The results of percutaneous transluminal coronary angioplasty and coronary arteries stent implantation within a year after an operation have been analyzed in 412 patients. Angina pectoris relapse occurs in most patients in a year after an operation. CHD course is noted to be more favourable in a group of patients after coronary arteries stent implantation in comparison with angioplasty. Death rate and rehospitalization are found to decrease evidently in endovascular treatment in comparison with conservative treatment. The rate of restenosis is noted to depend on initial degree of coronary arteries impairment according to morphological classification of stenoses. Myocardial contractility was observed to increase in a patients' group with initially decreased ejection fraction and to decrease in a patients' group with coronary arteries restenosis.

The review of the literature is devoted to the rationalization of the antibiotic therapy and the choice of cephalosporines at the treatment of infectious diseases. It is shown, that at high cost of cephalosporines the pharmaco-economic analysis gives the advantage to cephoperazone, effective at Pseudomonas aeruginosa and anaerobe infection. This medication for the lack of biotransformation in a liver, excretion with bile in high concentration can be applied at renal failure, biliary infections, pelvic infections, aspiration and pneumonias associated with mechanical ventilation and nosocomial infections. Choosing the cephalosporines following their pharmacological properties, it is possible to increase the efficiency and safety of antibacterial therapy and to lower its cost.

Cholelithiasis is one of the most widespread and expensive in the treatment of all the gastro-intestinal diseases. Standard treatment provides laparoscopic cholecystectomy. Oral litholytic therapy by bilious acids (ursodesoxycholic acid) is the alternative in patients with moderately expressed symptoms accompanying cholesterol stones. Its efficiency can be raised by the correct selection of patients. There are some potential strategies in increasing of the efficiency of prophylaxis. The efficiency of the new organizational — educational form of prophylaxis — «School of the cholelithiasis patient» is shown.

On experience of 1991 patients authors have studied the opportunities of ultrasonic diagnostics of colorectal cancer and preoperative sonographic staging of this process. The ultrasonic diagnosis of rectal tumors are confirmed at 117 patients (5.9%). Liver metastasises are revealed and verified at 31 patients (26.5%) with the confirmed diagnosis of rectal cancer. Sensitivity of a method at staging of rectal tumors was 95.6%, specificity— 40.0% and accuracy— 85.7%, and at revealing of the metastasises in pararectal lymph nodes sensitivity was 95.2%, specificity— 95.0% and accuracy— 92.3%. The conclusion is, that transabdominal ultrasonography of rectum and liver is non-invasive and informative method of screening — diagnostics of rectal cancer and the metastasises. The diagnostic algorithm developed by authors allows to determine the indications to the operative treatment in the preoperative period and to lower rectal cancer relapses.

Closing of septal defects by various devices began since 1976. This technique has wide application after the device Amplatzer Septal Occluder has been invented and applied. Since 2000 the use of such devices in Russia has started, but, however, because of high cost was not accepted widely. Among 65,000 occluders implanted in the world only about 300 were implanted in Russian Federation. In December, 2005 in Primorsky Region the Amplatzer occluders have been implanted to 9 patients of 6—12 years. There were no complications in the nearest postoperative period in our series. In the long follow-up period one patient (in 2 months) had ventricle extrasystoles.

Fragments of shunts of coronary arteries at 36 patients after revascularization of myocardium are investigated (total 122 shunts: 36 of the left intrathoracic arteries and 86 autovenous). On the coronarography and morphological research the high stability of the autoarterial shunts as more adapted to a high blood pressure is shown. Among autovenous shunts one year after the by-pass more than one third were nonfunctioning. Technical errors of transplant taking and suturing, the distal lesion of a coronary flow and mediastinitis have been excluded. The level of blood cholesterol did not influence functional viability of venous shunts in the first year after the surgery. Authors suggest that not only anatomic-physiological features influence the outcome of shunts but it's also determined by the pathological changes of a venous wall which are not registered visually.

This research was experimental (40 rats) and clinical (100 patients) investigation of comparative efficiency of local treatment of postoperative wounds in colo-rectal practice. Gel with the additive of biologically active substance — tinrostim and ointment "Laevomecolum" was used. The high efficiency of local treatment by the biopolymers containing tinrostim was shown: healing of wounds was more rapid, more gentle scar was formed, the amount of complications decreased, and functional results of treatment improved.

