Background. Studying the microbiome in the conditions of a sluggish process and low-symptom clinical picture in women with miscarriage will help to understand the role of the microbial factor in the development of chronic inflammatory diseases of the pelvic organs (CIP).
The aim. To study the composition of vaginal microbiota in chronic cervicitis and chronic endometritis to assess the scope of diagnostic examinations in case of miscarriage.
Material and methods. The observational study involved 113 patients with miscarriage associated with chronic inflammatory diseases of the pelvic organs. The respondents filled out questionnaires, underwent general clinical, gynecological and instrumental examination. Evaluation of the microbiota of the vaginal contents included microbiological, molecular biological and bacteriological methods. Statistical analysis of the data was carried out using the Statistica 6.1 Statsoft Inc., USA program.
Results. In all study groups, associations of microaerophiles with mycoplasma representatives were revealed (p > 0.05); obligate anaerobic and facultative anaerobic flora prevailed in patients with CE and CE with chronic cervicitis (ꭓ² = 0.014, p < 0.05); HPV in association with obligate anaerobic and facultative anaerobic flora were observed in groups with chronic cervicitis (p < 0.001); herpesvirus infection was detected in groups with chronic cervicitis and CE with a predominance of CMV infection in patients with chronic endometritis (ꭓ² = 0.045, p < 0.05), while the number of lactobacilli did not have significant differences.
The species diversity of the vaginal biotope in chronic endometritis did not depend on the activity of plasma cells in the endometrium, the microbiota was detected in low non-pathogenic titers (10²–10⁴ CFU/ml).
Conclusion. It is necessary to take into account the qualitative and quantitative composition of dysbiotic changes in the vaginal microbiota to improve the diagnosis of the etiological factor and justify an in-depth examination, including an assessment of the immune status, in order to improve the effectiveness of preventing miscarriage associated with chronic pelvic inflammatory disease.

The review examines the evolution, structural and functional organization and regulatory properties of glucokinase, which is predominantly expressed in β-cells of the pancreas and in liver hepatocytes. Considerable attention is paid to the possible role of glucokinase in the etiology and pathogenesis of type 2 diabetes mellitus (T2DM), and the development of approaches to normalize insulin secretion, glucose homeostasis, carbohydrate and lipid metabolism using regulators of glucokinase activity. Data are presented on the influence of variants in the glucokinase gene and glucokinase regulatory protein in the development of disorders of the insulin-secreting function of the pancreas. Thus, inactivating mutations in the glucokinase gene cause T2DM, while activating mutations lead to congenital hyperinsulinism. Data are discussed that L-arginine, allosterically interacting with glucokinase, stimulates insulin secretion and inhibits the degradation of the enzyme, protecting it from ubiquitination. It is concluded that glucokinase and functionally related proteins are promising targets when developing approaches to normalize the sensitivity of pancreatic β-cells to glucose, restore insulin secretion and glucose homeostasis in T2DM and other metabolic disorders. Data for this review were identified by searching MEDLINE, PubMed, and references of articles published in English and Russian between 1966 and 2024.

Background. Current and past COVID-19 infection can provoke and aggravate the course of cardiovascular diseases, initiating the processes of thrombosis, inflammation and fibrinogen synthesis, affecting the pleuropericardial space, increasing the load on the right heart. The staging of the infectious process requires prospective studies to verify the nature of heart damage and its relationship with clinical manifestations and prognosis in each phase.
The aim. To identify the features of heart damage after past COVID-19 infection with lung damage in practically healthy people, their condition dynamics during a 6-month prospective observation, and compare them with the clinical manifestations of post-COVID syndrome.
Materials and methods. A closed cohort prospective (6-month) clinical and echocardiographic study of 100 patients was conducted. The echocardiographic study data were compared with the clinical manifestations of post-COVID syndrome.
Results. In the first month of observation, the main clinical manifestations in patients after the COVID-19 infection were general weakness, shortness of breath during physical exertion, swelling of the lower extremities, palpitations, arterial hypertension, thoracic pain, dilation of the left atrium and right ventricle on echocardiography, increased pressure in the pulmonary artery, signs of impaired relaxation of the left ventricle, valvular regurgitation, the presence of fluid in the pericardial cavity, with positive dynamics by the 6th month of observation. Echocardiography indicators are reliably associated with shortness of breath, general weakness, palpitations, increased blood pressure, and swelling of the legs.
Conclusion. The first month after the COVID-19 infection, in the studied group of patients, echocardiography is characterized by dilation of the heart chambers, increased systolic pressure in the pulmonary artery and valvular regurgitation, impaired diastolic function of the left ventricle and the presence of fluid in the pericardial cavity with stabilization of the indicators by the sixth month. A relationship was found between echocardiography parameters and clinical manifestations.

