Introduction. The main method of varicose vein disease treatment is surgical intervention. At the same time, there is a rather large group of patients who postpone surgical treatment indefinitely. In this situation, conservative measures come to the fore, the key one among which is compression therapy.

Aim. Study of the immediate effect of compression therapy on venous outflow from the lower extremities in patients with varicose veins and the medium-term results of medical knitwear classes 1 and 2.

Materials and methods. The study enrolled 64 patients (mean age 28.3 ± 2.2 years, mean BMI 25.3 ± 4.1) with large saphenous vein reflux to the upper third of the tibia. Blood flow return time and pump force were measured while walking without and with zero, class 1, and class 2 compression knitted garments on.

Results and discussion. On photoplethysmography return times without and with zero compression were 18.4 ± 2.2 s and 18.9 ± 1.4 s (p = 0.62), tibial venous pump strength was 3.6 ± 0.3% and 3.4 ± 0.2% (p = 0.57). Wearing a class 1 knitwear significantly increased return time and lower leg muscle venous pump strength to 21.6 ± 1.9 sec and 6.2 ± 1.8% (p < 0.001). Grade 2 knitwear increased return blood-flow time and tibia musculo-venous pump strength to 28.2 ± 2.6 sec and 12.3 ± 1.6%, which was significantly higher (p < 0.001). Global quality of life index according to CIVIQ-14 at baseline and follow-up was 44.3 ± 4.6 and 17.8 ± 3.6 points respectively (p < 0.001) in the class 1 group. Compression Class II had a mean value of 45.1 ± 3.9 and 18.1 ± 4.3 (p < 0.001).

Conclusion. In summary, the RAL class 2 standard compression knitted fabric shows better immediate correction of lower leg muscle venous pump function in patients with primary varicose veins compared to the class 1 compression knitted fabric. In the mid-term followup there were no differences in the elimination of initial venous specific symptoms and in the improvement of the global quality of life index between class I and class II knitwear.

Introduction. Treatment of thrombophlebitis should be complex and, along with mandatory compression, include both systemic and local use of drugs.

Aim. To evaluate the efficacy and safety of the standardized use of the combined drug indomethacin/troxerutin in gel in real clinical practice in the treatment of superficial vein thrombophlebitis.

Materials and methods. The study included 71 patients with varicose veins complicated by superficial vein thrombophlebitis. In group I patients (n = 35), topical drugs were not used. In group II patients (n = 36), combined drug indomethacin/troxerutin in gel was used daily. The drug was applied to the skin of the lower extremities three times a day, 4–5 cm of gel. Its total daily amount did not exceed 20 cm of gel. The observation period was 10 days. A dynamic scoring of clinical symptoms was performed using a linear analog scale and thermometry of the skin of the lower extremities.

Results. On day 10, patients of the main group showed a statistically significant decrease in thermographic parameters in the area of thrombophlebitis: Tmin – 33.23 ± 0.12 °C, Tmax – 39.86 ± 0.24 °C, Tmean – 40.01 ± 0.16 °C (p ≤ 0.05). When assessing the symptoms of thrombophlebitis using a linear analog scale after 10 days of treatment, there was a general decrease in the number of points in the control group to 16.4 ± 0.12 and in the main group to 12.3 ± 0.16 points (p ≤ 0.05).

Conclusion. Combined drug indomethacin/troxerutin in gel is an effective and safe combined drug for the treatment of patients with thrombophlebitis of the superficial veins of the lower extremities.

