The article presents the results of the analysis of gender differences in patients hospitalized with diagnosis "acute coronary syndrome". The most common risk factor of acute coronary syndrome among men was smoking. The most common risk factors of acute coronary syndrome among women were general obesity, abdominal obesity, arterial hypertension and diabetes. Men significantly more frequently had multiform coronary disease with predominantly proximal level of the pathological process in comparison with women. Men are more often subjected to invasive treatment of acute coronary syndrome.

We conducted pharmacoeconomic analysis of comprehensive treatment using herbal tea "Baikalskiy-6" and conventional therapy in patients with acute and chronic pyelonephritis. The relation "cost - effectiveness" was investigated. Using herbal medicine increases the effectiveness of treatment, prolongs relapse-free period, reduces the number of recurrences of infection in the long-term period. The relation "cost - effectiveness" in the treatment of patients with the use of phytotherapy assets during the year by 36,6% lower than just a course of antibiotic therapy during exacerbations. Using herbal medicine in treatment of patients with acute and chronic pyelonephritis increases the duration of disease-free period and reduces the number of recurrences of urinary infection during the year.

This work is about outcomes of surgical treatment aortic arch obstruction in children performed with the use of selective cerebral perfusion and moderate hypothermia. The study included 97 patients with aortic coarctation, recoarctation and hypoplastic aortic arch. The patients were divided into 3 groups. 75 patients with isolated coarctation and recoarctation or with concomitant atrial septal defects, patentforamen ovale and patent ductus arterious were assigned to the 1^st group. The 2^nd group included 13 patients with aortic arch obstruction and ventricular septal defects. The 3^rd group consisted of 9 patients with coarctation, recoarctation and complex intracardiac anomalies. All patients underwent reconstruction of the aortic arch with selective cerebral perfusion and moderate hypothermia. Overall mortality rate was 4%. Postoperative complications took place in 7% of the cases: 1% - postoperative bleeding, 1% - paresis of the diaphragm, 2% - pneumothorax, 2% - chylothorax, and 1% of the cases - vocal cords paresis. Respiratory postoperative complications were registered in 5% of cases. In 6% of the cases patients had neurological postoperative complications. After the operation there was no gradientfound between the pressures on upper and lower extremities. We consider that antegrade selective cerebral perfusion and moderate hypothermia during aortic arch reconstruction are effective methods of brain and visceral organs protection.

We report the analysis of the results forming esophageal-jejunal anastomosis in 19 patients with postgastrectomy syndrome after radical treatment of gastric cancer. Diaphragm crurotomy technically facilitates the formation of the anastomosis. The results of a comprehensive survey show that the healing of the esophageal-intestinal anastomosis is held by the type of primary tension in 16 (84,2%) operated patients, and in the late postoperative period shows no sign of stenosis of the anastomotic ring and the last remains elastic, performing closing function. Up to 1 year after surgery the overall quality of life in patients increased on average by 7,5% and amounted to 112,6 ± 5,1 points. Three years after surgery index tended to increase, reaching an average of 120,2 ± 4,1 points.

Authors of given article conducted an estimation of pharmacotherapeutic efficiency of gel Kvotlan in the treatment of long-to-heal trophic ulcers of venous ethiology. 32 patients with venous trophic ulcers were included in the analysis of case records. There were 12 (37,5%) men and 20 (62,5%) women among them. The age of patients varied from 32 to 69 years. A preparation applied in the form of gel in a combination with gauze wad once a day, putting on ulcer wound interface. Treatment took 21 day. Application of Kvotlan on wound interface stimulated macrophagal reaction, strengthened proliferation of fibroblasts and epithelial, reduced degree of bacterial contamination of trophic ulcer. Clarification of ulcers from fibrin presence was reached by 15,2 days from an start of treatment. Along with clarification of wound interface there was a considerable decrease in a painful syndrome and also reduction of degree of discomfort. Kvotlan has expressed antibacterial and antioxidant effects. Besides, gel has expressed recycling and wound healing properties in comparison with comparison preparations. High percent of recovery of patients after one course of treatment and low level of relapses allow to recommend gel application of Kvotlan in complex therapy of trophic ulcers in case of chronic venous insufficiency diseases.

