The article analyzes the influence of the vertical development of the facial skeleton on the occurrence of temporomandibular joint (TMJ) dysfunction in patients with distal occlusion. The influence of dental occlusion disorders on the TMJ has been determined. The relationship between the symptoms of TMJ dysfunction (deviation of the lower jaw when opening the mouth, the presence of noise in the TMJ and tension of the lateral pterygoid muscles during palpation) with an increase in the vertical incisal overlap has been revealed. Some aspects of the treatment of TMJ dysfunction in patients with distal occlusion have been considered. The data on the type of growth (brachy-, meso-, dolichocephalus) have been compared with the findings of the MRI of the temporomandibular joint. The relationship between the type of growth of the facial skeleton and the severity of TMJ dysfunction has been revealed.

The authors analyzed the frequency of ileocecal intestinal obstruction in 207 men after transurethral contact lithotripsy with obstruction of the right ureter by a calculus. A comparative analysis of the results of the study of the incidence of postoperative intestinal dysfunction after transurethral contact lithotripsy on the right showed that in patients with permanent blockades of the surgical intervention area, the frequency of clinical manifestations of ileocecal intestinal obstruction was significantly lower. In addition, their recovery of defecation, restoration of anthropometric parameters of the anterior abdominal wall in the right iliac region, and normalization of nitrogen-containing compounds in the blood were significantly faster. A reasonable conclusion was made about the expediency of using permanent blockades of the surgical intervention zone, which provide a decrease in the incidence of postoperative functional ileocecal intestinal obstruction after transurethral contact lithotripsy.

The aim of this work is to study the features of neuro-reflex regulation of the morphofunctional state of the small intestine under the influence of over-venous laser blood irradiation in a complex treatment of experimental ethanol intoxication. The work is devoted to fundamental medical and biological research which allows us to understand the significance of laser stimulation in the complex treatment of ethanol intoxication. Experimental pathogenetically substantiated use of laser stimulation initiates the activation of adaptive processes in neurotransmitter structures and increases the activity of aerobic cycle enzymes in the muscular membrane of the small intestine. The results obtained in the course of the experimental studies, according to the integrity of the pathogenetic concept of ethanol intoxication, allow a differentiated approach to the use of over-venous laser irradiation of blood in the complex treatment of this pathology. The significance of the pathology under consideration determines the relevance and necessity of conducting experimental and clinical studies.

Despite the achieved success in the prevention and treatment of periodontitis, it remains one of the main problems of modern dentistry. The interest of researchers in the study of the mechanisms of chronic pain syndromes development and their influence on the course of various forms of pathology has grown significantly in recent years. It is of interest to study the effect of chronic pain on the periodontitis development due to its high prevalence in society. Chronic pain syndrome was modeled by bilateral ligation of the sciatic nerves, and experimental periodontitis — according to the method proposed by Volozhin A.I. and Vinogradova S.I (1990). The animals were removed from the experiment on the 7th, 14th, and 21st days after modeling experimental periodontitis. It has been shown that the modeling of periodontitis is accompanied by the development of edema of all layers of the periodontium, the presence of inflammatory infiltrates, dystrophic changes in epithelial cells, vascular sclerosis, gradual development of newly formed connective tissue over 7-21 days of the experiment. The following peculiarities of the experimental periodontitis development in rats with preliminary formed chronic pain syndrome were established compared to the experimental periodontitis group: edema, dystrophic changes in cells were more pronounced, the relative volume of inflammatory infiltrates was significantly higher, and the relative volume of newly formed connective tissue was lower. The results of the study allow us to conclude that there is an increase in infiltrative processes and inhibition of regeneration in the periodontium in animals with experimental periodontitis and chronic pain syndrome.

