The purpose of the work is to study macular hemoperfusion in patients with nonproliferative diabetic retinopathy according to optical coherence tomography with angiography of the macula.Material and methods. The ophthalmologic examination of patients with diabetes mellitus complicated with non-proliferative diabetic retinopathy, which constituted the main group, and patients without eye pathology, who formed the control group, was conducted. All the patients of the main and control groups were subjected to standard ophthalmologic examination and optical coherence tomography with angiography of the macula.Results. The results of the study showed the reliability of differences in terms of maximum correctable visual acuity, intraocular pressure, perfusion area at the «chorionic capillaries» level, total capillary pattern density at the «superficial plexus» level and total capillary pattern density at the «deep plexus» level of the main and control groups.Conclusion. As a result of the examination of the patients, a violation of the hemoperfusion of the inner and outer layers of the retinal macular zone at the level of the capillary link was found according to optical coherence tomography with angiography of the macula in patients with nonproliferative diabetic retinopathy.

Objective. The aim of the study was to investigate left ventricular (LV) structural changes in overweight and obese young women with arterial hypertension (AH).Design and methods. In the study, according to inclusion criteria, 108 young women of 18-45 years old were included. Three groups were identified: the women with obesity without arterial hypertension, the women with obesity and 1-st degree of arterial hypertension, the women with obesity and 2-nd degree of arterial hypertension. All patients underwent anthropometry (height and weight) with calculation of body mass index (BMI), echocardiography was performed according to a standard procedure with calculation of LV structural indexes. The LV geometry phenotypes were determined.Results. Echocardiography LV dimensions (posterior wall thickness, interventricular septal thickness, diastolic and systolic LV diameter), as well as LVM and LVMI were higher in obese women compared to control group. LV hypertrophy (LVH) developed in 61,9% obese patients without AH and in 76,4% and 78,1% patients with obesity and AH. Normal LV geometry was found in 23,8% patients with obesity, concentric remodeling - in 14,3% cases, 35,7% patients had concentric LVH, and 26,2% - eccentric LVH. In obese patients with 1-st degree of AH the distribution of various types of LV remodeling was as follows: 17,6% / 6% / 52,9% / 23,5%, respectively, and in obese patients with 2-nd degree of AH - 12,5% / 9,4% / 53,1% / 25%, respectively.Conclusions. Young age overweight and obesity are risk factors for LVH and the development of various LV geometry phenotypes. Markers of myocardial remodeling is an affordable way of early cardiovascular risk stratification in overweight and obese young women.

The study presents a comparative assessment of the quality of life of 29 patients after radical cystectomy with conduitis and 32 patients with orthotopic urine derivation, interviewed on special questionnaires based on the Michigan questionnaire «Bladder Cancer Index» (Bladder Cancer Index - BCI; The University of Michigan). Subjective assessment of somatic status (the degree of discomfort experienced by patients due to urinary disorders, developing azotemia, mucus in the urine, digestive dysfunction and sexual disorders) did not reveal significant differences between the comparison groups. Moreover, in objectively more difficult situation of patients with ileoconduitis (taking into account the severity of their disease, age and concomitant diseases), their subjective assessment of their condition and quality of life can be comparable with the level of subjective assessment of more «young» patients with orthotopic urine derivation. At the same time, a more negative assessment of the quality of life (according to subjective assessments of general health and problems with social adaptation), noted in patients with orthotopic derivation, may be due to their agepsychological characteristics of the perception of their situation: «younger» patients in this group at comparable levels of somatic ill health evaluate the overall quality of their life as more catastrophic and severe. More negative subjective assessments of their wellbeing and quality of life of patients in this group pose the problem of insufficient psychological preparation of patients for living conditions «after the RC» and their subsequent psychological support in the system of long-term postoperative follow-up.

