Amur State Medical Academy

A blind comparative pilot study was conducted to evaluate the quality of simulation scenarios generated by generative artificial intelligence (AI) models compared to human-generated scenarios. The objectives of the study were to test the feasibility of generating scenarios by AI models, compare their quality with human-generated scenarios, and assess the ability of experts to determine authorship. Three models (Grok, ChatGPT and DeepSeek) were used to generate scenarios based on a standardized prompt, and the ROSOMED competition case served as the reference standard. Five independent experts evaluated four scenarios using the original scale of assessment of a simulation scenario (SASS). The ChatGPT scenario (average score of 3.4) outperformed the human scenario (2.9). The AI evaluator generally ranked the scenarios similarly to the human experts, but it showed bias towards its own work when self-evaluating.

Introduction . I n vivo model for experimental creation of the necessary pathological processes is an important element of scientific research planning. Numerous series of experiments have demonstrated the relevance of modeling oxidative stress in laboratory rats by exposure to hyperthermia, magnetic field and noise. The problem of finding the advantages of each particular prooxidant factor in modeling stress response underlies the current experiment, and its expediency is induced by the need to generate a robust response of the prooxidant/antioxidant system, with statistically significant changes of its parameters, at various periods of time. The study aims at conducting a comparative assessment of the effect of noise, hyperthermia, and magnetic field on the intensity of lipid peroxidation processes in rats. Materials and Methods. The study was conducted at the Research Laboratory of Amur Medical Academy in 2023–2024. The experiment involved 120 white rats divided into four equal in number groups. The animals in the first group (intact) were not subjected to any impacts; the animals in the second group (experimental group 1) were subjected to hyperthermia; the animals in the third group (experimental group 2) were exposed to magnetic field; and the animals in the fourth group (experimental group 3) were exposed to noise. On 7 th , 14 th , and 21 st days of the experiment the rats were decapitated (10 animals from each group) and their blood was sampled for analysis. Oxidative stress markers were determined using the standard techniques; the results were analysed using the Mann-Whitney and Kruskal-Wallis tests. The critical significance level was set to 0.05 for all assessment procedures. Results. With regard to the influence on the accumulation degree of conjugated dienes, statistically significant advantages of noise model over the magnetic field model were recorded (p=0.000005 on 14 th and 21 st days) and over hyperthermia model (p=0.002039 on 14 th day; p=0.001837 on 21 st day). With regard to malondialdehyde, noise exposure surpassed hyperthermia by the end of the experiment (p=0.000561). With regard to ceruloplasmin, the advantages of the noise model over hyperthermia model were established (p=0.0167980 on 7 th day; p=0.004813 on 21 st day), as well as over the magnetic field model (p=0.000005 at all control points). In relation to vitamin E, the noise model advantages over the magnetic field (p=0.000006 on 21 st day) were revealed. Discussion and Conclusions. Significant advantages of the noise-exposure model over the hyperthermia- and magnetic-field-exposure ones in modeling the oxidative stress were established, along with the respective changes in prooxidant/antioxidant system components. By the end of the first, second, and third weeks of the experiment, the statistically significant deviation of oxidative stress markers in laboratory animals occurred under exposure to noise, unlike exposure to temperature and magnetic field. In future, studies on the acoustic load influence on the adaptive potential of warm-blooded organisms are planned to probe possible pharmacological medications to negative influence of noise.

