卷 80, 编号 4 (2025)

Background. External genital endometriosis (EGE) is a complex, systemic clinical syndrome characterized by the presence of endometrioid tissue outside the uterine cavity and associated with chronic pain, menstrual irregularities, and negative impact on reproductive health and quality of life in women. Understanding these mechanisms of influence will improve fertility prognosis and minimize the risks associated with pregnancy, helping to reduce the incidence of its complications.

Aims — to study the concentration of vascular adhesion protein (VAP-1) production, collagen content (COL1) and collagenase activity (MMP-1) of various stages of EGE.

Methods. 137 women were examined, divided into 2 groups — the main and the control. The main group (47 patients with EGE) was divided into 2 subgroups: the first consisted of 25 patients with stage I–II EGE, the second included 22 patients with stage III–IV EGE. The control group consisted of 90 patients with no history of endometriosis. The production of vascular adhesion protein VAP-1, collagen and collagenase activity were determined by solid-phase enzyme-linked immunosorbent assay using ELISA kits, USA. The studies were conducted using samples of blood serum and peritoneal fluid.

Results. As a result of the discriminant and correlation analysis in all studied biofluids, significant correlation relationships were found between the production of collagen and VAP-1 especially for subgroup 1 (stage I–II endometriosis) (r = –0.90; p < 0.05).

Conclusions. Based on the data obtained, we proposed a method for early diagnosis of small forms of endometriosis, which made it possible to diagnose NGE in patients who did not have clinical manifestations of this process based on the content of VAP-1 in the blood serum of women of reproductive age (priority certificate No. 2024134973 (077609) dated November 21, 2024 was received).

Bacterial vaginosis (BV) is a widespread disease among women of reproductive age worldwide and is associated with unfavorable gynecological and obstetric outcomes. The polymicrobial nature of the disease, the high recurrence rate (up to 80%) and asymptomatic course (up to 50%), the formation of an extensive layer of bacterial biofilms resistant to traditional therapy necessitate the search for new approaches to diagnosis and treatment options. The purpose of this review is to summarize research on the role of individual representatives of the female reproductive tract microbiota in the development of bacterial vaginosis, to consider the inter-bacterial interaction of BV-associated microorganisms using biofilm as an example, and to review approaches to the diagnosis and treatment of the disease. The vaginal microbiota is a complex and dynamic ecosystem, subject to constant fluctuations throughout a woman’s life, and the genus Lactobacillus plays an important role in maintaining the state of the vaginal microbiome. Excessive growth of bacteria such as Gardnerella spp., Fannyhessea vaginae, Prevotella bivia, Mobiluncus spp., Peptostreptococcus anaerobius, Megasphaera spp., etc. It mediates the development of bacterial vaginosis, and therefore it is necessary to study modern concepts of microorganisms involved in the development of BV, in terms of both their individual characteristics and pathogenicity factors, as well as their ability to associate with each other, including through the formation of biofilms.

Background. Bone marrow transplantation is necessary for the treatment of hematological, autoimmune and oncological diseases. But at the moment, it is not common to carry out analytical work to assess the effectiveness of the recruitment activities of world bone marrow donor registries.

Aims — to determine quantitative indicators of the recruitment activities of world bone marrow donor registries and analyze these indicators to assess effectiveness. To determine the general trend in the number of potential bone marrow donors included in world registries.

Methods. The study used quantitative data obtained from open Internet sources. Based on the data obtained, quantitative indicators were generated and a correlation analysis was carried out.

Results. A number of countries have been identified in which the level of popularization of bone marrow donation is highly developed: Germany, USA, Brazil. The main directions of development of the most effective bone marrow donor registries from the point of view of recruitment are presented. Information is provided on the creation and development of the Russian Federal register of bone marrow donors.

Conclusions. A general trend has been identified to increase the number of donors in world bone marrow donor registries. However, despite the positive dynamics, in most countries the percentage of donors among the total population of the countries is small. This suggests the need to carry out comprehensive work to develop the donor movement in most countries.

