The peculiarities of the influence of cytokines and metabolites of the systemic inflammatory reaction and stress-implementing and nutritional factors contributing to the transformation of the phenotype of the resident intestinal microflora with an increase in its virulence are described. From the perspective of expression of genes and conformations of proteins and phospholipids, the influence of temperature as a signaling factor in increasing the virulence of the intestinal microbiome is considered. Evolutionarily formed mechanisms of expression of the maximum pathogenic phenotype of microorganisms and, thus, achieving an increase in their biomass and maximum dissemination through the microorganism compartments increase the probability of the transmission of commensals to another biotope, i.e., increases the probability of their survival after the death of the host organism. To prevent bacterial translocation after the relief of critical conditions, early enteral administration of β-glucans in food mixtures, iron excretion, and relief of inorganic phosphate deficiency, including by induction of alkaline phosphatase synthesis, are substantiated.

Background. The article highlights potential pathomorphological and pathophysiological mechanisms of effective treatment of polypous rhinosinusitis. Materials and methods. The study included patients diagnosed with bilateral polyposis rhinosinusitis, who were conducted immunohistochemical analysis of TLR9 expression using monoclonal antibodies in biopsy postoperative material (twice: prior to treatment and 20 days after treatment), and cytological examination of nasal reprint smears stained by Romanovsky-Giemsa method (immersion microscopy 7×90). Results. The study detected individual features of the proliferative activity of the epithelial pool of the nasal mucosa and pathological polyposis tissue in response to complex immunocorrective therapy. Conclusions. The results obtained allow including immunocorrective therapy in the complex treatment of polyposis rhinosinusitis to reduce possible relapses of the pathology.

The characteristics of the biology of influenza viruses and coronavirus that determine the implementation of the infectious process are presented. With provision for pathogenesis of infection possible effects of serine proteinase inhibitors, heparin, and inhibitors of heparan sulfate receptors in the prevention of cell contamination by viruses are examined. It has been determined that chelators of metals of variable valency and antioxidants should be used for the reduction of replicative activity of viruses and anti-inflammatory therapy. The possibility of a pH-dependent impairment of glycosylation of cellular and viral proteins was traced for chloroquine and its derivatives. The use of low-toxicity drugs as part of adjunct therapy increases the effectiveness of synthetic antiviral drugs and interferons and ensures the safety of baseline therapy.

The expansion of the range of anesthetic aids for ENT operations is largely associated with the development of endoscopic surgery and pharmacology. Taking into account the characteristics of each type of anesthesia, as well as the patient’s somatic state and the nature of the pathological process, the operating team makes a decision about choosing the type of anesthesia. The article presents the experience of anesthesiological support of operations in the Department of Otorhinolaryngology No. 1 of Voronezh Regional Clinical Hospital No. 1, there are also parallels with the works of Russian and foreign colleagues. For the purpose of efficiency research of different types of anesthesia for otorhinolaryngological operations, as well as for investigating opportunities to minimize the risk of complications, 2569 anesthetic aids were analyzed. Drug sedation was performed in 2163 cases (84,2%), endotracheal anesthesia in 266 cases (10,35%), short – term intravenous anesthesia in 110 cases (4,28%), and Stand-by anesthesia in 30 cases (1,17%). The stress response to surgical intervention was controlled according to the value of blood cortisol level, which patients have in all groups, both intraoperatively and in the postoperative period, was within the reference range (138–690 mmol/l), which indicates the adequacy of the ongoing allowance. Authors make a conclusion that the adequacy of anesthesia should be ensured by matching the type of anesthetic aid to the nature of the pathological process, the type and duration of surgery, taking into account the patient’s condition and the likelihood of developing emergency situations intraoperatively and in the postoperative period. Using modern achievements in otorhinolaryngology and anesthesiology, competent interaction between the surgeon and the anesthesiologist during the operation allows to significantly reduce the operational and anesthetic risks and increase the quality of otorhinolaryngological care.

The biology features of influenza viruses and coronaviruses that determine the implementation of the infectious process are described Taking into account the pathogenesis of infection, the possible effects of serine proteinase blockers, heparin and heparan sulfate receptor blockers in the prevention of cell contamination by viruses are considered The necessity of using chelators of metals of variable valency and antioxidants to reduce the replicative activity of viruses and anti-inflammatory therapy is determined The possibility of a pH-dependent violation of the glycosylation of cellular and viral proteins is traced for chloroquine and its derivatives The use of low-toxic registered drugs as part of adjuvant therapy increases the effectiveness of antiviral synthetic drugs and interferons, ensures the safety of the use of basic therapy Изложены особенности биологии вирусов гриппа и коронавирусов, определяющие реализацию инфекционного процесса С учетом патогенеза инфекции рассмотрены возможные эффекты блокаторов сериновых протеиназ, гепарина и блокаторов гепарансульфатных рецепторов в профилактике контаминации клеток вирусами Определена необходимость применения хелаторов металлов переменной валентности и антиоксидантов для снижения репликативной активности вирусов и противовоспалительной терапии Возможность pH-зависимого нарушения гликозилирования клеточных и вирусных белков прослежена для хлорохина и его производных Применение низкотоксичных лекарственных средств в составе вспомогательной терапии повышает эффективность противовирусных синтетических препаратов и интерферонов, обеспечивает безопасность применения средств базисной терапии

The article is dedicated to the 100th anniversary of the Department of Otorhinolaryngology of Burdenko Voronezh State Medical University.

