The article is devoted to the topical issue of endoscopic hemostasis in the treatment of polyps and early gastric cancer. The study included 231 patients with tumor pathology of the stomach, of which 140 (60%) patients with polyps and early stomach cancer (groups A1 and A2) operated on according to the principles of tissue surgery. And the comparison group (B1 and B2) consisted of 91 patients (40%), treated by traditional endoscopic methods. A comparative analysis of the application of these methods of endoscopic treatment has been made. Tissue endoscopic surgery due to the improvement of local hemostasis is effective in the treatment of flat epithelial formations up to 30 mm, as well as creeping polyps spread out on a broad basis, as well as in combination with loop electroscission. Studies have shown a reduction in the duration of operations, changes in blood loss, the healing time of the mucosal defect, the quality of hemostasis and a number of complications. Methods of tissue endosurgery demonstrate their relevance and have the prospect for further development and widespread use in medical institutions.

The study aimed to analyze diagnostic value of the longitudinal contact of the parasitic masses with inferior vena cava (IVC) in planning its resection and reconstruction for patients with alveococcosis. Medical records and computed tomography data of 64 patients with alveococcosis were retrospectively analyzed in the interval from 2014 to 2018 yy. All the patients underwent liver resection of different volume, as well as transplantation from a living related donor. The minimum longitudinal length of the contact of the parasitic masses with the IVC when surgeon should plan its resection and prosthetics was 34mm. The sensitivity, specificity, prognostic value of positive and negative results, accuracy of this threshold in the planning of circular resection and reconstruction of the IVC were 100%, 45,8%, 66,7%, 100% and 74% respectively. Conclusion: the longitudinal length of the contact of parasitic masses with IVC according to CT data less than 34 mm allows predicting the absence of the need for its circular resection and prosthetics.

Recent years witness a rising interest to the study of metabolic specific processes in respiratory organs. The term “nonrespiratory functions of the lung” was introduced by J.Jane in 1969. Manifestations of non-respiratory lung function as hypocoagulating and detoxifying processesdepend on the stage of the disease and its complications. The purpose of the research is to study non-respiratory function of the lungs in children with external intestinal fistula (EIF).The work is based on the results of the study of 97 (30.7%) patients with EIF aged from 1 to 18 years old. To assess the degree of hypocoagulating and detoxifying function of the blood, hemostatic parameters and markers of endogenous intoxication in mixed venous blood (MVB) and arterial blood flowing from the lungs were evaluated.The studies of hypocoagulating and detoxifying lung function in children with EIF, depending on the stage of the disease, arterial blood flowing from the lungs and flowing to the lungs mixed venous blood allowto determine the stage of the disorder and the severity of the pathological condition. Markers of endogenous intoxication syndrome and the effect of lungs on MVB and arterial blood flowing from the lungs depending on the underlying disease and its complications were studied. Summary: according to flowing arterial blood, it is possible to judge upon the violation in the system of lung hemostasis in case of EIF. Changes of blood rheology in MVB and arterial blood flowing from the lungs allow to predict latent DIC in the lungs and in the bloodstream.For objective evaluation of general health state of children with EIF it is necessary to control hemostasis system in flowing arterial blood and MVB.

Clinical monitoring of the health status of pregnant women, their fetuses during pregnancy and childbirth, as well as newborns was carried out. At the same time, the generally accepted standard for radiation diagnosis of the fetus was supplemented with a specially developed functional test for the resistance of the fetus to hypoxia. The values of normal and low adaptation of the fetus to hypoxia were revealed. A direct correlation was established between the low resistance of fetuses to intrauterine hypoxia and the high frequency of hypoxic injuries of newborns. It is shown that the absolute majority of fetuses have a high adaptive resistance to hypoxia, therefore, they have normal health indicators during pregnancy, as well as during and after childbirth. Low prenatal resistance of fetuses to hypoxia indicates a depleted adaptation reserve, which significantly more often leads to intrapartum hypoxic brain damage in newborns. The results of observations showed a high prognostic value of the invented functional test. Therefore, it is proposed to supplement medical care for pregnant women with a test for the stability of their fetuses to intrauterine hypoxia.

