Objective of the work is a one-center study of the features of carotid artery remodeling and functional disturbances of intracardiac hemodynamics in patients with multifocal atherosclerosis (MFA) under conditions of the Regional Vascular Center No. 1 in Ufa.Depending on the vascular lesion, patients were divided into 3 clusters according to the clinical manifestation of atherosclerotic lesions of the heart, brain and arteries of the lower limbs by the method of hierarchical analysis of categorical variables. 131 of themhad MFA with primary heart damage (1st cluster), 87 with MFA with predominance of carotid lesions (2nd cluster), and 29 patientswith lower limb ischemia (3rd cluster). All patients underwent clinical assessment, ECG, coronary angiography, echodopleroscopy of the carotid and arteries of the lower limbs. According to the indications, magnetic resonance imaging of the thorax and abdominal organs, ultrasound of the abdominal cavity and kidneys were made, and ultrasound of the pelvis, if necessary, was carried out.We found that:The 1st cluster is accompanied by the growth of stage III AH in combination with unstable angina, a history of myocardial infarction (MI), associated with stenotic carotid artery disease, left atrial dilatation, and left ventricular diastolic dysfunction of type 2; The second cluster with acute and chronic ischemic impairment of cerebral circulation also predominantly occurred with the presence of Stage III AH, which was combined with stable angina of 2nd FC and left ventricular hypertrophy, with stenosing carotid artery lesions among them being less often detected and the significance Stenosis was lower, but 25% of the patients showed an in-crease in carotid CTM of 1.3 mm or more, which was regarded as a sign of atherosclerotic carotid artery disease;The 3rd cluster with hemodynamic ischemia with clinical manifestation of vascular lesion of the lower extremities revealed prevalence of grade II AH, stable angina with PK2, early onset of CEH without a previous history of stroke, with intermittent claudication, which was combined mainly with the growth of atherosclerotic plaques, diastolic dysfunction Type 1, dilatation of the ascending aorta and hypertrophy of the interventricular septum.The mutual influence of the comorbid background in MFA changes their clinical picture, the nature of the course, increases the number of complications associated with the development of remodeling of the main arteries and violations of intracardiac hemodynamics.

Sick sinus syndrome (SSS) is a relatively seldom disease characterized by symptoms of tissue hypoperfusion and manifestations on the electrocardiogram. During implantation in the long-term period surgical complications may develop. Features of coronary blood supply are also of great interest. The aim of the study was to analyze surgical complications in patients with SSS and implantd pacemakers, living in the Republic of Bashkortostan.In these patients (n = 61) we analyzed surgical complications over 39,7±0,8 months. In some patients (n=156) features of blood supply were analyzed. After the pacemaker’s implantation complications were found in 10,4% of cases, most often hematoma pocket pacemaker (n=18, 2.9%), pacemaker syndrome (n=10, 1.6 %), pacemaker dysfunction (n=9, 1.4 %) and pacemaker pressure ulcers (n=8, 1.3 %) were registered. During pacemaker implantation according to the type of stimulation complications occurred more often in in VVI - 9.9 % and in DDD stimulation - 9.3 % of cases, less frequently in AAI - 8.8 %. CAG revealed left artery descendens (LAD) stenosis in 32.1% of causes, right coronary artery (RCA) in 26.3%, CA in 21.2% and RCA trunk in 5.1%. In bradycardia LAD were more often stenosed (36.33 %), sinoatrial block II - LAD and RCA (6.33%), sinoatrial block III degree and node failure - LAD and RCA (9.36%).Thus, it was established, that after the pacemaker’s implantation complications were found most often in VVI stimulation and CAG revealed left artery descendens stenosis in most cases.

Diverticular disease of the colon (DDC) occurs in 30% of population. 10-60% of DDC cases develop complications of acute inflammatory character, the most frequent being perforations (27.2%).This paper presents the analysis of the results of early diagnostics and treatment of complications of DDC - perforated diver-ticulitis. The studied group included patients with DDC, complicated with perforated diverticulitis, admitted for in-patient treatment in State Clinical hospital № 21 (Ufa) over the period 2000 to 2016. The issues of diagnosis and both medicinal and surgical treatment of patients with perforated diverticulitis are discussed. The paper shows the possibility of conservative treatment of perforated diverticulitis complicated by local limited peritonitis.

