Anesthesia in patients with massive mediastinal tumors remains a current problem of thoracic anesthesiology as at this category of patients the disease often is complicated by the syndrome of a mediastinal compression (MCS) that results in high risk of haemodynamic and respiratory problems during anesthesia induction.We have proposed a technique of anesthesia induction to patients with MCS by method of mask inhalation anesthesia with sevoflurane excluding muscular relaxants. For assessment of degree of a mediastinal compression we offered functional orthoclinostatic test - transfer of the patient to the Fovler’s position with an inclination by 45% with determination of dynamics of the cardiac index.The results have shown that inhalation anesthesia induction with sevoflurane is a preferable method in patients with mediastinal compression syndrome, revealed during functional test (increase in the cardiac index in the Fovler’s position). It is characterized by more stable parameters of mean arterial pressure, less number and severity of critical incidents.

Changes in oxygenation, brain metabolism in various types of anesthesia during the operation of carotid endarterectomy were studied. The study included 80 patients who underwent an eversion carotid endarterectomy. Depending on the type of anesthesia,patients were divided into 2 groups, in the first group operations were performed under total intravenous anesthesia on the basis of propofol, in the second group - under endotracheal anesthesia based on sevoflurane.The conducted study showed that in case of sevoflurane anesthesia in reconstructive surgery of carotid arteries in comparison with total intravenous anesthesia on the basis of propofol a more optimal level of cerebral blood flow and brain metabolism is supported, which makes it a choice variant in this area of vascular surgery.

Instrumental studies were conducted to predict restenosis in the coronary stent at the acute coronary syndrome. The study included 4028 patients with acute coronary syndrome receiving inpatient treatment in Republican Cardiology Center of Ufa in the period from 2003 to 2017. To improve the long-term results of percutaneous coronary interventions, it is necessary to identify the predictors involved in the pathophysiology of restenosis in the coronary stent. Research methods included biophysical (ECG, Holter-ECG, Holter-AD, intravascular ultrasound, optical coherence tomography, MRI, MSCT, coronary angiography, echocardiography) investigations. Laboratory indices of heart failure, destruction of cardiomyocytes (myoglobin, CPK-MB, and Troponin T) of the coagulation and anticoagulation system of the blood (fibrinogen, INR, APTT). The analysis of the obtained data showed that restenosis in the coronary stent most often developed in men of the older age group, who had single long, narrow stents. The most significant parameters for the prediction model of restenosis development in the coronary stent in the late postoperative period after emergency stenting of coronary vessels are the number and diameter of the stents with the highest sensitivity and specificity, as well as such parameters of echocardiography as the final systolic size of the left ventricle and the diameter of the ascending part of the aorta.

Basic risk factors, provoking pelvic floor muscle dysfunction are: pregnancy, vaginal delivery, obstetric trauma, systemic dysplasia of connective tissue. The frequency of the disease in women of reproductive age varies from 26 to 31%. All over the world, different modifications of Kegel’s exercise complexes are used for strengthening pelvic floor muscles. However, nowadays, there are no clear clinical guidelines, target circle of patients is not defined, there are no specific schemes of therapy and evidence base is absent. Health care providers don’t motivate women enough to perform pelvic floor muscles strengthening exercises regularly at home, they don’t use biofeedback method, as control.In results of our study, in comparison with other groups, women after first vaginal delivery with episiotomy had the lowest indi-ces of pelvic floor muscle strength. By the authors opinion, it might be caused by maximal perineal trauma during delivery. In this group usage of exercise complex for pelvic floor muscles strengthening with biofeedback significantly improves pelvic floor muscle contraction strength. Usage of exercise complex in women after first vaginal delivery without episiotomy did not have significant impact on pelvic floor muscle contraction strength.Indices of pelvic floor muscles contraction strength after 8 months postpartum don’t restore up to the indices before pregnancy. Further prolonged researches are required in order to define whether it is generally possible to restore completely postpartum functional opportunities of pelvic floor muscles.

