The article is devoted to the question of how the problem of the lack of professionally trained specialists in the periphery was solved in the pre-revolutionary period in the Russian Empire. Several options have been used. Local governments allocated funds for scholarships, but in order to receive them, it was necessary to work for several years in the region after graduation. Public organizations also allocated funds for training, but on the condition of signing an agreement and further repayment of the provided loan. The practice was continued in the form of the distribution of graduates in the Soviet period, and target education in modern Russia.

Introduction. Artificial Intelligence (AI) is becoming an increasingly important tool in modern healthcare. It can revolutionize the ways of medical care, from diagnosis and treatment to high-tech medical care; and make adjustments to modern medical education by providing new methods of teaching and learning. This article considers the place of AI in modern healthcare and medical education, including its benefits, issues and future prospects for using these technologies.

The objective was to identify opportunities, define problems, and evaluate the prospects for the use of AI in healthcare and medical education. Methods and materials. The main general scientific research methods (dialectics, induction, deduction, description, comparison, analogy) and specific scientific methods (logical-analytical, system-structural, statistical, etc.). The sources of open information served as the materials for analysis.

Results. As a result of this research, the most promising directions of using AI in health care and medical education have been identified, the problems of using these technologies have been defined and ways to overcome them have been outlined.

Conclusion. AI is a rapidly growing field of innovation that has the potential to transform many sectors, including health care and medical education, revolutionizing not only the ways of medical care, making it more efficient, accurate and personalized, but also modernizing teaching and learning methods in medical education. However, there are a number of problems associated with the application of AI technologies that require further research into the totality of interactions between all actors (AI technologies, patients, doctors, medical staff, etc.) and the impact of digital technologies on human capacity in terms of medical care, taking into account serious internal risks and external threats that should be considered when making decisions about the introduction of AI technologies in an uncertain, contemporary geopolitical and economic environment, as well as sanctions constraints.

Introduction. Amino acids and their derivatives are involved in synaptic transmission as neurotransmitters and neuromodulators, and some of them are involved in the formation of neurotransmitters of the nervous system. Therefore, the study of the state of the amino acid pool in incomplete cerebral ischemia plays a significant role.

The objective was to assess the nature of changes in amino acid pool and evaluate their participation in oxidative processes in rats with incomplete cerebral ischemia.

Methods and materials. The experiments were carried out on 16 male outbred white rats weighing 260±20 g in compliance with the requirements of the Directive of the European Parliament and of the Council No. 2010/63/EU of September 22, 2010 on the protection of animals used for scientific purposes.

Results. Compared with the indicators in the control group, rats with an ischemic period of 1 hour in the parietal lobe had a decrease in the content of sulfur-containing amino acids: methionine by 12 % and cysteate by 28 %. In addition, there was an increase of L-arginine in the parietal lobe by 39 %, and in the hippocampus – by 56 %.

Conclusions. The following changes are characteristic for one-hour incomplete cerebral ischemia: a decrease in the content of sulfur-containing amino acids, with a decrease in both methionine and an increase in the content of L-arginine. Changes in the parietal lobe and hippocampus had a similar nature, except for the absence of a drop in the level of cysteate in the hippocampus, as a reflection of the higher sensitivity of the parietal lobe to oxygen deficiency, compared with the hippocampus.

Introduction. Ph-positive acute lymphoblastic leukemia (ALL) is a high risk group of B-lineage acute lymphoblastic leukemia (B-ALL). Since tyrosine kinase inhibitors (TKIs) were introduced, controversial data have been obtained on the efficacy of allogeneic hematopoietic stem cell (allo-HSCT) in the first complete remission.

The objective was to evaluate the efficacy of allo-HSCT in the first complete remission of Ph-positive ALL in adult patients after remission induction with continuous chemotherapeutic exposure in combination with TKIs.

Methods and materials. The retrospective analysis included 74 patients with a median age of 32 years (range 18–59) after allo-HSCT in the first complete remission and 58 patients with a median age of 39 years (range 18–65) in the first complete remission after conservative therapy. Ninety-one per cent and 83 % of patients received imatinib as TKIs in remission induction in the allo-HSCT and conservative therapy groups, respectively. The median time from the first complete remission to allo-HSCT was 7 months (range 2–33). Thirty-six patients (49 %) had positive minimal residual disease (MRD) status prior to allo-HSCT. Eighteen patients (14 %) over 40 years underwent allo-HSCT in the first complete remission.

