The article highlights modern approaches to laboratory verification of chlamydial infection in the mucous membrane of the upper respiratory
tract in patients with acute and chronic nose and throat diseases. A brief description, application field, advantages and disadvantages of bacterioscopic, immunological, molecular-biological and cultural methods for the diagnosis of chlamydia are given. The authors present the views of leading scientists, as
well as their opinion on the possibility of diagnosing chlamydial infection of the upper respiratory tract using each of these methods, besides, they present a developed and approved set of diagnostic examinations and methods for taking clinical material for diseases of nose, paranasal sinuses and pharynx

The aim of the research is to establish the prevalence of major risk factors (RF) for chronic non-infectious diseases (NID) among first-year students in the town of Tomsk.
Material and methods. 978 first-year students were examined, their average age varied 18.6 ± 1.1. The behavioral parameters (smoking, drinking, poor nutrition, low physical activity) and metabolic (hypercholesterolemia, hyperglycemia, arterial hypertension, overweight / obesity) were evaluated for RF of NID.
Results. The prevalence of behavioral RF, such as alcohol abuse and poor nutrition, among first-year students in Tomsk is comparable to national indicators. In comparison with other regions of the Russian Federation, smoking is more common, among first-year students of Tomsk without any gender differences, while low physical activity is less common. It was revealed that the prevalence of behavioral RF among studying youth significantly exceeds the general population indicators. It was also established that metabolic RF among first-year students of Tomsk remain at a lower level compared to general population, while their prevalence does not significantly differ from national indicators. The most common metabolic RF among the examined individuals is overweight, while arterial hypertension, hypercholesterolemia and hyperglycemia are less frequent. Along with high prevalence of RF of NID, first-year students have a low level of preventive knowledge.
Conclusion. It is necessary to create and implement a regional primary prevention program for the first-year students of Tomsk, primarily aimed at prevention of alcohol and tobacco use, as well as of poor nutrition and physical inactivity

The aim of the research is to summarize the results of clinical examination of the emergency workers (EW) at the Chernobyl station (ChS) with the diseases of internal organs and their outcomes for 30-year period after the accident.
Material and methods. In 1996 -2002 117 EW were examined, who, since June 1986, in 1987 and 1988, worked in different places in 30-kilometer emergency zone and whose work duration differed. The absorbed dose of external γ-radiation ranged from 50.0 to 270.0 mGy (on average 163.06 ± 9.54 mGy). The research methods included standard clinical examination of patients, the study of the diseases of respiratory system, heart and blood vessels, digestive, hematopoietic, central nervous system and peripheral nervous systems with autopsy morphological diagnostics and conducted in vivo. Then analysis of life status of EW and of mortality structure was performed.
Results. The study showed that the pathological effect of ionizing radiation (IR) consists in widespread severity of damage (of various degrees) of
microvasculature (Mv) from vasculopathy to the manifestation of productive vasculitis, established in biopsy materials of the right ventricular myocardium
and skin-muscle flap. Generalized vascular lesion of the Mv has caused the microvascular form of coronary artery disease often diagnosed in EW, the
development of diffusion and vascular insufficiency of the respiratory apparatus, caused damage of the glial component of CNS and vegetative part of nervous system, leading to the development of neuropsychiatric diseases and disorders. For the period passed since the accident, super mortality is established in this cohort at working age. Until 2002, the mortality was caused by external causes and diseases of circulatory system, and then it was caused by the diseases of circulatory system and malignant neoplasms of lungs.
Conclusion. The important targets of the damaging effect of “small” doses of IR include Mv of the brain and heart vessels. Their changes happened in the
remote period after the accident exacerbate the psychosomatic maladjustment of these patients and can explain high mortality from various causes of external character and diseases of cardiovascular system.

The aim of the research is to study the characteristics of nutrition, body composition, food hormone activity in patients with hypertension with non-dipping phenotype.
Material and methods. It is an open, descriptive, comparative study of 54 patients with arterial hypertension (based on ESH / ESC 2013). The average age of patients varied 57.63 ± 11.87 (years), males and females. The check group consisted of 27 healthy patients, correlated by sex and age. Anthropometric parameters, body composition, actual nutrition, daily blood pressure monitoring were assessed.
Results. When comparing the average values of anthropometric indicators and body composition indicators, the following ones were determined: the increase in the incidence of overweight and obesity, the increase in the ratio of waist volume to hip volume, high average value of normalized growth of fat mass in patients with arterial hypertension, 1.2 times (p = 0.0466) exceeding the performance of check group. In the analysis of laboratory parameters, violation of lipid profile, adipocytokine status in the group of patients with arterial hypertension has been revealed. When conducting multiple correlation analysis, a positive relationship is established.
Conclusion We propose to use adipose mass normalized for height, atherogenic index, leptin level, leptin-binding receptor, adiponectin as additional criteria for nutritional disorders in patients with arterial hypertension

