The purpose of this article is to trace the historical path of medical education in Rostov-on-Don. In general terms, the development of higher education, laid down in Western Europe in the 12th century, is presented. The special social status of the University, its classical structure and traditions are considered. Western European models of higher education had a great impact on Russian universities and in particular on the Imperial University of Warsaw. Special attention is paid to the history of foundation, functioning and fate of the Imperial University of Warsaw from 1816 to 1917. The University of Warsaw played an outstanding role in the development of higher education and higher medical education in the South of Russia. The relevance of the topic is that the development of the modern model of medical higher education the development of the program of activities and the principles of its implementation require further reference to historical experience.

The article presents historical review material of pharmacological school on the Don region from the time of its appearance up to the present day. The chronicle of the Rostov School of Pharmacology is inextricably linked with the history of the development of Don medicine, at the origins of which were outstanding researchers and doctors. The modern Rostov pharmacology’s school combines the continuity of professional skills, loyalty to scientific traditions, as well as progressive scientific and practical ideas and innovations.

Objective: to assess the relationship of polymorphism of the main genes involved in the pathogenesis of arterial hypertension (AH) with indicators reflecting the state of target organs in the group of patients with arterial hypertension.

Material and methods: we examined 100 patients with arterial hypertension who underwent standard diagnostic procedures, as well as molecular genetic research.

Results: in patients with arterial hypertension statistically significant associations of AGTR2, GNB3, and NOS3 gene polymorphism with left ventricular hypertrophy, CYP11B2 and NOS3 gene polymorphism with left ventricular diastolic dysfunction, and NOS3 gene polymorphism with increased vascular wall stiffness were found (p < 0.05).

Conclusions: the results of the study indicate that patients with arterial hypertension are a genetically heterogeneous group in terms of the relationship of specific gene polymorphism with indicators that characterize the state of target organs. The use of genetic approaches is promising for early screening of patients with arterial hypertension, belonging to the high-risk group, in order to ensure timely and effective organoprotection.

Objective: to identify the features of structural and functional remodeling of the right heart in patients with chronic heart failure (CHF) against the background of a combination of atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD), to assess the effect on the concentration of the heart failure marker NT-proBNP.

Materials and methods: the study included 120 patients who were divided in to 4 groups depending on the presence of CHF, AF and COPD. Patients underwent an echocardiographic (EchoCG) study, and the concentration of the N-terminal fragment of the brain natriuretic peptide precursor (NT-proBNP) was determined.

Results: comparison of EchoCG parameters of the right heart in patients with CHF of different groups was performed in pairs to determine the effect of diseases on the remodeling of the right atrium (RA) and right ventricle (RV) in comorbid conditions. In patients with CHF, AF and COPD, in comparison with patients with CHF and AF without COPD, lower volume parameters of RA (p=0.004), greater wall thickness of the RV (p<0.001), lower values of the indexed end-diastolic area (EDA) of the RV (p=0.007) and its fractional area measurement (FAM) (p=0.011) were revealed, which allows us to judge the effect of chronic bronchoobstruction on heart remodeling in patients with CHF and AF. When compared with patients with CHF and COPD without AF in patients with CHF, AF and COPD have large size of RV (p=0.012), its indexed end-systolic area (ESA) (p<0.001), lower ejection fraction (EF) of RV (p=0.002), FAM (p<0.001), systolic excursion of the tricuspid valve plane (TAPSE) (p=0.012), indicating the influence of concomitant AF in EchoCG parameters in patients with CHF and COPD. A higher concentration of NT-proBNP was found in patients with CHF, AF and COPD compared to the marker level in both patients with CHF and AF without COPD (p=0.010) and in patients with CHF and COPD without AF (p<0.001), due to more pronounced remodeling of the RV.

Conclusions: In patients with CHF, AF and COPD were the features of the remodeling of the right heart, caused by influence of, on the one hand, AF, on the other, with COPD the structural and functional parameters of heart in patients with this combined pathology. Using the extended protocol EchoCG studies identify additional characteristics of structural-functional state of the right heart (ESA and EDA RV, RV EF, TAPSE and FAM) will optimize early diagnosis of CHF and cardiovascular and bronchopulmonary diseases.

Objective: to study the level of angiogenesis factors (fibroblast growth factor, platelet growth factor, endostatin), as well as tumor necrosis factor alpha in the acute period of myocardial infarction 6 months after the event, depending on the presence of drug revascularization.

Materials and methods: patients with AMI of the anterior wall of the left ventricle with St segment elevation were Included. AMI patients were divided into groups: I group included patients who received thrombolytic therapy (TLT), II - patients who did not receive TLT. Group III was composed of relatively healthy volunteers. Angiogenesis indicators were studied depending on the TIMI scale and complications at the hospital and outpatient stages of treatment.

Results: In AMI patients, an increase in angiogenesis processes was detected, regardless of the presence or absence of thrombolytic therapy, and an increase in the level of angiogenesis inducers. Six months after the activity of angiogenesis processes is maintained, while inflammation decreases − a decrease in the tumor necrosis factor alpha.

