Vol 1, No 3 (2021)

The aim of the study was to investigate the frequency and patterns of HER2 protein expression and HER2 gene amplification, as well as to evaluate the cellular phenotype in severe precancerous changes: from indeterminate epithelial dysplasia to invasive adenocarcinoma. Material and methods: biopsy material of gastric mucosa obtained during endoscopic examination in patients with clinical manifestations of dyspepsia. Histological, immunohistochemical (IHC) studies and silver-enhanced in situ hybridization (SISH) were performed. Results: In the IHC evaluation of HER2 protein, 23% of invasive carcinoma specimens showed high HER2 production, of which 15% corresponded to the "3+" variant and 8% to the "2+" variant. In all cases with high HER2 protein expression, amplification of the HER2 gene was detected as determined by SISH. No amplification of expression with increasing precancerous lesions (from low and high grade intraepithelial dysplasia to adenocarcinoma) was detected. In 81% of dysplasias in all categories, IHC evaluation of HER2 protein revealed non-canonical staining. Based on immunohistochemical evaluation of mucin expression, a gastric phenotype was detected in 25% of dysplasias, an intestinal phenotype in 46%; a mixed phenotype with gastric predominance in 16%, and a mixed phenotype with intestinal predominance in 13% of total cases. No correlation determined using the distribution of the sum of squares of independent standard normal random variables (chi-squared χ2) was found between dysplasia grading groups and the non-canonical HER2 protein expression patterns detected in them, as well as between dysplasia grading groups and the corresponding immunophenotype.

Serrated formations of the colonic mucosa are a group of neoplasms with "serrated" morphology and a specific pathway of carcinogenesis that can lead to the development of colorectal carcinomas. Over the last decade, data have accumulated to clarify the morphologic classification and molecular characterization of serrated colorectal lesions. This review presents current classification criteria for dentate lesions, insights into molecular pathogenesis, and characterizes the endoscopic and morphologic presentation and histologic patterns of inherent dysplasia variants in dentate lesions. A number of issues related to dentate neoplasia remain unresolved to date. Due to the marked molecular and morphologic heterogeneity of this group of neoplasms, its classification still requires modifications based on a combination of clinicopathologic and molecular profiles. The development and validation of immunohistochemical and molecular biomarkers is necessary for a clear differential diagnosis of these subgroups.

Thirty literature sources, including 28 periodicals included in the US National Library of Medicine's Medline bibliographic database of medical science articles and 2 books, were used in this work.

Objective. To evaluate the possibility of using miR-21 expression as a marker in the system of risk prediction of gastric adenocarcinoma development. Material and methods. Main group: 60 stomachs resected for adenocarcinoma - 1 fragment of adenocarcinoma and 4 fragments of gastric mucosa of distant zone (2 - of antral region and 2 - of gastric body at a distance of more than 10 mm from the border of invasive growth). Comparison group: 62 cases of gastric mucosa biopsy examination, with material sampling from 5 points. Sampling in both cases was carried out taking into account the recommendations of the OLGA system. Assessment of the stage of chronic gastritis, severity of inflammation to determine the index of prevalence of body gastritis was carried out on the basis of visual analog scales of the Russian revision of the OLGA International Classification of Chronic Gastritis. Expression of miR-21 was assessed by semiquantitative real-time reverse transcription polymerase chain reaction (RT-PCR), with normalization to small nuclear RNA U6 by the 2ΔCq method. Regression analysis with construction of a multiple logistic regression model was used to assess the predictive potential of the variables and to construct a nomogram for gastric cancer risk assessment. Analytical statistics was performed in the STATISTIKA 10.0 program package. Results. According to the results of multiple logistic regression, statistically significant positive association with the presence of gastric adenocarcinoma was demonstrated by all assessed predictor variables - for the stage of chronic gastritis according to OLGA system the value of Odds Ratio (OR)=8,07 (confidence intervals (CI) from 1,52 to 42,85, p=0,013), gastric body gastritis prevalence index OR=11,77 (CI=from 2,59 to 53,6, p=0,001). The low level -2 Log likelihood=58,3 and high level - concordance criterion χ2 (3)=110,84 (p=0,00001) allows to assert the sufficient level of model quality, the model corresponds to the initial data, diagnostic accuracy is equal to 92%. The area under the AUC curve according to the results of ROC-analysis is equal to 0.97. Using the model indicators and calculating the risk level at different values of variables, a nomogram was constructed, which allows to perform a stratified risk assessment of the association of chronic gastritis with gastric adenocarcinoma. Conclusion. Predictive statistical model and nomogram based on multiple logistic regression, including the stage of chronic gastritis, gastric body gastritis prevalence index and tissue expression level of miR-21, allow stratified risk assessment of gastric adenocarcinoma development with high validity.

