The objective of the research was to study nitric oxide metabolism in blood serum and in the condensate of the exhaled air in patients with chronic obstructive pulmonary disease (COPD) and its combination with community - acquired pneumonia (COPD+CAP).55 patients were included into the study. The first group consisted of 28 patients with exacerbated form of COPD. The second group (n=27) consisted of patients with COPD combined with community - acquired pneumonia (COPD+CAP). In patients of both groups the intensity of the symptoms has been assessed, clinical, laboratory and instrumental data have been obtained and analyzed. Dynamic changes in the values of nitrite and nitrate anions (NO2- and NO3-) as well as their total concentration (ƩNO2-/NO3) in the blood serum and exhaled air condensate (EAC) have been determined.In the patients enrolled in the study the increase in NO2-, NO3-, ƩNO2-/NO3- levels in the blood and EAC have been revealed. This indicated the impairment of nitric oxide (NO) metabolism. These changes in the blood were more marked in patients with COPD+CAP. Nitric oxide metabolism values correlated with the state of the lungs function and Creactive protein (C.R.P.) content in the blood serum. Disturbances in the nitric oxide metabolism and signs of the inflammatory process have been found to be preserved during treatment. After the course of treatment more marked symptoms of the disease and higher levels of NO2- in the blood and EAC as well as content of C.R.P. in serum have been found in patients with COPD+CAP compared to the patients with COPD.Thus the course of the disease in patients with COPD+CAP and in patients with exacerbated form of COPD is characterized with the development of nitrosive stress. Its intensity is more marked in patients with COPD+CAP. The study of nitric oxide metabolites in patients gives additional information about the severity of the inflammatory process and the efficacy of the undertaken therapy.

One of the main risk factors for pneumonia development in people with cerebral stroke is artificial ventilation of the lungs. The paper presents the results of clinical and pathological analysis of 37 cases (the main group) of the organs section in cerebral strokes complicated by ventilator-associated pneumonia. The comparison group included 29 observations, when the post-stroke period was accompanied by the development of nosocomial pneumonia without ventilation. The control group included 17 people who did not develop pneumonia in the postinfarction period against the background of the ventilator. It is revealed that the leading microbial agents, both in monoculture and in the association are representatives of the Enterobacteriaceae family. The mixed nature of flora causes significant pathomorphological changes in the lesion of pulmonary parenchyma, which worsens the prognosis. Preexisting lung pathology refers to the risk factors for hospital pneumonia, and the pathological process in the body is common.

This article analyzes parameters of Holter ECG monitoring (circadian index, corrected QT-interval, heart rate variability) being sensitive and priority to predict the occurrence of life-threatening ventricular arrhythmias. Evaluation of these indicators is important for the early detection of life-threatening ventricular tachyarrhythmia, development of indications for subsequent dynamic monitoring and control of therapy effectiveness. The study included 80 patients with myocardial infarction with ventricular arrhythmias and lack thereof. Group 1 included 48 patients with myocardial infarction with occasional extrasystoles. Group 2 included 32 patients with myocardial infarction with frequent ventricular arrhythmias. The control group consisted of 47 patients with no ectopic activity or single extrasystoles. It was found that there is a significant decrease in circadian index, heart rate variability, and lengthening of the corrected QT-interval in patients with myocardial infarction and heart rhythm disturbances in comparison with groups without ventricular arrhythmias.

The aim is to analyze the effectiveness of MazeIV procedure in cardiac surgery under bypass conditions. The work analyzes surgical treatment of 102 patients with atrial fibrillation (AF), who underwent simultaneous with the main phase of the operationMazeIV procedure under bypass conditions. During the study period, up to 48 months, sinus rhythm was maintained in 63 (61.8%) patients, AF relapse was diagnosed in 39 patients. Control echocardiography showed a reduction in the size of the left atrium and left ventricle of the heart, an improvement in the contractility of the left ventricle myocardium and a decrease in pulmonary hypertension. The study also analyzed the effectiveness of preventive saturation of patients with amiodarone before the surgery, in contrast to patients in whom amiodarone was used only in the postoperative period. Significantly best results were obtained in the group of patients with amiodarone saturation before surgery for AF relapses (more than 3 times) and for arrhythmic complications (more than 2 times). Reliable predictors of recurrence of AF in the form of an arrhythmic anamnesis more than 2 years ago and initial dilatation of the left atrium more than 5.5 cm were also revealed .