Background. Cancer drug resistance represents an obvious problem in clinical oncology. Among various intracellular pathways activated during drug resistance development, proinflammatory cascades considered to be involved as well. The inflammatory process may also play a key role in the formation of melanoma resistance to the chemotherapeutic agent dacarbazine.
The aim. To characterize differentially expressed genes and signaling pathways associated with cancer resistance to alkylating agent dacarbazine in melanoma cells in vivo with the use of high-throughput sequencing for transcriptomic profiling.
Methods. The effect of dacarbazine on melanoma cell gene expression was studied in a C57Bl6/B16 melanoma model in vivo. Mice were injected intraperitoneally with dacarbazine (50 mg/kg) on days 8, 10, and 12 after melanoma tumor transplantation. Total RNA was extracted from tumor nodes on the 14th day after melanoma transplantation to animals and the transcriptome was analyzed using a next generation sequencing method. Bioinformatic analysis was applied to identify differentially expressed genes and corresponding signal pathways.
Results. Twenty one differentially expressed genes were identified, of which an increase in expression was observed in 10 genes, and a decrease in expression activity was observed in 11 genes involved in signaling pathways associated with the inflammatory process “Comprehensive IL-17A signaling”, “Oxidative stress and redox pathway”, “TNF alpha NF-kB signaling pathway”.
Conclusions. Dacarbazine alters the expression of genes regulating inflammation, which may play a role in the development of chemoresistance.

Аsthma is associated with systemic inflammation, an important role in the development of which is played by lipid metabolism disorders, in particular, changes in the physiological balance of essential fatty acids (FAs). The balance of ω3 and ω6 polyunsaturated fatty acids depends on their adequate exogenous intake and endogenous processing with the participation of FA desaturases and elongase enzymes. Desaturases are encoded by FA desaturase genes (FADS), elongases by elongase genes (ELOVL). Most studies have focused on FADS gene polymorphisms that can alter the exogenous synthesis of PUFAs, which underlies the disruption of the formation of pro-inflammatory and pro-resolving lipid mediators responsible for the development of chronic inflammation. However, the mechanisms underlying the predisposition of carriers of polymorphic variants of FADS genes to the development of asthma are unknown. Evidence is emerging that ELOVL is involved in the pathophysiology of аsthma. Other genes associated with the development of аsthma, atopy, and PUFA metabolism have recently been discovered, the genes of members of the prolyl oligopeptidase family DPP10 and CD26/DPP4. Identification of carriers of these gene polymorphisms will allow to review and supply modern methods of treating asthma. The health effects of dietary ω3 and ω6 PUFAs may also vary depending on genetic variants in genes associated with PUFA metabolism. This raises the question of the need to study the genetic component in the formation of the body’s response to the development of systemic inflammation in asthma and methods of its correction through nutritional PUFAs.
The aim. To summarize the current understanding of the association of polymorphism of FADS, ELOVL genes and other genes associated with PUFA metabolism with lipid metabolism disorders and their role in the development of аsthma based on an analysis of articles published before 2024 in the PubMed database.

Background. The mediators of inflammation, which is the most important mechanism for the development of coronavirus infection, accompanied by various complications from the nervous system, both in the acute period of the disease and in the long term, are a group of interleukins.
The aim. To clarify the relationship between previous coronavirus infection and the content of serum interleukins in diseases of the nervous system.
Methods. The study involved 146 patients with acute cerebrovascular accidents (32), diseases of the central (60) and peripheral nervous system (54), of which 47 had COVID-19. The comparison group included 54 people comparable in age and gender without clinical signs of acute and chronic diseases. Using diagnostics from Vector Best, the content of interleukins 6, 8, 10 and 18 was determined by ELISA.
Results. In the blood of patients with diseases of the nervous system, the content of detectable interleukins is increased, the most characteristic of interleukin 6, the content of which in the blood of patients depended on the nature of the disease and was higher in patients who had recovered from COVID-19.
In the blood of patients with diseases of the nervous system, the content of detectable interleukins is increased, most characteristic of interleukin 6, the content of which in the blood of patients depended on the nature of the disease and was higher in patients who had recovered from COVID-19.
Conclusion. A greater intensity of the inflammatory process was established in patients who had recovered from COVID-19, manifested in a higher content of proinflammatory interleukins in relation to patients who have not recovered from coronavirus infection.

