This study focuses on comparing and analyzing the satisfaction of quality of medical care for patients with acute stroke in the Russian Federation (RF) and the People’s Republic of China (PRC) to identify major problems and the most successful organizational solutions in the system of medical care for patients with stroke. The analysis of differences was performed by the following parameters: quality of care in hospital assessed by patients; the attitude of the medical and nursing staff and the physician to patients (assessed by patients); timely diagnosis and treatment; the level of staff qualifications assessed by patients; satisfaction with the outcome of treatment; availability and volume of conversations held with the patient about the nature and causes of the disease; test results by the life quality scale EQ-5D.

Over the recent years, there has been an increase in the number of patients with psychosomatic disorders, as well an increase in the number of «masked depressions». High social significance of psychosomatic diseases is predetermined by the fact that it is extremely common among people of working age. The aim of the study was to analyze the medical and social composition of the patients at the psychosomatic department, as well as to show the efficiency of treatment in such department. The analysis of data obtained during the survey department of psychosomatic patients for anxiety and depressive disorders is presented. The survey was conducted by using the Hospital Anxiety and Depression Scale (HADS). The medical documentation of the department was also analyzed. The study found that the social composition of patients was heterogenous. Most of the patients (54.3 %) were in hospital with a diagnosis of organic anxiety disorder. It was revealed that the largest share among the somatic pathology accounted to such pathology as hypertension of the III degree in conjunction with coronary artery disease (20.7 %) and hypertension of the II stage (19.6 %). The efficacy of treatment in this department was proven. By the 20th day of hospitalization, 30 % of patients did not experience anxiety and/or depression. Combined symptoms of anxiety and depression were observed only in 14 % of patients by the 20th day of treatment.

The problem of restricted availability and quality of ophthalmologic medical care remains one of the main ones in the national healthcare. The article gives a comparative analysis of the opinions of rural residents of Leningrad region are in need of surgical treatment for ophthalmologic diseases, availability and quality of specialized medical care. A questionnaire was developed based on the methodology proposed by the Federal compulsory medical insurance Fund, through formal interviews of respondents of patients who received specialized ophthalmologic medical care in Leningrad region before opening of eye care hospitals for surgical treatment of cataract and glaucoma (148 patients) and afterwards (320 patients). The results show that almost all patients who received treatment after the modernization of ophthalmologic offices are satisfied with the quality of medical care (completely satisfied – 91,3 %, quite satisfied – 7,6 %), which is significantly higher than the figures obtained in the survey of the patients before creation of specialized departments (t=3,6, p<0.05). Availability of medical care before reequipment of ophthalmologic departments in hospitals satisfied 62.8 % of respondents, and after the organization of activities of eye care hospitals – 75, 3 % (t=2,8, p<0.05). However, despite the new form of organization of medical aid, 27.5 % of the respondents are still not satisfied with its transport accessibility. Thus, patients receiving operative treatment of cataract are generally satisfied with the availability and quality of their medical services. Higher ratings of availability and quality of specialized eye medical care were received after opening of eye care hospitals for surgical treatment of cataract and glaucoma in Leningrad region.

Modern narcology demonstrates a problem of insufficient effectiveness of pharmacotherapy for stabilization of remission in patients with opioid dependence. Effectiveness of the existing pharmacological approaches to solving this problem varies from patient to patient. In Russia, naltrexone is a medication mainly used for stabilization of remission in patients with opioid dependence. The main course of inefficient effectiveness of naltrexone in treatment of opioid dependence could be explained by poor compliance. The effectiveness can be improved by three ways: 1) using extendedrelease formulations of naltrexone; 2) using naltrexone combined with other medications to reduce symptoms resulting in relapse; 3) conducting a pharmacogenetic analysis to provide patients’ stratification by the effectiveness of pharmacotherapy. The main objective of this review is to analyze opportunities for improving pharmacological treatment methods in stabilization of remission in patients with opioid dependence using the combined pharmacotherapy and pharmacogenetic analysis in order to develop individualized pharmacological treatment approach.

