Vol 20, No 2 (2023)

Achievements in integrative areas of medicine can significantly supplement the traditional ideas about the etiopathogenesis of temporomandibular joint dysfunction, based on the positions of occlusal and neuromuscular theories and mainly limited to consideration of the elements of the stomatognathic system. The article presents the results of a study of data on the influence of the state of the spine on the pathogenesis of diseases of the temporomandibular joint and data on the effectiveness of the treatment of combined pathology of the joint and posture according to publications in domestic and foreign literature over the past 15 years. Expanding the view on the structure and function of the maxillofacial region and the role of craniopostural and craniovisceral relationships requires the development of a unified methodological approach to the diagnosis of patients with dysfunction of the temporomandibular joint, which will help reduce the number of diagnostic errors and the risk of chronic pain phenomena.

Schizophrenia is a chronic psychoneurological condition that encompasses a wide variety of neurochemical, morphological, bioelectrical and behavioural changes. Comprehension of the mechanisms underlying schizophrenia and psychosis cannot be fully acquired in clinical studies with humans. For this reason, a number of experimental animal models of schizophrenia have been developed. Although none of the existing models of schizophrenia fully reproduces the complete spectrum of schizophrenia, critical aspects of pathology processes can be experimentally recapitulated. In this review we summarise the pathological features, advantages and limitations of the major pharmacological animal models of schizophrenia, including maternal immune activation. Commonly used pharmacological models of schizophrenia are useful for the preclinical evaluation of antipsychotic drugs and involve the dysfunction of various neurotransmitter systems, including dopamine, glutamate, serotonin. The review also describes maternal immune activation and neurodevelopmental rat models of schizophrenia. Positive, negative, and cognitive symptoms vary in degree and combination depending on the type of model used. A greater understanding of the strengths and weaknesses of various animal models of schizophrenia and the use of more than one model to evaluate antipsychotic activity would help to improve the efficiency of the drug discovery process and therapy translation from preclinical studies to patients.

A comparative analysis of the level of adaptive capabilities of cadet corps and secondary school students based on the study of heart rate variability. Materials and methods: Cadets (n = 64) and schoolchildren (n = 86) aged 10–12 years took part in the study; spectral parameters of the heart rate were evaluated at rest and under conditions of an active orthostatic test. Results: It was found that the severity of the HF component of the heart rate decreases with age in cadets, which indicates a decrease in the effects of the parasympathetic system, (40.2 ± 8.7) % – at 10 years and (25.1 ± 3.6) % – at 12 years; р = 0.024. At the age of 12, the values of LF (р = 0.034), LF/HF (р = 0.031) and SI (р = 0.041) in cadets are higher than in schoolchildren, and HF (р = 0.022) are lower. During the active orthostatic test, the cadets showed a decrease in K30:15, as well as an increase in LF (р = 0.035), LF/HF (р = 0.041) and TI (р = 0.038), which demonstrates the predominance of the central contour of regulation. Conclusions: 1) spectral analysis of the heart rate indicates a marked increase in the stress of adaptive mechanisms with age in the cadets of the Cossack corps, which reflects increased physical, intellectual and psycho-emotional stress compared with schoolchildren; 2) spectral characteristics of heart rate variability can be used as sensitive markers of stress of physiological systems and a decrease in adaptive reserves.

The paper presents the results of a retrospective analysis of the prevalence of diseases of the oral mucosa. It is noted that the high prevalence of various ORS diseases is associated with a new coronavirus infection COVID-19 due to immunopathological changes in the patient’s body. It is known that patients with OOP diseases represent one of the most difficult groups of patients in dentistry. An increase in the frequency of occurrence of erosive-ulcerative lesions of the ROR was noted, which have different etiology and pathogenesis, while their clinical picture is quite similar. The study was carried out in the dental clinics of Volgograd – clinical bases of the Department of Dentistry of the Institute of the NMFO FSBEI HE VolgGMU of the Ministry of Health of Russia. 2719 medical records of a dental patient (form 043y) were studied in the period 2019–2022. There was a significant dynamic growth, especially in 2022, of inflammatory-destructive pathologies of the COR, as well as the highest prevalence of COR pathologies in middle-aged people. A persistent increase in complicated cases with a generalized spread of pathological elements was revealed, which proves the relevance of searching for new methods for managing these patients.