Among patients with varicose veins, superficial vein thrombophlebitis occurs in 4–59% of patients. Unfortunately, despite the large number of published official sources with recommendations for the treatment of vein thrombophlebitis in our daily clinical practice, we continue to meet not just with casuistic cases, but because of their absurdity, which are beyond reasonable understanding (the appointment of leeches, c auterization of veins with celandine, alcohol compresses and lotions with dimexide). This clinical case report describes the case of a 65-year-old patient who initially sought medical help from a local therapist due to the appearance of a single seal and hyperemia in the upper third of the lower leg. For two weeks, the patient tried to independently stop the inflammation with alcohol compresses. Due to the lack of a positive effect, the district therapist prescribed antibiotics and warming compresses with combined nonivamide/nicoboxil ointment. Two weeks later, with the progression of inflammation and multiple purulent wounds on the background of necrosis foci throughout the inner surface of the entire lower limb, the patient turned to our medical center. As a result, it took us more than two months to stop the inflammation and heal extensive purulent wounds with secondary tension. Treatment of vein thrombophlebitis in varicose veins has been developed in detail for a long time and in detail. The tactics of using conservative means and operational benefits depend on the localization, prevalence, acute or chronic course of the disease. The purpose of this publication is to focus the attention of specialists of a wide profile on a specific example from practice on the choice of methods of treatment of vein thrombophlebitis.

Venous trophic ulcers take place in the terminal stage of chronic venous insufficiency. The problem of venous trophic disorders is extremely relevant due to the high prevalence among the population. This review considers the comparative characteristics of morbidity data on the example of Germany and the Russian Federation. Particular attention paid to the influence of the course of the disease on patient’s life quality during treatment. The causes of high-cost treatment are reported with approximate calculations for 1 clinical case and total annual costs according to foreign researchers (Australia, Great Britain, USA). The risk factors are discussed in the form of certain concomitant nosologies that significantly aggravate the healing process of ulcers with a brief description of the pathogenesis. The review defines the main goals of the treatment of venous trophic ulcers, as well as separate groups of directions in which it is reasonable to carry out therapeutic measures. Article presents a comparative analysis between the methods of applying compression therapy (elastic bandaging, the use of special stockings) and the influence of the choice on the quality of life of patients. Various methods of topical wound care are described with the obligatory consideration of the stage of the wound process, alternative methods of local treatment are listed (for example, the use of autologous platelet-rich plasma). The efficacy of systemic pharmacotherapy in trophic disorders and the treatment potential of various groups of drugs on the rate of ulcer healing were evaluated. The advantages of using surgical treatment are determined, the main surgical techniques are listed, highlighting the advantages and disadvantages of each. Possible treatment strategies for elderly patients also discussed. The complexity of evaluating the effectiveness of new techniques and an integrated approach to treatment is shown, which in the future will help to correct the direction of finding new ways to solve the problem of venous ulcers in this specific group of patients.

Introduction. For revascularization in the absence of autovenous material, epoxy-treated bioprostheses from the bovine internal mammary artery are widely used in the Russian Federation, which are subjected to certain structural deformations.

Purpose and objectives. To compare the structural changes of the biological prosthesis and autovenes in the long-term period after surgery and to determine the influence of some clinical and laboratory parameters on this process.

Materials and methods. The study included 45 patients with isolated occlusion of the superficial femoral artery (PBA), who underwent blood flow restoration using various types of prostheses. The patients were divided into 2 groups: group 1 (main) – 25 patients who underwent femoral-popliteal proximal bypass surgery with epoxy-treated bioprostheses from the bovine internal mammary artery; group 2 (control) – 20 patients who underwent femoral-popliteal proximal bypass surgery with a reversed autovena.

Results and discussion. During the follow – up period from 1 year to 8 years, 28% of bioprostheses underwent expansion, and 20.0% of patients with autovena showed narrowing of the shunt. In the main group, males had better biological graft patency (RR = 0.76 CI (0.3 2; 1.77)), but in the control group, the male sex increased the risk of occlusion (RR = 1.25 CI (0.18; 8.77)). When followed up for 5 years, the relative risk of prosthetic expansion decreased. At the same time, in patients of the control group, which is not characterized by ectasia, we revealed a decrease in the relative risk of stenosis. The clinical factor affecting the expansion of the biological prosthesis was type 2 diabetes mellitus.

Conclusions. The characteristic structural changes in the separated period (more than a year) for an autovenous conduit are narrowing, and for a biological prosthesis – expansion with the formation of aneurysms.

Introduction. An alternative way in the treatment of intermittent claudication is the use of genetic engineering technologies that lead to the stimulation of their own vasculogenesis in ischemic limbs. Treatment is carried out on an outpatient basis.