The main cause of death of patients with mechanical jaundice is the progression of hepatic insufficiency after performing surgical intervention. Postoperative mortality among patients with non-tumorous jaundice is 5.6-6.3%, and among patients with tumorous jaundice - 10,6-25,7%. A comparative analysis of the surgical treatment of two groups of patients with a syndrome of mechanical jaundice of different genesis was carried out. The first group included patients whose surgical treatment was performed without prior X-ray endobiliary intervention. The second group consisted of patients who had previously undergone X-ray endobiliary interventions of various volumes. The presented comparative analysis showed that the use of preliminary drainage and decompression of the bile ducts allowed to reduce postoperative complications from 17% to 9.1%, and lethality - from 11% to 6%. The article ends with a brief summary of the possibilities of x-ray endobiliary technologies in the complex treatment of mechanical jaundice of various genesis.

High prevalence of somatic diseases among patients with bipolar disorder requires further widening of knowledge about interaction of affective and somatic pathologiesThe aim of the research was to study the structure and clinical importance of somatic comorbidity in patients admitted to psychiatric hospital with diagnosis of bipolar affective disorder (BAD).A continuous sample of 64 patients admitted to Samara Psychiatric Hospital in 2016th year with diagnosis of BAD (F.32) was studied. 18 of them (28%) were female and 46 (72%) - male. Mean age of the patients was 45.5±12.1 years old.All the patients had comorbid somatic disorders. Each patient had from 2 to 12 somatic diagnoses, 6.2±2.98 on an average.Structure of chronic somatic disorders in patients with BAD was the following: 96% had neurological diseases, 80% had cardiological, 72% - nephrological, 52% - endocrinological, 36% - gastroenterological, 36% - pulmonological, 28% - autoimmune and allergical, 12% - oncological, 16% - other. 86% of the studied women had gynecological diseases.The most important consequence of present somatic comorbidity in patients with BAD is need for many organizational and clinical decisions in providing medical care, besides the ones aimed at psychopathology. In training doctors and ordering equipment for psychiatric hospitals, points considering the revealed comorbidity structure should be stressed. Another aspects influencing the clinical practice are: somatic disorders as a precondition for emergency conditions; somatic disorders modifying the course and prognosis in BAD and vice versa; somatic comorbidity as a contraindication to for psychopharmacotherapy and as a fact requiring special attention to interaction between the drugs prescribed for treatment of BAD and a comorbid somatic disease.

Ionizing radiation affects not only a tumor but also normal tissues and organs, which are inside the exposure area, and leads to late adverse effects of radiotherapy. Adipose tissue is considered to be an alternative to bone marrow as a source of multipotent mesenchymal stem cells (MMSCs). High regenerative potential of fatty tissue is due to presence of MMSCs in it, hence it is reasonable to use different products based on lipoaspirate in regenerative medicine.The goal of this study is to analyze morphologic and immunophenotypic profile as well as proliferative potential of adiposederived stromal vascular fraction (SVF). For SVF isolation enzymatic digestions was used. The results of the study proved the presence of vital MMSCs in lipoaspirate, obtained by aspirate liposuction. Thus, cell products based on adipose tissue is a promising material for future investigations and implementation into clinical practice.

The purpose of this study is to develop a universal algorithm for analyzing the spectrograms of Raman scattering (Raman- spectroscopy) using intelligent data processing methods.The presented algorithm is realized by the authors in the programming language Python and represents a sequence of mathemat-ical transformations of Raman spectra for the purpose of automatic recognition of normal and tumor tissues.It is found that the optimal algorithm is the calculation of the baseline spectrum by iterative polynomial regression, subsequent frequency analysis of the spectrum, determination of the main components of the spectrum, and machine learning. The reliability of identification and classification of normal tissue and tissue of a malignant tumor was 97.5 to 98%.

