Objective: To improve the management of mild cervical dysplasia by correcting serum folic acid as an epigenetic risk factor for disease progression.

   Materials and methods: 90 patients with different outcomes of dynamic follow-up of LSIL associated with one type of HPV VCR were included in the study (16, 18, 33). Group I — 43 patients with regression of the disease; Group II — 30 patients with persistence of HPV infection and group III — 17 patients with LSIL progression. The effectiveness of the differentiated approach to the management of patients in the study groups was assessed based on the results of cytology of cervical smears and immunocytochemical reaction, the level of viral load, the results of colposcopic examination, and the dynamics of serum folic acid levels. Statistical processing of the results was performed using IBM SPSS Statistics 28.0.1.1, STATISTICA 13.5.0.17 and MedCalc 20.027.

   Results: the prognostic significance of a number of anamnestic parameters and serum folate deficiency, the totality of which can be used as predictors of disease outcome progression, has been established; a computer program has been developed to calculate the individual risk of disease progression (IRD), which facilitates the use of the developed method for calculating progression in clinical practice.

   Conclusions: The proposed method with a high degree of reliability and informativeness allows predicting the progression of LSIL without violating the algorithm of current clinical recommendations, timely forming among patients a high-risk group for the development of a more severe form of the disease (HSIL) and individually determining further treatment tactics.

   Objective: to identify risk factors for the occurrence of discoordinated labor activity (DRD) and to conduct a comparative analysis of them in first- and repeat-bearing women.

   Materials and methods: the analysis of the course of pregnancy and the outcome of childbirth in 175 women with DRD was carried out. The cases of DRD over five years have been analyzed. All women underwent general clinical studies, ultrasound diagnostics (ultrasound), dopplerometry (DPM), cardiotocography (CTG).

   Results: functional disorders of the autonomic nervous system, morphological changes in the cervix, transferred FGM, as well as a combination of these types of pathology can be predictors of the development of DDD. There were no significant differences in the number of pregnant women suffering from NCD, having FGM, who suffered complications during pregnancy, as well as in the number of patients with prenatal and early discharge of amniotic fluid in the two groups. There are significant differences in the number of women with morphological changes in the cervix, they are significantly more in the second group. In women of the second group, significantly more often than in the first, delivery was performed by caesarean section.

   Conclusions: to reduce DRD in childbirth, in the process of pre-pregnancy preparation, it is necessary to identify risk groups, which will include pregnancy-planning patients with VSD, morphological changes in the cervix, VZHPO. These women should be recommended correction of the existing genital pathology. At the onset of pregnancy, patients with VSD should be recommended to undergo psychoprophylactic preparation for childbirth. These measures, in our opinion, will help to reduce the percentage of DRD, and reduce the overall percentage of delivery by caesarean section.

   Objective: to identify the diabetogenic type of the lateral behavioral profile of asymmetries, which reveals the highest incidence of GDM and obstetric complications in overweight pregnant women and, on its basis, to study the features of the somnological status in women with diabetogenic lateral constitution at the preconception period.

   Materials and methods: the study used special testing (Annette test, sleep quality questionnaire, sleep apnea/hypopnea syndrome questionnaire, sleepiness scale (Epworth)), polysomnographic study.

   Results: based on the results of a questionnaire survey and a polysomnographic study, somnological disorders were identified, expressed in a decrease in the efficiency and quality of sleep, fatigue, perceptible drowsiness in wakefulness, breathing disorders during sleep and other sleep disorders, which contributes to an increased risk of gestational diabetes mellitus mainly in women with an ambidextral lateral phenotype.

   Conclusion: the identified sleep disorders in overweight women in the pregravid period are, on the one hand, the result of hormonal changes against the background of already existing metabolic and vegetative abnormalities in overweight women planning pregnancy, on the other hand, they act as a “trigger” functional disorders both during the manifestation of GDM and during the formation of obstetric complications due to increasing hypoxemia in the maternal body against the background of the “obstructive sleep apnea” syndrome, which contributes to the development of fetal distress.

   Objective: to identify the presence of chronic endometritis in patients with adenomyosis and its cumulative role in the formation of reproductive losses.

   Materials and methods: 101 women of reproductive age with grade II adenomyosis and habitual miscarriage were examined. The comparison group (group 2) consisted of 49 patients with grade II adenomyosis without a history of early reproductive losses. The control group (group 3) consisted of 50 healthy patients. In order to diagnose chronic endometritis, a comprehensive immunohistochemical study of the expression of specific immunological markers of chronic endometritis (natural killer CD56, B cells (CD20), plasma cells (CD138) and activated lymphocytes (HLA-DR) with antibodies and the determination of CD68 macrophages was carried out. Polymerase chain reaction in the “real-time” mode (PCR) was used to determine the types and amount of endometrial microbiota. Statistical data processing was carried out in the environment of the STATISTICA package.

