Introduction. Medical evacuation of newborns in critical condition remains an important area of neonatal intensive care. The study of threat-metric tools for assessing severity during the inter-hospital transport phases is of considerable practical interest.

The aim of the study was to determine the ability of the NTISS scale to predict neonatal outcomes during the pre-transplant preparation phase, depending on the score obtained.

Materials and Methods The cohort study includes data from 604 visits of the resuscitation and consultative center (RSCC) transport team to newborns under remote monitoring by the RSCC between August 1, 2017, and December 31, 2018. Division of the total sample into subgroups according to the score on the studied scale, with subsequent comparison of characteristics and outcomes in these subgroups was performed.

Results In the subgroup of patients with a score of 30 or more there was a significant predominance of children with a birth weight of less than 1000 grams (85.72 %); in the subgroup with a score of 0–9, children with a birth weight of more than 2500 grams accounted for 83.33 %. Similar patterns were observed in the analysis of gestational age. Analysis of the volume of intensive care indicates an increase in the proportion of patients requiring high-frequency ventilatory ventilation, dopamine and adrenaline infusion as the NTISS score increased. When analyzing outcomes in the overall sample, there was an increase in the proportion of fatal outcomes from 0.00 % to 75.00 % as the NTISS score increased.

Discussion The NTISS scale, being a therapeutic profile instrument, divided the sample according to the need for intensive care, which was significantly associated with birth weight and gestational age. Thus, the observed differences in outcomes are a legitimate result of the prevalence of extremely premature infants at high NTISS scores.

Conclusion The NTISS scale demonstrates a reliable division of patients by severity and predicts the outcomes of the hospital phase of treatment. 

Introduction The morphofunctional status of the sentinel lymph node (SLN) is a prognostic factor of tumor metastasis. According to the modern concept, lymphagenic metastasis of the tumor is highest in the SLN, and in the absence of metastases in it, the probability of the absence of metastases in other lymph nodes is high. In the era of the development of new immune treatments for breast cancer, the identification of biomarkers that can predict the status of lymph nodes becomes an important task.

The aim is immunohistochemical study of the expression level of T- and B-lymphocyte markers in breast cancer in the absence and presence of metastases in them.

Materials and methods Sentinel lymph nodes without metastases and with metastases obtained during breast cancer surgery in 18 patients were studied using the immunohistochemical method.

Results Comparative morphological analysis revealed that the number of CD3- and CD20-immunopositive cells was significantly higher in the SLN without metastases.

Discussions The humoral and cellular immune systems take part in the antitumor immune response. Control over the growth of the tumor is carried out mainly by T cells. The results of our study showed a relatively high level of them in the SLN without metastatic lesion. The information about the antitumor activity of B-lymphocytes is contradictory since both the positive and negative role of B-cells in anticancer immunity is shown. The results of the studies showed that in the case of secondary foci of tumor growth, the number of CD20+ B cells is significantly lower, which indicates the important role of humoral immunity in addition to cell-mediated immunity in breast cancer.

Conclusion Quantitative evaluation of (CD3+CD20) cells in the SLN can be used as a possible prognostic marker for breast tumor metastasis.

Introduction. The problem of lung malignant neoplasms diagnosis is extremely urgent. Verification of peripheral lung malignancies using ultrasound bronchoscopy does not exceed 70.6 %.

The aim of the work is to demonstrate an increase in the verification of peripheral lung malignancies by endobronchial lung ultrasound examination.

Materials and methods The study was conducted on the basis of the endoscopic department of the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine from 2019 to 2021, in which 142 patients were included. The patients were divided into 2 groups. The main group included 68 patients whose examination included fibrobronchoscopy with endo ultrasound with biopsy according to a modified technique. The comparison group included 74 patients who underwent ultrasound bronchoscopy with biopsy according to the standard technique. The manipulation time with biopsy according to the standard technique ranged from 12 to 42 minutes, on the average 29 ± 5 minutes. Ultrasound bronchoscopy with biopsy to the modified technique lasted from 14 to 44 minutes, on average – 30 ± 5 minutes.

