The article reviews how the academic staff and students acted during the most difficult period of the Great Patriotic War. The Institute was reorganized to a military regime of work, students and teachers were called up to the active army. Curricula and programs were restructured. New algorithms were developed for interaction between students and the administration of the Institute.

This review was based on the databases https://cyberleninka.ru/, PubMed, MedArt, and CSML. In recent decades, chronic endometritis has received increasing attention as a potential factor in unexplained infertility or recurrent pregnancy loss, especially in cases of unsuccessful in vitro fertilization programs or repeated early miscarriages. At the same time, the nosological entity of «chronic endometritis» remains insufficiently defined.
From a pathogenetic perspective, two variants of chronic endometritis development are identified: an infectious-inflammatory process and an autoimmune pathology, in which the initial triggering factor that started the process is leveled. Immunologic changes associated with processes that affect the outcome of implantation, determining fertility impairment, are nonspecific and cannot be considered as diagnostic criteria for chronic endometritis. The exception is, with reservations, infiltration of CD138 (+) plasmacytes by endometrial stroma. The endometrial receptor disorder detected in chronic endometritis appears to be a nonspecific result of a large number of heterogeneous pathologic conditions.
If the infectious-inflammatory pathway of chronic endometritis development is proven, etiotropic therapy aimed at elimination of the infectious agent is justified. In other cases, it is necessary to identify the causes and/or maintenance of secondary autoimmune process.
The objective of the review was to facilitate the physicians’ search for the most effective ways to overcome infertility and pregnancy failure associated with chronic endometritis.

Relevance. The morphological development of the fetus and the weight of the newborn are key indicators of perinatal health, reflecting both the biological, socio-economic, demographic and medical characteristics of the mother. In the context of regional differences and the changing structure of motherhood, it is necessary to comprehensively study the influence of such factors as socio-economic status (income level, education, parity, and smoking status), maternal age, as well as the presence of diseases and anthropometric indicators (BMI) before pregnancy on the outcome of childbirth.
The objective of this study was to determine the cumulative effect of socio-economic, demographic and medical factors on the morphometric parameters of the fetus and the weight of the newborn in a regional analysis, as well as to identify optimal parameters for the formation of favorable intrauterine development.
Methods and materials. The study conducted a retrospective analysis of the data of 5,161 pregnant women who were observed at the Kirov Regional Clinical Perinatal Center. All data were divided into subgroups by maternal age (younger than 20, 20–30, 31–40, ≥41 years), socio-economic indicators (income level, education, parity, smoking status) and medical characteristics (presence of diseases: hypertension, preeclampsia, diabetes mellitus, SARS-CoV-2, fetoplacental insufficiency; BMI before pregnancy). Methods of descriptive statistics, univariate and multifactorial analysis of variance (ANOVA), post-hoc Tukey test, multiple linear regression and logistic regression were used for statistical processing. The software was SPSS (version 26.0) and R (version 4.0.2).
Results. Multifactorial analysis showed that all the studied factors have a statistically significant effect on the weight of the newborn (p<0.001). Optimal indicators were found in mothers aged 20–30 years with a high level of income and education, non–smokers, having a second pregnancy, a normal BMI (18.5–24.9 kg/m2) and the absence of concomitant diseases. Low BMI and the presence of diseases (hypertension, preeclampsia, diabetes mellitus, SARS-CoV-2, fetoplacental insufficiency) lead to a decrease in newborn weight by up to 20 % compared with the control group, while an increased BMI (25.0–29.9 kg/m2) partially compensates for the negative effects of diseases, increasing fetal weight by 8–10 %.
Conclusions. The obtained results emphasize the need for an integrated approach in perinatal medicine, taking into account socio-economic, demographic and medical factors. A personalized pregnancy management strategy, including monitoring the state of maternal health, optimizing anthropometric indicators, and correcting social factors, improves birth outcomes and reduces the risk of fetal hypotrophy. The results of the study are of practical importance for the development of programs to support pregnant women in regions with different social structures.