Wound complications, associated with bacterial infection, developing after mesh implantation at hernioplasty, present a serious problem, which doesn’t have a definite approach to its solution. The authors suggest an original method to remove infected mesh implants using ultrasound. The results of the study show that the use of ultrasound cavitation of antiseptic solution results in delicate separation of infected mesh implants from the abdominal wall without its damage and having a good germ-kill effect. Lowtraumatic separation is achieved by means of accurate entering of ultrasound cavitated antiseptic into the layer between the implant and abdominal wall tissues. The proposed technique allows to completely extract the implant from its adhesions with the abdominal wall tissues without damage completely, and to achieve efficient elimination of microorganisms. Preserved abdominal wall tissues ensure the reliability of the framework, and thereby prevent the subsequent formation of recurrent hernia.

The authors conducted a comparative assessment of the clinical efficacy of spinal-epidural and epidural components combined with general anesthesia based on sevoflurane in patients with radical cystectomy and simultaneous ileocystoplasty.Study design - prospective, controlled, non-randomized, single-center. Control group (n-58) underwent epidural anesthesia with endotracheal anesthesia on the basis of sevoflurane. The main group (n-58) had a combination of neuroaxial blockade with endotra-cheal anesthesia on the basis of sevoflurane.Dynamics of intra-operative hemodynamics and oxygen transport in patients of two groups were similar in nature; no inter- group differences were found. During the most traumatic time of surgery, cortisol and glucose levels were significantly higher in pa- tients in the control group. We revealed the insolvency of the microcirculation in the area of operational fields in patients without spinal-epidural anesthesia.Thus, during extended, radical, reconstructive-plastic surgical interventions in patients with advanced bladder cancer combined spinal-epidural anesthesia with endotracheal anesthesia on the basis of sevoflurane is more safe.

The article presents the results of analysis of serum cytokines level in children with HFRS. The study was conducted in 47 children aged 5-17, 25 of them had HFRS of medium-severe form, 22 - HFRS of severe form. Control group included 24 healthy children aged 5-17 years old. The content of cytokines IL-1β TNFα INFα INF-γ IL-10 in patients was studied in febrile, oliguric, polyuric periods and in the period of convalescence, 1 month after discharge from the hospital.It was determined, that HFRS children show an increase in content of anti-inflammatory cytokines IL-1β and ТNFα at the beginning of febrile period. The highest point of these cytokines is noted during oliguric period. INFα and INF-γ levels decrease and are the lowest at oliguric period in case of severe HFRS. Concentration of anti-inflammatory cytokine IL-10 during febrile period has a tendency to increase, significantly important increase is noted during oliguric period and keeps increasing at polyuric period.

High biological activity of humic substances determines the need for a research of humic acids of the low-mineralized silt sulphidic mud. The relevance of study of humic acids as individual fraction is connected with simplicity of their technological extraction from native dirt and substantial output of the final product in comparison with separate fractions (humic, hymatomelanic and fulvic acids) of humic substances. According to the method proposed in the work, the humic acids of peloids are isolated, their elemental composition is determined, IR, UV, NMR13C spectral analysis is performed. The results of elemental analysis allow us to refer the selected drug to the class of humic. On the basis of spectral characteristics some features of structure and functional group composition of humic acids of peloids are revealed. The obtained data proves the presence of aromatic conglomerate in the molecular structure of humic acids of peloids. In composition of this conglomerate carboxyl, carbonyl, alcohol functional groups predominate, as well as a significant number of alkyl groups.

