The review presents extensive information about the position, form and functions of neurons of spinal lamella X in different animals that are the evidence of cells presence in autonomic nervous system (central nucleus), premotor interneurons and ectopic primary sensory neurons. With sufficient detail it is presented the results of the study of neuronal activity of acetylcholinesterase and nicotinamide adenine dinucleotide phosphate-diaphorase by histochemical methods, choline, gamma-aminobutyric acid, and nitric oxide synthase and calbindin by immunohistochemistry, supported by illustrations of their own research. These data allow the authors to believe that around the central canal of the spinal cord is functioning complex cluster of premotor neurons providing excitatory and inhibitory effect on motor neurons, preganglionic neurons of the autonomic nervous system, simpatotsity exercising innervation of the spinal cord vessels, as well as the primary sensory neurons.

The research is a literature review dedicated to the evolution of surgical treatment of breast cancer. Over the last century there was a paradigm shift from surgical tactics mastectomy (removal of the aden with the lymph nodes) to a lumpectomy (removal of the tumor from the aden) in combination with a biopsy of the signal node, radiation therapy, or oncoplastic surgery. In recent years, surgical treatment strategy for breast cancer is reviewed in the direction of aesthetic surgery. It has become possible due to the development of theoretical ideas about the nature of the disease, and the improvement of adjuvant therapies. Currently, in addition to medical problems it becomes important an achievement of the optimal aesthetic result and the maximum extension of high-quality and socially active life of patients.

A wide range of biological activity of regulatory peptides of glyproline family allows us to consider them promising pharmacological agents. We detected the ability of peptides of glyproline range to show an anti-ulcer activity. Tripeptide progly-prol exhibits it in a greater degree which suggests the possibility of creating on its basis a new drug. The paper discusses the general idea of the regulatory peptides, there are some published data about the effect of the peptides of glyproline family and peptide semax on the ulcer formation processes and summarizes the possible mechanisms of oligopeptides action.

This article represents a lecture at the International Conference "The future of modern medicine in the East-West medical perspective", which has been held at the Pacific State Medical University (Vladivostok) on October 3, 2016. Scientists from more than 40 countries are studying marine bioactive metabolites. Results of these investigations have been described in almost ten thousands scientific articles containing the information about 27 thousands low molecular weight natural compounds. Near a dozen effectively acting drugs, created on the basis of these metabolites, has been applied in different fields of medicine, including oncology, cardiology, and ophthalmology. Recent years new trends have appeared at the interface between natural products chemistry, cellular biology, microbiology, molecular genetics and fundamental medicine. Some results obtained in the framework of these trends are discussed in this article. Several examples of the studies on natural products, carried out at G.B. Elyakov Pacific Institute of Bioorganic Chemistry of the Far-Eastern Branch of the Russian Academy of Sciences, were shown in order to illustrate the achievements, connected with the search for, isolation, structure elucidation, and biological activity of marine natural products.

The research objective is to analyze the possibilities of using the rating clinical scale CoMiSS and the determination of endogenous proteins and peptides in coprofiltrates for the improvement of diagnosis of cow's milk protein allergy (CMPA) in infants. Methods. The study included 60 infants of the first year of life with suspected CMPA: 30 infants with CMPA (the 1^st group), and 30 infants with the secondary lactase deficiency (the 2^nd group). The control group included 20 healthy infants. We assessed clinical symptoms using CoMiSS instrument and cutaneous syndrome based on SCORAD index, determined in coprofiltrates endogenous proteins and peptides: ß-defensin 2, zonulin, eosinophilic cationic protein. Results. In the monitoring groups the total number of points on the scale CoMiSS the score was higher than in the control group, but not significantly different between groups. The differences in the severity of symptoms of lactase deficiency were also unreliable and symptoms of skin lesions were more common in the 1st group. The defeat of the respiratory tract is not registered in any of the child with a secondary hypolactasia. An increase in the ß-defensin 2 in coprofiltrates was typical only for children with the CMPA, zonulin content in children of the 1^st was 1.5 higher than that of children in the 2^nd group, and 2.3 times higher than the control parameters. The level of eosinophil cationic protein in patients with the CMPA was 2.9 times higher than that of children in the 2^nd group, and it was 2.7 times higher than in healthy children. Conclusions. The widespread use of SCORAD index and the tool CoMiSS, and the analysis of the content of endogenous proteins and peptides in coprofiltrates can improve the diagnosis of the CPMA in infants by avoiding invasive research methods and provocative diets.

