The article presents data on the prevalence of gastroesophageal reflux disease (GERD) in people of different nationalities and ethnic groups. It
shows the trend to the widespread increase in GERD morbidity. Ambiguous data on symptoms incidence of the disease were obtained from Asian population. Epidemiological features of GERD in the Russian Federation related to multi-ethnic character of the country are shown. Among the most significant factors of this pathology development risk are: male gender, overweight / obesity, age. The role of such factors as alcohol, coffee, smoking, eating habits are discussed.

The review covers two types of ventricular arrhythmias (VAs) – ventricular tachycardia (VT) and ventricular fibrillation (VF), which complicate the course of acute myocardial infarction (AMI). Despite the fact that VAs are relatively infrequent in patients with AMI, they influence the prognosis of this
disease significantly. Timely identification of predictors of life-threatening arrhythmias data is of particular interest. Such patients require special attention and long-term monitoring. Close approach to VAs treatment and prevention of AMI raises many questions. In particular, it happens due to the fact that many anti-arrhythmic drugs, being prescribed to relief VAs or to prevent them, have pro-arrhythmogenic effect. Therefore, arrhythmia data attract scientists and researchers.

In modern medicine the problem of patients with chronic pain diagnosis and their treatment is quite relevant. An idea of organizing a network of
centers for pain treatment was suggested as an effective measure to solve this problem. International Association for Study of Pain distinguishes 4 levels in aiding patients with chronic pain, which differ in the set and level of aid complexity. This article describes in detail organization of pain centers network by the example of Spanish healthcare system as one of progressively developing countries in this field. Principles of facilitation, set of provided aid at each level are described. In addition, the attention is drawn to principles of interdisciplinary interaction, to the development of treatment strategies and to the organization of work with patients applying to the pain center. Moreover, the article gives information on the work of a pain center based on multi-specialized hospital in Russia.

The aim of the research is to identify the main trends in blood groups distribution according to AB0 and Rh systems, depending on age, to characterize the change in blood cellular composition and biochemical profile, associated with blood group belonging of the studied.
Material and methods. The study involved 2 groups: check one, consisting of 4,988 people, whose average age was 34 ± 3 years and a comparison group of 127 young adults (average age – 19 ± 0.47 years). The blood group was determined according to ABO and Rh system, hematology examination was conducted and metabolic profile was evaluated. Variation of blood cell composition and metabolic parameters, depending on blood group were assessed. The analysis of the results and statistical calculation was carried out using Microsoft Office Excel 2016 Software and IBM SPSS Statictics 23.
Results. The obtained data indicate a change of blood groups distribution: A (II) blood group predominates in check group, in the comparison group - O
(I). For the first time there were no Rh-negative individuals among AB (IV) blood holders. Biological variations of cellular structure and biochemical profile associated with the blood group of the studied were stated.
Conclusion. Blood group is the basis for individual and group biological characteristic features variations, that gives new perspectives for personalized medicine approaches. The features of AB0-system are studied and its contribution to the maintenance of human body homeostasis is an important task for future researches.

The aim of the research is to compare morphology, mineral and organic profile of magnesium phosphate bions (MPB), and calcium-phosphate bions (CPB) to evaluate MPB acceptability as a comparison group in order to test specificity of CPB endotheliocytes action.
Material and methods. MPB and CPB were synthesized artificially with the aid of blood environment oversaturation by magnesium and calcium salts,
respectively. Morphological properties of MPB and CPB were studied by means of electron and atomic-force microscopy, the elemental composition was studied with the help of energy-dispersive X-ray spectroscopy, atomic-emission spectroscopy and CHNSO- analyses, functional groups were studied by means of infrared spectroscopy with Fourier transform and Raman spectroscopy, X-ray powder diffractometry was used to study the formula included in bions composition of chemical compounds. The protein MPB and CPB was examined by polyacrylamide gel electrophoresis followed by staining it with silver nitrate.
Results. Both MPB and CPB were spherical particles of sponge-like structure, 80-200 nm in diameter and average diameter is approximately 120 nm that tend to form clusters of several particles. Both MPB and CPB consist of carbon, oxygen, nitrogen, hydrogen and phosphorus, but MPB contained magnesium and is characterized by minimum calcium content. MPB and CPB contained phosphate, carbonate and hydroxyl groups, wherein MPB consisted of magnesium phosphate hydrate and hantit, while CPB contained hydroxyapatite and carbonate-hydroxyapatite. MPB and CPB protein profile was similar.
Conclusion. MPB and CPB are similar in all ways, except for the formula of their constituent compounds, that is why they can be considered as suitable
comparison group to assess the specificity of CPB toxic effect on endothelium.