Background. In recent years, the tick Haemaphysalis concinna has drawn increased attention from researchers due to its expanding geographic range and its growing role in the transmission of diseases of various etiologies to humans and animals. However, studies on the infection of H. concinna with tick-borne pathogens affecting humans and animals in the Baikal region have been minimal, despite its known capacity to carry at least 40 pathogen species pathogenic to humans.
The aim. To investigate the infection of Haemaphysalis concinna with tick-borne pathogens affecting humans and animals in the Baikal region.
Materials and Methods. A total of 998 specimens of H. concinna ticks collected from natural habitats in the Baikal region were analyzed by PCR for the presence of markers of various viral, bacterial, and protozoan pathogens.
Results. In the examined H. concinna ticks, the following pathogens were detected: Kemerovo virus RNA (1.1 %), Borrelia burgdorferi sensu lato (1.3 %), Borrelia miyamotoi (0.5 %), Ehrlichia sp. / Anaplasma sp. (3.7 %), Rickettsia sibirica (1.6 %), Rickettsia raoultii (2.8 %), «Candidatus R. tarasevichiae» (32.6 %) and Babesia spр. (3.5 %). Tickborne encephalitis virus (TBEV) RNA was not detected in this study; however, in earlier PCR-based investigations, TBEV RNA was found in 0.6 ± 0.6 % of H. concinna samples from the Baikal region. In one tick sample, the nucleotide sequence of the groESL operon (1315 bp) was identified and found to be identical to sequences of Ehrlichia muris. Based on 18S rRNA gene sequence analysis, Babesia species genetically close to small ruminant piroplasms – Babesia crassa and Babesia motasi – were identified. For the first time, a Babesia sp. DNA sample was detected with nucleotide sequences identical to the Kh-Hc222 strain (KJ486568), previously identified in Khabarovsk Krai.
Conclusion. The data obtained underscore the need for continuous monitoring of H. concinna tick populations in the Baikal region and further investigation into their infection with both well-known and newly identified vector-borne pathogens.

Rationale. The number of patients with type 1 diabetes mellitus (DM1) in the Russian Federation is 277.1 thousand people, and this number continues to grow. Disturbance of glycemia leads to the development of oxidative stress and damage to the walls of the vascular channel, increasing cardiovascular risk in patients with DM1. Endothelial and enterocyte damage leads to translocation of bacterial components, particularly lipopolysaccharide (LPS), into the systemic bloodstream and the development of a state of “metabolic endotoxemia” that supports inflammation.
The aim of the study. To evaluate the levels of all major LPS-binding systems and C-reactive protein (CRP) levels in patients with DM1.
Materials and methods. The study included 92 patients with a verified diagnosis of type 1 diabetes mellitus. A control group of 42 practically healthy respondents, who were comparable to the DM1 group in terms of age and gender, was also formed. Patients in both groups were examined for biomaterial (blood plasma) by enzyme-linked immunosorbent assay (ELISA) to determine the level of lipopolysaccharide-binding protein (LBP), bactericidal permeability-increasing protein (BPI) and sCD14, as well as a marker of systemic inflammation – CRP.
Results. In patients with DM1, there was a statistically significant increase in the levels of LBP and sCD14 compared to the corresponding indicators of the control group (p < 0.001). BPI levels were significantly lower in the group of patients with DM1 than in the control group (p < 0.001). The DM1 group had a statistically higher CRP level of 0.81 (0.43–2.07) compared to the control group (p < 0.001).
Conclusion. Our results indicate the dysregulation and imbalance of LPS-binding systems in patients with DM1. We also found a significantly higher level of SRB in patients with DM1, which confirms the presence of low-intensity inflammation in these patients.

Background. Ischemic strokes are one of the leading causes of primary disablement with complete and partial disability. Rehabilitation measures initiated at the earliest possible time from the onset of stroke contribute to a faster and more complete recovery of impaired functions of the central nervous system.
The aim. To establish the pathogenetic factors of functional and metabolic disorders of the cardiovascular system in ischemic stroke and to evaluate the effectiveness of rehabilitation measures.
Methods. Holter monitoring of ECG and blood pressure upon admission and on the 10th day of stay in the rehabilitation department. Patients daily received dry carbon dioxide baths, low-intensity magnetic therapy on the cervical-collar region, therapeutic massage of the cervical-collar region, ethylmethylhydroxypyridine succinate 50 mg. Descriptive and mathematical statistics methods were used with the Statistica 10.0 software package.
Results. On the 10th day of rehabilitation treatment, patients showed an increase in heart rate, a decrease in supraventricular ectopic activity and the number of pauses > 2500 ms, a decrease in systolic and diastolic blood pressure, an increase in the index of functional changes in 65 % of patients, the Kerdo autonomic index in 59 %, the endurance coefficient in 85 %, pulse arterial pressure in 80 %, and the adaptation potential in 80 % of patients.
Conclusion. The results of the study indicate a clear tendency towards normalization of the functional state of the cardiovascular system in patients during rehabilitation treatment in the early recovery period after ischemic stroke and may indicate an adequate compensatory response of this system and mobilization of the body’s adaptive capabilities. The results obtained can serve as a basis for developing recommendations for further rehabilitation measures in the late recovery period after ischemic stroke.

