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The development of innovative ingredients of specialized formula for children with intolerance to cow's milk proteins requires accounting the influence of the protein component on the allergic sensitivity. The aim of the research was to study the effect of lactoferrin (LF) from cow colostrum, cow's milk protein hydrolysate (CMPH) and mare's milk protein hydrolysate (MMPH) on the severity of the systemic anaphylaxis reaction, the levels of specific IgG antibodies and cytokines in rats parenterally sensitized with ovalbumin (OVA). Material and methods. The experiment was carried out on 4 groups of 26 male Wistar rats, which were sensitized intraperitoneally with chicken egg OVA and a systemic anaphylaxis reaction was induced on the day 29 by intravenous administration of a challenge dose of the antigen (6 mg per kg body weight). LF, CMPH and MMPH were introduced into the diet in doses of 1.4-2 g/kg body weight per day (on an average 1.59±0.04, 1.53±0.05 and 1.48±0.05 g per kg body weight respectively). The content of IgG antibodies in the blood serum was determined by an indirect ELISA; the levels of cytokines IL-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12(p70), IL-13, GM-CSF, IFN-γ and TNF-α were detected by multiplex immunoassay. Results. Dietary LF did not have a significant effect on the severity of active anaphylactic shock (AAS), concentrations of antibodies and cytokines in the blood of animals. As a result of CMPH consumption, there were no significant changes in AAS severity and IgG antibodies to OVA but significant increase in TNF-α level was observed as well as a significant decrease in IL-1α (p<0.05). In animals receiving MMPH, there were also no significant changes in the severity of AAS, but a 1.9-fold decrease in the level of IgG antibodies to OVA (p<0.001) was noticed along with a significant increase in IL-12(p70) (p<0.05) and IL-10 (p<0.10) level. Conclusion. Cosumption of LF by sensitized rats didn't significantly affect their anaphylactic sensitivity and cytokine profile, while CMPH intake induced some signs of pro-inflammatory processes. Consumption of MMPH was accompanied by the formation of an anti-inflammatory cytokine profile, which corresponds to a decrease in the intensity of the humoral immune response to the model allergen. Differences in the effects of two hydrolisates, which have similar degrees of hydrolysis, may be associated with the specific composition of glycopeptides formed during the enzymatic cleavage of milk protein produced by these two species of dairy animals.

Chronic disturbances of consciousness (CDC) are a consequence of severe brain damage and are conditions that arise after emerging from a coma with the preservation of the sleep-wake cycle in the absence of signs of conscious behavior. When conducting inpatient medical rehabilitation of this group of patients, the state of nutritional status is not always taken into account and, as a rule, there is no nutritional support with an assessment of metabolic needs, including the introduction of various modes of physical activity during physical therapy and an increase in physical load on the patient's body. The purpose of the study was to assess the nutritional status and optimize the nutritional support system in patients with CDC at the inpatient stage of medical rehabilitation (MR). Material and methods. The study analyzed the results of examination and treatment of 152 patients with CDC of traumatic origin who received medical rehabilitation from 2016 to 2022 in the Department of Physical and Rehabilitation Medicine of the Nikiforov Russian Center of Emergency and Radiation Medicine, Ministry of Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters. Results. In patients with CDC of traumatic genesis, signs of malnutrition (objective, anthropometric, laboratory) were diagnosed at the inpatient stage of MR, and there were also risks of malnutrition progression with the introduction of additional physical activity. Conclusion. To create an effective and adequate nutritional support system during inpatient MR, metabolic monitoring (indirect calorimetry) is of fundamental importance, taking into account the influence of additional physical activity. The use of a calculation method for estimating energy requirements can lead to hyperalimentation.