Introduction. Diagnosing the causes of acute abdominal pain in pregnant women is challenging. Due to the absence of ionizing radiation and better visualization of the appendix compared to ultrasound, magnetic resonance imaging is increasingly recommended as an alternative for examining pregnant women with acute abdominal pain. However, in some cases, it is not possible to perform MRI, which limits the use of this method and necessitates stratification of pregnant patients according to the likelihood of adding MRI to the diagnostic complex.
The objective was to develop a model for predicting the risk of developing acute appendicitis in pregnant women in the 2nd and 3rd trimesters.
Methods and materials. The analysis of data of pregnant patients hospitalized at the Pavlov First Saint Petersburg State Medical University with suspected acute appendicitis was performed from January 2020 to January 2025 (n=94). The study took into account epidemiological, clinical, laboratory, instrumental, surgical and postoperative data. A univariate analysis was performed to predict the presence of acute appendicitis in pregnant women in the 2nd and 3rd trimesters, followed by the construction of a diagnostic model and the identification of risk classes. To confirm the quality of the constructed model, regression analysis was used followed by risk analysis.
Results. A model for predicting acute appendicitis in pregnant women in the 2nd–3rd trimesters was constructed based on clinical and laboratory parameters and ultrasound diagnostics with the identification of risk levels (AuRoc 0.84). The patients included in the average risk group underwent MRI to clarify the diagnosis of acute appendicitis and perform differential diagnostics with other pathologies of the abdominal cavity and pelvic organs. The proposed model for predicting acute appendicitis in pregnant women in the 2nd–3rd trimesters using MRI diagnostics in the average risk group has a high predictive quality (AuRoc 0.98) with a sensitivity of 96.9 % and a specificity of 97.6 %.
Conclusion. The identified factors (pain in the right lower quadrant of the abdomen, leukocyte level≥12.5·109/l, granulocyte percentage ≥76.4, positive Kocher sign, nausea/vomiting and C-reactive protein level> 6.0 mg/l) can be used to predict acute appendicitis in pregnant women in the 2nd and 3rd trimesters, taking into account the data of instrumental studies (ultrasound and MRI). The constructed model for predicting acute appendicitis, based on clinical and laboratory parameters and ultrasound diagnostics with the identification of risk levels, can be recommended for use in the diagnostics of acute appendicitis in pregnant women in the 2nd and 3rd trimesters. Stratification of pregnant women by the risk level of acute appendicitis allows for the reasonable use of MRI only in the average risk group for the purpose of differential diagnosis of the disease.

Introduction. Gastroduodenal ulcerative bleeding is a common complication of peptic ulcer disease and remains one of the most pressing problems of modern emergency abdominal surgery, as well as one of the leading causes of emergency hospitalization in surgical hospitals. Despite the development of endoscopic and X-ray endovascular technologies, the frequency of recurrent bleeding and postoperative mortality remain high, especially in patients with large ulcers and penetration into the head of the pancreas. A possible option for improving the treatment of patients with chronic duodenal ulcers complicated by bleeding is the use of hybrid hemostasis, which is a combination of endoscopic and X-ray endovascular intervention.
The objective was to improve the treatment results of patients with chronic duodenal ulcers complicated by bleeding by using hybrid hemostasis.
Methods and materials. A retrospective and prospective analysis of 349 patients with ulcerative duodenal bleeding was performed. A prognostic model for assessing the risk of recurrent bleeding was developed based on regression analysis of key factors (ulcer size and location, type of bleeding according to J.A. Forrest, presence of comorbid pathology, intake of anticoagulants and/or antiplatelet agents, ulcer penetration into the head of the pancreas, type of endoscopic hemostasis). Three risk groups for recurrent bleeding were formed: low, medium, high. For each risk group, a treatment strategy using hybrid hemostasis was determined. The outcomes of the retrospective and prospective groups were compared in terms of recurrence rate, mortality, and length of hospitalization.
Conclusions. The use of a treatment and diagnostic algorithm based on the assessment of the risk of recurrent bleeding using hybrid hemostasis allowed to significantly reduce the frequency of relapses (from 34.8 % to 14.5 %), mortality (from 16.8 % to 4.3 %) and the average hospital stay. Hybrid hemostasis can be an effective way to finally stop bleeding in the group of medium risk of recurrent bleeding, and in the high-risk group it can be used as preoperative preparation for surgery.

