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Purpose of the study: substantiation of indications and assessment of results X-ray endovascular treatment of "critical" PE in patients with acute hemorrhagic cerebrovascular accident. Material and methods: the study included 47 patients with acute violation of cerebral circulation for hemorrhagic and mixed types complicated by massive pulmonary thromboembolism of high risk, with "critical" manifestations of right ventricular failure. Depending on the method of PE treatment used, the patients were divided into 2 groups: the study group (17 people), in which endovascular mechanical fragmentation of thromboembols was performed, and the control group (30 people), in which only basic intensive therapy was used. Results: patients of the study group underwent thromboembolic fragmentation in order to transfer embolism of the trunk and the main branches into embolism of smaller branches of the pulmonary artery. Technical success of the procedure (destruction of the central thromboembolus) was achieved in 100% of the cases. 14 patients (82.4%) showed positive clinical dynamics in the form of an improvement in the general condition, a decrease in pressure in the pulmonary artery, and a decrease in the volume of the lesion of the pulmonary bed according to CT angiography. Three patients (17.6%) died in the early postoperative period. In the control group of 30 patients, 25 patients died, hospital mortality was 83.3%. Conclusion: the method of catheter endovascular fragmentation of thrombi for the treatment of "critical" pulmonary embolism in patients with acute hemorrhagic cerebrovascular accident leads to a rapid and safe decrease in pulmonary artery pressure. 

The actuality of the problem of thermal trauma is determined by its high prevalence. Severe disorders of central, regional and peripheral hemodynamics are developing with a predominant violation of microcirculation and metabolic processes in the body during burn disease. Promising NO donors suitable for biomedical use are dinitrosyl iron complexes (DNIC). The aim of the study was to evaluate the effect of DNIC on the state of microcirculation in normal conditions and on the model of combined thermal trauma (CTT). The experiments were carried out on white male rats of the Wistar line. CTT (contact burn on the area of 20% of the body surface and thermal inhalation exposure to hot air and combustion products for 20-30 seconds) was applied under anesthesia. Animals with CTT were treated daily with intraperitoneal injections of a 10% DNIC solution (1 ml; 0.3 micromol/l). Laser Doppler flowmetry was used to assess the dynamics of the microcirculation state. The physiological and biochemical mechanisms of microcirculation disorders in CTT are revealed in the work. There was an increase in the endothelial, neurogenic and respiratory components of microcirculation, microhemodynamics of the border area of the burn, and the index of the microcirculation bypass. It was shown that when using 0.3 micromol/l of DNIC in rats under normal conditions, there is a decrease in the neurogenic and respiratory components, an increase in perfusion and the myogenic component of the microcirculatory channel. The role of 0.3 micromol/l of DNIC in the normalization of microcirculation in CTT was established.

The work aimed to study the protein spectrum, morpho-functional state of erythrocyte membranes under stress and correction by low-intensity laser radiation. The experiments were carried out in vitro. Low-intensity laser radiation with a wavelength of 830 nm and a power of 90 mw was used for irradiation. Laser therapy was performed using an autonomous laser shower "MarsIK" (NPO "Petrolaser", St. Petersburg). The protein fractions of red blood cells were analyzed by electrophoresis, the morphology of red blood cells by laser interference microscopy, the еletrophoretic mobility of erythrocytes was measured by microelectrophoresis in our modification and the concentration of malondialdehyde in red blood cells by reaction with thiobarbituric acid spectrophotometrically. It is proved that the change of protein fractions in the erythrocyte membrane under stress, a decrease in the amount of spectrin, band 3 protein, glycophorin and ankirin. The stress is characterized by an increase in the number of echinocytes, stomatocytes and degenerative-altered red blood cells. Exposure to LLLT on blood samples determined the recovery of the studied parameters to the control group values (physiological norm). The role of the discovered metabolic changes in RBC in stress and their correction by LLLT is under discussion.

Increase in the life expectancy of the population is associated with a tendency of aging in patients with chronic heart failure (CHF). Gender, age and genetic differences of the individual risk factors are still discussed in the aspect of influence on the heart failure clinical phenotype. The study aimed to identify the gender and age differences of chronic heart failure clinical characteristics in terms of the ZBTB17 gene (rs10927875) polymorphism. Materials and methods. A total of 351 patients with CHF of ischemic etiology of both genders were examined. The average age of men was 65.3±9.9, women  ̶  69.7±9.61 years. Results and conclusions: CHF of ischemic etiology in the absence of differences in the burdened family history, previous myocardial infarction (MI) observed mainly in middle-aged and elderly men and elderly and senile women. Significant gender differences in comorbidities were revealed: in 40% of men, CHF was associated with chronic obstructive pulmonary disease (COPD), in 47.3% of women ‒ with chronic kidney disease (CKD) and in 32.2% - with diabetes mellitus (DM). The distribution of rs10927875 polymorphism ZBTB17 genotypes were corresponded to the Hardy-Weinberg equilibrium (χ2 = 0.272, p = 0.873). CC genotype in men was associated with reduced left ventricular ejection fraction (LVEF). CT genotype in women associated with CHF FC III and IV due to the frequent indications in the past on myocardial infarction, concomitant DM, obesity and hypercholesterolemia. The CT genotype rs10927875 was characterized by a frequent combination of CHF with COPD in men and CKD and DM in women.

The aim of the work was to study the effects of photobiomodulation (PBM) in the red spectrum (640 nm) with fluences from 3 mJ/cm² to 2 J/cm² in combination with ionizing radiation (IR) at doses of 2-6 Gy against human BJ-5ta-hTERT - postnatal fibroblasts. The cells were exposed to low-intensity red light before or after their exposure to IR, the viability of the cells was determined by MTT 24 hours after the last exposure. It is shown that the effects of PBM depend on the fluence of PBM, the dose of IR and the sequence of the actions of these physical factors on cells. The adaptive effect of PBM was observed only for high fluences-1 and 2 J/cm² when exposed to PBM and subsequent (after 1 hour) irradiation of IR. At the same time, the stimulating effect of PBM was observed only for low fluences from 3 to 300 mJ/cm² under IR irradiation and subsequent (after 1 hour) exposure to PBM. These data should be taken into account when using PBM for the correction of adverse events of radiation therapy in an oncological clinic.