Studying the patterns of dynamics of the body component composition of practically healthy individuals, using the example of the cadets’ adaptation to study at a military university, should be conducted on the basis of a multicriteria assessment using a set of statistical techniques. The purpose of the study is to identify gender–related correlational pleiades of indicators and assess their contribution to the adaptation of the body component composition of boys and girls to training in a military educational organization. A related sample of 387 male and 27 female cadets was examined during the period of their studies at 1-6 years. The body component composition was measured using the Tanita MС-780 MA body component analyzer. Correlational pleiades were formed based on the data obtained. The reliability of the impact of training at a military university, gender and their combined effect were evaluated using two-factor analysis of variance. The sexual characteristics of adaptation to training at a military university are associated with the formation of two alternative complexes of interrelated parameters. In men, changes in the body component composition during adaptation are associated with BMI, and in women with the total body water volume. In addition, in male cadets of a military university, the adipose tissue of the upper extremities plays an important negative role, as indicated by the correlation with the pulse. Studying at a military university, regardless of gender, gradually develops such indicators as trunk muscle mass and physical development rating, as well as stops the growth of visceral fat and BMI due to age-related changes. The obtained data demonstrate that, as a gender-independent marker of successful adaptation of the body component composition to training at a military university, it is possible to use the trunk muscle mass and the rating of physical development. Men's adaptation is best characterized by the dynamics of BMI, women's one is characterized by total body water volume.

An analysis of the morphological state of the liver was carried out in 160 patients with obstructive jaundice of non-tumor etiology who received treatment in the Novgorod Regional Clinical Hospital and Central City Clinical Hospital. The results of liver biopsy during surgery were studied. Pronounced structural and functional changes in liver tissue were revealed, which were further aggravated due to an increase in the duration of occlusion. In cases with long-term chronic jaundice, after decompression of the bile ducts, sclerotic changes, histiolymphocytic infiltration and proliferating biliary epithelium, fibrosis and foci of hepatocyte necrosis remain in the portal tracts. Ultrastructure analysis revealed changes in the cell membrane, cytoplasmic structures, destruction of mitochondrial membranes, formation of secondary lysosomes, disruption of the integrity of the nuclear membrane and signs of karyolysis. The study of puncture and surgical biopsies for obstructive jaundice makes it possible to establish the form and severity of cholestasis and, along with other diagnostic indicators, affects disease prognosis and the tactics of surgical treatment. Taking the different timing and severity of cholestasis into account, it is necessary to use therapeutic technologies in advance that lead to an improvement in liver morphology.

Individual variability or variant anatomy is most common in blood vessels, among which brachiocephalic arteries should be distinguished. The article presents a case of the detection of one of these variations – an aberrant left vertebral artery branching off from the aortic arch in a 68-year-old patient. This artery was identified in him after a CT scan of the aortic arch and brachiocephalic arteries for pronounced vertebral-basilar insufficiency. In studying the angiogram, the authors carried out a morphometric analysis of all arteries branching off from the aortic arch.

In this article, we report a case of the combination of COVID-19 with diffuse alveolar lung injury and diffuse large B-cell lymphoma with coronary artery compression by tumor nodules in the epicardium, resulting in myocardial infarction and subsequent fatal outcome. The article reviews the complex interaction between COVID-19 and oncological diseases, demonstrating how the coronavirus infection can significantly exacerbate the progression of malignant neoplasms through different mechanisms. These mechanisms include respiratory insufficiency caused by diffuse alveolar damage, systemic respiratory hypoxia, and thrombus formation, which ultimately leads to tumor tissue necrosis and the development of infarctions in various organs, particularly in the heart. Investigating such cases is important for studying intercellular interactions in the combined course of coronavirus infection and chronic diseases, and is highly indicative in the study of possible mechanisms of complications, such as myocardial infarction.

The purpose of the authors' study is to conduct a critical analysis of data on methods for modeling ischemic stroke presented in peer-reviewed sources indexed in the Pubmed and Russian Science Citation Index databases for the 2019-2023 period. Modeling of ischemic stroke is in demand for studying pathogenesis, developing diagnostic methods and treatment. Analysis of literature data allows us to identify a number of experimental ischemic stroke models. In vitro models are represented by cellular cultures; the 3D cellular model is most preferable, since it is the closest one to the nervous tissue of the brain in its functional ability. In vivo models are most often replicated in rodents. The SHRSP rat strain is the most preferred among animal models, as it has the greatest propensity for cerebrovascular diseases, stroke in particular. The most relevant MCA model occlusion is endovascular MCA occlusion, by introducing monofilament threads into the lumen of the vessel, as it has a simple manipulation technique, a low risk of infectious complications and injuries. The embolic SMA model has a high clinical similarity to human ischemic stroke, but low resistance to the body's fibrinolytic system. Endothelin-1 and photothrombotic models are less preferred due to their technical difficulties in implementation and the low profile of studying new therapeutic options for the ischemic stroke treatment. In silico ischemic stroke modeling can serve as an alternative, since it combines risk factors for stroke, features of blood supply to the brain, cerebral metabolism and blood clot morphology.

