Purpose of the study. To study functional changes in the neuropsychological status of reproductive age patients with newly diagnosed breast cancer and to assess the possibility of using xenon-oxygen therapy to correct disorders.

Patients and methods. This study included 60 reproductive age patients with newly diagnosed breast cancer who were undergoing surgical treatment at the Department of Bone, Skin, Soft Tissue and Breast Tumors of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2018 to 2020. The main group included 30 patients with breast cancer diagnosed at the surgical stage of combined treatment, who underwent a rehabilitation course of xenon-oxygen therapy in the early postoperative period. The control group was formed from patients with the same diagnosis, without the use of this therapy. The functional state of the central nervous system in all patients was assessed by the parameters of the electroencephalography (EEG) bioelectrical activity. For the final assessment of the physiological and psychological state of the patients, a standardized questionnaires of the quality of life – ESAS, MOS-SF‑36, were used. Statistical data processing was performed using the Statistica 10 software package.

 Results. During the study, statistically significant differences were found in the assessment of subjective indicators, so in the group of patients using xenon-oxygen therapy, there was an improvement in well-being by 2.6 times, a decrease in depression by 2.3 times, a decrease in symptoms of nausea by 3 times, anxiety 1.9 times (p < 0.05). Against the background of an improvement in the psychophysiological state, the EEG showed a significant increase in the power of slow delta and theta rhythms, an increase in the power of the alpha rhythm and a decrease in the power of the beta rhythm, while in the patients of the control group only a decrease in the power of the beta rhythm was noted.

Conclusion. The early postoperative period in patients with newly diagnosed breast cancer is characterized by the formation of a depressive symptom complex. The use of a course of xenon-oxygen therapy contributes to the normalization of the subjective feeling of physical and psychological health, increasing vital and social activity. Changes in the indicators of brain bioelectric activity and an improvement in psychophysiological state occur against the background of changes in brain activity caused by the normalizing effect of xenon.

Purpose of the study. This research was devoted to study of mRNA and miRNA expression patterns in glioglastomas using The Cancer Genome Atlas (TCGA) data, to search for genetic determinants that determine the prognosis of patient survival and to create of interaction networks for glioblastomas.

Materials and methods. Based on the data of the open TCGA database groups of glioblastomas and conventionally normal brain tissue samples were formed. Survival gene and miRNA expression data were extracted for each sample. After the data stratification by groups the differential expression analysis and search the genes affecting patient survival was carried out. The enrichment analysis by functional affiliation and an interactome analysis were performed.

Results. A total of 156 glioblastoma samples with mRNA sequencing data, 571 samples with microarray microRNA analysis data, and 15 control samples were analyzed. Networks of mRNA-miRNA interactions were built and expression profiles of genes and miRNAs characteristic of glioblastomas were developed. We have determined the genes which aberrant level is associated with survival and shown the pairwise DEG and DE of microRNA correlations.

Conclusion. The microRNA-mRNA regulatory pairs identified for glioblastomas can stimulate the development of new therapeutic approaches based on subtype-specific regulatory mechanisms of oncogenesis.

Purpose of the study. To evaluate the results of breast cancer screening (BC) in the conditions of an unfavorable epidemiological situation COVID‑19 based on the analysis of the BC screening project in the Kaluga Region.

Patients and methods. Screening system: creation and implementation in practice of mobile mammography complexes (MMC); training of medical personnel in the method of conducting a standardized mammographic examination (ME); quality control of ME; "Cloud" storage and software development for archiving patients; an independent review of mammograms by certified specialists; expert review of images in case of discrepancies in diagnoses; referral of patients diagnosed with BI-RADS IV and V to the regional oncological dispensary for further examination and treatment. From 04.2018 to 12.2020 patients were examined on MMC according to the BC screening protocol. We examined 47367 patients over the age of 40 years. SD 57.66 ± 8.17 years (38-93). During the COVID‑19 pandemic, imaging of breast diseases must be carried out in compliance with all safety regulations for both personnel and patients. Balancing the need to avoid delays in diagnosing BC while preventing infection requires careful attention to personal protective equipment, handling of diagnostic equipment, diagnostic facilities, and physical distancing and vigilance to maintain these measures.

Results. From 07.2020 to 11.2020: a total of 10736 studies have been carried out. In the context of new coronavirus infection, we noted an increased demand among patients wishing to undergo BC screening. The flow of patients over the same period of previous years was less, which indicates the demand and justification for screening mammography and the use of MMC in an unfavorable epidemiological situation. 174 patients received category BI-RADS IV-V and were referred for a follow-up examination and required treatment at an oncological dispensary. In 39 patients (22.4 %), BC was verified, and appropriate treatment was carried out. In 135 cases, benign processes were verified.