Authors of the given work develop a technique of high spinal anaesthesia in the operations on the upper part of abdominal cavity, and also conduct the assessment of its efficiency and safety at the operations. Experience of performance of 112 operations is presented. The given way of one-stage high spinal anaesthesia allows to achieve the high neuromuscular block to level of the 1-2^nd thoracic vertebras. Time introductions anaesthetics in volume to 5 -10 ml. makes (on the average) 1 - 2 minutes that allows to create high degree of turbulence of an entered solution and as promotes distribution of vortical streams in cranial a direction liqour spaces for the purpose of distribution anaesthetics further from an injection place. In the early postoperative period anaesthesia was not required from patients narcotic analgetics. Complications in a kind: headaches, a nausea, vomiting, temperature it has not been noted. Complications from operative intervention it was not marked. In article it is shown that high spinal anaesthesia has considerable advantages before other kinds of anaesthesia, in particular before endotrachea a narcosis. It is easier transferred by the patient, does not cause terrible complications.

The article presents clinical-anatomical grounding and the first clinical experience of pancreatoduodenectomy with preservation of the lesser pancreas. Implementation of this technique is feasible due to relative anatomical and functional isolation of the lesser pancreas. For the first time in Russia, in the Clinic of Hospital Surgery of Siberian State Medical University pancreatoduodenectomy surgery with preservation of the lesser pancreas was successfully performed in female patient with cancer of the head of pancreas. Pancreatoduodenectomy with preservation of the lesser pancreas enables to augment surgical radicality and to achieve endocrine function of the pancreas at the level requiring relatively low doses of insulin therapy if any. This approach increases the length of life in this category of patients and preserves the quality of life.

We studied gender-specific clinical manifestations and risk factors for gastroesophageal reflux disease (GERD) in the urban population of Ulan-Ude. The study included 352 patients with GERD. It was found that in both sexes prevailed not erosive reflux disease. It was detected in 64,2% of men and in 88% of women (p = 0,005). Men significantly more often had severe forms of the disease: erosive esophagitis - 19,8% more often than in women (p = 0,04), in 2,9% of men we revealed esophageal ulcers, in 1,1% - Barrett esophagus, while the in women didn't have these forms of the disease. Daily repeated heartburn was found in women twice more often than in men. Average grade of GERD-Q questionnaire for women was also significantly higher than for men by 19% (p = 0,04). Women had higher levels of anxiety and depression (average grade on BDI was higher by 29% than in men). Men had significantly more frequently such risk factors as smoking, alcohol intake and women more often had diabetes, hypertension and coronary heart disease.

Postoperative sternal dehiscence is a severe complication of cardiac surgery. The aim of the study was to evaluate the outcomes of different surgical treatment tactics in patients with postoperative sternal mediastinitis. A total of 41 patients with postoperative sternal mediastinitis were studied from 2010 to 2014. Patients comprised 29 men (70,7%) and 12 women (29,3%) aged 61,12 ± 8,62 years. The first stage of surgical intervention included: secondary surgical debridement; surgical debridement with metal osteosynthesis (MOS) by metal suture (configurations: 1-1-1-1-1-1; 1-Х-1-1-1-1; 1-8-8-8) and longitudinal MOS of the left middle third of the sternum + transverse MOS (configurations: Z-Z-Z and 1-1-88-1-1 among others); sternal resynthesis with mesh titanium nickelide implant according to originally designed method (patent of the Russian Federation N 2489097). The study demonstrated that routine sternoraphy is not recommended in patients who underwent operations involving median sternotomy or if the re-thoracotomy is required due to infection complication in the sternum and anterior mediastinum. Indeed, this method did not result in recovery in 72,22% of cases and even worsened sternal fragmentation. In case of the absence of severe sternal fragmentation and when elimination of acute inflammation was achieved (surgical debridement, correct antibiotic therapy, and bandaging), sternal resynthesis with mesh titanium nickelide implant was preferable. Combination of this method with surgical debridement of the sternum and anterior mediastinum was acceptable in patients with chronic sternal osteomyelitis and mediastinitis. The method of sternal resynthesis with mesh titanium nickelide implant achieved good immediate results and secure fixation of the sternal fragments with recovery of sternal continuity. This method should be indicatedfor treatment of patients without severe sternal fragmentation.