The article discusses the pathogenesis of a new coronavirus infection caused by the SARS-CoV-2 virus in relation with sex and age aspects. The frequency of asymptomatic course and the frequency of complications of the disease are analyzed. The known factors of the development and severity of the course of the disease in patients of different sexes are described. The statistical structure of the distribution of respiratory tract lesions in a new coronavirus infection is considered, as well as the distribution of clinical symptoms present in patients by age and sex. The analysis of outpatient records of 100 patients diagnosed with coronavirus infection caused by the SARS-CoV-2 virus was carried out. The structure of respiratory tract lesions in these patients was studied depending on the described clinical manifestations. The pathogenetic substantiation of the clinical picture of acute upper and lower respiratory tract lesions with SARS-CoV-2 virus is given. It was found that the leading symptoms of COVID-19 in children were fever, catarrhal symptoms, and gastrointestinal manifestations.

The risk of death of a patient from COVID-19 is affected by the severity of the disease itself, the presence and severity of concomitant (comorbid/competing) pathology, and the availability of medical care. Obtaining information during a selective in-depth clinical and pathoanatomic analysis of fatal observations is of great relevance. The aim of the study: to analyze the possibility of the influence of mild COVID-19 complications on the cause of death according to pathologic and morphological data. The analysis of medical documentation, sectional material and forensic medical examination data provided by the Pskov Regional Bureau of Forensic Medical Examination was carried out. Patient N., 39 years old, was taken by ambulance to the city hospital from the pool with the diagnosis: condition after a series of seizures. Despite all the measures taken, the phenomena of cerebral edema progressed. Two days later, death was pronounced. Diagnosis: asphyxia during drowning. Histologically: fields of loss of nerve cells of the brain; circulatory disorders in the form of venous fullness with erythrocyte sludge in capillaries and venules, which are one of the leading complications. With hypoxemia, the bone marrow releases immature red blood cells into the bloodstream, which are prone to gluing and creating a sludge phenomenon. Hypoxic erythrocytosis often leads to death. Another important aspect is the connection between a seizure attack and COVID-19, as a manifestation of a viral invasion of the central nervous system and/or pneumonia with hypoxemia, leading to brain damage and seizures. Even with a mild form of the disease, it is possible to develop exercise intolerance. In the case under consideration, the coronavirus could become a trigger of epiactivity in the patient. Conclusions: based on the data of forensic medical examination and laboratory materials, it can be assumed that COVID-19 led to multilevel organic lesions of tissues and organs that could cause asphyxia. This is evidenced by perivascular and pericellular edema of the brain, erythrocyte sludge in blood vessels.

Histological preparations of liver tissue were studied in 82 patients with long-term (more than two weeks) obstructive jaundice of non-tumor etiology, who were treated at the Novgorod Regional Clinical Hospital in the period from 2014 to 2021. There is a twofold increase in the stroma, due to the development of connective tissue; destruction of blood capillaries is revealed, which entails a deterioration in the blood circulation of the liver; a decrease in the volume of the nucleus and cytoplasm is detected with obstructive jaundice, which indicates an increase in necrotic processes; structural changes appear in the intrahepatic bile ducts and their filling with lipocytes, the functional activity of hepatocytes slows down, the rate of their division decreases, all types of exchanges slow down. Studies of the liver tissue in obstructive jaundice make it possible to determine the form and severity of cholestasis, which, together with other data, affect the prognosis of the disease and the determination of therapeutic tactics. Repeated puncture biopsies of the liver allow you to monitor the condition of the liver after decompression and determine the effectiveness of the treatment.

