2015, volume 11

The aim of the research is to determine the status of ТВ as a vector of professional specialization, based on the survey of medical students. Material and methods. The survey of the 5th year students of Saratov State Medical University n.a. V. I. Razumovsky. Results. The status of ТВ in the views of students in the context of its impact on the selection of individual career has been identified. Conclusion. The study has found out the low professional ТВ status. The survey results help update the search for solutions to the problem of forming the prevalence of ТВ status as a specialization.

Aim: improvement of early diagnostics of prostate cancer by developing a technique, which makes possible to predict its clinical significance in outpatient setting before initiation of invasive procedures. Material and Methods. Clinical data of 398 patients who underwent transrectal prostate biopsy in 2012-2014 in SSMU S. R. Mirotvortsev Clinical Hospital, was used to build an artificial neural network, while its output allowed to determine whether the tumour corresponds to Epstein criteria and which D'Amico risk group it belongs to. Internal validation was performed on 80 patients, who underwent prostate biopsy in September 2014 — December 2014. Sensitivity, specificity, positive and negative predictive value of artificial neural network were calculated. Results. Accuracy of predicting adenocarcinoma presence in biopsy specimen was 93,75%; accuracy of predicting whether the cancer meets active surveillance criteria was 90%. Accuracy of predicting T stage (T1c, T2a, T2b, T2c)was 57,1%. Prediction of D'Amico risk group was accurate in 70% of cases; for low-risk cancer accuracy was 81,2%. Conclusion. Artificial neural networks may be responsible for prostate cancer risk stratification and determination of its clinical significance prior to biopsy.

Objective: to contribute to better surgical intervention outcomes in patients with cholelithiasis. Material and Methods. 41 patients were investigated prior to elective cholecystectomy The group of the study has formed the patients with raised level of the total bile acids and verified X-rays duodenal dyskinesia in subcompensation. These patients underwent laparoscopic cholecystectomy supplemented with mobilization of duodenojejunal junction without dissection of Treitz ligament (Clermont operation). Other patients underwent standard laparoscopic cholecystectomy. Life quality evaluation was performed 30 days after the surgical intervention using the unified GSRS questionnaire followed by statistical treatment. Results. Laparoscopic cholecystectomy performed simultaneously with Clermont procedure is executed in 29,3% cases (12 patients) with duodenal dyskinesia according to the classification of Ya. D. Vitebsky Life quality in group of the study was well above, than in groups of the comparison. The bile acids in group of the study were far less, than in comparison groups. Conclusion. Laparoscopic cholecystectomy performed simultaneously with Clermont operation is considered to be minimally invasive and rather effective in prevention of post-cholecystectomy complications.

The purpose was to evaluate the efficacy and tolerability of travoprost and timolol use in the treatment of patients with initial stage of primary open angle glaucoma (POAG), as well as a preservative effect on the state of the cornea. Material and Methods. We observed 30 patients with a diagnosis of POAG first revealed. Group 1 patients (24 eyes) afforded 0.004% solution travoprost, patients in Group 2 (16 eyes) — 0.5% solution of timolol maleate. Patients in Group 1 who received travoprost with ВАК were administered travoprost with preservative polyquad in the same mode instillation. After 3 months after changing medication patients underwent examination of the cornea by laser scanning confocal imaging. Results. Intraocular pressure (IOP) in patients in Group 1 dropped from 33±3mm Hg. Article 18±2mm Hg.Art. In group 2, IOP decreased from 32±2mm Hg. to 21 ±1,5 mm Hg. Art. After 3 months of treatment with travoprost polyquad total number of epithelial cells of the cornea increased to 6231 ±415 cells/ mm2, signs of edema were not detected in 18 of 24 eyes in 6 cases, swelling of the corneal epithelium decreased, decreased number of "bright" keratocytes, endothelial cells well visualized and of hexagonal shape. Conclusion. Application of travoprost in patients with POAG provides a marked hypotensive effect compared with timolol. Application of travoprost with polyquad improves the state of the front layers of the epithelium and the corneal stroma of patients with glaucoma, reduced patients complaints to sensation of a foreign body and eye discomfort and redness.