Results The modified technique of biopsy with endosonographic control of endoscopic instrument position in the pathological focus during ultrasound bronchoscopy allows to increase the percentage of peripheral lung malignant neoplasms verification by 19.8% (p < 0.05). Ultrasound bronchoscopy with biopsy according to a modified technique is a relatively safe manipulation, complications were detected in 2.9 % of patients and were successfully treated conservatively.

Discussion Endobronchial ultrasound examination of the lungs is a sufficiently effective and informative technique. Introduction of modified biopsy technique into clinical practice and its wide application will allow to replace more invasive and traumatic diagnostic procedures, to increase informative value of ultrasound bronchoscopy.

Conclusion The use of a modified biopsy technique during ultrasound bronchoscopy will increase the verification by 19.8 % (p < 0.05), thus allowing to reduce the period of examination of patients and prescribe antitumor treatment earlier.

Introduction. Tick-borne encephalitis (TBE) is a widespread natural focal viral neuroinfection in Russia and the Sverdlovsk region. The high level of morbidity, leading to disability, and the annual registration of focal forms and lethal cases determine the relevance of the search for early differential diagnostic criteria for acute tickborne encephalitis (TBE). A promising direction in the early diagnosis of TBE is acquired by magnetic resonance imaging (MRI).

The aim of the study was to study the features of the MRI picture in patients with focal forms of TBE.

Material and methods. The study included 38 patients with focal forms of OKE who were treated in the neurological department of Sverdlonsk regional clinical hospital № 1 since 2009 to 2019.

Results. In the acute period of focal forms of TBE, pathological changes of an inflammatory nature during MRI of the CNS were more often detected in the cerebral hemispheres (mainly in the white matter) in 40.4 % and subcortical structures in 36.8 %, in the brainstem in 16.7 %, less often in 6.1 % – in the region of the cerebellum and spinal cord. Bilateral nature and combined lesions of the CNS structures were detected 2 times more often. Discussion A detailed analysis of the localization and nature of MRI changes in the CNS in patients with severe focal forms of the disease, in contrast to single descriptions of the MRI picture of TBE according to the literature, made it possible to identify combined lesions of the frontal and parietal lobes characteristic of TBE in combination with pathological changes in the region of the thalamus and basal ganglia.

Conclusion. Identification of typical MRI changes in the CNS in patients with a clinical picture of viral encephalitis in the spring-summer period contributes to the early diagnosis of a severe course of TBE.

Introduction. Analysis of the semiotics and etiological structure of central acute vestibular syndrome (c-AVS) in patients admitted to the neurological department with suspected stroke is important for the development of differential diagnostic algorithms for the timely identification of candidates for reperfusion therapy and early secondary prevention.

The aim of the study was to study the clinical characteristics and determine the etiological structure of the c-AVS in patients admitted to the neurological department with suspected stroke.

Materials and methods We examined 59 patients who were urgently admitted to the neurological department with suspected stroke. A detailed assessment of the otoneurological status (NIHSS and eNIHSS scales, STANDING and HINTS+ algorithms), search for the cause of stroke, and neuroimaging (DWI MRI) were performed.

Results Thirty-four out of 59 patients had c-AVS. Spontaneous nystagmus was observed in 70 % of patients, blast-induced nystagmus in 94 %, unilateral positive impulse test of head rotation in 18 %, acute hearing loss in 21 %, and unexpressed cerebellar dysfunction in 56 %. One third of patients had visualized foci of cerebral lesions – infarcts in cerebellar artery basins (n = 9) and 2 cerebellar hemorrhages. Possible vestibular migraine was diagnosed in seven patients of this subgroup. Two patients were eventually diagnosed with possible Meniere's disease. The etiology of ts-OVS remained unknown in 12 patients.

Discussion This study showed that the principle judgment on the nature of AVS according to STANDING and HINTS+ algorithms did not differ at the primary and repeated examinations, which confirms the effectiveness of using these diagnostic tools in emergency conditions.

Conclusion One in three patients with c-AVS admitted to a neurological department with suspected stroke is identified by neuroimaging; a quarter of patients are eventually diagnosed with possible vestibular migraine and Meniere's disease; in the remaining patients the etiology of dizziness remains unknown.

Introduction. The effectiveness of any type of medical care for children is observed and measured by specialists and parents, whose participation is especially important in the rehabilitation of children with the consequences of diseases of the perinatal period.