Recent studies have shown that one of the main causes of spontaneous abortion is an autoimmune response with the prevalence of inflammatory cytokines, which contribute to the enhancement of the rejection reaction with the development of the immune response along the cellular pathway and its predominance over the humoral one. Whereas its imbalance is important and responsible for the preservation of pregnancy. The work studied the results of treatment of threatened miscarriage in 87 primigravidas, making up the main group in the early stages (4-7 weeks) of pregnancy. The control group consisted of 56 primigravidas with a physiologically proceeding pregnancy. It was shown that the administration of progesterone support to prolong pregnancy makes it possible to block the interleukin cascade along the Th1 pathway and activity along the Th2 pathway.

The purpose of our research was to make a study of impact of acetylcysteine (NAC) on lipid peroxidation index in platelets, antioxidant system, vascular thrombocytic haemostasis in patients suffering from severe chronic obstructive lung disease (COLD).The results suggested that NAC administration for comprehensive treatment of COLD encourages lipid peroxidation activity decrease: indices of lipid peroxidation were on average 1.6 times lower than in the group of standard treatment with faster antioxi-dant protection recovery, encouraging improvement in the clinical course of the disease.

Lack of donor material and immune rejection are an acute problem of existing methods of keratoplasty. Modern cellular technology can be an effective solution. In our work, we consider human corneal keratocytes as an accessible source of induced pluripotent stem cells.Human keratocytes isolated from the donor cornea were subjected to episomal reprogramming. Within a day the colony of ker-atocytes was affected by a number of reprogramming factors: Oct4, Sox2, Klf4, Lin28, L-Myc and p53. After several phases of keratocytes division, cell foci similar in their characteristics to pluripotent stem cells were identified. The derived induced pluripotent stem cells were mechanically isolated, passaged and verified by immunofluorescence analysis.

The article presents the results of the study of morphological and anatomical features of burnet raw materials with the use of macroscopic and microscopic analysis. The study revealed characteristic external signs of burnet, identifying raw material: for the herb it is a description of stems, leaves, flowers and blossoms, their color and smell; the morphological features of the roots and rhizomes include the nature of bending and coloring of the outer cork. Investigation of microscopic features of burnet raw material determined diagnostically significant signs that allow to set the indicators of authenticity. Description of burnet pays attention to the sinuous epidermal cells of leaves with clearly visible bulges, amphistomatic leaf type, stomata of irregular-celled type; presence of simple, capitate trichomes, clusters of calcium oxalate, a container with yellow contents; the polygonal cells of the epidermis of the flower with simple hairs, clusters, stomata of anomocytic type, characteristic of the pollen grains. Rhizomes of burnet is characterized by a well-pronounced core with large parenchymal cells, cork, primary bark, continuous cambial ring, powerful radial rays. Roots of burnet have a secondary structure with a pronounced cork, primary bark, central cylinder and characteristic microdiagnostic elements.

Incisors and canines of the lower jaw have a complex structure. On average, every third central and lateral incisor has an additional channel. In 6% 33 and in 2% 43 teeth are two-rooted, two-channel, with two apical holes. The cervical additional roots, which are formed in the region of the tooth neck and apical, which are formed in the lower apical third of the tooth root, have been revealed. Cone-ray computed tomography allows to study in detail the features of the structure of incisors and canines of the lower jaw.

The work aimed to establish the feasibility of performing simultaneous bilateral minipercutaneos nephrolithotripsy in a female patient with bilateral nephrolithiasis having medium sized concrements, and to describe the surgical technique.Materials and methods: а 54-year-old woman was diagnosed with the presence of medium sized stones in both kidneys. MSCT of the abdominal cavity without contrast showed the presence in the right kidney of one stone with a maximum diameter of 25mm, density 1440 HU, in the left - two stones located in the pelvis and upper calyx with a maximum diameter of 22 and 17mm. and a density of 2580 and 1440 HU, respectively. The patient underwent simultaneous bilateral minipercutaneos nephrolithotripsy.Results: the total operation time was 90 minutes. Intraoperative complications were not reported. The postoperative period was uneventful. The level of creatinine in the early postoperative period (after 1 day) was stable and amounted to 86 μMol / l. The patient was discharged in 48 hours after surgery. Ureteral stents were removed in seven days after the procedure. The MSCT of ab-dominal organs performed after 2 weeks without contrast demonstrated the absence of stone and normal functioning of both kid-neys.Conclusions: Simultaneous bilateral mini-percutaneous nephrolitholapaxy is a safe procedure and can be offered as a method of surgical treatment of bilateral nephrolithiasis in patients with medium sized stones. These manipulations can be performed by highly qualified endoscopic urologists in specialized clinics.

