[Public health risk threats associated with coronavirus infection in Moscow and the need to counteract].

PURPOSE OF THE STUDY: to determine the main threats to the health of the population of Moscow based on the analysis of the medical and demographic situation in Moscow and the Russian Federation in the context of the COVID-19 pandemic, in order to develop management decisions at the regional level. MATERIAL AND METHODS: Materials of the Federal State Statistics Service (Rosstat), as well as statistical collections of the Russian Research Institute of Health of the Ministry of Health of Russia for 2013-2022 were used. RESULTS: Coronavirus infection has changed the morbidity and mortality rates of the population of the Russian Federation and its constituent entities. In the Russian Federation mortality in 2019-2021 increased from 12.3 to 13.6‰, while in Moscow the increase in the indicator is significant - from 9.5 to 16.7‰. The incidence of COVID-19 in Moscow in 2020-2021 (over the two COVID years) increased from 6191.0 to 8976.0‰oo. The noted decrease in incidence rates across almost all classes of diseases during the COVID period (2019-2020) was associated with the lower medical check-ups and preventive activities, while during 2019-2021 there was an increase in disease incidence of the following classes: mental disorders, behavior disorders; diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, etc., indicating the need for rehabilitation of this group of patients. CONCLUSIONS: The need to counter the threats to the health of the population of Moscow caused by the coronavirus infection requires the development of management decisions aimed at strengthening preventive activities and rehabilitation of patients in the post-COVID period.

[The problems of rural health care and prospects of development].

Further reforming of the rural health care should be proceeded with special attention to availability of medical care in countryside.The purpose of the study is to develop on the basis of analysis of accounting data and research results recommendations for improving organizational forms of medical care to country dwellers. The exploration of peopleware and main performance indicators of medical organizations in rural areas was implemented.The statistical, analytical and sociological methods were applied. The reporting forms 47, 30, 12 of Federal statistical monitoring are analyzed.Results. The provision of population with medical personnel in rural municipalities in 2010-2018 increased from 12.5 to 14.5 per 10 thousand of rural population. The provision with paramedical personnel made up to 52.3%oo and during the same years indicator decreased from 55.4 to 52.3%oo. During the analysis period, 4241 feldsher obstetric posts were reduced and in 2018 their number made up to 33,350. The number of feldshers in rural areas decreased on 18.5%. In 2005-2018 number of central district hospitals and district hospitals decreased in 2.5 times. At that, provision of beds in municipalities of rural areas decreased from 49.6 to 38.8%oo. There significant winding up of district hospitals and their restructuring into branches of central district hospitals occurred. In 2018, remained only 47 out of them equipped with 1549 beds. Unfortunately, the reporting forms of the Ministry of Health of the Russian Federation do not account branches of central district hospitals. This information is to be included in accountability of the Ministry of Health.It is necessary to expand scope of authority of local government bodies in resolving medical and social problems in rural territories.

[Extra-intracranial bypass surgery using the orifice of maxillary artery in a patient with middle cerebral artery aneurysm. Case report and literature review]. / Pervyi opyt vypolneniya ekstra-intrakranial'nogo shuntirovaniya s ispol'zovaniem ust'ya verkhnechelyustnoi arterii u patsienta s anevrizmoi srednei mozgovoi arterii. Opisanie klinicheskogo sluchaya i obzor literatury.

OBJECTIVE: To present the technique of extra-intracranial bypass surgery using the orifice of maxillary artery bypass, to evaluate the advantages and disadvantages of this and alternative revascularization options. MATERIAL AND METHODS: Radial artery graft harvesting was performed at the 1st stage. Simultaneously, the second team of surgeons performed a combined (submandibular and anterior) access to the donor artery (mandibular segment of maxillary artery behind the ramus of the mandible). Craniotomy and mobilization of potential recipient arteries (M2-M3 segments of the middle cerebral artery) were performed at the 2nd stage. Distal anastomosis in end-to-side fashion was formed with M3 segment of the middle cerebral artery. At the 3rd stage, radial artery was passed through a subcutaneous tunnel in zygomatic region. The orifice of maxillary artery was resected together with distal external carotid artery (ECA) and orifice of superficial temporal artery. After transposition of ECA and orifice of maxillary artery, proximal end-to-end anastomosis was performed with radial artery. After that, the main surgical stage was performed, i.e. exclusion of M3 segment of the middle cerebral artery together with aneurysm. RESULTS: Harvesting of mandibular segment of the maxillary artery as a donor vessel reduces the length of bypass graft to 12-14 cm since this branch is localized close to the skull base. You can also form optimal proximal end-to-end anastomosis for intracranial redirecting blood flow maxillary artery. CONCLUSION: The described method makes it possible to form anastomosis with a short bypass graft and reduce the risk of thrombosis. This procedure is effective for cerebral bypass in patients with skull base tumors, complex aneurysms, and occlusive-stenotic lesions of carotid arteries.

