2020, volume 16

The article presents biographical information about Professor M. F. Tsytovich, presenting his scientific and practical contribution to the formation and development of native otolaryngology. It matches his teaching methods in preparation of scientific and pedagogical personnel characterizing his social activities in the first half of the twentieth century.

Aim: to analyze the distribution of first-year students by the levels of their self-esteem and the preferred form of work in the team, which are best implemented when various forms and methods of training are introduced into the educational process, which allow them to understand the significance of basic biological knowledge for the future practical work of a doctor on the chosen specialty. Material and Methods. During the course of the work, the data of a sample survey among first-year students were used. Results. The relative distribution of groups of students according to individual characteristics that determine their style of work in the team and the level of self-esteem — in relation to oneself, is clarified. Most of the students surveyed by us (95.8%) have high and medium levels of self-esteem, which, according to the style of work in the team, correspond to the leading and collaborating types, and to respondents with low self-esteem (4.2%) — the slave. The role of introducing various teaching methods for the successful adaptation of freshmen to the educational process at the university is analyzed. Conclusion. During the first year of study, the level of self-esteem largely determines the successful work in a team and the adaptation of students to the workload. Positive motivation in training, implying the practical significance of the material studied, taking into account future medical specialization, stimulates the cognitive activity of students and helps to increase their level of self-esteem.

Macrophages are heterogeneous population of cells, which differentiate into distinct functional groups depending of the external signals. Agonists of toll-like receptors (TLRs) and cytokines bind to corresponding receptors and cause changes in the metabolism and expression of genes in myeloid cells located in the innate immune system. These changes in phagocytes are occurring during their activation. As a result, they become polarized, acquiring a determined phenotype. This gene expression changes realize in the tumor microenvironment. mTOR — serine/threonine protein kinase, which receives various signals from cell environment. It causes changes in protein biosynthesis and cell metabolism. mTOR takes part in the activation of macrophages influenced by cytokines or agonists of TLRs. It determines the role of kinase in reprogramming mechanisms and in the regulation of cytokines production according to the type of received signals respectively. The review has been made about the role of mTOR in macrophages' reprogramming, in particular tumor-associated ones. The PubMed resource is used for information search

Aim is to analyze the dimensional characteristics of the width of the periodontal fissure in the teeth of the upper and lower jaws with increased tooth abrasion in adults. Material and Methods. 204 people of both sexes aged 22 to 60 years were served as the object of the study. Using cone beam computed tomography, the width of the periodontal fissure was studied at the level of transition of the upper third to the middle third of the root, at the level of transition of the middle third of the root to the lower third, and at the level of the apex of the tooth root. In the upper molars, the measurements were performed at the palatine root, in the molars of the lower jaw — at the distal root. Results. The dimensional characteristics of the width of the periodontal fissure on both jaws statistically significantly increase from the first period of adulthood to the second in persons of both sexes: in men at the level of the upper third of the root by 12.5-96.3%, the middle third —11.8-78.6%, tops of the tooth root —22.2-106.7; in women —by 2.4-65.8, 3.0-22.0and 19.1-93.6%, respectively. Conclusion. The results of the study indicate that the width of the periodontal fissure is not the same in different parts of the root, varies depending on the functional load and does not depend on the group affiliation of the tooth. The width of the periodontal fissure at the level of transition of the upper third of the root to the middle third, the middle third of the root to the lower third and in the region of the apex of the root in the teeth on the lower and upper jaw, statistically significantly increases from the first period of adulthood to the second in both men and women.

Purpose of this research was to identify features of somatometric, index and bioimpedance indicators in the assessment of the physical status of patients with gastric cancer in the Krasnoyarsk region. Material and Methods. In this report constitutes the results of the exploration of 200 patients diagnosed with stomach cancer, 108 women and 92 men. The average age is 61.6 ± 10.9 years. Patients with an established diagnosis of gastric cancer, were examined by anthropometric and bioimpedance methods of research. During the research of the physical status of patients with gastric cancer of different age groups at of both sexes was carried out, the index of body weight (IBW) or J. M. Tanner index (1951). By this index is calculated type of gender dimorphism. Results. Features of the physical development of patients with gastric cancer are received. There are the increased body weight and obesity, gynecomorphic type of men, women have a mesomorfic and gynecomorfic types of a constitution. According to the results of bioimpedance analysis the indexes of component composition of the body, decreased in men and women representatives gynecomorfic body type. Conclusion. The features of somatometric, index and bioimpedance indicators characterizing of the physical development of patients with gastric cancer were revealed.

The aim of the study is to assess the degree of adherence of patients with rheumatic diseases to the treatment of non-steroidal anti-inflammatory drugs (NSAIDs). Material and Methods. 196 patients were surveyed using a specially designed questionnaire, which included Morisky — Green test. Statistical data processing was carried out by methods nonparametric statistics (criterion x2)- Results. Patients took NSAIDs in rheumatoid arthritis (50.0%), ankylosing spon-dylitis (37.8%), vertebrogenic dorsalgia (20.4%). 49.0% of patients took NSAIDs constantly, 39.3% — during courses of treatment, 11.7% — on demand (in pain). 81.1 % of patients were engaged in self-treatment of NSAIDs. 20 patients (10.2%) were adherent to the treatment of NSAIDs, 29 patients (14.8%) were insufficiently adherent (patients were united in one group), 147 patients (75.0%) were not adherent to the treatment. Non-adherent patients mostly violated the regimen of treatment if they felt well (85.7%). For adherent patients the most significant motive was deterioration after taking NSAID (20.4%). Adherent patients mostly had higher education in relation to non-adherent (71.4 and 53.7% respectively) (x2=6.647; p<0.05). Side effects of NSAIDs were absent in 73.5% of adherent patients and in 32,0% of non-adherent (x2=24.795; p<0.01). Conclusion. The level of education, the frequency of side effects and subjective assessment of the patient's state of health affect the degree of adherence of patients with rheumatic diseases to the treatment of NSAIDs.