The purpose of the research is to work out the measures of an improvement of the out-patient rehabilitation of patients with cerebral infarction in the early recovery period. Materials and Methods. Method of the expert evaluation was used for collecting data (29 questionnaires); analysis of variance, Kolmogorov-Smirnovtest, Kendall coefficient of concordance, Kemeni median were applied for processing data. Results. According to the expert opinion it is necessary to increase the role of polyclinics in a process of the rehabilitation of patients with cerebral infarction and to improve the quality of out-patient medical care in cases of this disease. Experts consider that insufficient technical provision and lack of personnel in the system of primary health care foremost lower quality of medical care. Absence of an equipment and staff shortage lead to imperfection of the rehabilitation process and poor results of recovery after cerebral infarction. Conclusion. The improvement of out-patient medical care in the early recovery period of cerebral infarction is possible through the integral impact on all components of the quality: structure (upgrade of equipment and staff provision), process (increase of length and frequency of patients' visits) and result (adoption of efficiency criteria of cerebral infarction treatment).

Цель; изучить влияние флавоноидсодержащих экстрактов аврана лекарственного, бессмертника песчаного и кукурузы обыкновенной на костный мозг и периферическую кровь при внутримышечном и пероральном введениях в эксперименте на лабораторных крысах с перевитой саркомой-45. Материал и методы. В эксперименте использовано 48 самцов белых беспородных крыс линии Wistar, которым через 72 часа после перевивки опухоли перорально и внутримышечно в течение двух недель ежедневно вводили экстракты (аврана, бессмертника и кукурузы). При этом ежедневно оценивали динамику роста опухоли. После окончания эксперимента у животных забирали кровь, костный мозг (изготавливали мазки) и опухоль для гистологического исследования. В дальнейшем подсчитывали клетки и рассчитывали лейкоцитарную формулу и миелограмму, проводили описание гистологических препаратов опухоли. Результаты. Все три изученных экстракта замедляют темпы роста перевиваемой саркомы и вызывают в ней выраженные морфологические изменения, а также не оказывают токсического эффекта на периферическую кровь. Экстракты аврана лекарственного и кукурузы антациаоновой благоприятно влияют и нормализуют процентное соотношение клеток красного костного мозга у животных с перевитой саркомой, а экстракт бессмертника не оказывает влияния на миелограмму. Заключение. Флавоноид-содержащие экстракты положительное влияют на периферическую кровь и костный мозг и обладают противоопухолевой активностью.

Aim of the investigation: to conduct a comparative analysis of methods of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding. Materials and methods. A retrospective analysis ofthe extent of the surgical and anesthetic risks and results of treatment of 71 patients with peptic ulcer bleeding has been conducted in the study. To evaluate the surgical and anesthetic risks classification trees are used, scale ТА. Rockall and prognosis System of rebleeding (SPRK), proposed by N. V. Lebedev et al. in 2009, enabling to evaluate the probability of a fatal outcome. To compare the efficacy ofthe methods the following indicators are used: sensitivity, specificity and prediction of positive result. Results. The study compared the results ofthe risk assessment emergency operation by using these methods with the outcome ofthe operation. The comparison ofthe prognosis results in sensitivity leads to the conclusion that the scales ТА. Rockall and SPRK are worse than the developed method of classification trees in recognizing patients with poor outcome of surgery. Conclusion. The method of classification trees can be considered as the most accurate method of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding.

Prostate cancer is one of the most urgent problems of modern oncology. The article provides an overview of the methods of treatment of locally advanced prostate cancer, comparative characteristics, the advantages of both independent and combined methods. The results of multicenter studies have been stated.

The article deals with the problem of development and the modern state of biomechanics as a scientific and practical direction in medicine under the context of technological advance herein a specific attention is paid to the achievements of the Russian schools. It is shown a necessity of wide usage of instrumental biomechanical diagnostics of locomotive disorders for intrinsic substantiation of rehabilitation treatment tactics and monitoring of its medical efficiency particularly for persons with remote effects of surgical interventions such as osteosynthesis, spondylosynthesis, total joint replacements. Non-invasive technique, possibility of its multiple application and rather low cost make actual using of locomotion clinical analysis techniques for rehabilitation treatment of concerned patients of different age groups.

Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART); to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies), from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.