Objective: to study the immunophenotypic features of bone marrow myeloma plasma cells (BM PC) and peripheral blood circulating tumor cells (CTC MM) with multiple myeloma (MM) complicated by plasmacytomas.Materials and methods. 18 patients with MM, aged 41 to 85 years, were examined (Me 58). All had stage 3 disease according toDurie-Salmon and plasmacytomas of different localization. The average Karnowski index was 40%. 9 patients had primary MM, 9 previously received chemotherapy.Results. All patients showed positive expression of CD56, CD81, CD27 and CD11c antigens on BM PC and CTC MM. An increase in the frequency of occurrence of positive expression of CD19, CD79b, a low occurrence of positive expression of CD138 onthe CTC MM was noted. Expression of CD20 was detected significantly more often on BM PC as compared to CTC MM in patientswith plasmacytomas less than 7 cm in diameter.Conclusions. The results indicate a less «mature» immunophenotype of the CTC MM, its high ability to spread the tumor process, and the appearance of local tumor growth.

The objective is to assess the quality of life of patients with uterine myoma after various treatment options.Today, conservative treatment of uterine myoma with the help of mifepristone is gaining popularity. The indicators of the quality of life of women in the three groups before and after treatment are analyzed. Group 1 (n = 38) - laparoscopic conservative myomectomy without subsequent anti-relapse drug therapy; Group 2 (n = 43) - laparoscopic conservative myomectomy followed by an-ti-relapse drug therapy - mifepristone at a dose of 50 mg daily from the 2nd day of the menstrual cycle for 3 months; Group 3 (n =36) - drug monotherapy - mifepristone in a dose of 50 mg daily from 2nd day of the menstrual cycle for 3 months. As a result, it was noted that after treatment, indicators of physical and role functioning, due to both physical and emotional state, were higher in groups 2 and 3. Thus, mifepristone positively affects the quality of life of patients with myoma, as in the case of combined treatment, and in the form of monotherapy.

The objective: to assess the effect of antigestagenic therapy of uterine myoma on ovarian reserve in the patients of reproductive age. Due to the increasing incidence of uterine myoma among women of young reproductive age, conservative treatment modalitiesfor this pathology are becoming relevant. However, the proportion of surgical interventions for uterine myoma remains high. Thepreservation of the ovarian reserve in patients of fertile age remains an important issue to be considered. In our study, we evaluated the effect of antigestagen therapy on the condition of the ovarian reserve. The indicators of the ovarian reserve among women of three groups before and after treatment were analyzed. Group 1 (n = 38) received surgical treatment in the form of laparoscopic conservative myomectomy without subsequent anti-relapse drug therapy; Group 2 (n = 43) received surgical treatment in the form laparoscopic conservative myomectomy followed by anti-relapse drug therapy including mifepristone at a dose of 50 mg daily from the2nd day of the menstrual cycle for 3 months; Group 3 (n = 36) received drug monotherapy including mifepristone at a dose of 50mg daily from the 2nd day of the menstrual cycle for 3 months. According to the results of the study, the indicators of the ovarian reserve in the group of drug treatment with antigestagens remained the same, in the groups receiving surgical treatment (1 and 2), a deterioration was recorded. Thus, the mifepristone drug does not adversely affect the condition of the ovarian reserve in women of reproductive age.

The purpose of the study is to identify changes in the cardiotocogram curve (CTG) of the fetus during the use of methods of labor pain relief. Fetal CTG is the primary method for assessing the status of the fetus during labor. Currently, the observation protocol with the use of CTG involves the assessment of the classification of the International Federation of Obstetricians and Gynecologists (FIGO), which distinguishes compensated, doubtful and pathological condition of the fetus. Some authors indicate that the use of intrapartum CTG, especially continuous monitoring increases the number of unwarranted surgical interventions, including cesarean sections.Material and methods: we conducted a prospective study of 117 CTG curves obtained during childbirth. Analysis of 82 cardi-otocograms in women with various anesthesia methods revealed that more than 80% of the curves obtained in childbirth were categorized as doubtful or suspicious, and the relationship between CTG changes and the frequency of birth of children in the state of asphyxia during labor anesthesia was not established. Results of the study showed no evidence of a direct adverse effect on the fetus in case of prolonged epidural anesthesia and / or intravenous administration of Trimeperidine, when curves of doubtful type were most often recorded.