Purpose: to present the results of complex conservative treatment using a drug based on a plasmid with the VEGF165 gene in patients with grade II CINI according to the Fontaine – A.V. Pokrovsky classification for 7 years after one course of gene therapy.

Materials and methods. From 2009 to 2015, 50 patients were treated. Men – 41, women – 9. Average age 64.3 ± 10.5 years. All patients received basic therapy for atherosclerosis. In addition, a 1.2 mg gene preparation was injected twice into the muscles of the ischemic limb. The preservation of the limb, the survival rate of patients, the change in the distance of painless walking according to the treadmill test were assessed.

Results and discussion. The safety of the limb after 7 years was 94%, the survival rate was 80%. Significant and moderate clinical improvement was noted in 68% of cases, satisfactory result – 6%, deterioration – 2% of patients. Only in 6% of cases there was an unfavorable outcome associated with the progression of chronic limb ischemia. All patients showed good tolerance to the drug and no side effects. Continuous conservative treatment of patients with peripheral atherosclerosis is the key factor preventing rapid progression of the disease. There is high requirement for the development of new areas of the combination treatment, which would lead to compensation of blood circulation in the extremities in peripheral atherosclerosis. The provided innovative treatment method with widespread introduction into outpatient practice will improve the quality of life of patients with intermittent claudication.

Conclusions. Long-term results of treatment of patients with grade II CINI using gene therapy have been demonstrating high efficiency for 7 years. The presented innovative method of treatment, with its widespread introduction into outpatient practice, will improve the quality of life of patients with intermittent claudication by increasing the passable distance without pain in the legs, reduce the risk of ischemia progression, and minimize the burden on the healthcare system.

The article discusses the treatment of osteoarthritis (OA). In recent decades, ideas about the pathogenesis of OA have undergone significant changes. If at the dawn of the study OA was presented as a degenerative process associated with age, now that some immunological and genetic aspects of the disease have become known, the idea of the pathogenesis of OA has changed. Currently, there are clinical guidelines developed by professional communities that define approaches to the diagnosis and treatment of patients with OA. In Russia, the Association of Rheumatologists and Orthopedic Traumatologists in 2021 developed clinical guidelines for the management of patients with gonarthrosis and coxarthrosis, but currently no clear consensus has been developed in any of the treatment recommendations regarding the use of nutraceuticals and dietary supplements. While according to published studies of plant and botanical nutraceuticals developed from natural products, promising data on efficacy compared to placebo drugs and their potential for the treatment of patients with OA have been demonstrated. According to a study conducted by N.E. Lane et al., patients with OA regularly use supplements, as well as over-the-counter products in combination with prescription drugs, and the likelihood of using prescription products increases with increasing duration and severity of OA. And currently there is not enough knowledge and information about the possibilities of additional use of nutraceuticals in the treatment of patients. The article discusses the composition of the biologically active additive, which has anti-inflammatory, anti-catabolic and antiproliferative effects and can be considered as an addition to NSAIDs, chondroitin sulfate, glycosamine (sulfate or hydrochloride) and their combinations in OA. Type II collagen peptide, curcumin (curcuminoids 95%), black pepper extract (piperine) and Boswellia pilchata extract in clinical studies have demonstrated efficacy and safety in the treatment of patients with OA. A number of studies have also found a number of pleootropic effects. Effects such as anti-inflammatory, neuroprotective, immunomodulatory, cardioprotective and antitumor effects will be important in patients with comorbidity.

Introduction. The effectiveness of the treatment of hemorrhoidal disease is based on the frequency of recurrence of hemorrhoid symptoms, the development of early and late postoperative complications, as well as the degree of patient satisfaction with the results of treatment. However, such an indicator as quality of life, which reflects the health of the patient, is not taken into account.

Aim. Obtaining data on the influence of the method and type of treatment on the quality of life of patients suffering from acute or chronic hemorrhoids.