The aim is to study endogenous intoxication in association with other indicators of homeokinesis in patients with purulent-inflammatory diseases of the abdominal cavity, who were operated by different surgical approaches.Material and methods. The results of surgical treatment of 107 patients with purulent-inflammatory diseases of the abdominal cavity are analyzed. The main studied group consisted of 55 (51.4%) patients after minimally invasive surgical approach - laparoscopy. The patients' age was 44.8±2.5 years (from 22 to 76 years). In the gender composition males prevailed (28 (50.9%). The control group included 52 (48.6%) patients after standard laparotomy. The age of patients ranged from 18 to 80 years. The average age was 45.6±2.5 years (p> 0.05). 27 (51.9%) (p> 0.05) of them were males. Both groups of patients were comparable according to the reasons of peritonitis development.Results. Comparative analysis showed that in the group of patients after minimally invasive operations, disorders of the indices of homeokinesis were less prolonged and less pronounced. This was primarily determined by the reduction of the phenomena of endogenous intoxication syndrome. A significant decrease in leukocyte index of intoxication, the level of molecules of average weight and lactoferrin was noted. The decrease in the level of the latter in the early stages after surgery in patients of the main group was less than the control by 9.7% (p <0.05).It turned out that in the early postoperative period after minimally invasive operations, a significant decrease in the severity of oxidative stress and phospholipase activity was recorded. So, after one day of the operation, the content of malondialdehyde in the blood plasma in the main group was less by 23.7%, after three -by 19.5%, after seven days - by 14.7% (p <0.05). At the same time, the antioxidant activity was quickly restored. A smaller increase in the activity of phospholipase A2 was found, which in the control group in the early postoperative period increased almost 1.5 times during a day (p <0.05). The advantages of laparoscopic operations were also expressed clinically, which was primarily determined by a significant decrease in hospital stay of patients in 2.8 beddays (p <0.05). A decrease in the number of wound complications by 17.4% (p <0.05) was noted.

The article presents the results of the screening immunological ELI-test to identify levels of autoantibodies (AAB) to 24 types of tissues of organs and systems of the body in patients with tuberculosis (TL) (53 people) and sarcoidosis (SL) (24 patients) of the lungs. A large mosaic of target organs and systems at TL and SL was revealed: in the first case, AAB was determined in 10 samples (in 6 - in high concentrations), at SL - in 15 (high concentration - in one case) above the norm. Mean values of AAB levels at TL were less than in healthy people, were determined with the value «-» (LuM-02 - 33,1±5,4%; LuS-06 - 15,0±2,3%), and at SL the same average indicators were higher than in healthy people, recorded with the sign «+», amounted to +3,5±1,8% and +4,3±2,5%, respectively, were significantly higher than their values at TL (p<0,05). It can be assumed that in TL there is a mechanism to block the production of immunocompetent cells AAB to antigens of damaged lung tissues, and in SL test results indicate the autoimmune nature of lung tissue lesions.

The study was conducted to evaluate the effectiveness of the use of the deoxyribonucleate sodium immunomodulator - «Derinat» in the complex therapy of 60 newly diagnosed patients with infiltrative and disseminated pulmonary tuberculosis. All of them received specific chemotherapy for pulmonary tuberculosis. Patients were divided into 2 groups - the main one - 30 patients, who were prescribed «Derinat» intra-muscular for 5 ml of solution, 5 injections per course and inhalation (spray) once a day, the course of 25-30 procedures. In the comparison group, there were 30 patients, whom «Derinat» was not assigned. The use of «Derinat» in the complex treatment of patients with advanced forms of pulmonary tuberculosis allows to achieve a cessation of bacterial release by 6th month of treatment in 66.7%, in the comparison group - only in 16% of patients (p = 0.003). There was an increase in the number of lymphocytes by 4th month of treatment (p = 0.04). In the main group, resorption of infiltration was achieved in a larger number of patients than in the control group (p = 0.012).

The article presents questioning results of 3120 undergraduates of higher educational institutions of Ufa. Questioned students included 2496 young women (80%) and 624 young men (20%), average age of respondents was 20,89±2,24 years old. In the research 91,2% of respondents claimed that they already have had sexual intercourse. Actual average sexual initiation age among questioned young men is 16,58±1,86 years old, young women - 18,05±1,57 years old, herewith 34,8% of young women and 43,2% of young man claimed that optimal sexual initiation age is higher than the actual one. Female students from Ufa named the optimal age for childbearing 23,66±2,0 years old, males - 24,54±2,48 years old. Among respondents pregnancy was found in 7,2% of questioned students, only 53,3% of them were wanted and the number of young men, whose partner`s pregnancy was wanted is only 7,1%.

