№3, 2019, volume 15

The introduction of a competence-based approach in the context of the implementation of the latest generation of the GEF leads to the formation of a new control and assessment system of educational results, which allows to take into account all the indicators obtained by students during the course of the discipline, i. e. to evaluate not only the final one-time result, but also the learning process. The formation of a fund of appraisal tools for test control of knowledge at the departments of the medical university is being discussed with the aim of objectifying the assessment of the level of competence in the disciplines of the main educational programs. It reveals the approaches to understanding the role and place of testing in assessing the level of competence acquired by senior students of higher education, as well as analyzes its experience. The advantages and disadvantages of using tests in the process of defining educational achievements are described.

The article presents the generalized experience of biology teaching. At the Saratov State Medical University the biology program is available both in Russian and English. Given research favor optimization of the classes, makes them more efficient and informative. The ways of search of the new innovative methods and approaches in the teaching aimed at formation of profession competencies were purposed. Using of the modern information technologies in education and at the format of distance learning as well as integration of students into the educational media of university are the necessary conditions of foreign students teaching. The teaching of foreign students can enhance the prestige of the Russian education and increases the contingent of persons for which our country is welcomed.

Objective; to analyze of the dynamics of frequency of alcohol-related fatal automobile trauma in the Saratov region over the years 2006-2017. Material and Methods. The study was conducted on the basis of the results of forensic medical examinations of the corpses of persons dead in a car accident in the period from 2006 to 2017 Results. During the study period in the Saratov region slightly decreased the proportion of alcohol intoxication in traffic accidents from 35-40% (2012-2015) to 23.5% (2017). Until 2015, the frequency of alcohol intoxication with trauma in the cabin and pedestrian injury almost did not differ, making up 35-40%. By 2017, the proportion of injured pedestrians with ethanol in the blood more than twice exceeded those affected in the cabin, moreover, the structure of ethanol intoxication in pedestrians is dominated by a concentration of 2.5-3.5%o and more. Along with the decrease in the frequency of ethanol in the blood among drivers (from about 40% in 2012-2015 to 23.5% in 2017), the share of heavy ethanol intoxication decreased, which until 2012 ranged from 33 to 60%, in 2017 it decreased to 25%. The age structure of alcohol-associated automobile trauma has changed: the share of intoxication among persons of 17-30 years has decreased, has increased in age groups of 31-40 years and 41-50 years. Conclusion. During the twelve-year period in the Saratov region in the structure of alcohol- associated automobile trauma there have been positive trends, expressed in a decrease in the proportion of victims in the cabin with the presence of ethanol in the blood, among drivers, and also a decrease in alcohol intoxication among young people. Negative trends should be considered an increase in the proportion of pedestrians with the presence of alcohol in the blood with a predominance of concentration corresponding to a severe degree of ethanol intoxication, increase of the share of ethanol intoxication in older age groups.

Purpose: a comparative analysis of the morphological changes of the kidneys that occur with different models of light desynchronization. Material and Methods. The study was conducted in two stages on 60 white male rats. Model LL 0:24 was studied on the first and second experimental groups, which were in conditions of round-the-clock light exposure for 10 and 21 days. Model LD 18: 6 was studied in the third and fourth experimental groups, which were also in the experimental conditions for 10 and 21 days, respectively. The control group throughout the experiment was in vivo. Results. The recorded decrease in the size of the renal corpus in animals of the third and fourth groups is more persistent and pronounced compared with changes in the first group. The reduction in the area of the vascular glomeru-lus and the expansion of the Shumlyansky — Bowman capsule with round-the-clock illumination are observed only for 21 days, and when studying the 18:6 model, these figures are significantly different from the control values already on the 10th day of the experiment. Also, animals of the third experimental group recorded significant changes in thejuxta-medullary nephrons, which is associated with the activation of collateral blood flow on the 10th day of the experiment. Conclusion. The detected morphological changes indicate a stronger stress effect of the LD 18:6 model, compared with the LL 0:24 model. However, in both experimental groups, the observed changes are ischemic in nature, leading to the development of sclerotic changes, which can adversely affect the work of the kidneys and lead to the development of irreversible changes.

Aim is to study topography of incisive canal depending on sex, parameters of craniofacial complex and dentition. Material and Methods. 174 adult persons of both sexes aged 21-35 years (first adult persons) (80 men and 94 women) were objects of the research. Garson facial index, upper face index and average modulus of maxilla were determined. Number of Stensen foramen and foramen incisivum, their sizes and shape; distances between foramen incisivum and inferior palatal and inferior labial point of maxillary alveolar process; length, shape, type and angle of inclination of incisive canal; bone density around incisive canal were determined on CBCT. Results. Size of nasal and incisivum foramen, length of incisive canal is significantly higher in men, and distances between foramen incisivum and inferior palatal and inferior labial points of alveolar process is significantly higher in women. Dimensions of heart-shaped foramen incisivum prevailed over sizes of droplet-shaped and oval foramen incisivum, and oval-shaped sizes were the smallest. Length of hourglass-shaped incisive canal was 3.4% higher than length of funnel-shaped canal, and 5.6% more than cylindrical shaped ones; length of spindle-shaped incisive canal was 12.7% higher than length of cylindrical canal. Conclusion. Incisive canal has individual variability of sizes, shape and topography depending on its shape and type, gender, cephalotype and average modulus of maxilla were determined.