Materials and methods. The analysis of the influence of the treatment method on the quality of life of patients suffering from acute or chronic hemorrhoids was carried out. The analysis included 1032 patients with stage I–IV hemorrhoids. The age of the patients was 44.8 ± 13.0 (18–94) years. The study included 509 (49.3%) men and 523 (50.7%) women.

Results. Quality of life indicators before treatment in all groups are within the reference values, which is associated with adaptation of patients to the disease. After treatment, quality of life indicators naturally increase. However, in patients after hemorrhoidectomy, regardless of the nature of the technique, quality of life indicators are significantly lower than in patients of groups 1 and 2.

Conclusions. Quality of life indicators in all groups before treatment are within the reference values and do not have statistically significant differences in the considered indicators. After the treatment, there is a statistically significant increase in the quality of life indicators in all scales. After hemorrhoidectomy, regardless of the nature of the technique, quality of life indicators are significantly lower than in patients of groups 1 and 2, which is associated with surgical trauma. Since the groups of patients are heterogeneous in terms of the stages of the disease, it can be assumed that for each stage of hemorrhoids, there is a subjective perception of the disease, which can be reflected in the quality of life indicators, which requires additional analysis of the results obtained.

This paper highlights the problem of chronic constipation, their epidemiology, etiology, clinical features in some concomitant diseases, diagnostics and approaches to therapy with a focus on sodium picosulfate preparations. Based on several scientific papers, an analysis of a group of sodium picosulfate preparations was performed, indications, dosage, efficacy and possible side effects were considered. The paper also provides a clinical example of managing a patient with chronic constipation. Who received therapy with sodium picosulfate. Constipation is a violation of the act of defecation less than 3 times a week or more than three days. At the same time, it is possible to say about chronic constipation if such symptoms persist for 6 months. To date, the discussion about constipation as a nosological unit continues. The study of the epidemiology of constipation in various scientific sources indicates the wide spread of this disease. The diagnosis of “Constipation” is based on the Rome Criteria IV adopted in 2016. By origin, constipation can be primary and secondary, and among the factors provoking them are not only gastroenterological diseases, but diseases of other organ systems, as well as environmental factors and the intake of certain groups of medicines. Therapy of chronic constipation is carried out both medicamentally and non-medicamentally (surgical methods today have no proven effectiveness). The analysis of sodium picosulfate preparations proved their effectiveness and safety, which was also noted in our clinical case.

Introduction. Sphincterotomy is a pathogenetically justified method of surgical treatment of chronic anal fissures with spasm of the sphincter, but the risk of anal incontinence can reach 44%. Therefore, other methods are being sought to eliminate spasm of the sphincter, and the greatest interest is the medical relaxation of the internal sphincter.

Aim. To determine the efficacy and limitations of the use combined preparation in the form of a gel of 0.3% nifedipine and 2.0% lidocaine for the treatment of chronic anal fissure.

Materials and methods. All patients included in the study were recommended to apply gel 2 times a day with an interval of 12 hours on the skin of the anus and inside the anal canal. In total, the results of treatment of 40 patients were analyzed.

Results. Before the start of treatment, the average pain during defecation was 5 (4.5; 7), on the third day of treatment – 4 (4; 5), and on the 10th day – 2 (2; 3). By day 10, 80% (32) of patients refused to take painkillers. On day 21, complete epithelialization was observed in 31 (77.5%) patients. The average healing time of anal fissures was 17 ± 3 days. In patients with complete epithelization of anal fissures, according to the results of EMG on the 21st day of therapy, spontaneous wave activity was absent. In 9 patients, despite the reduction of pain, sphincter spasm persisted after therapy and cracks in the anal canal did not heal.

Discussion. When analyzing the reasons that led to the ineffectiveness of the use of gel, it was revealed that in all cases, according to ultrasound studies, there were fibrous changes in the internal anal sphincter.

Conclusion. Summarizing the above-mentioned, we can state that the use of a fixed-dose combination of 0.3% nifedipine and 2.0% lidocaine is effective for the treatment of chronic anal fissure with sphincter spasm.

