The depth of needle insertion is determined by the acupuncturist during the procedure based on the patient's sensory responses and motor responses that may occur at the tip of the inserted needle (De-qi reaction). Despite the existing specific recommendations and standards for the selection of acupuncture depth for almost all acupuncture points, the difficulty of performing acupuncture in patients with significant deviations in body weight from the norm remains. In this regard, we decided to determine the De-qi needling depth (DND) by the needling method and the safe needling depth (SND) by the ultrasound method of acupuncture points: HT1, HT2, HT3, HT4, HT5, HT6, HT7 in healthy people taking into account the body mass index (BMI). Materials and methods: 90 volunteers were examined by needling method to determine DND and by ultrasound to determinate the depth of underlying neurovascular structures and SND after converting individual Сun to millimeters. Results: DND of HT1, HT2, and HT3 were more superficial in UWG compared to HWG at 1.83 mm and deeper in OWG compared to HWG at 4.9 mm. In contrast, the DND deviation of HT4, HT5, HT6, HT7 was significant but mild in both groups, with a slight decrease in UWG compared to HWG of only 0.54 mm and a slight increase in OWG compared to HWG not exceeding 1.5 mm. Conclusion: The depth of the acupuncture points of the heart meridian HT1, HT, HT3 strongly depends on the degree of obesity in overweight people and is less responsive to body weight in underweight people. At the same time, changes in the points HT4, HT5, HT6 and HT7 have slight deviations in underweight and overweight people compared to people with healthy weight. Moreover, the depth of the heart meridian points is directly related to the depth of the underlying neuroarterial structures and weakly correlates with the Cun value in millimeters.

The prediction and prevention of congenital malformations in the fetus of women with epilepsy is an urgent problem due to the need for long-term use of antiepileptic drugs. The aim was to study the frequency of carriage of single-nucleotide variants (SNVs) rs1801133 and rs1801131 of the MTHFR gene; rs1801394 of the MTRR gene, rs1805087 of the MTR gene and rs1051266 of the SLC19A1 gene in women with epilepsy and to evaluate their associations with congenital malformations of the fetus (CMF). Materials and methods. The study included 61 patients with epilepsy who had a history of one or more pregnancies with a known outcome due to the presence of CMF in the child. The patients were divided into two groups: 20 patients had various CMF (the main group), 41 patients had children who were born without CMF (the comparison group). DNA was isolated from the blood, and genotyping of five DNA sequences in four genes was performed by polymerase chain reaction. The frequencies of genotypes and alleles in the mothers of the main group and the comparison group were determined, the differences were assessed using Pearson's chi-square criterion (χ2) and Fisher's exact criterion. Results. There were no statistically significant differences in the frequencies of genotypes and alleles for all analyzed SNVs between the main group and the comparison group (p > 0.05). There were no statistically significant differences in the frequencies of genotypes and alleles of SNVs of the studied genes in mothers of children with CMF (n = 14) and without CMF (n = 22) taking valproic acid (p > 0.05). A statistically significant relationship has been revealed between the carrier of a certain haplogroup of the mother and the formation of CMF. Conclusion. The development of VPD in a child is a multifactorial phenomenon in which genetic factors with a small effect size can play a role only in the case of certain unfavorable combinations.

This study investigates the relationship between cognitive function and oxytocin levels in blood and saliva among male patients with multivessel coronary artery disease (CAD). Existing literature highlights a significant association between CAD and cognitive impairment, with prevalence rates varying widely due to inconsistent diagnostic criteria. Objective: To determine the relationship between cognitive function and oxytocin levels in blood and saliva among patients with multivessel coronary artery disease. Methods: Our research involved 91 male patients undergoing coronary artery bypass grafting, excluding those with concomitant diseases or significant cognitive deficits. Neuropsychological assessments were conducted using validated screening scales, including the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Oxytocin levels were measured through enzyme-linked immunosorbent assay (ELISA). Results indicated significant correlations between cognitive performance and oxytocin levels, with direct relationships observed for MMSE and word recall tests, and inverse relationships for the Schulte test. Discussion: These findings suggest that oxytocin may serve as a potential biomarker for vascular cognitive impairment in CAD patients, offering a rapid and objective diagnostic tool that could enhance clinical practice. Conclusion: Ultimately, this study contributes to the understanding of cognitive deficits in CAD and supports the exploration of oxytocin as a diagnostic biomarker.

Antipsychotic therapy often causes side effects, one of which is metabolic syndrome. This condition increases the risk of cardiovascular disease and increases mortality in patients with schizophrenia. Currently, to improve the safety of antipsychotic therapy, the possibility of introducing into clinical practice the monitoring of hematologic inflammation coefficients as predictors of the development of metabolic syndrome is being considered. Objective: was to determine the presence of correlation between hematologic inflammation coefficients and metabolic syndrome in patients with schizophrenia. Methods: The study included 32 patients diagnosed with schizophrenia paranoid (F20.0, ICD-10), treated in a psychiatric hospital and receiving clozapine therapy. Patients were divided into two groups according to the presence or absence of metabolic syndrome. Metabolic syndrome was defined according to the International Diabetes Federation criteria. The groups were matched as similar as possible in terms of sex, age, therapy, smoking status and comorbidities of the patients. Results: In our study, no significant differences were found between patients with absence and presence of metabolic syndrome in terms of hematologic inflammation coefficients: neutrophil to lymphocyte ratio (p=0.752), monocyte to lymphocyte ratio (p = 0.734), systemic immune inflammation index (SII) (p=0.564), monocyte to high density lipoprotein ratio (p = 0.169). Discussion. The results of our study showed no significant differences between schizophrenic patients with metabolic syndrome and those without metabolic syndrome in terms of hematologic inflammatory coefficients. This may suggest that these inflammatory markers are not reliable predictors of the development of metabolic syndrome in patients with schizophrenia receiving clozapine therapy. Conclusion. However, these findings require further investigation, as existing data on the relationship between inflammatory processes and metabolic disorders in patients with psychiatric disorders remain inconsistent.

Therapy-resistant schizophrenia and its subtype, ultra-resistant schizophrenia, remain one of the most serious socially significant psychiatric disorders. The lack of unified diagnostic criteria complicates the interpretation of research data in this area and reduces the effectiveness of therapy in real clinical practice. The development of standardised approaches and in-depth study of resistance mechanisms remain priority tasks of modern psychiatry. The analysis of the literature shows that ideas about therapy-resistant schizophrenia have changed significantly over the last decades. This narrative review considers the criteria for treatment-resistant schizophrenia from the first criteria proposed by Kane et al. to the current ones, including TRRIP, which take into account the duration of therapy, the dose of the drug, the form of its administration, and the patient's compliance. Special attention is paid to the criteria for ultra-resistant schizophrenia in the absence of therapeutic response to clozapine. Currently, there are significant differences in the definition of therapy-resistant schizophrenia, which underline the need to unify its diagnostic criteria.