[Scaffold technologies in regenerative medicine: history of the issue, current state and prospects of application]. / Skaffold-tekhnologii v vosstanovitel'noi meditsine: istoriya problemy, sovremennoe sostoyanie i perspektivy primeneniya.

Development of methods for replacing human tissue defects based on scaffold technologies in regenerative surgery proves the prospects of this industry. High-tech manufacturing of scaffold matrices suggests complete replacement of obsolete methods of treatment with new developments in the near future. At the same time, additional studies devoted to these methods and their results are needed. One of the promising goals for development of scaffold technologies is creation of versatile materials used in various fields of regenerative medicine.

[Innovative concept of aging prevention for modern Russia.]

The article presents an innovative concept for aging prevention of older citizens based on using elements of the International Classification of Functioning, Disability and Health which taking into account the influence of aging processes on changes in health and social adaptation of older citizens. The functional features of the departmental systems of health care and social protection of the population operating in Russia that impede their integration within the framework of providing comprehensive medical and social assistance to citizens of older age groups are analyzed. The biopsychosocial model of functioning and disability has advantages in comparison to another models given possibility of developing a social adaptation and implementation of an integrated systematic approach to the prevention of aging. A set of measures is proposed and justified to improve the efficiency, quality and accessibility of services health care for elderly by restructuring the functional interaction of departmental structures, attraction of resources and potential of non-governmental, public organizations, scientific and educational centers, professional communities and volunteers.

[State support to elderly citizens: which gerontology needs modern Russia? (Part 1).]

The article discusses the causal relationship between the low efficiency of state policy in extending the period of active longevity. It is characterized by the absence of a correlation between basic and applied research in the field of aging and the use of an unsystematic approach to the development, implementation of targeted federal and regional programs aimed improving the quality of life older citizens. It is shown that the current negative situation, characterized by an aggravating decline in the quality and accessibility of state medical, social and psychological assistance to elderly citizens, is largely due to the incompleteness of existing laws and regulations in the field of their social support. The lack of both scientific justification for programs and terminological correctness allows officials to use a formalized, extensive approach when planning the development of the healthcare and social protection sectors, which do not take into account population aging. The problem of positioning gerontology as a scientific discipline that provides a synthesis of natural science, applied and socio-humanitarian knowledge, a complex of four scientific areas: biology, medicine, psychology, sociology is considered. The unity of the components of gerontology provides scientific background for improving public policy aimed on adapting socio-economic development to the demographic processes of population aging.

[State support to elderly citizens: which geriatric needs modern Russia? (Part 2).]

The publication continues to consider the cause-subsequent relationships of low efficiency of the state policy in the field of prolonging the period of active longevity altogether with unsystematic approaches to the formation and implementation of state programs. In the context of the analysis of the reasons for the insufficient effectiveness of existing state programs in the field of improving social support for senior citizens, geriatrics is positioned as an integral part of gerontology - an area of applied research that provides solutions to medical, social, psychological and other problems that arise among citizens of elderly. In particular, these problems are associated with the psychophysiological, socio-economic, educational, cultural and legal status of this category of citizens. Geriatric care and its status as a basic component of comprehensive medical and social assistance to senior citizens are formalized. The influence of gerontology and geriatrics in the process of providing systemic support for improving the quality of life of senior citizens, which is one of the priorities of Russian state policy, is substantiated. The motivation is the need to amend existing laws and regulations governing the provision of state support to senior citizens, systematic processing of existing government programs in this area, based on the use of a scientific approach to solving the problem of adapting the state to the aging processes of society.

[Regional System of Integrated Health and Social Care for Elderly People: Experience and Expertise of Saint-Petersburg.]