Immune mechanisms involved in the pathogenesis of recurrent miscarriage and infertility. Despite the fact that fetal cells carry antigens of both mother and father, there is 'an immunological paradox' of pregnancy associated with the occurrence of immunological tolerance. Methods. The object of study - 22 women with pollinosis who had episodes of miscarriage in the medical history and 31 women with pollinosis, but without a burdened obstetric history (control group - 20 women without aggravated allergic and obstetric history). Results. Changes in immunological parameters in patients with pollinosis had a similar clinical picture. However, in the group with recurrent miscarriage noted high activity of NK-cells with a cytotoxic phenotype. In women without the burdened obstetric history NK-cells were defined within the normal range during pregnancy and changed their phenotype to immunosuppressive one. Conclusions. A preconception period program in women having had episodes of miscarriage in their medical history should cover the pollinosis screening, and in women with detected pollinosis should detect the NK-cells levels and cytoxic T lymphocytes assessing their functional activity.

Study objective is to analyze brain response rate of a human by the recordings of spectral function caused by bioelectric activity during the positional computer game. Methods. To record and to analyze the diffusion rhythm of the activating brain system in 6 women aged 23-58 years old we used double-channel inductive magnetoencephalograph RS MEGI-01. Results. Alpha- and beta-rhythms of the spectral brain function during playing a game were close to back rhythms, so different spectral function occurred to be small for these frequencies. Strong rise occurred in the diapason of slow and delta-waves, respective to the second gaming session, especially for the left hemisphere. Conclusions. Before the brain response rate were measured in increments of 1-5 c, recording its electrical activity for several hours. On the basis of the conducted study we can say that the brain response rate is visible in enlarged scale in increments of 160 c with the use of spectral function caused by bioelectrical activity of the brain. This feature occurs differently for each hemisphere and depends on a brain transitional state.

A systematic analysis of certain aspects of the problem of cystic fibrosis (CF) is necessary to improve the quality of care requires. Methods. The study involved 52 patients with CF: children - 66.5 %, adults - 33.5 %. We studied the structure of the gene mutations transmembrane conductance regulator (CFTR). The level of neonatal blood immunoreactive trypsin was defined in 72,746 newborns. It was examined the spectrum of bacterial pathogens, the state of the nutritional status of patients, the level of fecal elastase-1. Results. The frequency of CF in the Primorsky territory - 2.69 per 100 thousand population. The frequency of birth of patients - 1 per 6,613 newborns. The average patient age 13.5±8.4. Among adult patients, 77.8 % of men. Among the dead children, girls accounted for 66.7 %. During the 17-year of follow-up verification of the terms of diagnosis decreased by 5.3 times. The structure of the allelic frequency prevails «severe» mutations in CFTR, often - F508del (53.7 %). In the structure of the microbial pathogen Pseudomonas aeruginosa and Staphylococcus aureus were verified more frequently. В 1,6 раза увеличилась частота выделения Burkholderia cepacia complex. Meconium ileus, rectal prolapse, weight deficiency, the severity of the disease and low levels of fecal elastase-1 are the objective criteria of exocrine pancreatic insufficiency degree. Only 61.4 % of the patients systematically implemented the recommendations for treatment and rehabilitation. Conclusions. In Primorsky territory, there are opportunities for the timely diagnosis of CF, to determine risk factors that predict it in different age groups, carrying out and monitoring the efficiency of basic therapy. There remain problems with the practical awareness of doctors and patients about the risk groups, diagnostic capabilities and modern therapy.