Biomechanical analysis of the cervical spine segment as a method for studying the functional and dynamic anatomy of the human neck.

BACKGROUND: Traditionally, dynamic and functional anatomy, in particular the dynamic anatomy of the neck, is studied on cadaveric material. However, the development of in vivo visualization technologies and in silico modeling has made it possible to expand these possibilities. Despite significant progress in the study of dynamic and functional anatomy of the neck by means of in silico methods, the issues of validating the developed models and taking into account the pronounced nonlinearity of soft tissues as well as local anisotropy remain open. The aim of this study was to develop a virtual dynamic anatomical model of the human neck and reproduce the dynamic processes in the cervical spine from this model using the finite element method. MATERIALS AND METHODS: Reverse engineering was used to generate a dynamic anatomical model of the neck from CT data (both male, 24 and 22 years old). Two segments of the cervical spine (C3-C5, C2-T1) were isolated from the resulting model for finite element analysis. Finite element mesh generation and contact interactions were performed using the HyperMesh software (Altair Engineering Inc, Troy, Michigan, USA). The anisotropic hyperelastic Holzapfel-Gasser-Ogden model was used to describe the material behavior of the fibrous rings of the disc. Material modeling and finite element analysis were performed using Abaqus CAE 6.14 software (Simulia, Johnston, Rhode Island, USA). RESULTS: A technique for creating a virtual dynamic anatomical model of the neck was elaborated and implemented. The model includes 79 major anatomical structures of the neck segmented from radiological data. A finite element analysis of the cervical spine was performed. The results of finite element analysis of the C3-C5 segment under axial load were compared with in vitro data. The proposed model shows nonlinear deformation of the disc under static loading; the model predicted displacement values agree well with the experimental ones. The displacement of the С3-С5 central vertebra with an axial load of 800 N reaches a value of 0.65 mm. For the segment C2-T1, data on intradiscal pressure, stress plots and displacements during flexion were obtained. The maximum stress value of 10.036 MPa is observed in the C3-C4 disc. CONCLUSION: Simulation results using the proposed methodology are in good agreement with experimental data. The generated biomechanical models allow describing dynamic phenomena in the cervical spine and obtaining a wide range of quantitative properties of anatomical objects, which are otherwise inaccessible to classical methods for studying dynamic and functional anatomy.

Preparation of Type II Collagen Short Peptides: Temperature Conditions of Cartilage Homogenization and Collagen Hydrolysis.

Physicochemical properties of hyaline cartilage homogenates were studied by the method of microcalorimetry. Collagen hydrolysates were obtained after homogenization of hyaline cartilages under high pressure conditions at the temperatures that denaturate collagen. Thermodynamic parameters of thermal transition of collagen in cartilage suspension were determined. Enthalpy of thermal transition ΔН decreases in comparison with the control. Thermal transition half-width ΔТ varies with temperature. More denatured and homogeneous samples were obtained at homogenization temperature 80°C. According to spectral studies, particles in the samples obtained at the temperature of 80°C were smaller. The temperature of 80°C is preferred for homogenizing hyaline cartilages and obtaining collagen type II short peptides.

[Comparative characteristic of clinical efficacy of the original drug Movalis and its generic Amelotex in the treatment of non-specific lumbar pain]. / Sravnitel'naya kharakteristika klinicheskoi effektivnosti original'nogo preparata Movalis i Ameloteksa v lechenii nespetsificheskoi poyasnichnoi boli.

OBJECTIVE: To perform a comparative analysis of the efficacy of the original drug meloxicam (movalis) and its generic (amelotex) in the treatment of patients with lower back pain. MATERIALS AND METHODS: The analysis of treatment results of 112 (61 men and 51 women) employees of JSC «Admiralteyskie Verfi¼, aged 18 to 60 years, was carried out. All these patients were treated in the period from 2015 to 2017 at the Medical Center of JSC «Admiralteyskie Verfi¼ due to dorsalgia of lumbosacral localization (ICD-10, item M54). The average age of the patients was 42,6±10,4 (from 22 to 59 years). Age range of patients was 20-35 years (n=34); 36-50 years (n=49); >50 years (n=29). RESULTS: Compared to amelotex, movalis was more effective for the duration of pain intensity reduction (5±1,4 days (min 3, max 9) in the movalis group and 7,37±1,68 days (min 3, max 10) in the amelotex group) as well as for the total duration of temporary disability (labor losses 6,43±1,4 days (min 4, max 10) and 8,61±1,59 days (min 5, max 12), respectively). In addition, patients receiving movalis showed a more significant improvement in the Clinical Global Impression (CGI) score in all age groups compared with patients in the amelotex group. CONCLUSION: The lack of therapeutic equivalence between movalis and amelotex determines the relevance of the drug choice for complex therapy of these patients, which will improve the prognosis of the disease and the quality of life of the patient.

