The purpose of the work was to assess the formation of environmental culture of medical university students through the specialized discipline of the elective course – medical ecology. Material and methods: A questionnaire was used for 100 medical university students to identify the general level of environmental culture and commitment to environmental activities. Results: The differences in the level of environmental competencies between faculties that have mastered and have not mastered the program of the variable course, as well as gender differences in the degree of program development, are shown. Conclusion: The effectiveness of studying medical ecology within the framework of the elective course, the growth of the general level of environmental culture of university students, as well as certain gender differences in the activity and value components of environmental culture are shown.

Introduction: GDM is the most common metabolic disorder during pregnancy. Macrosomia, which accompanies 15-45% of deliveries in patients with GDM, poses significant risks for both mothers and newborns, such as shoulder dystocia, birth trauma, and a high probability of cesarean section.
Validation of qualitative and quantitative values of laboratory and clinical markers of GDM and macrosomia is the key to building an adequate model for predicting and dynamically monitoring the effectiveness of prevention and therapy of maternal and fetal metabolic disorders.

Aim: To create a bank of biological materials and conduct a series of studies using omics technologies to expand our knowledge of the pathogenesis of fetal growth and developmental abnormalities in gestational diabetes mellitus.
Materials and Methods: In order to conduct the research, we collected blood plasma samples from pregnant women in their first trimester, laboring women, amniotic fluid, and umbilical cord blood plasma residue. These samples were then frozen and stored at a temperature no higher than -80°C for no longer than 6 months. This study included a sample size of 100 laboring women aged 18-45 with a gestational age of 34-41 weeks. The women were divided into groups with and without gestational diabetes mellitus (GDM).
Enzyme-linked immunosorbent assay (ELISA), molecular genetic, and mass spectrometry analysis were performed on the samples.
Results: A comparative analysis revealed that women with gestational diabetes mellitus (GDM) had higher body mass index (BMI) values and plasma concentrations of glucose and fibrinogen, compared to the control group. They were also more likely to have a specific gene polymorphism in the fibrinogen G/A gene, and their profile of autoimmune antibodies was altered by supraphysiological levels of apoptosis and insulin resistance, respectively. In the absence of fetal macrosomia, there was a decrease in the level of tissue plasminogen activator in the plasma of mothers with GDM.
Mass spectrometric analysis of blood amino acids in women with GDM showed lower concentrations of tryptophan (TRP) and gamma-aminobutyric acid (GABA). There was also a decrease in amino acids responsible for protein synthesis, such as lysine and methionine, in the amniotic fluid and umbilical cord blood of women with GDM, while the concentration of amino acids associated with macrosomia increased.
Conclusion: The study confirms the presence of metabolic, immune and hemorheological abnormalities in maternal GDM, associated with altered amino acid composition in umbilical cord blood and amniotic fluid of newborns with macrosomia. These metabolic changes may serve as biomarkers for early identification of the risk for adverse perinatal outcomes. Further research on biological material in early pregnancy and the use of advanced bioinformatics techniques for data analysis could help to justify the feasibility of a dynamic biobank from early pregnancy to delivery for personalized maternal care in women with metabolic conditions.

Key words: gestational diabetes mellitus; pregnancy; macrosomia; metabolomics; biomarker; biobanking;

Aim. To optimize the microRNA sequencing library preparation protocol based on the commercial QIAseq miRNA UDI Library Kit to improve the quality of the obtained data.

Material and methods. Plasma and serum samples of four study participants were selected from the biobank collection of the NMRC for Therapy and Preventive Medicine. RNA was isolated for each sample in parallel from 200 and 300 μl. From each RNA sample, two libraries were prepared for sequencing using the QIAseq miRNA UDI Library Kit according to two versions of the manufacturer's protocol: for 1 ng of input RNA with a reduced number of amplification cycles and for 10 ng of input RNA. Sequencing was performed on a NextSeq 550.

Results. When comparing groups of samples prepared using different protocol versions, the tags per million reads (TPM) per sample for human genes (ENCODE v47) and for miRNA genes were significantly different (p<0,001).

Conclusion. It was shown that when using plasma and serum biosamples, the main parameter influencing higher miRNA sequencing rates is a decrease in the number of PCR cycles during library preparation.

Aim. To assess the effect of long-term storage of biobanked plasma samples on the profile of circulating microRNAs.

Material and methods. The study included paired aliquots of plasma from 10 patients from the biobank collection of the National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthсare of the Russian Federation. The control group consisted of microRNA samples isolated 1.5 years after plasma collection and then stored in an aqueous solution for 3.5 years. In the long-term plasma storage group, microRNA was isolated from the second plasma aliquot after 5 year storage. All samples were stored at -70 °C. Sequencing was performed for both groups simultaneously on the NextSeq 550 platform (Illumina, USA) using the High Output 1×75 bp protocol.

Results. Principal component analysis based on human microRNA gene expression data (ENCODE v47) showed heterogeneity of the studied groups. In the long-term plasma storage group, statistically significant decreases in library concentration and size, and more than two-fold increase in expression levels were observed for 31 microRNAs compared to controls.

Conclusion. Circulating microRNAs showed higher stability when stored in plasma than in aqueous solution. These results highlight the need to consider the storage time of isolated microRNA along with other preanalytical factors to improve the reproducibility of microRNA studies.