In national literature there are only a few papers on the structure and dynamics of kidney disease in the adult population of various regions of the Russian Federation. Methods. We conducted the analysis of the structure of glomerulopathy (GP) in patients older than 18 years old, verified on the basis of 1955 renal biopsy in the Research Institute of Nephrology of Pavlov First Saint Petersburg State Medical University during 15 years. Results. It was shown the increase of frequency nefrobiopsy, reached by 2014 in the region of 20 per million population per year. Primary GP occurred to be the dominant disease group - 72.3 % of cases, secondary GP were diagnosed in 16.2 % of patients. Primary GP incidence decreased within aging, and till 2010 the proliferative pathologies prevailed. However, in the 2010-2014 the number of non-proliferative GP has exceeded the number of proliferative, which was primarily due to focal segmental glomerulosclerosis and membranous nephropathy. Conclusions. The number of renal biopsies in the Northwestern Federal district of Russia exceeds the number of such European countries as Serbia and Romania, and is significantly behind Finland and Denmark. The tendency to the incidence reduction of proliferative GP in recent decades is accounted for the higher living standards, improving the quality of care and the early use of effective antibiotics.

The administration of radiation sensitizer into a tumor succeeded by ray treatment leads to the additional secondary radiation inside the neoplasm that improves the effect of the ray treatment. Methods. Measuring the dose of ionizing radiation was conducted by using the phantom (WP 600). The 2.5 % suspension of nanoparticles (NPs) of tantalum oxide (Ta₂O₅) or control solution (0.9 % NaCl solution) were placed into a spherical sample. Dimensions of NPs were determined with the tool Zetasizer NanoZS and constituted 71±1 nm (А) и 81±1 nm (В). Со⁶⁰ was used as a source of radiation. The measuring was carried out with the ionization chamber FC65-P, which recorded the total intensity of Y-radiation. The measuring was carried out at the open gate, the passage of Y-camera under the test specimen at a distance of 0.5 cm. Data were processed in Wolfram Mathematica 9.0. Results. The total radiation for samples containing NPs Ta₂O₅ was higher than those obtained in the measurement of ionizing radiation by a 0.9 % solution of NaCl. The increase for particles with a size of 65 nm was 5.5 % for particles with a size of 71 nm - 5.2 %, for a particle with a size of 81 nm - 7 %. The reason for increase in the emission intensity when passing hard Y-radiation through the low Ta₂O₅ is the generation of the secondary low-energy ionizing radiation. Conclusions. NPs Ta₂O₅ is a promising medicine for the treatment of local radio modification malignancies.

The research objective is a hygienic assessment of actual nutrition of adolescent population and territorial distribution of the values of its indicators in Primorsky Territory. Methods. We studied 1555 adolescents aged 14-17 years (757 boys, 798 girls) in 24 administrative entities, covering all geographical zones of Primorsky territory. The average daily diet of adolescents studied simultaneously on February 17-19, 2015 by analyzing the frequency of food consumption. Caloric value of diet and levels of nutrient intake was calculated from the table of the chemical composition of domestic food. Results. The daily ration of the teenage population in Primorsky Territory is characterized by lower to 15-23 % energy value, carbohydrate and calcium deficiency (34-56 %), vitamin A (27-56 %), vitamin C (55-65 %) or more, than 1.5-fold excess of sodium. We revealed an imbalance of protein, fats and carbohydrates in the diet: 1:0.9:2.3 - young men, 1:0.8:2 - the girls (at medical rate of 1:1:4). Features of the diet of adolescents characterized by excessive consumption of sausages, pasta, porridge from cereals, combined with a marked shortage of milk, dairy products, vegetables, potatoes and fruit. Conclusions. There were no sharp regional differences in terms of actual nutrition of adolescent population of Primorsky territory. Only the intake of calcium by girls in remote rural areas and provincial cities was significantly lower (about 1.5 times) than in Vladivostok with the highest standard of living in the region. This difference in the calcium content in the diet of girls is the result of more than two-fold difference in the consumption of milk and dairy products.

The research objective is to analyze the dynamics of infant mortality, and also the mortality in early neonatal, neonatal and postneonatal age in Khabarovsk Territory. Methods. The object of the study was a cohort of children died in the first year of life in the Khabarovsk Territory during 2000-2015. The mortality rate was calculated with Bodio procedure. Results. A positive dynamics of infant mortality was estimated -reduced by 4.9 times, but it was higher than the average in the 25 EU countries (2013) and Japan: 4 and 2.8 deaths under 1 year per 1000 live births. The formula of the exponential calculation showed that if the trends in the demographic situation remains the same in the region by 2020, the infant mortality rate would be 8.71 of deaths under 1 year per 1000 live births. Conclusions. Trends and reduction of mortality and its components in the region can be considered as encouraging thus it is necessary to maintain the maternal and child protection service and to maintain the scientific approach to further improvement of medical care to women and children.

