In accordance with modern regulatory requirements of the educational policy of the Russian state, the implementation of the competence-based approach and the search for means and ways of its implementation in higher and postgraduate medical education is relevant. However, the lack of a sufficient scientific and methodological basis for its validity, taking into account the existing realities and continuous modernization of not only the system of higher medical education, but also the health care industry, which is the primary consumer of its graduates, makes these processes ambiguous and problematic. Four main principles of the competence-based paradigm of education are set out in relation to the training of students of a medical university at the preclinical stage of training. Time variation is one of the main and essential criteria of the competence-based approach in education, the competence-based approach also implies mandatory and widespread use of all the possibilities of modern teaching and learning technologies. The basic principle of the competence-based educational paradigm is a change in the role of teachers and the need to determine the content of competencies, the development of reliable criteria for their assessment. It is emphasized that full implementation of all basic principles of the competence-based paradigm of education in the current conditions and traditions of the national medical school is impossible for a number of reasons. The requirements for the formation of professional competencies are analyzed using the example of a set of competencies developed by the Royal College of Physicians and Surgeons of Canada for general practitioners and the role of medical and biological (morphological) departments at the preclinical stage of higher medical education in this. The conclusions emphasize the need to implement a unified understanding of the principles and essence of competence-based training by teachers of morphological departments, as specialists who lay the professional foundation for subsequent medical activity, as well as the need to study the effectiveness of the implementation of the competence-based educational paradigm based on a corresponding comparison with the results of the implementation of other educational technologies. A state unified system of advanced primary and periodic training for teachers of the medical universities training should also be implemented within the framework of programs, with unified terminology, concepts, principles and requirements.

It is known that axillary lymph nodes are the main barrier to the spread of breast cancer metastases. Therefore, the study of the effect of breast carcinoma on the parenchyma of the lymph nodes seems relevant. The purpose of this study is the morphological features of axillary lymph nodes in breast cancer without metastases and with metastases in the axillary lymph nodes. Using histological methods, light microscopy and morphometry, we examined axillary lymph nodes from 18 women (35-81 years old, average age 63 years) diagnosed with invasive lobular carcinoma without signs of specificity (GII, GIII), 5 of them without metastases, and axillary lymph nodes of 5 deceased (15 nodes) due to cardiovascular diseases aged 57-70 years ( group of the comparison). The nodes were fixed in 10% neutral formalin solution and embedded in paraffin. From each lymph node preparation, 25–30 histological sections 4–5 μm thick were prepared. The sections were stained with azure-II and eosin, hematoxylin and eosin, and the Mallory method. In each structural element of the node, the absolute and percentage content of all cells located there was calculated in 60 fields of view of one histological slice. It was established that breast cancer affects the cellular composition of the axillary lymph nodes even before the onset of metastasis, causing a decrease in the number of lymphocytes and an increase in the number of fibroblast cells in all structural components. We regard these transformations as a morphological manifestation of the preparing metastatic "niche". At the onset of metastasis, cells with a well-structured nucleus and oxyphilic cytoplasm, possessing proliferative potential, enter the lymph node. Subsequently, as tumor cells spread in the structures of the lymph node parenchyma, cells with signs of secretory activity, as well as with signs of destruction, appear.

Congenital heart defects in children have a significant influence on the state and functions of other body systems, in particular, the urinary system. The kidneys, performing the endocrine function, regulate arterial pressure by the juxtaglomerular apparatus. The aim of the study was to determine the influence of congenital heart defects on the formation of the juxtaglomerular apparatus of the paracortical nephrons in childhood. The objects of the study were of 20 kidney autopsies cases aged from 2 months to 6 years, who were divided into 6 groups by age and the presence or absence of cardiovascular pathologies. The preparations were fixed in neutral 10% formalin, embedded in paraffin, stained with hematoxylin and eosin. Polyclonal primary antibodies to renin were used for immunohistochemical analysis. The sections were used to determine the cross-sectional area of ​​the renal corpuscle, the cross-sectional area of ​​the juxtaglomerular cells, and the degree of renin expression in the juxtavascular cells. The most active growth of the renal corpuscles of the nephrons is observed after 1 year of life, while in patients with cardiovascular malformations, their hypertrophy is noted. The area of ​​the juxtaglomerular cells in the groups without pathologies also increases with age, and in the groups with heart malformations, it increases even more intensively. The revealed dynamics indicate that congenital malformations of the cardiovascular system, causing circulatory disorders, increased blood pressure, involve the juxtaglomerular apparatus of the kidney in the pathogenesis, leading to an increase in the area of ​​rennin-producing cells. Not only the juxtaglomerular cells located in the walls of the afferent arterioles, but also the juxtavascular cells of the vascular glomerulus contribute to the overall level of secreted renin. In early childhood, the area of ​​juxtaglomerular cells increases, while renin expression in juxtavascular cells decreases. In cardiovascular pathology of child, both the area of ​​juxtaglomerular cells and the degree of renin expression by juxtavascular cells increase, which undoubtedly increases the overall level of renin in the body.

