The continuum of transitional states is considered as a concept of the development of changes in the palatine tonsils from normal variants, through functional deviations and borderline states, to impaired function (from the development of chronic tonsillitis to the occurrence of various associated diseases). This process is based on changes occurring at different levels – from molecular genetic, biochemical and further into the field of clinical manifestations. In the development of chronic tonsillitis, starting from the first manifestations of the disease, the following stages can be distinguished: conditionally healthy, latent forms of the disease, active forms of the pathological process. The control of risk factors creates the basis for the transition from the treatment of chronic tonsillitis that has already arisen to preventive measures at the prenosological stage, a balanced and scientifically based personalized approach in the interests of the patient. Modeling of transient processes of the body state is possible on the way of building mathematical models.

The objective of the study was a comprehensive analysis of various options for surgical treatment injured with critical deep burns of the skin and attracting the attention of specialists to such an urgent problem. The relevance of the study was due to the increasing favorable prognosis for the life of injured with critical deep burns of the skin in connection with modern medical technologies of resuscitation and intensive care.

Methods and materials. The article discusses modern surgical technologies for restoring the skin of injured with critical deep burns of the skin based on an analysis of modern literature in the Russian Federation and abroad. Effective examples and comparative analysis of modern surgical methods for treating burnt patients are provided.

Conclusion. Modern aspects of surgical treatment of critical deep skin burns are relevant and significant in improving survival rates, prognosis and treatment outcomes. However, to achieve satisfactory results, a large team of qualified medical personnel is required, the burn hospital is well equipped with consumables and modern medical equipment.

Lichens synthesize unique secondary metabolites, most of which are not found in other living organisms. More than 800 such metabolites are known, which can be found in various parts of the lichen thallus. Typically, their content varies from 1 to 6 % of the dry weight of the thallus, but sometimes can reach 20 %. In recent years, interest in these metabolites has increased due to their biological and pharmacological activities, including antioxidant, cytotoxic, antimicrobial, anti-inflammatory and analgesic properties. This makes them promising sources of new pharmaceutical substances, although the molecular cellular mechanisms of their action require further study. The most numerous classes of lichen metabolites are depsides, formed via the acetate-polymalonate pathway. They are conjugated from two or three phenolic rings of the orcinol or β-orcinol type. To date, about 141 orcinol-type depside compounds are known, but biological activity has been described for less than 10 % of them. This review summarizes the data on the cytotoxic and antitumor effects, as well as the molecular cellular mechanisms of action of the orcinol-type depsides and tridepsides, emphasizing the need for further study of this group of compounds, for most of which the biological activity has not yet been studied.

Introduction. Postpartum endometritis is an inflammation of the endometrium with possible involvement of the myometrium that occurred after childbirth or cesarean section. The main components of its treatment are antibiotic therapy and removal of necrotic contents of the postpartum uterine cavity (necrectomy). Ultrasound cavitation with fluid aspiration was used for necrectomy.

The objective of this study was to evaluate the effectiveness of necrectomy using ultrasonic cavitation with aspiration of various fluids in the treatment of postpartum endometritis. furacilin solution.

Materials and methods. 45 puerperants with postpartum endometritis were examined and treated. The patients were divided into 3 groups: in the 1st group, treatment was performed without necrectomy; in the 2nd group, cavitation of the uterine cavity using isotonic sodium chloride solution was added to the treatment; in the 3rd group, cavitation of the uterine cavity with furacilin solution.

Results. On the 7th day of treatment, all patients noted an improvement in well-being, normalization of temperature parameters, and reduction of uterine soreness. At the same time, the most pronounced uterine involution was observed in patients of the 3rd group. For example, in patients of group 1, the length of the uterus decreased by 16.9 %, and in patients of group 3 – by 29.5 %. The dynamics of the content of tumor necrosis factor α and interleukin 10 in blood serum was also most pronounced in patients of group 3. Thus, in patients of group 1, the content of IL10 decreased by 84.1 %, and in patients of group 3 – by 90.9 %. The bed-day in this group was 9.3 days, and in the 3rd group was 7.0 days.

Conclusion. The inclusion of ultrasound cavitation of the uterine cavity with furacilin solution in the treatment of patients with postpartum endometritis increases the effectiveness of treatment of this disease.

Introduction. Since the beginning of the development of the transsphenoidal approach, many practicing surgeons in their publications have emphasized the steep learning curve of this field, highlighting the difficulties that may arise for novice surgeons. Despite the evidence of the overall effectiveness and safety of endoscopic surgery, a variety of factors, as reported in the modern literature, affect the curves of surgical training in minimally invasive endoscopic methods, including transsphenoidal endoscopic surgery of the pituitary gland, and, accordingly, the results of surgical treatment.