The aim of the work was to identify parents' attitudes toward the organization of multilevel medical rehabilitation of children with the consequences of perinatal diseases.

Materials and methods An analysis of the results of a sociological survey of 295 parents whose children underwent rehabilitation/rehabilitation in the catamnesis service of one of the first catamnesis centers in the Russian Federation, established in St. Petersburg on the basis of the Children's City Multiprofile Clinical Specialized Center of High Medical Technologies was conducted.

Results and discussion More than one month after discharge from the hospital, 80.0 % (N = 236) of those who noted an unsatisfactory state of the child applied to the follow-up service. The parents interviewed rated the work of the catamnesis office with their children very highly. The average rating on a five-point scale was 4.96 ± 0.1. Parents noted that during the visit to the follow-up care unit all the children were examined by the medical specialists according to the profile of the disease, almost two-thirds of the children (62,9 %, N = 186) had laboratory tests, 37,0 % (N = 109) had instrumental studies, and more than half (57,1 %, N = 168) underwent psycho-pedagogical diagnostics of development. All parents were given recommendations for further action by specialists at the Center after the rehabilitation/ habilitation course was completed. On the whole, the vast majority (92.7 %, N = 273) of the parents surveyed were satisfied with the system of organization of medical aid. The results show the high efficiency of the rehabilitation service.

Conclusion According to the results of the analysis of the questionnaire, parents' satisfaction with the organization of rehabilitation and habilitation assistance for children was quite high.

Introduction. The first year of life of a child, especially the first six months, is characterized by high rates of growth and development. The influence of the nature of feeding and nutrition is one of the factors determining the harmony of development, the formation of immunological reactivity and resistance to infectious diseases.

The aim of the study was to assess the provision of micronutrients (phosphorus, calcium, magnesium) to nursing women and to determine their impact on the physical and neuropsychological development of children in the first six months of life.

Materials and methods Babies aged 5 days to 6 months and their nursing mothers (n = 53) were prospectively followed up. Anamnestic data, objective examination, evaluation of physical and neuropsychological development, determination of calcium, phosphorus, and magnesium levels in the blood serum of nursing mothers, and determination of calcium, phosphorus, magnesium, and vitamin D in breast milk were studied.

Results The indicators of physical development in most of the examined children were within ±2 sigma deviations (SD). In the evaluation of neuropsychological development, Group I children predominated. We found calcium, phosphorus, magnesium, vitamin D deficiency in breast milk samples (52.8 %; 5.6 %; 17.0 %; 7.7 %, respectively).

Discussion Calcium deficiency in natal milk affects the formation of delayed neuropsychological development of the child, the development of subacute rickets, atopic dermatitis. When breast milk with high phosphorus content is fed, the child's body weight increases. However, the higher the level of magnesium in mother's milk, the lower the z-score on body weight / length and BMI / age in children. Low levels of magnesium in breast milk lead to the development of atopic dermatitis and greater susceptibility of the child to respiratory infections.

Conclusion Inadequate provision of micronutrients to a nursing woman and the identified deviations in the child's health status dictate the need to introduce the monitoring of the actual nutrition of a nursing woman and the assessment of her nutritional status in order to prevent deviations in the health status of the child into outpatient visits of a district pediatrician.

Introduction. Currently, there is evidence of a beneficial effect of statins among patients in the acute period of COVID-19. Much less is known about the effect of taking statins on the health of patients in the immediate period after recovery from COVID-19, especially in patients with concomitant cardiological pathology.

The aim of the study was to evaluate the relationship of regular statin intake with the development of cardiovascular events in discharged patients with cardiovascular pathology during the acute period of COVID-19 and within 3 months after discharge from the infectious diseases hospital.

Materials and methods A retrospective, cohort, observational study of patients who have had COVID-19 and have a history (before COVID-19) of cardiovascular pathologies, in which regular intake of hypolipidemic drugs is indicated, was conducted. Telephone and face-to-face visits were conducted with patients discharged from the infectious diseases hospital after 3 months.

Results During the first three months after discharge from the infectious diseases hospital, 9 (21,95 %) new cardiovascular events were registered in patients not taking statins. In the subgroup of patients taking statins, 1 (3,03 %) cardiovascular event was registered. The chances of developing cardiovascular events in patients in the subgroup of patients not taking statins were 9 times higher than with regular administration (OR 0,11; 95% CI: 0,01–0,92), p = 0,036.

