УДК 616.697-07-091.8

The most difficult form of male infertility to treat is azoospermia. It is identified as a complete absence of sperm in the ejaculate. Depending on the nature and causes of impairedspermatogenesis, azoospermia is divided into obstructive  (excretory,  OA)  and  non-obstructive  (secretory,  NOA).  Testicular  biopsy  is  the  most  effective  method  of diagnosis and a component of possible treatment for azoospermia. It is the only objective method of differential diagnosis between non-obstructive and obstructive forms of azoospermia.The aim:histological analysis of testicular biopsies of men with various forms of azoospermia. Мaterials and Methods.78 infertile men with azoospermia were examined. They were divided into two groups: the first group, men with NOA (n = 28); the second group, men with OA (n = 50). The biopsy was preceded by a manda-tory ultrasound  diagnosis  of  the  portal  system. The  biopsy was  performed  using  the  method  of  open  operative access. Biopsies were mostly taken from the more palpable testicle or from both testicles. Biopsies were fixed in buffered 10% formalin (pH 7.2). After 1 day, they were dehydrated in 70% ethanol and embedded in paraffin. For histological studies, sections with a thickness of 5 μm were stained with hematoxylin and eosin. Biopsies were evaluated in accordance with previously described methods.Results.Histological analysis of testicular biopsies from 28.7% of patients with a non-obstructive form of azo-ospermia showed swelling of the testicular stroma, destructive changes in testosterone-producing cells, disruption of the structure of the syncytial complexes of the spermatogenic epithelium, and the complete absence of the process of sper-matogenesis in individual tortuous seminiferous tubules, the absence of contacts between sustentocytes, and in erythro-cyte sludge in the lumen of vessels. 42.8% of patients had fibrosis of the testicular stroma, stroma swelling, thinning of the wall of convoluted seminiferous tubules, violation of the structure of the syncytial complexes of the spermatogenic epithelium, proliferation of the wall of the convoluted seminiferous tubules into their lumen, and infiltration of the testic-ular  stroma  with  lymphocytes. In  54.0%  of  patients  with  preserved  spermatogenesis  and an  obstructive  form of  azoo-spermia, it was possible to find a history of orchoepididymitis in the anamnesis; one patient (2.0%) underwent bilateral orchopexy  at  the age  of 5  years due  to  cryptorchidism;  6.0%  recalled the  trauma calculi  in  the anamnesis; and 38.0% denied any factors affecting fecundity in the anamnesis.Conclusions.The non-obstructive form of azoospermia is characterized by the following parameters: mostly a violation of the structure of the spermatogenic epithelium, a complete absence of the process of spermatogenesis in indi-vidual  convoluted  seminiferous  tubules,  a  violation  of  the  structure  of  the  hematotesticular  barrier,  and  a  violation  of blood microcirculation. The histological picture of preserved spermatogenesis is of the same type in 88.0% of patients with an obstructive form of azoospermia. In most tubules, a fixed number of cell rows is preserved, and cells of various stages of spermatogenesis are determined in them: spermatogonies, spermatocytes, a moderate number of spermatids.In the lumen of the tubules, exfoliated cells and a moderate number of spermatozoa are found.

У статті розглянуто роль цифрової компетентності, як однієї з восьми ключових життєвих навичок, визначених Європейською комісією на етапі самовдосконалення фахівця шляхом навчання впродовж життя, набуття та володіння компетенціями для навчання. Проведений аналіз поняття «компетентності» як «здатності» чи ефективності використання теоретичних знань у діяльності, прояв високого рівня професійної майстерності, майстерності та таланту; знання, навички, здібності та поведінка, які сприяють індивідуальній і організаційній ефективності. Зазначено необхідність розвитку таких компетентностей як цифрової, комунікаційної та професійної, особливо в змінних умовах навчального процесу. Викладач в умовах сьогодення завдяки окреслених компетентностей змушений оперативно переходити від онлайн навчання до офлайн навчання чи змішаної форми навчання. Визначено складові цифрової компетентності: інформаційна грамотність, комунікаційна складова, безпекова складова, вміння створювати цифровий контент. Ефективна взаємодія викладача зі студентами можлива завдяки комунікаційній компетентності. В умовах дистанційного навчання посилюється взаємовплив цифрової та комунікаційної компетентностей. Звернено увагу на поняття «професійної компетентності» викладача. Зазначено зміст професійної компетентності, який, окрім діяльнісного аспекту, включає певні характеристики особистості. Окреслено роль професійної компетентності для постійного збагачення фахових знань, дізнавання нової інформації за допомогою цифрових технологій, вміння її опрацьовувати та застосовувати у своїй діяльності, вміння складати план дій у нестандартних ситуаціях за наявності суперечливої інформації. У результаті робиться висновок, що розвиток та вдосконалення професійної та комунікаційної компетентностей є нерозривним із розвитком цифрової компетентності, оскільки кожна з описаних компетентностей взаємодоповнює та підсилює дію одна одної

Background. Earlier, we found a close canonical correlation between parameters of gas discharge visualization (GDV) and principal neuroendocrine factors of adaptation.