Results. Allo-HSCT improves overall survival (OS) and relapse-free survival (RFS) and by 9 months since the achievement of the first complete remission, they were 70.1 (95 % CI 56.4–88.6) in the allo-HSCT group versus 45.1 (95 % CI 33.4–61.0) in the conservative group, p=0.025 and 63.3 % (95 % CI 47.6–84.1) in the allo-HSCT group versus 44.8 % (95 % CI 33.2–60.4) in the conservative therapy group, p=0.04, respectively. Allo-HSCT in patients over 40 years does not improve 5-year OS and RFS and were 57.2 % (95 % CI 30.0–84.4) versus 59.8 % (95 % CI 36.9– 82.7), p=0.69, and 42.6 % (95 % CI 14.0–71.2) vs. 50.9 % (95 % CI 29.5–72.3), p=0, 88, respectively.

Conclusion. Allo-HSCT performed before 9 months from achievement of the first complete remission after induction with imatinib is the preferred method of remission consolidation in patients from 18 to 40 years old. The optimal therapy for patients older than 40 years in the first complete remission is a conservative approach in combination with TKIs.

Cardiovascular system is a significant target for SARS-CoV-2.

The objective was to study morphological changes in the heart in patients who died from COVID-19.

Materials and methods. Autopsy material of the heart of those who died from COVID-19 (700 autopsies) was analyzed. The analysis of autopsy protocols was carried out, macroscopic changes were assessed, histological preparations stained with hematoxylin and eosin, van Gieson stain, Schiff’s reagent, the results of immunohistochemistry with antibodies to CD68, CD3, CD4, CD8, CD45 were analyzed.

Results. The leading pathomorphological changes in the heart in COVID-19 are acute discirculatory changes with predominant disorders in small intramyocardial vessels. Lymphocytic myocarditis was confirmed in 1 % of cases.

Conclusion. Damage to cardiomyocytes in COVID-19 is multifactorial and associated with manifestations of the underlying cardiovascular pathology, changes in intramyocardial vessels due to the action of SARS-CoV-2, and hypoxia due to progressive lung damage.

Introduction. Sarcopenia is common among patients with liver cirrhosis (LC) and has a significant impact on the quality of life of patients, the nature of the course of the disease and mortality. The phase angle (PhA) is the arctangent of the ratio of reactive and active resistances for a variable frequency current obtained using bioimpedance analysis. Data on the relationship between PhA and sarcopenia are limited, so the analysis of this topic is the important step towards understanding the role of sarcopenia in LC.

The objective was to evaluate the relationship between the values of the phase angle and the index of skeletal musculature obtained by CT volumetry in patients with LC.

Methods and materials. The study included 15 patients diagnosed with LC. The anthropometric examination was carried out, followed by an assessment of the component composition of the patients’ body using the ABC-01 «Medass» device (STC Medass, Russia). According to the indications, all patients underwent CT of the abdominal cavity without contrast enhancement.

Results. Median and interquartile interval PhA (°): 5.3 [4.2–5.7] in men and 5.2 [4.9–6.1] in women, skeletal muscle index (cm2/m2): 51.82 [48.33–53.75] cm2/m2 in men and 44.114 [38.9–49.32] cm2/m2 in women. The correlation analysis revealed a positive correlation of the average strength between the skeletal muscle index (cm2/m2) and PhA (°): r=0.2619, p-value=0.036845.

Conclusion. Determination of the components of body composition and their relationship with the course of diseases in patients with LC may have practical application and requires further study.

Introduction. The relevance of the research is determined by the insufficient study of the psychological characteristics of female patients in the cosmetological clinic and the dynamics in the process of non-surgical correction and, in general, the psychological aspects of cosmetological treatment.

The objective was to study the dynamics of the psychological characteristics of female patients of a cosmetological clinic in the process of medical correction.

Methods  and  materials.  Using  psychodiagnostic  methods  “Neuropsychic  Adaptation  Test”  (NPA),  Wellness  Index (WHO-V),  Visual  Analogue  Scale,  Big  Five,  Quality  of  Life  Satisfaction  Questionnaire  (QL),  193  female  patients  of  the cosmetological clinic (mean age 39.19±0.8 years) were examined in the period before treatment and 3 months after it. Data processed by SPSS v. 25.0 using Pearson’s χ2 and Wilcoxon’s Z tests.

Results. The results showed statistically significant changes in the course of treatment of 11 out of 20 psychodiagnostic indicators reflecting the positive dynamics of the following psychological characteristics: the level of neuropsychiatric adaptation (р=0.014), the level of psychological well-being (р=0.000), perception of one’s appearance (р=0.000), individual characteristics of the personality “self-consciousness” (р=0.003) and “personal resources” (р=0.001), overall satisfaction with quality of life (р=0.000) and its individual components.