   Results: despite the absence of pathogenic and conditionally pathogenic microflora, according to the results of microbiological examination from the vagina and cervical canal of all examined patients, statistically significant differences in the detection frequencies of various microbiota taxa of crops from the uterine cavity were obtained. Patients with reproductive losses on the background of adenomyosis had microbiological and immunohistochemical signs of chronic endometritis of moderate and mild severity. The presence of chronic endometritis combined with adenomyosis contributes to the occurrence of pronounced endothelial dysfunctions, eventually leading to a violation of reproductive function in patients with a combination of HE and adenomyosis.

   Conclusion: The similar symptoms of adenomyosis and CE, a reliable association of adenomyosis with CE in patients with habitual miscarriage requires the inclusion of immunohistochemical and microbiological examination of the endometrium in the volume of pre-gravidar examination, even if there are negative results of microbiological examination of the environment of the cervical canal.

   The presented review summarizes current data on the tactics of accompanying patients with uterine myoma at various stages of their reproductive potential realization: the stage of pregravid preparation, the stage of pregnancy management, the moment of delivery and the postpartum period. Based on the analysis of domestic and foreign special scientific and practical literature, various methods of childbirth are proposed, from more preferable delivery through the natural birth canal, to the necessary caesarean section, performed strictly according to indications. Data are presented on the options for elective and emergency myomectomy during pregnancy, during operative delivery and in the postpartum period. Based on the results of systematization of the information received, the authors raise the question of the need for further research in the field of developing methods for optimal management of patients during pregnancy and childbirth complicated by uterine myoma, due to the relevance of the problems discussed.

   Objective: to assess the impact of various wartime stresses on the condition of patients with mental illnesses, followed by the development of preventive measures.

   Materials and methods: a questionnaire and a survey of 510 patients with mental and behavioral disorders were conducted on voluntary terms. Then the subjects were divided into 2 groups: 1 group — those who were in the zone of direct combat operations; 2 group — those who were in safer zones. The calculation of the proportion of persons depending on the appropriate answers to questions, a comparison of the levels of anxiety and anxiety in connection with the military situation in patients of groups 1 and 2, as well as an analysis of the corresponding 510 outpatient charts studied in order to assess the impact of wartime stress on the nature of the course of mental illness.

   Results: the negative impact of wartime stress on the course of mental disorders was established in the form of a worsening of the clinical picture of diseases, an increase in the number of exacerbations and resistance to therapy.

   Conclusion: according to the results of the study, preventive measures are recommended.

   Objective: to compare the severity of the relationship between mental state and insomnia of medical students working and not working as nurses.

   Materials and methods: research methods — sociological, psychometric, statistical. The study was conducted at the Bashkir State Medical University (BSMU) from February to April 2022. Data collection was carried out using Google Forms. Study group №1 — 172 students working as nurses. The proportion of males is 41 % (70/172), females — 59 % (102/172). The average age was 21-23 years. Study group № 1 — 66 non-working students. Among the studied 16.7 % (11/66) men, 83.3 % (55/66) women. The average age is 21-23 years. SCL-90-R (Symptom Check List-90-Revised), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) were used as methods. Statistical processing was carried out using Microsoft Excel, STATISTICA 10, Spearman correlation coefficient, U — Mann-whitney test.

   Results: the degree of manifestation of insomnia in the study group № 1 and № 2 positively correlates with both all SCL-90-R scales and second-order indices. when comparing the studied groups, it was found that the mental state of non-working students is more unstable, the quality of sleep is worse.

   Conclusions: the relationship between the mental state and insomniac disorders in medical students, both working as nurses and not working, has been established. we assume that students who do not work as nurses have low adaptive abilities, as a result of which their mental state is accompanied by more pronounced insomniac disorders.

   Currently, there is a significant prevalence of psychosomatic disorders: from 15 to 50% in the general population, 21-33 % in outpatient and 28-53% in inpatient somatic institutions. However, taking into account the variety of clinical manifestations of psychosomatic disorders and patients' seeking help not only from psychiatrists, but also from doctors of other specialties and representatives of nontraditional medicine, in reality these indicators are significantly higher. Untimely detection of the psychosomatic factor in the development of somatic disease often leads to the appointment of unreasonable and expensive treatment, including invasive interventions. The main cause of psychosomatic disorders is stress, prolonged exposure to which on the body leads to functional changes in the organs and their gradual destruction.

