[Organisational aspects of medical support for civilians employed in the Armed Forces in the military-medical institutions of the Ministry of Defence, deployed in Moscow].

Organisational aspects of medical support for civilians employed in the Armed Forces in the military-medical institutions of the Ministry of Defence, deployed in Moscow. To ensure social protection of the civilian personnel of the Armed Forces is one of the main tasks of the Ministry of Defence of the Russian Federation. In Moscow formed a territorial system of medical support of citizens who have the right for medical care in military medical institutions of the Ministry of Defence of the Russian Federation. Russian legislation does not provide the right for medical assistance provision to the civilian personnel of the Armed Forces in military medical institutions at the expense of funds allocated from the federal budget for the maintenance of the Ministry of Defence of the Russian Federation. The function of the physician in providing primary medical care performs primary care physician. Providing medical assistance to the civilian personnel of the Armed Forces of the Russian Federation in military medical institutions on the basis of their attachment to the clinics onlv the Russian Defence Ministrv. or in the direction of the clinics of Moscow.

[Polyclinic of the Branch N 6 of the 3rd Vishnevskiy Central Military Hospital celebrates the 40 years anniversary].

Polyclinic of the Branch N 6 of the 3rd Vishnevskiy Central Military Hospital celebrates the 40 years anniversary. The history of development^of the policlinic of the branch N 6 of the Federal Government Budgetary Institution <> of the Ministry of Defence, which dates back to 1976, when the 9th clinic of the Moscow garrison was formed. Over the years, repeatedly changed the organizational and staff structure and the name of the clinic (9" consultative-diagnostic polyclinic, polyclinic of the 52,d Consultative Diagnostic Centre MF), continuously improved patient care technology. Currently, the clinic deployed 26 medical-diagnostic branches and offices, with more than 200 employees. Among them, 1 Honoured doctor, 5 candidates of medical sciences, 50% of doctors and 65% of nurses have the highest qualification category. To health care is more than 22 thousand people.

[Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)].

The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people.

[Opportunities for diagnosis and treatment of nocturnal hypoxia in outpatient clinic].

Sleep disordered breathing is an important medical and socio-economic issue. A lot of evidence exists for the impact of sleep apnea on the pathogenesis of cardiovascular diseases, occupational injuries, as well as all-cause mortality. Detection of this type of pathology is challenging due to the complexity and high cost of the procedures. The nocturnal polysomnography was considered as a "gold standard" in the management of any sleep disorders for a long time. However, the development of technology simplified diagnostic equipment and make it possible to diagnose sleep disordered breathing in outpatient department. In this article we reviewed 3-phase approach to the diagnosis and treatment of sleep apnea. Also we describe our own cost-effective experience of implementing of screening examination for sleep apnea in outpatient clinic, using the continuous pulse oximetry monitoring.

[Antihypertensive therapy in the elderly patients with metabolic syndrome].

The article is concerned with modern methods of assessment of arterial hypertension in patients with metabolic syndrome and characteristics of modern antihypertensive drugs and its combinations necessary for the elderly. The authors gave their own example of treatment of more than 2000 patients with arterial hypertension and metabolic syndrome.

[Aspects of anaesthetic practice of modern ambulatory surgery].

Authors analyzed and generalized experience of 2910 anaesthetic supports, performed at the Branch 6 of Vishnevskiy 3rd Central Military Clinical Hospital of Russian Federation Defense Ministry during 2010-2012 in case of outpatient surgery such as endoscopic examinations (gastrofibroscopy, colonoscopy), gynecological support, dental care, ORL-surgery, urologic surgery, diagnostic and treatment arthroscopy. Authors gave information about preoperative, intraoperative and postoperative aspects of outpatient anaesthesia.

[Improvement of pharmaceutical benefits for military retirees in outpatient care].

For the purpose of improvement of pharmaceutical benefits for military retirees was designed the drug usage standard. This standard consists of 216 drug titles and is utilized in outpatient care in case of consistency. Monthly outpatient care costs for one military retiree are more than 900 rubles. New procedural and institutional mechanisms, ways of interdepartmental interactions, rational forms of its organization are necessary for the improvement of the effectiveness. These measures correspond to main principals of reorganization of the system of health care.

[Correction of anxiety and psychosomatic disorders in a clinic for former combatants].