The present study is devoted to the morphofunctional substantiation of the model of female hypogonadism, which is important for the subsequent evaluation of the effectiveness of its targeted pharmacological correction, as well as to elucidate the resistance of ovarian endocrine cells to damage as a result of experiencing a single acute ischemic effect. In three groups of adult female rats under anesthesia, the arteries of the right and left ovaries were ligated for 30, 45, and 60 min (4 rats in each group). After the operation, the wound was sutured. Sham-operated rats (4 rats) served as controls. After 7 days, the results were analyzed. The blood levels of sex steroid hormones (17β-estradiol, progesterone) and gonadotropins (FSH and LH) were determined by enzyme-linked immunosorbent assay. In the meridional histological sections of the mature tertiary follicle and the corpus luteum of the right and left ovaries, after survey staining, the number and percentage of viable and dead endocrinocytes were counted, and the area of viable endocrine cells was determined. The significance of differences in the median, upper and lower quartiles of the compared parameters was determined using the nonparametric Mann–Whitney test. It has been established that a single acute ovarian ischemia induces massive death and degenerative changes in a significant part of the viable endocrine cells of the mature tertiary follicle and corpus luteum, most pronounced with a one-hour bilateral occlusion of the ovarian vessels. These quantitative and structural changes in interstitial endocrine cells and ovarian luteocytes cause a significant decrease in the production of sex steroids, which, in turn, causes hyperproduction of the corresponding pituitary tropins. Morphological changes in both types of ovarian endocrine cells in this model of acute single ovarian ischemia are highly sensitive; the use of a number of morphometric parameters of endocrinocytes in combination with the determination of the concentration of peripheral and regulatory homones will allow using this model to assess the effectiveness of the correction of female hypogonadism with various pharmacological preparations.

To achieve the aim of the study, 12 white mature male rats were selected and divided into two groups: the group I consisted of animals treated daily for 60 days intragastrically with sodium benzoate at a dose of 1000 mg/kg of body weight, and the group II are control animals. Samples of thyroid gland were taken for electron microscopy, processed, sectioned, and stained according to a standard protocol. In animals of the group I, large-sized secretory granules prevailed in the cytoplasm of C cells, some of them had low electron density, some had heterogeneous content, while others remained electron-dense. The nuclei of parafollicular cells had a narrow rim of heterochromatin under the karyolemma. Most of the mitochondria showed irregularly shaped cristae. In addition, local mitochondrial damage was also present. Short and thin cisterns of the rough endoplasmic reticulum with a small number of ribosomes on their outer surface were found. The above morphological features of the thyroid gland C cells in mature rats indicate a change in the mechanisms of calcitonin synthesis in the cisterns of the endoplasmic reticulum, the protein-synthetic function of cells and its energy supply under the influence of sodium benzoate.

The article is devoted to the role of tumor-associated fibroblasts in the development of non-small cell lung cancer. Their main properties are considered in comparison with normal fibroblasts. Characteristic markers are given, which can be used to judge whether tumor-associated fibroblasts belong to different sources of origin (resident and recruited). The patterns of transformation and activation, proand anti-tumor interactions in the tissue microenvironment of the tumor are ызусшашув. The main known mechanisms of the influence of tumor-associated fibroblasts on the formation of drug resistance in non-small cell lung cancer are described: stimulation of epithelialmesenchymal transformation, compaction of extracellular matrix proteins, hypoxic signaling, maintaining stemness of cancer cells.

The high prevalence of using chemotherapeutic drugs requires studying the mechanisms of their effect. This article discusses some of the mechanisms of the pro-apoptotic effect of doxorubicin on the liver in experimental animals. A number of patterns of structural morphological responses have been identified. As the object of the study, white outbred mice formed according to the principle of pairs of analogues were used, with the formation of two experimental groups and one control group. On day 14, the animals were withdrawn from the experiment, followed by a visual assessment of the abdominal organs and the microscopic organization of the liver. As a result, a macroscopic examination revealed a pronounced reaction with the formation of aseptic peritonitis and the development of rather gross functional changes in the unpaired abdominal organs of the abdominal cavity. Microscopic examination revealed non-specific types of responses to the administration of doxorubicin with the formation of leukocyte infiltration in various parts of the liver and hepatic lobules, the accumulation of fatty inclusions in the cytoplasm of hepatocytes. Also, there are pronounced differences in responses among individuals of different sexes to the injection of an equal amount of doxorubicin. The severity of responses to the drug administration also had a dose-dependent effect.