Neutrophilic granulocytes play an important role in the realization of innate immunity. In 2004, the phenomenon of netosis was discovered, accompanied by the release of neutrophil extracellular traps (NETs). Since then, a large number of studies have accumulated on their structure and function in pathological conditions. The purpose of this review is to highlight scientific achievements in the field of netosis research. The contribution of NETs to the pathogenesis of tissue alteration, inflammation, and thromboembolic complications was assessed. The main netosis-associated diseases in which the concentration of circulating NETs components such as extracellular DNA, myeloperoxidase, neutrophil elastase, and histones is increased have been identified. The basic information about the success of therapeutic drugs that destroy NETs structures is summarized. The diagnostic and prognostic value of NETs detection in the development of a wide range of diseases is shown. The presented material emphasizes the need to study NETs-associated diseases as a promising area for a doctor's practice.

Fractures of the lower jaw are the most common type of damage to the bones of the facial skeleton. However, despite the introduction of new surgical technologies into clinical practice, the incidence of complications in patients with this type of injury remains unacceptably high, which dictates the need to improve their treatment methods. Objective of the study — to assess the capabilities and effectiveness of digital technologies in providing medical care to patients with fractures of the lower jaw, based on an analysis of literary data. This study is the first systematic review on this issue. The RINTS, Medline (PubMed), Google Scholar databases were studied from 2000 to 2024. Search terms were used reflecting the concepts of “digital technologies”, “fractures of the lower jaw”, “osteosynthesis”, “computer-assisted surgery”, “convolutional neural network”. The existing studies are devoted to improving diagnostic methods, creating repositories of large clinical and radiological databases with the possibility of their automated analysis, deep learning of convolutional neural networks for interpreting the obtained radiological images, technical support of surgical manipulations in order to improve the accuracy of repositioning bone fragments and their fixation. Digital technologies currently allow evidence-based assessment of the significance of certain clinical parameters when choosing treatment tactics, play an auxiliary role in assessing radiological images, increase the accuracy of the location of fixing structures and matching bone fragments, and reduce the time of surgery. The article discusses the factors that currently hinder the widespread introduction of digital technologies in the practice of treating patients with this type of injury and ways to overcome them.

The article presents the Russian methodology for assessing avoidable mortality. Based on the analysis of existing scientific data and approaches of other countries to the definition of preventable mortality, the criteria of preventable mortality, taking into account the peculiarities of the Russian health care system, are proposed. The criteria were developed jointly with leading federal experts in the field of health care, including chief non-staff specialists of the Ministry of Health of Russia. The upper age limit of avoidable mortality was defined and set at 78 years, which corresponds to the national development goals of the Russian Federation. The methodology includes 147 items for various causes of death and provides for the division of avoidable mortality into preventable and treatable mortality, specifying the proportions for 17 groups of causes of death. The concept of avoidable mortality is presented as a way of assessing the quality and objective capabilities of the health care system. Therefore, the methodology can be used as a tool for assessing the quality of medical care, an indicator of the effectiveness of preventive measures and a marker of progress in achieving the national goal of improving public health. The introduction of the methodology will make it possible to identify priority areas of prevention, assess the effectiveness of treatment and diagnostic measures, monitor the dynamics of avoidable mortality and form targeted programmes to reduce mortality, as well as to identify realistic reserves for reducing mortality by reducing avoidable mortality. In particular, it seems necessary to study avoidable mortality in the regional context, which will make it possible to assess not only the national reserves of mortality reduction, but also individual reserves for each region. At the same time, the analysis of regional differences in avoidable mortality will help to better understand the factors of interregional differences in mortality in general.

On July 03, 2025, it was the 60th anniversary of the outstanding Russian epidemiologist, well-known specialist in the field of medicine and public health, Honored Doctor of the Russian Federation, Laureate of the Prize of the Government of the Russian Federation in Science and Technology, Academician of the Russian Academy of Sciences Vasily Gennadievich Akimkin.

On July 22, 2025, the 85th anniversary was celebrated by the legendary Russian scientist of world renown, specialist in the field of epidemiology and infectious diseases, laureate of the State Prize of the Russian Federation in Science and Technology, laureate of the Prize of the Government of the Russian Federation in Science and Technology, Academician of the Russian Academy of Sciences Viktor Vasilyevich Maleev.