In the end of the year 2019 there was an outbreak of the new coronavirus infection with the epicenter in China, Wuhan (Hubei province). On 11th of February WHO defined an official name of the infection generated by new coronavirus – COVID-19 (COronaVIrus Disease 2019). On the 11th of February the International Committee on Virus Taxonomy assigned the name to the causative agent – SARS-CoV-2. The emergence of the COVID-19 set the task to the medical specialists connected with the fast diagnostics and providing medical treatment to the patients. Currently the intensive study of the clinical and epidemiological peculiarities of the disease, the development of new ways of prevention and treatment is the ongoing process. In this article the results of the morbidity and death rates connected with COVID-19 of the patients having cancer in Primorskiy region from 31st of March to 31st of August 2020 are introduced.

Radiation therapy is an integral component of the treatment of breast cancer. Although its implementing after breast reconstruction sufficiently increases the number of complications, particularly capsular contractures. After having analyzed published materials and meta-analysis research the authors made a conclusion – if a patient is planned to have a breast reconstruction, it’s better to make it with her own tissue. On the other hand the risk of capsular contractures development significantly decreases when using acellular matrix and polyurethane shell to cover the implant. This fact gives hope that conflict between breast reconstruction and the necessity of the radiation therapy can be solved.

There is progress in applying photodynamic therapy in cancer clinic during the last decade. The promising direction to develop this way of treatment is the use of photosensitizers with given characteristics. It is based on a local activation of a photosensitizer in a cancer tissue by using luminous radiation of an appropriate wave length to launch photochemical reaction following the atypical cells’ destruction. In spite of a successful experience of using photodynamic therapy in different areas of medicine, not all its opportunities are studied. There are general information in this literature survey about the use of photodynamic therapy and its perspectives in oncology.

Treatment for the patients suffering ventral hernias after surgeries with abdominal cancer is a serious problem of abdominal surgery. One of its peculiarities is the necessity to perform a hernioplasty on the background of chemical therapy and immunosuppression, including malignancies caused by oncological pathology. There is a survey on spreading incisional ventral hernias in different regions. The causes of its development and contemporary methods of its prevention are studied. Main tendencies of future researches are defined to solve problems of surgical way of treatment.

Contemporary data on different therapy schemes for colorectal cancer are presented from the point of view of “costeffectiveness” indicator. There is an information about Federal programs aimed at increasing annual healthcare financing connected with preventing and curing malignancies. The statistics of the annual growth in colon and rectum cancer rates is discussed. An actual problem of increasing number of resource-intensive medicines for oncology treatment is stated. This is the reason to analyze cost-effectiveness.

There are clinical and morphological options of kidney disease in case of myeloma disease (multiple myeloma, Rustickyi-Kaler’s disease, generalized plasmacytoma) in literature survey. Myeloma takes 10–15% in the structure of oncohematological diseases. Kidney damage can be the only or the first demonstration of the myeloma nephropathy. Kidney damage connected with myeloma includes myeloma tubular nephropathy (50%), AL-amyloidosis (10–20%), L-chain disease (5–10%) and some other states.

The review of the publications devoted to the methods of early diagnosing autism spectrum disorders (ASD) among children. The spread of this pathology causes mixed assessments in scientific community. The frequency of ASD in different countries makes up from 5 to 90 among 10,000 children and teenagers. An increase in morbidity makes the problem of diagnosing ASD among children very urgent. The main method of diagnosing is behavioral, but they allow to diagnose autism when the child is older than 1.5 years old, when medical and corrective actions are no longer effective. The prenatal diagnostics of the ASD are almost unused. The methods of genetic analysis are considered to be additional and don’t have the direct diagnostic meaning connected with the lack of clear understanding of the etiology and pathogenesis of ASD. According to Russian medical regulations children having early signs of autism can’t be defined in the age when timely medical treatment is effective. Due to this fact it was concluded that it is necessary to develop screening methods and regulations of providing medical treatment to children an teenagers having ASD.