Aim. To evaluate the territorial features of the main incidence and mortality indicators for malignant lymphomas in the population of the Amur Region from 2014 to 2023. Materials and methods. This study used data from the official oncology service reports (Form 7, “Information on Malignant Neoplasms”) and mortality statistics from local branches of the Federal State Statistics Service, processed using standard oncology statistical software.Results. In the Amur Region in 2023, there were 17.7% more new cases of malignant lymphomas registered compared to 2022. The average statistical incidence rate in 2023 among men was 2.09 ± 0.26 per 100,000 population (p = 0.190) (vs. 1.48 ± 0.25 in 2020), representing a growth rate of +108.4% since 2014. In the female population during the same year, this indicator decreased to 2.08 ± 0.37 per 100,000 (p = 0.918) (vs. 2.34 ± 0.31 in 2020), with a decline rate of –54.3% since 2014. In the structure of classical Hodgkin’s lymphoma forms, nodular sclerosis (70.3%) and mixed cellular lymphoma (23.7%) prevailed. Due to limited capacity of the oncology service in 2020–2023 under the challenging conditions of the COVID19 spread in the studied area, no actively detected cases were registered. The patient accumulation index dropped to 7.2 in 2023 (vs. 10.8 in 2021). The proportion of patients with stage I–II malignancy increased to 19.5% (vs. 12.8% in 2014), as did the share of advanced disease (20.7% vs. 2.9% in 2014). The number of morphological examinations matched the national average (100%). The average mortality rate among men was 0.55±0.07 per 100,000 population (p = 0.352) (vs. 0.51 ± 0.09 in 2020), exceeding that of women, which was 0.42 ± 0.08 (p = 0.317) (vs. 0.93 ± 0.23 in 2020). The number of patients followed for 5 years or more increased to 68.5% (vs. 56.4% in 2014), while the proportion of patients dying within the first year after diagnosis also rose to 29.0% (vs. 27.1% in 2014).Conclusion. The insufficient level of preventive measures did not allow for more extensive active detection of malignant lymphomas between 2014 and 2023 and did not substantially improve the main indicators of medical care for this patient category in the region under study.

Two novel gold(iii) complexes with doubly protonated forms of phenanthrolines, (neocH2)[AuCl4]·Cl (1) and (1,7-phenH2)[AuCl4]·NO3 (2), were synthesized using the phenanthrolines.

In the 21st century, humanity has made a significant leap in the development of information and computational technologies, leading to the active advancement of artificial intelligence (AI). Initially, AI had primarily an entertainment character, but now technologies based on AI are actively being integrated into various professional fields. The Russian Federation is also increasing its research volume, including the application of these technologies in medical activities. This article examines some of the issues related to the active implementation and use of AI and AI-based products in medical practice in Russia. Literature data on existing legislation and legal practice are presented, along with discussions on ethical and deontological issues of AI use in medicine. Problems of information security and material-technical support are also highlighted. Based on the analysis conducted, we have formulated conclusions pointing to the controversial aspects of AI-based technologies' application in current medical activities. It is important to note that the authors do not oppose the integration of AI-based technologies into medical activities but have merely analyzed the problematic issues. The formulated conclusions and identified problems can help form a unified trajectory for the development and integration of AI into practical healthcare in Russia.

INTRODUCTION: Uveal melanoma (UM) is an oncological disease, which develops metastases mainly to the liver. One of treatments for this pathology is isolated hepatic chemoperfusion (IHCP). The implementation of this method requires surgical isolation of the liver from the systemic circulation and the use of a heart-lung machine. Due to a small number of observations of this treatment method in the world, the optimal vascular access for its implementation has not been determined so far. AIM: To analyze the in-hospital results of IHCP in patients with UM metastases performed from three different vascular accesses. MATERIALS AND METHODS: Over three years, 38 IHCP procedures were performed of the Kostroma Clinical Oncological Dispensary. Depending on the vessels into which the cannula for perfusion with Melphalan was inserted, patients were divided into 3 groups: group 1 with cava-porto-arterial access (perfusion into the inferior vena cava, portal vein, and common hepatic artery), n = 14; group 2 with cava-arterial access (perfusion into the inferior vena cava and common hepatic artery), n = 21; group 3 with a forced access, n = 3. The study took into account major complications: death, bleeding; and minor complications: tumor lysis syndrome, abscess of the left lobe of the liver, peritonitis, a systole, deep vein thrombosis of the lower limbs, hydrothorax, acute liver failure, anasarca, polyserositis, ischemic cholangiopathy, thrombosis of the common hepatic artery, detachment of the common hepatic artery intima. A combined endpoint was the achievement of at least one of the listed complications. In case of several complications in one patient, they were not summed up and were considered as ‘1’. RESULTS: In the postoperative period, the highest number of bleedings including those requiring revision, was noted in groups 1 and 3. The combined endpoint in the total sample made 42.11% and was lowest in group 2. Fatal outcomes were recorded in 3 cases (2 in group 1 and 1 in group 2), and were caused by increasing liver failure. CONCLUSION: The lowest number of complications IHCP was identified with cava-arterial access. Further continuation of the study is necessary to investigate the immediate and remote outcomes of IHCP.