The article examines the factors influencing the incidence and development of a severe course of a new coronavirus infection (COVID-19) in HIV-infected patients. The study included all co-infected patients (n=68) who received inpatient care for COVID-19 in various medical institutions of the Novgorod region in the period from January 1, 2020 to December 31, 2021. The results of the study showed that COVID-19 infection was more often registered in HIV-infected patients with a long history of HIV infection (5 years or more) and not taking antiretroviral drugs. COVID-19 in HIV-infected patients was more often in the moderate form of the disease (77.9%). Factors aggravating the severity of COVID-19 in HIV-infected patients are signs of progression of HIV infection (the level of CD4lymphocytes is less than 200 cells/µl; the viral load is more than 100,000 cop/ml) and the absence of antiretroviral therapy. Comorbid pathology (the presence of opportunistic infections and concomitant diseases) is a trigger factor in the development of severe forms of COVID-19 and adverse outcomes.

The article analyzes the epidemiological situation of meningococcal infection (MI) in the territory of the Novgorod region for 2018–2020, which was characterized as stable and complex, with signs of an interepidemic period. Currently, in the developed countries of the world, in most regions of the Russian Federation, including the Novgorod region, meningococci of serogroup B predominate in the structure of MI diseases. The share of N. meningitidis of serogroup B can account for up to 90% of MI cases, and 50% of the cases are children under 2 years old. The emergence of new, modern vaccines for the prevention of MI makes it possible to prevent MI disease in children, adolescents and adults, serves as a reliable basis for active intervention in the epidemic process, making it manageable, and also preventing the catastrophic impact of MI on young children. In the territory of the Novgorod region in 2018– 2020, MI incidence rates exceeded the national average by 2.9–4.5 times. Only sporadic morbidity with a generalized form of meningococcal infection was recorded, with a tendency to decrease and involvement of mainly urban population in the epidemic process.

The purpose of this work was to study the antimicrobial properties of untreated Baltic amber and succinic acid in relation to S. aureus. The antimicrobial activity of alcohol and acetone extracts from untreated amber and an aqueous solution of succinic acid was revealed against such clinical isolates of Staphylococcus aureus as: BS-1, BS-9, BS-12, BS-19, isolated from hospitalized patients (MIC — from 2500 µg/ml to 5000 µg/ml) and a reference strain from the American type culture collection S. aureus ATCC 29213 (MIC — 2500 µg/ml). In experimental modeling of intestinal staphylococcal infection in mice, a positive effect of succinic acid on the clinical isolate of S. aureus (BS-9) was established. The amount of S. aureus in the intestinal content decreased in all experimental animals (2.35×104) compared to positive control animals (8.58×105). The minimum inhibitory concentration of an aqueous solution of succinic acid in relation to S. aureus corresponds to the value of 2.5 mg/ml.

Cytokines are mediators of intercellular correlations during inflammation and the formation of an immune response. Genetically engineered biological products (GEBPs) are a group of medicines that includes monoclonal antibody preparations. The effect of GEBPs is directed against pro-inflammatory cytokines (when the synthesis of the latter is significantly increased), their receptors and signaling pathways, helps to eliminate the imbalance of cytokines, that develops in such diseases as a new coronavirus infection and rheumatoid arthritis. The groups of GEBPs administered to patients with the new coronavirus infection and rheumatoid arthritis (RA) were analyzed. We studied 50 case histories of patients diagnosed with the new coronavirus infection (Group 1) and 64 patients diagnosed with RA (Group 2). In the treatment of coronavirus infection in patients with moderate and severe cases, drugs of 3 groups (inhibitors of IL-6 receptors; IL-6 inhibitors, as well as group A vascular endothelial growth factor inhibitors) are used. In the treatment of RA, TNF-α inhibitors, anti-B-cell drugs, inhibitors of T-cell activation are used in addition to drugs from the group of interleukin 6 inhibitors. The introduction of GEBPs makes it possible to achieve an improvement in clinical and laboratory parameters both with the new coronavirus infection and rheumatoid arthritis.