The mechanisms of the gastroesophageal reflux disease (GERD) development and its complications are analyzed on the tissue and cell levels. That’s why studying polymorphism of interleukin (IL) genes is important. Genotypes IL1β-511Т/Т, IL1β31С/С and IL1RN2/2 (receptor antagonist IL1) associate with high risk of complicated course of GERD disease. Researching genes polymorphism of the pro-inflammatory cytokines of the patients having gastroesophageal reflux disease and changes in gastric mucosa it was determined that genotype IL1β-511Т/Т is associated with the deeper local level of IL1β. Meanwhile the patients having erosive esophagitis had lover level of IL1β. It was determined that genotype IL1RN2/2 and haplotype IL1RN*2 /IL1В-31*Т are connected with the high risk of esophagus cancer of patients having Helicobacter pylori. Genotype IL1β-511Т/Т and haplotype IL1β-511Т/Т /IL1RN1/1 of the patients having GERD are associated with the low risk of the esophagus cancer. So, the allele IL1RN*2 and genotype IL1RN2/2 can combine by independent predictors of GERD progression. The study of this field should be continued taking into account not only changes in gastric mucosa, presence of helicobacteriosis, but also the nature of gastroesophageal reflux.

Objective: General indexes of the disease and death rate among the Far East region due to stomach cancer during the last decade (2008–2017).

Methods: Disease and death rates, statistical reports of patients with oncology and official documents by public health authorities were analyzed.

Results: there were 25,155 new registered cancer cases in Far East region in 2017. It’s 26.6% higher than 10 years ago. 128,776 patients (2.1% of the region population) were under outpatient observation. In the structure of primary morbidity stomach cancer takes the fourth place, and in overall death-rate it’s on the 2nd place, going after trachea, bronchial and lung tumor. The number of patients having I–II phase of stomach cancer had increased from 2008 to 2017, the disease rate among women significantly decreased. The percentage of actively defined cases has increased by several orders for ten years. However the index of accumulation of contingents of the diseased with stomach cancer has decreased. The rate of morphological confirmation of such diagnosis turned out to be lower than the average rate in Russia. The proportion of the diseased registered for 5 years or more has exceeded average numbers. The death rate was the highest during the 1st year of being diagnosed. It can be explained by a very high rate of neglecting.

Conclusions: comparing the increasing number of cancer diseased in Far Eastern Region, the constant decrease of the disease and death rates were noticed at the beginning of the 21st century. This fact can’t be explained by an exact reason now. 

Objective: To estimate the effectiveness of the target therapy with bevacizumab combined with chemotherapy for metastatic colorectal cancer.

Methods: Life expectancy of 208 patients having 3rd and 4th stages was retrospectively analyzed. They received different kinds of treatment: FOLFOX, canecitabin with FOLFOX combined with bevacizumab.

Results: Average life expectancy of the patients having 3rd stage of colorectal cancer is 11.4 months of those who applied FOLFOX scheme, and 14.4 months taking “FOLFOX+bevacizumab” scheme. Of those patients having the 4th stage of cancer this combination of chemotherapy and target medicine resulted in an increase in life expectancy for 3.7 months.

Conclusions: Inclusion of bevacizumab in treatment plan of the patients having 3rd and 4th stages of colorectal cancer improves life expectancy indexes of the patients. 

Objective: Experimental estimate of the secondary radiation on the surface of implants and expanders, used for breast reconstruction in case of mastectomy, after making radiation therapy.

Methods: Special equipment was constructed by radiation study department. It consists of linear accelerator as a source of ionizing radiation and a gamma-ray spectrometer with the detector on the basis of ultrapure germanium. The objects of research were the implants and expanders of the different producers.

Results: The maximum amount of the secondary photons on the implants and expanders was generated on the energy level lower than 700 KEV. The level of photons’ generation between 600–300 KEV was higher on the surface of the implants than on the surface of expander filled with saline.

Conclusion: The photons of the secondary radiation with the energy level from 100 to 700 KEV are generated under the influence of ionizing radiation on the implants and tissue expander filled with saline. It can be one of the causes of capsular contractures development after mastectomy. 

Objective: Develop a new organizational form of a personalized approach to assign a target therapy to the patients with metastatic nephrocellular cancer concerning its clinical and economic effectiveness.