We studied the frequency of osteoporotic fractures of different localizations in patients of 40 years and older living in Ulan-Ude. It was revealed that women have osteoporotic fractures 2,4 times more often than men. Elder patients suffer low-energy fractures more often than younger ones. Buryat residents of Ulan-Ude had osteoporotic fractures twice more often than Russian ones. The frequency of fractures of all studied localizations among men and women of different race did not differ. Women more often had fractures of the distal forearm, men more often had broken ribs.

The purpose of this study is to assess the prevalence of major risk factors for the development of nonalcoholic fatty liver disease (NAFLD), such as the morbidity of the population of the Buryat Republic with diabetes mellitus (DM), obesity, arterial hypertension (AH). The study used the statistical datafor 2008-2012. It is revealed that the growth rates of the incidence of diabetes mellitus is 18% higher in the Buryat Republic than in Russia; the incidence of obesity of the total population of the Buryat Republic exceeds 34%, the incidence of obesity in the Russian Federation; the morbidity of essential hypertension in the Buryat Republic exceeds the arterial hypertension incidence for Russian Federation on 13%.

The study reviewed the antioxidant properties of the extract of Potentilla alba L. The effect of Potentilla alba L. on the rate of accumulation of lipid peroxidation, superoxide radicals binding, nitrogen oxide (11) fixation and iron-binding capacity has been studied. It was found that the increase of Potentilla alba L. concentration leads to the increase of free radicals binding and the reduction of TBA active products. These effects are caused by flavonoids containing hydroxyl groups in the extracts which are traps for free radicals and metals ions because of not allowing them to start the cascade of free-radical reactions.

Authors of article make an assessment of pharmacotherapeutic activity of Ventrophyt and Polyphytochol at chronic duodenal ileus. Using large number of clinical observations (218 patients) authors analyze the effect of these plant agents on a disease pattern, indicators of intraduodenal pressure, motor evacuation function of various departments of a gastroenteric path. Researches showed that the agents favorably influence on motor evacuation activity of a gastroenteric path. Ventrophyt have expressed impact on bioelectric activity of both stomach and duodenum with increase of rhythmicity factor. Polyphytochol in complex therapy has the impact on activity of duodenum with increase rhythmicity factor and without significant influencing bioelectric activity of a stomach. Besides, the agents reduce intraduodenal pressure, normalize biochemical indicators of gastric juice, improve the quality of life of patients both in acute and in the remote period. In the remote period it is established more expressed pharmacotherapeutic efficiency of Ventrophyt in comparison with Polyphytochol. The researched plant agents can be widely recommended in clinical practice.

In the article the authors have shown the role of corporate culture in shaping of image of the organization. Corporate culture is viewed as a set of value concepts, norms and patterns of behavior that dominate in the organization and that determine the sense and operation model of employees. The authors have emphasized features of the corporate culture of educational organization (spirituality, high quality educational activities, responsibility, openness to change, respect for the dignity and rights of employees). The authors have given a description of the components of culture: axiological, normative, behavioral and communicative. Health of educators is characterized as a synergistic effect of corporate culture. The authors have described professional factors that negatively affect the health of educators. The authors have described the signs of occupational stress, which indicate violation of cognitive processes, violations in emotional and behavioral spheres, physical health. The authors have concluded that one of the needed directions of activity of the administration of the educational organization on forming of positive corporate culture - preservation and maintenance of professional health of employees.