Epilepsy is one of the most common neurological diseases in childhood and adolescence. It is on the third place in the structure of diseases of the nervous system. The social significance of this disease is determined by the highest percentage in disability of patients. Currently, many leading national and foreign epileptologists expresses the same opinion that the one of the most important purposes in helping patients with epilepsy is to improve their quality of life. Cognitive disorders play a leading role in disturbances of patients’ adaptation in the community, so their role can be more considerable in disability than seizures, thus impairing the quality of life. The most common cognitive disorders in patients with epilepsy include memory impairment, retarded intellectual development and attention deficit disorder. In recent years, a special interest is given to the introduction of neuropsychological methods in studying the brain organization of higher mental functions in children with epilepsy. Analysis of neuropsychological features and characteristics of cognitive disorders with various forms of idiopathic epilepsy is of particular interest.

Modeling of allogeneic bone marrow transplantation and graft-versus-host disease (GVHD) plays a crucial role in the improvement of transplantation procedures and testing novel immunosuppressive drugs. In this study we evaluated the feasibility of busulfan and cyclophosphamide conditioning with posttransplantation cyclophosphamide (150 mg/kg) in donorrecipient pairs C57Bl/6-Balb/с and Balb/с-C57Bl/6. We observed that Balb/с mice as opposed to C57Bl/6 mice can’t be the recipients because of the unacceptably high acute mortality from acute toxicity of chemotherapeutic drug. Histological studies in the C57Bl/6 recipients revealed acute GVHD in 93 % of animals. All animals had only grade I–II severity of GVHD. This model has the potential for future studies in the field of transplantology, nonetheless a decrease in the intensity of prophylaxis is required to augment the manifestations of GVHD.

Reduction of minimal residual disease to undetectable levels is the key criterion for efficiency of allogeneic hematopoietic stem cell transplantation (alloHSCT), along with engraftment of transplanted cells with complete replacement of recipient hematopoiesis, i. e., full posttransplant chimerism. Among different approaches, molecular genetic techniques are preferable, being based on the analysis of highly polymorphic DNA sequences (short tandem repeats, STRs). However, this approach, despite its high specificity, has a limited sensitivity. In this regard, it seems appropriate to introduce more sensitive diagnostic solutions, in particular, analysis of insertion/deletion (InDel) polymorphisms, followed by real-time detection of PCR products. The data obtained upon analysis of several genetic markers have shown higher sensitivity of this method. However, the deviations in the range of 10 to 90 % in evaluation of the cell ratios indicates the feasibility of using this approach just to evaluate the residual populations of recipient cells.

Aim of the research – to assess the clinical and laboratory parameters in patients with chronic hepatitis C (CHC) on the early stages of development and their comparison with the level of galectin3. The study included 78 patients with oligosymptomatic course of the disease and minimal liver fibrosis in the most cases. In the most patients with stages of the disease exceeding 8 years, viral load was over a million copies/ml. In 10 % of patients on the early stages of the disease, changes corresponding to severe liver fibrosis and cirrhosis F3 and F4 were detected. Moderate correlation of ALT activity, viral load and low severity with the duration of the disease was identified. There is a trend towards a higher level of galectin3 in a long course of CHC in comparison with earlier stages of its development, with significantly higher average level of galectin-3 in patients with minimal liver fibrosis (F0–F1) as compared to advanced stages, suggesting its importance in the launching and initial mechanisms of fibrogenesis.

Glioblastomas are the most frequent malignant neoplasm among primary brain tumors of childhood. Despite the advances in a multimodality treatment approach including neurosurgery, radiotherapy and chemotherapy, the overall survival of such patients remains poor and doesn’t exceed 14 months. The using of targeted agents such as gefitinib in unselected patient populations showed insufficient efficacy. Nowadays, the most perspective approach is a selection of patient populations potentially sensitive to targeted therapy based on predictive markers of response. We performed a comprehensive analysis of the mutational patterns in 30 glioblastomas of children. Data Analysis was based on the new method of mass spectrometry (OncoCarta v1.0, Sequenom) that enabled us to estimate 298 mutations in 19 genes and to identify 10 mutations in 9 tumors (30 %). Mutations were found in BRAF, CDK, HRAS, EGFR, FGFR, MET and PI3K. The most mutated pathway was EGFR – in 20 % of the samples (6/30). The obtained results seem to be very promising in terms of possibilities of using new targeted agents including BRAF inhibitors for treatment of children with glial brain tumors.