The objective of the work was the analysis of the results of treatment of patients diagnosed with pituitary adenoma by transsphenoidal endoscopic method for the period from 2019 to 2022 in experienced and inexperienced surgeons, the determination of the threshold for learning this method and ways to overcome it.

Methods and materials. This article describes the statistical analysis of the results of treatment of patients diagnosed with pituitary adenoma by transsphenoidal endoscopy for the period from 2019 to 2022 in experienced and inexperienced surgeons, a review of the literature determining the learning curve of surgeons for this approach.

Results. A neurosurgeon performing more than 200 transnasal operations per year had lower rates of endocrinological, ophthalmological and infectious complications, a lower frequency of postoperative liquorrhea, a higher rate of radicality of the operations performed, and shorter surgery time. However, it is important to note that for inexperienced surgeons performing less than 50 operations per year and with a total experience of less than 100 operations, the percentage of complications does not exceed the figures published in modern literature.

Conclusion. The learning curve is a crucial factor in acquiring new manual skills. Understanding the relationship between the learning curve and surgical outcomes will allow surgeons to better understand what to expect and what measures to take as these surgical skills develop. It seems that the mastery of endoscopic surgery of the base of the skull must necessarily be carried out in a large specialized neurosurgical center, which has an expert-level neurosurgeon with experience of several thousand operations and performs at least 200 operations annually.

Introduction. Today, despite the therapeutic and diagnostic algorithms in the treatment of patients with ulcerative bleeding and the development of medical technologies, high postoperative and overall mortality remains amid a decrease in operational activity, which indicates the urgency of the problem and requires optimization of existing therapeutic and diagnostic algorithms.

The objective was to analyze the results of treatment of patients with chronic duodenal ulcers complicated by bleeding.

Methods and materials. A multicenter retrospective analysis of medical records of patients diagnosed with gastrointestinal bleeding was conducted in 4 hospitals in St. Petersburg for the period from 2018 to 2023. The sample included 379 patients with chronic duodenal ulcers complicated by bleeding. Such indicators as the size and localization of the ulcerative defect, J.A. J.A. Forrest type of bleeding, type of primary hemostasis, relapse rate, age, bed-day, mortality, presence of comorbid pathology, use of oral anticoagulants and antiplatelet agents were assessed.

Conclusions. A high mortality rate in patients with duodenal ulcers is associated with a high frequency of recurrent bleeding. The cause of relapse in some cases is inadequately performed endoscopic hemostasis. For chronic duodenal ulcers complicated by bleeding, combined endoscopic hemostasis with clipping of the bleeding vessel and subsequent drug therapy is indicated. The existing tactics in the treatment of ulcer bleeding are universal for ulcers of various diameters, however, as a retrospective analysis showed, a high percentage of recurrent bleeding and mortality is associated with bleeding from ulcers with a diameter of more than 2 cm, which determines the need to optimize treatment tactics specifically for ulcers of this ulcer diameter.

Introduction. Coordination stability is expressed in psychomotor control of motor activity by the human nervous system and in postural balance as a consequence of cortical-subcortical regulatory processes. With mental retardation, there is a violation of the integrative activity of the higher parts of the brain, a violation of the synthesis and analysis of afferent information of all mental and motor functions, and a violation of spatio-temporal interactions. It is relevant to determine the lateralization of psychomotor processes in people with intellectual disabilities as one of the predictors of understanding the relationship between motor asymmetries in the context of the mechanisms of initiation and further regulation of motor actions.

The objective was to determine the nature of lateralization of psychomotor processes in children with intellectual disabilities and to identify the degree of influence on coordination stability.

Methods and materials. The study involved 40 children aged 14–15 years, who were divided into 2 groups: 20 children with mild mental retardation and 20 normotypical children from a secondary school. Identification of the individual profile of functional interhemispheric asymmetry included passing 7 tests to determine the functional asymmetry of the arms and 6 tests to determine the functional asymmetry of the legs. Also 2 tests for coordination stability.

Results. In normotypical schoolchildren, right-sided lateralization predominates, which indicates the dominance of the left hemisphere. In schoolchildren with mental retardation, the coefficient of manual asymmetry revealed left-sided lateralization. These features are expressed, among other things, in motor manifestations; the regulation of motor actions in some cases is uncoordinated.

Conclusions. There is no specific algorithm for psychomotor control that can be observed in normotypical schoolchildren; motor skills, as well as bilateral body coordination, have reduced development.

Introduction. Childhood obesity is a pressing public health problem worldwide. According to WHO, in 2022, there were 390 million overweight children and adolescents aged 5 to 19 years in the world. Experts consider this problem not only from a somatic point of view, but also from a psychological component.

The objective was to identify the features of adaptive resource potential, personal anxiety and the specifics of parental attitudes of overweight and obese adolescents.

Methods and materials. A total of 120 respondents took part in the study, including 30 overweight and obese adolescents and 30 their parents. The comparison group consisted of adolescents with a normal body mass index and their parents. Psychodiagnostic survey techniques were used aimed at studying adaptive resource potential, the level of personal anxiety and the specifics of parental attitudes.

