The authors show maximum neuroprotective efficacy of hypoxia and hypercapnia combined effect in comparison with their isolated use. They
discuss the role of possible mechanism of this A-1 receptors efficacy to adenosine, mitochondrial ATP-sensitive potassium channels, apoptosis, cellular synthetic activity, chaperones, neurotrophic protein S-100b, stress of the endoplasmic reticulum, HIF-1a transcription factor. The hypothesis about
carbon dioxide potentiation of neuroprotective efficacy of hypoxia is formulated. The prospects of clinical use of hypercapnic hypoxia in neurology are considered

The review shows the state of scientific research in the field of the most demanded components of blood usage as the materials for creating
scaffolds from the point of view of tissue engineering and regenerative medicine. The data of studies concerning the structure and properties of scaffolds, the activity of cellular processes, the proangiogenic potential of cell matrices due to the properties of various blood components in their composition
are analysed. The interrelation of mechanical properties, composition, structure and activity of cellular processes in scaffolds on the basis of blood
components are shown. The mechanisms influencing the regenerative potential of scaffolds due to the properties of various components of blood in their composition are considered

This article is a review of the literature on the problem of aorta coarctation. The review provides a historical background showing the main stages of aortа coarctation surgery development from the moment of its first description till the development of surgical treatment of the defect. In the framework of modern approach, the authors present the material on a new vision of bleeding hemodynamics, treating the defect not as anatomical narrowing of the aorta, but as a disease of the whole cardiovascular system with unfavourable course without surgical correction, as well as with the
delayed treatment. A constantly changing surgery approach to the correction of this defect, various methods currently used in this connection and their
effectiveness are described. The article presents the review of new directions in the treatment of aortic coarctation, applied in cases when classical surgery
methods are not suitable. Thus, aorta coarctation is still a kind of cardiovascular disease that is under investigation, without any consensus on surgery approaches and operation time.

The review presents the main historical aspects of the development of laparostomy, one of the most active methods of widely spread purulent
peritonitis treatment, as well as severe abdominal trauma. The article shows the existing ways of its formation and their distinctive features. The experience of using this treatment method, both in Russia and abroad, is given. The review compares the effectiveness of various methods of laparostoma formation, and discusses the problems, connected with this treatment method. When describing technical aspects of laparostomy, the emphasis is placed on the most widely used practice in the world along with widely used methods of its formation

The aim of the research. To study the frequency of CYP2C19 and ABCB1 genes polymorphisms, associated with the change, caused by clopidogrel antiagregant among the Russians and the Buryats of the Baikal region.
Material and methods. Polymorphisms CYP2C19 * 2 (681G> A, rs4244285), CYP2C19 * 3 (363G> A, rs4986893), CYP2C19 * 17 (-806C> T, rs12248560) and ABCB1 (3435C> T, rs1045642) were determined in 250 healthy voluntary representatives of two ethnic groups, residing on the territory of the Baikal region (136 Russians, 114 Buryats). The carriage of polymorphic genes markers was determined in real time by polymerase chain reaction method. The obtained results of the research were compared with the literature data, that were searched in PubMed, Medline, e-Library, CyberLeninka, Google Scholar databases.
Results. There were no significant differences in the frequency of CYP2C19 * 2 (681G> A) among the Russians and the Buryats. The difference in the frequency of other CYP2C19 gene polymorphisms in the Russians vs the Buryats was statistically significant: CYP2C19 * 3 (363G> A) was found only in the Buryats - 9.2% (р˂0.0001), CYP2C19 * 17 (-806C> T) frequency in the Russians was 26.8% vs the Buryat - 6.1% (p˂0.0001). As for ABCB1 gene, there were no significant differences in the incidence of ABCB1 (C3435T) polymorphism in the studied ethnic groups. The frequency of carriage among the Buryats at least one allele of CYP2C19 * 3 (* 1 / * 3 + * 3 / * 3) was 17.55% (p˂0.0001). Carriers of at least one “fast allele” CYP2C19 * 17 (* 1 / * 17 + * 17 / * 17) among the Russians were 45.6% vs among the Buryats - 11.4% (p˂0.0001).
Conclusion. Statistically significant differences in CYP2C19 * 3, CYP2C19 * 17 frequency, caused by clopidogrel antiagregant, between ethnic groups of
Russian and Buryat population of the Baikal region were obtained, which is important for personalized approach development of antiagregant therapy
in terms of primary and secondary prevention of cardiovascular diseases in these ethnic groups in order to increase the effectiveness and safety of
pharmacotherapy.