The purpose of the study is to evaluate the prognostic value of the combined first trimester screening with the calculation of the risk of pre-eclampsia (Pre-eclampsia Predictor from PerkinElmer ™). We retrospectively analyzed the results of the combined screening of the first trimester with the calculation of the risk of early (EPE) and late preeclampsia (LPE) in 144 patients with singleton pregnancy. The risk was calculated based on the assessment of a complex of factors: serum concentration of placental growth factor, protein associated with pregnancy, ethnicity of patients, history of PE, arterial hypertension, body mass index, mean arterial pressure (MAP) and uterine artery pulsatility index (PI) levels in the uterine arteries. The conclusion on the efficacy of the prognostic algorithm was based on the data on predictive value of both positive and negative screening results. The high prognostic value of a negative preeclampsia test indicates the need for widespread implementation of this algorithm in practice.

The indices of intraluminal ultrasonography and dopplerometry were studied in 24 patients with ulcerative colitis who underwent surgical treatment. The wall thickness and blood flow rates in the mesentery and the wall of the affected rectum and small bowel reservoir were evaluated at various stages of surgical treatment. In the patients included in the study, the wall thickness and blood flow velocity in the rectum differed from this indicator after the different stages of surgical treatment. These indicators in the formed reservoir increased after the final stage of surgical treatment. During the evaluation of the results obtained with ultrasonography with Doppler, wall thickening is detected, blood flow is increased in the submucosal mucous layer of the rectum, despite the fact that during endoscopy there may be no data on the activity of the process. The results obtained allow us to quantify the condition of the inflamed rectum and the formed small intestinal reservoir, which allows to correct the conservative treatment of ulcerative colitis, to plan the optimal timing of the stages of surgical treatment.

Purpose of the study was to conduct a comparative analysis of the results of the posterior automated lamellar keratoplasty (PALK), performed using different types of microkeratomes in patients with epithelial and endothelial corneal dystrophy (EECD).The study included 56 patients (56 eyes) with EECD, who underwent PALK in Ufa Eye Research Institute between 2011 and2016. The main group consisted of 29 patients (29 eyes) who underwent PALK using a graft made of PocketMaker microkeratome (DioptexGmbh, Austria). The control group consisted of 27 patients (27 eyes), in which the stage of graft dissection was performed using a Moria microkeratome (France) according to the standard procedure.An increase in the corrected visual acuity was achieved up to 0.8 in the main group compared to the control 0.6 (p <0.01) 12 months after PALK. The decrease in endothelial cell density (ECD) was 34% (1963 ± 354 cells / mm2) in the main group and 40% (1789 ± 172 cells / mm2, p <0.01) in the control group compared to baseline values (2976 ± 240 cells / mm2).A comparative analysis showed the advantages of using grafts made of the PocketMaker microkeratome compared to Moria during PALK, confirmed by morphological and functional results. Transplantability in 12 months was 89,7% in the main group and 81,5% in the control group.

Treatment of the syndrome of angina in valvular heart disease causes certain difficulties, because surgical correction of heart defects is not always accompanied by a decrease in anginal symptoms, and the use of antianginal drugs with hemodynamic action is often contraindicated or is accompanied by a large number of side effects that limit their use. Under dynamic observation there were 40 patients with acquired heart defects who underwent cardiac surgery for valvular pathology. In the treatment group after surgery, an additional drug of non-hemodynamic action of meldonium in capsules was administered at a dosage of 500 mg 2 times a day. In the control group, standardized therapy was used, which included nitrates, beta-blockers, antiplatelet agents. The course of treatment and the duration of observation was 6 months. When assessing the quality of life, 6 months after valve replacement in patients taking the drug meldonium, there was a significant increase in exercise tolerance, a decrease in the incidence of attacks of pain behind the sternum compared with the control group. Thus, administration of Meldonium reduces the frequency of clinical manifestations of transient myocardial ischemia, improves the quality of life of the patient, increases exercise tolerance, helps to reduce the functional class of angina syndrome.