Purpose: To study the eye hydrodynamics indicators and eye morphometric parameters in presbyopic subjects with emmetropia and hyperopia under the usual professional visual load with using of progressive and monofocal spectacles correction. Material and methods: 49 subjects (98 eyes) of 45–56 y.o., mean age (48 ± 1.7) years, were examined. There were 20 men and 29 women. Emmetropia was present in 22 subjects (44 eyes), mild degree of hyperopia – in 19 subjects (38 eyes) and moderate degree of hyperopia – in 8 subjects (16 eyes). All subjects who were included in the study had not any eye diseases other than presbyopia and hyperopia. All persons were examined against the background of intense visual load at the end of the working day. First examination was performed without spectacles using, second one – after prescribing and using of monofocal or progressive spectacles correction. The examination methods were represented by visometry, refractometry, pneumotonometry, computer tonography, ultrasound biometry, determination of accommodation amplitude using the «Push up test», optical coherence tomography of the anterior segment of the eye. Results: The critic intensity of eye hydrodynamics processes, anterior chamber depth decreasing and the iridocorneal angle increasing were revealed under conditions of visual load at near distance in presbyopic patients with hyperopia and emmetropia without spectacles correction. Using of progressive spectacles correction led to significant decreasing of intraocular pressure (IOP) (p < 0.001), increasing of aqeous humor outflow (p < 0.001), anterior chamber depth decreasing (p < 0.01 in emmetropia and p < 0.001 in hyperopia) and iridocorneal angle increasing (p < 0.001). Significant increasing of the accommodation amplitude was recorded with using of progressive correction in both hyperopic (p < 0.001) and emmetropic subjects (p < 0.05). Conclusion: The use of progressive glasses as a permanent correction has a positive effect on the state of eye hydrodynamics and morphometric parameters of the anterior chamber in emmetropic and hypermetropic patients with presbyopia. Lack of correction in persons of presbyopic age not only causes visual fatigue, but can lead to disruption of hydrodynamic balance and the development of glaucoma.

It was found that in experimental rats there is a decrease in the number of Leydig cells, the ratio between active and inactive endocrinocytes and, as a consequence, a decrease in the activity index of his cells. The effect of 30-day dark deprivation and 14-day correction with exogenous melatonin on the steroidogenic ability and morphofunctional state of the spermatogenic epithelium of the testes, interstitial endocrinocytes (Leydig cells) of white mongrel male rats aged 4 months was analyzed. The level of corticosterone, testosterone, and Clotho protein in blood serum was assessed by enzyme immunoassay. It was found that 30-day dark deprivation increases the level of corticosterone, reduces the level of testosterone and Clotho protein in the blood serum, which is a marker of premature aging. It was found that morphological changes in the testes were characterized by a decrease in the thickness of the spermatogenic epithelium, the area of Leydig cells and their nuclei for 30 days after dark deprivation. The introduction of exogenous melatonin led to a partial restoration of androgenogenesis, the morphofunctional state of the testes: spermatogenic epithelium, Leydig cells.

In experiments, in female rats, the novel substance dipiarone with hypoglycemic activity when administered intragastrically at doses of 0.5 mg/kg and 100 mg/kg from 6 to 16 days of gestation did not have a damaging effect on the processes of organo- and fetogenesis and did not contribute to the occurrence of deformities and abnormalities in the development of fetuses recorded in the antenatal and postnatal period of their development. Intragastric administration of dipiarone to rats at a dose of 100 mg/kg from 6 days of pregnancy until delivery showed that the formation of physical development of rat offspring in the postnatal period corresponds to the control parameters, while they had an increase in the rate of body weight gain, ahead of the time of formation of sensory-motor reflexes, activation of motor and emotional behavior.