Obesity takes epidemic proportions, encompassing different groups of society. Particularly high rates of obesity are now being identified among young women. Arterial hypertension appears at a younger age and much more often. Researchers point to the role of obesity and arterial hypertension in the development of cognitive impairment.Objective of the study: to assess the state of cerebral hemodynamics autoregulation and cognitive function in young women with obesity and arterial hypertension.Material and methods. The study presents examination results of 84 young women at the age of 18-45 with obesity and arterial hypertension. The survey included estimation of speed indicators at the level of the middlecerebral artery and internal carotid arteryby ultrasonic doppler method with calculation of peripheral resistance indexes (ripple index, resistance index). Cerebrovascularreactivity state was evaluated by functional test with nitroglycerine.Results and conclusions. Excessive body weight causes a change in cerebral blood flow and becomes a predisposing factor for the development of cognitive insufficiency in young women with arterial hypertension.

The purpose of research was to analyze the effectiveness of additional pulmonary artery denervation (PADN) procedure in patients with mitral valve diseases complicated by atrial fibrillation and pulmonary hypertension, and to identify predictors of low efficiency of the proposed method.Material and methods. During the research the analysis of surgical treatment of 140 patients with mitral valve diseases complicated by high pulmonary hypertension (more than 40 mm Hg) and atrial fibrillation was carried out.Conclusions. Integrated surgical approach in the treatment of patients with mitral valve defects, atrial fibrillation and pulmonaryhypertension, implying not only the correction of mitral valve diseases and arrhythmias, but also surgical treatment of pulmonary hypertension can improve the contractility of the left ventricle by 14%, the remodeling of the left ventricle cavity by ESD by 25%, of the right ventricle by 13%, the left atrium by 24%, the right atrium by 21%, and also allows to eliminate pulmonary hypertension by 28% compared with the control group (p <0.05). Additional PADN procedure in patients with mitral valve diseases, complicated by atrial fibrillation and pulmonary hypertension contributes to a decrease tricuspid regurgitation - by 29.5%, an increase in the efficiency of the Maze IV procedure - by 18% and, ultimately, a decrease in clinical manifestations of chronic heart failure by 18% (p<0.05). Predictors of low efficiency of PADN procedure in patients with mitral valve diseases complicated by atrial fibrillation and pulmonary hypertension are the presence of infectious endocarditis, EUROSCORE > 6 points, LV EDD>6.1 cm, LV ESD >4.5 cm, LV EDV>186.9 ml, LV ESV>97.3 ml, LV EF <53.2%, RV ESD>3.8 cm, (p<0.05).

Purpose of the study. The aim of this work is to study the possibilities and advantages of laparoscopic access for incarcerated inguinal and inguinal-scrotal hernia in children.Material and methods. From 2002 to 2017, we used laparoscopic access for herniorrhaphy in 68 patients aged 1 month to 3years old with incarcerated inguinal and inguinal-scrotal hernias. The results were compared with the treatment results of 57 patients who were operated by an open access. During the study, we identified the hemodynamic features of the blood supply to the testis in boys and the benefits of laparoscopic access.Conclusion. Laparoscopic access allows more accurate visualization of pathological changes in the incarcerated organ and suturing of the internal inguinal ring with minimal trauma to the testicular vessels and deferent duct. This allows to reduce both surgical trauma and frequency of diagnostic errors in incarcerated inguinal and inguinal-scrotal hernia in children.

Purpose of the study is to improve the results of surgical treatment of the ingrown nail according to the A.Winograd method.Material and methods. We compared the results of the treatment of ingrown nail by the A.Winograd method with the incision of the posterior nail cushion and mechanical destruction of the germinative matrix (25 patients) and without the incision of the posterior nail cushion, but using Volkmann’s pre-sharp spoon to perform a better growth zone cureting (27 patients).Conclusions. A.Winograd surgery in the classic version is an effective way of treating an ingrown nail, but with careful curettage of the growth zone of the removed part of the nail plate. The use of a pre-sharpened Volkmann spoon allows you to perform this operation less traumatically - without cutting the posterior nail cushion, but more radically. This reduces the recovery time from14.3±4.7 days to 9.2±1.5 and reduces the rate of relapses (2 in the main group and 0 in the comparison group). This type of surgery, according to the authors, is indicated to patients with a second and partially with a third degree of ingrown nail according to the C.J. Heifetz classification.

