The investigation was carried out at the bases of Hospital № 40 and of the Health Protection Department of I.P. Pavlov St. Petersburg State Medical University. The authors analyze the scope of the ambulatory medical aid for the patients with leiomyoma of the uterus provided in the system of obligatory medical insurance in St. Petersburg. The scope of the ambulatory aid for the mentioned patients significantly varies in different districts of the city - the fact to be taken into consideration.

The authors have analyzed the results of the City Psychosomatic Centre (CPSC) activity in 2009-2011 ys in order to find out the most important trends in the clinical work that may be helpful in planning of management and prophylaxis. The methods applied were statistical and clinico-statistical analyses of the results of of the Center work in 2009-2011 ys. There were changes in the structure by increasing the incidence of diseases associated with stress and organic damage brain with mental disorders, showed an increase in the flow of male patients. Found that the average length of stay in bed in the center of psychosomatic inpatient unit was 9.2-9.7 days, which creates barriers to good practice the use of antidepressants. Overcoming of these challenges can be achieved through the formation of new forms of continuity between the departments of the psychosomatic center, the health center and the offices of St. Petersburg SHCI «Alexander's Hospital,» and other medical institutions of the city.

To define the risk factors of myopia development among the students the authors got acquainted with spreading of the pathology among the students and their parents. 313 students of Tuimaizy medical college (at the age of 16 to 22 ys) and their parents (n = 579) participated in the study. Attention was paid to the internal factors (heredity, family atmosphere, quality of life) and to the external factors (the life, intensity in studying) -the factors promoting development of myopia. Special psychomedico-pedagogical commission has been organized for better health protection of the organ of vision in teenagers in Tuimaizy medical college.

The authors studied the extent of chronic diseses and of pathological conditions in the working people in on district of the Leningrad region using the data of prophylactic examination. The analysis showed that practically all people (90.4 % of the examined people) had chronic diseases: 26.3 % of the people had one pathology, 29.6 % had two diseases, and 34.5 % of the people had three and more pathologies. The women were more vulnarable than the men to three and more pathologies (40.2 % and 22.2 % of the cases respectively. The data obtained should be the basis for planning of the scope of preventive, curative and diagnostic measures for the working population.

Alzheimer's disease is a well-known neurodegenerative disorder. One of its main risk factors is age. Due to a worldwide increase of human longevity Alzheimer's disease became the most common form of dementia. The disease has been studied in different countries for many decades but still its etiology remains unclear. By now there is no cure for Alzheimer's, moreover there are no that can at least slow down the disease progression. In this review we made an attempt to summarize all current studies of the most advanced drugs for Alzheimer's.

The aim of the work is to improve the diagnostics of spinal AVMs. For the proper diagnosis of Foix-Alajouanine syndrome the speed of progression and the dynamics of the spinal focal neurological signs, as well as the volume of the spinal lesion should be taken into account. Evaluation of the results of additional methods of investigation: spinal MRI, spinal MR angiography, MR-tractography, etc. is also needed. Selective spinal angiography remains the optimal diagnostic method for spinal AVMs. The treatment must include anticoagulants and surgery.

A comparative clinical and psychopathological examination of psychotic manifestations in the patients of three groups - with schizophrenomorphical disorders in the late period of craniocerebral trauma (35 patients) with schizophrenia (33 patients), and with a combination of schizophrenia and TBI (32 patients). Marked clinical and diagnostic evaluation criteria allow to differentiate the hallucinatory-delusional disorders within shizophreniamorphical disorders in traumatic disease of the brain from an equal psychopathology in schizophrenia. Particular issues of treatment and prognosis are highlighted.

The aim of the research was to improve the results of treatment of severe craniocerebral traumas by development of the scientifically based technology of surgical management of various intracranial hematomas using modified crowned cutters of different diameters. Comparative analysis of the surgical treatment of the patients with craniocerebral injuries in the main group and in the control one showed clinical and practical efficiency of the modified structures of the crowned cutters in the surgical treatment versus the traditional cutters - 50 % shorter time of the bone stage craniotomy in the main group, 4.3 % lowered blood loss, and 14.7 % shorter period of hospitalization.

The aim of our study was to identify the most significant biological markers characterizing the behavior of the tumor and to forecast its clinical course and to specify an individual therapy regimen for each patient.