Background. The study of the subpopulation composition of cytotoxic T lymphocytes and the expression of co-inhibitory proteins on their surface in regional lymph nodes is necessary for the development of new methods of targeted therapy for colorectal cancer (CRC).
The aim. To assess the subpopulation composition of cytotoxic T lymphocytes and the expression of co-inhibitory molecules on their surface in regional lymph nodes in patients with colon cancer.
Methods. The relative content of cytotoxic T lymphocytes in regional lymph nodes, the subpopulation composition of cytotoxic T lymphocytes, and the expression of immune checkpoints (CTLA-4, PD-1, TIM-3) by CD8-positive cells in 105 patients with stage III colorectal cancer were determined using flow cytometry. The control group consisted of 75 patients who underwent colon surgery for non-neoplastic diseases.
Results. In patients with CRC, the number of naive CD8⁺ lymphocytes (CD3⁺CD8⁺ CD45RA⁺CCR7⁺) in regional lymph nodes decreases by 1.6 times, the relative content of cytotoxic T lymphocytes of effector memory (CD3⁺CD8⁺CD45RAССR7^- ) increases by 2.6 times, and the relative content of CD8-positive cells expressing CD57 on their surface increases by 2.6 times. In patients with CRC, on the surface of CD3⁺CD8⁺ lymphocytes of regional lymph nodes, the expression of the co-inhibitory molecule CTLA-4 increases by 4.5 times, PD-1 by 2.2 times, and TIM-3 protein by 1.7 times. Conclusion. In patients with colorectal cancer, the subpopulation composition of cytotoxic T lymphocytes in regional lymph nodes changes, which is expressed in a decrease in the proportion of naive cells and an increase in the relative content of effector memory cells. In CRC, the expression of co-inhibitory molecules (CTLA-4, PD-1 and TIM-3) on cytotoxic T lymphocytes in regional lymph nodes increases.

Background. Malignant neoplasms of the skin are among the three most common human tumors; despite the low mortality rate, the problem of treatment remains relevant, since most often, malignant neoplasms of the skin occur in the head and neck area, and treatment of relapses is a more difficult task. Considering the socially significant localization, there is a need for one-stage radical removal of the tumor, with the minimum available margin, to preserve aesthetics. A modern non-invasive method for determining the boundaries of a skin tumor is ultrasound.
The aim. Comparison of ultrasound sizes of skin tumors, evaluation of treatment results with the inclusion of preoperative ultrasound diagnostics of basal cell carcinoma (BCC).
Materials and methods. The study included 17 patients who were treated at the Regional Oncology Dispensary in the department of surgical methods for the treatment of head and neck tumors from December 2021 to September 2022. Before the operation, they underwent an ultrasound of the skin tumor and marking of the boundaries of the pathological focus.
Results. Аll patients underwent surgical treatment and postoperative histological examination; no tumor was found at the resection margins; there was no recurrence at follow-up examinations. The average tumor thickness according to ultrasound was 2.55 ± 0.32 mm (95% CI 1.87–3.22). The average thickness determined on a microslide was 2.49 mm ± 0.3 mm (95% CI 1.82–3.15). The difference between the mean thickness determined histologically and the mean thickness determined by ultrasound was 0.06 mm. The correlation coefficient (r) was 0.993 (p < 0.01). The value of the coefficient was interpreted in accordance with the Chaddock scale: the relationship between tumor thickness on ultrasound and pathomorphological examination is direct and functional.
Conclusion. Ultrasound assessment of the tumor makes it possible to achieve radical tumor removal and minimize unnecessary distance from the tumor, which can affect the aesthetic result.

