Benign prostatic hyperplasia is the most common urological disease in men over 50 years of age. The decrease in the quality of life of patients with benign prostatic hyperplasia dictates the need to study the risk factors for the development of this disease, as well as to develop effective treatment strategies. The development of benign prostatic hyperplasia is characterized by proliferation of stromal and epithelial cells in the transitional zone of the organ that surrounds the urethra, which leads to compression of the urethra and the development of symptoms of the lower urinary tract. The drugs of first choice for the treatment of patients with prostatic hyperplasia are α1-adrenoblockers, among which the selective drug Tamsulosin is the most popular. According to the literature, the use of Tamsulosin is associated with the risk of developing a number of serious side effects, which can negatively affect the quality of life of patients and reduce their adherence to treatment. The article provides information about a combined drug containing bioregulatory peptides and tamsulosin in the form of suppositories, which helps to reduce the systemic effect of the drug and the development of undesirable side effects.

Cardiac depression, also known as myocardial depression, is one of the typical complications of severe acute pancreatitis. The review describes modern views on the mechanism of development of this phenomenon; the place of the term «myocardial depression factor» at the current stage of study of the problem was discussed; pathogenetic factors of myocardial depression requiring further study have been identified. An attempt to consider cardiac depression as a phenomenon involving the whole cardiovascular system, rather than the heart along, was made. Each pathophysiological factor is examined in terms of the possibility of clinical use.

Introduction. The high incidence of community-acquired pneumonia and the high complication rates in the cases of severe pneumonia actualize the search for new pharmacotherapy tools to improve the effectiveness of standard patient management regimens. A high level of severe inflammatory response underlies the high risk for developing septic complications of pneumonia, along with impaired immune responses.The aim is to evaluate the efficacy of azoximer bromide introduction in the combination therapy regimen for hospitalized patients with moderate to severe community-acquired pneumonia.Materials and methods. A prospective, open label, parallel group, randomized study comparing the efficacy of azoximer bromide introduction in the combination therapy of hospitalized patients with moderate to severe community-acquired pneumonia was conducted at the premises of Federal Scientific and Clinical Center for Reanimatology and Rehabilitation. 30 patients were included in the study group and 37 patients in the comparator group. The baseline characteristics were comparable in both groups. Results. The azoximer bromide introduction in the combination therapy of patients with community-acquired pneumonia led to a statistically significant reduction in the duration of hospital stay (Me (LQ; HQ): 9 (8; 10) days for the study group and 13 (10; 14) days for the comparator group, (p = 0.000078), duration of ICU stay (Me (LQ; HQ) 2 days (1.5; 2.5) and 5 days (5.0; 6.0), respectively, (p = 0.00001), the duration of febrile fever 5 (± 0.6) days versus 10 (± 1.2) days (p = 0.0000), the incidence of acute respiratory failure (13.33% in group 1 versus 37.84% in group 2, p = 0.024) and septic shock (10% in group 1 versus 32.43% in group 2, p = 0.0285).Conclusions. The azoximer bromide introduction in the standard therapy regimen for patients with community-acquired pneumonia allowed to reduce the duration of hospital stay, the duration of ICU stay, the length of febrile fever, the incidence of septic shock and respiratory failure. The possible mechanisms of action may include a reduction of the severe inflammatory reactions and an optimization of the patient's immune response to the infectious process.

Кардиодепрессия, известная также как миокардиальная депрессия, является одним из характерных осложнений тяжелого острого панкреатита. В обзоре изложены современные взгляды на механизм развития этого феномена; обсуждено место термина «фактор депрессии миокарда» на текущей стадии изучения этой проблемы; выявлены патогенетические факторы миокардиальной депрессии, требующие дальнейшего изучения. Была предпринята попытка рассмотреть кардиодепрессию как явление, вовлекающее целостную сердечно-сосудистую систему, а не только сердце. Каждый патогенетический фактор рассмотрен с точки зрения значимости в прогрессировании заболевания и возможности его коррекции.

Несмотря на высокую частоту встречаемости острого повреждения почек (ОПП), диагностика его ранних этапов затруднена в связи с низкой чувствительностью и специфичностью стандартных методов исследования. Общеклинические и биохимические показатели крови и мочи не позволяют прогнозировать течение и исход патологии. Целью данного обзора явилась систематизация литературных данных относительно молекулярных маркёров ОПП. Проведён анализ белее ста источников по таким базам индексирования, как Scopus, MEDLINE, The Cochrane Library. Учитывались как факторы риска возникновения и прогрессирования заболевания, так и механизмы развития ОПП, а также маркеры его диагностики и прогноза исходов. Подробно представлены генетические аспекты возникновения и развития ОПП и перспективные методы ранней диагностики. Установлена возможность использования молекулярных маркёров для определения степени тяжести процесса. Предполагается, что идентификация конкретных генов и биомаркёров начальных стадий ОПП улучшит диагностику и поможет прогнозировать течение заболевания и его исходы. Despite the high incidence of acute kidney injury (AKI), diagnosis of its early stages is difficult due to low sensitivity and specificity of standard study methods. General clinical and biochemical blood and urine tests cannot predict the course and outcome of the disease. The aim of this review was to systematize reports of molecular markers for AKI. More than a hundred sources indexed in Scopus, MEDLINE, and Cochrane Library were analyzed. Both risk factors of AKI onset and progression and its mechanisms, and its diagnostic and predictive markers were included in the analysis. The review focused on genetic aspects of AKI onset and development and on promising methods for early diagnosis. A possibility of using molecular markers to determine the AKI severity has been demonstrated. The authors suggested that identifying specific genes and biomarkers for early stages of AKI would improve the diagnosis and the prediction of AKI course and outcome.