Now laparoscopic operations are standard at surgical treatment of various renal masses. In spite of the fact that many moments of this access are well studied, a problem of surgical complications is still relevant.To improve the results of treatment and decrease frequency of iatrogenic complications, we propose a method of preoperative planning by performing CT scan in operational position of the patient on one side with determination of optimal laparoscopic access to the retroperitoneal organs.The research included 100 patients after laparoscopic operation of renal masses. 50 patients had computer tomography in lateral operational position before surgery. The received data are considered during operation that has a positive impact on surgical results.

The goal is a comparative analysis of the antioxidant activity of kumis and dairy products; assessment of the effect of the degree of kumis maturity on its antioxidant properties. The antioxidant ability of the samples was determined in vitro by recording the induced chemiluminescence in model systems generating reactive oxygen species (ROS) and reproducing lipoperoxidation processes using chemiluminometry. The suppression of the processes of ROS production and lipid peroxidation (LP) was evaluated by reducing the intensity of chemiluminescence. It was established that the addition of kumis to model systems is accompanied by a pronounced dose-dependent antioxidant effect: with an increase of its concentration, a proportional decrease in the parameters of the light sum and maximum luminosity occurs. Kefir and milk also suppressed the intensity of free radical processes, but had less pronounced antioxidant properties. With an increase in shelf life, the antioxidant capacity of kumis decreased, but no imbalance of pro- and antioxidant systems was found. It is concluded that the therapeutic and prophylactic effects of kumis in various pathological conditions can be associated with its antioxidant activity and limitation of the phenomena of oxidative stress and lipid peroxidation.

The antagonistic activity of the probiotic Bacillus subtilis 3H was studied with respect to 4 reference strains of yeast-like fungi of the genus Candida (C. albicans 001, C. albicans No. STC885-653, C. stellatoidea ATCC 10264, C. Krusei Harv ATCC 6259), 6 clinical isolates (C. albic, C. Krusei, C. stellatoidea, C. tropicalis, C.glabrata, C. guilliermondi), as well as testing cultures (Staphilococcus aureus, Escherichia coli, Streptococcus mitis, Streptococcus mutans, Streptococcus sanguis, Streptococcus agalactis) and clinical strains of periodontopathogenic microflora (Staphilococcus aureus, Streptococcus mitis, Streptococcus mutans, Streptococcus sanguis, Streptococcus agalactis, Streptococcus salivarius, Prevotella intermedia, Treponema denticola, Agregatibacter actinomycetecomitans), separated from periodontal pocket contents. Minimal suppressive concentration was performed by diffusion method (perpendicular streak technique).The results of the study show that all 4 referent strains of fungi of Candida genus are sensitive Bacillus subtilis 3H probiotic. C. Albicans and C. Krusei are more sensitive than the rest 4 clinical isolates. When inhibition zones of periodontopathogenic microorganisms were compared, the smallest zone was identified in Streptococcus mitis, and the largest in Streptococcus agalactis and Staphilococcus aurius.

The aim of the study was a comparative assessment of the surface structure of the studied samples of hard tissues of teeth after dental whitening by various methods. To study the quality of the tooth surface after whitening with various preparations, samples of the studied teeth were prepared for scanning microscopy of enamel using a scanning electron microscope. According to scanning electron microscopy, the use of bleaching agents containing 35% hydrogen peroxide leads to the appearance of foci of enamel destruction. After whitening the enamel, its surface was marked by multiple erosion. Bleaching teeth with whitening pastes does not damage the structure of the enamel. A necessary condition for individual therapeutic and preventive measures is to motivate the patient to use oral hygiene products.

Low back pain (LBP) is one of the most common diseases in medical practice, reaching 70%, with nonspecific pain observed in90% of cases. The aim of the work is to show the possibilities of complex rehabilitation treatment of patients with pain syndrome in the lower back, including therapeutic blockade and physical therapy according to the method developed by us. The study included42 patients with LBP aged 24 to 54, of which 28 (66.7%) men and 14 (33.3%) women, who were randomly divided into 2 groups. Patients of the main group (30 people) were given selective injections, from 2 to 7 injections depending on the severity of the painsyndrome and the duration of the disease. Patients of the control group - 12 people, were treated in accordance with the standard of care for LBP. After the course of treatment there was a decrease of clinical symptoms in both groups. The results of a comparativeclinical and instrumental study show a higher efficiency of differentiated use of selective injections of drugs and therapeutic exercis-es than standard medical care for LBP (analgesics, NSAIDs, muscle relaxants, physiotherapy).