High Potassium Concentration during Culturing of Early Mammalian Embryos: Normal or Extreme Situation?

Analysis of the element composition of oviduct and uterine fluid in mammals showed high potassium concentrations in the early embryo microenvironment in vivo. The results of early embryogenesis of mammals in vitro in the presence of high potassium concentrations are discussed. The data are summarized in accordance with the conditions of experimentally modeled pre-implantation development. Comparative assessment of the quality of embryo development until the blastocyst stage in vitro proved the embryos more successfully developed at potassium concentrations close to those registered in the oviductal fluid.

ROLE OF MICRORNA IN PREDICTING OF ADENOCARCINOMA DEVELOPMENT IN BARRETT'S ESOPHAGUS.

Barrett's esophagus is considered as a predictor of esophageal adenocarcinoma with multistage neoplastic progression at present time. The research assessed an expression of microRNA-21 in 25 patients with different degree of metaplasia and dysplasia of mucous coat of esophagus. The level of expression of microRNA depended on the presence and degree of expression of neoplastic changes of mucous coat of esophagus. The expression rising of microRNA was noted in patients with columnar-celled metaplasia and intraepithelial neoplasia and in case of esophageal adenocarcinoma. The treatment strategy could be determined by the method of estimation of the level of microRNA expression in biopsy material from mucous coat of esophagus in patients with gastroesophageal reflux disease and using other criteria.

ANTIREFLUX RESECTION OF MUCOUS MEMBRANE OF ESOPHAGOGASTRIC ANASTOMOSIS IN TREATMENT OF BARRETT'S ESOPHAGUS: INITIAL EXPERIENCE.

Antireflux resection of mucous membrane of esophagogastric anastomosis (ARMS) was performed on 6 patients with typical symptoms of gastroesophageal reflux disease (GERD). The patients had a short segment of сolumnar-celled metaplasia (1-2 cm) without radiological and endoscopic signs of hiatal hernia. All the patients received medicamentous therapy by antisecretory agents more than 3 years. The operation included the endoscopic resection of2/3 circle of mucous membrane of esophagogastric anastomosis and resection of the area of columnar-celled metaplasia. The results of treatment were assessed during 3-7 months after ARMS. There was noted an absence of clinical manifestations of GERD, regression of inflammatory signs of mucous coat of esophagus in 4 out of 6 patients. Symptoms of GERD remained in 2 patients, although the intensity of signs significantly decreased.

Double Subgenomic Promoter Control for a Target Gene Superexpression by a Plant Viral Vector.

Several new deconstructed vectors based on a potexvirus genome sequence for efficient expression of heterologous proteins in plants were designed. The first obtained vector (AltMV-single), based on the Alternanthera mosaic virus (AltMV) strain MU genome, bears a typical architecture for deconstructed plant viral vectors, i.e. a triple gene block was deleted from the viral genome and the model gene of interest was placed under control of the first viral subgenomic promoter. To enhance the efficiency of expression, maintained by the AltMV-single, another vector (AltMV-double) was designed. In AltMV-double, the gene of interest was controlled by two viral subgenomic promoters located sequentially without a gap upstream of the target gene. It was found that AltMV-double provided a significantly higher level of accumulation of the target protein in plants than AltMV-single. Moreover, our data clearly show the requirement of the presence and functioning of both the subgenomic promoters for demonstrated high level of target protein expression by AltMV-double. Taken together, our results describe an additional possible way to enhance the efficiency of transient protein expression maintained in plants by a plant viral vector.

Amino Acid Correction of Regulatory Volume Decrease Evoked by Hypotonic Stress in Mouse Oocytes In Vitro.

Regulatory volume decrease in response to hypotonic stress is typical of the oocytes and early mouse embryos. Changes in the kinetics of osmotic reaction can be used as a marker of the modulating effect of the incubation medium on transmembrane transport in embryonic cells. Quantitative laser scanning microtomography (QLSM) was used to measure oocyte volume. In this paper, it is shown that addition of 5 µM glycine, taurine, or GABA, as well as ATP to Dulbecco's medium abolished the regulatory volume decrease in mature mouse oocytes.

Genetic differentiation of Pacific cod Gadus macrocephalus in the Sea of Okhotsk and in the Bering Sea.

Genetic differentiation of the Pacific cod Gadus macrocephalus was studied. Samples from six regions of the Sea of Okhotsk and the Bering Sea were analyzed with two mtDNA genetic markers-gene of cytochrome 1 and the control region (D-loop). Comparative analysis showed significant genetic differentiation between the two groups of samples. The first group included samples from Tauiskaya Bay and waters of Western Kamchatka. The second group consisted of the samples collected in the waters of the Iturup Island (Sea of Okhotsk), Northern Kurile Islands, Navarin region of the Bering Sea, and Anadyr Bay.