The study objective was the development of quantitation technique for some drugs in whole blood using thin-layer chromatography with videodensitometry. The study subject was model samples of whole blood containing morphine, codeine, verapamil, baclofen, doxylamine, amitriptyline. The identification parameters of drugs by thin-layer chromatography were defined, interferences of blood matrix and other drugs were studied. Limits of detection in blood samples were 600,0 ng/ml (5,0 μg/spot) for morphine, codeine, amitriptyline, 150,0 ng/ml (1,0 μg/spot) for verapamil, doxylamine, 75,0 ng/ml (0,5 μg/spot) for baclofen. For drug quantitation the chromatograms were scanned, images were processed and calibration models were designed using videodensitometry computer program. The calibration model is described by polynomial (square) regression. The limits of quantitation for different drugs were from 300,0 to 1500,0 ng/ml; accuracy and precision does not exceed 25%.Thus, a quantitation technique for analysis of some drugs in whole blood by thin-layer chromatography with videodensitometry was developed. The ranges of quantitation allow using this technique for forensic chemistry and clinical analytical toxicology.

Thymus serpyllum L. and Origanum vulgare L. are common in the Samara Region. The main pharmacological effect of these plants is determined by the presence of different groups of biologically active compounds, such as essential oil, flavonoids, fatty and organic acids. Qualitative and quantitative contents of essential oil components mainly depend on geographical, climate and ecological conditions of the place of growth and vegetation phase of the plant. Thus, determination of qualitative and quantitative composition of essential oils of Thymus serpyllum L. and Origanum vulgare L., growing on the territory of the Samara Region seems to be significant.The components of essential oils of herb of Thymus serpyllum L. and herb of Origanum vulgare L. were investigated by chromatography-mass spectrometry. The main components of Thymus serpyllum L. essential oil were identified. They include thymol (54.4% of the total area of the essential oil components on the chromatogram), germacren D (4.5%), β-bisabolene (3.8%). In the essential oil of the herb of Origanum vulgare L. the main components were germacren D (25.6% of the total area of the essential oil components on the chromatogram), α-cadinol (7.0%), β-cariophyllene (6.7%).

The aim of the study was to analyze the morphological features of the lymphoid tissue of the vestibule of vagina in women of reproductive age in different phases of the ovarian-menstrual cycle.Microanatomical methods have been used to study small glands of vaginal vestibule in women of reproductive age. The glands were examined depending on the phase of the ovarian-menstrual cycle. The phases of secretion and proliferation were differentiated by histological examination of the ovaries. At the level of the middle third of the vaginal vestibule transverse sections with further staining with hematoxylin-eosin, picrofuxin by van Gieson were performed.The results showed that all the morphogenetic forms of lymphoid tissue are present in the walls of the vaginal vestibule. Structural parameters of the lymphoid tissue of the vaginal vestibule significantly change during the ovarian-menstrual cycle. Thus, in the phase of secretion, the proportion of lymphoid nodules containing the center of reproduction is larger, compared with the phase ofproliferation and desquamation. The area and length of the lymphoid nodule with the center of reproduction in the vaginal vestibulewalls in the secretory phase is greater than in the proliferation and desquamation phases. The area ofthe reproductive center at the lymphoid nodule, in the phase of secretion is somewhat larger than in the proliferative and desquamation phases.