Cholecystectomy (CE) is one of the most frequently performed surgical interventions and the main method of symptomatic gallstone disease treatment. Despite the widespread implementation of minimally invasive surgery techniques, significant proportion of patients develop spectrum of symptoms after CE. These manifestations require correction with different approaches including medical nutrition. The aim of the research was to perform structured review of recently published data related to diet therapy and nutritional support of patients after CE. Material and methods. A literature search was performed in PubMed/MEDLINE, EMBASE, Cyberleninka, eLibrary databases using the keywords "Cholecystectomy" in combination with "Diet", "Medical nutrition", "Nutritional support" and their Russianlanguage equivalents for the relevant databases. Correct description of interventions, analyzed outcomes, statistical processing and found effects where necessary for the inclusion to the analysis. Duplicate publications were excluded. Results and discussion. A review of the recommendations on nutritional support after CE has been conducted, including handbooks and clinical guidelines, results of relevant clinical trials evaluating the efficacy of different measures of nutritional support. The rational of traditionally used dietary approaches for the correction of symptoms that develop after CE has been assessed, as well as recently published data on the effectiveness of nutritional support methods. Conclusion. Disturbed regulation of bile secretion in the early CE postoperative period may support the need for limitation of fat consumption. Impaired circulation of bile acids and possible changes in the balance of intestinal microbiota may support the need for the use of prebiotics (like dietary fiber), as well as probiotics, especially when antibiotic treatment was administrated for the patient. These interventions may be important from the viewpoint of prevention of late complications after CE.

Digital interactive learning is spreading across many medical specialties, using a variety of methods: from problem-solving simulators to standardized patients, from computer modeling to mannequins. The purpose of the study was to analyze innovative approaches to independent work when studying issues of child nutrition by pediatric students and practicing doctors. Material and methods. The pediatric simulator, developed by the Higher School of Education and Science in collaboration with the teaching staff of seven medical universities in Russia, allows you to train and test students in conditions close to real ones, and to reinforce the issues of child nutrition. An analysis of the effectiveness of organizing online education among students (n=150, 15.7% boys, 85.3% girls, average age - 20.0±1.4 years; duration - February-May 2020) of the 3rd year of Sechenov and Smolensk Medical Universities was carried out using a single-blind randomized controlled trial. Using Google forms, the questionnaire was created with questions regarding the respondents' attitude towards distance learning. The effectiveness of distance learning on the studied simulator was analyzed for 84 students (n=48 - main group, n=36 - control group), a case analysis was carried out with the prescription of the diet therapy to a virtual patient with the lactase deficiency. Results. In two modes of the program (training and testing) the imitation of a dialogue with a virtual 3D patient, examination, diagnosis and treatment, including diet therapy were implemented. A number of diet therapy algorithms are presented in additional illustrations. The use of a children's simulator with a 10-point assessment system showed greater effectiveness in mastering practical skills in the main group compared to the control group. The students who mastered the digital simulator indicated satisfaction in acquiring new knowledge and skills, increased motivation to learn and gain practical skills in examination, supervision and prescription of the diet therapy, approaching 6-9 points (р=0.005). For the control group, the questionnaire showed consistently low results (p<0.05). Analysis of the prescription of the diet therapy in a situational task showed good and excellent results for all students of the main group. Conclusion. The interactive digital simulator has shown high efficiency in training future pediatricians. Clinical cases help develop practical skills and build professional competencies, including child nutrition issues.

One of the most pressing medical, social and government tasks is to ensure health saving, improve the quality of life and increase the life expectancy of the Russian population. The most important lever to ensure the solution of these issues is the optimization of nutrition and the use of methods of artificial intelligence (AI) and new information technologies to support decision-making in this area. The purpose of the study was to familiarize specialists with the Scientific Instrument for Nutrition Analysis (SINA), created on the basis of AI technologies to optimize nutrition and prevent alimentary diseases in order to preserve the health of the population of the Russian Federation. Results. A patent was created and received for a scientific web tool (SINA) based on AI technologies for actual nutrition analyzing with subs equent assessment of health status and generation of recommendations, including a personalized diet, which is formed based on individual human needs for energy, nutrients and bioactive compounds, taking into account genome, gender characteristics, age, food preferences, profession, diseases, medication treatment, clinical blood parameters, individual morphological and constitutional characteristics, his physical activity, etc. Conclusion. The results of using SINA can reduce the labor costs of doctors; personalize diets as much as possible taking into account many factors; increase patient adherence to the prescribed diet and recommendations; increase public awareness of nutrition issues, reduce morbidity rates and improve public health. The high-tech approach using AI is advanced and is capable of solving many key challenges in the field of health care, prevention and medicine in general, and improve the quality of life of the population.