This article focuses on the implementation of the pilot project «Development of the medical rehabilitation system in the Russian Federation» in the city hospital № 26 (Saint Petersburg). By the experience of rehabilitation of stroke patients at the 1 stage, we analyzed the use of ICF for the purpose of setting a rehabilitation diagnosis and management of the rehabilitation process using the program «ICF-reader». We identified key issues and errors of ICF use in rehabilitation diagnosis. The article presents data on the frequency of using the different ICF domains in practice of rehabilitation. In this paper, we analyzed the average time of inspection of one patient by multidisciplinary team at admission to rehabilitation of the 1st and 2nd stages. The average time of examination was 10 [9; 13.5] minutes (median [percentile 25 %; 75 %]). Thus, the inspection of one patient needs of 5 to 15 minutes. During this period, the team has time to examine and discuss the patient, to make a diagnosis rehabilitation, to assign responsible specialists from the team and to make a rehabilitation plan for a week, to solve the issue of the rehabilitation potential and future patient routing. The introduction into rehabilitation process for stroke patients of such notion (tool) as rehabilitation diagnosis in terms of ICF fundamentally changes the nature of work of the rehabilitation team. Compliance with the «new» model of rehabilitation through implementation of the rehabilitation diagnosis and rehabilitation plan encourages the rehabilitation team to implement the basic principles of modern rehabilitation: the biopsychosocial model of disease, multidisciplinary principle, patientcentered principle, problemoriented approach and personalized principle. Implementation of the principle of the multidisciplinary team’s work and the use of the «ICFreader» leads to time reduction and intensification of the rehabilitation process.

The aim of the research is to identify factors influencing the safety and efficacy of the transfusion therapy with hematopoietic stem cell transplantation (HSCT). From January 1 to December 31, 2015, 329 patients with hematologic diseases and malignancies who had undergone 367 HSCT were included into the study. Transfusion therapy was conducted in 345 HSCT – 94 % of cases. Totally, 9074 cases of transfusion of blood components were recorded: red blood cellcontaining – 2378 (26.2 %), plateletcontaining – 6255 (68.9 %), fresh frozen plasma – 441 (4.9 %). АВ0incompatibility between the donor and recipient was determined in 60.4 % of cases (n=154) in HSCT from allogeneic donor. Acute «graft versus host disease» was observed in 34.9 % of cases (n=89). Hemorrhagic complications were in 46 cases (12.5 %), mainly nasal, gastrointestinal bleeding and hemorrhagic cystitis. Pprevention and treatment of anemic and hemorrhagic complications in HSCT requires longterm and massive transfusion therapy with the availability of АВ0-incompatibility. The use of leukofiltrated, γ - or x-ray irradiated, individually and immunologically compatible blood components can reduce the risk of development of acute and delayed transfusion reactions in HSCT.

The study was aimed to evaluate the efficacy and safety of injections of botulinum toxin typeA (BTA) in the neck muscles under electromyographic control and without it to reduce head tremor, muscle tone and dystonic postures, as well as pain in patients with cervical dystonia (CD). 49 patients with CD and dystonic head tremor who received injections of BTA were examined. 33 (67 %) patients received Dysport in an average dose of 695 (627; 762) units, 15 (31 %) patients received Xeomin in an average dose of 262 (227; 297) units and 1 (2 %) patient received 300 units of Botox. 16 (33 %) patients received injections under EMGcontrol. The level of symptoms of CD and tremor before and 4 weeks after the treatment were measured by the TWSTRS and Tsui scales. Evaluation of the treatment efficacy was carried out using the patientreported Clinical Global Improvement (CGI) scale, and the presence or absence of head tremor after injection was also recorded. The TWSTRS score decreased from 39 (36, 42) to 24 (21, 26), the TZUI score decreased from 9.8 (9, 10) to 4.9 (4, 6) in 4 weeks after injection (p <0.001). The level of tremor measured by Tsui scale decreased from 2.1 (1.7, 2.4) and 0.7 points (0,5; 0,9) (p <0.001). In 24 (49 %) cases, complete disappearance of tremor was noted in 4 weeks after injection. Complete regression of tremor was observed significantly more frequently in patients with torticollis who received injections with EMG-control in 10(71 %) cases vs. 8(32 %) without it (p <0.05). 28(57 %) patients noted moderate or significant improvement on the CGI scale. Pain decreased from 5.4 (3.9, 6.9) points to 2.4 (1.3, 3.6) (p <0.001) according to section 3 of TWSTRS scale, pain completely regressed in 15 (52 %) patients. BTA injections are highly effective and safe treatment of CD symptoms such as dystonic posture, pain and dystonic tremor. BTA injections in the neck muscles under EMGcontrol can improve outcome in patients with torticollis associated with dystonic head tremor.