In connection with a steady increase in the number of liver diseases, the search for new herbal formulations that have a hepatoprotective effect is topical. To introduce new medicinal herbal preparations into practice, it is necessary to develop a regulatory document regulating the quality of herbal formulations. The article deals with the development of a methodology for the quantitative determination of flavonoids in a new hepatoprotective preparation. To develop the technique, a spectrophotometric method was used. Various parameters of extraction of flavonoids have been studied. Optimal conditions for the extraction of flavonoids (raw materials, ethyl alcohol concentration, extraction time), the amount of complexing agent, and the formation of a complex of flavonoids with aluminum chloride were detected. According to the research, a spectrophotometric method for quantifying the amount of flavonoids in terms of hyperoside was developed. The content of flavonoids in the hepatoprotective collection averaged 1.53±0.03%. Based on the data obtained, a numerical indicator was developed for the inclusion in the draft of a pharmacopoeial article for hepatoprotective collection - the content of flavonoids is not less than 1.2%.

The paper presents the results of the study of acute toxicity and antidepressant activity of hydrazide of 2-[1,3-dimethyl-7- (tiethanil-3) xanthinyl-8-thio]acetic acid with a single and long-term administration in a wide dose range. The experiments were performed on white outbred mice. A singly studied compound was tested at doses of 35 mg / kg, 23 mg / kg, 12 mg / kg, 5.4 mg / kg,3.7 mg / kg, 1.95 mg / kg and 0.97 mg / kg. In chronic administration, the compound was administered at the lowest effective dose(0.97 mg / kg) during 14 days. It was found that hydrazide of 2- [1,3-dimethyl-7-(tiethanil-3)xanthinyl-8-thio]acetic acid belongs to the class of low-toxic compounds. In the tests, "tail suspension" and "forced swimming" showed that the most pronounced antide- pressant effect of the compound is after a single dose of 5.4 mg / kg, reducing the ID by 61% compared with the control. In chronic administration at a dose of 0.97 mg / kg, 2-[1,3-dimethyl-7-(tiethanil-3)xanthinyl-8-thio]acetic acid hydrazide has an antidepressant effect comparable to that of the comparative preparation fluoxetine. In the "open field" test, the compound under study with a single and prolonged intraperitoneal injection does not affect the motor and orienting-research activity and emotional anxiety of mice.

Derivatives of аnthranilic acid, which became known as representatives of a wide range of pharmacological activities, are an interesting and promising class of compounds in the field of synthesis.R-benzylidenhydrazides were obtained by the reaction of condensation of hydrazide NH-2-methoxybenzoyl-5-iodoаnthranilic acid with aromatic aldehydes in the ethanol medium in the presence of hydrochloric acid under stirring for 1 hour at a temperature of 18-20°C. Purity of the obtained products was controlled by TLC. The structure of the compounds was confirmed by 1H NMR spectroscopy.Antimicrobial and antifungal activities were investigated in the obtained new compounds. According to results of the study, the obtained substances exhibit a depressing effect on the growth of bacterial and fungal cultures in a concentration of 1000 mcg/ml.

The genus Lunaria L. of the family Brassicaceae in the flora of Russia is represented by 2 species, of which 1 species - Lunaria annua L. is widely cultivated as an ornamental plant. Lunaria annua L. can be considered as a promising domestic source of medicinal plant raw materials. The ability to use a new type of raw material in scientific medicine makes it necessary to study the morphological and anatomical structure of Lunaria annua L. and detection of its characteristic diagnostic signs.The article presents the results of studying the morphological and anatomical features of the flowers of Lunaria annua L. The study of macro-and microdiagnostic features was carried out according to the General Pharmacopoeia articles of the state Pharmacopoeia of the Russian Federation XIII edition. The result of the research revealed the characteristic diagnostic features that allow to reliably identify medicinal plant material, and can be used in the development of regulatory documents for «External features» and«Microscopic features». Morphological and anatomical characteristics of flowers of Lunaria annua L. were studied for the first time.