Background. Lamellar hole of the macula is a serious lesion of the vitreomacular interface. Modern technological advances in optical coherence tomography of the posterior part of the eye reveal new aspects of the etiology and pathogenesis of this disease.
The aim. To study microstructural and functional changes in the occurrence and development of lamellar ruptures of the macula, to identify criteria for the progression of this disease.
Material and methods. A retrospective analysis of 47 eyes was performed in 47 patients aged 66.4 ± 8.6 years with idiopathic lamellar macular hole (LMH) at a time of 22.3 ± 11.2 months. Morphological features of LMH were studied; functional changes in visual acuity and microperimetry were evaluated.
Results. As a result of monitoring, a traction trigger for the development of LMH was established in 38/47 (81 %) patients. The main morphological and functional criteria for the progression of this disease have been studied and described, which makes it possible to optimize the management tactics of these patients.
Conclusion. The study showed that currently there are clear criteria for the diagnosis of LMH according to OCT. Long-term monitoring of patients has proven that the disease has a slowly progressive course. At the same time, the assessment of the progression of LMH should be comprehensive, based on the morphological and functional results of the examination, which will make it possible to correctly select and optimize the tactics of managing these patients.

Difficulties in correcting hypermetropia and predicting the refractive effect require an optimal choice of correction of medium and high degree hyperopia. At the same time, it is also important for the patient to adapt to the new quality of vision.
The aim. To perform a comparative analysis of refractive indices, optical aberrations and retinal visual acuity in patients after Femto-LASIK for hyperopia correction in groups with subjective satisfaction and dissatisfaction with the result obtained.
Materials and methods. The study included 68 patients aged 18 to 37 years (27.52 ± 7.3) with moderate to high degree hypermetropia. All patients underwent a standard ophthalmological examination. The assessment of changes in visual functions was carried out before surgery, a day later, 1 and 12 months after surgery. The degree of subjective satisfaction was assessed by using tests of the quality of vision and asthenopic complaints. The severity of asthenopic complaints was determined using the questionnaire “Symptoms of asthenopia with insufficient convergence”. The results were processed using standard methods using Statistica10 programs.
Results. In the postoperative period, vision improved in all patients (Strehl coefficient increased by 4 times, visocontrastometry by 2 times, reduction of aberrations of the lens, cornea and the entire optical system of the eye by 3 times). The survey showed an increase in the quality of vision by 3 times, the symptoms of asthenopia decreased by 2 times. 14 patients (20 %) were dissatisfied with the result. The age of these patients was 5.2 ± 0.61 years higher than the age of satisfied patients.
Conclusion. Femto-LASIK is highly effective in correcting moderate and high degree hypermetropia in combination with astigmatism in 83 % of cases. Dissatisfaction with the obtained result was observed when the refractive effect shifted towards myopia, as well as in patients over 30 years of age.

The problem of miscarriage is relevant from the point of view of perinatal and neonatal morbidity and mortality, as well as the growing costs to the country’s economy. According to the World Health Organization, about 15 million children are born prematurely every year, and over the past decades this figure has tended to increase in all countries. The review provides a systematic analysis of modern domestic and foreign literature devoted to the study of the consequences of premature birth in premature infants. At the time of writing, September 2024, the following information databases were used in the study: eLibrary.ru, Scopus, PubMed, MEDLINE, ScienceDirect, Cochrane. The sources of the last 10 years have been analyzed. The search was performed by keywords: “prematurity”, “cerebral palsy”, “autism spectrum disorders”, “Attention deficit hyperactivity disorder”, “neonatal seizures”, “mental retardation”. The issues of prevalence, existing classifications, the influence of risk factors on the mother and fetus in the occurrence of premature birth, premature babies in the development of neurological disorders were considered. It has been statistically confirmed that the probability of negative outcomes and mortality significantly decrease with an increase in gestational age and birth weight. The longer the child was in the womb and the greater its birth weight – the higher the chances of a favorable outcome. Carrying out the prevention of miscarriage, including lifestyle modification in high-risk groups, will increase the duration of pregnancy, the weight of the fetus at birth, and reduce the frequency of premature birth and the number of premature babies, improving perinatal outcomes.

Background. The analysis of the mental well-being of girls during puberty is an important factor in predicting their reproductive potential. The assessment of emotional status in the detection of comorbid sleep disorders and menstrual function is of particular relevance.
The aim. To assess the psychoemotional state of adolescent girls with irregular menstrual cycles and sleep disorders.
Materials and methods. Eighty nine girls aged 15–17 were examined. Three study groups were formed: 1 – girls with irregular menstrual cycles complaining of sleep disorders (n = 31), 2 – girls with irregular menstrual cycles without complaints of sleep disorders (n = 42), 3 – girls without menstrual disorders and complaints of sleep disorders (n = 16). An adapted version of the ASHS questionnaire was used to assess sleep quality. In order to assess the psychological status, the methods of Spielberger – Khanin, Bass – Darki, and Beck were used.
Results. Patients with menstrual dysfunction and sleep disorders showed increased indicators of personal and situational anxiety, a high index of hostility dominated by resentment, and more pronounced depressive symptoms.
Conclusions. The mental health of adolescents is closely related to their reproductive function. Stress and sleep disorders provoke menstrual dysfunctions, which worsen the psychological state. It is especially important to take this into account during puberty. An integrated approach to the diagnosis and treatment of these interrelated disorders helps to prevent complications.