Discussion The positive effect of taking statins observed in discharged patients after COVID-19 may be due to their additional pleiotropic effects.

Conclusion The use of statins in patients with cardiovascular pathology was associated with a significant decrease in cardiovascular events within 3 months after discharge from the infectious diseases hospital.

Introduction. Conducted a periodic medical examination of workers under the influence of harmful factors of production has shown a high prevalence of risk factors and chronic non-infectious diseases (NCDs).

The aim of the study was to evaluate the effectiveness of patient-oriented prevention of NCDs in workers exposed to hazardous industrial factors in different occupational categories.

Materials and methods The study included 656 workers who received one NCDs prevention program after a periodic medical examination. The effectiveness of the undertaken patient-centered prevention program was evaluated on the following grounds: the dynamics of primary NCDs morbidity, the prevalence of NCDs risk factors and NCDs control, temporary and permanent disability, frequency of visits for medical care, regularity and completeness of medical records, the frequency of preventive appointments with a therapist and cardiologist in the health center, cardiovascular and occupational risks.

Results One year after the patient-oriented prophylaxis, the course of NCDs was monitored. Good result was achieved in 43 % of workers, after 5 years – in 29 %. At the same time higher results were obtained in the group with 4–6 harmful industrial factors. The leading factors were general vibration and industrial noise, industrial dust, welding aerosol. The reduction of cardiovascular risk by 47 % and occupational risk by 30 % was registered. Median temporary disability was 10.6 days (95 % CI: 6.2–12.3) after 1 year in group 2, which was 5.2 days less; the lowest median time of NCDs was 12.4 months (95 % CI: 7.7–15.1) in the comparison group.

Discussion. Previously, there was already an organization of therapeutic and preventive work in shop floor health posts. Its application of new methods and tools proves the effectiveness of patient-oriented prevention of NCDs among workers at an industrial enterprise.

Conclusion Patient-oriented prevention of NCDs was carried out in different occupational groups. The results demonstrated the effectiveness of this work in workers exposed to harmful occupational factors.

Introduction. In the treatment of tuberculosis in children, the proportion of adverse events to therapy can be as high as 55 %, especially at the initial stages of treatment. Timely detection and monitoring of their development can improve the effectiveness of tuberculosis treatment.

The aim of the work was to study the peculiarities of adverse reactions in children and adolescents during antituberculosis therapy for their prediction and timely detection.

Materials and methods A retrospective cohort study including 243 patients aged 0 to 17 years who received treatment in two major institutions of Kemerovo Oblast – Kuzbass during 2018–2021 was conducted. Statistical processing of the material assessed risk factors for the development of adverse events in the groups with dyspeptic, toxic and allergic reactions.

Results In the course of chemotherapy 88 patients (36.2 %) developed adverse reactions: dyspeptic – in 55 patients (62.5 %), allergic – in 29 (32.9 %) and toxic – in 28 patients (31.8 %). Adverse reactions developed more often in children and adolescents with concomitant diseases of the gastrointestinal tract, in the presence of complaints before treatment for tuberculosis, during treatment on IV, V chemotherapy regimens with the presence of Pto, Pas, Lfx and Cm in the scheme, as well as when taking broad spectrum antibiotics and anti-tuberculosis drugs.

Discussion Despite the involvement in the process of identifying and monitoring the development of adverse reactions in TB treatment in children, the main risk factors for their development have not yet been identified. The study demonstrates the contribution to the development of adverse reactions of such factors as treatment on IV, V chemotherapy regimens, comorbid GI diseases, presence of complaints during hospitalization in a TB hospital and taking antibiotics together with antituberculosis drugs.

Conclusion Undesirable phenomena were mostly observed at the start of antituberculosis therapy. Allergic, toxic and dyspeptic reactions occurred most frequently in the study group. The risk factors for their development were: IV, V chemotherapy regimens (OR = 2.5), presence of Pto (OR = 2.7), Pas (OR = 3.0), Lfx (OR = 2.3) and Cm in the CT regimen (OR = 3.8), comorbid GI diseases (OR = 3.5), complaints during hospitalization in the TB hospital (OR = 1.8) and taking antibiotics together with antituberculosis drugs (OR = 2.5).