Plasters of various types are widely used in life and work of various medical organizations In their production various excipients as adhesive materials or means of fixing of the main material of the carrier are used. Due to the fact that main excipients in the composition of plasters are substances of foreign production, it is rather urgent to replace them by substances of domestic production.The objective of the research is to study the possibilities of use of low-molecular polyethylene (LMPE) as the main component in plaster production.When determining an appropriate structure of a plaster on the basis of low-molecular polyethylene we studied various struc-tures of plaster masses and influence of various excipients on physical, chemical and technological qualities of the plasters received on their basis (resistance to flaking, the amount of plaster weight in a plaster, vapor permeability, water penetration of the fixing layer). It is established that LMPE in a certain combination with excipients can be used as the main substance for obtaining plaster weight meeting the requirements of General monograph "Medical plaster" of GF XIII edition. An appropriate ratio of LMPE with polyethyleneglycol is 400 - 60:40.

As a result of this study, synthesis of N -phenylacetamide derivatives of thiethanylpyrimidine-2,4(1 H ,3 H )-dione was studied. The structure of the newly synthesized pyrimidin-2,4(1 H ,3 H )-dione derivatives was determined using spectral methods of analysis, and their physico-chemical properties were investigated. The antimicrobial and antifungal activity of the obtained compounds was studied.The identity of the synthesized compounds was confirmed by thin-layer chromatography and the determination of the meltingpoint, the establishment of the structure of the obtained compounds was carried out using IR and NMR spectroscopy methods. Determination of antimicrobial and antifungal activity was carried out by the method of "diffusion into agar" and tenfold serial dilutions in meat-peptone broth.The corresponding 2-chloroacetanilides were synthesized by acylation of arylamines with chloroacetyl chloride in an aqueous alkaline medium or in acetone. Alkylation of 6-methyl-3-(thiethan-3-yl)pyrimidine-2,4(1 H ,3 H )-dione with 2-chloroacetanilides in the presence of potassium carbonate leads to the formation of the corresponding N -phenylacetamide derivatives.As a result of the study of antimicrobial and antifungal activity, some patterns of the structure-activity relationship have been established. Thus, the presence of acetylphenyl, methyl fragments in the structure of acetamide derivatives of 6-methyl-3-(thiethane- 3-yl)pyrimidine-2,4(1 H ,3 H )-dione led to the manifestation of antimicrobial and antifungal propertiesThe obtained results show the prospects of searching for new antimicrobial and antifungal drugs in the series of N - phenylacetamide derivatives of thiethanylpyrimidine-2,4(1 H ,3 H )-dione whose structure is fundamentally different from the known antibacterial drugs.

Currently pyracetam substance and its medicinal forms are widely used in medicine. But there is no unified method of quantitative determination of pyracetam in the substance and medicinal forms.The aim of the research is to develop the unified method of quantitative determination of pyracetam in substance and dosageforms by high performance liquid chromatography (HPLC).Taking into account the properties of the studied preparation, the stationary phase and the eluent, a mobile phase from methanol and water (2:8) was experimentally selected for the quantitative determination of pyracetam in the substance and dosage forms. Validation of the results of the study showed specificity, high reproducibility and accuracy of the developed procedure with a relative error of ±1.53% for capsules of pyracetam and ±0.98% for the injectable solution of pyracetam.Thus, a reliable unified procedure for the quantitative determination of pyracetam in dosage forms by the HPLC method was developed.

Arterial hypertension is one of the most widely spread diseases. About 40 % of Russian population suffers from hypertension, including not only old patients, but also young people. The latter have a high risk for symptomatic hypertension, determined by chromaffinoma and paraganglioma as well.The paper presents a clinical case of retroperitoneal malignant paraganglioma in a young man. It also reveals current data on diagnosis, clinical picture and treatment of abdominal paragangliomas.The presented clinical case of retroperitoneal malignant paraganglioma once again demonstrates the necessity of timely appointment and adequate interpretation of modern laboratory and radiation diagnostic methods, especially in young patients with es-sential hypertension, and also the advisability of more active use of surgical methods for diagnosis and treatment of retroperitonealtumors.