The aim of the research. To study the frequency of repeated myocardial infarction (MI) development during 5-year follow-up period, depending on the fact of revascularization in primary MI.
Material and methods. On the bases of a retrospective observational study using the register database of acute coronary syndrome (ACS) of Kemerovo
Regional Clinical Cardiology Clinic for 2009, the patients, diagnosed with acute primary MI, according to the current criteria of the Russian Cardiological Society, were selected. During the next 5 years, all cases of recurrent MI (fatal and nonfatal) development were tracked, after which all the patients were divided into groups: 125 (26.5  %) with one or several developed repeated MI, 346 (73.5  %) without any. Further the analysis of group differences was
performed being based on the fact of revascularization in primary myocardial infarction and its method, as well as other possible factors, determining the
failure of coronary blood flow recovery.
Results. The frequency of repeated MI development during 5-year follow-up period was 125 cases (26.5 %): 23 (18.4 %) cases with fatal outcome and 102 (81.6 %) patients with non-fatal outcome. Patients without the development of repeated MI had coronary angiography 1.2 times and emergency stenting 1.8 times more often during primary hospitalization. This is due to the fact that such patients were more likely to have clinically uncomplicated by Killip forms of MI with the ST segment elevation requiring urgent high-tech aid, as well as 1.8 times more frequent isolation of the coronary pool lesion. Among the patients with the development of repeated MI, on the contrary, MI without ST-segment elevation prevailed, some of which were initially ignored in the assessment of coronary anatomy, as well as during coronary blood flow restoration, due to 3 times more frequent multivessel lesions, complications of MI by Killip, initially among elderly patients, the presence of manifestations of multifocal atherosclerosis, allowing 1.8 times more often to select such patients for direct revascularization by cardio-team. In addition, a considerable contribution to the development of repeated MI was made by low adherence to the prognosis of the best therapy observed among this group of patients, and associated with a lower level of knowledge and a lack of income among these patients.
Conclusion. The need for the fastest and the most valuable revascularization in MI, along with the advisability of other risk factors modifying, are determined by high incidence of repeated MI during the first 5 years.

The aim of the research. To study functional parameters and deformation properties of the right ventricle (RV) with complete blockage of the right crus of atrioventricular bundle (BRCAB).
Material and methods. 48 individuals without obvious heart diseases were involved in the study. All the patients underwent coronaventriculography and
12-lead ECG. The group with BRCAB (QRS 144.9 ± 22.7 ms) included 24 people (46% of women). The control group included 24 people (50% of women) without any disorders of intraventricular conduction. All the participants underwent echocardiography with the assessment of hemodynamics, myocardial deformation using 2D-Speckle Tracking Imaging technology for the left and the right ventricles, evaluation of the dimensions, indices of contractility and diastolic function of the right ventricle (RV).
Results. The studied groups did not differ in the main parameters, characterizing the function of the left ventricle (LV). Patients with idiopathic BRCAB, compared with the control group, had greater longitudinal size of the RV – RVD3 (respectively, 65.5 ± 6.8 mm and 57.8 ± 8.6 mm, p = 0.0211), the final diastolic area of RV – RVEDA (15.0 ± 3.6 cm² and 12.6 ± 2.8 cm², p = 0.0409) and the final diastolic area of the RV – RVESA (9.4 ± 2.4 cm² and 7.2 ± 2.8 cm², p = 0.0405). Evaluation of the diastolic function of RV showed significantly lower rates of early tricuspid filling rate to the filling rate in the right atrial systole - Etr / Atr (0.97 ± 0.23 and 1.18 ± 0.27, p = 0.0367) and deceleration time of early diastolic filling flow - DTEtr (213.6 ± 26.9 ms and 167.7 ± 23.3 ms, p = 0.009). In the group with BRCAB, compared with the control group, there were smaller indicators of global longitudinal deformation of RV, GlStRV (-18.1 ± 11.1 % and -30.8 ± 8.2 %, p = 0.036).
Conclusion. BRCAB can affect anatomic structure and the function of the RV. The RV deformation parameters, defined for BRCAB, can be used as reference for evaluation of its condition in case of cardiovascular diseases development.