Introduction. Primary cell cultures of breast carcinoma (BC) are used as a model for study the processes of intratumoral heterogeneity, drug resistance and various molecular and biological processes. One of the variants of primary culture is non-adhesive cell culture in the form of spheroids – mammospheres. There is evidence that cells isolated from mammospheres have mesenchymal features. However, the acquisition of mesenchymal features in mammospheres derived from tumors correlates with suppression of estrogen receptor expression and, therefore, with resistance to therapy against hormone-dependent tumors.

The aim of the study was to determine the effect of the method of culturing BC cells on the ability of cells to preserve the epithelial phenotype.

Materials and methods A comparative analysis of two BC culture samples examined over three passages using different methods of cultivation was performed. Staining for morphological evaluation was carried out according to Pappenheim. Determination of belonging to epitheliocytes was performed using anti-Pan Keratin (AE1/AE3/ PCK26) Primary Antibody (Roche diagnostics, USA).

Results Three passages (P2, P3, P4) of non-adherent and three passages of adherent cells were taken for culture analysis. During the study of these BC culture variants, the morphological features of the cells in each passage were determined and it was found that regardless of the technique chosen during cultivation, the cells of the cultures under study retained the epithelial phenotype. However, the study of the adhesive culture revealed a higher percentage of cells showing the epithelial phenotype compared to the cells of the non-adhesive culture.

Discussion In the course of our study, six morphological groups of cells obtained during the creation of a primary culture of a BC sample were identified, among which differences in the preservation of the epithelial nature throughout the cultivation were manifested.

Conclusion The choice of cultivation technique influences the ability of cells to retain the epithelial phenotype for three passages. In the second passage, the level of pancytokeratin expression in the adhesive culture is significantly differed from that in the non-adhesive culture. By the fourth passage there is a sharp decrease in the number of epithelial cells.

Introduction. The purpose of the study is to determine the leading and least represented on the website of the Federal project "Development of exports of medical services" (Federal project) profiles of medical services for the formation of proposals for the development of medical tourism in the Chelyabinsk region.

Materials and methods The study is based on empirical and theoretical methods of studying the website of the Federal Project and the information of the Coordinating Center for Medical Tourism Development placed on the websites of the Ministry of Health of Russia and Central Research Institute of Health Organization and Informatization. Statistical method and questionnaire survey method were used.

Results and Discussion Factors influencing the choice of medical organization are: availability of information about the medical organization in free access, transport accessibility, staffing of hospitals with equipment, level of professional training of doctors, quality of service and patient safety in medical organizations, the cost of medical services. Leading areas of medical tourism for adult patients: obstetrics and gynecology, neurology and neurosurgery, traumatology and orthopedics. Rating of medical services profiles for children's age category of foreign tourists: pediatrics, rehabilitation, ophthalmology, neurology, otorhinolaryngology and dentistry. The main factors motivating managers of medical organizations to participate in the Federal project: attracting additional funds, development of quality system management and obtaining a JSI certificate, improving the image of the medical organization in the framework of medical tourism. Reasons that hinder participation in the project: lack of targeted funding, problems of interaction with the project organizers, maintenance and processing of permits for medical tourism, pandemic conditions.

Conclusion The condition for effective implementation of the Federal project in the Chelyabinsk region is to create a Regional Coordinating Center, which will organize and carry out activities aimed at the development of medical tourism in the region and the promotion of medical organizations in the Chelyabinsk region. 

Introduction. Occupational neurosensory hearing loss is one of the most common occupational diseases. So far, there have been no studies in the scientific literature devoted to a retrospective analysis of professional conditions and conditions of medical care organization in case this pathology is detected in workers served by the system of health care institutions of FMBA of Russia.

Materials and methods The study used data from the "Industry register of persons with occupational diseases", accounting documents and regulations that allow an analysis of working conditions and medical care.

Results The rate of neurosensory hearing loss was 31.3 % in the structure of occupational diseases among employees of enterprises and organizations served by FMBA health care institutions of Russia in 2010-2020. The frequency of continuous use of anti-noise personal protective equipment decreased from 77.8 % (2010–2015) to 75.4 % (2016–2020). Occupational neurosensory hearing loss was diagnosed in 79.4 % of workers based on periodic medical examinations and in 20.6 % of workers based on self-referrals. The decision to refer an employee for determination of the degree of disability was made in 16.5 % of cases.