This clinical observation presents the experience of using multispiral computed tomography (MSCT) with bolus contrast with the use of a reduced amount of contrast medium in the evaluation of renal transplants of patients in the late post-transplant period. The majority of the subjects were patients with transplanted kidneys on the external iliac artery. For research, two groups of patients were formed and divided according to the principle of conserved and non-existent functions of transplants. Multispiral computed tomography (MSCT) with bolus enhancement is the most reliable method of organ evaluation, it allows to assess the appropriate functioning of the renal system after kidney’s transplantation or the validity of transplantatectomy. It should be noted that the use of ultrasonography in these cases is safe, but we can’t get practical information of the filtering ability of the kidney. This research considers the use of MSCT in patients after kidney transplantation, as well as in patients with chronic renal failure (CRF) in the terminal stage, receiving a substitution therapy as program hemodialysis.

The article describes a new method for determining the sensitivity of microbes to antibiotics. The urgency of the problem is determined by the need for early prescribing in purulent diseases and postoperative complications of antibiotics effective for the identified microflora in a particular patient.To obtain a microbiological conclusion, certain time is usually required and the so-called “starting” therapy with antibiotics isusually prescribed, the latter may be ineffective at this particular infection. The proposed method allows to calculate the sensitivity of microbes of a particular species to a specific antibiotic (coefficient ka), and also using the second coefficient (kg) - to determine the proportion of microbes of a given population that is sensitive to one or another group of antibiotics. The first factor ka allows to choose the most optimal antibiotic for a particular patient, and the second kg - to designate in the clinic, a medical organization antibiotics of reserve to reduce the likelihood of antibiotic resistance.

Doubling of the gallbladder occurs in 1 case per 4000. The so-called “ductular” gallbladder is a variant of doubling gallbladder. There are two completely formed organs, nourished by two cystic arteries. Literature data present observations of calculus formation in one or simultaneously 2 gallbladders with the development of acute calculous cholecystitis.The paper presents a case of successful treatment of rare congenital malformation of biliary system, true "ductular" doubling ofthe gallbladder.

Infections associated with health care (IAHC) or nosocomial infection (NI) (Healthcare associated infections - HAIS) are infections acquired by patients during treatment and medical care. Surgical site infections (SSI), according to WHO are the most frequent type of nosocomial infection in countries with middle income. SSI is found in 1/3 of patients after surgical intervention. The review provides data about the epidemiology and prevalence of SSO and describes methods of preoperative prevention.

The aim of this work was to analyze the market of drugs purchased by the State-financed Institution of Healthcare "Orenburg regional Clinical Psychiatric Hospital № 1". The objects of the research were operational and statistical reports of the specialized in- stitution and data of the public procurement portal. We used systemic, logical and marketing analysis techniques.Budget financing of the institution for medicines was not the same and significantly changed in the period of 2013-2016. In2014, there was a dynamic increase in funding by 216% compared to 2013, but in the period from 2015 to 2016, there was a sys- tematic decrease in funding to the level of 2013. A large share of the budget for medicines was spent on the purchase of neurolep- tics, namely in 2013 - 84% of the total funding in 2014, 2015 and 2016 - 98%.The average price for the most popular neuroleptics for the period of 2013-2016 remained unchanged or increased insignificant- ly, at the level of average annual inflation in Russia. The institution managed to maintain the quality of specialized psychiatric care for patients with schizophrenia.

Currently, the priority tasks of public health in any country are the standardization of terms and the creation of the nomenclature classification of medical devices, which make it possible to identify and regulate their circulation at the world level. Based on the translation of the electronic publication «Global atlas of medical devices» and the content analysis of legal documents and reference materials, it was revealed that countries in six WHO regions (African, Southern and North America, Eastern Mediterranean, European, Southeast Asia and Western Pacific) use world nomenclature classifications, such as UMDNS (12% of the responding countries surveyed in the WHO survey), GMDN (10%) and national nomenclature classifications of medical devices (26%). The use of these or those nomenclature classifications depends on the geographical location of the country and the level of income per capita per year. Only 19% of the responding countries use the existing nomenclature classifications of medical devices for the purchase of medical devices and to regulate their treatment. The Russian Federation, which is part of the WHO European Region, has its own national nomenclatural classification, developed on the basis of the world classification of GMDN, for regulating the stages of medical devices circulation.

