Background. Acute gastrointestinal bleeding is a pressing life-threatening problem in emergency abdominal surgery. Upper gastrointestinal bleeding predominates, accounting for >70% of cases. Acute blood loss is associated with a high threat to life, and qualified diagnosis and timely treatment are required to mitigate severe consequences.

Objective: to evaluate the treatment outcomes in patients with gastrointestinal bleeding using modern hemostasis methods.

Material and methods. The treatment outcomes of 132 patients with upper gastrointestinal bleeding admitted to the surgical clinic at Blagoveshchensk City Clinical Hospital in 2025 were analyzed. The age ranged from 21 to 78 years; male patients predominated — 103 (76.3%). Within the first 24 hours of bleeding onset, 105 (79.5%) patients were admitted; 20 (15.2%) were admitted after 24 hours or more; and 7 (5.3%) patients were admitted more than 3 days after bleeding onset. In 63.6% (84) of patients, the bleeding was of moderate to severe degree, and this category of patients was hospitalized in the intensive care unit.

Results. In addition to endoscopic hemostasis, pharmacotherapy was administered, with proton pump inhibitors as the baseline drugs, along with hemostatic and infusion therapy. Bleeding recurrence occurred in 22 (10.6%) patients; in 12 (5.8%) patients, bleeding was stopped after repeat hemostasis. In 10 (4.8%) patients, endoscopic hemostasis proved ineffective. These patients underwent emergency surgery. The following operations were performed: laparotomy, gastrotomy, duodenotomy with excision or suturing of the ulcer defect – 5 (3.8%) patients. Delayed operations were performed within the next 24 hours in patients with unstable hemostasis and chronic callous ulcers of the stomach and duodenum. Distal gastrectomy with Billroth anastomosis was performed in 2 (1.5%) patients, and Paciari operation in 1 (0.76%) patient. Twelve (9.1%) patients with gastrointestinal bleeding died; these were elderly individuals with severe comorbidities and patients admitted to the hospital 24 hours or more after the onset of bleeding.

Conclusion. Timely diagnosis and comprehensive treatment with the use of endoscopic methods of local hemostasis allowed for a reduction in the number of forced surgical interventions and an improvement in the quality of treatment.

Background. Ingrown nail is a pathological penetration of the lateral edge of the nail plate into the soft tissues of the digit, leading to chronic inflammation of the nail fold and accompanied by a set of morphological and functional changes in the nail plate, its matrix, and the soft tissues. Despite the seeming simplicity of the problem, it requires timely diagnosis and a differentiated approach to treatment.

The aim of the study is to analyze the structure and management tactics of children with ingrown toenails.

Material and methods. A retrospective analysis of 44 outpatient medical records of patients followed at Children's Polyclinic No. 1 (Blagoveshchensk, Russia) from 2022 to 2025 was carried out, with assessment of demographic data, disease stage, treatment, and its outcomes.

Results. Over the entire study period, 24 (54.5%) boys and 20 (45.5%) girls were seen among the 44 patients. The total number of visits was 49, with 5 (10.2%) repeat visits. By localization, a unilateral process on the first toe predominated – in 43 (87.7%) patients. Involvement of both feet was observed in 5 (10.2%) patients. In 1 (2.1%) case, the lesion was located on the 3rd finger of the left hand. Conservative treatment prevailed in the majority of cases – 44 (89.8%) visits. Surgical treatment was performed in 5 (10.2%) cases, at disease stages 2–3 with pronounced inflammation and failure of conservative measures.

Conclusion. Ingrown nail in children occurs more frequently in boys and predominantly on one foot. Most cases are diagnosed at stages 1–2 of the disease. Conservative treatment is effective in 88.6% of patients, especially in the early stages. Surgical treatment is usually required when the disease progresses.

Diffuse ossification of the lungs is a rare pathological process characterized by the formation of bone tissue in the lung parenchyma. In the morphological aspect, this condition differs from calcification, since it is characterized not by the deposition of calcium salts, but by the formation of mature bone tissue with a lamellar structure, osteocytes in lacunae and, in a number of observations, elements of bone marrow.