Discussion. There are showed limitations and research prospects associated with the further expansion of the range of studied psychological characteristics, their relationship with the severity of a cosmetic defect and, in a broader context - with the determination of the role of psychosocial factors in the mechanisms of development and the effectiveness of correction of facial skin defects.

This work is devoted to a literature review and description of a clinical case of Hypomelanosis of Ito. Considering the rare frequency of the disease, not much literature data has been accumulated to date. The description of the disease can be interesting for a number of reasons. Hypomelanosis of Ito is a congenital variant of phacomatosis affecting the skin and nervous system. The disease appears sporadic. The majority of cases are diagnosed clinically, which is due to the lack of a precisely established molecular defect and, as a result, the «difficulties» of molecular diagnostic. This is evidenced by the absence of standard genetic analysis. Cytogenetic and molecular genetic diagnostic methods often do not establish a «causal» mutation. This description of the clinical case of the disease is dedicated to the child who was observed in the Department of Pediatric Neurology of Saint-Petersburg State Pediatric Medical University. The patient was diagnosed clinically in early childhood; the leading symptoms of the disease were delayed speech development and epileptic seizures. No family history of neurocutaneous disorders was noted.

Given the different approaches to the genetic verification of the syndrome, some methods of cytogenetic diagnostics were performed at the department, as the most frequently prescribed study to date. According to the results of the studies, no damage was found. Given the fact that genetic verification itself does not affect the prognosis and management of patients, it was decided not to continue molecular diagnostics.

High levels of high-density lipoproteins (HDL) in blood plasma have traditionally been considered an anti-atherogenic factor, but this opinion is not always supported by epidemiological and genetic studies. The functions of lipoproteins are of much greater importance, the main of which is the implementation of the reverse cholesterol transport (RCT) from cells to the liver. The part 1 of the review presents the sequence of passage of cholesterol in HDL, shows the importance of each link in this chain for the development of atherosclerosis; the main methods for determining RCT are given. Changes in the structure and function of HDL, which play the important role in the pathogenesis of a number of chronic diseases that in one way or another stimulate the development of atherosclerosis, are considered in part 2 of the review.

The article summarizes the data of a systematic review of scientific publications on acute myeloid leukemia over the past 10 years.

The objective was to conduct a meta-analysis of the data published in the open press to investigate the nature of the association of mutations in the RUNX1 gene with the outcome of acute myeloid leukemia.

Methods and materials. The search for publications was carried on library platforms eLibrary.ru, Google Academy, PubMed, Web of Science according to the criteria PRISMA 2020. The selection of studies was carried out using the Rayyan online program. The meta-analysis was performed on the basis of the RStudio application package. The main characteristics in the studies were reflected in overall survival, relapse-free survival, hazard ratio and were assessed by a standardized effect size. The magnitude of the effect was based on the difference between the observed patients and patients with mutations in the RUNX1 gene. The outliers filtering based on the combines confidence interval. The bias of publications was assessed visually and quantitatively.

Results. The search identified 579 publications, 10 were included in the meta-analysis, the total sample was 2733 patients. The results of statistical tests on the Cochran Q-test (p-value < 0.0001) and the Higgens–Thompson test (92 %) indicate a high heterogeneity of the included publications. The variance of heterogeneity together with the 95 %CI (0.177; 1.528) indicates the heterogeneity of the research results. The combined 95 %CI (0.47; 2.90) does not suggest that mutations in the RUNX1 gene always lead to a poor prognosis. Egger’s regression test (p-value > 0.098) showed no publication bias.

Conclusion. The results of the study revealed a statistical relationships between the influence of mutations in the RUNX1 gene and the outcome of the disease.

The article is devoted to the generalization of information on the use of potential-sensitive probes (PSP) to assess the viability and functional state of an entire cell. Usage of membrane PSP is of great importance for assessing both the viability and functional integrity of the cells and their structural components (mitochondria, nuclei, cytoplasmic membranes, ion channels). Potential advantage of this approach includes studies of native viable cells in order to assess functional state of donor hematopoietic cells before transplantation as well as upon their storage and cultivation. These staining tools allow to assess the state of cellular bioenergetics, i.e., the balance between production and consumption of energy in living cells. The production of energy in mitochondrial structures ensures the cell viability, whereas its impairment leads to the development of different disorders and aging. In clinical medicine, this method can be used to assess the condition of donor cells before their transplantation, primarily in oncohematology, the treatment of patients with severe ischemic myocardial lesions.

The purpose of the work: to study the results of the research of the use of PSP to assess the energy potential and viability of cells.