Heart failure is one of the causes of morbidity and mortality worldwide, but myocardial infarction is the leading cause. A heart attack alters a viable myocardium, and this damaged tissue is replaced by a non-contractile scar, which leads to cardiac dysfunction and significantly increases the likelihood of developing heart failure in the patient. Limiting the size of a heart attack scar has been the goal of preclinical and clinical studies for decades. However, in addition to reperfusion, the clinic has not found an effective method of treatment that will limit the formation of the necrosis zone, respectively, new approaches are needed. This review reveals new clinical and preclinical evidence demonstrating that ventricular unloading prior to reperfusion with percutaneous left ventricular support devices reduces ischemic and reperfusion injury and limits the size of the infarction area. The focus will be on understanding the mechanisms of the new therapeutic approach in the treatment and prevention of myocardial infarction.

The presented review of the literature provides data on the use of the method of medical infrared thermography in musculoskeletal pain. The conventional method to examine the pathology of the spine is X-ray, CT and MRI. To study trigger points in myofascial pain syndrome, ultrasound elastography of muscles and EMG are used. The main disadvantages of X-ray and neuroimaging methods are radiation load, as well as a high cost of diagnostic procedures. In addition, not all medical institutions of the country are equipped with devices for ultrasonic muscle elastography, and needle electromyography is quite painful diagnostic manipulation, which is difficult to carry out with repeated studies. Safety, non-invasiveness, cheapness of the study, as well as the ability to detect pathological changes in the musculoskeletal system at the preclinical stage necessitated the introduction of medical infrared thermography.The article presents data on the diagnostic possibilities of the method for dynamic control in the treatment of musculoskeletal diseases in various fields of medicine: neurology, traumatology, orthopedics and sports medicine, rheumatology.

The aim of the work is to develop a model of informational interaction of pharmaceutical specialists with the population. A factor analysis of the aspects of pharmaceutical information used by consumers of pharmacy products was carried out. It is found that during the selection of drugs consumers prefer such factors as quality (I 0,9), price (I 0,79), a minimum of side effects (I 0,69), convenience of use (I 0,59 ); most often they receive information about drugs from the instructions for use (I 0.74), from pharmaceutical specialists and doctors (I 0.62 and I 0.65). As a factor of pharmaceutical information in everyday life they use indications for use (I0.83); dose of the drug (I 0.82); contraindications for use (I 0.66) and side effects (I 0.64). Based on the research data, a model forthe informational interaction of pharmaceutical specialists with pharmacy customers has been developed, including methodological support for the quantitative estimation of interactive indicators in the interaction of pharmaceutical specialists with a client base, which allows improving the quality of public services.

The aim of the work was to study organizational, methodological and geographical characteristics of higher and secondary medical educational institutions of the Republic of Tajikistan (RT), providing education in pharmaceutical field. It was necessary to determine the number of graduates of these educational institutions over the past 5 years and assess their employment, taking into account the existing jobs in the country, as well as to prepare recommendations to improve the quality of training qualified pharmaceutical personnel. Detailed information was collected about the industry specialists who graduated from educational institutions of pharmaceutical profile in the period from 2014 to 2018, while the data of the National testing center under the President of the Republic of Tajikistan were also used. The methods of statistical processing, observation, comparative analysis, description were used. Data were analyzed by Microsoft Eхcеl 2016.The results of the study showed that the number of specialists with higher and secondary pharmaceutical education in Tajikistan is increasing every year. Thus, over the past 5 years, more than 6,000 specialists have graduated from the institutions. However, the number of jobs is quite limited. There are about 30 pharmaceutical enterprises in Tajikistan, which are engaged in the production and packaging of medicines. However, these enterprises, as a rule, are small, because the process of packaging of foreign drugs predominates, so the administration of these enterprises can not provide a large number of jobs for specialists with pharmaceutical education.According to the state supervision Service of health and social protection of the population of the Republic of Tajikistan in June2018, there were 2359 pharmacies in the country. If we take into account that in 2019 more than 2500 thousand students will be admitted to educational institutions in the specialty of pharmaceutical profile, and in 2020 about 2000 people will receive diplomas, even without accurate calculations, we can conclude that there is an overasupply of pharmaceutical personnel in Tajikistan.Thus, it is necessary to improve ways of providing Tajikistan with highly qualified human resources in the field of health. We have developed and recommended measures to coordinate the three main components of the development of the pharmaceutical training system: planning, training and rational use.