The aim of the research is improving the effectiveness of complex treatment of patients with acute pancreatitis by alleviating the phenomena of thrombo-hemorrhagic syndrome and reducing microcirculating disorders by means of cryoplasma-anti-enzyme therapy and by the correction of proteinase-inhibitory imbalance in blood and in the lesion.
Material and methods. The results of 446 patients’ treatment, with moderate and severe acute pancreatitis, were analyzed. 213 (47.8%) patients made up the main group, in the complex treatment of whom cryoplasma-anti-enzyme therapy and local administration of proteolysis inhibitors were used. 233 (52.2%) patients, who made up the comparison group, received conventional treatment for acute pancreatitis.
Results. The pathogenetic approaches, used in the treatment of patients with acute pancreatitis, improved the results of treatment and reduced mortality from 21.5% to 12.7%.
Conclusion. The use of cryoplasma-antienzyme complex and local administration of proteinase inhibitors in patients with acute severe pancreatitis in complex therapy allows improving outcomes of the disease.

The aim of the research is to determine features of metabolic syndrome and leptin role in women of early reproductive age with polycystic ovary syndrome.
Material and methods. 60 women of reproductive age with and without PCOS were examined by means of clinical, gynecological, instrumental, laboratory and statistical methods.
Results. Metabolic syndrome is diagnosed in 22 (73.3%) women of early reproductive age with polycystic ovary syndrome, while it was diagnosed only in 10 (33.3%) women without this syndrome (p = 0.0001). All diagnostic criteria of metabolic syndrome, such as: obesity (p = 0.005), ratio of waist circumference to hip circumference more than 0.85 (p = 0.049), blood pressure higher than 140/90 mm Hg (p = 0.028), high triglycerides (p = 0.0001), fasting plasma glucose (p = 0.0001), low level of high-density lipoprotein (p = 0.0001) were stated in women of early reproductive age with PCOS more often compared to healthy ones. Leptin contents in blood serum of women with PCOS was 8.9 ng / ml [3.5 - 16.5], which did not differ significantly (p = 0.252) with the level of leptin in healthy women blood - 11.0 ng / ml [ 6.3 - 18.6 ng / ml]. However, in women with metabolic syndrome (body weight excess and obesity) – it was higher (17.2 ng / ml [15.6 - 22.1] and 20.4 ng / ml [18.6 - 29.2], p = 0.151 respectively). This level increase is correlated with BMI increase (p = 0.0001).
Conclusion. Thus, women of early reproductive age with PCOS are more often diagnosed with metabolic syndrome in comparison with healthy ones. Overweight, violated carbohydrate and lipid metabolism are the main factors of metabolic disorders formation. The study of indicators of metabolic syndrome in women of early reproductive age with PCOS is a promising direction that will allow to select treatment technique more accurately. Leptin plays an important role in obesity, as it intensifies metabolic disorders. The obtained results demonstrate the need to include leptin level determination in women of reproductive age with PCOS as an additional diagnostic criterion of metabolic syndrome.

The aim of the research is to compare safety and efficacy of left main coronary artery trunk stenting in patients with medium and high risk of coronary lesion severity according to SYNTAX scale score.
Material and methods. The study included 112 patients with multivessel coronary trunk involvements combined with stem lesion (SYNTAX score ≥23) and with severe concomitant affection. The “Heart Team” refused from aortocoronary bypass surgery in all patients. The patients were divided into two groups. The first group with Syntax Score 23-32 (n = 66) and the second group with Syntax Score> 32 (n = 46).
Results. The most severe coronary atherosclerosis patients made 2-nd group (97.82% lesion of more than two vessels, 67.39% marked calcification). Technical success of PCI was achieved 100% in both groups. There were two lethal outcomes (1-I c. 1 (1.51%), 2-I c. 1 (2.17%), p = 0.4). Both patients were admitted to hospital with acute myocardial infarction. At hospital treatment stage, there were no cases of stent thrombosis, no fatal myocardial infarction, no strokes in both groups.
Conclusion. The first results of the study showed that the left main coronary artery trunk stenting in patients with middle and high SYNTAX Score is possible and is safe. The effectiveness of left main coronary artery trunk stenting at hospital treatment stage did not differ in both groups and is applicable in patients with SYNTAX Score ≥23