Conclusion. BC screening should not be stopped against the backdrop of the COVID‑19 epidemic since a delay in BC diagnosis later threatens to reveal more voluminous processes with a worse prognosis for treatment and rehabilitation than timely detected changes in the mammary glands in the early preclinical stages of the disease.

Purpose of the study. Assessment of the molecular genetic profile of cytological processes in the kidney tissue of patients with COVID‑19.

Material and methods. Kidney fragments from patients with confirmed COVID‑19 (n = 96) were studied by real-time polymerase chain reaction to determine the expression of SARS-CoV‑2 viral RNA and genes encoding protein complexes: ACE‑2 and Furin.

 Results. In patients affected by COVID‑19, the presence of coronavirus genetic material in kidney tissue was recorded, as well as increased expression of ACE‑2 (7.49 ± 0.27, p < 0.01) and Furin 2.0 times (8.59 ± 0.65, p < 0.01,) compared with the control group (3.9 ± 0.48, p < 0.01 and 4.2 ± 0.8, p < 0.01, respectively), which creates favorable conditions for the invasion of SARS-CoV‑2.

Conclusion. According to the results of RT-PCR for SARS-CoV‑2, assessment of the expression of ACE‑2 and Furin, it is possible with a high degree of probability to assert about the viral load and the vulnerability of the kidneys, since these proteins are informative markers of viral damage. Elderly people with increased vulnerability to SARS-CoV‑2.

Purpose of the study. Currently, laparoscopic technique has become widely used in the treatment of extended strictures and obliterations of the ureter. The use of minimally invasive approaches will also be relevant for such a relatively new operation as buccal ureteroplasty. In the literature, there are isolated publications devoted to this technique. The aim of this study was to study the results of our own experience of laparoscopic ureteral reconstruction using a buccal graft.

Patients and methods. We observed 5 patients – 2 men and 3 women, at the age of 30–62 years. All patients have already been operated on the urinary tract, of these, in four patients, the urinary tract was drained with a nephrostomy or internal ureteral stent. Two patients underwent replacement ureteroplasty with tubularized buccal graft, and three patients underwent augmentation ureteroplasty with buccal graft using the onlay method.

Results. All operations in this group were carried out without conversions. The average length of the ureteral defect was 4.9 cm (4.0–6.0 cm). The patients did not have severe complications in the postoperative period according to the ClavienDindo classification. One patient underwent treatment for exacerbation of chronic pancreatitis; one man experienced ureteral stent migration, which required restentation. The follow-up period was 1–15 months; one woman developed unextended ureteral restenosis, which was eliminated by endoureterotomy and ureteral stenting. At the moment, all patients are spared from permanent urinary drains, they do not have upper urinary tract obstruction.

 Conclusion. All operations in this group were carried out without conversions. The average length of the ureteral defect was 4.9 cm (4.0–6.0 cm). The patients did not have severe complications in the postoperative period according to the Clavien-Dindo classification. One patient underwent treatment for exacerbation of chronic pancreatitis; one man experienced ureteral stent migration, which required restentation. The observation period for the patients was 1–15 months, one woman developed short ureteral restenosis, which was eliminated by endoureterotomy and ureteral stenting. At the moment, all patients do not have permanent urinary drains, violations of the urodynamics of the upper urinary tract were not revealed in them.

Purpose of the study. To evaluate morphological changes in the testes in experimental animals after tension-free inguinal hernia repair modeling.

Materials and methods. The study included male rabbits, aged 120 days, weighing 3.8 ± 0.9 kg. All rabbits were divided into two groups depending on the type of operation: in the first group (n = 10) of animals, we made a model of tension-free inguinal hernia repair and used a polypropylene mesh; in the second group (n = 10) of animals, we left the structures of the inguinal canal intact. Morphological assessment of spermatogenesis was performed after 40 days. All morphometric measurements were carried out on strictly cross-sections of the convoluted seminal tubules.

Results. In rabbits of group 1, the volume of the testicle was significantly three times less than in animals of group 2 (p < 0.05). In the animals of the first group, a significant deterioration in spermatogenesis was observed (p < 0.05). Histological examination of sections of the testes of these animals showed that hypoplasia of the spermatogenic epithelium was present in the convoluted seminal tubules, in 1/8 of the tubules there was subtotal aplasia of the spermatogenic epithelium, Sertoli-Cell-Only Syndrome was detected only in 2 %. Atrophy of the convoluted seminal tubules was not recorded at this period of observation. In the animals of the control group, almost 90 % of cases of spermatogenesis disorders were not detected.