The objective was to study possibilities of magnetic resonance imaging in the visualization of formations located in the parapharyngeal space or extending into the parapharyngeal space from adjacent areas.
Methods and materials. According to the Pavlov University data, during the follow-up period from 2015 to 2024, pathological changes in the parapharyngeal space were detected in 33 patients out of 462 examined patients with suspected formations of the lateral surface of the neck, thus, the incidence of these changes, according to our data, was 7.14 %. All examined patients underwent high-field magnetic resonance imaging (MRI) of the soft tissues of the neck, with intravenous administration of a paramagnetic contrast agent. All the results were verified histologically.
Conclusion. Magnetic resonance imaging makes it possible to visualize the structures of the parapharyngeal space and adjacent spaces, reliably differentiate the location of formations (located in the parapharyngeal space or in the structure of adjacent spaces or extending from other spaces of the neck) and suggest the histological structure of formations at the preoperative stage, which will allow to develop a surgical intervention plan.

Introduction. The LITT (Laser Interstitial Thermotherapy) laser technique uses radiation of the same wavelength, either 0.98 microns or 1.06 microns, spectrally located nearby. According to the absorption spectrum, these radiations are predominantly hemoglobin absorbing and are similar in interaction with biological tissue.
The objective was to determine the possibilities of using waves differing in chromophores in laser hyperthermia of tumors.
Methods and materials. We conducted the study on the effectiveness of exposure to different wavelengths, both in the variant of sequential and simultaneous irradiation of the phantom of the surrogate of living tissue (SLT) and the protein model of hemoglobin with absorbable and water-absorbable radiation. An optical fiber with a butt end and a radial tip type was used.
Results. Water-absorbing radiation with wavelengths of 1.56 microns and 1.94 microns made it possible to quickly achieve volumetric coagulation of egg white. On the contrary, radiation of 0.97 microns poorly coagulated egg white at similar radiation powers, due to the absence of hemoglobin in the egg. In the SLT containing hemoglobin, the volume of coagulate depended on the wavelength used, the concentration of hemoglobin and the type of fiber tip. The largest volume of coagulated SLT phantom was achieved by using 1.56 microns radiation with the radial end of the optical fiber. The use of a simultaneous combination of two radiations of 0.98 microns and 1.56 microns at standard power parameters in the coagulation mode seems impractical due to the more aggressive interaction on the example of SLT.
Conclusions. The optimal mode of irradiation when performing interstitial laser hyperthermia of a tumor is the consistent use of initially water absorbing and then hemoglobin absorbing wavelengths.

Introduction. Hematopoietic stem cell transplantation (HSCT) is a complex method characterized by high-dose chemotherapy exposure, a long period of pancytopenia and the use of immunosuppressants, which can cause undesirable complications, including those involving the nervous system. The most common complications with damage to the nervous system in oncohematology are toxic reactions, infectious, cerebrovascular diseases, and dysmetabolic conditions. Among deficiency states, as a result of thiamine deficiency against the background of impaired appetite and gastrointestinal toxicity syndrome, the development of Wernicke encephalopathy (WE) can be expected.
The objective was to detail risk factors for WE in oncohematology and to increase alertness among physicians of various specialties regarding the likelihood of developing this complication during cytostatic, immune therapy and HSCT.
Methods and materials. In the framework of the retro- and prospective study, the transplantation activity of the Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation from 2018 to 2024 was analyzed. During the study period, 2081 HSCT were performed, among which 5 cases of WE were identified.
Results. The risk factors for WE in the study group of patients are presented. Data on the differential diagnosis of WE with other diseases characteristic of the post-transplant period of allo-HSCT are collected. Literature data on the detection rate, clinical, neuroimaging, morphological features of WE in the group of patients undergoing HSCT were analyzed. Recommendations were given for the implementation of nutritional therapy in the oncohematology center, as well as for emergency therapy of thiamine deficiency.
Conclusion. In the structure of oncohematological centers, especially those specializing in the implementation of HSCT, the optimal step is the creation of an interdisciplinary service – laboratory, hematological, neurological, nutritional – focused on the nuances of specific complications during antitumor treatment.