Object is the analysis of histological changes of conjunctiva and sclera regeneration after surgical intervention with intraoperative application of 0,05% solution of Cyclosporine A.The study was conducted on Wistar rats (n = 48), they were divided into 2 groups: the main (n = 32), including subgroups "a" (n= 16) and "b" (n = 16) and the comparison group (n = 16). We performed a through cut of the conjunctiva and the surface layers of the sclera. A hemostatic sponge impregnated with 0,05% Cyclosporine A solution was applied to the surgical intervention zone. In the subgroup "a" duration of application was 3 minutes, in the subgroup "b" - 6 minutes. In the comparison group application of the hemostatic sponge without a cytostatic was performed.A six-minute application of 0,05% Cyclosporine A solution was found to cause a lesser degree of infiltrative changes, which is caused by the suppression of cell migration to the surgical intervention zone. In contrast, early development of fibrosis changes was noted in the comparison group, where application of cytostatic was not performed.Using a 0,05% solution of Cyclosporine A in the form of intraoperative application to the zone of a surgical trauma causes slowing of regenerative processes. The greatest effectiveness is observed in case of 6 minutes application.

Reactions of ethyl 2-[8-bromo-3-methyl-7-(thietanyl-3)xanthinyl-1]acetate (1) and ethyl 2-[1-benzyl-3-methyl-7-(thietanyl-3)xanthinyl-8-thio]acetate (4) with hydrazine were investigated and hydrazine 2 and hydrazide 6 derivatives were synthesized. Reactions hydrazine 2 and hydrazide 6 with aromatic carbonyl compounds arylmethylenehydrazides 3а,b и 7а,b were obtained. The structure of the synthesized compounds was confirmed by spectroscopy. Based on the prediction of biological activity of the synthesized compounds in the PASS program we selected promising inhibitors of c-AMP phosphodiesterase, and their molecular docking with an active cAMP phosphodiesterase 4A binding site was performed. The calculated inhibition constant of cAMP phosphodiesterase 4A by compounds 2 and 7a is lower than that of pentoxifylline by 15 and 253 times, respectively, which confirms the prospectivity of the search for cAMP inhibitors of phosphodiesterase 4A in the series of hydrazine derivatives of 2-[3-methyl-7-(thietanyl-3)xanthinyl-1]acetic and 2-[3-methyl-7-(thietanyl-3)xanthinyl-8-thio]acetic acids.

The results of validation of critical stages of technological process of obtaining Crataegus almaatensis fruits extract by means of maceration method applying ultrasound exposure under a pilot scale conditions at LLP “FitOleum” are described in the article. The analytical evaluation of validation process of three pilot scale batches production have revealed the statistical controllability of applied operations: relative standard deviation (RSD) is not more than 2%, in the Shewhart control charts (the change of process parameters) deviations are not present, all values are within 3σ, Anderson-Darling test results do not exceed 1.0, the indexes of process possibility are within accepted criteria. The analyzed critical parameters have shown the validity, stability, continuity and effectiveness of the technological process from batch to batch and its suitability for the release of guaranteed quality product.

Cholestasis of pregnancy (CP) is multifactorial disease, the leading factors of which are hormonal and genetic factors. This pathology develops due to mismatch of increasing metabolic load during pregnancy and the adaptive abilities of the liver. This results in disrupted process of bile formation and bile flow in the intracranial bile ducts. The main clinical symptom of CP is skin itching, which may be local or generalized. Jaundice and pain in the right hypochondrium are less common. Laboratory diagnosis is to identify markers of cholestasis in pregnant women, such as high level of cholesterol, alkaline phosphatase, gammaglutamyltranspeptidase, and in more severe cases-increased alanine aminotransferase and aspartate aminotransferase. The most common complications of CP are premature birth, bleeding, fetal hypoxia. The article presents a case of complicated course of CP with abnormally high levels of alkaline phosphatase.