The epidermis, being the object of therapeutic action in the model of atrophic scar, represents its key structure, which is under the control of growth factors and, in particular, vascular endothelial growth factor. Numerous studies have demonstrated the effectiveness of epidermal growth factor and platelet-rich plasma in the therapy of atrophic scars. A number of studies have shown that vascular endothelial growth factor also has a significant spectrum of effects capable of exerting a therapeutic effect on atrophic epidermis, increasing its thickness and accelerating keratinocyte proliferation. The aim of the study is to study the morphological characteristics of the epidermis in the model of atrophic scar during experimental treatment with a bio-composite with vascular endothelial growth factor. The study was conducted on 36 male Wistar rats. The animals were divided into 6 groups: 1st – intact animals, 2nd group – control group with atrophic scar model, 3rd group – experimental treatment with aluminum hydroxide gel, 4th group – experimental treatment with silicone gel, 5th group – experimental treatment with vascular endothelial growth factor and 6th group – experimental treatment with aluminum hydroxide-based bio-composite and vascular endothelial growth factor. In the studied experimental model, data on epidermal atrophy, decreased mitosis frequency and smoothing of its surface were obtained. Under the influence of inorganic gels, these changes were partially leveled, to a greater extent under the influence of aluminum hydroxide, which was chosen as the basis for the manufacture of the bio-composite. A statistically significant increase in epidermal thickness was noted during experimental treatment with vascular endothelial growth factor in the 5th group of animals; in addition, an increase in the number of Ki-67+ keratinocytes was observed during experimental treatment with the bio-composite. Thus, the bio-composite material based on aluminum hydroxide and vascular endothelial growth factor has the ability to combine the effects of its components and is a promising drug for further research.

Progesterone and its neurosteroid derivatives play a fundamental role in ensuring trophic processes in hormone-dependent tissues, which in turn are of key importance in the development and functioning of the central nervous system. The concentration of progesterone in the brain is 20 times higher than in blood plasma. We did not find any literature data on the effect of progesterone on the morphology of the choroid plexus of the cerebral ventricles. In this regard, it is important to study the characteristics of the choroid plexus of the cerebral ventricles under the influence of progesterone. Objective: to study the morphological organization of the choroid plexus of the cerebral ventricles of ovariectomized Wistar rats under the influence of progesterone. The object of the morphological study was 20 female Wistar rats of sexually mature age. All animals were divided into two groups: 10 females in the control group and 10 females after ovariectomy with injection of progesterone at a dose of 250 mg per kg of animal weight. To assess the volume of the cerebral ventricles, sections were selected with their maximum cross-sectional area, the values ​​​​of the indicator were determined on digitized microphotographs at a magnification of 4 times by outlining the boundaries of the cerebral ventricles and subsequent calculations in the morphometric computer program ImageJ. Determination of volume fractions of vascular plexuses in the cerebral ventricles was carried out stereologically on serial sections using an ocular grid with 60 equally spaced intersection nodes at a magnification of 400 times. As a result of the study, it was revealed that progesterone has a significant effect on the structure of the vascular plexuses of all cerebral ventricles in ovariectomized animals. In the lateral ventricle, the maximum area increases, the relative volume of the vascular plexuses decreases, the volume fraction of the vessels inside the plexus increases, the volume fraction of the cells decreases, and the volume fraction of the connective tissue tends to increase. Similar dynamics are characteristic of the third and fourth ventricles.