The aim of the research is to study the causes of renunciation from hospitalization among patients with suspected acute coronary syndrome (ACS).
Material and methods. The study included 56 patients with suspected ACS who called the ambulance, but refused from hospitalization. The facts of
hospitalization and death within 30 days from the moment of the first call for ambulance and the type of attitude towards the disease were assessed.
Results. Among 56 patients, only 15 people were males (27 %). From 56 patients, 53 (95 %) were suspected for ACS without ST segment elevation and 3 (5 %) patients were suspected for ACS with ST elevation. It was impossible to get in touch with 6 (11%) patients who refused to be hospitalized and to find out their fate, five more patients (9 %) refused to answer any questions. It was established that within 30 days one patient with ACS with ST elevation died after refusing from hospitalization (2 %). When interviewing 45 patients refused from hospitalization, it was found that in 43 cases (96 %), within a few hours after the call for the ambulance, the emergency medical service teams made an active home visit to the patient, during which 10 patients (22 %) were hospitalized. 19 from 45 interviewed patients (42 %) were hospitalized within 30 days after the first call for the ambulance. The main reason of refusing from hospitalization (25 %) is
the lack of trust in inpatient doctors. Anosognosic type of attitude to the disease occurred in 30 % of patients with suspected ACS refusing from hospitalization.
Conclusion. Among patients with suspected ACS who refuse from hospitalization, three quarters are females. More often, patients with suspected ACS without ST elevation refuse to be hospitalized. 42 % of patients with suspected ACS, who initially refused to be hospitalized, are hospitalized after repeated calls for the ambulance. Every fourth patient with suspected ACS refuses to be hospitalized due to the lack of trust in hospital doctors.

The aim of the research is to study the role of environmental and genetic factors in the development of febrile convulsions in infants.
Material and methods. In total, 151 children aged from 3 to 36 months were under observation, the main group consisted of 121 patients with FС (average age varied 21.69 ± 10.32 months), the check group included 30 children with the development of hyperthermic syndrome with ARVI (average age 14.63 ± 8.24 months.)
Results. The largest number of FCs was registered among boys 60.3 ± 4.4 % (73 people), in the check group, on the contrary, girls prevailed (20 people; 66.7 ± 8.6 %; p <0.05). Family history of FC in probands of the main group was burdened in one third of cases. In the etiological structure of ARVI in children with FC, the influenza A virus (37.2 %) and the PC virus (23.1 %) prevailed, and 38.7 % of the patients showed persistence of HSV-6. The association of homozygous genotypes in two highly producing allelic variants of IL-1B gene promoter was more common in the recurrent course of FC. In patients with HSV-6 persistence and recurrent FC, there was a homozygous genotype of IL-1B genes in a quarter of cases. The carrier rate of the SCN1A gene (rs16851603, rs3812718) in patients with FC and children with hyperthermic syndrome without FС according to statistics was significantly different in hetero-and homozygous genotypes (p <0.05).
Conclusion. The results of the study confirm the multifactor nature of FC development in children, that greatly expand the previously obtained data.

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The aim of the research is to study the involvement of polymorphisms of IL17A (rs2275913) and IL17F candidate genes (rs763780, rs2397084) in pathogenesis of atopic bronchial asthma with different levels of disease control in children of Caucasian origin of Eastern Siberia.
Materials and methods. The objects of the study were children of Caucasian origin, patients with severe / moderate atopic bronchial asthma (ABA) with
different levels of control over the course of the disease (n = 211). The diagnosis, severity, level of control over the course of the disease were established in accordance with the recommendations of GINA. Two groups of patients with ABA were defined: with controlled (n = 101) and uncontrolled flow (n = 110). The check group consisted of practically healthy individuals (n = 135). Amplification of the IL17A / F cytokine gene regions was carried out by PCR and RFLP analysis, followed by visualization of the results in UV light after electrophoretic separation in a 2 % agarose gel.
Results. As a result of the research, data on IL17A / F polytypes and alleles of polymorphisms distribution in patients with atopic bronchial asthma and in
population sample of Caucasian origin living in Krasnoyarsk were obtained for the first time. Rare allelic variants are A * IL17A (rs2275913) and allele G *
IL17F (rs763780 and rs2397084), which is consistent with global data. Statistically significant differences in the distribution of AG and GG IL17F genotypes (rs763780), as well as GG IL17F ones (rs2397084) between children with asthma and the population sample, are shown.
Conclusion. Genetic risk markers for the development of atopic bronchial asthma were established: AG and GG IL17F genotypes (rs763780) and the GG * one (rs2397084) are predisposing to ABA development and to its uncontrolled course in children. The results of the study supplemented the data on the contribution of polymorphisms of cytokine genes of the IL-17 family to the development of atopic bronchial asthma and the control of the course of the disease in children using the example of the Caucasoid population of Krasnoyarsk