Conclusions: In patients with AMI with ST segment rise in the acute period, there is an increase in angiogenesis processes, regardless of the presence or absence of TLT.

Objectives: to analyze the results of echocardiography 1 year after STEMI in patients undergoing pharmaco-invasive reperfusion using various thrombolytic drugs.

Materials and Methods: 240 patients with STEMI after pharmaco-invasive reperfusion were included in an open-label prospective cohort study. Depending on the thrombolytic agent used, the patients were divided into 4 groups: in the 1st (n = 73) — lysis was performed with alteplase; in the 2nd (n = 40) — tenecteplase; in the 3rd (n = 95) — forteplase; in the 4th (n = 32) — streptokinase. Depending on the fibrin-specificity of the thrombolytic, all patients were presented with 2 groups: the group of fibrin-specific thrombolytics (FST, n = 208) and the group of fibrin-nonspecific streptokinase (FNST, n = 32). Echocardiography was assessed 1 year after reperfusion.

Results: after 1 year, there was a slight violation of the global LV systolic function, while the EF between the groups did not differ (p = 0.420). A higher EF was recorded in the FST group compared with FNST (49.8 ± 7.4 % versus 47.4 ± 6.8 %; p = 0.048). After 1 year, violations and local LV contractility persisted in each of the four groups (p = 0.161). At the same time, lower WMSI were recorded in the FST group compared to FNST (1.19 [1.06; 1.38] versus 1.25 [1.175; 1.5]; p = 0.029). In the FST group, significantly lower iEDV were recorded (p = 0.048), and iESV (p = 0.022) and LA size (p = 0.007) compared with FNST. In dynamics, 1 year after reperfusion in the FST group, there was a significant increase in EF by 5.5 % (p = 0.000) and a decrease in LV WMSI by 5 % (p = 0.000) compared with the FNST group.

Conclusions: pharmaco-invasive treatment of STEMI with the use of thrombolytic drugs after 1 year of follow-up is characterized by comparable echocardiography parameters. After 1 year of follow-up, patients undergoing pharmaco-invasive treatment with fibrin-specific drugs had significantly higher EF, as well as lower WMSI, iEDV, iESV, and LA size compared to fibrin-nonspecific streptokinase.

Objectives: to study the relationship between sleep duration and cardiometabolic parameters in patients with diabetes mellitus.

Materials and methods: the study included patients with type 1 and type 2 diabetes mellitus in the absence of acute metabolic decompensation. The exclusion criteria were: the presence of a depressive episode, the presence of alcohol dependence. In addition, the study did not include patients with cancer, erythrocytosis, sleep apnea syndrome. The duration of the patient’s sleep was determined by answering the question: less than 6 hours, more than 6 hours and up to 8 hours inclusive and more than 8 hours and up to 10 hours inclusive. In addition, the patients were questioned about their compliance with the doctor’s recommendation to take hypolipidemic hypoglycemic and antihypertensive drugs during the last 6 months preceding the survey. Statistical data processing was carried out using the Kolmogorov-Smirnov test. Since the sample was nonparametric, the data are presented by Me (Q25; Q75), where Me is the median, Q25 is the 25th percentile, and Q75 is the 75th percentile, and Spearman’s rank correlation coefficient (P) was calculated to assess the relationship between events.

Results: a total of 92 patients were interviewed. 7 patients were excluded from the sample due to the identification of a depressive episode and four patients due to the presence of alcohol dependence. Thus, the study included 81 patients, of whom 21 patients were observed for type 1 diabetes mellitus and 60 patients for type 2 diabetes mellitus. Spearman’s correlation coefficient showed that there is a direct relationship between sleep duration and HbA1c level (p < 0.01).

Conclusion: in our pilot study, the relationship between the level of glycated hemoglobin as an indicator of compensation for carbohydrate metabolism and sleep duration was confirmed.

Purpose: the Assessing of the relationship of the daily diet of dialysis patients with chronic kidney disease with a change in the levels of myostatin and protein kinase-β in order to determine the areas of potential impact on the development of protein-energy deficiency.

Materials and methods: тhe study included 80 patients with chronic kidney disease 5D. All patients underwent laboratory tests and the average daily diet was estimated from 3-day nutrition diaries. MSTN and AKT levels were determined in the blood by ELISA.

Results: in the study, the prevalence of PEW was 90%. We have proposed a catabolic muscle tissue index (CMTI), which takes into account the complex effect of the relationship between MSTN and AKT on the development of PEW. The daily calorie and protein in patients were less than recommended. The interconnections of dietary features and markers of catabolism of muscle tissue were determined, which is an area of potential interest in the prevention and progression of PEW and requires further study.

Conclusions: correction of the diet of dialysis patients is important for nutritional deficiency and control the catabolic way of the myostatin.

Objective: to improve the assessment of activity of ulcerative colitis and the ability to predict the development of relapse of the disease, as well as the selection of adequate therapy.

Materials and methods: the study included 90 people: 70 patients with ulcerative colitis and 20 healthy volunteers. The disease activity was evaluated using 7 disease activity indices. The expression of matrix metalloproteinase -9 (MMP-9) in the colon mucosa was evaluated by immunohistochemistry.