Kawasaki disease is an acute inflammatory disease that typically affects medium- to small-sized muscular arteries, especially the coronary vessels. In Novgorod region, from 2016 to 2023, Kawasaki disease was diagnosed in 5 children aged 3 months to 12 years. All children were admitted to the hospital with fever lasting from 5 to 8 days. Complete blood count and urinalysis were performed. Levels of transaminases, C-reactive protein, total protein, albumin, glucose, and coagulation tests were done in the serum. Samples of blood cultures for sterility were taken. The research plan included such instrumental methods as electrocardiography, echocardiography, chest radiography, ultrasound examination of the abdominal cavity and kidneys. 3 patients were diagnosed Kawasaki disease before the 10th day of illness. A 3-month-old baby was diagnosed Kawasaki disease on the 13th day. Another baby of the same age was diagnosed posthumously. The pathogenetic mechanisms of detected symptoms in children were considered.

Sepsis is a typical form of pathology, which is based on the body's reaction in the form of generalized inflammation to an infection of various nature, leading to acute multiple organ dysfunction. In sepsis, endothelial dysfunction, platelet adhesion and aggregation, hypercoagulation, hypocoagulation occur, microthrombogenesis, disturbances in the anticoagulant and fibrinolytic systems increase. Only a few studies have assessed the relationship of single nucleotide polymorphisms (SNPs) of hemostatic factors in the prognosis of sepsis: VWF, EPCR, SELP, SELE, ITGA2, ITGA2b, ITGB3, GP1BA, FGG, FGA, FII, FV, FVII, THBD, PAI-1. The disparity of the SNP results highlights the need for larger-scale studies within the framework of a personalized approach to complement the theoretical basis of the pathogenesis of sepsis, as well as to obtain new laboratory tools to improve prognostic scales, the formation of a mathematical model depending on the outcome of sepsis.

Pertussis is an acute anthroponous infection that occurs with damage to the respiratory tract and it causes attacks of spastic cough. Despite specific prevention, it remains an important cause of childhood illness and mortality. The article analyzes the literature data on the mechanisms of infection pathogenesis, highlights aspects of immunization and the work of the immune system after the introduction of pertussis vaccine. Examples of own observations of children diagnosed with pertussis are given. It was concluded that vaccination does not guarantee the full-fledged immune response and the risk of pertussis infection remains even in vaccinated children, but in such cases, the infection proceeds in an atypical form. At the same time, a child unvaccinated with the anti-pertussis vaccine has a higher risk of contracting the infection with a prolonged course and the possibility of developing complications from the respiratory, cardiovascular and nervous systems.

The article discusses the modern possibilities of providing non-opioid analgesia in terms of the pharmacodynamics of drugs affecting different levels of analgesia using the concept of the metasympathetic nervous system role in maintaining homeostasis. When developing a hypothesis for further research, the analysis of scientific research considers the proposed options for the development of new drugs with minimal side effects for the purpose of their use in clinical pharmacology. It is substantiated that the pathological processes in the body indicated in the above analysis are significant in the formation of undesirable effects of hemodynamic changes, which is reflected in an increase in the reactivity of the cardiovascular system. A hypothesis has been put forward to continue research on the development of a new combination of drugs, including an agonist of the purinergic system and an α2-adrenergic receptor agonist for non-opioid analgesia in order to reduce the severity of their side effects, which will activate the use of such compounds in clinical pharmacology with continued research on their pharmacokinetics and pharmacodynamics in clinical practice. It is assumed that expanding the range of drugs with the ability to form compensatory reactions necessary to actualize the autoregulation of homeostasis through the activation of synaptic mechanisms that control the homeostatic potential will optimize the effectiveness of treatment, which is applicable by clinical pharmacologists in practical healthcare institutions.

The article presents the results of studying blood renin in arterial hypertension in men and women in two age groups: young and middle-aged. Renin was determined by examination of venous blood by enzyme-linked immunosorbent assay. In a study of a group of 80 patients: 40 women and 40 men, it was found that the normorenin type of arterial hypertension predominates at young age: 95% in men and 90% in women. In the course of the study, the following feature was revealed: the incidence of high-renin arterial hypertension increases with age. In middle-aged men, high-renin arterial hypertension predominates (55%), while in middle-aged women, the normorenin type of arterial hypertension predominates (60%).