The purpose of this review is to analyze the modern literature about renal damage caused by vesicoureteral reflux (VUR). VUR is the most common urodynamic pathology in children and reflux nephropathy (RN), as its main complication, ranks first among the causes of chronic kidney disease (CKD). The risk factors for the appearance and progression of RN are presented in the first part of the review. In the framework of this issue, the main methods of treatment of VUR and associated urinary tract infection are described. The possibilities of conservative and surgical methods for the elimination of reflux for prevention of RN and prognosis of its course are considered. The main morphological aspects of RN formation are described.

The second part of this review is devoted to the issues of modern and promising diagnosis of RN in children. The advantages and limits of the available methods for recording the structural and functional state of the kidneys in childhood are considered. Particular attention is paid to possibilities non-invasive methods for diagnosis and prediction of the disease course. Data on promising biomarkers of the early stages of RN formation and progression are presented. For the purpose of a comprehensive and adequate assessment of morphological changes in the kidneys, the necessity of studying various combinations of cytokines in biological media with the subsequent determination of the optimal spectrum is shown. The sensitivity and specificity of molecular indicators of renal damage reviewed as potential targets for renoprotective therapy in the nearest future.

CAR-Т cell therapy with the use of cytotoxic lymphocytes with chimeric antigen receptors occupies an important place among modern approaches to the cancer treatment. This therapy has established itself as an effective method of the treatment of CD19+ acute lymphoblastic leukemia. Nevertheless, the recurrences of the illness are not uncommon; the treatment of solid tumors with genetically engineered lymphocytes shows modest results and it is accompanied by the high toxicity. One thing, however, is certain: CAR-Т cell therapy has great potential in the treatment of cancer and further improving of the structure and functions of genetically engineered lymphocytes with chimeric Т cell receptors help greatly increase the efficiency of antitumor treatment.The review includes the current data on the structure of chimeric lymphocytes of different generations and the trends in improving CAR-Т cell therapy. It includes also the fundamental platform for formation of ideology of use CAR-Т cells for the treatment of solid malignant tumors.

OBJECTIVE:To identify an effect of the neurohumoral response on the severity and orientation of Fas-ligand-initiated processes in the acute period of IS.MATERIAL AND METHODS:The study included 155 patients with IS in the territory of the left and right middle cerebral arteries, the control group consisted of 28 people. The National Institutes of Health Stroke Scale (NIHSS), the Hospital Anxiety and Depression Scale (HADS), and the Daily Life Stress scale were used. Concentrations of sFas, sFasL, cortisol (K), adrenaline (A), norepinephrine (NE), adrenocorticotropic hormone (ACTH) in the blood plasma of patients with IS were measured by enzyme-linked immunosorbent assay on days 1, 7 and 21 and once in the control group. CD3CD95+ lymphocytes phenotyping was performed using flow cytometry.RESULTS AND CONCLUSION:The hypothalamic-pituitary-adrenal axis dominance is associated with the activation of the apoptosis-inducing properties of peripheral blood in the first week after the IS onset and their decrease towards the end of the acute period, which is clinically represented by the increased levels of anxiety and depression, an unfavorable outcome of the acute period of IS.

The article presents the results of research in the field of early diagnosis and dynamic monitoring of immunological changes in the human body in the course of COVID-19 coronavirus infection and after the disease. The article presents the results of laboratory tests for the presence of IgG antibodies to the SARS-CoV-2 coronavirus in 2112 patients living in 5 regions of the Russian Federation. The aim of this study was to evaluate the dynamics of IgG class antibodies to SARS-CoV-2 coronavirus (COVID-19) in the blood of patients who had a new coronavirus infection. We found that there were no significant changes in the level of IgG antibodies to the SARS-CoV-2 coronavirus from the 14th day of illness to the 3rd month of observation from the moment of the first symptoms of the disease. Starting from the 4th month of observation, the level of antibodies decreased in both groups by multiples in relation to the maximum values, decreasing by the 6th month of observation to the values of the control group. The results of the study can be used to develop an optimal diagnostic, therapeutic and preventive algorithm for reducing infection in the population and the number of severe cases of the disease.