The aim of the research is improving the results of diagnostics and surgical treatment of patients with gastroduodenal ulcer bleeding.
Material and methods. The results of examination and treatment of 405 patients with chronic stomach and duodenal ulcer bleeding for the period of 2007-2016 in SBIH BR CCH № 18 in Ufa City.
Results. The patients were divided into two groups. The first group consisted of 204 patients who received traditional methods of treatment. There were 201 patients in the second group. Patients treatment included diagnostic and treatment algorithm based on determining gastroduodenal ulcer bleeding kind developed by the authors. While assessing patients state and bleeding severity, general clinical examination data, laboratory and endoscopic studies were used. According to bleeding type, the patients were distributed: 66 (16.4%) patients had arterial bleeding, and 339 (83.6%) had venous one. Separation of arterial and venous bleeding type allows to choose the tactics of surgical treatment in patients with gastroduodenal ulcer bleeding and to reduce the overall mortality rate up to 3.5%. In case of arterial bleeding
with a sharp violation of homeostasis, hemorrhagic shock occurs quite rapidly, as a rule. In such situations, hemostatic therapy provides only temporary effect. In case of venous bleeding, the bleeding has long duration, there are no signs of hemorrhagic shock, the bleeding recurs less and hemostatic therapy is effective in most cases.
Conclusion. Among 405 patients admitted to hospital with gastroduodenal ulcer bleeding, 232 (57.3%) were of working age and 173 (42.7%) were over 60 years. Proportion of patients admitted in 24 hours after the disease was 9% and 31.3% in groups respectively. The use of the developed diagnostic and treatment algorithm in gastroduodenal ulcer bleeding with the determination of blood loss type and severity allowed to reduce the risk of bleeding recurrence, complications and mortality up to 3.4%.

The aim of the research is to provide the results of clinical application of thermal destruction stereotactic treatment method in patients with drug-resistant epilepsy, and to evaluate feasibility and tolerance to such local intervention.
Material and methods. Functional stereotactic surgical procedures were performed in 163 patients with drug-resistant forms of temporal lobe epilepsy, and registered bilateral temporal focal locus, there were 79 men and 84 women among them. The age of patients at the time of surgery was 17 to 62 years (median - 34 years). 326 stereotactic operations were carried out in total since 2001 to 2006. Destruction of the epileptic locus was held by thermal affection generator.
Results. Efficacy of stereotaxic operations was evaluated on the base of nature and frequency of seizers observations. Catamnesis duration ranged from 1 to 5 years. Tonsils thermal destruction on both sides was performed in 147 patients (90%), bilateral destruction of the anterior hippocampus was performed in 71 patients (43.6%). There were no complications or side effects associated with symmetrical destruction of nuclei of the brain limbic system in postoperative period. There was positive dynamics in mental processes, favorable changes in emotional and personal sphere in 44.2% of cases in the postoperative period. Frequency of excellent and good results (patients of 1 and 2 groups) decreases through time: in 1 year – 75.5%, in 2 years – 70%, in 3 years – 59.8%, in 4 years – 46.3%.
Conclusion. The achieved results (positive effect continues to persist in 70% of patients in 5 years) suggest that this method in most cases, allows exactly to localize and destroy the loci of epileptic activity and its pathway in the brain.

The aim of the research is estimation of priority toxicants, grain-size and material composition of dust suspensions in the air of working area of the basic electrolytic aluminum production trades.
Material and methods. We analyzed and systematized long-term data on the content of hydrogen fluoride, fluorides, dialuminium trioxide and resins sublimates in the working area at the workplace of buildings with self-calcinating anode and prebaked anodes technologies. Electron scanning microscope with the attachment for energy dispersive X-ray microanalysis was evaluated for the size of 7,340 particles; besides elemental analysis was carried out for 613 particles.
Results. Using prebaked anode technology reduces the concentration of harmful substances in the air of working area to the MPD levels, except for hydrogen fluoride, the content of which is still higher than the pollution standard in 1,7-3,0 times. Analysis of dust powder revealed 1-3-micron particles (41.9%, 42.7%, 43.8% and 31.8%) prevailed in the working place of pot operator, anode electrolytic bath operator, baths service and anode frames waist operators. Particles of 0.5-3 micron (69.0%) and 0.5 microns (46.2%) prevailed in crane driver cabin and crane maintenance operator. Study results have shown that the overwhelming number of aluminum production dust powder particles are the ones of aluminium, cryolite, aluminium fluoride due to elemental composition.
Conclusion. The main air pollutants of aluminum production are fluorides, resins sublimates and dialuminium trioxide. Aluminium production aerosol comprises individual or collected dust agglomerates with stuck nanodispersed particles. The main typical elements in them are: fluorine, carbon, aluminium, sodium and oxygen. Iron, silicon, nickel, chromium and sulfur were identified in dust samples

The article provides supervision of generalized cryptococcosis in patients with HIV 4B -5 stage (AIDS) by V. I. Pokrovskiy. Central nervous system affection in the form of severe meningoencephalitis, as well as affection of internal organs (lung, liver) were diagnosed. The presented case demonstrates developing of generalized cryptococcal infection in HIV-infected patients, that should be kept in mind for timely diagnosis and treatment
of this pathology.