Summary. 
Objective: to study the effectiveness of integrating lectures into the process of teaching therapeutic disciplines in medical education with the focus on developing competencies related to empathy, communication, and interdisciplinarity, as well as the correct and timely routing of clinical cases. 
Materials and methods: the project is being implemented at the Siberian State Medical University of the Russian Ministry of Health. Students, residents, and continuing education students participate in integration classes that combine the disciplines of "Hospital Therapy" and "Hospital Surgery." The classes are conducted according to the working programs and the academic schedule. Real-life cases, discussions, interactive methods, and elements of problem-based learning are used.

Results: The implementation of integration lectures improved the quality of education, increasing the students' interest and the depth of clinical material acquisition. Students and residents noted an increase in motivation and the effectiveness of independent work. The use of digital resources and the bank of integration lectures allowed for in-depth study of key areas of interdisciplinary interaction, such as the diagnosis and treatment of complex diseases of the esophagus and stomach. 
Conclusion: Integration lectures are an effective tool for developing interdisciplinary thinking and forming a holistic understanding of a doctor's professional activities. They contribute to improving the quality of medical education by providing a comprehensive understanding of medical issues and training specialists who can successfully navigate the rapidly changing healthcare landscape.

Aim: To study Russian medical universities' approaches to implementing the competency "Conducting and Monitoring the Effectiveness of Measures to Prevent and Promote a Healthy Lifestyle and Health Education of the Population," formulating achievement indicators, and assessing the "Know-Ability-Practicability" (KAP) levels.

Materials and Methods: Web scraping – extracting the main professional educational programs (MPEP) in clinical specialties from the official websites of medical universities. Subsequently, they analyzed the course syllabi, curricula, and competency matrices to identify the list of courses in which the general professional competencies (GPC) "Conducting and Monitoring the Effectiveness of Measures to Prevent and Promote a Healthy Lifestyle and Health Education of the Population" are developed. A comparison of the indicator formulations and competency achievement results (KAPs) was conducted.

Results. A comparative analysis of the wording of the indicators and knowledge-based objectives for mastering the GPC-2 competency presented in the "Hygiene" course syllabi for specialty 31.05.01 "General Medicine" at three Russian medical universities does not allow us to confidently assert that graduates will develop this competency at the required level when implementing educational programs at some universities. Furthermore, at most universities, the implementation of this competency is carried out in theoretical departments and is not addressed in senior years during clinical courses.

Conclusion. The obtained results indicate a problem in Russian medical education: the lack of a unified approach across the country's universities to developing the general professional competency "Implementation and monitoring of the effectiveness of measures to prevent and promote a healthy lifestyle and sanitary and hygienic education of the population" and the absence of a list of courses that graduates must complete to master this competency.

Summary.
Purpose: The study is devoted to the introduction of innovative methods into the traditional training process of doctors in disciplines of the therapeutic profile, aimed at increasing the efficiency of the educational process through project activities, the use of the format "invertum" ("inverted class"), distance educational technologies and the principles of personalized medicine.
Materials and methods: The method "invertum" (the format of the "inverted class") was used, implying the preliminary independent development of theory by students outside the classrooms, followed by the analysis of practical tasks and cases in classes. Real case histories, laboratory indicators, and instrumental data were used to develop analysis, critical thinking, and decision-making skills. Special attention was paid to studying diagnostic indices, scales, and specialized panels, such as the gastropanel, which allows for the detection of chronic atrophic gastritis and the assessment of risks.

Results: It was found that the combination of traditional teaching methods with innovative technologies improves the quality of professional training of medical university graduates and students of the system of additional professional education. The educational process became more effective due to the optimization of time distribution, strengthening of the motivation of students and teachers, improvement of communication and teamwork skills. Students developed the ability to independently plan their time, quickly find the necessary information and critically perceive scientific data. The new approach allowed doctors to make timely diagnoses and prescribe appropriate treatment, taking into account the individual characteristics of each patient.
Conclusion: To further improve the quality of medical education, it is necessary to continue modernizing the educational process, including modern distance learning tools and interactive technologies in the programs, and reviewing the system.

Objective. To evaluate the results and identify problems associated with the primary accreditation process in the specialty of "General Medicine."
Materials and Methods. The results of the primary accreditation process for specialty 31.05.01 "General Medicine" for the period 2022-2024 were analyzed. The accreditation process was conducted at the multidisciplinary accreditation and simulation center established at the Saint Petersburg State Pediatric Medical University (SPbSPMU).
The total percentage of individuals who passed each stage of the primary accreditation process, as well as the scores for the first stage, were assessed. Statistical analysis was performed using the chi-square test.

Results. The initial number of individuals seeking primary accreditation over the three years under review was 109, 153, and 151, respectively. 48.4% of those accredited successfully completed the first stage on the first attempt. The proportion of individuals who failed the first stage, using three attempts, increased by 1.8 times from 2022 to 2024 (p<0.01), primarily due to international students. The overall trend of successfully completing the second and third stages in approximately 80% of cases persisted. When assessing the results of the first stage of accreditation, a percentage decrease in "excellent" results was noted from 34.0 to 19.2% (p<0.05).

Conclusion. Positive results in the primary accreditation process for the specialty "General Medicine" were reported by two-thirds of the graduates who applied. Unsatisfactory results are primarily related to the first stage of testing, with a significant contribution from the accreditation results of international students, who require a special approach to preparation.