Methods: The data by cancer register of the Primorsky region were used. 446 patients are included in the register, it allowed to estimate clinical-economic effectiveness of the target therapy by studying 88 cases.

Results: 5 medicines were used: sunitrib, soraphenib, bevazizumab, everolimus and pazopanib. The control of the progress of the disease and the toxicity covered 44,3% of the patients. The toxicity of the 3–4th levels were registered during the treatment by inhibitors tyrozinkinaz. The target line therapy increased expenditures by 10% and allowed to increase overall survivability to 42 months.

Conclusion: An electronic register of the patients provides monitoring, optimizes expenditures and increases the availability of the target therapy up to 19,7%. Sequential therapy is reasonable and provides the increase of the overall patients’ survivability. 

Objective: Comparative analysis of the antitumor characteristics of different pectins and the dependency of their biological effects on the structural features and the molecular weight.

Methods: Cell lines of the murine adenocarcinoma of the mammary gland C127, carcinoma of the cervix HeLa, adenocarcinoma of the colon SW620, adenocarcinoma of the mammary gland HTB-30 and the normal cells of the retina RPE were used to study the antitumor activity of the polysaccharides. The assessment of the antitumor and cytotoxic actions of the pectins was made by testing metabolic activity through MTT-assay and by making intravital fluorescent coloring of the live and dead cells using DNA-connecting color Hoechst and propidium iodide.

Results: The samples of the citrus pectins in the selected concentration range had a sufficient antitumor effect on the adenocarcinoma C127 cell line by decreasing metabolic activity and the cell proliferation, and also by providing cilinically important cytotoxic effect.

Conclusions: The data got in this study demonstrates that the reaction of the cancer cells on pectins depends on the type of the connection used and also on the sensitivity of the cells to pectins.

Objective: Secretion of the changes characterizing genetic instability of the gastric mucosa when having esophagus cancer.

Methods: 64 patients having esophagus cancer (main group) and 50 patients having gallstone disease were examined. They were undergoing treatment in the hospital No. 1 of the I.M. Sechenov First Moscow State Medical University. In all cases molecular tumor markers in the gastric mucosa after operation and biopsy were examined.

Results: Esophagus cancer turned out to be characterized by high frequency of RASSF1А and MLH1 genes methylation and high hTERT, MMP7 and BIRC5 genes expression, and also by high telomerase activity. There was also high frequency of TUSC3, CDH1 and DAPK genes methylation inside gastric mucosa approached to the edge of resection.

Conclusions: The study of the frequency of TUSC3, CDH1, DAPK, RASSF1А and MLH1 genes methylation and telomerase activity can be used as clinical markers defining changes in gastric mucosa after its resection concerning cancer. 

Objective: Clinical characteristics of the peculiarities of non-specific skin lesions with patients having malignant lymphomas (ML).

Methods: 130 patients having malignant lymphomas were observed, 50 patients – having Hodgkin’s lymphomas, 38 patients - B-cell lymphomas and 42 patients – T-cell lymphomas.

Results: Six main types of nonspecific lesions are defined among patients having malignant lymphomas: 1) skin lesions of auto toxic genesis, 2) skin lesions determined with vascular pathology, 3) skin lesions due to hemolysis and hemostatic disorders, 4) skin lesions of those having cryoglobulinemia/cryofibrinogenemia, 5) skin lesions due to metabolic disorder, 6) infectious diseases.

Conclusions: Lesions of auto toxic genesis and infectious diseases prevail among nonspecific skin changes when having malignant lymphomas. Patients having Hodgkin’s lymphomas experience dermal itching more often. Among B-cell lymphomas skin lesions are more pathognomonic for chronic lymphocytic leukemia, among T-cell lymphomas – for fungal mycosis. Nonspecific skin lesions, having arisen before typical clinical picture of malignant lymphomas allow to suspect and diagnose the main illness on time. Disappearance of skin lesions against the background of specific therapy can bear evidence to the efficiency of the malignant lymphomas’ treatment. 