The aim of the research. Identification of hemodynamic and structural parameters of the heart and pulmonary circulation in patients with myocardial
infarction (MI), depending on the diffusion capacity of the lungs.
Material and methods. There were 107 patients with myocardial infarction with ST-segment elevation with severity of acute heart failure of Class I by Killip classification. On the 10th -12th day echocardiography, spirometry, bodipletizmography were performed; lung diffusivity (DLCO) was determined. The diffusion capacity of the lungs was determined by single inhalation for carbon monoxide method. 100 (93.4%) patients underwent percutaneous coronary intervention with stenting.
Results. Depending on the diffusion capacity of lungs, patients are divided into two groups: Group 1 – 59 (55.1%) patients with normal DLCO, Group
2 – 48 (44.9%) patients with a decreased DLCO index. The studied groups were compared according to the characteristics of MI, and the course of
hospital period. The patients of the 2nd group had higher rates of pulmonary artery pressure and total pulmonary resistance. Echocardiography data of
patients from the group with reduced diffusion capacity of the lungs, showed higher linear and volume indices, characterizing the size of the left atrium
and left ventricle in systole. The method of multifactorial linear regression revealed factors, significantly influencing the decrease of DLCO in patients
with myocardial infarction.
Conclusion. It was established that the value of the parameters of the left atrial volume and pressure in the pulmonary artery can explain more than a quarter (27%) of variations of lungs diffusion capacity in patients with MI with ST-segment elevation. The revealed interrelation can reflect the role of pulmonary hypertension in the formation of violations of lungs diffusion and processes of myocardial remodelling

The aim of the research. Identification of serotypes, genotypes and resistance to antimicrobial preparations of Streptococcus pneumoniae strains, obtained
from healthy children and children with various forms of pneumococcal infection in the territory of Krasnoyarsk Territory.
Material and methods. PCR-serotyping, multilocus sequence typing (MLST), and antibiotic susceptibility determination by disk and serial dilution of 49
strains of S. pneumoniae in broth, obtained from healthy children who are bacteria-carriers and 23 strains, obtained from sick children who were hospitalized with acute otitis media, meningitis, community-acquired pneumonia. Bacteriological and molecular genetic methods were used in the research. To determine the statistical significance of the differences, the χ2
 criterion was used.
Results. The predominant serotypes / serogroups and genotypes of pneumococci in bacteria-carriers were: 23F (ST1500, CC30), 19A (ST320, CC320), 6ABC (ST315, CC315) and 15BC (ST1025, CC1025). In sick children, 19A (ST320, CC320) and 19F (ST271, ST1464, ST2323, ST9659 - CC320) prevailed. In 71.4 % strains serotypes obtained from bacteria-carriers and in 91.3 % obtained from sick children corresponded to the antigenic composition of 13-valence pneumococcal conjugate vaccine. Representatives of 315 and 320 clonal complexes were characterized by simultaneous resistance to erythromycin, azithromycin, clindamycin and tetracycline; moderate resistance to penicillin; sensitivity to ceftriaxone and ciprofloxacin.
Conclusion. Among pneumococci, that persist in the nasopharynx and cause infectious diseases in preschool children, strains with multiple drug resistance
are frequently found. One of the ways to overcome resistance at this stage is vicinal prevention of pneumococcal infection.

