The objective was to evaluate the levels of neurotrophins in the brain of mice with urokinase (uPA) gene knockout, carriers of B16/F10 melanoma developing in presence of comorbid pathology – chronic neurogenic pain (CNP).

Methods and materials. The study included female mice of two strains: С57ВL/6 (n=40) and C57BL/6-PlautmI.IBug-ThisPlau6FDhu/GFDhu (n=28). In the main groups, CNP was created by the bilateral sciatic nerve ligation, with В16/F10 melanoma transplanted under the skin of the back 2 weeks after. The comparison groups included sham operated animals with melanoma transplantation, the control groups – sham operated animals and animals with CNP. Mice were decapitated on day 21 of the tumor growth, and the brain levels of brain neurotrophic factor (BDNF); nerve growth factor (NGF), neurotrophins 3 (NT3) and 4 (NT4) were studied by ELISA.

Results. The brain of mice with uPA gene knockout demonstrated higher levels of NT3 (by 1.3 times (p=0.0146)), NT4 (by 2.6 times) and NGF-β (by 1.9 times (p=0.0021)) and lower BDNF (by 1.7 times (p=0.0203)), compared to mice without knockout. Cerebral reduction of NGF-β was a nonspecific brain response to CNP and neoplastic growth in female mice, enhanced in the combination of the pathological factors. Greater stimulation of subcutaneous melanoma growth in female mice with uPA knockout under the influence of CNP combined with a 2-fold decrease in levels of NT3 and BDNF in the brain, along with 2.2 times higher cerebral levels of NGF-β, compared to female mice without knockout.

Conclusions. In female mice with uPA gene knockout compared to mice without knockout, we revealed background differences and other dynamics of neurotrophin levels in the brain at melanoma growth both alone and in combination with comorbid pathology – CNP.

The objective was to analyze the views of citizens of the Russian Federation on a number of issues related to donation and transplantation of a cadaveric cornea.

Methods and materials. In order to conduct a sociological survey of citizens, we have developed a questionnaire that includes a number of questions concerning the topics of donation and transplantation. The total volume of the study was 768 observation units.

Results. Most of the respondents had a positive attitude towards posthumous donation. Almost all respondents knew about the existence of queues for organ transplantation, and also generally agreed with the opinion that informational popularization of posthumous donation should be carried out. The overwhelming majority of respondents believe that it is mandatory to have an informed consent during their lifetime, but some of them allow an operation to remove organs without such consent in some cases.

 Conclusion. Given the lack of knowledge about posthumous donation, there is a need to carry out sanitary and educational work among the population, revealing in detail all the main provisions related to posthumous donation.

Introduction. Early detection of patients with obstructive sleep apnea syndrome (OSAS) using preoperative screening is necessary to reduce risks in the perioperative period.

The objective was to assess the effect of OSAS on the perioperative management of patients.

Methods and materials. 54 patients with a BMI of more than 30 kg/m² were examined, for whom a bariatric operation was performed as planned. Before the operation, all patients underwent respiratory polygraph with the calculation of the apnea/ hypopnea index (AHI), mean saturation (SpO₂ m) during sleep and spirometry.

Results. Patients were divided into 2 groups according to AHI: gr. 1 (n=33) with AHI<15/hour, OSAS, gr. 2 (n=21) with a AHI ≥15/hour. In gr. 2 VC and FVC should be significantly lower than in gr. 1 (p<0.01). A significant decrease in SpO₂ m was noted (p<0.001). On the first day after the operation, there was an increase in pCO2 of arterial blood in gr. 2, in comparison with gr. 1 (p<0.05).

Conclusions. OSAS can be considered as an independent adverse risk factor for potential perioperative complications. Early detection of OSAS will reduce the risks of postoperative complications.

The objective was to improve the management of patients with acute biliary pancreatitis against the background of cholecystocholedocholithiasis.

Methods and materials. 133 patients with acute biliary pancreatitis against the background of cholecystocholedocholithiasis were treated between 2017 and 2021 years. Patients suffering from mild and moderately severe acute biliary pancreatitis underwent single-step (laparoscopic cholecystectomy with endoscopic papillosphincterotomy) or two-step (endoscopic papillosphincterotomy with delayed laparoscopic cholecystectomy) surgical interventions. Patients with severe acute pancreatitis underwent endoscopic papillosphincterotomy with or without common bile duct and pancreatic duct stenting. The comparative analysis was made to estimate the efficiency of different surgical interventions in different groups of patients.

Results. Patients with mild or moderately severe acute biliary pancreatitis showed better outcomes after single-step surgical intervention. Patients with severe acute biliary pancreatitis – after endoscopic papillosphincterotomy with common bile duct and pancreatic duct stenting.

Conclusion. Single-step surgical interventions (laparoscopic cholecystectomy with endoscopic papillosphincterotomy) are shown for patients with mild or moderately severe acute biliary pancreatitis, because this approach helps to preserve the complications, specific for two-step interventions. The single-step approach authentically helps to decrease the duration of hospital stay and reduce treatment costs. The two-step approach is shown for patients with severe acute biliary pancreatitis, but endoscopic papillosphincterotomy with lithoextraction should be supplemented by common bile duct and pancreatic duct stenting, in order to reduce the number of complications associated with delayed cholecystectomy.

Introduction. Organ lesions due to the new coronavirus infection are determined by several factors: direct cytopathic effect of SARS-CoV-2, release of an unbalanced amounts of proinflammatory cytokines leads to systemic damage of the vascular endothelium and increasing hypoxia. These factors in total result in organ dysfunction.

Methods and materials. We examined 96 pathological studies’ protocols of patients who died from the PCR-confirmed new coronavirus infection. Histological slides stained with hematoxylin and eosin were also analyzed.

Results. Macroscopical and microscopical changes seen mostly in lungs, myocardium and other internal organs were described. We reviewed main causes of death (pulmonary and cardiopulmonary failure, multiple organ dysfunction syndrome) and most common concomitant diseases (diabetes mellitus, essential hypertension, obesity). The morphological features of diffuse alveolar damage in the acute and proliferative phases were described in detail. Taken together with the synchronous involvement of the microvasculature in the pathological process it became the main cause of death. The most severe structural changes in lungs were seen after 20 days of disease. These changes were correlated with dysregenerative metaplastic and dysplastic processes. Processes of disturbed regeneration reflect both the severe viral transformation of the alveolar epithelium and the fact that regeneration developed under mechanical ventilation.

Нemimasticatory spasm (HMS) is a rare disorder of the nervous system, in which there are unilateral, violent spasms of the masticatory muscles innervated by the motor portion of the trigeminal nerve. The causes of HMS remain largely unexplored, but microvascular compression is most likely. Anticonvulsants, surgical treatment and botulinum therapy can be applied for the treatment of HMS.

We presented a clinical case of HMS in a 38-year-old woman who had been suffering from this disease for 18 years. The diagnosis of HMS was established only 10 years after the first visit to the doctor. Spasms could occur up to several hundred times a day with a duration up to 15 seconds. The magnetic resonance imaging allowed to exclude neurovascular conflict. Electroneuromyography revealed axonal lesion of the right trigeminal motor root and spontaneous activity in the right masseter muscle. Anticonvulsant treatment was ineffective. The patient received botulinum therapy with a good treatment result.