The dynamics of indicators of free-radical oxidation in various purulent-inflammatory diseases of the middle ear in 280 patients was studied. Significant violations of the processes of free radical oxidation in the serum of blood were taken for the patients, the degree of which depends entirely on the severity and nature of the inflammation. A complex treatment with the use of antioxidant therapy in 280 patients was carried out. Positive results were obtained, confirmed by clinical and laboratory indicators. The pathogenetic significance and dependence of the course of purulent-inflammatory diseases of the middle ear on the processes of free radical oxidation was established, which was reflected in the determination of the duration of treatment of various forms of both acute and chronic otitis media.

The present study was designed to investigate the clinical. laboratory, and morphological characteristics of the nasal obstruction process. It included 87 patients presenting with polypous rhinosinusitis. The dynamics of the serum leukotriene C4 (LTC4) level in the patients and the morphological changes in their polypous tissue suggested the existence of the pronounced exudative phase of allergic inflammation and provided a basis for the use of the leukotriene receptor antagonist in the form of the sodium montelucast tablets for the treatment of nasal obstruction.

We have studied clinical and anatomic features of frontal sinusitis cases in 229 patients aged from 14 to 78. 48.8% of patients were diagnosed with acute form and 51.2% - with chronic form. 17.4% of patients had catarrhal frontal sinusitis, 61% - exudative (purulent) one and 21.6% had a mixed form of it. A comparison study of peculiarities of the clinical course of frontal sinusitis cases with the data of micro-and endorhinoscopy, computed tomography of the paranasal sinuses and the information obtained by probing the frontal sinuses made it. possible to distinguish four groups of anatomical variants of ostiomeatal complex structure and to determine their role. in the development and progression of these diseases. 26.8% of patients of first and second groups were diagnosed with local damage to frontal sinuses. A polypathia of frontal sinuses was observed in 79.9% of patients of third group and in 95.9% of patients. of fourth group. Follow-up study after conservative treatment without the use of invasive methods in 1 to 3 months showed that the pneumatization of the frontal sinuses is not fully restored. In the presence of grade II and III ostiomeatal complex deformation, the defined deformation was corrected in 42% of patients using endoscopic equipment. Disease relapse in case of patients' follow-up within the period from 6 months to 5 years was 3.8%.

The review covers the problems of pharyngomycosis and the advanced trends of treatment. The problem of pharyngomycosis is of high social significance, not only due to the growth of this disease, but also due to the fact that the fungal throat diseases proceed much more severely than the other inflammatory processes of this localization. The growing number of patients with pharyngomycoses results, first of all, from microecology impairment, as well as the general decrease of human body immunoreactivity. In this regard, the first position is occupied by correction, that is, normalization of microecological dysbalance.

The regulatory function of the processes involving free radicals known to maintain cellular vital activity and their role as an intermediate stage of many vitally important enzymatic reactions attract the attention of researchers interested in the mechanisms of production and inactivation of free radicals. Investigations into prooxidant and antioxidant systems along with evaluation of the intensity of free-radical oxidation make it possible to resolve many problems including elucidation of dynamic activity of pathological process, prognosis of various pathological conditions, and the choice of possible methods for the correction of prooxidant/antioxidant balance in patients with ENT diseases. The development of algorithms and methods for the assessment of parameters of activity of the prooxidant system allows for their stage by stage measurement and evaluation.

The hypophysis on contribution of gastrointestinal pathology to development of chronic pharyngo-laryngitis (CPL) was investigated in the study of 110 patients with catarrhal, hypertrophic, atrophic and mixed CPL (20, 12.7, 27.3, 40% of patients, respectively). Gastroenterological examination revealed gastritis plus gastroduodenitis, gastroduodenal ulcer, biliary and pancreatic disease, combined gastroduodenal pathology in 21.8, 30.9, 20, 27.3% of patients, respectively. Combined therapy including treatment of gastrointestinal disorders, produced stable remission of pharyngo-laryngitis in 97.3% of the patients treated. Thus, it is evident that a close relationship exists between pharyngolaryngeal and gastrointestinal affections.