Aim: to analyze the trust risks structure in medicine and healthcare and to study of the possibilities of online communication in healthcare for managing these risks. Material and Methods. The methodological basis of risk analysis of trust in the institute of medicine was the theory of social trust (Luhmann N., 1988). The study used methods of a systematic approach, structural and functional analysis and typologization. An empirical analysis of the problem of trust in the dyad «patient-medical specialist» carried out in 2018-2019 at the Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n. a. V. I. Razumovsky using the developed and introduced into practice System of interactive monitoring and feedback (SIMF), which allows to improve the quality of management of patient' preparation for the upcoming high-tech operation and the subsequent process of medical rehabilitation of patients (N=381). Result. It has been developed a theoretic model for the treatment of trust risks in healthcare in relation to medical rehabilitation, which is the basis for development practical tools for the prevention of medical, social and socio-psychological risks based on SIMR Conclusion. The use of online communication services increases the effectiveness of medical and rehabilitation measures based on a personalized approach; expands the ability to manage the interaction of patients and medical professionals through the prevention of trust risks in the institute of medicine.

Aim: assessment of level and structure of incidence of female infertility in the territorial subject of the Russian Federation. Material and Methods. The study of the level and structure of incidence of infertility according to negotiability to the period from 2008 to 2017 among women of fertile age (15-44 years) of the Tambov region was carried out. The study of age of women and duration of infertility was carried out to the moment of the request for medical care for 2017 (n=812). Results. For the research period (2008-2017) there is a growth of incidence of female infertility six times to an indicator 3.5 cases on 1000 women of fertile age. Infertility of secondary genesis prevails over primary (53.1 and 46.9% respectively). In 2008, infertility of the endocrine genesis occupied the 3rd rank in the structure of causes (19.5%), in the second place — absolute tube infertility (31.1%), in the first place — infertility due to endometriosis, uterine fibroids, inflammatory processes (49.4%). In 2017, infertility of the endocrine genesis moved to the 1st place with an indicator of 43.3%, infertility of the absolute tube genesis remained in the 2nd place, but the indicator increased to 40.4%. Infertility due to endometriosis, uterine fibroids, inflammatory processes from the 1st rank place moved to 3rd with an indicator of 16.1%. Average age of the women who addressed in 2017 was 29.9±0.17 years. The average duration of infertility was 5.2±0.1 years. Conclusion. Results of the research demonstrate annual increase in number of women with infertility that shows the necessity of improvement of the organization of delivery of health care of this category of persons.

The substantiation of the need to improve the legal model of ensuring the safety of interaction between the patient and medical personnel in the provision of medical services is given. The study conducted a comparative legal analysis of the sources of legal regulation of individual components of the quality of medical services. The material for the assessment were articles of the Federal law "On the basis of health protection of citizens in the Russian Federation", as well as orders approved by the Ministry of Health of the Russian Federation. Proposals have been developed to improve the current legislation aimed at ensuring legal protection of medical personnel. On the basis of the conducted research it is established that there is no legal definition of quality of medical services. Existing laws protect the rights of patients, but the professional activities of medical personnel do not have a system of insurance of risks that create increased danger in the provision of medical care to the population.

The aim is to determine the possibility of organizing monitoring of the air basin according to interregional comparative assessment of the nature of the incidence of environmentally related pathologies. Material and Methods. A comparative analysis of the incidence in the Volga regions by pathologies, the occurrence and development of which correlates with indicators of air pollution. An assessment of the results of socio-hygienic monitoring of the quality of the air basin. Results. Differences in the intensity and nature of dynamic changes in the incidence of environmentally caused pathologies in the regions and their inconsistency with the air quality parameters defined in the framework of socio-hygienic monitoring are established. In the Volgograd region, there is a pronounced tendency to reduce the incidence of children with allergic rhinitis (r=-0.78; R2=61.6%), congenital anomalies (malformations) (r=-0.84; R2=71.3%) and dynamics stabilized incidence of pathologies of the endocrine system, in the Saratov region, the indicators of all these pathologies are stable in dynamics, and in the Astrakhan region their marked, significant growth is noted (allergic rhinitis r=+0.77; R2=58.7%, congenital anomalies r=+0.9; R2=81.8%, endocrine system diseases r=+0.93; R2=86.6%). Differences in the organization of air quality monitoring were revealed. In 2018, the concentration of 25 pollutants was monitored in the Volgograd Region (18,290 studies were conducted), in the Saratov Region — 20 pollutants (4,512 studies), in the Astrakhan Region —11 chemical compounds (1,704 studies). Conclusion. An interregional comparative assessment of the nature of the incidence of environmentally caused pathologies can be used to determine the potential air pollution by the corresponding chemical compounds and can serve as a basis for establishing priority pollutants to be controlled in a particular region.