The problem of inflammatory kidney diseases in pregnant women remains a burning issue in urologic, obstetric and neonatology practice. Over the last 20 years in Russia the number of patients with infectious and inflammatory renal pathology has increased 3.6 times. This pathology occurs both during pregnancy and directly during labor and delivery. There are a number of predisposing factors that increase the risk of gestational pyelonephritis (GP): inflammatory diseases of urogynetic sphere in the history, frequent change of sexual partners and so on. In the pathogenesis of the development of inflammatory diseases of the urinary tract during gestation are of great importance features inherent in the normal course of pregnancy: changes in hormonal background, growth of the pregnant uterus, changes in the immune response of the body, etc. Objective: To study the peculiarities of clinical course, diagnosis and treatment of patients with gestational pyelonephritis on the material of clinical case histories. Materials and methods: We retrospectively analyzed 441 case histories of patients with GP, who were hospitalized in the urological department of the urological department of the BUZOO GK BSMP № 1 from 2001 to 2020. Results: In the conducted study on the basis of the urological department of the urological department of the BOOZOO SC BSMP №1 from 2001 to 2020 we have established some features of this pathological process. Most often gestational pyelonephritis is observed in first-pregnant women in the 2nd and 3rd trimesters of pregnancy. Serous forms of inflammation are more common. The predominant side of the lesion is the right kidney. Previous inflammatory diseases of the genitourinary organs may predispose to the development of HP. The most frequent clinical manifestations of the disease are: pain syndrome on the affected side and fever. Dysuric manifestations are much less common. Diagnostic criteria of GP can be considered: determination of the symptom of lumbar concussion on the affected side, increased peripheral blood leukocyte count, leukocyturia. Conclusion: Gestational pyelonephritis remains one of the pressing problems of modern urologic practice. The use of diagnostic and treatment algorithm and cautious attitude to pregnant women with inflammatory diseases of urinary tract allows to reduce the risk of complications of this disease.

Activation of lipid peroxidation accompanied by accumulation of lipoperoxidation products in tissues is a universal mechanism of development of many diseases. One of the most significant in medico-social terms nosological forms associated with changes in the oxidative status of cells, is considered alcoholism. The key event in alcoholism is the formation of the alcohol withdrawal syndrome.

In order to find out the dynamics of changes in lipoperoxidation processes during alcohol withdrawal we have determined the parameters of peroxidation in the blood plasma of alcoholic patients. The main parameters of lipid peroxidation (content of primary, secondary and final molecular products in heptane-isopropanol extracts) were determined in blood samples. The subjects included patients diagnosed with "Mental and behavioral disorders as a result of alcohol consumption, middle stage. Active dependence syndrome. Withdrawal state, uncomplicated, medium severity". The content of lipid peroxidation products was estimated spectro-photometrically and expressed in oxidation index units. The determination of ascorbate-induced lipid peroxidation intensity was expressed as a percentage of the initial (basal) level of lipid peroxidation. The median, lower 25th (L) and upper 75th (H) quantiles were used as the main characteristics of descriptive statistics. The statistical significance of differences was assessed using the nonparametric Mann-Whitney (U) criterion for two independent samples.

A decrease in the level of heptane-soluble diene conjugates, ketodienes and conjugated trienes, an increase in the content of isopropanol-soluble keto-dienes and conjugated trienes, a decrease in the amount of isopropanol-soluble Schiff bases in blood plasma in different terms of the study were revealed. As a result of the conducted researches statistically significant reduction of secondary products of lipid peroxidation in blood at induction by iron/ascorbate mixture on the fifth and seventh days of alcohol withdrawal syndrome development is noted. The obtained data indicate that manifestation of lipid peroxidation enhancement and decrease in the capacity of lipophilic components of antioxidant defense is registered only on the fifth day of alcohol withdrawal syndrome development, as well as limitation of free-radical "attack" on unsaturated acid residues of nonpolar lipids during the formation of alcohol withdrawal. Possible reasons of these changes are analyzed.

Cognitive-behavioral therapy (CBT) is currently a popular branch of psychotherapy, as well as one of the few psychological interventions whose effectiveness has been confirmed by evidence-based research. This review discusses the general theoretical background of the method, its history (behavioral approach, cognitive approach, third wave methods), and the evidence for the effectiveness of CPT. There is a review of research on the effectiveness of CPT for the treatment of various mental disorders: depression (major depressive disorder, postpartum depression, depressive disorders of the elderly), schizophrenia, anxiety disorders (generalized anxiety disorder, social anxiety disorder, anxiety disorders of childhood), attention deficit hyperactivity disorder, epilepsy.