Discussion On the basis of the scientific literature and the results of our study, a proposal to take into account not only physical, but also chemical occupational hazards that aggravate the impact of industrial noise on employee health, as well as the anamnesis of tobacco smoking, cardiovascular disease, diabetes mellitus and atherosclerosis.

Conclusion The risk group for occupational neurosensory hearing loss is men over 50 years of age. The duration of formation of this pathology is 34,1 ± 1,1 years at the PS level of 90,6 ± 1,0 dB. The importance of optimal organization of periodic medical examinations and the need to control the use of anti-noise personal protective equipment in the workplace is noted.

Introduction. At the end of 2020, the clinical cure rate in all registration groups of patients with pulmonary tuberculosis was 48.2 %. There is now ample evidence that additional risk factors influence the more severe course of pulmonary tuberculosis and reduce the effectiveness of standard anti-tuberculosis therapeutic programs. Diabetes mellitus and tobacco use are among the significant risk factors. Complementing standard TB therapeutic programs with nicotine addiction and diabetes mellitus treatment programs with the formation of an individual comprehensive patient treatment plan will increase the effectiveness of TB treatment. Thus, the goal of this work is to demonstrate the high effectiveness of an individualized approach to the treatment of a patient with pulmonary tuberculosis with a comorbid background.

The aim of the work was to demonstrate the high effectiveness of an individualized approach to the treatment of a patient with pulmonary tuberculosis with a comorbid background.

Materials and methods At the Central TB Research Institute the patient underwent a comprehensive examination, including mandatory, additional and facultative methods of investigation. Based on the findings, the patient underwent complex treatment: antituberculosis chemotherapy, correction of carbohydrate metabolism disorders using oral antidiabetic drugs, nicotine replacement therapy according to the selected scheme, taking into account the degree of nicotine addiction.

Results and Discussion Against the background of complex treatment, by four months of therapy the following was achieved: knockdown of systemic inflammatory reactions, cessation of bacterial excretion, compensation of diabetes mellitus. X-ray examination revealed closure of a large decay cavity, resorption and consolidation of focal infiltrative changes. There was regression of infiltrative changes of trachea and bronchi. The patient completely stopped using tobacco due to nicotine replacement therapy.

Conclusion This clinical example demonstrates the high effectiveness of an individualized approach to the treatment of tuberculosis, including the need for an individualized regimen of anti-tuberculosis therapy, adequate compensation for diabetes mellitus, and the implementation of relevant smoking cessation techniques among smokers with pulmonary tuberculosis.

Introduction. Adjuvant therapy with the inclusion of 5-fluorouracil is used in patients with neoplasms of the colon and rectosigmoid in the postoperative period. However, along with a positive antitumor effect, 5-fluorouracilcontaining regimens have a negative effect on the mucosa of the gastrointestinal tract, which often leads to the need to replace or cancel drugs, thereby reducing the effectiveness of treatment.

Aim of the study was to improve the idea of the possibility of erosive and ulcerative lesions of the stomach and duodenum during treatment with 5-fluorouracil in patients with malignant tumors of the colon and rectosigmoid and the factors that aggravate their course, as well as to highlight the problem of prevention and treatment of gastrointestinal complications.

Materials and methods The search for publications by keywords was carried out in the databases of PubMed, Google Scholar, elibrary.ru and Russian specialized journals related to therapy, surgery, gastroenterology, oncology for the period from 2010 to 2022.

Results and Discussion An analysis of the literature allows us to conclude that the risk of damage to the mucous membrane of the stomach and duodenum during the use of chemotherapy with the inclusion of 5-fluorouracil is very high and amounts to 30–40 %. In addition, there are many factors that can complicate the course of this undesirable phenomenon. These include the advanced age of patients, the presence of serious comorbidity and postoperative complications in patients, as well as infection with Helicobacter pylori. The lack of generally accepted recommendations for the prevention and treatment of damage to the lining of the stomach and duodenum during the use of chemotherapy is a serious problem in modern medical practice.

