Purpose. To evaluate the results of treatment of echinococcal liver disease, to determine the most effective method of echinococcectomy and its role in the prevention of of the disease recurrence. Material and methods. The analysis of 1072 cases (1358 cysts) of echinococcal liver disease was carried out. Radical (closed) echinococcectomy with the use of high-tech resection devices was performed in 258 patients, including the use of ultrasonic dissectors and aspirators in 105 patients (main group), other resection devices (LigaSure, argon plasmic scalpel) — in 153 patients (comparison group). Results.

Length of hospital stay in the main group was 9.4 ± 2.1 bed-days, in the comparison group — 11.6 ± 1.7. Postoperative complications in the main group were recorded in 4.6% of cases, in the comparison group — in 11.0% respectively. Recurrence of the disease in the comparison group was noted in 2.3% of cases, in the main group there was no secondary echinococcusinduced liver injury. The quality of life of patients in the main group was 73.5 ± 1.8 points, in the comparison group — 72.8 ± 1.7 points. There were no deaths among patients who underwent echinococcectomy with the use of resection technologies.

Conclusion. The most effective way of echinococcal liver disease treatment is radical echinococcectomy: cystpericystectomy, liver resection. Ultrasound resection technologies are the most optimal for radical surgical interventions, they reduce intraand postoperative complications and improve the immediate and long-term results echinococcal liver disease treatment .

The study of intestinal and oral microflora and their metabolites playing an important role in intestinal homeostasis, has led to the identification of species closely related to the development of colorectal cancer, intracellular correlations of fungi and bacteria compared to control. The correlation between oral microbiota and intestinal microflora, as well as associated with the mucous membrane of the large intestine, was revealed. It was noted that the use of eu- and probiotics improved the immunological indices and the structure of the intestinal microbiota. Thus, studying the oral and intestinal microbiota and its metabolites may prove to be a simple, accessible and informative method for the early diagnosis of colon cancer. However, most studies indicate only changes in the quantitative and qualitative composition of the microbiota, hardly revealing its cause-effect relations with the processes of tumor formation in the colon. Therefore, it is necessary to continue studies of this problem.

The development of microcirculatory disorders is considered to be one of the earliest changes in the cardiovascular system with a combination of arterial hypertension (AH) and obesity. The rheological properties of blood play a significant role in the system of microcirculation. An important place in changing the rheological characteristics of blood is largely assigned to erythrocytes. Aggregation of erythrocytes is closely related to the magnitude of the surface-bound charge of their membranes or zeta potential of erythrocyte membranes. Purpose. To study the state of compound zeta potential of erythrocyte membranes in patients with hypertension and obesity. Material and methods. The study included 112 patients with AH and Index of Mass Corporal more than 30 kg/m2 (main group); the control group consisted of 25 people without AH and obesity. All patients of the main group received standard antihypertensive, lipid-lowering and hypoglycemic therapy to achieve the target levels of the indices under correction. Results. The level of compound zeta potential of erythrocyte membranes in patients with AH and obesity was significantly lower than in the control group and amounted to 1.57 ± 0.06 × 107 and 1.67 ± 0.03 × 107, respectively (p < 0.05). At the same time, in patients of the main group with an increase in AH, lower indices were noted. In patients with AH and obesity, a significant inverse correlation was found between the compound zeta potential of erythrocyte membranes and the degree of hypertension, which indicates a negative effect of hypertension on the rheological properties of blood at the microvasculature level. A correlation analysis was carried out to evaluate the association between Index of Mass Corporal and zeta potential of erythrocyte membranes in obese hypertensive patients. A negative direct correlation was revealed (r = 0.7, p < 0.05). Conclusion: a decrease in the total charge of erythrocytes can be considered as an early sign of microrheological disorders in patients with a controlled course of arterial hypertension and obesity.