IntroductionCarotid endarterectomy (CEA) is a surgery aimed at removing atherosclerotic plaque from the carotid artery. There are classical and eversion CEA techniques. The eversion technique is the most popular because it does not require the use of implants. Eversion CEA is also associated with a lower risk of restenosis in the late postoperative period. During the surgery, the carotid artery is clamped and blood flow to the brain comes from the contralateral carotid artery and vertebral arteries. However, if the circle of Willis (COW) is not closed, compensatory mechanisms for protecting the brain are reduced, which can lead to the development of an intraoperative stroke.PurposeTo analysis of in-hospital and long-term CEA outcomes in patients with different types of closed and non-closed COW.MethodsThis is a multicenter Russian study. In the period from 2010 to 2020. 641 eversion CEA were performed. Depending on the type of structure of the COW, six groups of patients were formed: Type 1 - Closed posterior part (CRS) - in the presence of the posterior communicating (PCOMA) and P1 segment of the posterior cerebral (PCA) arteries; Type 2 - Intermediate type of structure of the posterior part (ISRP) - with hypoplasia of PCOMA or PCA; Type 3 - Open back part (OBP) - in the absence of PCOMA or PCA; Type 4 - Closed anterior part (CFS) - in the presence of the anterior communicating artery (ACOMA) and the A1 segment of the anterior cerebral artery (ACA); Type 5 - Intermediate type of anterior part structure (IFPS) - with ACOMA or ACA hypoplasia; Type 6 - Open Front Section (OFS) - in the absence of ACOMA or ACA. The long-term follow-up period was 107.3 ± 14.6 months. The end points of the study were death, ischemic stroke, transient ischemic attack (TIA), myocardial infarction (MI), ICA thrombosis, hemodynamically significant restenosis of the internal carotid artery, bleeding, and combined endpoint (death + ischemic stroke + TIA + MI).The type of distribution was determined using the Kolmogorov-Smirnov criterion. Group comparisons were performed using the Kruskal-Wallis and Pearson chi-square tests. Differences were assessed as significant at p < .05. According to clinical and demographic characteristics, the majority of patients were male and elderly. In 20% of cases, patients had a history of MI and/or stroke/TIA. Diabetes mellitus was diagnosed in 10%. There were no significant differences between groups in EuroSCOREII.ResultsIn the long-term postoperative period, the largest number of deaths occurred in groups 5 and 6 (13 (45.1%) and 12 (30.1%)). The majority of strokes were diagnosed in groups 3 (OBP) and 5 (IFPS) (7 (13.5%) and 9 (17.6%)). The highest value of the combined end point (death + stroke/TIA + MI) was obtained in groups 3 (OBP), 5 (IFPS), and 6 (OFS) (23 (44.2%), 26 (50.1%), and 23 (58.9%)).ConclusionThe eversion technique of carotid endarterectomy for carotid artery stenosis is the most preferred. The greatest number of complications of eversion CEA in the hospital and long-term follow-up periods is observed in patients with OBP, IFPS, and OFS. In the presence of an unstable plaque, a temporary shunt can be used, which will exclude the pharmacological increase in blood pressure and the associated risk of embolization.

Conventional radial access in endovascular surgery has certain limitations, primarily associated with the presence of local complications and radial artery occlusion. Over the past 7 years, distal radial access has exploded into all areas of endovascular procedures, from interventional cardiology to vascular surgery and interventional oncology. However, puncture of the distal radial artery has its own nuances and features: a learning curve, the use of ultrasound navigation in the initial stages of mastering the access, limitations in patients with acute conditions (acute coronary syndrome and stroke). This review aims to analyze on important aspects of the procedure of distal radial access from preparation for it to hemostasis and to explore all data about the new roles of distal radial access in avoiding but also treating radial artery occlusion, as the first thing to begin with the development and implementation of new access.

