52 %. Against the background of a declining number of births, there was an increase in the prevalence of anemia among pregnant women, with values exceeding the national average in several years, as well as a rise in diabetes mellitus and endocrine disorders. An upward trend was also observed in complications of labor and the postpartum period, including obstetric hemorrhage and infectious complications. At the same time, operative rates activity increased. Positive changes were noted in antenatal care coverege: the proportion of women registered in early pregnancy reached 91.5 %, and coverage with prenatal follow-up remained high. Conclusion. The findings indicate unfavorable trends in maternal health in the Komi Republic and support the need to improve prevention of extragenital diseases, optimize management of pregnancy and childbirth in high-risk women, and further strengthen the regional maternal and child health system.

The article presents two autopsy cases of systemic scleroderma that led to the death of patients, as well as a review of the literature on the etiology and pathogenesis of the disease, with a focus on the development of infectious complications in these cases. Scleroderma is a rare connective tissue disorder, and one of the most common causes of death is infectious complications, including sepsis. The aim of this study was to analyze two clinical cases of systemic scleroderma that resulted in the death of patients. Materials and methods. The results of autopsies of two patients with a diagnosis of systemic sclerosis are presented: a 63-year-old woman and a 59-yearold man. In each case, an autopsy was performed with a macroscopic examination of all organs and tissues. For histological examination, in case 1, samples were taken from the lungs, heart, liver, kidneys, skin, esophagus, small and large intestines, right lumbar muscle, and bodies of the I and III lumbar vertebrae; in case 2, samples were taken from the lungs, heart, liver, kidneys, skin, and esophagus.