For more than 50 years, the concept of balloon angioplasty and coronary artery stenting has been included in practice. Over a period of development of the technique and new mechanisms of pharmacological influence, factors causing thrombosis of the stents have occurred.Purpose - to compare and analyze clinical and instrumental data before and after stenting.From 2007 to 2016, a total of 207 patients were included in a retrospective study. They underwent intervention in the anterior interventricular artery in the proximal segment. The patients were divided into 3 groups: Group I - no complications (N = 139),Group II - the presence of one of the complications (N = 54), III - the presence of two or more complications (N = 14). Data frombiochemical, general blood tests, coagulation, echocardiography, etc were evaluated in all patients. In total, 73 characteristics were included in the analysis.Based on the obtained data, 18 parameters were significant for the risk of complications, 14 were before stenting, 4 after. Com-paring the obtained numerical values, there are significant differences of group 3 compared with the first and second.It is becoming obvious that patients of group 3, were more severe in their comorbid background. In patients who had deliberately unsatisfactory results on the homeostasis system, the effect of the treatment was much better.

In recent years, the acute problem has been the choice of the method of surgical treatment of chronic osteomyelitis. The main method of treatment is sequestrectomy with subsequent replacement of the bone defect with various implants. Currently, preference is given to natural osteoplastic materials, but when used, inflammatory reactions may occur. The purpose of this work was a morphological study of reparative osteogenesis using a mixture of coral and experimental animal blood. This mixture was prepared by its own method (Patent No. 2644828, dated 14.02.2010). The prepared material was introduced into the experimentally formed bone cavity of rats. Biocompatibility and activity of the processes of reparative osteogenesis were evaluated by histological methods (hematoxylin and eosin, Mallory, Van Gieson, and Weigert). Throughout the experiment, the implant did not cause appreciable lymphocytic infiltration around coral granules, thereby positively influencing the processes of reparative osteogenesis.

The paper presents the results of study of hepatoprotective activity of multicomponent plant extract received from the following types of herbal substances: roots and rhizomes of elf dock, grass of common centaury, roots of Ural licorice, hips, hawthorn berries, under the conditions of model of the experimental hepatitis caused by single-pass intraperitoneal introduction of D-galaсtosaminein of 1,0 g/kg of mass in an animal. It is established that 14-days course introduction of the extract per os in a dose of 300 mg/kg to white non-linear rats with D-galaсtosamine hepatitis has hepatoprotective effect, surpassing effect of karsil.

The aim of the research is to develop the composition of syrup on the basis of complex phytopreparations of Althea and Lyco-Mukaltin substance (AND RK 42-5817-53, JCS « Chimpharm»), bioslastilin (RK M 3-№004554), fructose (SPh RK, v.2), tab-lets «Mukaltin» (AND RK 42-6855-14, JCS « Chimpharm»).Taking into consideration the limitations of Mukaltin tablets in children practice, we offer the bicomponent syrup “Mukaltin+” for kids.The following substances are recommended to include into the composition of Mukaltin+ syrup: Althea herbs (mukaltin), licorice roots (bioslastiline) and fructose (base). Combination of mukaltin and bioslastiline increases the pharmacological effect.The composition of syrup on the basis of complex phytopreparations of Althea, Licorice and fructose has been justified.Currently the technology of manufacturing is being experimentally developed.

The paper presents a generalized analysis of the results of the study of glycemic and psychoemotional status of patients with purulent-inflammatory diseases of the maxillofacial area (PID MFA) against diabetes mellitus and without general somatic pathology. We have revealed the peculiarities of the glycemic and psychoemotional status of diabetic patients with PID MFA.In patients with PID MFA on the background of endocrinological changes, unfavorable glycemic and burdened psychoemotion-al statuses are formed. Such a category of patients, if they have PID MFA, need a specific premedication before dental intervention. Diagnostics in such clinical casesmust not be limited to traditional dental examinations, a specialized endocrinological examination is required, designed to prevent the development of complications of a general nature before dental treatment, during the process and the postoperative period.