A comparative analysis of the oxidant system parameters in the liver homogenate of laboratory mice was carried out: the first group isintact, the second one with immunodeficiency induced by intraperitonealadministration of cytostatic cyclophosphamide, the third oneis characterized by having immunodeficiency after addinggluconatesof 3d-metals (3dMeGl). In the second group, there was a significant (4.2 times) activation of lipid peroxidation (LPO) and protein oxidative modification (POM). Therefore, the decrease in the activity of antioxidant enzymes was: glutathione peroxidase (GPX) by 10.4 times, superoxide dismutase (SOD) - 3.5 times, catalase (CT) and glutathione transferase (GT) - 1.7 times, respectively.The combinationof immunodeficiency and3dMeGl(where Me - Mn, Fe, Co, Cu or Zn) has led to the decreased intensity of LPO by 36-91%. Also, the activity of antioxidant enzymes increased depending on the compound used. After treatment withZnGl an increased activity was recorded in all evaluated antioxidant enzymes; CuGl - CT, GT, GPX; CoGl - GT and GPX; МnGl and FeGl -GPX. Moreover, when using CuGl and ZnGl, the values for CT and GT enzymes were significantlyhigherthan in the intact animals.The obtained results showed the corrective action of 3dmetal gluconates, that is the most active while using ZnGl and CuGlon,on the change of oxidant-antioxidant homeostasis during induced immunodeficiency.

Perforation of the gastrointestinal tract is the most frequent reason for abdominal troubles in newborn. Etiology of neonatal perforation of the intestinal tube is usually associated with the necrotic enterocolitis (NEC). However, the other reason for pneumoperitoneum in premature and mature newborns is gastric perforation (GP). Domestic and foreign scientific literature was analyzed. The study presents modern data which confirm the results from many research papers and demonstrate the changes that occurred recently and affected various aspects of the GP concerning its epidemiology, prevention, treatment and outcome prediction. In the present study we strived to present new knowledge of gastric perforation, introduce readers to novel surgical techniques and raise issues of treatment of the disease that remained unclear till now.

At present, there is a significant interest in the introduction of artificial intelligence into practical health care. Giants of the IT industry, such as Google, Microsoft, IBM launched ambitious large-scale medical projects based on artificial intelligence technologies. Moreover, national reports, dealing with using artificial intelligence in national health systems, are published in some developed countries.The paper gives a brief overview of the methods and tasks of artificial intelligence and discusses the prospects for its application to cancer diagnostics and treatment. Progress in automatic recognition of medical imagesis discussed. Artificial intelligence is shown to be able to cope with the task of finding a tumor and its metastases on digital microscopic photographs even better than the pathologist. The problem of malignant tumor diagnosis based on biopsy results is considered. This problem is shown to be solved with a high level of accuracy using various methods of artificial intelligence. The application of expert systems in oncology is discussed. The system "Oncological screening", designed to determine a patient's risk group for cancer, is considered.

In the population, the prevalence of ADHD is up to 5%. The problem of ADHD requires increased attention of the professional community. Previous clinical family studies show that ADHD can be inherited, they are found in our DNA and can be passed on. Currently, the loci associated with ADHD are identified. The study of endophenotype using methods of neurovisualisation and neuropsychology, along with improved statistical methods, allows to reveal non studied before polymorphic variants of a set of genes associated with the etiology of the disease. The study of ADHD risk genes provides us with tools for predicting the occurrence of the disease, assessing the severity of symptoms in the clinic picture, and optimizing treatment.