Biopsy of the sentinel’s lymph nodes is a standard procedure for patients having breast cancer with clinically nonaffected lymph nodes. Radioisotope research method with marked colloid has become classic since 1990s. However, this method has some drawbacks, which can be removed with the appearance of fluorescent lymphography using indocyanine green. In this survey there is a contemporary approach to making biopsies of the sentinel’s lymph nodes of the patients having breast cancer applied in Russia.

Objective: The creation of the medicine for a local radiomodification of tumors.

Methods: The level of the secondary radiation on the surface of the phosphate glass powder with the inclusion of tantalum oxide processed by 6 MeV deceleration emission was studied. Medical linear accelerator TrueBeam (Varian, USA), and Semiconductor diode detector PDI 2.0 (Sun Nuclear Corp., USA) having the system of moving in vertical plane and the system of position video recording were used.

Results: The presence of the phosphate glass (containing 20% Та2О5) on the surface gave a 63.7% increase to the secondary radiation. It’s around two thirds of the overall level.

Conclusion: An opportunity to create a medicine on the basis of phosphate glass, containing tantalum oxide, for local radiomodification of malignant tumors. 

26 patients (19 boys and 7 girls from 7 to 17 years old) received treatment on blepharoptosis in children’s’ ophthalmological center of the 2nd regional hospital from year 2017 to year 2019. 23 children were operated. In 3 cases operative treatment weren’t implemented because of contraindications. Resections and levator duplicature and suspending operations using threads and marilena mesh were implemented. The difference in ratios of the symmetry of palpebral fissures after operations and before them was on average 45,6%, the ratio of the treatment efficiency is 2,0.

Liquid-based material and traditional pap smears got during fine-needle biopsies of different tumors were analyzed. Cell-cycle blocks and monolayer pills were made from liquid-based material depending on the amount of cell structures. Original method using donor thrombocyte mass was implemented to create cell-cycle blocks, especially to condense and consolidate the sediment after centrifugation. After taking pancreas punctures different medical institutions in Vladivostok managed to form cell-cycle blocks in 71 cases from 2017 to 2019. In 9 cases (12.7%) the material was found to be diagnostically noninformative, in 15 cases (21.2%) – sufficient for morphological research, but inappropriate for immunohistochemistry. In 47 cases (66.1%) 206 immunohistochemical tests were made using 34 types of biomarkers.

Objective: Comparative analysis of the dynamics and causes of the primary disablement of the population of Primorskiy region.

Methods: Statistical indicators of the primary disablement were compared using statistical and analytical methods.

Results: Statistically important differences of the levels of primary disablement not only in general, but also according to nosological forms were identified. They pointed out the high level of the invalidization of the population of Primorskiy region among the patients having tuberculosis, disease caused by HIV, diseases of the oste-muscular system and of the connective tissue, the effects of injuries, poisoning and other impacts of external causes. The increase in the level of primary disablement was defined including consequently to the disease caused by HIV, malignant tumors, diseases of the ear and the mastoid and genitourinary diseases and the decrease was defined due to tuberculosis and occupational pathology.

Conclusions: The causes of the differences in the levels of primary disablement among the adult population in Primorskiy region and in Russian Federation in general and in certain classifications and units of diseases require futher studying based on interdepartmental interaction of the specialists. 

Objective: The analysis of the distant education experience of the students studying clinical subjects in medical university.

Methods: 410 students of the ISMU pediatric department. Author’s questionnaire was used. It consisted of 3 parts: socio-economic, organizational and methodical.

Results: Every second respondent noticed connection problems and every fourth – an increase in communication and equipment costs. 68.2% of students increased their level of knowledge through online learning, 40% had a negative opinion about distant learning (but every third respondent didn’t give definitive positive or negative conclusion). 57.5% of the participants noticed the relevance of the given marks. At the same time the distant method increased the time spent on studying two times or more.

Conclusions: The technologies used for distant education LMS Moodle got a positive feedback from students. Distant learning in case of involuntary isolation allows to keep an appropriate level of training and can extend ordinary studying and provide an opportunity of self-preparing for classes. In future it is offered to use distant learning for self-study and estimation of the quality of theoretical knowledge.