The influence of the red light on a mucous membrane of the duodenum was investigated at chronic duodenitis. Morphological changes were studied and the morphometric evaluation of the mucous membrane was carried out. Clinical features of duodenitis before and after the irradiation were simultaneously estimated. The clinical analysis has shown that at red light action on a mucous membrane of a gut the level of the neutrophils, lymphocytes and plasmocytes decreases, the edema and hypersecretion of mucosa decrease. Clinically it is expressed in the reduction of the symptoms of disease.

The tuberculosis is the reason for kidney removal in 21—34.5% of cases. Effective treatment is possible only by various sorts of the radical and reconstructive surgical procedures influencing not only the pathological process, but also the restoration or major correction of kidney function. In the Primorsky Regional Tuberculosis Hospital in 2004—2005 four transabdominal laparoscopic nephrectomies were done. The postoperative period was smooth. On 8—10 day stitches were removed, healing of wounds was primary.

The analysis of endovideosurgical procedures at first stages of medical evacuation in conditions of the local wars is done. It is shown, that such interventions are highly effective for diagnostics and treatment of victims with gunshot wounds of thorax, abdomen and lower extremities for the reduction of the amount of complications, early activities of patients, shortening of hospitalization and rehabilitation.

On representative material - 102 patients with bradyarrhythmias and significant changes of central hemodynamics - in comparison with the control group of clinically healthy 25 patients it is shown, that in conditions of rare heart contractions on a functional class of chronic heart insufficiency it is possible to use the final diastolic and final systolic volumes of the left heart ventricle as predicting factors.

The comparative analysis of duration of inotrope support and mechanical ventilation is shown at coronary bypass on working heart and in conditions of mechanical perfusion. The received results allow to say that duration of the inotrope support and mechanical ventilation in the early postoperative period were longer at coronary bypass in conditions of mechanical perfusion, than at myocardium revascularization on working heart.

The results of treatment of 84 patients with overaponeurotic plastic of postoperative abdominal hernia by polypropylene SURGIPRO Mesh are analyzed. In the nearest postoperative period the complications due to the surgical technique are revealed in 9 patients. 2 patients have died. Relapse of a hernia during 1-3 years is revealed at 2 patients. In experiment on 36 white not purebred rats (term of supervision up to 6 months) morphological changes in the plastics zone with the use of SUR-GIPRO Mesh were studied. The analysis of the received data allows concluding that on first stages there is inflammatory aseptic reaction of tissue with the subsequent growing of the fibrous tissue into the implantat.

The first experience of use of the method of surgical resynchronization at patients with chronic heart insufficiency is described. 17 interventions on electrocardiostimulators and cardioversion-defibrillator implantation were done. High efficiency of the used technique (only in 1 case the treatment had no effect) is shown, the typical clinical example is described.

58 patients with ischemic heart disease with a stenocardia of II-III functional class on NYHA and chronic heart insufficiency after massive myocardial infarction are examined. It is shown, that Fosinopril prescription for the 10-week period in an average daily doze 12.0±0.9 mg has resulted in the regression of clinical signs of heart insufficiency and also provides obvious clinical improvement in ischemic heart disease, reducing the amount of ischemic attacks and needs for nitroglycerine, thus, promoting improvement of quality of a life of patients. Fosinopril is shown to be well-tolerated.

The specific structure of hospital microbe strains for last 10 years in Primorsky Regional Burn Center has changed. Significant decrease of pathogenic E. coli and Acinetobacter spp is marked. There was a substantial growth of saprophyte microflorae: S. epidermidis and Enterobacter spp. There is high a percent of associative microflora in wounds. The complex approach to early antibiotic prophylaxis, based on monitoring of circulation of the new strains, resistant to antibiotics is discussed; clinic-laboratory prognostic signs of development of inflammatory complications are suggested, as well as the revealing of initial pre-trauma infections and antibiotic resistant strains. The strategy of first-stage prophylaxis is suggested and that allowed lowering the amount of septic complications at severe burns in 1.5—2 times.

The original technique of video-assisted treatment of floating ribs segments on the basis of three-dimensional computer modeling is described. Surgical tools of own design were applied. The experimental part of work is executed on 30 corpses. In the hospital the method was used in 13 cases with good results. The conclusion is, that mini-invasive fixing of floating ribs segments allows to lower risk of wound and inflammatory complications, and also the complications due to long mechanical ventilation.