Vitamins C and A have an immunostimulating effect, and their deficiency leads to an increased risk of developing viral infections. Numerous studies have indicated that the administration of vitamins can decrease the risk and severity of viral infections. The data obtained have stimulated an interest in the efficacy of these vitamins in people with a new coronavirus (SARS-CoV-2) infection. The article aims to evaluate the content of vitamins A, C, as well as peroxidation activity in the blood serum of patients with post-COVID syndrome. For the analysis, 30 patients aged 43 to 63 years were randomly selected, and 2 groups were formed. Group 1 included 12 patients with post-COVID syndrome, who have had a severe disease requiring hospitalization. Group 2 included 18 patients who did not have the new coronovirus infection but complained of physical and mental fatigue, muscle weakness. The serum levels of vitamin A, C and malondialdehyde were measured. Vitamin C content was determined in urine samples. It has been found that patients with postCOVID syndrome demonstrate significant changes in vitamin A and C levels, which trigger the processes that result in oxidative stress.

As a result of testing of laboratory animals (pigs) and ten unfixed corpses (death was confirmed no later than 24 hours before laparoscopic cholecystectomy) with a height of 165–181 cm and a weight of 60–80 kg, the sufficiency of the operative space for performing laparoscopic operations and minimal injury to the abdominal wall when the developed spiral laparolift was inserted into the abdominal cavity were proved. The results of a comparative study of the effectiveness of laparoscopic cholecystectomy of two representative groups of patients with cholelithiasis with concomitant pathologies of the cardiovascular and respiratory systems under conditions of intense pneumoperitoneum with injection of carbon dioxide into the abdominal cavity at a pressure of 12–15 mmHg and with the use of a spiral laparolift, make it possible to consider a 10% reduction in the period of postoperative rehabilitation, a reduction in the negative consequences for the cardiovascular and respiratory systems of patients when using "gas-free" laparoscopic cholecystectomy.

Clinical and dynamic qualification of post-COVID syndrome within the personal history of COVID-19 in patients with inpatient treatment for coronavirus infection is presented. We examined 43 convalescents of pneumonia associated with COVID-19, aged 34 to 84 years, mean age of 63.15 + 2.14 (19 men and 24 women), for 20 days, treated in a Novgorod clinic neurological department with a diagnosis of fatigue syndrome after a viral disease in the period from February to May 2021. Methods of clinical and dynamic neurological examination, neuropsychological screening of cognitive impairments (Montreal Cognitive Assessment) were used. Patients' subjective complaints about fatigue and sleep disturbance were assessed, which was verified by the State of health, Activity, and Mood (SAM) and the Epworth Sleepiness Scale questionnaires. The level of personal and reactive anxiety was assessed using the Ch.D. Spielberger and Yu.L. Khanin Anxiety Test. The level of depression was assessed using the Hospital Anxiety and Depression Scale (HADS). The method of clinical and dynamic assessment was used with statistical processing by calculating the confidence coefficient, the reliability of the indicators and the difference in the average values. The study revealed such components of post-covid syndrome as: asthenic; dyssomnic; affective with a predominance of anxiety-depressive variant. When comparing the study groups by gender, it was revealed that in women, the severity of physical activity disorders in the asthenic complex is significantly greater (p<0.05), but the normalization of well-being (p<0.01) and activity (p<0.05) indicators is significantly faster (within 20 days). High personal and reactive anxiety was revealed with a significant predominance in the group of women (p<0.05) both upon their admission to the neurological department and after three weeks of observation with severity up to the clinical level without a significant difference in dynamics, which was regarded as an affective component of post-COVID syndrome with anxiety disorder in women. There was also subclinical depression without gender difference.