Results: data were obtained on the activity of MMP-9 in colonobioptates in patients with ulcerative colitis with varying degrees of disease severity, which complements our knowledge of the pathogenetic mechanisms of UC and, based on the developed mathematical model, allows predicting the development of recurrence of UC. Based on the analysis of clinical indices of UC activity, an algorithm for evaluating the effectiveness of basic therapy has been developed.

Conclusion: tools are provided to improve the prognosis of UC relapse, and a personalized approach to evaluating the effectiveness of the alternatives of drug therapy is developed.

Objective: to estimate blood levels of serotonin and melatonin neurotransmitters in patients with irritable bowel syndrome and to evaluate the role of neurohumoral imbalance in the development and clinical manifestations of irritable bowel syndrome phenotypes.

Materials and methods: the study included 60 patients (range, 18 – 45 years) diagnosed with irritable bowel syndrome according to the Roman IV criteria for irritable bowel syndrome (2016). 20 patients with a confirmed diagnosis of ulcerative colitis (UC) were assigned to a comparison group. The control group was composed of 45 apparently healthy subjects. All subjects were assigned to subgroups based on the prominent clinical presentation: irritable bowel syndrome with constipation (IBS-C), irritable bowel syndrome with diarrhea (IBS-D) and mixed irritable bowel syndrome (IBS-M). In addition to all the necessary procedures (clinical, laboratory and instrumental), blood concentrations of endogenous serotonin and melatonin were measured using enzyme-linked immunosorbent assay (ELISA).

Results: the concentrations of endogenous serotonin and melatonin were significantly lower in patients with irritable bowel syndrome as compared with those having ulcerative colitis or healthy individuals. The detection rates of lowering serotonin levels were 53.3 % and 65 % — for melatonin. Low levels of melatonin were detected both in IBS-D and IBS-C patients. 69.57 % of IBS-D patients had elevated levels of serotonin as compared with the reference values for healthy subjects. We found a strong correlation between the severity of bloating and abdominal pain on the one hand, and low levels of endogenous serotonin and melatonin, on the other hand.

Conclusion: our findings suggest that serotonin and melatonin neurotransmitters play a significant role in the pathophysiology and clinical manifestations of estimate blood levels of serotonin and melatonin neurotransmitters in patients with irritable bowel syndrome.

The widespread use and availability in сlinical practice of diagnostic research methods (ultrasound, CT, MRI), which allow visualizing the abdominal organs (including the gallbladder and bile ducts), has led to a significant increase in the detection rate of gallbladder polyps. In some cases, these polyps can be considered from the point of view of precancerous diseases and lead to the development of gastric cancer. Algorithms for the diagnosis and management of patients have been proposed, depending on the size of the polyp, its characteristics, and the comorbidity of the patient. These algorithms should help primary care physicians to influence the risk of developing malignant neoplasms of the biliary tract.
The article highlights the issues of etiology, clinical course, modern diagnostic methods, as well as the possibility of surgical treatment of tumors of the biliary tract. An overview of the possibilities of various diagnostic methods for examining the biliary system is presented: ultrasound research method (including endoscopic), MRI, CT. The most effective methods of additional examination of patients with difficulties in differential diagnosis are shown.

The analysis of this clinical case is devoted to the need for strategic forecasting in the diagnosis of endocrine diseases. Autoimmune aggression is not directed against one organ, the progression of autoimmune damage is often slow, which increases the chances of missing a disease, and sometimes leads to a diagnosis at the time of crisis and decompensation. With timely suspicion of autoimmune polyglandular syndromes, the appointment of the necessary screening 1 time in 2-3 years, as well as patient education, we save them from years of diagnostic research, and timely compensatory therapy significantly improves the quality of life of patients.

The topical review discusses various points of view related to terminology, diagnostic criteria, difficulties in assessing the prevalence and stages of diabetic cardiomyopathy, presents used in clinical practice and potential instrumental and laboratory diagnostic methods, provides therapeutic methods and strategic directions for the treatment of this condition and the prevention of chronic heart failure.

The review presents data regarding the non-lipid effects of statins that may be useful in the treatment of patients with new coronavirus infection. The effects of statins such as antiflammatory, immunomodulatory, antithrombotic, as well as the restoration of endothelial dysfunction and the normalization of fibrinolysis are discussed. The effect of statins on SARS-CoV2 entry into the cell and viral replication is discussed. Recent data from observational clinical studies on the effect of statins on the severity of the course of a new coronavirus infection are presented.

Medical volunteerism gives an opportunity for future specialists to provide free assistance to practical healthcare, as well as to acquire personal and professional qualities required for a student at a medical university. Medical volunteers are implementing many large-scale campaigns and projects aimed at the prevention of chronic non-communicable diseases and other socially significant diseases, and at promoting a healthy lifestyle. The results of the work are to increase public awareness, as preventive measures are an important component of the healthcare system, aimed at the formation of the population's medical and social activity and motivation for a healthy lifestyle.