Activation of vascular endothelial growth factor VEGFR-3 leads to proliferation, differentiation and migration of lymphatic endothelial cells. The role of this factor in periodontal tissues in normal and inflammatory conditions requires extensive study. The purpose of this study: to study the distribution and expression of VEGFR-3 in the lymphatic vessels of the gum lamina proper during inflammation and the use of a diode laser in young and mature people. Slices of human gum biopsy material were studied by immunohistochemical method. As a result of the research , it was found that in the patients with conditionally healthy periodontal tissues, the number of lymphatic vessels depends on the age and differs in young patients compared to mature patients by 1.2 times. Simultaneouslyбол, it was found that in the control groups, the majority of vessels do not contain VEGFR-3 or have weak receptor expression regardless of age. The tendency to VEGFR-3-mediated increasing of the number of lymphatic vessels during the inflammation is observed only at the age of 41 to 60, however, the intensity of the expression of the VEGF type 3 receptor in chronic gingival inflammation shifts towards the increasing of the vessels with medium and strong VEGFR-3 expression in both groups. As a result of the study, it was found that the tendency to change the number of VEGFR-3-positive vessels is observed only in inflamed gum tissue in patients after 41. Diode laser has a stimulating effect on VEGFR-3-mediated vascular circulation in young patients, while in mature patients, diode laser therapy leads to increase the part of lymphatic vessels with medium and strong expression of the studied receptor, but practically does not affect on the number of detected vessels.

Temporomandibular joint dysfunction in patients with malocclusion is quite a widespread problem in modern dentistry. The study included: identification of patients with signs of TMJ dysfunction and malocclusion by pre-selection; diagnosis of dysfunctions in the main group of patients; preparation of the treatment plan using splint therapy and kinesiotherapy; assessment of the effectiveness of these treatment methods. Most of the subjects had a decrease in the tone of the masticatory muscles, pain sensitivity in the masticatory muscles and the TMJ area. Splint therapy, as well as kinesiotherapy, is the best choice in the treatment of these patients.

Regeneration of internal organs under conditions of negative environmental impact, as well as adaptation to changing conditions of internal homeostasis in conditions of illness, is an urgent problem in regenerative medicine. The key links in the regulation of homeostasis are neuro-immune-endocrine relationships, where the main role in the regulation of metabolism is assigned to the thyroid gland. Morphological changes in the thyroid parenchyma under conditions of altered homeostasis in chronic endogenous intoxication (CEI) can lead to the formation of undiagnosed thyroid disorders and are not taken into the development of thanatogenesis. We conducted an IHC study to determine the main patterns of development of regenerative and adaptive processes of thyrocytes in conditions of CEI based on the expression of thyrocyte proliferation factors (PHH3), stem cells (Oct3/4), as well as to determine the risk of developing malignant neoplasms (CK8, CK18). It was found that in the formation of nodular neoplasms with a pronounced expression of PHH3 with a mitotic index of more than 25 %, it is necessary to conduct an IHC study to determine the expression of CK8, CK18 to identify the risk of developing thyroid neoplasms.

The development and implementation of effective measures of secondary prevention of recurrent ischemic events and post-hospital mortality in patients with myocardial infarction remains relevant. A total of 130 patients (89 men and 41 women) with myocardial infarction of type I were examined. At the in-patient stage of treatment, a set of laboratory data characterizing endogenous intoxication syndrome was subjected to clustering. As a result, four clusters were formed: «polymarker-retentive», «necrotic-inflammatory», «hypoxic-inflammatory» and a cluster with no endogenous intoxication syndrome. Recurrent heart attack, stroke, and mortality from cardiac causes constituted the combined end point. The probability of its occurrence within 1 year after myocardial infarction development was 18.6 %. We proposed a model for predicting the development of the combined endpoint, taking into account the type of endogenous intoxication syndrome.

The choice of lung cancer treatment method directly depends on the diagnostisc and verification of the histological type of tumor. Important diagnostic criteria are DNA accumulation index and proliferation index of Ki-67. Materials and methods. DNA accumulation index was assessed in 200 cases of lung cancer using a microspectrophotometric method. Ki-67 proliferative index was calculated using immunohistochemical study in histological material with antibodies to Ki-67, Cytokeratin 5/6, TTF-1, Chromogranin A, Synaptophysin, Keratin.Pan, CD56. Results. As the degree of tumor differentiation decreases, DNA accumulation index and Ki-67 proliferative index increase, serving as criteria for the aggressive behavior of the tumor. Conclusions. Correlation analysis revealed a statistically significant relationship between DNA accumulation index and Ki-67 proliferative index (r = 0.987, p < 0.05). The obtained data may be useful for diagnosis and prognosis in patients with lung cancer.