The effects of coronavirus infection on the human genotype are still poorly understood. Some patients complain of memory impairment, some notice hair thinning, etc. Recently, medical specialists have also attracted attention to the study of the human immune system against coronavirus. The immunograms of middle-aged residents of Perm Krai during the pandemic have been analyzed. Immunograms were divided into two categories according to the patients' disease state. The immunograms of patients in the state of illness, which was evaluated by the deviation of immunoglobulins IgA, IgM from the reference interval and recovered patients, were of interest. Patients were grouped into three age groups ranging from 19 to 50 years. Small excesses in the absolute value of phagocytosis and phagocytic count were observed in those in the disease state. Decreases in the absolute value of phagocytosis, phagocytic number and phagocytic index were observed in the middle group with increased immunoglobulin levels.

The purpose of the study is a comparative analysis of the results of transabdominal preperitoneal laparoscopic surgery and inguinal hernioplasty according to Lichtenstein. From 2017 to 2023, 695 patients with inguinal hernias were operated on in Clinic 2 of the Central City Clinical Hospital of Veliky Novgorod. 322 (46.3%) patients had surgery performed by endovideosurgical method and 373 (63.7%) had open surgery according to Liechtenstein.

Conversion to open surgery was performed in 4 (1.2%) patients. A comparative analysis of the results shows that laparoscopic preperitoneal repair of inguinal hernias has certain advantages over open interventions, in particular, there is a statistically significant reduction in the time of surgical intervention (54.7 minutes and 63.8 minutes, respectively), a reduction in the period of relief of postoperative pain syndrome and the prescription of analgesics (1.3 days and 2.6 days), a decrease in the number of postoperative complications (5.0% and 8.6%) and length of hospital stay (3.6 days and 5.2 days, respectively). Laparoscopic preperitoneal hernia repair, performed with strict application of a standardized technique and by an experienced surgeon, is an excellent approach for treating the inguinal hernias compared with Lichtenstein surgery, regardless of whether it was used for unilateral or bilateral, primary or recurrent inguinal hernias, and is characterized by fewer postoperative complications and relapses with all the advantages of laparoscopic surgery, such as reduced postoperative pain, early mobilization and short stay in the hospital.

The article presents a clinical case of a patient with testicular feminization syndrome of incomplete type, manifested in the form of a congenital disorder of the external genitalia formation in the presence of a male XY karyotype, as well as monorchidism, scrotal hypospadias, prostatic aplasia and the presence of a rudimentary vagina. To recreate the usual appearance of the genital organs and optimal functioning of the urinary system, the patient has undergone a large number of plastic surgeries since the age of one. A review of the literature shows that therapy for this syndrome is characterized by multiple plastic surgeries followed by correction of hormonal The patient was referred to the hospital for an MRI to evaluate the condition of the pelvic organs after multiple surgical interventions. This article describes the results of surgical interventions and the features of the patient's anatomy, which were analyzed using MRI data.

The study includes medical records of patients with pudendal neuropathy (PN) who underwent the pulsed radiofrequency ablation (PRA) procedure. Clinical parameters and adverse events were studied during the entire perioperative period. The follow-up period for the respondents was at least 24 months. The study includes medical records of 25 patients (17 (68%) female respondents, 8 (32%) male respondents, the age of patients ranged from 28 to 80 years, the average age was 54.5±13.7 years) with a confirmed PN diagnosis, who underwent the PRA procedure of the pudendal nerves. Analysis of the severity of pain syndrome according to visual analogue scale (VAS) at 3, 6, 9, 12 and 24 months after the PRA procedure showed a significant decrease in this indicator (p < 0.001). In the early postoperative period (the first 7 days after the operation), there was a statistically significant improvement in the level of patients’ capacity according to Oswestry Disability Index (ODI) by 10–15% in 72% (p=0.042). In the late period of the respondents’ postoperative observation, we also noted a significant improvement in the level of capacity by ODI (p<0.001). The study of the time spent in the respondents’ sitting position showed a statistically significant increase in this indicator from 29±13 minutes to 83±37 minutes 3 months after the PRA procedure of the pudendal nerves and up to 86±41 minutes after 12 months (p<0.001). There were no significant adverse clinical events in the study group of patients. PRA procedure of pudendal nerves is an effective and safe method of minimally invasive surgical treatment of patients with PN. The clinical efficacy of PRA of the pudendal nerves in the long-term period of patients’ postoperative follow-up was 92%.