Conclusion Gastrointestinal toxicity associated with the use of 5-fluorouracil in the form of mucositis in patients with malignant neoplasms of the colon and rectosigmoid deserves close attention. The presence of damage to the mucous membrane of the stomach and duodenum in a patient requires immediate therapy, as this will improve the long-term results of the treatment of the underlying disease and ensure a high quality of life for the patient.

Introduction. Chronic mesenterial ischemia (CMI) is a group of extremely dangerous diseases, considered to be rare, clinically manifested by persistent abdominal pain syndrome, stool disorders, weight loss. CMI can develop both as a result of direct lesion of the unpaired branches of the abdominal aorta and as a result of compression from outside under the influence of extravasal factors. Up to 80 % of patients with diagnosed cardiovascular diseases have clinical manifestations of CMI.

The aim of the work was to determine the etiological structure, risk factors, principles of classification and diagnosis of chronic ischemia of the digestive organs.

Materials and Methods This review includes 47 papers on techniques, techniques, and outcomes of treatment interventions, selected from 835 publications found by keyword in PubMed, Google Scholar, and elibrary.ru databases with a search depth from 1990 to 2021.

Results and Discussion There is no generally accepted terminology and classification of CMI. More than 90 % of CMI cases are related to atherosclerotic vascular lesion. The high-risk population includes women over 60 years of age. The classic triad of CMI symptoms includes food-related abdominal pain, weight loss, abdominal aortic auscultation murmur, but due to the nonspecific nature of the complaints, diagnosis is difficult. Clinical suspicion of CMI and re-analysis of the data increase the informative value of radial diagnostic methods.

Conclusion Diagnosis of chronic mesenteric ischemia is an interdisciplinary problem, requires interaction of physicians of different specialties: general practitioner or general practitioner, abdominal and vascular surgeon, gastroenterologist, radiologist, endoscopist. The presence of clinical suspicion of CMI increases the informativeness, timeliness and adequacy interpretation of the results of high-tech methods of radiological diagnostics.

Introduction. Connective tissue dysplasia (СTD) is a common condition that affects the function of various components of the body.

The aim of the work is to determine the current state of the problem of structural and functional characteristics of erythrocytes in persons with СTD.

Materials and methods The authors conducted a search and analysis of works in the scientific electronic library E-library, the Federal Electronic Medical Library of the Ministry of Health of the Russian Federation, the bibliographic database of medical publications Medline using the keywords: erythrocytes, membrane structure, erythrocyte functions, hematopoiesis, erythrocyte life cycle, erythrocyte forms, combined with the terms: connective tissue dysplasia, connective tissue, diagnostic methods, antioxidant protection, lipid peroxidation. Fifty-three sources were selected for the review.

Results and Discussion Erythrocytes originate from mesenchymal tissue and have their own structural and functional features in individuals with СTD, namely, a violation of the structure of the submembrane cytoskeleton, a change in the composition and location of phospholipids inside the erythrocyte membrane, leading to a decrease in the plasticity of the blood cell membrane. In addition, the appearance of prehemolytic and degenerative forms of erythrocytes has been detected, which also contributes to a reduction in the life cycle of erythrocytes and a tendency to anemia in people with СTD.

Conclusion Individuals with СTD have an increased risk of anemia due to structural and functional features of red blood cells, which may lead to hemolysis, which should be taken into account in the examination and management of patients with СTD.

Introduction. The bioethical principles in the work of a nurse during the vaccination of the population against COVID-19 were discussed in the article. Emphasis on the role of the nurse in communicating with patients is placed in the article.

The purpose of this paper is to identify the key principles of bioethics that are most significant in the nursing profession.

Materials and methods The analysis of 15 documentary and literary sources found in the databases and electronic libraries Cyberleninka, ConsultantPlus, garant.ru. The study was carried out by means of the method of content analysis of legal acts.

Results and Discussion The content analysis of the normative-legal acts regulating the citizens' right to health protection and the sphere of vaccine prophylaxis of the population, scientific literature allowed to estimate the order of COVID-19 vaccination organization and the nurse's role in this process. The problems of complexity of vaccination decision-making on the part of the adult population were revealed. Showed the moral and ethical qualities that the nurse must possess.

Conclusion As transhumanism develops, its irreversible consequence is the erasure of the principles of humanism in medicine