   Due to the high relevance of the problem of verification of psychosomatic disorders, the aim of this study was to develop an integrated approach to the diagnosis of psychosomatic diseases based on the analysis of existing concepts and notions; to achieve this goal, a literature review was conducted using Scopus, PubMed, Cochrane Library and CyberLeninka electronic libraries using keywords "psychosomatic disorder", "psychosomatics", "psychosomatic medicine".

   The concept of psychosomatic scenario of the disease (certificate of deposit No. 2207787) is suggested, based on combining the knowledge of classical western, Eastern medicine and psychotherapy, which allows the doctor to analyze, realize the psychosomatic scenario of the disease and see, what psychoemotional conflicts of the person himself and/or inherited from parents and ancestors, as well as distorted ideas about his present and future, was launched by the mechanism of adaptation to these distortions in the physical body in the form of a disease.

   Objective: to estimate the incidence of recurrent myocardial infarction, stroke, and mortality in patients with different phenotypes of myocardial infarction against the background of chronic obstructive pulmonary disease.

   Materials and methods: 325 patients with myocardial infarction were examined: 195 patients with infarction against the background of chronic obstructive pulmonary disease and 130 patients without chronic obstructive pulmonary disease. We studied markers of endogenous intoxication: molecules of average mass, hematological indexes of intoxication, blood gas composition, apoptosis, protein peroxidation, lipid and antioxidant protection, inflammation and renal function. Statistical processing of the data was performed using SPSS 26.0 software package.

   Results: A two-stage cluster analysis formed four clusters, which were labeled as «polymarker-retentive», «necrotic-inflammatory», «hypoxic-inflammatory», and a cluster with no endogenous intoxication syndrome. Among patients with myocardial infarction against the background of chronic obstructive pulmonary disease, the hypoxic-inflammatory phenotype prevailed — in 53.3 % of patients. Necrotic-inflammatory phenotype was noted in 8.2 % of patients, hypoxic-inflammatory — in 36.9% of patients, phenotype with the absence of endogenous intoxication syndrome — in 1.5 % of patients. Recurrent myocardial infarction, stroke and mortality constituted the combined endpoint. The highest incidence of the combined endpoint was observed in the polymarker-retentive infarct phenotype — in 37 (55.2 %) patients.

   Conclusion: Vascular life-threatening and fatal events (recurrent myocardial infarction, stroke, death from cardiac causes) during 12-month follow-up are most typical for the polymarker-retentive phenotype. The clinical features of this phenotype were the frequent presence of Q-shaped MI, transmural myocardial damage, and the presence of complications in the acute period. COPD in these patients was characterized by a long course, high smoker's index, mostly 3^rd degree bronchoobstruction, and frequent exacerbations. The results of this study allow for a personalized approach to the assessment of the annual prognosis in patients with acute myocardial infarction against COPD.

   With the emergence of the SARS-CoV-2 virus in December 2019, all countries around the world have implemented various strategies to prevent its spread and intensively search for effective treatments. Initially, severe cases of the disease were considered only in adults, but later information appeared on the severe course of the disease in children and adolescents. This condition, which occurs as part of the transferred COVID-19, is called multisystem inflammatory syndrome (MIS) or Kawasaki-like syndrome. The available data indicate that MVS is the result of an innate and adaptive immune response characterized by a cytokine storm and a delayed immunological response to SARS-CoV-2. Epidemiological, clinical, and immunological differences classify MVS as a distinct syndrome from Kawasaki disease (БК), including age range, and geographic and ethnic distribution of patients. It should be noted that new data from patients with MVS point to unique characteristics of the immunological response, as well as clinical similarities with other inflammatory syndromes, which can serve as a guide in the search for molecular mechanisms involved in MVS. This review presents an analysis of studies on this topic: features of pathogenesis, diagnosis, treatment methods, as well as further directions for studying the problem. The search for mechanisms for the development of MVS in children continues, and, in turn, medical alertness, timely diagnosis and treatment make it possible to achieve the best possible result for such patients.

   A clinical observation of a newborn child with an extremely rare disease - PURA syndrome is presented. In the world scientific literature, there is a limited number of publications devoted to this pathology, which is the main reason that determines the complexity of diagnosis. This case demonstrates the need for persistent severe myasthenic syndrome in newborns, in addition to excluding hereditary metabolic diseases, to conduct whole genome DNA sequencing to detect PURA syndrome. A clinical case in a young child is presented as an example of a severe illness with an unfavorable course and the likelihood of a worsening separated prognosis.

   The goal was to highlight the clinical manifestations, the complexity of the treatment of this pathology by neonatologists, pediatricians, neurologists from the standpoint of improving the quality of diagnosis of this pathology.

   Objective: to study the effects of a new coronovirus infection on a number of standard biochemical blood parameters in patients of different ages.