Tuberculosis remains one of the most pressing medical and socioeconomic problems. Currently, about a third of the world's population is infected with Mycobacterium tuberculosis. Among the causes of death from infectious diseases, tuberculosis is more than 80%.Surfactant is known to have a special place in the local lung protection system. Surfactant proteins play the most important role in the regulation of phospholipid metabolism, in the organization of the structure of surfactant membranes, in immunity reactions. In this regard, the purpose of our study was to study the state of surfactant proteins in the foci of specific destruction and in the surrounding intact lung tissue to assess its functional state, the degree of respiratory failure and possible dissemination of tuberculous inflammation.The material for the study was fragments of the lungs of the dead or operated on for cavernous pulmonary tuberculosis (n =163) with active bacteria excretion (n = 89) and with clinical abacillation (n = 74).It was established that in all the studied samples, both in the areas of cavernous destruction and pericavernosal zone, and in the intact lung tissue, dynamic depression of surfactant-associated proteins B and C was detected. The maximum expression of immunohistochemical expression was recorded in the alveolar macrophages, which indicated intensive recycling and utilization of the components of the surfactant. In intact lung tissue, the amount of SP-C was significantly reduced. At the same time, in the focus of the cavernous destruction and the pericavernous zone, this apoprotein totally disappeared. Thus, a decrease in the production of surfactant components leads to disorganization of the alveoli with their subsequent collapse and the development of respiratory failure.

Given that in recent years there has been an increase in viral diarrhea in the structure of acute intestinal infections, including among adults, we have studied the cytokine status of pro-inflammatory and anti-inflammatory interleukins, as one of the leading mechanisms of immunopathogenesis and playing a significant role in the development and severity of the disease.

This article presents a prospective analysis of the features of the course of pregnancy and childbirth in patients with varicose veins of the lower extremities on the background of undifferentiated connective tissue dysplasia. This scientific work was carried out on the basis of the Department of Obstetrics and Gynecology of BSMU. The study involved 138 women, which were further divided into three groups. After examining all the analyzed material, it was concluded that for pregnant women with varicose veins on the background of NDCT the complications are characteristic, which are associated with the placenta. Adverse outcomes were associated with thrombocytopenia and thrombocytopathy in the first trimester.

Purpose: To assess changes in the biomechanical properties of the cornea after LASIK and FemtoLASIK at patients with different skin phototypes. The study involved 55 people (108 eyes): 25 women and 30 men aged from 18 to 49 years. On 57 eyes LASIK was performed, on 51 eyes - FemtoLASIK. Determination of the biomechanical properties of the cornea was determined by Ocular Response Analyzer II before and after surgical interventions at patients with different skin phototypes (phototype I - 14 people, II - 12 people, III - 19 people and IV - 10 people). A comparative analysis of the biomechanical properties of the cornea on the ORA II analyzer before and after excimer laser operations in patients with skin phototype I-IV showed that the magnitude of corneal hysteresis and the cornea resistance factor are weakened after the intervention, regardless of the skin phototype.

The aim of the study is to assess the effectiveness of the method of endocapsular mechanical phacofragmentation during ultrasound phacoemulsification. A comparative analysis of phacoemulsification operations with optimized endocapsular mechanical phacofragmentation and the «divide and conquer» technique has been carried out. Ultrasonic cataract phacoemulsification with optimized endocapsular mechanical phacofragmentation was performed on 124 eyes of varying degrees of density according to Buratto's classification at the Dordoy Ophthalmic Service medical center. With an observation period of up to a month, good visual functions and the absence of serious complications were observed in all eyes. The analysis showed that ultrasonic phacoemulsification with optimized endocapsular mechanical phacofragmentation has several advantages over the «divide and conquer» method of ultrasonic phacoemulsification.

Surgical treatment is the main method that has proven to be effective in treating patients with morbid obesity, and, in particular, with the metabolic syndrome. We have studied theurgency of the problem, various types of surgical interventions and the effectiveness of their influence on the course of the metabolic syndrome, and we also have conducted a comparative description of the new method of correcting the metabolic syndrome developed at the Clinic of Bashkir State Medical University - «laparoscopic gastroplating». We have reviewed the literature over the past 10 years. The results of the surgical treatment of patients were assessed in the short and long term periods from 1 to 5 years based on the study of postoperative complications, changes in body weight, the clinical course of concomitant diseases and the occurrence of pathological syndromes. Based on the data obtained, a good result was considered a weight loss of 30% or more, satisfactory - 15-30%. As a result of the study, we concluded that the use of bariatric interventions in patients with 2-3 degrees of obesity in earlier age groups will help to prevent the development of metabolic syndrome in the future. The «laparoscopic gastroplication» method developed at the Clinic of Bashkir State Medical University is technically simple, effective, well tolerated by patients, does not require large material costs and, if necessary, can be supplemented with one of the types of shunting operations.