Peripheral blood stem cell apheresis (PBSC) is an effective and safe method of collecting hematopoietic stem cells (HSC) in patients with malignant neoplasms (MN) for subsequent high-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT) compared to myeloexfusion. Optimization of the method for young children in terms of increasing efficiency and reducing the risks of associated complications remains a challenge. The article presents a single-center retrospective analysis of PBSC apheresis in children with cancer. The study included 97 patients who underwent 138 PBSC apheresis. The median age was 2 years 11 months, the median body weight was 16.05 kg. Mobilization of CD34+ cells was performed with filgrastim, in 2 cases with plerixafor. By the day of apheresis, the median CD34+ cell count was 100.5 (10.5–1032) cells/µl. The absolute CD34+ cell count as a result of 1 session ranged from 0.38 to 71.91, the median was 4.8·106/kg. Factors influencing the efficiency of PBSC apheresis were lower body weight (p=0.039), fewer courses of previous antitumor therapy (p=0.002), and a higher number of HSCs (CD34+/45+) in 1 µl of peripheral blood based on the mobilization results (p=0.001). There were no complications associated with the apheresis procedure. Adequate preparation and the proper concomitant therapy, taking into account the prediction of all risks, allow preventing complications and performing PBSC apheresis with a satisfactory result.

Introduction. The problem of treating cerebral contusions in combination with a novel coronavirus infection is highly relevant in modern medicine and holds significant socio-economic importance.
Methods and materials. During the study period (January 2021 – January 2023), 185 patients aged 18 to 80 years (median 38.5 years) with verified cerebral contusions (subarachnoid hemorrhage, contusion-hemorrhagic foci, subdural and epidural hematomas, traumatic intracerebral hematomas) confirmed by CT scans, and a diagnosis of «novel coronavirus infection» verified via clinical, laboratory, and instrumental data (PCR swab for SARS-CoV-2, chest CT findings), were examined at the St. Petersburg State Budgetary Healthcare Institution «Alexandrovskaya Hospital».
Results. The administration of glucocorticoids in patients with moderate to severe cerebral contusions combined with COVID-19 reduces hypoxia, cerebral edema, and consequently shortens the regression time of generalized and focal neurological symptoms. A reduction in hospitalization duration was observed. To date, this method can be effectively used in treating patients with traumatic brain injury (TBI) and COVID-19. The approach is promising but requires further randomized studies.
Conclusion. Dexamethasone reduces mortality and accelerates recovery in patients with cerebral contusions combined with COVID-19.

X-linked adrenoleukodystrophy (X-ALD) is an orphan hereditary disease belonging to the group of peroxisomal diseases with an X-linked recessive type of inheritance, associated with mutations in the ABCD1 gene, characterized by combined damage to the nervous system and adrenal glands. The article provides a review of the literature on this nosology with a description of the etiopathogenesis, clinical picture, diagnostic methods, differential diagnosis and treatment options for this disease. The article describes clinical cases of three patients who were hospitalized in the neurological department № 2 of Pavlov University between 2018 and 2024, based on their complaints, neurological examination data, and laboratory and instrumental diagnostic methods, they were diagnosed with X-ALD. In all the presented clinical cases, more than 3 years passed from the onset of the first symptoms to the final diagnosis, which is due to the difficulty of diagnosing X-ALD at early stages due to the polymorphism of the clinical picture: from classical manifestations of encephalopathy to infrequently encountered manifestations of myelopathy and polyneuropathic syndrome in this nosology. In this regard, timely diagnosis of the disease is important, since effective disease-modifying treatment methods can only be effective if therapy is started in a timely manner.

Morphologic diagnostics of melanocytic neoplasms can cause considerable difficulties. There are no absolute criteria to determine the malignancy potential in controversial cases. A clinical and morphologic observation of an intradermal nevus with histologic features of congenital nevus is presented. The features of congenital nevus – involvement of epithelium of skin appendages, growth around appendages and vessels, invagination of nevoid cells in the lumen of lymphatic vessels – are revealed. In differential diagnosis of melanocytic neoplasms of the skin, a morphologist should evaluate not only the presence/absence of signs of atypism and polymorphism of nevomelanocytes, but also signs characteristic of congenital nevi – growth around skin appendages with possible involvement of epithelium, as well as accumulations of nevomelanocytes around vessels with possible presence of nevomelanocytes in the lumen of lymphatic vessels. Expression of HMB-45 and CyclinD1 in few superficial melanocytes, low proliferative activity (as measured by Ki67) along with histologic features allow diagnosing melanocytic nevus with congenital features.