Background. The definition of risk factors for dangerous actions in mental disorders is relevant in psychiatry.
The aim. Study of risk factors for socially dangerous actions (SDA) in patients with paranoid schizophrenia.
Materials and methods. Clinical-psychopathological, clinical-anamnestic, and psychometric (PANSS scale) methods were used. The study examined male patients (average age 41.3 ± 12.8 years) with paranoid schizophrenia, an episodic type of course, undergoing compulsory inpatient treatment.
Results. In 72.7 % of cases, SDA was committed by patients under the influence of psychotic experiences with hallucinatory-delusional (22.7 %), delusional (50 %) syndromes, in 27.3 % of cases – with negative symptoms and severe behavioral disorders. Minor injury to health and crimes against persons unknown to patients were more common in the group with negative symptoms (p = 0.042 and p = 0.012, significant differennces – s.d.), рpatients with delusional syndrome were s.d. more likely to be single (p = 0.035). The accentuation of the emotionally unstable type, alcohol consumption, and psychoactive substances were s.d. more common in patients with negative symptoms (p = 0.008, p = 0.011); alcohol dependence syndrome, of the middle stage, with a hallucinatory-delusional seizure structure (p = 0.042).
According to the PANSS scale, in the group with hallucinatory delusional syndrome, s.d. among positive syndromes was 71.4 %. In patients with delusional syndrome and negative symptoms, the reliability among negative syndromes was 71.4 % and 51.7 %, respectively.
Conclusions. Identification of risk factors for the formation of socially dangerous actions in patients with schizophrenia helps to prevent dangerous actions.

This publication reviews a new study by A.V. Shcherbatykh and E.S. Filippov “At the origins of Irkutsk State Medical University (1919–1930)”. A review of the authors’ previous experience demonstrates that the book was the result of many years of effort to collect and systematize historical documents and materials. Seventy six archival files, periodicals, photographs and over 200 scientific publications were used as sources. The text of the work has a complex, branched structure. The principle of consistency is implemented by including the university in the panorama of the era. The materials concerning the establishment of the university in Irkutsk and its Faculty of Medicine are systematized. A significant amount is devoted to the characteristics of the founders of the Irkutsk Medical School. Attention is paid to the formation of educational and clinical bases of the Faculty of Medicine, as well as the organization of clinical education within its walls. The authors did not ignore the educational and scientific activities of medical specialists at the university. Information is also provided on the first (1922) and subsequent (1923–1930) graduates of the Faculty of Medicine. The author’s chronicle of the development of the Medical Faculty of Irkutsk State University completes the structure. The book contains 170 scanned documents, 132 photographs, 42 tables, 24 biographies and 2 maps, which allow us to fully reveal the circumstances of the first decade of higher medical education in Eastern Siberia. The analysis of the text of the work showed its non-standard construction. It combines scientific research, documentary narration and chronicling of events. The publication should be classified as a chronicle-documentary study.

Background. Currently, the replacement surgery of the first metatarsophalangeal joint (MTP joint) is considered to be one of the effective, invasive method for treating severe forms of osteoarthritis of the MTP joint. However, there are a number of postoperative complications that may be caused by the prosthesis itself. Research in this area can provide valuable information that will assist specialists in making decisions regarding the most suitable implant for each patient. Additionally, improvements in the design of implants for MTP joint replacement and further studies will help make them more effective, durable, and biocompatible.
The aim. To present a clinical case of osteoarthritis of the first metatarsophalangeal joint (Hallux rigidus) treated surgically by conducting total joint replacement with a monolithic ceramic implant featuring an optimal stem design.
Materials and methods. A clinical case is a 47-year-old patient presenting with deforming osteoarthritis of the 1st MTP joint. It was managed by arthroplasty of 1st MTP joint using an all-ceramic endoprosthesis with an optimal leg (RU № 226697).
Results. Three months after the operation, the pronounced significant increase in the range of movement and pain reduction in the 1st MTP joint were observed. Positive dynamics was preserved 6 and 12 months postoperatively.
Conclusion. The results of the surgery indicate that the replacement of the first metatarsophalangeal joint replacement using a monolithic ceramic implant with an optimal stem design is efficient surgical intervention. This approach significantly not only alleviates pain, but improves the quality of life for patients overall. However, to fully assess the long-term results and sustainability of the achieved effects, further studies are needed to analyze the distant outcomes of this intervention.