Aim. To evaluate changes in immunity in the second trimester of pregnancy in women with exacerbation of bronchial asthma associated with reactivation of cytomegalovirus infection (CMVI).Materials and methods. The concentration of secretory immunoglobulin A (sIgA), immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM) and circulating immune complexes (CIC) was studied in 112 women at 21-24 weeks of uncomplicated pregnancy and pregnancy complicated by exacerbation of mild-to-moderate asthma associated with CMVI. The first group included 30 women seronegative for CMV, with an uncomplicated pregnancy. The second group consisted of 30 patients with exacerbation of mild asthma, initiated by the acute phase of CMVI, which induces the development of chronic compensated placental insufficiency. The third group consisted of 27 patients with moderate asthma in the acute stage against the background of the acute phase of CMVI, leading to the formation of chronic compensated placental insufficiency. The fourth group included 25 patients with exacerbation of moderate asthma with CMV etiology, initiating the development of chronic subcompensated placental insufficiency.Results. In women of the second group, the concentration of sIgA was 5.91±0.371 mg/L, IgA – 2.64±0.089 mg/mL, IgG – 15.4±0.791 mg/mL, IgM – 2.32±0.144 mg/mL, CIC – 0.176±0.004 optical density units (in the first group, respectively, 4.31±0.266 mg/L, p&lt;0.001; 2.37±0.06 mg/mL, p&lt;0.05; 13.3±0.293 mg/mL, p&lt;0,05; 1.11±0.06 mg/mL, p&lt;0.001; 0.092±0.005 optical density units, p&lt;0.001). In patients of the third group, in contrast to the second one, no differences in immunity parameters were detected. In the fourth group, in comparison with the third one, lower parameters of sIgA (3.21±0.213 mg/L, p&lt;0.001), IgA (1.43±0.081 mg/mL, p&lt;0.001), as well as higher IgG values were detected (19.8±0.418 mg/mL, p&lt;0.001), IgM (2.94±0.082 mg/mL, p&lt;0.01) and CIC (0.198±0.005 optical density units, p&lt;0.05).Conclusion. In patients with moderate asthma with exacerbation against the background of CMVI reactivation, which initiates the formation of chronic subcompensated placental insufficiency, in contrast to women with moderate asthma in the stage of CMVI exacerbation in the second trimester of pregnancy, leading to chronic compensated placental insufficiency in the third trimester of gestation, a more pronounced imbalance of humoral immunity and autoimmune disorders are found, which are important in the development of chronic placental dysfunction.

The research was carried out in order to study the molecular mechanisms of herbicide binding (pinoxaden, quizalofop-P-tefuril, prometrin, metribuzin, metsulfuron-methyl) with target proteins (acetyl-CoA-carboxylase, acetolactate synthase, cytochrome P450, 4-hydroxyphenylpyruvate dioxygenase) of weeds growing in Siberia: common wild oat (Avena fatua L.), couch grass (Elymus repens (L.) Gould), red-root amaranthus (Amaranthus retroflexus L.), white gauze (Chenopodium album L.), and green foxtail (Setaria viridis (L) P Beauv). The study was carried out in Novosibirsk oblast in 2022–2023. Using the bioinformatic methods, virtual three-dimensional complexes of pesticides and their targets have been created. A new approach to identifying the parameters of the cavity of binding sites is proposed, which consists in combining the alignment method and the machine-learning technology. Docking of pesticides with targets has been carried out. Calculation of the binding energy indicates a high degree of stability of the ligand-protein complexes. The proposed in silico approach may be useful for elucidating the behavior of herbicides when bound to weed enzymes. This approach allows a deeper understanding of the mechanism of action and ecotoxicological aspects of pesticide use. The complexes of herbicides and proteins involved have a potential high stability due to the low energy of binding to receptors, which varies from –5.60 to –13.24 kcal/mol. The value of the binding energy has not shown a direct dependence on the number of amino acid residues of the ligand-binding site. In general, the study has complemented some aspects of the molecular mechanisms of herbicide binding to weed target proteins; however, more in-depth study is required in order to localize critical amino acid points involved in the biological functions of target proteins.