The results of the study conducted within the framework of the action "Everyone can save a life" to teach Omsk schoolchildren the skills of first aid in sudden circulatory arrest are presented. The study involved 647 students of 10-11 grades from 5 secondary schools. From the results of entrance testing of high school students for knowledge of the algorithm of basic cardiopulmonary resuscitation it follows that theoretical training on this issue is at a low level. The average result of the output testing results is multiple times higher than the starting level. The existing difference in the level of knowledge of the CPR algorithm at the start leveled out after the master class and became not so tangible as in the evaluation of the results of the entrance test.

The purpose of the article is an analytical review of the historical and cultural retrospective of humanitarian education in one of the oldest universities of Omsk. The article considers the main stages of formation and development of humanitarian education in Omsk State Medical University from the moment of its foundation as a medical institute to the present day. The material of the article is based on archival documents of Omsk State Medical University, documentary materials of the museum of the history of the university, articles and notes of the newspaper "For Medical Personnel", memories of veteran teachers.

The huge interest of researchers to the topic of artificial intelligence (AI) is associated not only with theoretical issues loaded with philosophical content, but also with the rapid introduction of new technical developments in the practice of social life, in particular, in medicine. In the case of AI, modern society, culture, and medicine find themselves in a situation where the time spent on the creation and practical realization of innovations is rapidly outpacing the time required for their understanding, comprehension, and evaluation. Active implementation of AI in science, medicine and everyday life is accompanied by various transformations of existing relations in society, processes in culture, traditions in medicine, which necessitates the development of new regulations of these relations (ethical, social, economic and legal) in these spheres. The aim of the article is to analyze the philosophical and socio-cultural aspects of problematization of these issues, including the understanding of expectations and challenges associated with the expanding prospects for the use of AI. The article touches upon the acute ethical, sociocultural and legal aspects of AI implementation in medical practice and healthcare, discusses the role of the physician in comparison with AI in different models of R. Veach's "moral medicine", studies the impact of AI on the physician's work, and predicts possible future conflicts. The problem of the legal status and trends of AI development are consistently covered. Special attention is paid to the changes in medicine itself in the context of the "4Ps of medicine" model and the prospects of AI development due to the rapid growth of its importance in this medical model, synchronized with the increasing medicalization. The question of AI autonomy as a philosophical problem is raised, the problem of creating a new type of ethics - machine ethics, which would allow to ensure two-way communication between natural and artificial intelligence, is touched upon. Material and methods. The empirical material for the article was scientific literature of the last decade devoted to AI research. We used the critical-analytical approach and the method of comparison as techniques of philosophical reflection, as well as the method of interpretation. The results we came to are related to the philosophical and sociocultural assessment of the status of AI in the present and future, as well as to the limits of the positive aspect of the introduction of AI in medicine and the challenges that the active introduction of AI in medicine, including its 4P-model, poses. The conclusion fixes that the vector of modern AI research is connected with attempts to define it in terms of personality and revealing the tendency to AI autonomy.

The purpose of this paper is to consider the birth of human individuality in the process of transgression. The article is devoted to the disclosure of the essence of man. In the modern world there is a threat of loss of humanity in man. Alienation of man in the conditions of rapid development of technologies in the modern world is increasing. Globalization and transhumanism can threaten the foundations of human existence.  Ideas of complete social control over man by means of artificial intelligence, improvement of man's nature through interference in his genetics and brain are emerging. In modern research, man is more and more often considered either as an all-natural or as an all-social being. The behaviorist approach, which reduces man to a system of reactions to environmental stimuli, is widespread in modern science. Meanwhile, the basis of human existence is freedom, which manifests itself in the fact that man can be independent in his choice of both natural and social laws, to remove these laws in his being. Human freedom is the result of the birth of human individuality, which takes place on the border of his natural and social existence. Material and methods. When writing the article, we relied on the works of J. Bataille, in which he unfolds his understanding of transgression in culture and human life. In our research we also used the dialectical approach presented in the works of A.F. Losev in his consideration of dialectical relations of essence and phenomena in the world. Results. According to the results of our research, the birth of human individuality presupposes acts of transgression. Transgression includes two main acts dialectically connected with each other. The first act consists in stopping the instinctive impulse of life through prohibition, forming through this stopping the space of labor and law, in which the human personality is formed. The second act presupposes the synthesis of natural and cultural being of man, in which human freedom and individuality are born. Conclusion. The birth of individuality is the formation of human being-for-self, which involves a dialectical synthesis of social and natural, natural and accidental, rational and irrational.