The article examines the challenges of creating a system of integrated health and social care for elderly people (the System) in Russia, these challenges being of particular significance in the light of the negative effects of the COVID-19 pandemic on the quality of life and mental and general health of elderly people, which need to be mitigated with due consideration of the dynamics of progression of age-associated chronic diseases of elderly people. The article describes the structure of the System, and the conditions and background of its establishment. It also looks at the components of system-based support of improvement of quality of life of elderly people. The article argues that it is essential to use the positive and negative experiences of different regions, to implement the practical and scientific expertise in the field of gerontology and geriatrics made so far in Russia, and to establish a meaningful and equal partnership among the state, research organizations, communities of professionals and non-public organizations. The authors suggest to look on Saint-Petersburg as a model region when establishing the System. The article contains a list of the major projects and events in the city from 2012 to 2020 aimed to provide system-based support for integrated health and social care for elderly people, not affiliated with any federal programs. Unbiased evaluation of the experience and expertise of Saint-Petersburg and other regions of Russia will allow to use them when establishing similar systems in other Russia's regions that do not possess sufficient resources. The authors suggest to establish the System in a step-wise manner at the federal district level. For example, a pilot project may be launched in the North-Western Federal District using the experience and expertise of Saint-Petersburg.

[System-Based Support of Improvement of Quality of Life for Elderly People in Russia: Outlook and Challenges.]

The article examines the outlook and challenges relating to the provision of system-based support of healthcare providers and social services in the course of delivering their healthcare, mental health and social services to elderly people, in particular amidst a crisis, such as the COVID-19 pandemic. The article gives the definition of integrated health and social care, its structure and the algorithm of delivering integrated health and social care to elderly people. The article argues that a system of integrated health and social care will improve the quality of life of older populations and extend their active longevity through a person-centered social services plan offered according to an older person's needs. The article gives the definition and a detailed description of the goals of system-based support of integrated health and social care for older populations. It describes the conditions for providing such system-based support in one specific region of the country. The article analyses the structure, aims and type of entity of the Geriatric Service which is viewed by the authors as a building block of the system of integrated health and social care for elderly people, and discusses the issues relating to coordination of activities among various divisions of the Geriatric Service and their cooperation with social services and healthcare providers. The article explains why it is important to establish a special research and methodological unit - the Center for System-Based Support - within the Geriatric Service.

[EFFECT OF ANTIOXIDANTS ON ESOPHAGUS TISSUE REPAIR UPON EXPERIMENTAL CHEMICAL BURN FROM ACETIC ACID].

This work is an experimental study on 30 rabbits to determine the effect of antioxidants on the process of repair of the esophagus. Chemical agent was 46% acetic acid, a The antioxidant "Mexidol" were injected to core group of test animals in 2 weeks. Animals were taken from the experiment at 5, 14, 21, 30, 45 and 60 hours. We conducted morphometric study of histological exemplars, determining the number of inflammatory cells, epithelial thickness, the area of newformed blood vessels. In the study group we reported an improvement of reparative processes in the wall of the body: it was increased blood supply to the burn surface on 242% and more rapid relief of inflammatory processes on 117% (p < 0.05).

[Efficacy of transesophageal pacing for correction of newly diagnosed atrial fibrillation of type I in patients with coronary heart disease].

AIM: To analyse the results of using transesophageal pacing (TEP) for correction of atrial fibrillation of type I (AF). MATERIAL AND METHODS: The study included 1283 patients with coronary heart disease (CHD) and newly diagnosed AF. All the patients were examined with transthoracic echocardiography, received basic antianginal treatment. AF was corrected with TEP. RESULTS: Sinus rhythm was reestablished in 83.48% patients, in 67.33% TEP was made without previous antiarrhythmic therapy, in the rest patients with this pretreatment. The best result was observed in pre-pacing administration of amiodaron or its combination with hinidin-durules. Only 2.88% patients retained AF after TEP. CONCLUSION: TEP is an effective method of type I AF treatment.

[Clinical and molecular correlation between chronic hepatitis and hepatocellular carcinoma induced by hepatitis B virus].