Background. Tuberculosis is one of the leading infectious diseases that claim millions of lives every year. In the Russian Federation, over the past 10 years, there has been a steady decrease in the incidence and mortality from tuberculosis. The effectiveness of the treatment of respiratory tuberculosis depends on the genetics and immunology of the host, environmental factors, drug resistance of the pathogen (MDR/XDR), the presence of concomitant comorbid pathology (TB/HIV). However, the state of the microbiota continues to be poorly studied, but an important factor.
The aim. To study the data of the world literature on the state of microbiocenosis of the respiratory tract in patients with tuberculosis of the respiratory system.
Methods. The search and analysis of literary sources in international and domestic databases (Google Scholar, PubMed, eLibrary) for the period 2018–2023 were carried out.
Discussion. To assess the microbiota of the respiratory tract, the 16s sequencing method of studying the species diversity of microorganisms is most successfully used. It has been proven that a violation of the microbiocenosis of the respiratory tract, namely the formation of dysbiosis against the background of persistent tuberculosis infection, can contribute to the development of bronchopulmonary complications. Currently, there is a wide variety of microorganisms inhabiting the respiratory tract of patients with tuberculosis of the respiratory system, while markers of pulmonary dysbiosis have not been established. Changes in the microbiota of the respiratory system depend on a number of factors: the presence/absence of bacterial release, sensitivity/resistance of the causative agent of tuberculosis to antibacterial drugs, chemotherapy regimen, etc.
Conclusion. The composition of the microbiota of the respiratory tract in patients with tuberculosis of the respiratory system has not been studied enough. The available research is fragmented and not conceptual in nature. However, epidemiological realities (pandemics, the presence of tuberculosis–endemic countries and regions, the trend towards an increase in drug-resistant forms of tuberculosis, the high incidence of bronchopulmonary pathology of non-specific etiology in patients with pulmonary tuberculosis) necessitate representative studies on this topic.

Background. Bronchial asthma (BA) is characterized by dysregulation of the adaptive immune response. A significant contribution to pathological processes in urban environments is made by air pollution with solid suspended particles (HDPE). However, the expression of cytokine (interleukin (IL) 4, 6) and toll-like receptors (TLR) CD8⁺ cells in BA patients and their dynamics under exposure to atmospheric microtoxicants practically have not been studied.
The aim. To determine the features of expression of IL-4R, IL-6R, TLR2, and TLR4 in CD8⁺ cells in BA of varying severity and under the influence of solid suspended particles of atmospheric air.
Materials and methods. The study included 244 patients with asthma, 60 conditionally healthy individuals. Loading with simulated atmospheric suspensions was performed at a dose of 1 microgram (µg) of suspension per 1 ml of blood. The expression of IL-4R, IL-6R, TLR2, and TLR4 on CD8⁺ cells was analyzed by flow cytofluorometry. Statistical processing of the results was performed in the program “STATISTICA 10.0”. The critical significance level (p) for testing statistical hypotheses was assumed at p < 0.05.
Results. The main differences in cell signaling were observed between the group with partially controlled moderate BA and the control group. The expression of IL-4R is particularly strongly increased – by 217 % (p < 0.001), TLR4 – by 103 % (p < 0.001). The same group of patients is characterized by the greatest significance of differences in T-cytotoxic cells in comparison with the group of patients with mild bronchial asthma. IL-4 receptor expression on T-cytotoxic cells increased by 160 % (p < 0.001), TLR4 – by 108 % (p < 0.001).
Conclusion. The intensification of receptor expression is observed with an increase in the severity of the disease. The expression of IL-4R and TLR4 changes most intensively in T-cytotoxic cells IL-4R и TLR.