Results. It was revealed that overweight and obese adolescents highly value their external adaptive potential more than their internal individual psychological adaptive potential. The level of psychological stability is most based on the external system: support from the family, friendly relationships with peers. In assessing the level of manifestation of personal anxiety in adolescents, a low level of anxiety is observed, possibly as an external manifestation of a defense mechanism. In the system of child-parent relations among overweight and obese adolescents, there is a tendency to display negative feelings, low control, and perhaps a more permissive attitude towards the process of raising and educating the child.

Conclusions. For overweight and obese adolescents, correctional and developmental classes should be conducted on self-regulation of their emotional state, increasing self-esteem, accepting their individual psychological qualities, as well as psychological work with the parents of adolescents, in general, with the family system.

Introduction. The creation of new compounds with pronounced cytotoxic activity is one of the priority goals in modern medicinal chemistry due to the emergence of multidrug resistance (MDR) to existing chemotherapy drugs for many types of tumour diseases.

The objective was the synthesis of DNA-tropic heterocyclic systems containing a quaternized nitrogen atom and one or two styryl moieties as side chains. The synthesized compounds must have pronounced cytotoxic activity and moreover bind with DNA macromolecules effectively.

Methods and materials. In this paper, 2 new compounds containing a 10-methyl substituted pyrimidobenzimidazolium core and 1 or 2 4-dimethylaminostyryl moieties as side chains were synthesized. The structures of targeting compounds were confirmed using mass spectrometry and NMR spectroscopy methods. The electronic spectra of these compounds were studied in this work. The investigations of targeting compounds proved their ability to bind with DNA macromolecules. The cytotoxicity of the synthesized compounds was studied on four cell lines.

Results. The target compounds were obtained in four-stage synthetic procedure. The purity of the target products was confirmed using NMR spectroscopy and mass spectrometry. The synthesized compounds are effective cyanine dyes with absorption maxima in the dark red and dark violet regions of the visible spectrum for mono and bis 4-dimethylaminostyryl derivatives, respectively in the its electronic absorption spectra. Both of the synthesized compounds can form a stable complex with DNA macromolecules with a significant deepening of the colour in the solutions. The compounds showed pronounced cytotoxic activity in in vitro experiments on a number of cancer-transformed cell lines. The target compounds were shown a high cytotoxic activity against triple-negative breast cancer cells, which are extremely resistant to chemotherapy.

Conclusion. 4-Dimethylaminostyryl derivatives of N-methyl-pyrimidobenzimidazolium iodides require a further study as new promising compounds with pronounced antitumor activity.

Snake venoms have long been the subject of research in order to obtain new antitumor compounds. Snake secretory phospholipase A₂ has cytotoxic properties that are realized through different mechanisms depending on the enzyme structure and cell type. HeLa and ECV340 cells were used as a model to evaluate the toxic effect of sPLA₂ in the venom of V. nikolskii with and without sPLA₂ inhibition. Varespladib was used as an inhibitor of sPLA₂. In order to understand the mechanism of the toxic effect of sPLA₂, the enzyme was activated by adding an emulsion of phospholipids, bovine serum albumin, and Ca²⁺ to the samples. The results indicate that the cytotoxic effect of sPLA₂ on ECV 340 cells is associated with the catalytic activity of the enzyme; the weak cytotoxic effect of the venom on HeLa cells was preserved upon enzyme activation.

Thus, we have proposed a methodological approach that allows to evaluate the toxic effect of sPLA₂, which has enzymatic activity, in the whole venom of V. nikolskii in relation to various cell lines.

Introduction. Diagnosis of obstruction of the ductal system of the salivary glands is a difficult task. Standard research methods cannot detect such pathology. CBCT-sialography is a modern technique that will simplify and increase the informative value of diagnostics compared to an X-ray image.

The objective was to study the possibility of visualizing the ductal system of the salivary glands by retrograde administration of a contrast agent using ultrasound navigation to perform cone beam tomography (CBCT-sialography).

Methods and materials. On the basis of the oncological Department № 8 of the FSBEI HE I. P. Pavlov SPbSMU MOH, the patient underwent the installation of a subclavian catheter under ultrasound control into the duct expansion cavity through the skin. Next, a radiopaque preparation was introduced, and a cone-beam computed tomography of the maxillofacial region was performed.

Results. Based on the results of the study, surgical intervention was performed. During control examinations, no pathological changes in the ductal system of the parotid salivary gland were detected.

Conclusion. This article describes a clinical case of the successful use of CBCT-sialography. This technique with a low radiation load has shown high informativeness and can be performed on an outpatient basis. Therefore, it is necessary to accumulate clinical material to evaluate the effectiveness of the technique in various pathological changes in the salivary glands.