This article is devoted to relevant and up-to-date issues of development of a flexible system of continuing professional education - continuing medical and pharmaceutical education. Special attention is paid to teaching methods, in particular, simulation training, which is successfully implemented in the Institute of Pharmacy of Kazan State Medical University based on the center “Training pharmacy of KSMU”.Conceptual framework of modern education, both basic and postgraduate, is a competence approach and result of education is possession of competencies. Competence approach is a departure from the usual information perception and search for the optimum use of existing knowledge in practice. This approach integrates the problematic, imitation-gaming, cultural and other methods.Authors carried out a sociological study by questioning pharmacists trained in this system. As a result we formed a sociological portrait of pharmacist-listener of certification training cycles. It has been stated that pharmacists-practitioners show big interest to simulation training methods. Male trainees expressed greater interest in debating, software and computer teaching methods. Female trainees showed more interest to explanation, conversations and lectures.

Currently, probiotics are widely used in medical practice and they are the subject for comprehensive scientific research. Materials of the study: the data of the Department of Drug Supply and Medical Equipment under the Ministry of Health of the Kyrgyz Republic on registration of probiotic preparations and price lists of wholesale pharmaceutical companies. A content analysis was conducted on the distribution of this group of drugs according to the classification of ATC, by producing countries; segmentation by basic dosage forms and price characteristics.As a result of the analysis of the pharmaceutical market of probiotics in the Kyrgyz Republic, it has been established that there are 17 trade names for probiotics on the local market. The largest part of the assortment consists of preparations from the group "A07FA01 - antidiarrheal microorganisms producing lactic acid", represented by 7 trade names (41.17%). Probiotic preparations from foreign countries (58.82%) prevail in the supply structure, Slovenia being the leading producer country. The most economically available probiotics are solid dosage forms, they also have a greater specific gravity among the remaining dosage forms, and they are remain in the price segment from 80 to 250 som ($ 1.5-3.62).

This article presents the results of the analysis of the pharmaceutical market of phytopreparations in the Kyrgyz Republic. Materials for our studies were the current data of the Department of Medicine Supply and Medical Equipment, as well as the State Register of Medicines and medical products for 2010-2018. Classification, statistical, comparative and economic analysis of phytopreparations market was carried out. We analyzed the assortment and dynamics of registration of phytopreparations of domestic and foreign production, classifying them according to the forms of release and the types of therapeutic action. We also determined the amount of phytomedicines delivered to the Kyrgyz market in physical terms for each year in the period from 2010-2017.In addition, we analyzed the dependence of the rate of growth on the price of herbal preparations for 7 years and an indicative marketing forecast for the development of the phytopreparations pharmaceutical market for 2017-2022. Based on the results of our forecast, the growth in the supply of plant-derived products to the CR market will continue, and by the year 2022, it may reach about 295 million soms.

The article presents the results of ranking by types of offences in the dispensation of medicinal products in the Lebanese Republic, 2010-2016. It was found that grade 1 had offenses related to the sale of drugs without a prescription: the cumulative proportion of specific gravity made up 93.59%. The highest rates of increase in the number of offenses were recorded among pharmacists with the release of medicines, in an unspecified place - an average of 196.19%. The comparative analysis of prescription forms for medicines in the Lebanese Republic, the United Arab Emirates, Kuwait, Jordan. According to the number of additional requisites in prescription forms for prescription drugs for medical purposes, with the exception of narcotic drugs and psychotropic substances, among the analyzed countries, the Lebanese Republic was ranked 1: the total number of requisites was 36. In this case the prescription of narcotic drugs and psychotropic substances additional details were 2.4 times less. The proportion of the additional details that have availability ratio in the recipe 0,13-0,25, in the Lebanese Republic had a maximum value of 50.00%.