High medical and social significance of the diseases causes of the circulatory system is a reason to study their prevalence and planning the need for surgical treatments. Methods. The analysis of the need for surgical treatment of cardiovascular diseases in Russia and the Far East Federal District (FEFD) was carried out, taking into account the prevalence of the main types of diseases of the circulatory system and the forecast changes in the incidence. Results. In comparison with 2006, the total incidence of circulatory system diseases among the adult population in Russia will increase by 14.2 % by 2016; among children aged 15-17 - 39.6 %, and among children under the age of 14 - will decrease by 13.4 %. In terms of basic nosology in the country and in the FEFD and growth of the primary disease in cerebrovascular diseases will be 1.6 and 1.7 times, respectively. Taking into account the rate of increase number of surgical interventions in diseases of the circulatory system the amount of growth is projected for 2016 operations for congenital heart diseases by 1.6 times, with acquired heart diseases - in 1.9 times, in coronary heart disease - by 2.9 and 5.7 times (coronary artery bypass surgery and transluminal angioplasty), during operations on the arterial bed - in 2,3 times. The minimum level of security operations at disturbances of heart rhythm and conduction in the country will be provided already in 2016. Conclusions. The data shows an increase in accessibility for the population of Russia and the FEFD cardiac care, but still insufficient for its needs.

We assessed the impact of tobacco smoking on some parameters of arterial stiffness and indicators of cerebrovascular blood flow in young people in the early stages of hypertension. Methods. We osereved 202 young patients with hypertension stage I-II hypertension and grade 1-2 (of which 77 smokers) and 100 healthy individuals with normal blood pressure (of which 37 were smoking). A comprehensive study of the state of stiffness of the great arteries and cerebrovascular blood flow by ultrasonic method was conducted. Results. Tobacco smoking and hypertension had a negative impact on the indicators of arterial stiffness, as evidenced by the significantly higher value of pulse wave velocity and cardio-ankle vascular index and no reduction in speed parameters of blood flow in the internal carotid and middle cerebral artery. Smokers and non-smokers with hypertension were decreased the growth of the internal jugular vein area during the Valsalva maneuver. Conclusions. Tobacco smoking and hypertension have a negative impact on the performance parameters of arterial stiffness and cerebral blood flow in young patients with hypertension of the I-II stage. At the same time the speed of blood flow parameters are largely affected by smoking, and indicators of arterial stiffness of the great arteries and internal jugular veins stretch - high blood pressure.

The purpose of the study was identification of additional differential diagnostic markers of urethritis in men by analyzing local and systemic status. Methods. We analyzed the indicators of local and systemic cytokine status in men with chronic urethritis (40 men with chronic viral urethritis and 40 men with viral and bacterial urethritis). The comparison group (control group) consisted of 20 healthy male volunteers. Cytokines were determined by ELISA, semen analysis indicators according to WHO protocol (5^th ed., 2010). Results. In chronic viral urethritis diagnostically significant is the improvement of TNFa in the venous blood serum, as well as a marked reduction of index IFNy/IL10 in the venous blood serum and seminal fluid, suggesting a dysregulation of the immune response at a local and systemic level in such patients. With mixed urethritis of viral-bacterial etiology diagnostically significant was the authentic increase in TNFa levels in the ejaculate that was significantly higher compared to the group of men with herpetic urethritis and control group, combined with strong content of the same cytokine in the venous blood serum, which indicates a high apoptotic activity precisely in this investigated group and helps to maintain chronic inflammation and impaired fertility. Conclusions. The increase in TNFa levels higher than 21 pg/ml in the venous blood serum and 12.4 pg/ml in the ejaculate is an additional criterion for the diagnosis of chronic viral-bacterial urethritis. TFNß levels in the ejaculate exceeded the values of both control group and group with viral urethritis, indicating that the negative impact of herpes infection on the clinical course of urethritis of mixed etiology and affects adversely on the reproductive health of men.