A widely accepted concept in human anatomy is the well-known thesis that the anatomical shape and sizes of various organs and body parts are determined by and interrelated with the constitutional features of bone, fat and muscle tissue development or body type. To prove this, measurements of conventional linear metric values ​​of a particular organ are widely used, and on the basis of their correlations with the body type, well-known conclusions are made. The hand is no exception, and standard anthropometric methods for studying the morphology of the hand depending on the body type are widely used. However, traditional anthropometry, based only on conventional linear measurements, allows only an indirect assessment of the shape of the hand, leaving the analysis of its spatial geometric shape beyond complete objectivity. In this study, we studied the relationship between the shape of the hand and the body type in 53 men and 47 women using geometric morphometry methods. It was found that the variability of the hand shape in the coordinates of the transverse axis (narrow - wide) is associated with its morphological type regardless of sex, and in the coordinates of the longitudinal axis (long - short) with its overall size. Only minor differences were found between the hand shape in male endomorphs and ectomorphs (Mahalonobis distance 1,848, p<0,05). In women, differences between hand shapes depending on the body totype are not detected and are weakly expressed only for endomorphs and mesomorphs (Mahalonobis distance 0,415, p<0,05). Multiple regression shows that differences in hand shape in individuals with different body types are insignificant and do not depend on sex. Thus, the results of geometric morphometry, which most fully and objectively characterize the hand shape in humans, indicate that the anatomical forms of hand variability and the frequency of their occurrence in humans do not depend on the body type.

The role of the ciliary body as a gas gland in the formation of intraocular fluid has not been sufficiently studied. The aim of the work was to compare the morphology of the ciliary body of the human eyeball and the gas gland of the swim bladder of bony fish to establish their structural and functional analogy. The swimming bladders of bony fish, carp (Cyprinus carpio L., n=7) and pike-perch (Lucioperca lucioperca L., n=7) were studied. For the study, physiological saline, silver nitrate solution and 1% hydroquinone solution were injected through the caudal artery under supravital conditions. After that, the swimming bladders were removed, stretched on wax plates, fixed in 10% formalin and poured into paraffin blocks. Serial sections 4–5 μm thick were stained with hematoxylin and eosin according to Van Gieson, Weigert's iron hematoxylin, Mallory's, orcein and resorcinol. The study established that the swimming bladders of open-bladder fish (carp) exchange gases using the so-called "oval", while those of closed-bladder fish (pike-perch) use the "oval" and the gas gland. The "oval" is an oval-shaped formation located on the inner surface of the dorsal section of the swimming bladder of fish and is distinguished by blood vessels upon visual inspection. In the area of ​​the gas gland, there is a dense cluster of blood vessels, from large arteries and veins to exchange micro-vessels, including capillaries. A large number of blood vessels participate in the formation of the "oval", in most cases these are micro-vessels, they are located in a thin plate over its entire area. The gas gland is formed by epithelial cells, entwined with numerous blood micro-vessels. The above-mentioned vascular structures of fish are similar to the vascular structures of the ciliary body of the human eyeball, the producer of intraocular fluid; they are formed according to the principle of countercurrent exchangers of the gas glands of the bladders of bony fish. Based on the data obtained, it can be concluded that the ciliary body of the human eyeball is an analogue of the gas gland of the swimming bladder of bony fish.