The article presents a comprehensive osteoscopic approach based on the visual identification of high- quality semi-diagnostic signs on the bones. The differences in the bones of the skeleton in this approach are determined by the greater development of the muscles in men as compared with women, as well as the performance of a fertility function by the woman. On the pelvic bones, differences are functional in nature: the structure of the male pelvis is determined only by supporting and motor functions, and the structure of the female pelvis must also ensure the function of delivery. An osteometric approach is described to determine the somatic sex from the pelvic bones of a person, the basis of which is the use of the instrumental method of determining the properties of objects, fixed in numerical values. It has been shown that almost all bones of the skeleton have the signs of sexual dimorphism, however, they are most clearly expressed in the bones of the pelvis and skull. Determining the gender of bone remains requires a complete examination of the bones presented. It depends on the number of objects, their state, the completeness of the methods used, as well as on the preparation of the expert. A careful analysis of the greatest number of signs revealed on the bones will allow us to arrive at the most reliable result, which is important when establishing the identity of an unidentified corpse.

Aim: to prove the use of decision making support system (DMSS) in spine-and-pelvic surgery as an instrument of control automation in health branch. Material and Methods. Development of DMSS presented in current work made at the base of methodology «planning-modeling-forecasting». For graphical analysis and description of DMSS performance applied the logic diagram method. Materials of DMSS performance evaluation were the data extracted from 22 protocols of its beta-testing processing. Results. Description of the development and beta-testing of organization tech- nology allowed to implement DMSS in healthcare at the base of Regional center (fulfilling medical and expert activity) and Technological center (fulfilling computational functions) interaction. Conclusion. Development and implementation of DMSS as an instrument of branch control automation allow influence the heath quality increasing by means of raising accuracy, specificity and personalizing of diagnostics, decreasing of complications and terms of rehabilitation. Besides this kind of systems allow reduce workload for medical personnel with rising of its labor efficiency that meets the needs of innovative development of medicine and healthcare.

Objective: to identify patterns of influence of social factors on the psycho-emotional state of the elderly and senile age. Material and Methods. A survey of 385 patients (average age-78.5±0.5 years). The following research methods were used: sociological (questionnaires composed of questions relating to the psycho-emotional state from the social block of the WHO quality of life questionnaire), statistical (Chi-square and the coefficient of mutual conjugacy of Chuprov»s qualitative signs using SPSS). Results. In the course of the study it was proved that the psycho-emotional state of the elderly and senile age is influenced by age, marital status, education and the number of children. Life satisfaction among married people was 3.4, widows and widowers 3.3, divorced 2.9 points. The strongest relationship between the level of education and satisfaction of respondents with their ability to make decisions and satisfaction with themselves as a person was revealed in persons with full secondary education (3.6 and 3.2 points, respectively), the lowest — in persons with secondary special (2.9 points) and incomplete secondary education (2.6 points). Respondents with two children and more (1.8 points) who are married (2.0 points) feel less lonely. In general, there is a reassessment of the individual, social status has a huge impact on the well-being and lives of people. They begin to perceive everything that is happening around them more sharply. All this together affects the objective component of life. Conclusion. The regularities of the influence of social factors on the psycho-emotional state of the elderly and senile age. Satisfaction with life in old and old age depends on marital status, education and number of children, which is connected with the opportunity to receive help and help others, and, accordingly, a higher appreciation of oneself as a person.

The purpose of the study is to analyze the compliance of cardiological patients to participate in the prevention of coronary risk and the role of doctors in the compliance formation. Material and Methods. The base of the study was the outpatient medical organizations of the Kostroma region. The study design included a systematic coronary risk assessment using the SCORE European scale; randomization of patients into groups according to the risk degree; assessment of prophylactic patient compliance; analysis of patient compliance; assessment of patient potential; assessment of the relationship between the level of prophylactic compliance of patients with the level of coronary risk; assessment of the quality of compliance prevention by primary care physicians. Scope of the study: 400 patients with cardiac profile, 200 cases of dynamic observation of patients with high and very high levels of coronary risk. Results. We found that 32.4% of patients had a high level of compliance; 64.5% of patients had an average level of prophylactic compliance and 3.1 % of patients had a low level (p<0,05). We discovered the main parameters of reducing of prophylactic compliance of patients, determining factors, as well as the parameters for reducing the quality of compliant prophylaxis in the primary health care system. Conclusion. The obtained data became the theoretical basis for the development of the technology for coronary risk compliance prevention including 7 stages and 3 levels.

The article presents data on the development of urothelial cancer and methods of its diagnosis. A clinical case of diagnosis of bilateral uroepithelial cancer in a patient by magnetic resonance imaging is described.