The research objective is an analysis of the characteristics of a respiratory burst and the activity of NAD(P)-dependent dehydrogenases in blood neutrophils in sensitive and resistant to acetylsalicylic acid (ASA) patients with acute coronary syndrome (ACS). Methods. The study included 53 patients with ACS. The resistance / sensitivity to ASA was studied in vitro, incubating the platelets to adenosine diphosphate and ASA. Status respiratory burst of neutrophils was studied by chemical luminescence, and the activity of NAD(P)-dependent dehydrogenases - by bioluminescent method. Results. In patients resistant to ASA the rate of synthesis of primary and secondary reactive oxygen lowered, the index of luminol- dependent activation of neutrophils decreased, of substrate stimulation of glycolysis and glucose oxidation by the pentose phosphate pathway increased. Conclusions. In patients with ACS resistant to ASA is marked a decrease in functional activity and disturbances in the metabolism of neutrophils. The possible cause of the condition described above is energy losses of a cell, associated with the increase of the intensity and substrate stimulation of glycolysis and glucose oxidation by the pentose phosphate pathway.

The study objective is to determine and to describe psychological features of drug addicts with early psychic trauma. Methods. A survey included 70 people of 27-43 age, 35 of which have suffered from drug addiction (cannabis addiction). We used the author's profile of R.V. Kadyrov, questionnaires LEQ and the FPI, the scale of intelligence and psychological basis of beliefs and other psycho diagnostic methods. Results. Among drug addicts it was often detected signs of early psychic trauma, it was greater severity of neuroticism and emotional lability, and such defense mechanisms as a projection and denial. Conclusions. The analysis revealed a number of psychological characteristics of drug addicts with early psychic trauma: the tendency to be impulsive, irritability, perception of other people as the detractors, etc. Intensity of protective mechanisms, «projection» and «denial» provokes anxiety, maladjustment and disorganization of behavior.

It is the clinical observation of Crohn>s disease in a child of 12 years old. The diagnosis was made on the basis of gastro and colonoscopy and detection in biopsies of the colon specific changes and epithelioid granulomas, to the exclusion of other non-specific and infectious intestinal lesions.

The article gives a critical analysis of healthcare system of the Russian Federation. It explains such concepts as 'iatrogenesis' and 'medical error', and the need to consider the iatrogenesis as a necessary part of treatment and diagnostic process. The author analyzing the euthanasia history brings up a question related to further intentional boost of death coming in our country and touches upon a problem of a transplantology.

The study objective is to assess the allocation of human resources management of the tuberculosis service in Primorsky territory using modern information technologies Big Data. Methods. Primary information about human resources of the tuberculosis service obtained from the datat of the state statistical reporting during 2000-2014. Processing was performed in the R-Studio. Results. The number of full-time positions of TB specialist in Primorsky territory increased by 1.875 units, whereas the number of population decreased by 2.5 units (r=-0,53). The number of TB specialists grew down much faster that the number of population (average rate of decrease - 3.58). The rate of TB-specialists per 100 hundred of population reduced from 6.73 to 5.8. The to tal number of full-time positions was inversely proportional to the average number of the population. The analysis of the staffing level and the rate of pert-time positions completes the vision of disproportions in human resources allocation. The dynamics of the rate of part-time positions shows that during 2004-2013 the duties of physicians increased. The number of specialized beds per 10 000 of population reduced from 7.7 to 6.3. The total number of visits to TB specialists grew up on 20 %, and the number of visits caused by a disease grew up on 15.7 %. TB specialists could not take more patients in outpatient clinics and worked at the maximum possible load. Conclusions. The results of our research indicate a range of problems impairing the tuberculosis service management. The one of them is a shortage of specialists in outpatient units that lead to the increased load per one physician by 20 %. Meanwhile in TB inpatients hospitals the load decreased by 15 %. It is necessary to conduct the in-depth study of human resources of all medicinal specialists using wide range of statistical methods. On this basis, should be developed additions and changes in the regional health development programs and should be ensured their effective implementation.