The aim of the research. Determination of the predictors of premature detachment of the normally located placenta (PDNLP) in preterm delivery (PD) with the risk of antenatal infection and the construction of the model with the use of multidimensional mathematical analysis.
Material and methods. The logistic model is based on 276 observations. Thirteen independent variables are ranked in accordance with the strength of
their relationship with the dependent variable. The diagnosis of “PDNLP” and preterm delivery was verified by clinical and anamnestic data, ultrasound
examination with dopplerography, cervicemetry. Analysis of prognostic models is performed using logistic regression. To determine the diagnostic value of the prognostic model, the ROC-curve was used, followed by the determination of the area under it (AUC). Comparing the standardized coefficients for the predictors, included in the equation by module, ranking of attributes based on the strength of their relationship to the dependent variable “ PDNLP “ is performed.
Results. In the logistic model, taking into account smoking, body mass index, hydramnios and oligoamnios, risk factors for antenatal infection, it was
found that polymorphism of the PAI-1 gene: 675 5G> 4G (pχ2 = 0.008) and polymorphism of the FGB gene: 455 G> A (pχ2 = 0,023) and the above
listed factors increase the risk of developing PDNLP in incomplete pregnancy. The heterozygous genotype PAI-1 5G / 675 / 4G was also associated
with PDNLP.
Conclusion. Important clinical-anamnestic and molecular-genetic predictors of the dependent variable “ PDNLP” were established. ROC analysis determined
high specificity and sensitivity of the model, while the integral indicator of the marker’s predictive efficiency (AUC = 83.6%), judging by the expert score for
its values, indicates a very good quality of the model.

The aim of the research. To study the influence of the inhibitor of vascular endothelial growth factor on the regression of functional cysts in the course of the experiment.
Material and methods. The experiment was performed on sexually mature white female rats of the Wistar line. Group I (basic, n = 25) – functional ovarian cysts modelling (introduction of follicle stimulating hormone) and introduction of bevacizumab. Group II (comparable, n = 35) –functional ovarian cysts modelling without subsequent treatment. Control group (n = 20) – intact animals. The rats were removed from the experiment on the 7th, 15th, 30th and 60th days. Histological and morphometric studies were carried out on dewaxed sections of the ovaries stained with hematoxylin-eosin and by Van Gieson.
Results. Functional ovarian cysts modelling in white rats was accompanied by an increase in the specific volume of vessels, increased atresia, decrease growing follicles and yellow bodies number and specific volume. The introduction of an inhibitor of vascular endothelial growth factor caused on the 15th day the decrease in number and specific volume of cysts, approximation of specific volume of vessels to the values of control group. By the 60th day, the number and specific volume of growing and atretic follicles and yellow bodies did not differ from the ones of the intact control group.
Conclusion. Bevacizumab introduction accelerates the regression of functional ovarian cysts by reducing vascularization in the cyst wall. The detected
decrease in the number of growing follicles and intensification of atresia in the follicles are short-term

The aim of the research. Identification of formation and course patterns of non-motor disturbances in Parkinson’s disease for the selection of the most
appropriate method of correcting and slowing the disease progression.
Material and methods. A non-motor fluctuation scale in Parkinson’s disease was used, a correlation analysis was performed to evaluate the relationship
between severity and frequency of dysuric non-motor symptoms such as: increased urination, urgencies, nocturia, and variance analysis to detect statistically significant difference between different study groups, depending on the disease duration.
Results. It was found that lengthening of Parkinson’s disease duration increase the severity and frequency of dysuric non-motor manifestations
(increased frequency of urination, urgencies, nocturia); according to the data obtained by non-motor fluctuations scale, there is a direct correlation
between the results of severity and the results of non-motor manifestations frequency; on the basis of the conducted dispersion analysis, statistically
significant effect of the disease duration on the manifestation of severity and frequency of dysuric disorders in patients with Parkinson’s disease was
noted.
Conclusion. It is necessary to take non-motor fluctuations into account in the treatment of patients with Parkinson’s disease, as well as actively to interrogate them for the presence of these complaints. There is a large number of methods for their diagnosis, but these are subjective and time-taking evaluation methods, so the issue of creating a new quicker and objective ways of qualitative non-motor disturbances’ evaluation remains open. Qualitative and timely treatment of non-motor symptoms will slow the progression of the disease, reduce disability and improve the quality of life of patients with Parkinson’s disease.