The article describes a rare case of helminthiasis on the face. Human infection occurs by transmissible way through the bite of blood-sucking mosquitoes, infected with larvae of dirofilaria. The disease in patient Kh., 64 years old, manifested itself in the form of dense tumor of the left infraorbital area, which appeared about a year ago. From the anamnesis of the disease it was found out that he did not leave the territory of Bashkortostan. The patient noted a double inflammation of the soft tissues in the area of the dense tumor. After hospitalization into the department of maxillofacial surgery with the diagnosis "Fibroma of the left infraorbital region" surgical intervention was performed under local anesthesia. The operating finding was filamentous round worm about 10 cm long, about 1 mm wide. The helminth identification was carried out at the Department of Infectious Diseases of the Bashkir State Medical University. A nematode of the genus Dirofilaria was identified. Two months after the patient's discharge from hospital in February 2017 we identified the second case of dirofilariasis in a patient Sh., 27 years old, localized in the right buccal region. In the preoperative period, the patient underwent an ultrasound of the tumor. The study did not diagnose helminthiasis. Dirofilaria was another operational finding.

Chronic intestinal failure is the main manifestation of a short bowel syndrome (SBS) and it develops after massive resection of a small bowel. Parenteral nutrition is vital for such patients. It allows ensure that the patients receive enough calories, nutrients and trace elements.In this study eight patients with SBS were included, who received parenteral nutrition. The underlying Diagnosis were necrotiz-ing enterocolitis, bowel atresia, midgut volvulus and Zuelzer-Wilson-Syndrome. Our study showed that parenteral nutrition keeps weight of the patients in normal range. Half of the patients lag behind in growth. One should remember that parenteral nutrition can lead to some life-threatening complications. Enteral nutrition is also very important for such patients. The management of chronic intestinal failure is complex, but very important part of the treatment.

Тhe fundamental task of regenerative medicine is the renewal or replacement of tissues and organs by recipient biocompatible implants. Pluripotent stem cells have the capacity for endless self-renewal and differentiation into more than 200 types of adult cells of human body. In the field of biomedicine, the introduction of induced pluripotent stem cells (IPSC) seems to be the most strategically advantageous, because their sources are relatively available, enabling to effectively produce and cultivate tissues in vitro. Reprogramming of somatic cells leads to their regression to the original pluripotent state. Independent groups of scientists have proposed a variety of ways to improve the induction of pluripotency, in order to limit immunogenicity, oncogenecity and to increase efficiency and speed up the kinetics of the process. In this review, we have analyzed a variety of approaches for obtaining IPSC and identified the most promising trends in the development of this direction.

Myelodysplastic syndromes (MDS) are a heterogeneous and complex group of clonal hematological neoplasms arising from a hematopoietic stem cell, and characterized by ineffective hematopoiesis, resulting from increased apoptosis in the bone marrow. Epigenetic changes are reported as key mutations in the case of MDS. Its incidence in Russia is documented as 2.0 new MDS diagnoses per 100,000 people and its incidence increases with age. Current diagnostic WHO classification of MDS was revised in 2016. The choice of therapy depends on the morphological MDS subtypes, the risk of its transformation into acute myeloid leukemia, age and general condition of the patient. Lenalidomide is an antineoplastic drug with the most impressive clinical activity, including achievement of transfusion independence and cytogenetic responses in MDS patients who harbor a deletion of the long arm of chromosome 5 (5q-). The hypomethylating agent azacitidine prolongs survival among patients with higher risk MDS compared with conventional care. In this article, we review the new classification of WHO, features of estimating the prognosis, mechanisms of action of lenalidomide and hypomethylating agents, and also discuss the most recent clinical data regarding its use in patients with MDS.

The presented review contains data on instrumental methods of assessment the morphofunctional state of the skin, used for allergodermathosis diagnostics. A common method of studying the morphology of the skin is biopsy. The main disadvantages of the histological method are the invasiveness with a scar as an outcome and possible complications (secondary infection). Limited capabilities and relative safety of the histological method led to the introduction of non-invasive organ-preserving research methods: confocal skin laser scanning microscopy, ultrasound investigation, optical coherence tomography, methods for measuring transepidermal water loss. The article contains data on methods that allow to increase the accuracy in diagnosis and to objectify the evaluation of effectiveness of allergodermathosis treatment. The improvement of intravital methods of morphofunctional skin study, allowing to determine the condition of the skin inside and outside of the lesion focus and to assess the treatment effectiveness, is the basis of a personified dermatology.