A method for allohernioplasty of indirect inguinal hernia has been developed, in which an additional layer consisting of the peritoneum of the hernial sac is formed between the spermatic cord and the mesh. The peritoneal flap prevents direct contact between the mesh and the spermatic cord and ensures rapid absorption of inflammatory serous fluid. The manifestations of implant-associate inflammation of the spermatic cord and persistent seromas decrease in the tissues. The method was applied in 25 patients in the period from 2017 to 2021.

Purpose of the study. To study the characteristics and frequency of lymphomas in patients with Sjogren's disease (SD) and anticentromere antibodies (ACA); to evaluate the predictors of the development of lymphoproliferative diseases (LPD) in this group of patients. Material and methods. Over the period from 1998 till 2019, 131 ACA-positive patients were under medical supervision at the Research Institute of Rheumatology named after Nasonova V.A. Isolated SD was diagnosed in 82 patients (62.6%), isolated limited form of SSc — in 12 patients (9.2%), combination of SD and limited form of SSc — in 37 patients (28.2%). Lymphoproliferative diseases (LPD) were diagnosed in 20 ACA-positive patients: in 15 — with SD, in 5 — with SD and SSc; no lymphomas were found in the group of patients with isolated SSc. All lymphomas were diagnosed on the basis of histological, immunohistochemical and PCR examination with of B-cell clonality determination in the tissue, and were classified on the base of haematopoietic and lymphoid tissue tumors classification by the World Health Organization. Further analysis included 15 ACA-positive patients with isolated SD and lymphomas. Results. In our study, 18.3% of patients with isolated ACA-positive SD were diagnosed with LPD, represented by MALT lymphomas of the salivary glands (subsequent transformation into aggressive diffuse large B-cell lymphoma (DLBCL) was noted in one patient) in most cases. The course of SD before the diagnosis of LPD was characterized by a gradual progression of dental manifestations of SD with the development of late stages of parenchymal parotitis, severe xerostomia, and significant enlargement of the salivary glands with a minimum number of systemic manifestations of the disease. Significant enlargement of salivary glands, severe infiltration of minor salivary glands, severe xerostomia, decreased level of C4-complement component, monoclonal secretion, low content of CD19+B-cells in peripheral blood, positive B-cell clonality in biopsy material were the main signs of LPD in this study. When diagnosing MALT lymphomas, a focal damage of the salivary glands with no signs of dissemination, no symptoms of B-cell intoxication, and minimal changes in laboratory assessment were found in patients with ACA-positive SD. Conclusion. The natural course of ACA-positive SD and the absence of pathogenetic therapy at an early stage contribute to the development of salivary gland lymphomas in the first 10 years of the disease. Persistent enlargement of the salivary glands in SD, especially in the presence of other predictors of lymphoproliferation, is a direct indication for biopsy followed by the research to exclude the presence of lymphoma.

The article represents the issues of information and analytical support of clinicians. The article deals with the theory and practice of creating a digital subsystem of medical support for the population and a modern system for examination and treatment, the collection, storage and use of medical information in the databases of medical organizations, as well as data processing centers and situational control centers of the federal level or subjects of the Russian Federation. The basic principles of digital medicine, such as continuous development, mobility of doctors and patients, as well as the interaction of sensors and executive devices are discussed.

New facts suggest that COVID-19 coronavirus infection is partly mediated by hypercoagulability reactions characterized by micro- and macrovascular thrombotic angiopathy, which leads to acute myocardial injury, myocarditis, arrhythmias and numerous cases of pulmonary thromboembolic disease . The article presents a clinical observation of acute myocardial infarction development as a result of early thrombosis of an implanted coronary stent in a patient diagnosed with a new coronavirus infection COVID-19.

