The paper of the president of Vladivostok State Medical University presented at the 1st Congress of medical workers of Primorsky region focuses a special attention on criticism of the current Russian medical insurance system, as well as on the problems in the public health service and higher medical education. On highlighting the necessity of deliberate implementation of the reforms in social sphere allowing for doctor and patient's interests, the author emphasizes the programs of strategic planning of the community health care, social maintenance of medical workers, and others which have top-priority among all the problems facing the regional public health care service.

The paper provides data on application of inert gas xenon in anesthetic practice. The authors point out its advantages over most of present anesthetic drugs and place the emphasis on the priority of domestic researches. On focusing the attention on practical difficulties of xenon anesthesia which relate to both application of low-continuous flow method and need for recycling and reduction of the spent gas, they draw a conclusion that new anesthetic is very promising for surgical practice.

This paper provides a literary review devoted to the study of nitric oxide involvement in regulation of the digestive system functions. While discussing the role of different cells (myocytes, enterocytes, neurocytes) in producing the nitric oxide and regulating its synthesis, the author emphasizes the function of other biologically active substances in these processes. Furthermore, inside the organs of the digestive system there is a large group of regulatory peptides, which interaction with the nitrogen oxide has not been examined up to now.

The paper represents a literature review devoted to the mechanisms of neurons death in the area of ischemia. The generation of both free radicals and peroxinitrites intensifies when there is a restoration of blood supply through the nidus of ischemic lesion and steadily results in necrosis and apoptosis of cortical neurons. Protective mechanisms include glutamate utilization with neuroglial cells, induction of neuronal-form nitrooxidesynthase, superoxide dismutase, neurotrophins and antiapoptotic enzymes. At separate neurons and synapses level, the aforementioned mechanisms are realized by way of local regulation of hemodynamics, which is mediated by neurovasal messengers and neurotransmitters. The balance of neurotoxic and cytoprotective actions determines selective resistance of separate neuron chemotypes to hypoxia and oxidizing stress that in prospects can serve as a basis for elaborating the directional pharmacological correction of the preceding abnormalities.

Localization of neuronal nitrooxidesynthase, serotonin and NADPH-diaphorase has been examined in cerebral cortex of fetuses (26-28 weeks), newborns and adults. In the subcortical white substance, as is shown, there is a nitroxydergic neuron population, a number and activity of which are unequal at different stages of neuroontogenesis. In an antenatal period a part of the nitroxydergic neurons synthesizes the serotonin and forms the neurovascular bonds.

The authors studied the eye retina of the human fetuses at 10-12 and 25-28 weeks of antenatal development. Having applied histochemical and morphometric methods of examination, they showed the decrease of cells in range of more than by 30%. Furthermore, a role of necrosis and apoptosis in rearrangement of the eye tissues in ontogenesis is considered as well.

146 cases with vertebral column fractures (97 males and 49 females) were carefully assessed and results were analyzed. The majority of patients suffered from home or traffic traumas, including falls from heights as a most frequent reason (36.1%). Depending on severity and complications all the spinal trauma cases were divided on major (69.2%) and minor (30.8%) injuries in accordance with E Denis classification. The mentioned above follow up of the spinal trauma patients resulted in well defined recommendations, such as contemporary standard approach to diagnosis and management, mandatory X-ray diagnosis and bone scan, substantiation of reconstructive and decompressive surgical techniques with preoperative modeling (a surgery can be performed in one or two steps), selection of surgical techniques in non stable vertebral injuries should be based on principles of early recovery of the blood-brain barrier and persistent physiotherapy, surgical techniques with transpedicular pivotal systems should be applied in patients with acute spinal trauma. In the distant period two-step surgery is an indication for stabilization of the damaged segment and anterior decompression with spondilodezis. Therefore, contemporary strategies in orthopedic surgical care of the spinal trauma patients will undoubtedly lead to reduction of the disablement time and length of a sick leave.

The assessment of long-term postoperative results in 9 patients in acute and 18 patients in chronic anterior instability of the knee was performed in 6 month and one year after surgery. Patients with acute ACL rupture had better results than patients with old rupture (according to Revised HSSKS). These better results are explained by minor symptoms of synovitis following the primary repair of ACL.

Based on the medical observation of 756 children suffering from hemangioma, the authors propose a staged treatment regimen of these tumors. They provide the grounds for early surgical procedure believing that both early initiation of the treatment and integrated approach to it allow to achieve more than just a recovery but also to ensure favourable cosmetic result.