Bisphenol A is one of the most common endocrine disruptors found in polycarbonate plastics used to manufacture a wide range of everyday products (food containers, children's toys, drainpipes, dental materials, etc.). It is known that the body's immune-resistance is largely determined by the activity of cellular elements of the mononuclear phagocyte system. In connection with the above, the aim of the study was to analyze the effect of bisphenol A on the ability of lung and abdominal macrophages and peripheral blood monocytes to adhere and spread. The study was performed on mature white laboratory female Wistar rats, which were exposed to bisphenol A daily for 45 days by forced sublingual treatment of the solution at a dosage of 15,000 μg/kg. The object of the study was their 60-day-old offspring at the stage of early sexual maturity. The content of macrophages, their ability to adhere and spread at different incubation times were assessed. Under the influence of bisphenol, A, the adhesive properties of mononuclear phagocytes are inhibited, as evidenced by a decrease in the number of adhered cells, including peripheral blood monocytes by 28.7%, peritoneal macrophages by 34.6%, and alveolar macrophages by 35.2. Also, the content of adhered cells in the study of peritoneal macrophages, alveolar macrophages and peripheral blood monocytes decreased in the experiment by 24.7%, 27.2% and 50.5%, respectively. Bisphenol A penetrates into the fetal blood through the placental bloodstream and has a negative effect on the process of hematopoiesis, including monocyte development, which ultimately causes a disruption in the formation of the receptor apparatus of tissue and circulating macrophages. Thus, chronic exposure of female rats to bisphenol A causes a change in the content of macrophages in various compartments of the offspring, and also inhibits their ability to adhere and spread, which indicates the failure of the receptor apparatus of cells.

An important health factor is physical development, monitoring of changes in which in adolescence leads to early detection and prevention of diseases that cause unfavorable changes in the gene pool of populations of individual regions and the country as a whole. The objective of this study is to identify regional features of anthropometric indicators characterizing body types of young men aged 17-21 years, permanently residing in the Penza City and in the Penza Region. The object of the study was a random sample of 97 young men aged 17-21 years, born in 1999-2004 and permanently residing in the Penza City and populated areas of the Penza Region of Russia. The conditions for inclusion in the study were place of birth, permanent place of residence, age 17-21 years, consent to participate in the study. To obtain the results, anthropometry and body typing were performed using the method of Viktor Bunak with subsequent calculation of statistical indicators. To assess the level of physical development, the method of body mass index and Rohrer, Erisman, Pigneur, Tanner indexes was used. To identify regional features of anthropometric indices of body types of Penza young men, a comparative analysis of the obtained results was made with data on the population of Russian young men of the Republic of Mordovia of Russia. When assessing Penza young men by body mass index, it was revealed that the majority of them had normal body weight (67%), excess body weight was noted in 17,5% of cases, underweight and obesity were determined much less often - in 8,3% and 7,2% of cases, respectively. According to the results of determining the Tanner index, it was established that andromorphy was found among Penza young men 1,5 times less often than among Russian young men of the Republic of Mordovia, and gynecomorphy 1,7 times more often, which indirectly indicates probable signs of gracialization. In general, it has been established that modern young Penza residents are characterized by a predominantly normal body type, a narrow chest, a high degree of physical development, andromorphic, and age-appropriate body weight.

The purpose of this article on the history of the development of Russian morphology (pathological anatomy) is to consider and analyze the main stages of the life path, scientific and pedagogical and administrative and social activity of Professor Nikolay Shlyapnikov. When writing, the historical and biographical method, analysis of the main stages of his life, professional and social activities and merits were used. The authors used information contained in papers on the history of medicine of the Middle Volga region. An important role in the preparation of materials was played by archival materials of the funds of the Central State Archive of the Samara Region and the archive of the department of the Samara State Medical University. The article presents his biography as a scientist and organizer of health care, dedicated to the 125th anniversary of his birth. The historical material highlights his life path, years of study at a real school, military service in the Red Army, study at the Saratov State University, work at the Saratov State Medical Institute as an assistant, Associate Professor and then Head of the Department of Pathology. The work during the Great Patriotic War is shown, his main scientific works are noted. The next period of Professor Nikolay Shlyapnikov activity after Saratov's period was the heading of the Department of Pathological Anatomy of the Kuibyshev State Medical Institute. Through his efforts, the City and regional pathological anatomical service were created, as well as the regional society of pathologists together with the Head of the Department of Pathological Physiology, Professor Suponitskaya. For ten years from 1952 to 1963, Professor Shlyapnikov was the Deputy Director of the Kuybyshev State Medical Institute for scientific activity. Under the supervision of Professor Shlyapnikov, morphological changes in various organs in gas infection, liver changes in wound osteomyelitis, the morphology of cancer and cancer metastases were studied, and research was conducted on organ changes in various diseases. In general, the article presents materials that reveal little-known information to the general public about the development of pathological anatomy in medical institutes of the Volga region.