The clinical of extragenital endometriosis is variable and depends on the localization, while the leading manifestation is a pronounced pain syndrome, which in some cases can simulate various surgical pathologies. Materials and methods: A morphological and IHC study was performed in 82 cases of extragenital endometriosis of various localization. Research results: An IHC study showed positive expression of α-SMA in fibrosis foci around and between endometriosis foci. The expression area of TGF-β1 was different for the cytogenic stroma and the perifocally located connective tissue. Conclusions: Fibrosis is an integral component of the morphogenesis of endometrioid heterotopias, while the degree of its severity depends on the duration of the existence of endometriosis foci. Severe pain syndrome is probably associated with deformation of organs and tissues, compression of nerve endings due to fibrosis processes.

The purpose of the study is to investigate the clinical features of recurrent vulvovaginitis in prepubertal age girls with extragenital diseases. We examined 110 girls with recurrent vulvovaginitis, which were registered with the dispensary of pediatric gynecologist. We divided them into three groups depending on extragenital pathology: I group – 38 patients with chronic urinary tract diseases; II – 36 girls with allergic diseases; III – 36 girls with gastrointestinal pathology, enterobiasis. Girls with chronic diseases of the urinary system complain of the pain and discomfort during urination, malaise in the genital area, discharge from the genital tract. Girls with allergic pathology complain of itching and burning in the genital area, restless behavior, dysuric phenomena. Girls with diseases of the gastrointestinal tract and enterobiasis complain of discomfort in the genital region, discharge from the genital tract because of constipation and bloating. The results of examination of the external genitalia, vulvoscopy also differed in girls. They depended on the acuty of the inflammatory process and predisposing factor. The clinical features of recurrent vulvovaginitis in prepubertal age girls with extragenital pathology were determined by the data of objective and instrumental examination of vulva.

The article proposes new strategies for the treatment of obesity-associated diabetes mellitus. The aim of the work was to study the effect of a high-carbohydrate type of nutrition on the qualitative and quantitative composition of the gut microbiota and feces of rats and the possibility of correcting the microbiome with the probiotic drug "Normobakt". Based on the results the gut microflora is proposed as a potential effective therapeutic target for improving the results of the treatment of diabetes mellitus and obesity.

Purpose: Due to the severe clinical course and the high socio-economic significance of acute kidney injury, the issue of methods for diagnosing and treating this pathology is on the agenda of the scientific community around the world. One of the most specific biomarkers of acute kidney injury is KIM-1. KIM-1 is an apical transmembrane protein of the proximal renal tubule. Elevated levels of KIM-1 in a model of ischemia-reperfusion injury of the kidneys correlate with inflammation and fibrosis in histological studies. The aim of this work was to study the protective effects of a combination of a peptide mimicking the α-helix B of erythropoietin (pHBSP) and infliximab on the epithelium of nephron tubules in ischemia-reperfusion injury of the kidneys. Methods: The experiment was conducted on 80 white laboratory male Wistar rats weighing 280–320 g. Animals were injected with a peptide mimicking the α-helix B of erythropoietin (pHBSP) and infliximab. Under anesthesia, atraumatic vascular clamps were applied to the left renal pedicle for 40 minutes, nephrectomy on the right. Within 12 hours after reperfusion, urine samples were collected for laboratory studies. Results: According to the results of the experiment, it was found that the use of a combination of a peptide mimicking the α-helix B of erythropoietin (pHBSP) and infliximab more effectively protected the epithelium of the nephron tubules from damage during ischemia-reperfusion injury of the kidneys than the administration of a peptide mimicking the α-helix B of erythropoietin or infliximab in mono mode. Conclusion: The results of the study clearly substantiate the prospects for the combined use of a peptide mimicking the α-helix B of erythropoietin (pHBSP) and infliximab to protect the nephron tubule epithelium from ischemia-reperfusion injury.

The article describes a clinical case of acute urticaria against the background of a parasitic infection in a child who was examined and treated in the pediatric department of the State Budgetary Institution of Healthcare of JSC "Children’s Hospital No. 1". The description of this clinical case shows the ambiguity of the search for verification of the diagnosis.