Introduction. The use of traditional anti-inflammatory and local anesthetic preparations during the non-surgical treatment of acute hemorrhoids is liable to cause the progression of serious side effects in patients.

Purpose of the study. To evaluate the clinical efficacy of homeopathic ointment as the topical preparation in the complex treatment of patients with acute hemorrhoids on the outpatient settings.

Materials and methods. The comparative analysis of the results of the non-surgical treatment was conducted and applied to 48 patients with acute hemorrhoids of 1–3 degrees, who were divided into two groups. In 23 patients (control group), traditional non-surgical treatment was conducted without the use of topical preparations. In 25 patients (the main group), traditional preparation therapy was supplemented with local treatment using homeopathic ointment.

Results. In the patients of the main group, a faster regression of pain syndrome and other manifestations of the disease (itching, burning and discomfort in the anal canal, perianal edema) was noted in the dynamics of treatment, and higher values of quality of life parameters were recorded than in patients of the control group. In the main group, good and satisfactory treatment results were obtained in 23 (92.0%) patients, unsatisfactory – in 2 (8.0%) patients. In the control group, good and satisfactory treatment results were observed in 18 (78.3%) patients, unsatisfactory results – in 5 (21.7%) patients.

Discussion. The maximum therapeutic effect with topical application of ointment was observed in patients with acute hemorrhoids of 2–3 degrees, the disease in which proceeded with a pronounced inflammatory-allergic component.

Conclusion. Our results allow us to consider homeopathic ointment as an alternative topical preparation in the non-surgical treatment of acute hemorrhoids in outpatient settings in patients with serious contraindications to the use of traditional topical preparations.

Introduction. Varicocele is a testicular varicose vein caused by pathological venous reflux. It is most common in infertile men. Clinically, varicocele is found in 15% of the male population, while in 35% of men with primary infertility and in 70–81% of men with secondary infertility. Varicocele, not accompanied by pain, is the most common cause of the development of pathospermia and infertility. Varicocele is detected at the age of 10 years in 1% of boys, increasing to puberty up to 15%. At the age of 50–80 years, the incidence of varicocele increases to 75–77.3%, thus adding an average of 10% every 10 years of life.

Aim is to investigate the fertility restoration after surgical procedures and the prognostic criteria for its restoration depending on age and the proposed medical rehabilitation.

Materials and methods. In the urological hospital for a short stay of the state autonomous healthcare institution of the Stavropol Territory “Regional Clinical Specialized Uro-Andrology Center” from 2011–2019. 1143 varicocelectomies were performed (244 laparoscopic varicocelectomy, 975 microsurgical varicocelectomy). The study is based on a comparative analysis of the results of examination of 100 patients with pathospermia and varicocele in the period from 2011 to 2019, who received surgical treatment and did not have concomitant pathology. All patients were followed up for 18 months after surgery.

Results and discussion. The pain syndrome was stopped in 100% of cases in the studied patients. Progression of hypotrophy of the left testicle in the postoperative period was not detected. Relapses and other complications were not noted. Patients in the control group were also observed for 1.5 years with an interval of 6 months. Deterioration of spermatogenesis in this group was not detected.

Conclusions. It was revealed that varicocele was the main cause of spermatogenesis and fertility disorders in the studied groups. Surgical treatment is a pathogenetically grounded and statistically proven method of restoring fertility in varicocele. After varicocelectomy, adequate medical rehabilitation allows to normalize the qualitative and quantitative parameters of sperm in most clinical cases as soon as possible (up to 3 months).

Introduction. Nowadays radiological diagnostics dives particular attention to the research of the pelvic veins in women. Absence of diagnostic criteria for identifying norms do not make it possible to establish the initial disease manifestations. It is also not sufficient enough to make a proper forecast about the formation of pelvic varicose veins.

Objective: To study the ultrasound criteria of diagnostic parameters of pelvic veins in women of reproductive age without stated venous pathology.