The aim of the present study was to assess the antihyperlipidemic and antioxidant effect of multicomponent plant remedy "Atherophyte" in hyperlipidtmic rats. The serum levels of TG, TC, HDL-C, LDL-C, VLDL-C were measured to determine deleterious metabolic effects. The level of MDA was measured as indicator of free radical activity and catalase activity - as indicator of antioxidant effect of "Atherophyte". After "Atherophyte" administration, the levels of TC, TG, LDL-C and VLDL-C were reduced, the level of HDL-C increased, the level of MDA decreased and CAT activity increased. Thus, the polyphytoextract under study exerts antihyperlipidemic and antioxidant properties.

The immune modulatory effect of fractions isolated from the aerial part of Gentiana algida Pall. has been established in experiments on the СВА mice in respect of cellular and humoral immune response at immune suppression caused by azathioprine. The introduction of testfractions (polysaccharide, ethyl acetate, chloroform, butanol) to mice increased the number of the antibody forming cells and index of hypersensitivity reaction of slow type compared with the level of suppression. The most immune modulating effect in respect of cellular and humoral immune response at immune suppression caused by azathioprine has polysaccharide fraction and an ethyl acetate fraction containing phenolic substances. The presence of marked immune modulating properties of the studied remedies in experimental immune suppression allow to recommend them for introduction into the medical practice for the prevention and treatment of immune deficiency conditions, as well as to conduct targeted search of new efficient and low-toxic immune correcting plant preparations.

Pancreas cages form a functional fabric and allocate hormonal substances necessary for indemnification of the lost structures of a pancreas of an organism. And, at input in an organism of ß-cells deprived of a substrate, life cycle transplanted xenogeneic cages considerably decreases under the influence of immune factors, during too time of a cage in an incubator function longer time, promoting construction of spatial architecture of new gland. The given methodology is effective in diabetes treatment as the transplanted cages it is very thin react to allocation of insulin depending on a condition homeostatic organism systems that is an actual problem at introduction of injections of insulin. Results of researches show that incubators of titanium nickelide are highly effective for their use as biocompatible matrixes. Features incubator spaces, and also a material titanium nickelide the titan promote creation fabric biosystems from various cages of an organism and to considerable prolongation of functional activity transplantation cages that accordingly conducts to increase in period of validity of therapeutic effect. Investigation have shown the formation of specific tissues in porous-permeable incubators of titanium nickelide for different cell populations. Allogeneic bone marrow cells immobilized in incubators of titanium nickelide possess antitumor (25%) and significant antimetastatic (45%) effect. The study of morphological parameters immunocompetent organs showed that administration of allogeneic bone marrow cells can decrease thymic regression, reduces splenomegaly in animals with transplantable tumors. Hepatocytes were implanted in porous materials of titanium nickelide mice with CCl₄-induced hepatitis provided significant antitoxic effect. Obtained initial results promising pancreatic tissue-engineering in complex treatment of diabetes. It is noted that the use of incubators permeable porous nickel-titanium increase therapeutic effect and significantly prolongs effect of transplanted cells, as opposed their injecting.

The results of research using 20 rabbits are presented in the article. All animals underwent esophagocardiopexia by fixing nickel titanium mesh prosthesis to the diaphragm and the anterior wall of the stomach. The morphology of tissues in contact with the implant, histological and ultramicroscopic picture were assessed. Evaluation of foreign body reaction have demonstrated minimal degree of tissue reactions. After 6 weeks the changes of normal histological structure of the investigated organs were not detected. At the end of research period the collagen fibers formed the ordered structures around the metallic filaments. The obtained data have shown high biocompatibility of titanium nickelide mesh prosthesis and the low level of mesh-related complications.