In contrast to the empirical anti-hypertensive therapy, the targeted antihypertensive therapy was combined with the earlier (6 months) and more pronounced approach of the lipid content of blood and magnesium to those in healthy individuals of appropriate temperament and anxiety; lower was the proportion of people with the areterial hypertension complications.

Experimental alimentary obesity leads to significant structural changes in the liver of rats. Structural changes in the parenchymal cells are accompanied by functional strain in the capillary-connective tissue structures, and by disorders in the blood circulation and lymph drainage in the liver.

The paper presents the results of evaluation of the pathogenetic relationship between atherosclerosis and functional abnormalities of the bile outflow. The main group included 54 patients with cardiovascular pathology and biliary dyskinesia. The group of comparison consisted of 20 patients with chronic coronary artery disease. The results suggest that the functional bile outflow abnormality is a risk factor of atherosclerosis progression leading to hypercholesterolemia and dyslipidemia, and should be considered in the development of integrated approaches to prevention and treatment of the diseases caused by atherosclerosis.

The authors have studied the effect of phosphatidylcholine (lecithin) - a derivative of choline - on the biological properties of streptococus pneumonia. The concentration of lecithin 0.01 g/l in a simple nutrient broth has a stimulating effect on proliferation, on in vitro stabilization of the population, and on pathogenic properties of the pneumococcus. Four - five times passaging of the strains on this medium (as opposed to the commonly used 20 % serum broth) retained the species and the typical properties of pneumococcus, but led to increased capsule formation, increased virulence and expressed β-hemolytic activity. These results suggest that phosphatidylcholine (lecithin), as the main supplier of pneumococcus growth stimulant - choline, has an expressing impact on the capsule formation - the main pathogenic factor, and on the substance of P-teichoic acid in the cell wall of pneumococcus that specifically interacts with the C-reactive protein.

The porphyrins produced by Propionibacterium acnes exhibit an orange-red fluorescence under UVA light. Our experience with treatment of 20 patients with different forms of ames has shown effectiveness of the external antibacterial therapy with the aid of the fluorescent photography of the skin.

The aim of the research was to define severity of atopic dermatitis (AtD) in the patients with hepatobiliary pathology. 221 patients with AtD were under investigation. 51 of them had associated biliary dyskinesia, 45 patients had chronic viral hepatitis (CVH) without replecative kinesis, 65 patients had chronic viral hepatitis (CVH) with replecative kinesis, and 50 patients had no hepatobiliary pathology. The results obtained showed marked effect of the hepato-biliary system pathology on the severity of the AtD pathology. The patients with biliary dyskinesia have a lichenoid kind of AtD and patients with deep-rooted viral hepatitis have an eczematous kind of AtD.

Apolipoprotein A-I is a key structure protein of antiatherogenic high density lipoproteins (HDL). The aim of the study was to investigate the relationship between (-75)G/A and 83C/T polymorphic variants of apolipoprotein A-I gene (APOA1) and the plasma lipid profile in the population of Saint-Petersburg. Allele T83 of APOA1 gene was found to be associated with the reduced risk of atherosclerosis development among Saint-Petersburg inhabitants. The study demonstrates that allele T83 of APOA1 gene is associated with higher plasma HDL cholesterol levels (p<0.02) and with reduced atherogenic ratio (p<0.02) in the population of Saint-Petersburg. Antiatherogenic role of allele T83 is related to the influence of 83C/T polymorphic variants of APOA1 gene on the plasma lipid profile.

The aim of the study was to find correlation between COMT gene alleles and the target precision of the athlete movement. 68 Russian competing athletes involved in boxing and volleyball, participated in the study. We found interrelation between COMT Met allele and a tall stature in the volleyball players.

The purpose of this study was to evaluate the capabilities of sonoelastography to monitor neoadjuvant chemotherapy of breast cancer and to determine correlation between reduction of stiffness of the tumor and the grade of pathology response.

The paper presents the follow-up results of the mini-access surgery for chronic calculous cholecystitis (72 patients) and for calculous cholecystitis (133 patients) performed 3-6 years ago. The long-term results were estimated on two international questionnaires of quality of life (SF-36, GSRS), and on the data of clinical, laboratory and instrumental methods of investigation. All patients operated on for chronic calculous cholecystitis had good long-term results. 99.3 % of the patients with acute calculous cholecystitis had good and satisfactory results of surgical treatment. Only 1 (0.7 %) patient had an unfavourable result, because of choledocholithiasis, identified 2 years after surgery.