This study evaluates the performance of the Project EX - tobacco use cessation program in Russian summer recreational camps. An eight-session clinic-based tobacco use cessation program for adolescents was tested in an experimental pilot trial that involved different youth that rotated through camps. We created two rotations of unique subject groups of smokers - experimental and control, receiving standard help. The total number of smokers was 164 smokers, 76 - program group, 88 - standard care control group. Evaluation involved an immediate pretest and posttest and a six-month telephone follow-up. At immediate posttest, Project EX was moderately well-received, significantly reduced future smoking expectation (46% reduction in EX Program Condition versus 8% in Control, p<.0001), decreased intention to not quit smoking (-5.2% in EX vs. +1.4% in Control, p<.05), and increased motivation to quit smoking (0.72 vs. -0.04, p<.0001). At the six-month follow-up, program subjects reported a higher intent-to-treat quit rate during the last 30 days (7.5% vs. 0.1%, p<.05). For the subjects who remained monthly smokers at the six-month follow-up, Project EX reduced subjects’ level of nicotine dependence (-0.53 vs. +0.15, p<.001). The results were quite promising for this program, which included motivation enhancement and coping skill. However, further research on teen tobacco use cessation programming in Russia with larger sample sizes, involving other locations of the country, and with stronger research designs is needed.

The aim of the study is to identify the features of cortisol level changes in the perioperative period in patients with thoracoabdominal injuries. A prospective study examined the cortisol content of venous blood samples in patients with thoracoabdominal injuries before, during, and within 24 hours of emergency surgery. Patients with thoracoabdominal injuries are characterized by high cortisol levels before surgery, its increase by the end of surgical treatment, followed by a decrease in the outcome of the first day after hospitalization in a specialized hospital. At the same time, a rapid decrease in the concentration of the substance is observed in patients over the age of 40. In the initial severe condition of the victim and unstable hemodynamics, a delayed increase in cortisol levels in the perioperative period is revealed.

The work analyzes the causes of complications in patients after reconstructive surgery with closure of the skin stomal wound in various ways. The closure of skin wounds by traditional method was marked by the following complications: postoperative wound suppuration is 11.1%, breakdown of postoperative stomal wound - 18.5%. A modified method of closing skin stomal wounds was implemented into practice. Conclusion: the introduction of a modified pouch suture at the closure of the stomal wound allowed to improve the results of surgical treatment by reducing postoperative pyoinflammatory complications and to achieve a good cosmetic result.

Asthma is a common multifactorial respiratory disease. Asthma develops by the interaction of hereditary predisposition, environmental factors and epigenetic changes. Sensitivity of patients to anti-asthmatic drugs is by 60-80% due to genetic factors. The article provides an overview of the effect of β2-adrenergic receptor gene polymorphisms in asthma development and the efficiency of asthma treatment. β2-adrenergic receptor plays an important role in the contractility of the respiratory tract. It is a target for β2-agonists having bronchodilative and bronchoprotective effects. Candidate, associative, pharmacogenetics, whole-genome and epigenetics studies results devoted to the study of the ADRB2 gene are analyzed.

Sexually transmitted infections (STIs) are one of the urgent problems of modern healthcare. The peculiarity of this problem is its strong connection with the social processes that take place in society. The purpose of this review is to analyze the current state of awareness of the population about sexually transmitted infections and measures for their prevention. The review presents an analysis of the results of domestic and foreign studies on this theme. The greatest attention is paid to risk groups for STIs: youth, injecting drug users, migrants, commercial sex workers, men who have sex with men. Behavioral risks leading to the spread of STIs, their relationship with the level of awareness are considered. The main prerequisites for the spread of STI at the present stage, as well as the direction of prevention, are given.

Since 1963, many papers have been published on the structure, function and participation of monosialoganglioside GM1 as a component of the cell membrane. Particular interest in this sphingolipid appeared after discovery of cholera toxin, when it was proved that the pathogenesis of cholera is induced after interaction with the membrane receptor GM1. The structure of gangliosideGM1 was established in 1963, and in the 1980s Lars Svennerholm proposed the classification of sphingolipids. In vitro experiments have shown that GM1 contributes to the recovery and survival of neurons in various brain lesions, by potentiating trophic factors such as NGF, bFGF, EGF, BNDF; and in the case of its exogenous administration it facilitates imitation of neurotrophic action and prevention of neuronal death. Despite the fact that using exogenous isolated GM1 on people is limited, in many clinical trials it has shown a good anti-apoptotic effect, as an independent substance, and in combination with other neuroprotectors.