The article is devoted to attempts of understanding the historical development of educational institution the «Pavlov First Saint Petersburg State Medical University» for more than 100 years of its activity.The author particularly describes the first tries of inner historical researches into the development of the medical institute, with use of archive, museum materials and especially different anniversary publications. In conclusion, the author notes that only the period of 1897–1917 is sufficiently analyzed. Later history of the university still awaits its extensive study.

Understanding genetic mechanisms and detection of biological markers of tumor growth forms an individual molecular phenotype of
transformed cells that characterizes stage of tumor, the ability to metastasize, hormonal sensitivity, chemotherapyefficiencyetc. Mutations in proto- and anti-oncogenes controlling mitotic activity of cells and their ability to DNA reparation are often found in tumor cells in patients with cancer. Defects of classical tumor suppressor genes (BRCA1/2, CHEK2, ATM, PALB2, NBS1, TP53, etc.) determine the hereditary predisposition to breast cancer caused by genomic instability and appearance of «chimeric» genes, aneuploidies and chromosomal aberrations. Breast cancer is a genetically heterogeneous disease with various molecular, biological and clinical features. Identificationof the molecular phenotype of breast carcinomas is an important prognostic factor of the disease, and it helps to individualize the therapeutic approach for patients.

Obesity has negative impact on female reproductive health. Various medical conservative and surgical interventions have been used to improve the reproductive function in obese women. In this literature review, we featurethe main modern methods of treating obesity in order to restore reproductive function in women.

Relevance. The use of inhaled glucocorticosteroids (IHCs) is one of the main basic treatment options forbroncho-obstructive diseases.
IHCs suppress chronic inflammation in the bronchial tree, but can be associated with the risk of pneumonia due to impairment of bronchus mucosal immunity and increased microbial colonization in the mucosa.

Aim. The aim of this study was to evaluate the incidence and risk factors of pneumonia during the IHCs therapy in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and with combination of COPD and asthma.

Materials and methods. The retrospective study included patients with confirmed COPD, BA and combined COPD and asthma. The endpoint of this analysis was the incidence of pneumonia. Potential additional risk factors (age, gender, smoking, diagnosis, duration of the disease) were analyzed.

Results. A total of 220 patients with broncho-obstructive pathology were included in the retrospective analysis. 184 patients received IHCs. 34 patients obtaining the basic therapy with IHCs developed pneumonia with a cumulative incidence of 36 % after 10 years. The primary diagnosis, gender, age and smoking did not significantly impact the risk of pneumonia.

Conclusions. IHCs therapy is associated with a risk of pneumonia, which should be taken into account when planning long-term control of broncho-obstructive pathology.

Relevance. In recent years, adipokines are considered as participants of pathogenesis in bronchial asthma (BA). The vast majority of studies on adipokines is based on the study of plasma (systemic) levels of adipokines. Studies of the influence of adipokines at the local, organ (lung) level are sporadic but extremely important. However, the available literature contains no research on the content of apelin – this newly discovered adipokine – in sputum.

The aim is to detect the presence of two isoforms of apelin: apelin-12 and apelin-36 in BA in the target organ (in sputum) and to establish their possible participation in the pathogenesis of the disease.

Materials and methods. 13 patients with bronchial asthma (BA) with different variants of the disease were examined. Sputum was obtained naturally (without induction). The sputum levels of apelin-12 and apelin-36 were determined by an enzyme immunoassay kit of «Human Apelin 36 ELISA Kit» (Cusabio, China), «Human Apelin 12 ELISA Kit» (Cusabio, China).

Results. In the sputum of patients with BA, both investigated apelins were identified: apelin-12 and apelin-36, but there were no significant differences between the levels of these apelins in allergic BA and non-allergic BA. Strong negative correlations of the apelin-12 level in sputum with volumetric values of external respiratory function (ERF) were revealed, as well as positive correlations between the apelin-12 level and the color index, mean erythrocyte volume. These two groups of correlations point to possible involvement of apelin-12 in the regulation of gas exchange, transfer of oxygen by erythrocytes, formation of a hypoxic state. Correlations of different directionality of apelin-36 in sputum with indicators of external respiration function in allergic BA and non-allergic BA have been revealed. In BA, there are inverse correlations between the levels of the apelins: apelin-12 with a relative amount of sputum eosinophils, and apelin-36 with a relative amount of sputum neutrophils.