Epidemics of new, previously unknown human viral diseases have been occurring with increasing frequency in recent decades. The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus has demonstrated humanity's unpreparedness for new challenges and a complete lack of understanding of the causes of viral aggression. An attempt to explain the catastrophic development of the pandemic by accidental transmission of the virus from an animal to a person does not seem convincing. The explosive development of the epidemic process in large ecosystems negates the existing ideas about the contact mechanism of pathogenic virus transmission from person to person. Probably, the causes of the pandemic are related to global changes in the biosphere of the planet. According to V. I. Vernadsky's theory, the biosphere consists of three main parts: plants, animals and microorganisms, the total mass of which is a constant value. In recent decades, the rate of destruction of forests as the main resource of the plant world has considerably increased. The number of wild animals has decreased and at the same time the human population has increased. The growing disproportions led to the expansion of viruses with a new vector from animals to humans. Global insight into the role of viruses in the biosphere of the planet leads to understanding of the COVID-19 pandemic causes. There is every reason to believe that viruses have wave properties, and are able to produce a magnetic field, stable coherent resonance systems and interact without the participation of biochemical transformations. The energy of the electromagnetic field can be high enough for non-contact infection and assembly of an active biological virus inside the human body. The physical theory of viruses significantly expands the existing understanding of the role of viruses in the biosphere of the planet and the causes of new viral infections.

The system of providing medical care belongs to the sphere of economic activity referred to as «range of services» in Russia.

The main criterion in the provision of services is the receipt of the final intended effect, which fully satisfies the customer of this service. If the final intended effect is not achieved, then this service cannot be considered as completed.

In medical care, there is no final guaranteed result. The purpose of providing medical care is the very process of its provision.

The intended result of treatment cannot be guaranteed, but the provider of medical care is obliged to apply all their experience and knowledge to achieve the most useful effect for the patient.

Russian legislation provides for the evaluation of the quality of medical care based on the final effect. This approach to solving the issue of medical care improvement quality does not allow the healthcare in Russia to adequately develop since the main emphasis is placed on the administrative command system of control and motivation of doctors to their work. The openness of the medical community to the society leads to an inadequate evaluation of the inevitable medical failures, complications and problems in the field of medical treatment. The absence of medical practice institution in Russia and the prevalence of hired labor of doctors deprive the medical community of one of the main criteria for the development of medicine — the discretion, provided personal responsibility before a patient. In fact, it is impossible to receive high quality medical care under circumstances where a physician is only a hired "addition" to the material and technical base of a medical institution.

The solution to the above problems can be found on condition of separating healthcare in Russia into a special sphere of economic activity with its own legal determination, structure, management, legislation. It is necessary to isolate medical community from society as much as possible, to limit free access to special information for public inspection and non-expert accusations. We should rely on the development of medical practice in the country as it fullestly reflects doctor's competence independent on the will of the employer.

In his medical and scientific work, the outstanding Russian therapeutist V. Kh. Vasilenko paid great attention to the methodology of clinical diagnosis and prognosis. He formulated the basic rules of diagnosis, determined the sequence of doctor's actions in the diagnostic process, clarified the concepts of «symptom» and «syndrome» , defined the clinical prognosis and highlighted its phases, showed the form of information to the patient about his prognosis.

Тhe article presents the facts of life and career of an outstanding Russian cardiologist, a talented organizer of medical science, a well-known public figure, a wonderful clinician and teacher, academician of the USSR Academy of medical Sciences, honored scientist of the Russian Soviet Federated Socialist Republic, Professor Vladimir Filippovich Zelenin.

The article represents data on the initial development of the territory of the Vyborg side and the construction of Land-forces and Naval hospitals according to the plans of Domenico Trezzini, M.G. Zemtsov, P.A. Trezzini, I.K. Korobov. Information about main creations of these famous architects in St. Petersburg is given.

The article presents the facts of life and career of a prominent domestic field surgeon, a talented organizer, a well-known public figure, an excellent teacher, a remarkable surgical clinician, a corresponding member of the Russian Academy of Medical Sciences, laureate of the USSR State Prize, professor, lieutenant general of the medical service Konstantin Mikhailovich Lisitsyn.