Materials and methods. This research examined 80 young, relatively healthy nulliparous women. The ultrasound criteria of diagnostic parameters of the following veins such as the left renal vein, ovarian veins, cluster-shaped and uterine veins, the angle between the aorta and the superior mesenteric artery, elasticity indices of the common femoral and popliteal veins were studied. Profound data analysis revealed that all patients had significant differences in the left renal vein indices. Based on this data 2 groups were formed: Group 1 (mean age 25.00 ± 3.31 years) 60 people, quite homogeneous according to the studied indices; Group 2 (mean age 24.25 ± 2.61 years) 20 people, quite heterogeneous according to the studied indices. Ultrasonography (Ultrasound examination) was performed using Logiq E9 (GE, USA) and AIXPLORER Super-Sonik Imagine, with convex, endovaginal, and linear sensors. Statistics processing was accom-plished using the StatSoft Statistica 10 software package.

Results. In the general sample of patients, positive correlations were found for the following pelvic veins: ovarian veins on both sides, and cerebellar veins on the right side; and cerebellar and uterine veins on the right side. The results of the studied ultrasound parameters in Groups 1 and 2 showed that they differ significantly (p < 0.05). Almost all diagnostic parameters in Group 2 were significantly higher (p < 0.05), all women had anatomical aorto-mesenteric pincer.

Conclusion. Ultrasonography of pelvic veins provides information on the anatomical-functional and hemodynamic state of the veins. That is important for prognostication of pelvic varicose veins and revealing asymptomatic forms of this disease.

Introduction. The involvement of pathological segmental venous hypervolemia of the lower leg in patients with varicose veins in the formation of chronic venous insufficiency (CVI) is an established fact, however, objective criteria for this pathohemodynamic phenomenon have not been definitively determined today.

The purpose of the study. Determination by air plethysmography (APG) of the degree of functional disorders in the limb and establishment of significant criteria characterizing pathological segmental hypervolemia of the lower leg in patients with CVD of various clinical classes according to CEAP.

Materials and methods. For the period from 2002 to 2019, 380 healthy individuals with no symptoms of chronic venous diseases and 896 patients with CVD were examined with the use of APG, with their distribution in accordance with the CEAR international classification as follows: C0–C1, C2–C3, C4–C6 clinical classes. To assess the intensity of venous blood flow, the following values were calculated: the maximum capacity of the leg veins (Venous Capacity – VC), the volume of their evacuation (Evacuation Volume – EV) for a set time, the maximum venous outflow (Maximum Venous Outflow – MVO), the ratio of these values on both limbs (Venous Capacity Index – VC1, Evacuation Volume Index – EVI, Maximum Venous Outflow Index – MVOI).

Results. The most statistically significant and conjugate correlation data were obtained (expectation, mean square deviation, standard error of expectation, median and coefficient of variation) during the analysis in groups according to the characteristic VCI.

Discussion. The obtained results allowed us to assert that APG is an informative functional method for diagnosing hemodynamic disorders in patients with lower limb CVD.

Conclusion. The established criteria of the venous capacity index will allow in practice to give an objective characterization of the degree of change in hemodynamic disorders in patients with CVD before and after the treatment undertaken.

Introduction. Over the past decade, thermal tumescent (TT) ablation became the “gold standard” treatment of varicose veins. Non-thermal non-tumescent (NTNT) methods emerged in response to minimize the interventional invasion.

Aim. To evaluate the two-year results of cyanoacrylate adhesive closure (CAC).

Methods. Between July 2019 and July 2021, CAC was performed in 457 patients (average age 57.8 ± 15.7 years), on 634 limbs and 725 saphenous veins. Patient distribution according to CEAP was: C2 – 38%; C3 – 37%; C4 – 19%; C5 – 4%; C6 – 2%. The inclusion criteria were: incompetence of sapheno-femoral/popliteal junction and axial reflux > 0.5 sec, diameter of saphenous trunk > 6 mm, presence of varicosities. CAC was performed according to the protocol of the American Vein Closure System In more than 2/3 of cases (76.2%), CAC was performed selectively without tributary treatment . The pain was assessed by visual-analogue scale (VAS). The control ultrasound was performed on the 3rd day, 1, 3, 6, and 12 months post-intervention.