Conclusions. This experimental study on rabbits showed that after using a polypropylene mesh for inguinal canal plastic, inhibition of germ cell maturation occurs after 1.5 months. Therefore, in men of reproductive age, it is necessary to use polypropylene mesh implants with caution in terms of performing inguinal hernia repair.

Due to the high lung cancer morbidity and the need for surgical intervention in that patient population, introduction of the concept of standard protocol for enhanced recovery after surgery (ERAS) may lead to a significant decrease of the rate of postoperative complications and hospital stay. The aim of the review was to assess the main components of ERAS protocol in thoracic cancer surgery using video-assisted thoracoscopic interventions (VATS). Systematic implementation of specific measures in pre- (patient consulting before the intervention, compliance with fluid and nutrition regimen, exclusion of routine sedation, prophylaxis of venous thrombosis, use of intravenous antibiotics and alcohol skin-prepping solution with chlorohexidine), intra- (prevention of hypothermia, thoracoscopic approach, single-tube approach in anatomic lung resections, exclusion of pleural tube insertion, urethral catheterization for less than 2 hours and only in case of epidural anesthesia) and postoperative (early mobilization and cessation of intravenous infusion, pain control using combination of acetaminophen with NSAIDs, maintenance of normovolemy, use of balanced crystalloid solutions and non-pharmacological measures for nausea and vomiting control) periods promote improved outcomes, decrease of postoperative complication rate and postoperative mortality

Nowadays, the problem of surgical treatment of incisional ventral hernia (IVH) still remains significant. According to the statistical data, the number of patients with postoperative ventral hernias has increased by more than 9 times over the past 25 years. Experts offer many solutions to this problem every year and the surgeon have to find the best method of postoperative rehabilitation in the flow of information. Academic research databases Google Scholar, CyberLeninka and others were used to search for the relevant literature. The following conclusions were drawn from this review. The etiology of IVH is multifactorial. There is no generally accepted evidence-based gradation of risk factors. There is no unified system for selecting the method of hernia repair of the anterior abdominal wall in patients with IVH. The choice of allotransplant material and the method of hernia repair are often individual. The value of the critical level of intraabdominal pressure have not been specified, however, all authors agree that its monitoring should become routine. The sublay technique remains the "gold standard" of plastic surgery by aponeurotic flap, inlay should be used when sublay is impossible to perform. Onlay should be used as a reserve method. In some situations, combinations of techniques are required. More and more laparoscopy is being introduced in the treatment of IVH as an assistance and in therapy. The introduction of new methods of hernia repair based on the uncontrolled separation of the anatomical structures of the abdominal wall imposes special requirements on surgical technology: plastic material, instrumental and technical support, wound closure and pharmacological support, especially in conditions of increased intra-abdominal pressure and tissue tension. We can use medication of pyrimidine’s row (xymedon) for a better implantation of the mesh implant and to increase the resistance of local tissues.

Currently, due to the dynamic development of surgical technologies, indications for organ-sparing treatment of kidney cancer are expanding. Acute kidney injury is a serious complication that leads to chronic kidney disease, increased postoperative mortality, deterioration of long-term functional outcomes, and increased hospitalization. At present, it is known that even a slight damage to kidneys or their impairment, presented by a decreased urine output and change in blood biochemical parameters, entails serious clinical consequences and is associated with a poor prognosis. Damaging factors, when the kidney is exposed, initially induce molecular changes, which entail the production of certain biomarkers, and only after that clinical aspects of kidney damage develop. The causes of acute kidney injury can be different, from specific renal disorders (acute interstitial nephritis, vascular and glomerular lesions, prerenal azotemia, obstructive disorders) to toxic damages, direct trauma and surgical treatment. The development of acute renal injury in the postoperative period is a serious complication of the surgical treatment of kidney disease, and, according to various authors, the frequency of its occurrence varies from 5.5 % to 34 %. An active study of this problem made it possible to find specific biomarkers that give the possibility to predict and diagnose acute renal injury in the early stages, to optimize the treatment strategy, to reduce the incidence of postoperative complications, and to shorten the period of postoperative rehabilitation. Currently, the most studied of acute kidney injury (AKI) biomarkers are cystatin C, neutrophil gelatinase-associated lipocalin‑2 (NGAL), hepatic protein L-FABP, KIM‑1 (Kidney injury molecule‑1), Interleukin – 18. Further study of AKI biomarkers will make it possible to determine the most significant ones for subsequent use in everyday practice

