The article is devoted to the first years of Soviet power, when there was a formation of the relationship between higher medical school and the Bolsheviks. Attention is given to carrying out the militarization of higher medical school in the early 1920s by Soviet authorities. It was the first attempt to reform the higher education for the purpose of building a new society. The experience gained by the People's Commissariat of Education in carrying out reforms, will be used in the mid-1920s, when the Bolsheviks begin to radically change higher education in the country.

Currently, there is a world-wide pandemic of a new viral infection — COVID-19. The Russian Federation ranks third in the world in the number of detected cases. In the context of the current pandemic, neurological departments are reassigned to infectious diseases departments, the routing of patients is changing, and patients with neurological symptoms are less likely to seek medical help because of the fear of SARS-CoV-2 infection. At the same time, early diagnosis of neurological diseases, including acute cerebrovascular accident, becomes even more complicated, and treatment standards are not always fully applicable. This situation further emphasizes the medical and social significance of neurological diseases. There is evidence that acute cardiovascular diseases can develop as a complication of SARS-CoV-2 infection and vice versa — preexisting cardiovascular diseases aggravate the course of COVID-19. The direct and indirect effects of the virus on the central and peripheral nervous system are discussed. Cases of necrotizing encephalopathy, Guillain-Barr syndrome, a clinical picture of skeletal muscle lesions associated with the COVID-19 infection are described. This article provides an overview of the available world literature on this topic.

Introduction. Under the conditions of circulatory disorders and coronary heart disease (CHD), amino acids acquire additional value as a source of intermediates of Krebs cycle, participating in cell energetics. If there is a disturbance of energy metabolism, the level of amino acids in the blood can change, including the minor non-encoding amino acid homoarginine (hArg).
The objective of this study was to compare the shifts in the levels of hArg and other amino acids in the venous blood flowing from the tissues of the heart and brain versus their levels in blood plasma from the cubital vein in patients with CHD.
Methods and materials. The study used plasma samples of 58 patients (46 men and 12 women) aged 62 (57 — 66) years with CHD and heart failure of functional class III (NYHA). The level of hArg and the spectrum of 22 other amino acids were determined by the reversed-phase high-performance liquid chromatography (HPLC). Besides, the levels of lactic acid (LA) were determined by spectrophotometric method, as well as routine biochemical parameters were determined using standard kits.
Results. Patients with CHD had compensated, without significant deviations, biochemical data of glucose level, lipid and nitrogen metabolism profiles. The level of hArg in the patient group of 1.4 (1.0—1.9) p.M was significantly lower compared to the reference interval, and the level of total homocysteine was increased, although there were no differences depending on the venous basin. The highest concentrations of LA, alanine and glutamine were detected in the plasma from the internal jugular vein. At the same time, lower concentrations of arginine, lysine and alanine corresponded to the lowest values of hArg.
Conclusion. In patients with CHD and heart failure, a significant increase in the levels of glutamine and alanine in plasma from the internal jugular vein and coronary sinus in comparison with plasma from the cubital vein was accompanied by profound dysregulation of energy metabolism with the decrease in hArg levels.

Introduction. The problem is actual due to the increasing of cystic fibrosis children quantity: according to neonatal screening, there were 124 children with cystic fibrosis in 2018 (72.9 % from all identified cases for the reporting year). Medical rehabilitation is the main method of the pathogenetic therapy and prevention of cystic fibrosis exacerbation. The new strategy of medical procuring for patients with orphan diseases, which is necessary to develop expert methods for diagnostics of rehabilitation potency and objectify individual rehabilitation programs, gives particular relevance to the problem.
The objective was the development of new rehabilitation programs for early aged children with cystic fibrosis, the search of efficiency assessment criteria.
Methods and materials. Physical and motor growth, clinical and functional parameters were estimated in 79 early aged children of main and control groups.
Results. It was proved that the weight index (absolute and relative), quantity of children with harmonic growth increased due to physical methods of rehabilitation while the quantity of children with acutely disharmonic growth reduced in main group. After applying the developed rehabilitation program, the formed motor skills amounted 83 — 92 % from age norm in the main group of children and 60 — 85 % in the control group. Normotonic reaction to physical activity after the physical rehabilitation program was registered in 73.2 % of the main group and 47.8 % of the control group. In dynamics, the rehabilitation efficiency coefficient amounted (1.68±0.10) in the control group of children and (1.97±0.14) (p<0.05) in the main group that could be corresponded as «improvement». That means the quality of clinical and laboratory shifts, dynamism of physical growth and development rate of motor skills is significantly higher in the main group of children.
Conclusion. The possibility of physical rehabilitation use in different rehabilitation programs of early aged children with cystic fibrosis was justified. The rehabilitation efficiency coefficient, the rehabilitation potential were offered, the effectiveness of chosen rehabilitation programs was proved.