Treatment and rehabilitation of patients with scoliosis is an extensive medical and social problem. With the advent of modern physical therapy equipment and the possibility of the use of physiotherapy in all stages of scoliotic damage widened. Methods. It was conducted a comparative analysis of the effectiveness of rehabilitation programs depending on the timing of their application in the preoperative and postoperative treatment of scoliosis in 71 patients aged 10-17 years. We assessed the degree of severity of pain, postoperative wound state, static muscle endurance, postoperative complications. Results. The most obvious decrease in the dynamics of the degree of pain, healing of the wound and static muscle endurance was observed in patients with preoperative preparation of physical factors, as well as the early onset of rehabilitation (1^st-2^nd postoperative day). Conclusions. The use of complex rehabilitation programs is excessively important for the prevention of severe postoperative complications and successful physical and social adaptation of children with scoliosis.

In the article we presented the dates of Clinical and Economic Analysis of the medicinal nomenclature for preferential categories of citizens who need of social support. Methods. The aim of our study is to analyse the rationality of medicinal structure and to compare it with The List of Vital and Necessary Medicines of Russian Federation. We studied the structure of medicinal purchases with the help of ABC VEN-analysis. We accentuated VEN-analysis that evaluated expenses for significant medicines. Results. The study has demonstrated that 112 from 150 medicines (74,7 %) were attributed to class V (vital medicines) by VEN-analysis, 25 from 150 medicines (16,7 %) were attributed to class E (essential medicines) and only 13 from 150 medicines (8,6 %) were attributed to class N (non-essential medicines). In the analysis of the range of medicinal nomenclature for compliance with the List of Vital and Essential Medicines in accordance with Annex № 2 to the Order of the Government of the Russian Federation dated 30 December 2014 No. 2782-r found that savings, which in itself carries the adoption of the order of 1,676,811.40 rubles by reducing the number of medicines with low or unproven therapeutic efficacy. Conclusions. According to our research the medicinal nomenclature was rational. The feasibility of utilization of financial resources and the priority of vital medicines is dictated by the principles of evidence-based medicine, contributing to a rational choice of medicines in each clinical case. Accepted Government Decree № 2782-r will in the future save money by avoiding medicines with unproven efficacy and direct means for highly efficient and safe medicines.

The work was carried out a sociological survey of 128 nurses in palliative care center. Methods. We used two types of surveys: writing (questionnaires) and oral (semi-structured interviews). Results. We identified the following problems: the nurses works with a high load (an overload) that leads to a reduction of communication time with patients and therefore reduce the quality of nursing care. Working time is distributed rationally, much of it is spent on service calls, transportation of patients, provision of workplace drug and consumables, courier duties. The main functions of ward nurses reduced to the implementation of manipulation and doctor appointments without a personal care. The lack of evaluation criteria for certain types of nursing activities hampers objective analysis of the quality of the nursing process in the departments of palliative care. Conclusions. The analysis of motivation and professional characteristics of nurses shows that the majority of nurses during the work in a palliative care unit gained additional professional experience. Nurses consider the priority of professional activity an 'interesting work', which indicates a positive impact on the quality of nursing care, internal (sense-) motivation.

The national health care reform conditions on the background of adverse health outcomes, priority of health care with the vector in the prevention of disease and disability, sharply raises the problem of modern social and hygienic studies aimed at improving enforcement and health agencies. Due to the absence of a broad network of specialized rehabilitation institutions, able to provide physically challenged children with a comprehensive medical, social and educational assistance, and insufficient regulatory documents regulating their activities. Many years' experience of the staff of Center for Restorative Medicine and Rehabilitation allows to make a number of proposals, the implementation of which in practice will enhance the level of care.

The study presents a theoretical analysis of the challenging problem relevant to medicine and clinical psychology -the formation of the compliance. We reviewed the trends of the modern society pointing to the necessity of abandoning the paternalistic model of doctor-patient relationship. The practical significance of this theoretical study is the need to find means to ensure the formation of compliance behavior and to reduce the loss of time and financial resources. t has been shown that the development of communicative competence of the physician will significantly increase the level of compliance behavior.