   Materials and methods: 514 patients of 3 age groups (group 1^st — 25–35 years old, group 2^nd — 36–50 years old and group 3^rd — over 51 years old) with a diagnosis of community-acquired pneumonia caused by COVID-19 infection were studied. All biochemical parameters of the blood of patients were determined using an Indiko biochemical analyzer.

   Results: the study of nitrogen metabolism indicators showed that in patients of all age groups, the content of total protein and urea does not undergo significant changes, however, there is an increase in the concentration of creatinine and uric acid, which is most pronounced in patients of the group 3^rd. The study of the activities of AST, ALT in the blood of patients showed a significant increase in all age categories, more significant in persons of the groups 2^nd and 3^rd. At the same time, the activity of α-amylase, the concentration of bilirubin increase with age, and the levels of iron decrease, reaching pathological values. The content of the inflammation marker — CRP shows the most pronounced dependence on the age of patients: in patients of the group 1^st, it increases by 6.9 times, in the 2^nd group — by 12.3 times, in patients over 51 years old — by 17.25 once.

   Conclusion: with an increase in the age of patients, the deviations of many biochemical parameters from the control levels corresponding to each group become more pronounced and reach values that deviate significantly from the reference.

   The problem of chronic traumatic encephalopathy is extremely relevant from both medical and sports points of view. Unfortunately, in the domestic literature to date, this issue is not discussed enough. The consequences of repetitive mild traumatic brain injury in sports play an important social role, which determines the relevance of studying the problem and the need to develop methods for solving it. This article provides a brief review of the literature on the chronic consequences of repetitive mild traumatic brain injury in athletes predominantly in contact sports. Statistical data on the prevalence of chronic traumatic encephalopathy in professional and non-professional sports associations are given. The issue of development conditions and mechanisms of pathogenesis of the studied pathology is discussed. Changes in the substance of the brain at the microstructural level, pathological biochemical reactions and factors of genetic predisposition are described. Modern criteria for the clinical diagnosis of traumatic encephalopathy, as well as criteria for differential diagnosis with other neurodegenerative diseases, are indicated. The main pathogenetic mechanisms of the development of clinically similar, but exclusively genetically determined neurodegenerations are briefly presented. An adapted classification of concussion in athletes and criteria for returning to sports activities after a mild traumatic brain injury are given. Special attention is paid to the radiological diagnosis of traumatic encephalopathy, based on modern methods of neuroimaging, such as magnetic resonance volumetry and positron emission tomography. At the end of the article, data are presented on promising directions for the development of methods for treating the disease under study.

   The article presents an overview of foreign and domestic studies on the prevalence and structure of mental disorders in the world and among the working population, the problems of preserving the mental health of workers, the prevention of its violations. The role of psychosocial production factors in the development of stress and stress-induced mental health disorders of workers is shown. Examples of mental disorders in employees of various types of professional activity are given. The features of mental health disorders in medical workers during the pandemic of a new coronavirus infection are described. Modern integrated approaches to providing support to employees with mental illnesses in the workplace are considered. The issues of psychosocial risk management as an effective measure of primary prevention of mental disorders in employees are highlighted.

   Objective: B-2 lymphocytes characteristic of patients with CVID in the process of forming a post-vaccination response to the peptide vaccine against SARS-CoV-2.

   Materials and methods: 10 people with CVID diagnosis were included in the study among a cohort of patients with primary immunodeficiency under the supervision of the Research Institute and the Department of Clinical Immunology and allergology of Rostov State Medical University. For the immunoprophylaxis of COVID-19, a recombinant peptide vaccine was used, which was administered intramuscularly at a dose of 0.5 ml twice with an interval of 21 days. The parameters of the immune system were evaluated before vaccination, then 21 days after the first and second doses and 72 days after the first injection. Phenotypic characteristic of peripheral blood B cells was performed by cytofluoriometry flow method.

   Results: before vaccination,  the number of memory B cells with a phenotypic option of switched and unswitched to antibody synthesis at the patients with CVID was lower than the control parameters of practically healthy donors. 21 days after the administration of the first dose, an increase in un-switched and switched memory B cells, plasma blasts, and a decrease in the proportion of B-regulatory lymphocytes were noted in relation to the initial values. 21 days after the second injection, an increase in the total pool of B-2 lymphocytes, naive B cells, switched memory B cells, plasma blasts were revealed. A month later, this tendency continued.

   Conclusion: in the process of forming a post-vaccination response to the peptide vaccine against SARS-CoV-2 in patients with CVID, a transformation of the subpopulation composition of B lymphocytes was revealed, as well as in the form of an increase in the number of memory B2 lymphocytes.