Psychological personality disorder among former combatants and their relationship to subsequent psychosomatic disorders are examined. For this purpose, in health centers performed clinical and psychological examination of 105 fighters and 100 military personnel who were not taking part in hostilities (control group) aged 27 to 40 years, three groups are outlined: low (24.7%), moderate (64.8%) and high (10.5%) anxiety level, represented by their clinical characteristics. Studies have shown that combat stress can contribute to postreaktive change not only the psyche combatant, but also the development of persistent psychosomatic disorders. The methods and results of treatment and preventive advice are given.

[About the advantages of endovenous laser coagulation of subcutaneous veins].

From February 2007 to March 2010 42 operations concerning the varicose vein disease of lower limbs with magistral valvate inefficiency at the stage of chronic venous insufficiency with the usage of endophleboid laser congelation were performed in clinical outpatient conditions. Diode lasers with wave-length 980 nm. The period of temporary disablement was 14,5 days, after the standard combined phlebectomy with cirsotome--19,5 days. The complications after endophleboid laser congelation in the form of hematomas, burns, sense shock, thrombophlebitis weren't recorded.

[Molecular genetic determinants of intraspecific polymorphism of the phytopathogenic fungus Cryphonectria parasitica].

The review summarizes the current evidence on the phytopathogenic fungus Cryphonectria parasitica, which is a classic object for studying hypovirulence. Phenotypic manifestations of hypovirulence and themolecular mechanisms of action of the mycovirus Cryphonectria hypovirus (CHV) infecting the fungus are described in detail. Genetic determinants of vegetative incompatibility in C. parasitica (a phenomenon increasing polymorphism of the fungus and preventing CHV expansion) are considered. The data on C. parasitica polymorphism are correlated with the data on the distribution of different CHV species in the European, American, and Asian populations of the fungus.

[Some aspects of outpatient care in the modem world].

The problems of improvement of outpatient care are considered, methodology of more active implementation of hospitalization technologies, the use of day care, hospital at home is proposed. It is emphasized that the introduction of hospitalization technology makes it less than treatment in hospital costs to improve quality of life for huge numbers of patients.

[Perspectives of improvement of outpatient surgical care in the Armed Forces].

The article presents experience of work of surgical units of the 52nd consultative-diagnostic center of MD RF in ingrafting stationary-staying technologies. In the hospital there were realized all necessary conditions for effectuating a wide range of operations of heightened for policlinic level complexity (hospital register). There is a day patient facility, firstly created in medical service of the Armed Forces in 1989. In general during 2003-2008 yy. were effectuated 11724 operations. Were proposed to create territorial centers of ambulatory surgery under big military policlinic institutes, were determined there sphere of duties and principes of functioning.

Tenoten in the therapy of anxious disturbances in patients with essential hypertension and coronary heart disease.

The study demonstrated high anxiolytic activity of tenoten, which was not inferior to the anxiolytic effect of grandaxin. The positive changes persisted after termination of treatment in the tenoten group (but not in grandaxin group). Tenoten can be recommended for the treatment of patients with cardiovascular diseases associated with neurotic disturbances.

Separation and characterization of deoxyribonucleases from hepatopancreas of freshwater snail in normality and under in vivo model intoxication.

Deoxyribonucleases (DNases) differing in the subcellular localization and specificity towards native and denatured substrates and in products of cleavage of endogenous DNA were isolated for the first time from the hepatopancreas of freshwater snail by differential sedimentation and preparative isoelectrofocusing. It was defined found that treatment with phenol leads to activation of most of the investigated DNases, especially in lysosomes, and induces two new DNases of lysosomal origin. The possible different participation of certain DNases of the snail hepatopancreas in the regulation of DNA degradation under intoxication is discussed.

[Effect of industrial toxic pollutants on the activity and isoforms of acid DNase in the freshwater snail (Viviparus viviparus L.)]. / Vliianie toksichnykh soedinenii tekhnogennogo proiskhozhdeniia na aktivnost' i mnozhestvennye formy kisloi DNKazy zhivorodki rechnoi (Viviparus viviparus L.).