Conclusions. The assumption is made on the predominantly paracrine function of the apelins (not associated with the endocrine function) in BA. It is assumed that the isoforms of the apelins, having opposite in their directional correlations in different variants of BA, may apparently participate as a protective regulator in respect of a number of processes underlying allergic and non-allergic inflammation.

Relevance. Diffuse toxic goiter (DTG) is an autoimmune thyroid disease, which is based on the excessive secretion of autoantibodies to thyroid-stimulating hormone receptor (TRAb). Over the last decades, high relapse rate of thyrotoxicosis is observed after withdrawal of conservative therapy. At the same time, there are no reliable criteria to predict the efficiency of drug therapy. It is widely discussedin literature that singlenucleotide polymorphism (SNP) at cytokine-encoding genesnot only confers susceptibility to the DTG, but also has impact on the features ofclinical course of the disease .

The aim of this study was to determine whether the SNPs in -572C/G (rs1800796) of IL6 or -1112C/Т (rs1800925) of IL13 genes can influence thedevelopment and clinical course of the diffuse toxic goiter (DTG).

Materials and methods. We examined 270 patients with diffuse toxic goiter and 200 healthy persons (reference subjects)with the help of molecular genetic analysis of polymorphic variants of the gene encoding the Pro-inflammatory cytokines. Identification of C-572G of IL6 gene and C-1112T of IL13gene was performed using the PCR method followed by the restriction analysis.

Results. We determined that the carriage of -572G allele of the rs1800796 in IL6 gene isassociated with the growth of recurrence risk of thyrotoxicosis and the absence of remission of DTGin 1.3 times (р=0.031, OR=1.3, 95 %, CI 0.98–1.76) and the carriage of CC genotype of the rs1800925 in IL13 – in 2.3 times (р=0.026, OR=2.3, 95 %, CI 1.09–4.82) respectively. The obtained results allowed to revealnew genetic markers of an adverse course in patients with diffuse toxic goiter, Saint Petersburg residents.

Introduction. Pseudoexfoliative syndrome (PEX) changes the morphological structureof corneathat can affects its biomechanical properties. These properties affect the results of the intraocular pressure (IOP) measurement.

Purpose of the study isto estimate the effect of PEХ on the error in intraocular pressure measurement (IOP) with Maklakov tonometer in relation to properties of the cornea.

Materials and methods. The main group – 126 patients with PEХ, reference group – 104 patients without PEX. The main estimated indicator is the difference between the levels of IOP measured by the Maklakov tonometer and Pascaltonometer and coordination between two methods. Pascal tonometer was used as a reference one.

Results and conclusions. The difference between the levels of IOP in the groups was unreliable. When measurements are made with Maklakov tonometer, PEX does not causethe significant tonometry error associated with properties of the cornea.

Introduction. Particularities of personality of a sick person play an important role in providing effective treatment and prevention of relapse in various pathologies. Therefore, the position of the patient in relation to his/her health and ongoing treatment, as well as to doctors and auxiliary medical personnel are important factors in the success of rehabilitation.Parafunctions of masticatory muscles, which are understood as an impractical inappropriate activity, are known to be often found. They are poorly amenable to treatment and very painful for patients. The use of psychopharmaceutical and psychotherapeutic methods aimed at changing the patient’s attitude to the disease can help to cure such dental patient. This can change the patient’s response to the disease and create realistic settings for treatment. At the same time, the study of the attitude of dental patients to the disease is practically not covered in the accessible domestic and foreign literature.

The purpose of study is researchthe attitude to the disease of adults suffering from various forms of parafunctions of the masticatory muscles.

Material and methods. The work was carried out to study the attitude of 29 adults suffering from various forms of parafunctions of the masticatory muscles to the disease. To determine the type of attitude to the patient’s disease,we used the TOBOL clinical test method (type of attitude to the disease), which implements the clinical and psychological typology of patient attitude and provides for the possibility of defining one of the twelve types of responses.

Results. It was found that before treatment, regardless of age in individuals suffering from parafunction of the masticatory muscles,there were more common types of attitude to the disease, in which the observed maladaptive behavior with predominantly intrapsychic oriented response to the disease manifested the characteristic reactions of the type of irritable weakness, anxiety, depressed and oppressed condition. The performed complex treatment with the use of complex dental treatment and preventive measures, physical therapy exercises and antispasmodic of skeletal muscles allowed to achieve treatment efficiency of 95.8 %. Thus, it changed patients’ inadequate response to the disease, eliminated significant signs of mental maladjustment, as well as createdrealistic attitude to treatmentin patients, helped to restore broad social relations and active participation in treatment.