The problem of the increasing obesity among children and adolescents is urgent. One of the most interesting and promising directions in this area is to study the correlation of individual microorganisms with the presence and absence of obesity. The aim of the study was to assess the correlation between the isolation frequency of individual microorganisms and the presence of obesity in children and adolescents and to identify possible associations between different groups of microorganisms in obese patients. Material and methods. 156 male and female patients aged from 7 to 17 years were included in the study. The patients were divided into a control group (n=23) (healthy patients), a group of children with exogenous constitutional obesity without complications (n=25), a group of children who had one or more complications of obesity (n=108). For all patients body mass index (BMI) was calculated. Additional examination included a cultural study of the intestinal microbiota. Fecal samples of patients were used as the material. Preparation of the material for inoculation, inoculation and subsequent incubation of the Petri plates were carried out under anaerobic conditions. The isolated microorganisms were identified using the MALDI-ToF mass spectrometry method. Results. When analyzing the correlation between obesity and individual taxa, statistically significant differences were obtained only for Bifidobacterium spp. (p=0.045). The analysis of the correlation between obesity and the isolation of individual microorganisms has shown that Bifidobacterium pseudocatenulatum (p=0.012), Candida albicans (p=0.012), Streptococcus salivarius (p=0.016), Bifidobacterium breve (p=0.003), Veillonella parvula (p=0.013), Haemophilus parainfluenzae (p=0.003), Streptococcus oralis (p=0.001), Weissella confusa (p=0.036), Enterococcus mundtii (p=0.036) were isolated less often in patients with obesity than in control group. Conclusion. The results of the study has demonstrated that only one taxon, Bifidobacterium spp., had a significant correlation with the absence of obesity. At the same time, a reliable correlation with the absence of obesity was also established for individual microorganisms, including several microorganisms from Bifidobacterium spp. and Streptococcus spp., which may enable to establish certain microbiological predictors of obesity and its complications.

The study of the genetic determinants of the disaccharidase activity opens up new prospects for improving diagnostics and choosing medical tactics in gastroenterology. The aim of the study was to systematize the data on the role of the sucrase-isomaltase gene (SI) in regulating sucrose metabolism and the contribution of SI mutations to the prevalence of sucrose malabsorption disorders (sucrase-isomaltase deficiency, SID) and certain forms of enterological pathology in different population groups. Material and methods. A review of the peer-reviewed scientific literature, mainly in the PubMed database (https://pubmed.ncbi.nlm.nih.gov) and eLibrary (https://elibrary.ru), was conducted using key words: carbohydrate malabsorption, sucrase, sucrase-isomaltase deficiency, sucrase-isomaltase SI gene. The search depth was not specified, but particular attention was paid to recent publications. The gnomAD database (https://www.ncbi.nlm. nih.gov/snp/rs781470490) was also used. Results. According to the review results, 37 out of 150 known SI gene mutations have been confirmed to contribute to reduced sucrase activity or restricted sucrase production. The prevalence of point mutations in the SI gene is estimated at 0.0006%, but carrier rates of the SI delAG deletion (rs781470490), manifested as homozygosity in SID, are very high (5-21%) in indigenous populations of Arctic regions in East Asia and America. Medicalgenetic research methods improve the accuracy of differential diagnosis of primary and secondary SID and other forms of disaccharide and polysaccharide malabsorption. The formation of databases on the prevalence of genetic determinants of sucrase-isomaltase insufficiency is a promising way to refine the epidemiology of SID. There is an increased (0.2-2.3%) risk of clinical manifestations of SID in homozygous carriers of the SI delAG mutation in the Chukotka, Kamchatka, and Northern Priochotye populations. Verification of reports on a less pronounced tendency to lipid metabolism disorders in SI delAG carriers compared with the control group is recommended. Conclusion. Manifestations of mutant SI variants in the phenotype are associated with the presence of accompanying carbohydrate malabsorption variants and specific gut microbiota. The SI 15Phe variant (rs9290264) may contribute to the development of irritable bowel syndrome.