The role of X-gene of hepatitis B virus (HBV), telomerase gene, structural HBV proteins is considered. Both factors of the virus and those of the host are involved in hepatocarcinogenesis. The duration of chronic B hepatitis may influence mitogenic and mutagenic conditions for accumulation of occasional genetic and chromosomal damage and result in hepatocarcinoma development.

[Effect of trimetazidine and perindopril on myocardial function and metabolism in patients with low cardiac output during postinfarction period]. / Otsenka vliianiia trimetazidina i perindoprila na funktsiiu i metabolizm miokarda u bol'nykh s serdechnoi nedostatochnost'iu v posleinfarktnom periode.

AIM: To investigate effects of trimetazidine and perindopril on myocardial function and metabolism in patients with cardiac failure after myocardial infarction. MATERIAL AND METHODS: A comparative study was mode of the effects of 6-month therapy with perindopril, trimetazidine alone and in combination on clinical symptoms, left ventricular function and perfusion, glucose utilization, excretion and utilization of fatty acids in the zones of postinfarction scar, periinfarction ischemia and in without infarction changes. RESULTS: Combined treatment with the ACE inhibitor and trimetazidine produced positive clinical and functional-metabolic shifts in postmyocardial infarction patients with cardiac failure. CONCLUSION: The addition to the program of mild cardiac failure treatment early after myocardial infarction of an ACE inhibitor and a cytoprotective drug (trimetazidine) promotes more complete clinical compensation of the patients.

[Assessment of the use of various cardiac pacing modes for selection of antiarrhythmic therapy for prevention of recurrent attacks of atrial fibrillation and flutter]. / Otsenka ispol'zovaniia razlichnykh rezhimov kardiostimuliatsii dlia opredeleniia protivoretsidivnoi antiaritmicheskoi terapii paroksizmov mertsaniia i trepetaniia predserdii

AIM: To determine optimal mode of transesophageal pacing for selection of appropriate antiarrhythmic therapy for prevention of attacks of atrial fibrillation and flutter in patients with ischemic heart disease. MATERIAL AND METHODS: Two hundred eighteen patients with ischemic heart disease and attacks of atrial fibrillation or flutter. Selection of antiarrhythmic drugs was carried out with the use of competitive, rapid, salvos of ultra rapid, and slowly accelerating ultra rapid modes of pacing. Results. Most effective and reproducible method for induction of attacks of atrial flutter and fibrillation was slowly accelerating ultra rapid mode of pacing. Average duration of positive clinical effect of preventive antiarrhythmic therapy selected basing on the results of this mode in patients with ischemic heart disease was 3.1-/+0.3 years. Unfavorable prognostic sign decreasing preventive effect of antiarrhythmic therapy was left atrial dilatation. CONCLUSION: Slowly accelerating mode of transesophageal pacing was most effective tool for selection of antiarrhythmic therapy aimed at prevention of attacks of atrial fibrillation and flutter in patients with ischemic heart disease.

[Diagnostic value of ventricular late potentials, heart rate variability and QT dispersion in patients with acute myocardial infarction]. / Diagnosticheskoe znachenie pozdnikh potentsialov zheludochkov, variabel'nosti serdechnogo ritma i dispersii intervala Q-T u bol'nykh infarktom miokarda.