The article is devoted to the actual topic of breast reconstruction with autologous tissues. The article discusses the key stages in the development of breast reconstructive surgery using free flaps using microsurgical techniques. A flap of the anterior abdominal wall, among other techniques, is the method of choice for breast reconstruction today, also because it allows you to achieve the most "natural" result. The authors compares different variants of autologous flaps, describes the advantages of the DIEP flap in comparison with the TRAM flap. Also, special attention is paid to the choice of breast reconstruction method depending on age, constitutional characteristics and the presence of risk factors such as smoking, diabetes mellitus and excess BMI. Analyzing the advantages of breast reconstruction with autograft flaps, the author concludes that there is a higher quality of life and improved outcomes in these patients than in patients who underwent implant-based reconstruction. Based on the literature review, it was found that breast reconstruction with the help of perforating flaps is still an area of innovation and constant progress: research in this area to date is mainly aimed at reducing the morbidity of the donor area and methods for isolating recipient vessels, shortening the rehabilitation period and developing reproducible reconstruction method.

The review provides information on the mechanisms of the antitumor action of natural and synthetic compounds of the tropolone series, obtained over the past 30 years in studies on cell cultures and, to a lesser extent, in in vivo experiments. Interest in this group of substances is due to the urgent need of clinical oncology for drugs that effectively damage malignant cells and, at the same time, are safe for healthy tissues. The processes that realize the effects of colchicine, hinokithiol (ß-tuyaplicin) and some of their derivatives (derivatives of bistropolone, α-substituted tropolones, etc.) have been studied most fully. Herewith, more numerous mechanisms of realization of the antitumor effect of hinokithiol and its derivatives were revealed in comparison with colchicine. In addition to the disruption in the formation of the cell division spindle, shown for colchicine and colchamine, such phenomena as caspase-dependent apoptosis and some other types of apoptosis, autophagy, limitation of mitochondrial metabolism, DNA damage and demethylation, and accelerated aging of malignant cells etc. have been described. The promising properties of 2‑quinolyl 1,3‑tropolone derivatives have been shown, and the relationship of their antitumor effect with the induction of apoptosis and changes in the activity of the ERK signaling pathway in some types of malignant cells have been revealed. The results indicate a multiplicity of possible ways of the influence of tropolones on the state of malignant cells, the conditions for the implementation of ones need to be clarified, especially with a lack of information about in vivo processes.

The review includes information from the literature presented in the Scopus, WoS, Pubmed databases. 35 % of articles have been published in the last 5 years.

Despite the results of technological progress in medicine, which has made high-resolution methods of medical imaging available, the problem of differential diagnosis of acute appendicitis does not lose its’ relevance. This can be explained by the fact that the symptoms of acute appendicitis are variable, non-specific, and can mimic other diseases with similar symptoms.

Three cases of rare diseases of the gastrointestinal tract that simulates acute appendicitis were presented. Those are primary torsion of the greater omentum with necrosis, caecum cancer with lengthy necrosis in a young patient and Crohn's disease that simulates appendicular infiltrate. All patients underwent surgery. Signs of acute appendicitis were indications for surgery. Laparoscopic resection of greater omentum was performed in the first case. In the second case caecum necrosis with peritonitis was revealed by laparoscopy. Conversion laparoscopy to laparotomy was performed. Caecum necrosis with caecum wall perforation and necrosis of terminal part of the ileum was diagnosed. right hemicolectomy with ileo-transverso anastomosis was carried out. Complicated case of Crohn’s disease was suspected. Nevertheless, the diagnosis of colorectal cancer is established by pathomorphology only. This case is interesting because of rare complication of colon cancer – the caecum and the ileum wall necrosis that was manifestation of the disease. In the third case of Crohn’s disease in a young patient the diagnosis of appendicular infiltrate and surgical policy were wrong. At the first laparotomy by McBurney was performed. A dense infiltrate was found in the right iliac fossa. The intervention was finished by local abdominal package. In the early postoperative period an intestinal fistula was formed. The patient underwent relaparotomy and right hemicolectomy with ileo-transversal anastomosis was carried out. Despite the diagnosis of Crohn's disease was questionable patomorphology and was established after half a year only by colonoscopy. The presented cases illustrate the complexity of acute appendicitis and the importance of modern approaches to diagnosis: irreplaceability of laparoscopy and the feasibility of using diagnostic scales. When the right diagnosis is not clear the intervention might be late for using methods of instrumental diagnostics.