The improvement of the novel foods' safety assessment algorithms is currently one of the food hygiene significant areas. Within the studying of Hermetia illucens insects' effect, the standard in vivo allergological research integrated in the protocol of medical and biological evaluation of genetically modified food has been used. The protocol was supplemented with cytokine profile indicators and pathomorphologic characteristics of immunocompetent organs' lymphoid tissue. The purpose of the research was to study the effect of black soldier fly (Hermetia illucens) larvae biomass on the rats' immune status in the experiment on the induced anaphylactic shock model. Material and methods. The effect of black soldier fly (Hermetia illucens) larvae biomass was studied in a 29-day experiment on growing (43-72 days of life) male Wistar rats fed with Hermetia illucens biomass - main group (n=29) and semi-synthetic casein diet - control group (n=29). The complex assessment of allergenic potential of Hermetia illucens biomass was carried out in the experiment on the induced anaphylactic shock model in Wistar rats. An expanded pool of immune status indicators was studied including active anaphylactic shock severity (lethality, number of severe anaphylaxis reactions, anaphylactic index); cytokine profile (content of proinflammatory and anti-inflammatory cytokines, as well as regulators of cellular and humoral immune response); IgG1 and IgG4 level before and after administration of ovalbumin permissive dose (4 mg/kg b.w.). In addition to this pathomorphologic characteristics of lymphoid tissue of the main immunocompetent organs (thymus, spleen, Payer's patches) have been obtained. Results. The significant systemic anaphylaxis reaction decrease in the main group has been shown. Comparative assessment of the serum cytokines (GM-CSF, IFN-γ, IL-10, IL-12(p70), IL-13, IL-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, TNF-α) as well as the level of immunoglobulins of the IgG1, IgG4 class before and after administration of ovalbumin permissive dose did not reveal significant differences in rats of the control and main groups. In the main group, there was a decrease in blood serum proallergic cytokines: the level of IL-4 reduced by 1.3 fold, IL-10 - 1.1 and IL-13 - 1.2 fold (p>0.05), and in animals with mild anaphylactic reaction - by 1.8, 1.4 and 1.4 times, respectively (p>0.05). The morphologic studies of the immune system organs showed no intergroup differences. Conclusion. Thus, allergological studies of black soldier fly (Hermetia illucens) larvae in the experiment with the use of systemic anaphylaxis rat model and determination of immune status indicators (anaphylactic shock severity, cytokine profile, IgG1 and IgG4 level, morphologic structure of immunocompetent organs) did not reveal any allergenic effect of the studied product.

Short-chain fatty acids (SCFAs) are an important link in the maintenance and normalization of some important body functions. Recently, the metabolic component of the SCFAs effects has also been actively studied; the effect on body weight, insulin resistance and glycemia is of particular interest in the context of the prevention and treatment of carbohydrate metabolism disorders. In this regard, it is relevant to study the characteristics of SCFAs' production in patients with impaired carbohydrate metabolism, mainly with type 2 diabetes mellitus (T2DM). The purpose of the research was to study the modern data on the synthesis peculiarities of SCFAs in healthy people and patients with impaired carbohydrate metabolism. Material and methods. The data of domestic and foreign literature presented in PubMed, Google Scholar, ResearchGate, Elsevier, eLibrary, CyberLeninka databases, published mainly over the past 10 years, have been analyzed. Results. According to the concept of the philometabolic nucleus, bacteria of certain species, which are of the greatest importance compared to the rest, are responsible for the synthesis of specific SCFAs. The gut microbiota (GM) has the property of plasticity - the ability to change its composition under the influence of various factors. Most studies describe the effect of GM and its metabolites on the carbohydrate metabolism, but an equally important aspect of this process is the effect of carbohydrate metabolism disorders on GM and its functional activity. In case of disorders of carbohydrate metabolism, some altered components of homeostasis negatively affect GM and its production of SCFAs. As a result, the total amount and variety of SCFAs decrease, which exacerbate the imbalance in relation to carbohydrate metabolism. There is evidence that in patients with T2DM, the concentration of butyrate, which has a positive effect on insulin resistance, body weight, fasting glycemia and postprandial glycemia, decreases. The concentration of propionate and acetate, which didn't show such a pronounced positive effect in studies on carbohydrate metabolism, on the contrary, increases. Conclusion. The production of SCFAs by GM representatives depends on many factors, such as nutrition, physical activity, medication intake and the presence of chronic diseases. Numerous studies have confirmed the difference in the characteristics of the production of SCFAs in patients with T2DM and healthy people. The study of the peculiarities of GM metabolism in patients with T2DM is a tool in understanding the basics of therapy and lifestyle correction in both patients with T2DM and healthy people in order to prevent disorders of carbohydrate metabolism.