The aim of the research. Identification of patterns of immunity system changes in the process of reparative osteogenesis.
Material and methods. 429 patients are divided into 10 groups with soft tissue wounds, osteomyelitis, fractures, without and with complications (false joints,
pathological fractures). All got immunograms, including determination of number of T- and B-lymphocytes, T-cell subpopulations, NK cells, phagocytic
neutrophils, immunoglobulins. Discriminant analysis was used to classify the patients.
Results. Gradations of clinical signs and numerical characteristics of more than 60 parameters, including immunogram indices, were studied. 15
indicators were selected; they affect the discrimination of patients into groups of complicated and uncomplicated reparative process: gender, age, number
of infectious agents, inflammatory process phase graduation, localization of pathological process in bone tissue, size of affected segment, type of surgical
bone treatment, type of operations on soft tissues, number of comorbid diseases, number of clinical signs and signs of immunological failure in history, absolute number of lymphocytes (109 / l), and of T-lymphocytes – (109 / L), stress-adaptive reaction, expressed by the number of signs of tension in the blood formula, IgG and IgA level. Equations of linear discriminant function are calculated for each group. It is shown that calculating the prognostic coefficient for each patient can determine the prognosis of the development of the reparative process before surgery. Graphical classification model of groups with complicated and uncomplicated flow of the reparative process is constructed on basis of calculation of Mahalonobis distances between groups.
Conclusion. Thus, the revealed patterns can determine the preoperative early prognosis of the reparative process of bone tissue, which allows to identify
patients with some problems and timely change the tactics of surgical and drug treatment.

The article presents cases of rare (orphan) forms of ectopic location of fetal egg – pregnancy in interstitial fallopian tube and in the rumen after
caesarean section. Risk factors that might lead to ectopic pregnancy are given. The complexity of timely diagnosis of these complications is demonstrated. The presented clinical cases are interesting both from scientific and practical point of view. Taking into account the tendency of increasing prevalence of risk factors (increased use of AFT methods, surgical delivery by caesarean section), there is a possibility for rare forms of ectopic pregnancy to transform to the category of more frequent pathologies.

Successful surgical treatment of valvular heart defects led to the need of overcoming new challenges. One of such complex clinical problems is
endocarditis of prosthetic valve – a serious complication of surgical intervention. In order to solve this problem, a clinician faces a number of difficulties, such as the need for high-tech methods of examination, the course of the disease on the background of severe comorbidity, the need to balance maximum efficiency and safety of treatment. A wide range of tasks requires mutual work of specialists in various fields: cardiologists, clinical pharmacologists, ultrasound specialists, cardiac surgeons, microbiologists. The presented clinical case demonstrates successful experience of “endocarditis team” in a cardiological hospital, which allows to ensure the correct sequence and continuity in the management of patients with endocarditis of prosthetic valves

In 2018, “Siberian Medical Review” journal celebrates the 100th anniversary of its foundation. A number of outstanding doctors, scientists, public figures of the Yenisei province, such as V. M. Krutovsky, P. I. Mazharov, R. K. Peacock and others were at the origin of the journal. Archival data on the
activities of a remarkable physician, public healthcare organizer, scientist Vladimir Mihailovich Krutovsky are presented.