Relevance. In the context of HIV epidemic, the number of cases of mycobacteriosis has increased.
The objective was to study clinical and laboratory characteristics of mycobacteriosis in HIV patients; to present a clinical case of severe generalized mycobacteriosis.
Methods and materials. Retrospective analysis of 48 cases from the archives of the St. Petersburg State Budgetary Healthcare Institution «S. P. Botkin Clinical Infectious Diseases Hospital» over the period from 2016 to 2018 was performed. The inclusion criterion was newly diagnosed mycobacteriosis. The following parameters were evaluated: HIV infection duration and stage; antiretroviral therapy (ART) duration; the primary syndrome and form of mycobacteriosis; laboratory and instrumental findings; causative pathogen verification methods.
Results. Median number of CD4-lymphocytes (CD4 + ) was 6.9 cell/pl. In 33.3 % of patients, HIV infection was diagnosed within 1 year before the detection of mycobacteriosis. The primary syndromes were: febrile-toxic syndrome (72.9 %), bronchopulmonary syndrome (29.2 %), diarrhea syndrome (18.8 %), abdominal pain syndrome (10.4 %). Generalized myco-bacteriosis was diagnosed in 65.3 % patients. Anemia was registered in in 96 % patients, leukopenia — in 43.8 % patients. Lymphadenopathy of various localization was the most common instrumental finding (75 %). The diagnosis was confirmed bacteriologically in 70.8 % cases. Mycobacterium avium complex group was predominant (62.5 %). There were 18.8 % deaths.
Conclusion. Mycobacteriosis developed in patients with advanced immunodeficiency. Clinical and laboratory findings were nonspecific. There was a trend towards generalization of infection. The proportion of deaths indicates the high importance of mycobacteriosis in the structure of mortality in HIV patients.

Relevance.The comprehensive assessment of cardiorespiratory coupling (CRC) for the diagnosis of functional adaptation in pulmonological patients is presented.
The objective of the study was to test the complex criteria of CRC for objective differential diagnosis of individual adaptive reactions of pulmonological patients.
Methods and materials. 30 volunteers without verified pathology and 31 patients with restrictive and obstructive disorders were examined. All subjects underwent physical examination with traditional routine method using spiroarteriocardiorhythmography (SACR) at rest and during performing functional tests with hypercapnia and moderate physical exercise.
Results. We proposed the methodology of integrated assessment of multicomponent system of CRC, which increases the diagnostic precision of SACR in the tasks of predicting the adaptive defects of the organism at different pulmonary syndromes.
Conclusion. Breathing with a fixed frequency normalizes the regulation of CRC, both in healthy and pulmonological patients. Moderate physical activity (80 W) modifies the indicators of CRC in pulmonological patients in comparison with the control group statistically due to disorders of the heart rate and circulation. During moderate physical activity, stroke volume (SV) statistically decreases in patients differently: SV were significantly lower in the group with obstructive disorders than in the group with non-obstructive disorders.

Relevance. Many young patients suffer from dental abrasion combined with hyperesthesia of teeth. This pathology is to be treated complexly. The first stage of the treatment is aimed at decreasing the hypersensitivity. This problem is usually solved by dental therapist who can face a problem of a desensitizing agent selection.
The objective was to evaluate the efficacy and convenience of using specific desensitizing agents at home in young patients with symptoms of hyperesthesia associated with generalized increased dental abrasion of the first degree of severity.
Methods and materials. Patients suffering from generalized hyperesthesia caused by increased abrasion of hard tooth tissues have taken part in this research. The patients were treated with one of four selected desensitizing agents at home. The efficacy, financial side and the convenience of each product were evaluated by using the questionnaire. Also, the efficacy of the treatment was also evaluated clinically.
Results. Clinical efficacy of the toothpaste containing arginine and gel with NaF (1.1 %) and gel based on nano-hydroxyapatite is approximately the same. The specific gel contained casein phosphopeptide-amorphous calcium phosphate is less effective.
Conclusion. The gel based on the nano-hydroxyapatite is the most effective and convenient specialized product for the treatment of hyperesthesia in patients with increased dental abrasion.

Charcot — Marie — Tooth disease belongs to a genetically heterogeneous group of monogenic diseases with a predominant lesion of the peripheral nervous system associated with predominant degeneration of the myelin sheath and/or axon of the motor and sensory nerves and spinal roots, accompanied by motor disorders and specific pain syndrome. The article presents a description of 2 clinical cases of patients (father and daughter), whose disease was manifested by chronically progressive weakness and atrophy of the distal limb muscles, reflexes reduction, foot and hand deformation, gait changes and sensory disorders. Genetic tests were performed to detect duplication/deletion of the PMP22 gene and the expansion of GAA repeats in the FXN gene, which yielded negative results. Based on complaints, neurological examination, family medical history and data of instrumental research (EMNG), we made a clinical diagnosis of the CMT with an autosomal dominant type of inheritance and a high degree of penetrance. At the department, patients received the infusion therapy (neurometabolic therapy, vitamin therapy), physical therapy courses according to an individual plan, physiotherapy and reflexotherapy with a moderate positive effect in the form of a subjective increase in muscle strength in the lower extremities, increasing walking stability and confidence. The article also highlights the peculiarities of the pathogenesis of different genetic variants of CMT and prospect for pathogenetic treatment of this disease.

Central pontine myelinolysis (CPM) is a concentrated, symmetric, non-inflammatory demyelination within the central basis pontis. In 10 % of patients with СРМ, demyelination also occurs in extrapontine regions: the mid brain, thalamus, basal nuclei, and cerebellum. Demyelination occurs in regions of compact interdigitation of white and gray matter as a result of cellular edema, which is caused by fluctuating osmotic forces, results in compression of fiber tracts. The most frequent cause of abrupt change in osmotic pressure is the rapid sodium correction of prolonged hyponatremia. In case that we report, there is a combination of central pontine and extrapontine myelinolysis, which occurs in 71-year-old woman owing to rapid sodium correction of prolonged hyponatremia which by turn developed due to salt-free diet, improper antihypertensive therapy and overheating. The diagnosis was confirmed by magnetic resonance imaging (MRI). The treatment led to significant decrease of neurological deficit.