Results. Anatomical success was achieved in 100%. The VAS pain score was < 3 in 93% of patients. Partial recanalization occurred in 4 (0.6%) patients. Distal deep vein thrombosis was detected in 2 (0.3%) patients, migration of glue – in 7 (1%) patients, phlebitislike skin reaction – in 50 (11%), superficial thrombophlebitis – in 20 (4.4%) and soft tissue granuloma at the access site was diagnosed in 6 (1.3%) patients.

Conclusion. CАC is a highly effective and safe treatment method with 99.4% occlusion rate in s. two-year follow-up period.

Introduction. In recent years, there has been an increase in the number of patients with purulent surgical diseases with severe endogenous intoxication and renal dysfunction. The problem of early diagnosis of purulent diseases is still not completely solved. The health systems of developed industrial Western countries do not always manage to provide all citizens with adequate high-quality medical care. This is due to the current health crisis. The problems of diagnosis, treatment, prevention and prediction of purulent diseases in surgery can be solved thanks to advanced digital technologies.

Aim of the study. To develop a diagnostic method for early detection of endogenous intoxication in outpatient surgery.

Materials and methods. We created three groups of observations for the design of a neural network system for the diagnosis of endogenous intoxication syndrome and chronic kidney disease. In the first group, the hematological parameters of 150 healthy people were studied. In the second group, the hematological parameters of 40 patients with chronic kidney disease without chronic kidney failure were studied. The third group included 84 patients with chronic kidney disease and end-stage chronic kidney failure. The following 25 laboratory parameters were studied: hemoglobin, red blood cells, color index, white blood cells, rod-shaped neutrophil white blood cells, segmental neutrophil white blood cells, eosinophils, basophils, lymphocytes, monocytes, ESR, total protein, albumins, urea, creatinine, bilirubin, beta-lipoproteins, cholesterol, glucose, seromucoid, sialic acid, potassium, sodium, chlorine, calcium. Statistical, neural network and algorithms with elements of fuzzy neural networks were used on a sample consisting of hematological parameters of 274 patients with chronic kidney disease and healthy ones based on 25 laboratory parameters. Mathematical modeling was carried out at the Department of “Computer Technologies” of the Penza State University.

Results. The effectiveness of neural network diagnostics of endogenous intoxication syndrome in patients with chronic kidney disease without chronic kidney failure reached 88.2%, and in patients with chronic kidney disease and chronic kidney failure – 97.6%.

Conclusion. The neural network method of diagnosis can help improve the early diagnosis of endogenous intoxication syndrome in outpatient surgery. 

Introduction. Currently, one of the important problems in surgery is the search for new markers of the inflammatory process to determine the prognosis of the disease, substantiate the need for surgical intervention and to assess the effectiveness of treatment.

Aim. To evaluate the possibilities and prospects of using modern markers of the inflammatory process in the practice of a surgeon.

Materials and methods. In the course of the present investigation we analyzed relevant sources of domestic and foreign literature on the topic of application and possibilities of use of modern inflammatory process markers in various fields of medicine. Information was collected from databases of ScienceDirect, Cyberleninka.ru, and PubMed.

Results. Acute phase proteins, as markers of inflammation, are valuable tools in the diagnosis, treatment and prognosis of inflammatory diseases, as they are sensitive to systemic inflammation. Important criteria for the use of biomarkers of inflammation are: a low number of false positive results and the possibility of using the marker not only as an indicator of the disease, but also to determine the severity of the patient’s condition. In order to assess the presence of inflammation in clinical conditions, laboratories evaluate the concentrations of various acute phase proteins in plasma. Currently, the most relevant markers of inflammatory processes are: C-reactive protein; haptoglobin; presepsin is also an early indicator of inflammation; fibrinogen; serum amyloid A; a complement system containing key markers of inflammation. Determining them in the surgeon’s practice will allow you to predict the outcome of the disease and evaluate the results of treatment.

Conclusion. At the moment, the determination of inflammatory markers helps in predicting the disease, planning treatment tactics, evaluating the effectiveness of therapy after surgery and in earlier diagnosis of severe conditions.