The paper provides data on the researches into the cytokine state under hemorrhagic fever with renal syndrome, chronic viral hepatitis type C, ixode tickborreliosis, and nosocomial pneumonias. The authors have inquired into the content of proinflammatory and anti-inflammatory cytokines at system and local levels (in blood serum, bronchoalveolar fluid supernatants, liver homogenate, expired air condensate). According to the findings, infectious disease pathogens are initiators of the infectious process, and the so-called «direction» in pathogeny belongs to organism immune response that detects the severity, clinical course and form of the disease.

Endobronchial biopsy is considered to be "a gold standard" while diagnosing the inflammation under bronchial asthma. At the same time, it is a "snap" belonging under invasive methods. An ideal tissue marker of the inflammation under bronchial asthma should be obtained by using noninvasive technique, as well as it should be in close association with the process activity and easily applicable. Based on 137 observations, the author has studied both expired air condensate and induced sputum, showing a high clinical efficacy of new diagnostic technique for monitoring of the bronchial asthma clinical course.

Prospective cohort research of economic losses resulting of the irrational administration of antibacterial drugs in patients with widely spread disease in men as acute appendicitis. We have analyzed through 118 medical charts, and direct and indirect pharmacy expenses of both inpatients and outpatients were evaluated respectively. It was shown that economic losses caused by irrational administration of antibacterial drug therapy were equal to 1857.33 rubles per a patient depending on preoperational prophylaxis protocol.

The paper defines the features of clinical course of bronchial asthma during the pregnancy. The authors detected the exacerbation rate of asthma depending on the severity of the clinical course and period of gestation, showing a high exacerbation rate of asthma (68,4% of pregnant women) and worsening of its clinical course during the pregnancy at 43% cases. The patients suffering from bronchial asthma had had a considerable rate of complications during pregnancy and labor, as well as pathologies of fetuses and newborns. Furthermore, the authors defined correlation between the severity of the clinical course of asthma, the rate of the disease exacerbation during the period of gestation, and perinatal outcomes.

Structural changes of elements of the "hippocamp-hypothalamus-thymus" system have been examined in vivo when introducing peptide morphogene of hydra and its three synthetic analogues. The authors have succeeded in reducing the variety of the effects under study to three ones by applying the factor analysis methods. The structure of the most powerful of them included as variables the indexes relating to both nervous and immune components.

27 patients suffering from acute respiratory distress syndrome of different severity degree against the background of acute surgical pathology have undergone artificial pulmonary ventilation by applying respirators Bird 8400 STi, Puritan Bennet 760 and Puritan Bennet 840. After respiratory backing CMV when improving oxygenation and clinical presentation, the patients underwent secondary ventilation SIMV, and then — CPAP. Based on the analysis of lung-thoracic compliance, ratio between the time of inspiration and expiration, and other parameters, the authors have shown that the respiratory support by using present-day equipment associated with complex intensive care makes for improving the treatment results of this category of patients.

The paper presents an experience of surgical treatment of mitral valvular diseases by using xenoaortic bioprostheses «KemKor» made in Kemerovo Cardiological Center. The authors have assessed clinicohemodynamic characteristics at patients suffering from different variants of mitral valvular disease after 130 operations. Overwhelming majority of the patients fell under the III-IV functional classes by NYHA. The age of the patients undergone the operation was from 18 to 71 years. The hospital lethality amounted to 5.4% (7 patients). Provisional data testify that using xenobiological prostheses makes for adequate correction of intracardial hemodynamics under different types of the bicuspid valve diseases.

Based on the data of 284 clinical observations of chronic atrial fibrillation, the authors inquire into the efficacy of palliative therapy methods. They draw a conclusion about high efficacy of atrioventricular junction ablation associated with implantation of frequency-adaptive artificial pacemaker. Under the drug treatment, the preference should be given to sinus rhythm preservation rather than to frequency monitoring of ventricular contractions.

The authors give consideration to the features of comprehensive blood-saving approach in cardiosurgery, which includes autoblood purveyance, erythropoietin and hypoxic therapies, minimization of volume of pump oxygenator primary filling, preperfusion autoblood sampling, postperfusion blood ultrafiltration, autoblood reinfusion and drain discharge return, hemostasis system correction, and early nutritious support. The blood-saving procedures in practice allowed maintaining the homeostasis indexes in the course of operation and during early postoperative period at optimum level. Favorable outcomes at patients having been operated using bloodless technique testify its efficacy and safety.