The article presents a clinicomorphological observation of a 68-year-old man who died of acute extensive anterior transmural myocardial infarction complicated by cardiogenic shock. Pathological examination revealed pronounced macroscopic changes in the lungs in the form of tissue with stony density and whitish cords. Histologically, multiple islands of immature bone tissue were detected in the interstitium and around vessels, along with thickening of the interalveolar septa, intra-alveolar edema, hemosiderosis, and microcirculatory disorders. Based on the combination of morphological signs, diffuse pulmonary ossification was diagnosed as a concomitant disease, unrecognized during life. This observation is of interest due to the rarity of this pathology and its postmortem verification in a patient whose clinical picture was dominated by acute cardiovascular disease.

Using the reform, development, and construction of Changchun Medical Vocational College as an example, this article examines the pathways for training highly qualified technical specialists in medical and wellness specialties within the context of the Healthy China initiative.

The model aims to provide individualized and multi-track specialist training, comprehensively enhancing their political awareness, professional skills, as well as developing innovative and entrepreneurial abilities. A talent training model for primary healthcare is proposed, based on deep industry-education integration and comprehensive optimization at all stages. This model is closely aligned with the needs of industry, sector, and specific job positions, and is implemented on the principles of mutually beneficial cooperation and joint training.

Familial hypercholesterolemia is one of the most common inborn metabolic disorders caused by a genetic defect, characterized by elevated plasma levels of total cholesterol and low-density lipoproteins.

Clinically, it manifests as early development of atherosclerotic lesions in the major vessels and the onset of cardiovascular disease at a young age.

This article describes a clinical case of a patient with heterozygous hypercholesterolemia diagnosed through opportunistic screening by lipid profile testing. The time to diagnosis was 1 year. No phenotypic manifestations of the disease were observed. Molecular genetic testing revealed a heterozygous mutation in exon 3 of the LDLR gene (chr19:11102719C>A), leading to a premature termination codon NM_000527.5:c.246C>A, p.(Cys82Ter), which is registered as pathogenic. Diet therapy and drug treatment made it possible to achieve target levels of total cholesterol and low-density lipoproteins (<3.3 mmol/L). Early diagnosis of heterozygous familial hypercholesterolemia, along with a combination of non-pharmacological and pharmacological interventions for correcting lipid metabolism disorders, serves as prevention of the atherosclerotic process in children. Regardless of the availability of molecular genetic testing, all family members of a patient with familial hypercholesterolemia and their relatives require lifelong monitoring and targeted clinical examination.

Esophageal foreign bodies in children are not merely a mechanical obstruction but also a potential threat to life due to the risk of severe complications: perforation of the esophageal wall, mediastinitis, and asphyxia. The range of ingested objects is extremely wide – from coins and toy parts to fish bones and construction set elements.

The article describes a clinical case of an esophageal foreign body in a one-year-old child. A chest X-ray was performed, based on which the esophageal foreign body was removed. During observation in the surgical department, the child remained in satisfactory condition and was discharged with improvement.

Timely diagnosis and a correctly chosen treatment strategy are the key to a favorable outcome and prevention of disability in the child.

Background. For more than 30 years, specialists have been actively discussing the most optimal surgical strategy for patients with combined atherosclerosis of the coronary and carotid arteries. There are proponents of both simultaneous and staged operations on the vessels of these territories. The debate also extends to the methods of arterial intervention — invasive and endovascular.

The aim is to review and analyze the approaches of Russian and foreign authors to various methods of surgical treatment of combined coronary and carotid atherosclerosis.

Materials and methods. Sources from the Web of Science, PubMed, Google Scholar, and eLibrary.ru databases published between 2010 and 2025 were analyzed. The search was conducted using the following keywords: “coronary atherosclerosis”, “carotid atherosclerosis”, “coronary artery bypass grafting”, “coronary stenting”, “carotid endarterectomy”, “carotid bypass”, “staged and simultaneous surgeries”.

Results. A total of 143 articles were identified, 30 of which were included in this review. The opinions of specialists regarding the priority of simultaneous surgeries for combined stenosing atherosclerosis of the coronary and carotid arteries were summarized.

Conclusion. The category of patients with combined coronary and carotid atherosclerosis is extremely heterogeneous. This makes it difficult to define a universal treatment strategy, which must be aligned with a thorough preoperative examination, individual patient characteristics, the experience and capabilities of the clinic, and the results of complication risk stratification. The final decision regarding the type of intervention should be made by a multidisciplinary team. During and after the operation, a protocol of perioperative neuromonitoring and hemodynamic control must be followed.