The study revealed that in case of standard survey of patients with phyllodes tumors (PT), mistakes are made in 66 % of cases. The use of a sonoelastography and ultrasonography with contrasting allows avoiding errors in most cases. Long-term results of treatment correlate with the PT subgroup. Recurrence–free (overall survival) figures in case of benign PT are reliably higher than in case of malignant PT. Limited excision of the tumor is followed by highly frequent local recurrence in case of any subgroup of PT (30 %). Lumpectomy is also followed by highly frequent local recurrence that first of all concerns malignant PT (57 %). The main options for surgical treatment of malignant PT are breast amputation or a mastectomy.

Based on the conducted research (60 patients) and analysis of the literature of this topic, it is possible to conclude that endoscopic mucosal resection with submucosal dissection for early gastric cancer is a highly effective and safe method of radical organsaving treatment with high quality of life in the future, which allows to recommend this treatment for this pathology.

Visualization of prostate cancer remains an actual problem in urology and oncology. Purpose of the study – evaluation of prostate cancer visualization using 320-slice perfusion computed tomography (PCT). PCT results of 15 patients with suspected prostate cancer were evaluated. Studies were performed with the 320-slice spiral computed tomography Aquilion One (Toshiba, Japan). Perfusion of the prostate was calculated by the maximum gradient. Next, the areas of interest were placed on each perfusion map. For each of the areas of interest, the following indicators were calculated: the average blood flow velocity, normalized blood flow velocity, the difference of blood flow velocity in the contralateral areas of interest, the difference of the normalized blood flow velocity in the contralateral areas of interest. Differences between indexes depending on the results of histological examination for each area of interest were evaluated by the variance analysis and by pairwise comparison with the Tukey’s criterion. Statistical significance of differences was assessed by the specialized computer language R v 3.2, using pROC packets. Totally, 180 biopsies were obtained. 19 – prostate cancer Σ Gleason 6, 17 – prostate cancer Σ Gleason 7, 5 – prostate cancer Gleason Σ 8, 7 – inflammation, 121 – not pathological, 11 – prostatic intraepithelial neoplasia (PIN). The areas under the ROC curves for the studied parameters were: average blood flow velocity 0.6343, normalized blood flow velocity 0.5300, difference of blood flow velocity in contralateral areas of interest 0.5875, difference of normalized blood flow velocity in the contralateral areas of interest 0.6263. The results of our study shows low sensitivity of the method in detection of lowgrade prostate cancer.

Nowadays, treatment of paraproteinemic polyneuropathy is a fairly complex interdisciplinary process. The main method of therapy is still the use of chemotherapeutic drugs as means of pathogenetic treatment of the underlying disease. However, the use of chemotherapy with neurotoxicity can cause development of toxic polyneuropathy which increases neurological deficit. Any comprehensive neurorehabilitation program for patients with these forms of polyneuropathies have not been developed to date. The article presents data of clinical observations of 26 patients with paraproteinemic polyneuropathy which had undergone a course of neurorehabilitation treatment, both medical and nondrug technologies, including the methods of kinesiotherapy and physiotherapy.

The study focuses on comparison and analysis of the work of big stroke units in the Russian Federation and the People’s Republic of China specialized in the medical care for patients with acute stroke. 522 patients were surveyed in Russia’s and China’s regional stroke units. In the Russian Federation, patients being treated in the «City Hospital No.26» (SaintPetersburg) took part in the study. In China patients of the First Affiliated Hospital of the Chongqing Medical University, Central Hospital Jiang jin, Regional People’s Hospital Yubei district, Regional People’s Hospital Bishan (Chongqing Province). The analysis of differences was performed by the following parameters: personality traits, age, gender, level of education, income, health insurance category, profession, employment, professional activities over the last year, place of residence of the patient, features of the stroke, time during the first symptoms of stroke to hospitalization, kinds of medical services, the main risk factors and value of prevention before stroke.

We proposed predictive method of cervical intraepithelial neoplasia progression in women with chronic cervicitis, it is favorable one in routine clinical practice. Two groups of women with chronic cervicitis aged 22 to 52 years old with low (n = 36) and high (n = 21) degree of squamous intraepithelial lesions in accordance with the histological examination of cervical tissue were compared. The discriminant analysis helped to develop a risk prediction formula for progression of intraepithelial neoplasia. The variables are «age», «number of sexual partners», «number of births», «Streptococcus pyogenese», and «smoking history». The predictive value of the discriminant function on available data is 0.97.