From 1994 to 2003 52 patients with renal abscesses were treated and followed. This article covers etiological, diagnostic and treatment issues of confined pyodestructive kidney diseases. The comparative characteristics of minimally invasive (percutaneous paracental drainage) vs traditional surgical approaches is presented. Practical recommendations for treatment of renal abscesses are listed. Authors concluded that the best approach for treatment of confined pyodestrucitve kidney lesions could be considered the percutaneous paracental drainage. This technique could be preferred due to its minimal invasiveness, low mortality rates and cosmetic advantages. Complication rate is minimal. Surgical and moral damage to patients is low that allows application of this technique in sever patient where traditional invasive techniques carry a high risk.

During the last years the appearance of the infections of "new" generation as though has moved "classic" venereal infections to the background. This paper defines the character of the morbidity of the urogenital ureaplasmic infection as compared with the data throughout Russia as a whole and concerning other regions depending on the territorial, demographic, and social features. Some decrease in the level of the sickness rate of urogenital infections especially as to "new" generation infections, which is officially recorded, is determined by their low active detectability, bad differential diagnostics, frequent absence of examination or underexamination, vast opportunities for anonymous treatment, increase in number of illegal treatment and self-treatment, accessibility of etiotropic drugs.

The paper provides the data on both medical examination of 82 children suffering from anhepatic form of portal hypertension and 35 operations for mesenteric portal shunting. The authors make up a conclusion that this type of surgical operation stops effects of secondary hypersplenism and prevents esophageal bleedings when there is a blood flow within the left branch of hepatic portal vein.

At early stages defibrillation is a paramount factor determining the increase in number of chances to survive when in sudden cardiac arrest. Piacenza Progetto Vita a new system of the early defibrillation outside the hospital being carried out by volunteers coming to the call site first has been organized so as to make the early defibrillation more accessible. The technical facilities of the system include 39 biphase semi-automatic external defibrillators, 12 pieces of them have been installed where there is a heightened risk of the sudden cardiac arrest, 12 — inside the ambulance cars being served by doctor's assistant brigades, and 15 — inside the police cars. 1285 lay volunteers have taken a course in using defibrillators. The accessibility of the early defibrillation has made for increasing in the survival rate of the patients having been undergone the sudden cardiac arrest outside the hospital three times more.

The authors present information on monitoring of application of central venous catheters ARROW+ard Blue in hematological department. Absence of infection-septic complications is provided for owing to unique technique of insertion and impregnation of the aforementioned catheters with anti-infective agents.

Allowing for current state of biological and medical science, the forensic medical examination of male reproductive function should be subdivided into two groups: 1) examination of disputable paternity when there is a child (fetus) by using molecular-genetic methods; 2) other examinations without a child (fetus). In the latter case, when solving a question as to the sperm fertility, it is not enough to make the ejaculate examination by applying routine methods. So as to ensure objective appraisal of spermatogeneous function it is expedient to use the whole ensemble of the present-day methods, which allow for manifold physiological characteristics of the male reproductive system.

The paper is devoted to the work on automated computer-based system of image analysis named AllegroMC created by the authors. Based on the biomicroscopy and morphometry of the microcirculatory channel, the authors have shown the high precision and functionality of the system, which differs from the foreign analogues in far smaller cost. As a result, AllegroMC is very promising for most of works in the field of life-time analysis of the microcirculatory channel state.

The paper provides the results of conception and strategy development aimed at improving the teaching and educational process at the pre-graduation stage of higher medical education. The basis of the conception implies person and vocation-oriented principles of the innovation educational paradigm. The strategies of advanced development are aimed at principal directions of the educational process while modernizing the higher school.

Nowadays the worsening of epidemiological situation is most likely to occur when there are local military conflicts, natural disasters and calamities. Furthermore, migratory processes increasing over the last years can result in spreading of «new» infectious diseases, which lead to emergency situations. All the aforesaid require implementing a special set of hygiene, sanitary and antiepidemic measures. The paper investigates both mechanisms of development of the epidemic process within the emergency area and system of measures on antiepidemic securing of the population suffered.

The authors describe four cases of Sipple's syndrome, a combination of medullary carcinoma of the thyroid gland and pheochromocytoma, within one family. The mother, two daughters and their maternal cousin have been kept under observation. The mother died of cerebral haemorrhage, the surgical treatment applied to the sisters turned out to be successful. As a result, the integrated examination of the endocrine glands when there is a tumorous affection of one of them is of the essence. According to the authors' standpoint, under the Sipple's syndrome the surgery should be started with removing the pheochromocytoma and thereupon the special operation for the thyroid gland should be performed.