At present, non-developing pregnancy (NDP) is the most common form of miscarriage, and this parameter tends to increase. The article presents the results of a retrospective analysis of 137 medical cards of pregnant women and maternity patients diagnosed with NDP for the period from 2012 to 2015 (general sample). We have analyzed the main medical and social characteristics of women (symptoms, age, menstrual function, age of onset of sexual activity, characteristics of present and previous pregnancies, extragenital and gynecological pathologies) at the time of diagnosis of NDP, drug treatment and pharmacotherapy in the presence of individual and associated diseases with the use of statistical data processing. The study shows that the most significant medical and social characteristics of women with subsequently diagnosed NDP include asymptomatic course of pregnancy, active reproductive age, normal menstrual function, social status (employees). Most of the patients live in the city, they have the first pregnancy, 1-2 combined extragenital pathology, 1 gynecological disease.The analysis of medical care for pregnant women established the identity of the actual therapeutic and regulated measures.

The purpose of the study is to analyze the staffing of pharmaceutical companies in the Privolzhsky Federal District (PFD) with pharmaceutical specialists, and also to evaluate the perspective of satiety of retail market with pharmacists and pharmaceutical chemists during 2016-2020.It is established that in the retail sector of the pharmaceutical market of the PFD as of 01.01.2016, about 54 thousand of graduates are employed, about 85% of which work in the private sector of the pharmaceutical market. The total number of employees in the state pharmacy organizations of the regions of the district is about 11.7 thousand of people, 60.3% of them have pharmaceutical education. In the structure of the total number of pharmaceutical specialists in the public sector, pharmacists (61%) prevail, and pharmaceutical chemists account for 39%. About 44% of public sector specialists are aged 50 years and over, in the private sector of the pharmaceutical market this indicator varies from 19% to 90%. Given that the actual inflow of personnel into the retail sector of the pharmaceutical market in the Privolzhsky Federal District in the period from 2010 to 2016, will make about 6.0-6.5 thousand of people, it is possible to make the forecast about preservation of personnel deficit in the pharmacy organizations of the district.

Domestic pharmaceutical market is actively developing under the influence of economic, social, demographic, political and other factors. A great contribution into its development is made by budget-financed programs of medicine assistance.On the example of the Samara region - one of the largest in terms of population in the Privolzhsky Federal District - an analysisof the implementation of the program of provision of necessary medicinal products for the period from 2014 to 2016 was carried out. In the study there were used the methods of comparative, structural, logical, retrospective, marketing and content analyzes. It is determined that a significant proportion in the cost structure during the implementation of the this program is presented by the medicines that affect the alimentary tract and metabolism (in particular, insulins), antineoplastic and immunomodulating medicines, medicines for the treatment of diseases of the nervous system and for the treatment of respiratory diseases (in particular, medicines for the treatment of obstructive airways diseases).

The article presents the development of an algorithm for the Automated information system (AIS) "Pharm-Optima" and its client application designed to optimize the range of subsidized medicines (SM) for the treatment of patients with diabetes mellitus (DM), taking into account the background and related morbidity. The paper presents the structure, interface and functionality of the developed AIS, which allows to conduct a comparative analysis of various regulatory lists of medicines, to form questionnaires forexpert evaluation to identify effective, safe and frequently prescribed drugs, to conduct a survey in the network and Autonomous modes and to carry out statistical processing of the examination. The final product of the program is the list of pharmaceuticals to optimize pharmaceutical care to patients with diabetes eligible for social support measures in the part of the medical plan, to include these SM in the preferential list of drugs to the Territorial programs of state guarantees. The program can be useful for health professionals, managers and specialists of medical and pharmaceutical organizations engaged in the provision of medical and pharmaceutical care to patients with diabetes.