Hereditary hemochromatosis is a group of genetically determined diseases characterized by excessive iron accumulation in organs and tissues, which, despite its significant prevalence, often remains latent. This article presents a brief review of the literature on hereditary hemochromatosis. Two clinical cases are described: in the first case, the disease was suspected after a coronavirus infection against the background of persistent hyperferritinemia; in the second, hereditary hemochromatosis had long "masqueraded" as non-alcoholic fatty liver disease with elevated transaminases and hepatomegaly. In both cases, the diagnosis was confirmed genetically (homozygous C282Y mutation). Treatment with phlebotomies made it possible to achieve remission and normalize iron metabolism parameters at the precirrhotic stage. In both cases, the disease was verified at the precirrhotic stage thanks to the determination of ferritin and serum iron levels, followed by molecular genetic testing, which revealed a homozygous C282Y mutation.

The prescribed pathogenetic therapy (regular phlebotomies) demonstrated efficacy as early as the induction phase, and the maintenance phlebotomy regimen allowed for a stable remission with normalization of iron metabolism parameters. These cases show that the key factors for a favorable prognosis in hereditary hemochromatosis are clinical alertness of physicians, timely laboratory diagnosis, and early initiation of elimination therapy before the development of irreversible organ damage. Routine inclusion of iron metabolism parameters in the diagnostic minimum for chronic hepatopathies and asthenic conditions in middle-aged men is clinically justified.

Timely diagnosis and effective treatment can prevent the development of severe complications and provide patients with a life expectancy comparable to that of the general population.

Background. The World Health Organization officially declared the COVID-19 pandemic on March 11, 2020, affecting all age groups. Despite a milder course in children, the systemic nature of the lesions and the risk of severe complications necessitate continuous study of the clinical and epidemiological characteristics of the infection in this patient category to improve prevention and therapy methods.
Objective: to systematize and analyze Russian and international data on the dynamics of the epidemic process, clinical evolution, and pattern of multiorgan involvement in children.

Materials and methods. A search of Russian and international publications was conducted in PubMed, Medline, CyberLeninka, and eLibrary.ru, relevant to the topic, review objective, and keywords: “novel coronavirus infection COVID-19”, “children”, “epidemiology”, “clinical picture”, “complications”.

Key findings of the review. As of March 8, 2026, Russia had recorded 24.901.467 COVID-19 cases with 404.290 deaths. In the Amur Region, the incidence peaked in 2022 (72.387 cases), with a shift in morbidity structure towards children: from 10% in 2020 to 17.8% in 2022. A decrease in the proportion of viral pneumonia (from 22% in 2021 to 4.6% during Omicron dominance) and a predominance of mild respiratory forms (>93%) were observed. A heterogeneous pattern of neurological disorders (neurotoxicosis in 11.6% of young children, polyneuropathy in 46.5% of school-age children) and cardiac complications (myocarditis in 45.8% of patients) was identified. The kidneys are defined as a key target organ. The frequency of acute kidney injury in intensive care units reaches 20–30%. Risks of cyst formation and chronic kidney disease in the post-COVID period are described. Mortality in childhood is determined by the degree of multiorgan dysfunction (pSOFA score ≥5.6), while the survival rate of children on mechanical ventilation (73.4%) is higher than in older age groups.
Conclusion. The wave-like course of the pandemic with changing SARS-CoV-2 genetic variants led to increased pediatric involvement while maintaining the risk of serious organ damage. The data obtained justify the need for a multidisciplinary approach involving medical specialists from various fields, as well as long-term monitoring to assess the long-term consequences of the infection.

Ormond’s syndrome is a rare and little-known disease characterized by nonspecific inflammation in the retroperitoneal adipose tissue, leading to the formation of dense fibrous tissue.

The aim is to highlight the etiology, pathogenesis, diagnosis, and treatment of Ormond’s syndrome. The causes of this pathology continue to be actively discussed in the scientific literature. It has been established that etiological factors provoke an immune response, which leads to damage to the peritoneum, and then to fibrosis. The main pathogenetic trigger is the increased expression of the IgG4 complex by plasma cells. In addition, the disease may be genetic or secondary.

Its ability to mimic other diseases and its prolonged latent course make diagnosis difficult. It is essential to recognize the disease in time and select optimal treatment, because delayed diagnosis invariably leads to irreversible sclerotic changes in the retroperitoneal tissue with compression of tubular structures.

Given the difficulties of primary diagnosis and a number of other unresolved issues, it is necessary to further study and develop standards for the management of patients with Ormond's syndrome.