The experiments were carried out on white Wistar rats. The probable embryotoxic, teratogenic and fetotoxical influences of the plant remedy "Pancreophyt" at the doses of300 (1/10 DL₅₀) and 600 mg/kg (1/5 DL₅₀) were studied. The findings have shown that all indices of embryo lethality (the number of implantation sites, the number of alive fetus and the number of resorptions) in female white rats treated with the "Pancreophyt" do not differ significantly from the indices of the control group. The mass and craniocaudal dimensions of the fetus in the experimental group corresponded to the indices in the control group. In the second set of experiments the influence of the "Pancreophyt" (300 mg/kg) on the postnatal development of white rat offspring was studied. It was revealed that the death of infant rats was noted only on the 1^st day of observation and was 4,7%; the liveweight gain and linear size of infant rats do not differ from the indices of those in the control group.

The studies were carried out on white Wistar rats. The dry extract from Serratula centauroides L. was introduced to the animals at the doses of 50,100, and 150 mg/kg for 7 days prior to the testing. The nootropic effect of S. centauroides was estimated by using the test "conditioned passive avoidance reflex". In the groups of animals treated with the S. centauroides extract the number of animals with retained reflex was more than in the control group and the latent period of input into the dark bay of the device was longer than in the animals of the control group. The anticonvulsive activity of the S. centauroides extract was tested on the model of thiosemicarbazide-induced convulsions (30 mg/kg). It has been shown that the S. centauroides extract at the doses of 50-150 mg/kg prolongs the latent period of convulsion onset by 33% and increases the lifespan of the animals by 31-47% on the background of thiosemicarbazide-induced convulsions.

The experiments were carried out on white Wistar rats. The dry extract from Rhaponticum uniflorum L. roots was administered to the animals at the doses of 200 and 300 mg/kg for 7 days before testing. The behavior of animals was observed with the use of the tests "elevated plus maze" (EPM) and "dark/ light chamber". Under the influence of the extract from Rhaponticum uniflorum L. at the doses of 100, 150 and 250 mg/kg the number of entries into the open branch of EPM rises to 2,0-3,0 times and staying period in them rises 3,1-4,1 times in comparison with the control. The test "dark/light chamber" has shown that the number of entries of the experimental animals into the light bay of the "dark/light chamber" and the period of staying in it is 2,0 times increased.

The problem of preventing the development of metabolic disorders in the early postanesthesia period is relevant in modern anesthesiology and pharmacology. This article is devoted to pharmacological correction of energy metabolism in the liver and brain of white rats by phytoremedy «Polynoophyt» in the early postanesthesia period after application of sodium thiopental. The experiments were performed on 33 white Wistar rats. The content ATP as the main macroergic component and energy-supply metabolites (lactate and pyruvate) was determined. It shown that the course administration of «Polynoophyt» resulted to rising of ATP content in the liver and brain at 68% (p < 0,05) and 54% (p < 0,05) compared with the control, respectively. Furthermore, the ratio of lactate/pyruvate decreased indicating the normalization of the intensity of glycolytic and oxidative transformation of carbohydrates into the liver and brain. It should be emphasized that the phytoremedy «Polynoophyt» reduced the concentration of lactate in the liver and brain in 2,5 and 1,6 times respectively. The pyruvate content in brain increased at 45% (p < 0,05) accelerating the ATP resynthesis. The effect of energy-supply improvement was caused by the presence of a complex of biologically active substances (flavonoids, tannins, polysaccharides etc.) providing a wide range of pharmacological actions.

The method of gas chromatography - mass spectrometry was studied for the first time in patients with sterile pancreatic necrosis. The parameters defined in the normal conditions are presented. We studied the microbial landscape of patients with sterile pancreatic necrosis in the dynamics of complex treatment. Qualitative analysis was based on the comparison of retention times and mass specter of the total corresponding pure compounds using a library of standard data and mixtures N1ST08.L. We detected elevated markers in patients with acute pancreatitis associated with anaerobic microflora (peptostreptococcus, staphylococci, eubacteria, fusobacterium, clostridium), and at the same time low level of lactobacilli, bifidobacteria, some ruminococcus, actinomycetes and other microorganisms that caused dysbiosis.