Coronary heart disease (CHD) is the leading cause of morbidity and mortality in the world. To this day, there is an urgent need to develop and test reliable and minimally invasive biomarkers for the diagnosis and prediction of coronary artery disease, as well as new therapies that could be used alone or in combination in modern clinical practice. MicroRNAs (miRNAs) are endogenously expressed RNA molecules 18-22 nucleotides in length that suppress gene expression at the post-transcriptional level by binding to a 3 ′ untranslated region of m RNA targets. Many studies have shown that miRNAs play a key role in the normal functioning and pathophysiology of the cardiovascular system. It is known that circulating miRNAs are in a stable form and can be detected in human biological fluids, such as blood, urine, cerebrospinal fluid (CSF), and saliva. Therefore, circulating miRNAs are considered as new biomarkers of interest in many diseases, including CHD. Thus, we summarize here the latest results of studies that look at miRNAs as biomarkers and therapeutic targets.

The article covers the questions of diagnostics of such widespread pathology as an acute appendicitis. The authors provide modern literature data on efficiency, course and use of the video laparoscopic equipment at an acute appendicitis.In the paper it is noted that in modern surgery of abdominal area laparoscopy is recommended in difficult and doubtful clinical cases, when there is no opportunity to verify the diagnosis and to carry out differential diagnostics. The authors bring up a question of lack of international standards of treatment and diagnostics of an acute appendicitis by alaparoscopy method. An assessment is given to the arising complications and features of performing video laparoscopy at various location of an appendix.

The present review of current literature provides data on the prevalence of acute gastroduodenal bleeding throughout the world, the level and causes of mortality. The incidence remains stable, and mortality, despite the achievements of therapeutic endoscopy, has no tendency to decrease. In modern clinical guidelines developed by professional communities, it is recommended to stratify the risk of adverse outcomes in all patients with AGDB at the admission department stage. Selecting patients with a high risk of recurrence of bleeding or death, appropriate therapeutic measures can be taken in a timely manner and better treatment outcomes can be achieved. The review includes the most cited and current forecast systems. It presents a comparison of the effectiveness of various scales, possible limitations of their use. The authors conclude that risk stratification is one of the possible tools to reduce mortality. According to the authors, the forecast system should have a high sensitivity and specificity, be as simple as possible to use, and include evaluation criteria available to the doctor on duty.

The growth rates of immunobiological medicines sales volume, including vaccines, in the Russian pharmaceutical market from 2013 to 2018 is analyzed. The maximum growth rates of the studied indicators were noted in 2014 and 2015. The monotonous tendency of studied indicators increase in the subsequent period is noted. The share of sales volumes of vaccines in the general structure of immunobiological medicines consumption and dynamics of producers countries sales volumes of vaccines in Russia in real and cost index is studied. It is established that the share of consumption of vaccines of domestic production increased every year and today makes up 80%. Domestic leaders in sales volumes of vaccines in dynamics - NGO Microgen, Fort, LLC NPO Petrovax Pharm are revealed. Leaders in the volume of import of vaccines to Russia are Pfizer, Inc., the USA and Sanofi Pasteur, France. The leading positions in the ratings of indicators of export volume of pharmaceutical products from Russia are taken in recent years by J07 group of Vaccine.

The aim of the work is to develop a methodology for factor analysis of aspects of pharmaceutical information used in medical practice and testing of this method in medical organizations of the Oryol region. A quantitative assessment was made of the degree of use by doctors of sources of information on drug preparations and the degree of necessity in the daily work of every aspect of pharmaceutical information. As a result of the research, it was revealed that doctors most often use Medicines Handbook as a source of information (Usage Index 0.79); regulatory documentation and instructions for use of medicinal preparation (Usage Index 0.72); Internet resources (Usage Index 0.7).Medical specialists need first of all information about the method of use, side effects and contraindications to the use of drugs (Index of necessity 0.92); indications for use (Index of necessity 0.9); the principles of the selection of the dose of the drug (Index of necessity 0.88); international non-proprietary name (Index of necessity 0.82); pharmacotherapeutic group (Index of necessity 0.81); Information about new drugs (Index of necessity 0,8).