The effect of various toxic compounds (phenol, gasoline, detergents, halogenated benzenes, and copper salts) on the activity and multiple forms of acid DNase was investigated in the liver of the widespread freshwater snail species Viviparus viviparus L. Characteristic variations in the specific activity and isoform pattern of the enzyme depending on pollutant concentration and exposure time were revealed. It was shown that the pattern of DNase isoforms in V. viviparus could be an index of water pollution.

Acid phosphatase complex from the freshwater snail Viviparus viviparus L. under standard conditions and intoxication by cadmium ions.

Acid phosphatases differing in both subcellular localization and substrate specificity were isolated for the first time from the liver of the freshwater snail Viviparus viviparus L. by preparative isoelectrofocusing. One of five characterized phosphatases is highly specific to ADP and the others can hydrolyze (at variable rate) a series of natural substrates. A scheme is proposed for the involvement of the studied phosphatases in carbohydrate metabolism. We have also studied some peculiarities of the effect of Cd2+ in vitro and in vivo on the activities of individual components of the acid phosphatase complex and corresponding changes in metabolism of the freshwater snail as a new test-object allowing the estimation of toxicity in water.

[Neurotransplantation in the treatment of Parkinson disease: follow-up]. / Neirotransplantatsiia v lechenii bolezni Parkinsona (katamnez).

The paper presents the results of follow-up of 11 patients with Parkinson's disease (PD) after neurotransplantation (NT) of fetal brain dopaminergic suspension into the caudatus and putamen on one or two sides. All the patients were clinically assessed at least 3 months before and during a follow-up (for as long as 9 years) in accordance with the Core Assessment Program for Intracranial Transplantation (CAPIT) by a Russian group of the Network of European CNS Transplantation and Restoration (NECTAR) Programme by using the Unified Parkinson's Disease Rating Scale (URDRS). An analysis of clinical findings showed that: 1) there was a slight amelioration in bradykinesia, rigidity, and smaller dosage of L-DOPA; 2) tremor and drug-induced dyskinesia remained unchanged; 3) subsequently (till 9 years), the clinical effect slightly decreased in almost all patients with PD and in some of them the clinical status became worse than that prior to surgery; 4) repeated NT (2 cases) in the striatum contralaterally did not improved the situation; 5) only neurostimulation of subcortical structures improved clinical results. So we can conclude that NT alone cannot be beneficial and requires additional interventions at the subcortical level.

[Gene and gene cellular therapy and neurodegenerative diseases]. / Gennaia i genno-kletochnaia terapiia i neirodegenerativnye zabolevaniia.

The modern methods of the treatment of the neurodegenerative diseases are considered. Neurodegenerative diseases originate due to the degeneration of the neuronal cells of central nervous system that leads to imbalance of the neurotransmitter synthesis and, as a consequence, movement disorders and mental disabilities. Traditional methods of pharmacotherapy and neurosurgery give short-term effect. Since 1980 neurotransplantation was developed as a new technology for the treatment of the neurodegenerative diseases. This approach represents a case of cell therapy being used for transplantation of the human fetal material. Cell transplantation compensates the local deficiency of the neurotransmitter level by substitution of degenerated neurons of patient's brain (e.g. dopaminergic neurons). Gene-cell conjunction of cell therapy with modification of genome of transplanted cells is the most perspective approach to increase an efficiency of neurotransplantation. Short description of gene therapy approaches and a search for optimal gene-cell protocols for therapy of neurodegenerative diseases are presented in this paper.

[Use of neurotransplantation in the treatment of Parkinson's disease]. / Ispol'zovanie neirotransplantatsii v lechenii bolezni parkinsona.

The outcomes of transplantation of the human embryonal mid-brain into the striatum of patients with Parkinson's disease are presented. For this, a procedure for obtaining, isolating, preparing the human embryonic midbrain, as well as a method for stereotactic administration of embryonal nerve tissue suspension having high dopaminergic neuron levels into the patients' striatum are specified. Patients underwent neurological examinations by the international protocol Core Assessment Program for Intracerebral Transplantation including monthly video recording within 3 months before and 3-24 months after surgery. Electrophysiological, neuropsychological, and immunological examinations were made at the same intervals. Most patients had positive dynamics: diminution of the severity of main disease symptoms, reduction in the efficiency of a single dose of DOPA-containing drugs, decrease in the magnitude of side effects of drug therapy.