Conclusions. The obtained data about the type of attitude of patients with such chronic, severe and painful pathology as parafunct ions of masticatory muscles are of practical value, as the achievement of a positive therapeutic result and successful rehabilitation are possible only if the patient’s attitude toward the disease changes, especially in the second and third types in the framework of the test «Type of attitude towards the disease» (TOBOL), therefore the involvement of a clinical pharmacologist or psychiatrist is necessary for rehabilitation of such patients.

Introduction. Numerous studies have established the role of psychological factors in the development, treatment, prognosis of the cardiovascular diseases, as well as in formation of compliance and the quality of patients’ lives. However, few of any psychological studies of patients with chronic heart failure (CHF) waiting for transplantation were carried out, despite the obvious need for reliable psychosocial assessments in the preoperative period and development of psychological support programs. In view of the foregoing, a pilot screening study aimed at assessing the state of the cognitive and affective spheres, personal characteristics of patients with CHFwaiting for the HTas wellanalyzing the relationship between psychological, medical and biological characteristics of patients.

Material and methods. 30 patients withCHF took part in the study at theFederal State-Funded Institution «Federal Almazov North-West Medical Research Centre» (Saint-Petersburg). The authors’ structured interviews and psychodiagnostic methods were used in the study: «The index of well-being», (WHO, 1999), «The Brief Neuropsychological Cognitive Examination» (BNCE), «The Zung Self-Rating Depression Scale» (SDS), «The State-Trait Anxiety Inventory» (STAI), «Test the Big Five» (BIG V). Statistical data processing was performed using the Mann–Whitney U criterion and the Spearman correlation (SPSS v. 20.0).

Results. Absence of violations of cognitive functions was revealed in 23 % of respondents, mild degree of cognitive deficiency – in 60 %, average degree – in 17 %. The lowest average scores were obtained in the BNCE subtests, reflecting the success of active attention, visual-spatial memory, psychomotorics, abstract thinking.The average group index of depression was 45.9±7.2 (normative level). A detailed analysis showed that absence of signs of depression occurred in 74 % of patients, subdepression – in 23 %, moderately expressed depression – in 3 %. In the entire sample, the average level of situational anxiety prevailed (42.4±6.8) with personal anxiety (39.7±8.1). According to the averaged scales of the BIG V questionnaire, moderately pronounced extroversion features predominated in the patient’s personality structure. The relationship between BNCE indices and duration of chronic HF (r = –0.676, p <0.001) was revealed. A statistically significant reduction in the overall level of cognitive function in patients with concomitant diabetes mellitus was found in comparison with patients without it (U = 61) at p = 0.033; According to the data of SDS depressive symptoms in patients with IHD are more pronounced in comparison with patients with dilated cardiomyopathy U = 47 (p = 0.019).

Background. This study contributes to theon-going University research of personal characteristics, self-regulation features and professional self-determination among junior medical students in order to develop an effectivecomplex system of psychological support.

The purpose of the study was to find psychological criteria that could be significantly prognostic for academic success in the Univercity. Psychodiagnostic tests (Big Five P.Costa, R.McRae; State – Trait AnxietyInvertory, method of V. I. Morosanova, Style of Self-Regulation Test) and special Survey have been used to study professional self-determination, personal characteristics and self-regulationfeatures. Grade Point Average (GPA) for the study duration,calculated as the ratio of the sum of all ratings for number of passed objects, number of sessions without debts and the existence of debts were taken as academic success criteria.

Materials and methods. The study involved 697 the 3rd year students of «Pavlov First Saint Petersburg State Medical University». Psychological testing of these students were conducted twice (during the first and the third years of education). The first year psychological test results have been used to search the role of psychological parameters in academic success prognostic criteria.

Results. Lower situational anxiety and ability to program, evaluate and plan actions have been found significant in predicting higher grade point average; lower self-regulation of behavior, lower organization, conscientiousness and extraversion – in predicting expulsion from the University. Further development. It is important to use the study results in order to develop programs of psychological support and individual approach to students with lower intellectual and personal resources at the beginning but who still would like to complete education.

Conclusions. The received results demonstrate the necessity for further in-depth and consistent study of correlation between psychological variables and academic success, and further search for academic success prognostic criteria.