Biofilm as a form of existence of many bacteria that allows them to survive in unfavorable environmental conditions. Such pathogens include some strains of tularemia pathogen. Immunogenic properties of Francisella tularensis strains capable of biofilm formation are insufficiently studied. One of the key indicators of the activation of innate immunity is an increase in the level of TLRs expression. A comparative analysis of TLRs gene expression in immunocompetent cells of animals infected with biofilm and agar cultures will allow us to assess the degree of their adaptive capacity to the pathogen, as well as add to the existing data on the pathogenesis of tularemia.
The aim. To evaluate the effect of biofilm and agar cultures of F. tularensis on the expression of TLRs genes of types 2 and 4 by blood and spleen cells of white mice.
Materials and methods. The study was carried out on 125 certified mongrel white mice. Material (blood and spleen) was collected on days 1, 2, 3, 7 and 14. Seven-dayold biofilm and two-day-old agar cultures of attenuated vaccine strain F. tularensis 15B of the NIIEG line and avirulent F. tularensis I-384 were used to create experimental tularemia infection. RNA molecule detection and reverse transcription were performed using commercial reagent kits. TLR2 and TLR4 cDNA concentration was determined by real-time PCR using specific primers.
Comparative analysis of TLR2 and TLR4 gene expression in response to the introduction of biofilm and agar cultures of F. tularensis revealed a statistically significant increase in TLRs gene expression in cells of experimental animals infected with biofilm cultures compared to agar cultures.
Conclusion. The obtained results indicate a significant effect of F. tularensis subspecies and conditions of its cultivation on TLR2 and TLR4 genes expression in blood and spleen cells of white mice in experimental tularemia.

Introduction. Tuberculosis is among the most common infectious diseases in humans. One of the main drugs for treating tuberculosis, isoniazid, has a wide range of adverse effects, including hepatotoxicity, making the search for ways to reduce its toxic reactions highly relevant.
The aim of the study was to assess liver damage, as well as the levels of the cytokines IL-6 and TNF-α, metalloproteinases MMP1 and MMP9, and the protease inhibitor TIMP-1 in mice with BCG granulomatosis. These factors were evaluated immunohistochemically following intraperitoneal injection of isoniazid, dextrazide, or a liposomal form of dextrazide (LFD), along with its inhalational injection.
Methods. Fifty male BALB/c mice were infected with BCG vaccine via retroorbital route. After 3 months, isoniazid or its compositions with oxidized dextran were injection twice a week at a dose of 14 mg/kg body weight for 2 months; the control group received NaCl solution. Liver was followed by histological processing and immunohistochemistry.
Results. Tuberculosis granulomas were detected in the liver 5 months after infection. The total number of granulomas was reduced in mice receiving all forms of isoniazid, but LFD injection by inhalation was the most effective. The volume densities of lymphoid infiltrates and tissue damage were greatest in the livers of mice injected with NaCl, with lower values observed in the isoniazid-treated groups. The number of cells producing IL-6, MMP1, and MMP9 was highest in the isoniazid group, while TNF-α production was highest in the NaCl group. The lowest values for these parameters were observed in mice treated with LFD. The number of cells producing TIMP1 was highest in the groups receiving LFD.
Conclusion. Two months after starting the isoniazid treatments, the amount of mycobacterium tuberculosis (MBT) in the liver decreased, particularly with the inhalational injection of LFD. This suggests that LFD helps modulate the inflammatory response in tissues and reduces damage, likely due to the systemic anti-inflammatory effect of oxidized dextran in the LFD.

Background. Matters of developing new medicinal drugs with nootropic action require systematization of our knowledge as well as conducting of experimental and clinical research.
The aim. Evaluation of the neurotropic activity of the phytocomposition “Memoris”.
Materials and methods. Research is performed on male Wistar rats. Results were evaluated after the end of 14-day-old intake of studied phytocomposition and reference drug Cortexin. Neurotropic activity was measured by tests in open field, elevated plusmaze and Morris water maze. Serotonin, noradrenaline and dopamine content were defined by HPLC-MS/MS.
Results. Under the influence of “Memoris” composition the significant enhancement of locomotor activity in central zone of the open field apparatus had been achieved. This enhancement manifested in statistically significant increase in number of crossed squares, time of movement and time of immobility within central part. Administration of the phytocomposition increased the time rats spent in open arms and in the center of the plus-maze, increased number of head-dips and decreased number of entrances into enclosed arms. Training in the Morris water maze with hidden platform demonstrated statistically significant decrease of latent period of platform search in rats which received phytocomposition and Cortexin by the second day of testing (in control group rats – by the third day). At the day 2 of testing, the time of platform search was statistically significantly different in the groups of rats which received phytocomposition and Cortexin as compared to the control group. Under the influence of “Memoris” phytocomposition increase of serotonin (by 92 %, р = 0,001) and dopamine (by 57 %, р < 0,001) content in hypothalamus, as well as decrease of noradrenaline (by 17 %, р = 0,002) content in hypothalamus were observed.
Conclusion. Phytocomposition “Memoris” has anxiolytic effect comparable to that of Cortexin, increases capabilities for associative learning in rats, affects the concentration of important neurotransmitters – serotonin, dopamine and noradrenaline.