The experience in application of the new generation of polypropylene mesh with PLA resolved hooks has been analyzed. These prostheses need no supplementary fixation with suture. Our experience confirms their positive clinical efficacy - the reduction of the time of operation, the safety of the use, goods immediate and remotes results.

The inflammatory periodontal diseases (IPD) take the second place after caries of teeth therefore the questions of treatment and prevention of IPD are especially actual. In the IPD treatment are the most effective, it is possible to allocate the surgical methods. In the present article questions of improvement of traditional techniques of surgical treatment, and also development and deployment of the new are considered.

The principles of competent approach in the teaching of the medical university students in the disease prevention and healthy lifestyle are given in the article. For the formation of competence in the disease prevention and healthy lifestyles the pedagogical integral technology is used, developed by integrating content and disciplines of the medical education and Physical Culture. Further formation of competences in the preventive medicine and healthy lifestyle is being accomplished through the project method of teaching based on active projects. Advantages of the assessment of the competence of the medical university students in disease prevention and healthy lifestyle in the form of an authentic representational portfolio are given in the article. Modern assessment activity in education is focused on personal achievements of students, which may be reflected in different versions of portfolio. Authentic assessment is the most convenient and reliable in the case of the competence assessment, since it focuses primarily on the practical results of activity takes into account and promotes initiative, personal potential of the student, provides an opportunity to see the results and to obtain an assessment of achievements, allows not only to generate individual educational trajectory, but also to monitor the level of development of the educational content. The article reveals the content of the authentic representational portfolio and provides recommendations on its design and evaluation.

The article presents the literature review of current conception of development, etiology, pathogenesis, clinical manifestations and management of discoordination in labor activity. Special attention is payed to the clinical course of the labor and its outcome and for morhpofunctional features of the myometrium in this category of patients.

The frequency of breast tumors has been studied in inbreed C3H-A mice with affected thyroid status. It has been shown that frequency of breast tumors was significantly higher in the animals with hyperthyroid condition versus the hypothyroid group (р<0.01). The development of tumors was found on the 21, 29, and 36 weeks of the experiment for hyperthyroid, euthyroid, and hypothyroid, groups correspondingly. The frequency of breast tumors was 86.6, 62.5 and 30.0 % for hyperthyroid, euthyroid, and hypothyroid, correspondingly, at the end the experiment. Throughout the experiment the frequency of breast tumors in hypothyroid group was significantly lower as compared to the frequency of breast tumors in euthyroid and hyperthyroid as well. Morphological study elucidated the changes in ovary of mice with hyperthyroid status. The profound atrophic changes of the gland structures, absence of generative function, chronic inflammation, and development tubular adenoma were detected in the ovary of the hyperthyroid mice. In some animals the mammary glands were affected by malignant transformation characterized by development of glandular epithelial complexes as clear outlined tubes. It could be suggested that those tumors represent ductal adenocarcinoma. The data clear prove the idea that hyperthyroid condition triggers development of breast tumors.

Examined 12 patients with gliomas of the big hemispheres of a brain. Used immunoenzyme method for semiquantitative determination of the level of autoantibodies to NR2A-subunit of NMDA- and GluR1-subunit of AMPA-receptors of glutamate. All patients were performed positron emission tomography of the brain with 2 radiopharmaceuticals: 2-[¹⁸F] fluoro-2-deoxy-D-glucose and L-[methyl-¹¹C]-methionine. Features of alteration of NMDA- and AMPA-receptors of a glutamate and sequence of changes of a metabolism in a perifocal zone in gliomas of the cerebral hemispheres are studied. It is shown pre-emptive increase the level of autoantibodies to GluR1- subunit of AMPA-receptors of glutamate in patients with gliomas, current with epileptic syndrome.

The syndrome of professional burning out is a complex of symptoms and signs evidenced in various negative psychic conditions at individual, interpersonal and organizational levels. It is formed owing to a long mismatch between the requirements of the professional environment and the resources of the expert. Analysis of the preventive and correctional programs as a psychological assistance showed insufficiency of such approach. Creation of preventive and correctional programs within psychological maintenance from the position of involution of professional resources, taking into account the theoretical - methodological basis (the concept, the purposes, tasks, system approach, criteria of efficiency) and the subjective-personal resources of counteraction directed at activization to burning out at all stages of professional development is progressive.