Late ventricular potentials (LVP), heart rate variability (HRV) and dispersion of QT interval (QTd) were studied in 91 patients with myocardial infarction with various ventricular arrhythmias. Patients with episodes of sustained ventricular tachycardia (group 4) had the following characteristics: prevalence of LVP 73.7%, QTd 82.5 ms, standard deviation of RR intervals (SD) 26.5 ms; spectral analysis of HRV revealed preponderance of sympathetic influences and lowered vagal activity. Frequency of LVP detection, QTd and SD in patients with ventricular extrasystoles (Lown classes 3-5) (group 3) were 33.3%, 72.8 ms, and 42.8 ms, respectively. Patients of group 3 also had augmented sympathetic and lowered parasympathetic influences. These data significantly differed from those obtained in patients with Lown class 1-2 ventricular extrasystoles (group 2) and patients without extrasystoles (group 1). Groups 3 and 4 had significantly different prevalences of LVP and values of some HRV parameters but similar QTd. There was close correlation between presence of severe ventricular arrhythmias and some parameters of HRV and signal averaged ECG. Stepwise regression analysis showed that the following group of parameters was related to the presence of malignant ventricular rhythm disturbances: heart rate, SD and total QRS duration (p<0.05). Thus patients with life threatening ventricular arrhythmias were characterized by the presence of LVP and changes of some parameters of HRV and QTd. Registration of these parameters can apparently be used for prediction of potentially fatal ventricular arrhythmias in patients with myocardial infarction.

[Sinus node functions, sinoatrial conduction, atrial conductivity after incipient paroxysms of atrial fibrillation and flutter in patients with ischemic heart disease]. / Funktsii sinusovogo uzla, sinoatrial'noe provedenie, predserdnaia provodimost' posle vpervye voznikshikh paroksizmov mertsaniia i trepetaniia predserdii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

AIM: Prediction of the rate of recurrent paroxysms of atrial fibrillation (AF) and flutter (AFl) after the first arrhythmia episode; determination of relevant antiarrhythmic treatment. MATERIAL AND METHODS: 157 patients with ischemic heart disease (IHD) complicated by new episodes of AF and AFl entered the study. After the initial episode and 1-2 arrhythmia recurrences all the patients have undergone assessment of hemodynamics, atrial conduction of excitation, sinus node function using transesophageal pacing. The patients were divided into two groups: group 1 consisted of 42 patients having no recurrent paroxysms of AF or AFl for at least 6 months; 115 patients of group 2 had at least one episode of recurrent arrhythmia for 6 months after the first paroxysm. RESULTS: Patients of group 2 vs those of group 1 had a significantly longer first episode, more frequent occurrence of calcinosis of mitral and/or aortic valve, more serious systolic and diastolic dysfunctions and most frequent retrograde atrial excitation conduction after the first paroxysm. CONCLUSION: In detection of only disturbed intraatrial conduction in IHD patients after the first paroxysm of AF and AFl predicted are clinical recurrences of arrhythmia with the recurrence-free period more than 6 months. In retrograde atrial conduction of excitation combined with systolic and diastolic left ventricular dysfunction, sinus node dysfunction prognosis was made of more frequent episodes of AF and AFl.

[Various regimes of cardiostimulation in determination of anti-recurrence therapy of atrial fibrillation and flutter paroxysms in patients with ischemic heart disease]. / Ispol'zovanie razlichnykh rezhimov kardiostimuliatsii dlia vybora protivoretsidivnoi terapii paroksizmov mertsaniia i trepetaniia predserdii u bol'nykh ischemicheskoi bolezn'iu serdtsa.

AIM: Choice of optimal cardiostimulation regimens using transesophageal pacing for design of antirecurrence antiarrhythmic therapy (AAT) in IHD patients. MATERIAL AND METHODS: 198 patients with IHD complicated by paroxysms of atrial fibrillation (AF) and atrial flutter (AFl) received AAT chosen at concurrent, frequent, volley UHF and slowly increasing UHF stimulation using transesophageal pacing. RESULTS: Slowly increasing UHF stimulation proved most effective both in detection and reproduction of induced paroxysms of AF and AFl. The duration of positive clinical effect of antirecurrence AAT of AF and AFl paroxysms in IHD patients determined at using this regimen of cardiostimulation averaged 3.1 +/- 0.3 years. Left atrial dilatation is an unfavorable prognostic criterion in respect to efficacy of the recurrence AAT. CONCLUSION: Slowly increasing UHF stimulation is most effective in determination of antirecurrence AAT of AF and AFl paroxysms in IHD patients.