Cystic fibrosis (CF) is the most common hereditary disease with multiple organ manifestations that are in progress throughout the patient’s life. The article
describes the clinical case of severe cystic fibrosis associated with diabetes mellitus and protein-energy malnutrition of 3 degree supervised in regional center with remote consultations for correcting continuous high-dose antibacterial intravenous and inhalation therapy, nutritional status by setting percutaneous endoscopic gastrostomy and by “night sipping” by means of gastrostomy. Complex, multidisciplinary approach to the development of individual management plan allowed to stabilize clinical condition of the child as well as spirography indicators and to prevent further weight loss. The use of remote consultations for regional center, as a type of tele-medicine, help to optimize treatment of serious cases with multiorgan insufficiency.

The aim of the research is mathematical description of correlation between mortality age-index and socio-economic indicators of living standards among the population of Buryatia.
Material and methods. The used data on mortality and socio-economic indicators of living standards among the population of Buryatia, obtained from official site of Territorial institution of Federal Republic of Buryatia State Statistics (http://burstat.gks.ru) and from official resource “United interdepartment information and statistical system” (http://www.fedstat.ru). Statistical calculations were made with the help of special software package Statistica v10. The main class of used statistical methods are: methods of linear and non-linear regression analysis.
Results. Working-age population mortality has a direct link with the main indicators of living standards (income level, cost of living, poverty level), that is explained by direct correlation between mortality from the diseases of circulatory and respiratory system and other external reasons and living standard (according to the data during 2003 - 2017.). The main indicator of living standards associated with a mortality rate of working-age population and young people up to 29 years, is the lack of income and cost of living level. The strongest linear correlation is observed between the mortality of elderly people aged 80 to 84 years and cost of living level (r = 0,96).
Conclusion. Socio-economic standard of living is directly related to the mortality of the Buryats, and particularly with the mortality of working-age population (children, the elderly). Mortality from external reasons is related to the poverty level in direct proportion. The designed models allow to get a better idea about the nature of the phenomena and qualitative forecast of Buryats mortality depending on the living standards indicators

The use of information systems in the conditions of modern healthcare is becoming more and more common both in the Russian Federation and abroad. Organization of single information space can improve the availability and quality of medical care, effectiveness of management and decision-making, as well to reduce economic costs. The authors of the article presented the main IT used today in the field of medicine, they also showed positive aspects of operating these systems, their shortcomings, and possible ways to improve the efficiency of information space

The aim of the research is studying dynamics of indicators, characterizing organization of perinatal care in Krasnoyarsk territory on the level of obstetrics organization.
Material and methods. There was analysis of data obtained from 232 forms “Information on regionalization of obstetric and perinatal care in maternity hospitals (departments) and perinatal centers”, in Krasnoyarsk territory for the period from 2012 to 2017. Data on number of beds, total number of births and number of births during pregnancy period of 22-27 weeks, mortality of pregnant and parturient women, perinatal mortality index, natimortality and mortality of newborns up to 168 hours after birth.
Results. By 2017 the total number of beds of obstetric service has decreased by 20.1%, that is associated with the reduction of beds number at I and II levels of obstetric and perinatal care and correspond to the trend of number of births reduction in the Krasnoyarsk territory. Changes in the number and structure of hospital beds, as well as in the number and structure of obstetric due to the level of obstetric and perinatal care has increased the number of births per obstetric bed at all the levels. Analysis of indicators, characterizing lethal cases related to pregnancy and childbirth in Krasnoyarsk territory for the studied period, showed that there has been a significant decrease in all indicators for 6 years. At the same time in 2016 and 2017 there were no cases of mortality among women in obstetric hospitals.
Conclusion. During the analyzing period along with the increase in the proportion of all births in medical institutions of III level in the obstetric structure in Krasnoyarsk territory due to the level of obstetric care service institutions, there was a decreased number of deaths both among parturient women and among newborns. The proportion of premature births in the period of 22-27 weeks in hospitals of III level obstetric services has increased in Krasnoyarsk territory. In 2017 more than one third of premature births at this period of pregnancy was carried not in hospitals of III level, where should be due to the routing system, but in institutions of I and II levels. It is concluded that it is necessary to develop new or to specify existing pregnant routing technologies in Krasnoyarsk territory.