The purpose of this study is to elucidate the relationship between GDV and immunity parameters.

Material and research methods. We observed twice 10 women and 10 men aged 33-76 years without clinical diagnose. In the morning in basal conditions at first registered kirlianogram by the method of GDV by the device “GDV Chamber” (“Biotechprogress”, SPb, RF). For further analysis the following parameters were selected: Area, Shape Coefficient as ratio Square Length of outward contour gas discharge image to its Area as well as Entropy of contour in Right, Frontal and Left projections registered both with and without polyethylene filter. Estimated also Energy and Asymmetry of virtual Chakras. Then registered routine parameters of cellular and humoral Immunity. Results processed by method of canonical analysis, using the software package “Statistica 5.5”.

Results. According to the value of the canonical correlation coefficient R with GDV parameters, the immunity parameters are arranged in the following order: IgA (0,716; p=0,005), CD8⁺CD3⁺ Tc-lymphocytes (0,646; p=0,004), IgG (0,645; p=0,002), IgM (0,622; p=0,0001), “active” T-lymphocytes (0,572; p=0,007), CD4⁺CD3⁺ Th-lymphocytes (0,566; p=0,003), CIC (0,491; p=0,018), 0- lymphocytes (0,457; p=0,036), CD16⁺ NK-lymphocytes (0,396; p=0,043), CD22⁺ B- lymphocytes (0,439; p=0,105). The integral canonical correlation between the parameters of GDV and Immunity was very strong (R=0,994; p<10^-4).

Conclusion. Between parameters of Immunity and parameters of GDV exist strong canonical correlation suggesting relevance and informativenes this method.

Key words: Gas Discharge Visualization, Cellular and Humoral Immunity, Relationships. 

Abstracts

Background. In previous studies, we have shown that electrokinetic index of buccal epithelium (EKI) correlated with some functional and metabolic parameters. Subsequent studies have shown that сhanges in EKI correlated with changes in some parameters of EEG, HRV, hemodynamics, metabolism, immunity and fecal microbiocenosis. Further research in this direction was continued on a significantly increased contingent of patients and with the involvement of new methods and factors of influence. This message starts the presentation of the obtained results.

Material and methods. Under a observations were 44 men (49±15 years) and 30 women (51±13 years) without clinical diagnosis or with chronic pyelonephritis in the phase of remission (23 men). We registered caused by the various therapeutic factors changes in EKI, state of the vegetative and hormonal regulation as well as immunity and metabolism, then calculated relationships between changes.

Results. In 49 patients the changes in EKI were in the range of ±2,5%, in 19 people EKI increased by more than 2,5% (M±SD=+4,0±1,6%), while in 9 people decreased by more than 2,5% (-4,2±1,7%). The canonical correlation between changes in EKI, on the one hand, and HRV and immunity parameters, on the other, is moderate: R=0,478; p=0,023. The method of discriminant analysis revealed 10 immune and 6 HRV parameters as well as triglycerides and cholesterol, whose changes are characteristic of multidirectional changes in EKI.

Conclusion. Electrokinetic index of buccal epithelium responds to therapeutic factors in different directions, accompanied by characteristic changes in a number of parameters of HRV, immunity and metabolism.

Keywords: Electrokinetic index, HRV, hormones, immunity, metabolism, relationships.

UDC 577.346

 COVID-19 infection, preeclampsia and gestational diabetes mellitus in pregnancy cause similar changes in the placenta and influence development of the fetus between conception and birth in gestation. Proper uterine and placental vascularization is essential for normal fetal development. The transplacental exchange is regulated and maintained by the placental endothelium. During placental implantation, the trophoblast differentiates into two distinct layers, the inner cytotrophoblast and outer syncytiotrophoblast, which are key elements of the human placental barrier. Proinflammatory cytokines exacerbate ischemic events and create an upward spiral of an inflammatory reaction in the placenta. Placental pathology in gestational COVID-19 shows desquamation and damage of trophoblast and chronic histiocytic intervillositis. Similar lesions also occur in gestational diabetes mellitus and preeclampsia. Common ground: The systemic inflammatory response of the mother, the increased inflammation in the placenta and cytokine production by placental trophoblasts should be monitored throughout pregnancy. Placental angiogenesis can be evaluated by serum vascular endothelial growth factor, Annexin A2, placental growth factor or sclerostin. Tissue damage can be assessed by measuring levels of serum lactate dehydrogenase and myeloperoxidase. Blood flow can be monitored with three-dimensional Doppler and pathological changes can be documented with paraffin-embedded tissue sections stained with hematoxylin and eosin, and electron microscope images as well as immunohistochemistry tests for vascular endothelial growth factor, placental growth factor, sclerostin and Annexin A2. Opinion: The damage of maternal and fetal vascular perfusion (villitis and fibrin deposition) is a common mechanism of gestational diseases. The placenta lesions liberate anti-endothelial factors that lead to anti-angiogenic conditions and are the common mechanism of maternal placental vascular malperfusion in gestational diseases.