The aim of the research is to study the severity of anxiety-depressive disorders and dyssomnias in university students of different profiles at the end of the academic year, depending on sports activity.
Material and methods. The study was conducted on 118 full-time university students (79 males, 39 females, average age varied 21 ± 3.32g.), studying different profiles by means of author’s questionnaire, which includes State-Trait Anxiety Inventory, Zung Self-Rating Depression Scale and the Pittsburgh Sleep Quality Index questionnaire. Statistical processing of the data was performed with the help of software package Statistica 8.0 for Windows XP. The quantitative characteristics of indicators were represented by the median (Me, Q2 - the second quartile), the first and the third quartile (Q1 and Q3, respectively). Intergroup differences were studied by means of non-parametric Mann-Whitney test. Correlations were evaluated by means of Spearman test.
Results. It is shown that anxiety, depression and worsening of night sleep are interrelated pathological phenomena among students at the end of academic
year. Doing low-static and medium-static sports of different dynamics reduce the severity of affective disorders and dyssomnias in students.
Conclusion. Trainings are recommended, which include regular 1.5-2.5 hours of exercise at least thrice a week, which prevent the occurrence of the studied disorders. Long-term athletic experience and a sport title reduce the severity of affective disorders and dyssomnias among students at the end of the academic year in case of an early start of sports activity, i.e. in childhood and adolescence

The pathogenesis and classification of Mirizzi syndrome (MS) is presented. It is noted that the diagnosis of cystic choledochal fistula at the preoperative stage is a difficult problem. With the introduction of magnetic resonance cholangiopancreatography (MRCP) into clinical practice, diagnostic capabilities for MS have been improved. The given clinical case demonstrates a comprehensive diagnosis of MS and a stage approach to treatment.

The aim of the research is the study of mortality rate from tuberculosis among the population of the Republic of Buryatia and its dynamics for the period 2013-2017 in order to assess the effectiveness of anti-tuberculosis interventions.
Material and methods. The data of the forms of federal statistical observation No. 8 “Information about active tuberculosis diseases”, No. 33 “Information
about patients with tuberculosis” were used. The number of the deceased is presented according to the Federal State Statistics Service. Mortality rates are
calculated on the average annual population.
Results. At the end of 2017, only 52 people died of tuberculosis, the mortality rate was 5.2 per 100 thousand of population, which is 20% lower than in the previous period (2016 - 6.5) and 1.2 times lower than average federal indicator (RF - 6.5 in 2017). When compared with the indicator for the SFD (12.7), the mortality rate in the republic is 2.4 times lower. By the end of 2017, the Republic of Buryatia ranks the 11-th among the 12 regions of the Siberian Federal District.
Conclusion. In recent years, there has been a significant decline in mortality. There is an increase in the proportion of female population in the structure of the deceased from tuberculosis and acutely progressive forms of tuberculosis, as the main cause of death. At the same time, the proportion of deaths from HIV infection is increasing. In recent years, HIV infection has a significant impact on reducing the mortality rate of the population from tuberculosis.

The aim of the research is to study the readiness of visiting nurses in conducting primary medical prevention in the population.
Material and methods. In order to study additional opportunities increasing the availability of primary medical prevention in the population, a sociological
survey of visiting nurses was conducted to determine their readiness for primary medical prevention.
Results. As a result of the conducted sociological study, it was established that visiting nurses are focused on the main areas of primary medical prevention, they read medical literature and participate in scientific conferences and seminars on primary medical prevention, they consider themselves qualified to conduct it and wish to undergo additional trainings in the main areas of primary medical prevention. Visiting nurses marked the most interesting questions on primary medical prevention and the most convenient forms of increasing their competence in these issues. Visiting nurses noted the population’s need for information on primary medical prevention and appropriateness of providing information on primary medical prevention on the Internet to the population, they also expressed their desire to participate in the development of information materials on medical prevention.
Conclusion. As a result of the conducted sociological study, it has been established that visiting nurses are now an additional information channel for
preventive work with the population under the guidance of local general practitioners and doctors of the departments or medical prevention departments of medical organizations that provide medical care on outpatient basis.

The aim of the research is conducting an analysis of the basic principles and stages of implementation of the quality management system in the healthcare organization.
Material and methods. We used State Standard ИСО 9001-2015, State Standard ИСО 15189-2006, standard of Association of Russian Dentists, ИСО / IWA 1: 2005. The following research methods were used: expert assessment method, analysis and synthesis, information compilation.
Results. A methodological approach was created for the development and implementation of QMS in medical organizations according to eight points.
Conclusion. Analysis of native experience, basic principles and stages of implementing quality management system in healthcare organizations, State
Standards ИСО 9001-2015 “Quality management system. Requirements”, State Standard ИСО 15189-2006 “Medical laboratories. Particular requirements for quality and competence”, standard of Association of Russian Dentists “Requirements for quality management systems in dental organization”, ИСО / IWA 1: 2005 “Quality management systems. Recommendations for improving the processes in healthcare organizations” allowed developing methodological scheme for the implementation of quality management system in healthcare organizations. The use of methodological approach in the development and implementation of quality management system will minimize risks, reduce quality and labor costs of employees in the organization, reduce the period of development and implementation of quality management system. The work done has practical application for improving the activities of healthcare organizations, as well as of organizations in other fields of the economy