Method of gas chromatography - mass spectrometry was used for the study of patients with microbial landscape pancreatonecrosis. In patients with necrotizing pancreatitis concentration of organisms was determined in serum at the admission to the hospital, in the middle of the treatment and at discharge. Increased concentrations of Helicobacter pylori, Herpes, anaerobic bacteria were detected in the blood serum of patients with limited sterile pancreatic necrosis who had medical diagnostic laparoscopy. This fact, in our opinion, extends the etiology of this disease. We found that patients with pancreatic necrosis has limited sterile dysbiosis, which can be adjusted over time by gas chromatography - mass spectrometry.

Method of gas chromatography - mass spectrometry was used for the study of microbial landscape of patients with pancreatonecrosis. It was found that the provision of sterile necrotic destruction dysbiosis occurs that requires correction during the treatment. Unlike conventional methods of diagnosis of infection pancreatogenic gas chromatography - mass spectrometry allows to express mode (3 hours) monitored landscape microbial degradation pancreatogenic patients. In patients with necrotizing pancreatitis concentration of organisms was determined in serum on admission, on day 5, day 10, day 15, day 20 of treatment. Data on the composition of microorganisms, participants of widespread sterile necrotic destruction when assessing the overall microecological status, obtained for each patient allow to get a qualitatively new comprehensive information to make adequate antibiotic therapy and complex treatment that significantly broadens the etiology of this disease.

Maxillo-facial area phlegmon is a common, serious, costly and deadly disease. Over the last decade, the attention of researches and clinical was focused on the search the optimal methods of diagnosis and treatment of this pathology. It is necessary for timely initiation of adequate causal antibiotic therapy and prevention of complications. Gas chromatography - mass-spectrometry is one of the most powerful analytical methods to obtain data on the exciter. The review highlights the current understanding of the role and potential of the method in the improvement of measures aimed at prevention and treatment of phlegmons and their complications.

Non-steroid anti-inflammatory preparations (NSAlDs) - a unique class of the medical products possessing analgesic, anti-inflammatory and febrifugal effect. NSAlDs are widely used in various branches of medicine, especially at a pathology of the oporno-impellent device for knocking over of a pain after traumas, and also for symptomatic therapy of acute and chronic rheumatic diseases. Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most important methods for diagnosis of diseases of the pancreatobiliary zone. ln addition to visualizing intraductal changes, this technique allows a wide range of surgical procedures, such as papillosfinkterotomiya, removal of stones, stenting and more. Unfortunately, during ERCP, serious complications may arise, primarily acute pancreatitis. To prevent the development of this pathology are offered a variety of technical and pharmacological approaches, but not all of them have proven effective in clinical trials. One of the most successful means for the prevention of post-ERCP acute pancreatitis was the use of nonsteroidal anti-inflammatory drugs. Appointment NSAlDs at carrying out ERCP - in an hour to - or is direct after procedure, essentially improves its shipping. First of all it is a question of reduction of number and reduction of weight of ERCP - associated acute pancreatitis potentially menacing to life of complication. Though in clinical researches it has not been shown authentic decrease mortality from the given pathology, nevertheless, it is necessary to think that active preventive maintenance will allow to rescue patients from the destruction caused heavy iatrogenic by a pancreatitis. This review is devoted to an analysis of published data on the subject.

This article presents the literature review dedicated to the assessment of economical damage caused by vascular cer-ebropathies and covers a wide range of problems including medico-economical assessment, grounding of technologies and medical action programs. The review gives monetary evaluation of costs for delivery of health care at cerebral stroke that testifies to the extremely high financial burden for health care system including treatment, medico-social rehabilitation and secondary prevention. The data on the annual costs value and the structure of average expenses related to the accomplished case of medical treatment at cerebral stroke, transitory ischemic attacks, postinsult vascular dementia determined by the disease gravity and length of hospital stay. Also the review presents the indices that describe the effectiveness of the delivery of health care: level and terms of hospitalizing of patients with cerebral stroke to the neurology unit, accessibility of appliance of neuroimaging and some other modern and high-technology methods of diagnostics and treatment.