10—30% of patients with heart insufficiency have defects in intra-ventricular conductivity with asynchrony reductions of the ventricles. The risk factor of sudden heart death is deterioration of the left ventricle with reduction in its ejection fraction below 30%. Bi-ventricular electrocardiostimulation has proved its efficiency as a method of treatment of heart insufficiency and prophylaxis of sudden heart death. The review of the literature is devoted to the efficiency of implanted cardioversion-defibrillators in comparison with medical therapy of heart insufficiency.

On the basis of results of 6-month's supervision over 12 patients with chronic heart insufficiency of the III-IV functional class the high efficiency of the bi-ventricular electrocardiostimulation is shown. It was possible to provide the correction of the severe heart insufficiency and to reduce intra- and inter-ventricular asynchronism. The positive effect of heart resynchronization was not registered only in one case - at the patient with dilatation cardiomyopathy and very low ejection fraction of the left ventricle (28%).

Since 1996 to 2005 1524 laparoscopic cholecystectomies were done in the cases of the acute and chronic cholecystitis. Non-standard situations were observed at 92 cases (6%) among which 35 patients were with severe adhesive and inflammatory processes in choledochal area, 27 — with Mirizzi syndrome of I and II type, 26 — with choledocholithiasis found intraoperatively and 4 — with choledochal-bowel fistulas. Conversion was done in 17 cases (1.1%). In other cases operation was finished laparoscopically. Authors' opinion, that modeling of technique in difficult (non-standard) laparoscopic cholecystectomies is the important practical task.

The purpose of this research was an estimation of efficiency and safety of the uterine arteries embolization. We examined 27 patients with the uterus myoma in the age of 26 — 44 years old with clinical signs of disease as polymenorrhea and (or) menometrorrhagia. Embolization of the uterine arteries by polyvinylalcohol was provided to patients with absolute indications to operative treatment who refused that for the various reasons. The clinical effect as the termination of the uterine bleedings has been marked in 24 cases. Reduction of the uterus in average up to 40% in 60 days after the embolization is registered in all cases. At control examination in 12 months the reduction of the uterus up to 60-70% was observed in 14 cases. All patients had subjective improvement after the intervention.

The article is devoted to the problem of anesthesia support in endoscopic GI procedures, in particular, fibrooesophagogastroduodenoscopy. The personal approach of authors to this problem is shown. The comparative analysis of sedation by benzodiazepines in 83 patients is done. The opinion for the benefit of Midazolam (Fulsed) as a choice is stated, in comparison with traditionally used Diazepam (Relanium). The conclusion is that for safety of individual use of medications of this group it is necessary to think of many factors among which the most important are the presence of cardiovascular system disease, advanced age, chronic diseases, dosing, etc.

The paper is devoted to the review of system of CPR efficiency improvement on pre-hospital stage. The basic elements are «...analysis—training—standards—equipment—monitoring system—motivation—execution—analysis...».  The concrete actions on each element of system, ways and variants of achievement of the purpose are described. The example of successful introduction can be served with increase of rate of survival of the patients with a sudden cardiac arrest on pre-hospital stage in Vladivostok from 4.3 (1999) up to 10.2% (2003-2005), in Yakutsk - from 0 (2004) up to 8.9% (2005). The necessary conditions for a successful beginning of activity also are determined.

More than 6 years ago, the American Heart Association published Improving Survival From Sudden Cardiac Arrest: The "Chain of Survival" Concept. The paper identified the idea that all communities should adopt the principle of early defibrillation. This principle applies to all personnel who are expected, as part of their professional duties, to perform basic CPR: They must carry an AED and be trained to operate it. Health professionals who have a duty to respond to a person in cardiac arrest should have a defibrillator available either immediately or within 1 to 2 minutes. Responsible personnel should authorize and implement more widespread use of automated external defibrillation by community responders and allied health responders.

This is the brief review of the literature and rare practical surgical cases at children suffering of giant lymphangiomas of the chest wall, neck and mediastinum. Examples of rational preoperative evaluation and surgical tactics are suggested.

Rare clinical case: the woman of 23 years old, perforation of the uterine wall by the intra-uterine contraceptive with migration of it into the ileocecal area and development of acute appendicitis. The rarity of such complication, late diagnostics and inadequate treatment at pre-hospital stage are marked.

Two clinical cases. At complex trauma of thorax and abdomen two patients of 29 and 20 years old underwent endovideosurgical procedures which have allowed to diagnose the rupture of the diaphragm, to specify the damage picture in inner organs and to plan the surgical treatment. Necessity of endovideosurgical techniques in treatment of victims with severe traumatic damages is emphasized.