Analysis of the effects of blue light on morphofunctional status of in vitro cultured blastocysts from mice carrying gene of enhanced green fluorescent protein (EGFP).

We studied the effect of blue light (440-490 nm) on the development of late blastocysts of mice carrying the gene of enhanced green fluorescent protein (EGFP). Exposure to blue light for 20 min reduced adhesive properties of blastocysts and their capacity to form primary colonies consisting of the cells of inner cell mass, trophoblast, and extraembryonic endoderm. The negative effects of blue light manifested in morphological changes in the primary colonies and impairment of differentiation and migration of cells of the trophoblast and extraembryonic endoderm. The problems of cell-cell interaction and inductive influences of the inner cell mass on other cell subpopulations are discussed. EGFP blastocysts were proposed as the model for evaluation of the mechanisms underlying the effects of blue light as the major negative factor of visible light used in in vitro experiments on mammalian embryos.

[Information theory of ageing: studying the effect of bone marrow transplantation on the life span of mice].

In this paper the method of life span extension of multicellular organisms (human) using the reservation of stem cells followed by autotransplantation has been proposed. As the efficiency of this method results from the information theory of ageing, it is important to verify it experimentally testing the basic concepts of the theory. Taking it into consideration, the experiment on the bone marrow transplantation to old mice from young closely-related donors of the inbred line was carried out. It has been shown, that transplanted animals exhibited a survival advantage, a mean life span increased by 34% as compared to the control. This result not only demonstrates the efficiency of the proposed method for life span extension of multicellular organisms, but also confirms the basis of the information theory of ageing.

[Use of fluorescence microspectral method for studying bone marrow EGFP+ cells transplantation in 5-fluorouracil-treated mice].

In this paper the experimental results of bone marrow transplantation from C57BL/6-Tg(ACTB-EGFP)1Osb/J transgenic mice into C57BL/6 mice subjected to 5-fluorouracil treatment are represented. It has been shown that EGFP+ cells engraftment in bone marrow, spleen and thymus of host mice after 5-Fu treatment significantly increased. More long-term engraftment was recorded after transplantation between closely related donors and 5-fluorouracil treatment hosts. We have also obtained data on differences in the dynamics of EGFP+ cells engraftment in host investigated organs. To assess the effect of the donor's bone marrow cells on the host immune system, functional activity of the synthetic apparatus (synthetic activity) of cells in bone marrow, spleen, thymus and blood have been investigated with fluorescence microspectral method. The results obtained allow of improving techniques for bone marrow transplantation without host irradiation in order to minimize the adverse effects.

[Genetic variations in Clupea pallasii herring from okhotsk sea based on microsatellite markers].

The genetic variations among spawning groups of herrings from different spawning grounds of the northwestern part of the Okhotsk Sea was assessed using ten microsatellite loci. All loci were polymorphic with the ex- pected heterozygosity estimates varying at different loci in the range of 0.7-95.0% (with a mean of 68.5%). The degree of genetic differentiation displayed by the herrings from the Okhotsk Sea was not statistically sig nificant (0 = 0.74%). The level of pairwise genetic differentiation F(ST) varied in the range of 0.002-0.014, no was it statistically significant in all comparison pairs between the herring samples.

[Preliminary data on variation of four microsatellite loci in Pacific herring Clupea pallasii].

Variation of microsatellite loci Cpa 10, Cpa 113, Cpa4, and Cpa7 was for the first time examined in Pacific-type herring Clupea pallasii from the White Sea (CI. pallasii marisalbi), the Kara Sea (CI. pallasii suworowi), the Sea of Okhotsk, and Lake Nerpich'e, Kamchatka Bay, northwestern Pacific (CI. pallasiipallasii). All loci exhibitedhigh genetic diversity. The estimates of expected heterozygosity varied from 41.5 to 95.6% (mean, 82%). The level of pairwise genetic differentiation Fst at all microsatellite loci varied from 0.005 to 0.076 (0.019, on average) and t was statistically significant (P < 0.05) in most of the pairs of herring samples. Estimates of genetic differentiation among the herring of one subspecies were lower than between the groups belonging to different subspecies.

[Comparative estimation of the EGFP effects on the development of embryos obtained by reciprocal crossing of C57BL/6-Tgn(ACTbEGFP01Osb/J and C57BL/6 mice].

The effect of enhanced green fluorescent protein (EGFP) on the in vitro viability of early embryos of C57BL/6--Tgn(ACTbEGFP010sb/J mice has been studied. The number of viable ova in hemizygous females (-/egfp) has been shown to decrease. Irrespective of the EGFP level, it has no deleterious effect on the early development of embryos obtained by reciprocal crossing of hemizygous (-/egfp) and wild-type (-/-) mice.