In the context of the COVID-19 pandemic, it is of practical importance to study the clinical features of not only severe, but also mild forms of this disease. The aim of this research was to study the clinical features of the course of a mild form of coronavirus infection. It was revealed that the most frequent complaints in mild COVID-19 were low-grade fever, cough, general weakness, loss of smell and taste, rhinitis, sore throat. Data were obtained on the age-sex structure of patients with mild COVID-19 and on the incidence of overweight in this group of patients. The results of the research complement the known information obtained in the study of moderate and severe forms of the disease and confirm the hypotheses about the role of the studied factors in the pathogenesis of COVID-19.

Conducting surgical interventions during a pandemic requires taking into account a number of specific factors affecting the performance of operations both in patients with coronavirus infection and conditionally “clean” patients. An analysis was made of the treatment of patients with acute surgical diseases of the abdominal cavity in the Central City Clinical Hospital of Veliky Novgorod for the period from 2017 to 2021, and the results of treatment of 4455 patients with "acute abdomen", including 267 patients with COVID-19 during the pandemic 2020-2021, were separately studied. 2021 The issues of routing and selection of patients in need of emergency and planned operations, the principles of functioning of the surgical department, the operating room, the features of ensuring the safety of personnel during operations in infected patients, the choice of priority intervention for the surgical treatment of patients with acute surgical diseases of the abdominal organs are considered.

In connection with the emergence of new, more aggressive strains of SARS-CoV-2, research aimed at creating the most effective strategies for the use of drugs that have already proven themselves in the treatment of COVID-19 and are registered for use in severe forms of this disease is of particular importance. The aim of this study was to analyze the experience of using monoclonal antibodies, interleukin-6 inhibitors, in adult patients with a moderate form of the new coronavirus infection. According to the results obtained, in the majority of patients with a moderate form of the new coronavirus infection with a threat of deterioration of the condition, the administration of monoclonal antibodies, interleukin-6 inhibitors, was effective in preventing the transition to a severe form. The drugs used in such clinical situations were olokizumab (artlegia) and levilimab (ilsira). The third drug studied in this research, tocilizumab (actemra), was used only for severe cases and when the condition worsened despite the administration of olokizumab. The results of the study show the actual possibility of using monoclonal antibodies, interleukin-6 inhibitors, in patients with a moderate form of COVID-19 in order to prevent the transition to a severe form and prove the need for further research to justify this approach.

During the period from 2017 to 2021, 256 people were urgently operated on for complicated colorectal cancer in the Central City Clinical Hospital of Veliky Novgorod. Among the complications of colorectal cancer, acute intestinal obstruction was observed in 166 patients (64.8%), diastatic perforation of the large bowel was noted in 23 (9%), perifocal tumor inflammation — in 20 (7.8%), tumor perforation — in 36 (14%) and in 11 (4.3%) cases, bleeding from the tumor was detected. There were 111 men (43.4%), 145 women (56.7%). The age of the patients varied from 24 to 93 years and averaged 50.9±3.8 years. By localization, tumor of the cecum was noted in 20 (7.8%) patients, the right flank of the colon — in 64 (25%), the left flank of the colon — in 36 (14%), the sigmoid colon — in 97 (37.9%) and the rectum — in 39 (15.2%) patients. Operations with tumor removal were performed in 218 patients (85.2%), including 11 patients with laparoscopy. In 38 patients (14.8%), surgical interventions were symptomatic and limited to the removal of colostomy. Among 256 patients operated for complicated colorectal cancer, 42 patients died, postoperative mortality was 16.4% and was significantly lower than the figures published in the literature.

The article attempts a new understanding of the pedagogical views of A.S. Makarenko in the context of the past and present. Two related issues are being considered. The first question is why A.S. Makarenko was criticized by the authorities during his lifetime, and after his death was recognized as the main Soviet teacher. The second question is how A.S. Makarenko and his colleagues at the Gorky Colony and the Dzerzhinsky Commune managed to raise decent citizens from extremely socially neglected teenagers, boys and girls. In the pedagogical and historical aspect, the principle of parallel action, the law of collective movement and the principle of "burned biography" are considered theoretically justified and implemented in practice. As one of the main reasons for the successful activity of A.S. Makarenko, his dedication and selfless work are noted.