[From the history of the buildings of the Mandryka Central Military Clinical Hospital].

The article deals with the history of the complex of buildings of the Mandryka Central Military Clinical Hospital located in Moscow's Serebryany and ArivoniKilsply lanes. Famous historical figures, physicians and writers whose names are associated with the buildings of the hospital are listed. In 2014, the Moscow government commission decided to recognize the architectural monuments of the building of the surgical hospital and the income house of MD S.M.Rudnev and the inrnmp hnus of A. R.Lednitskv. currently Dart of the architectural ensemble of the hospital.

[Children's department and child care institutions of the Central military, hospital of People's commissariat during the Great Patriotic War].

The article presents historical data about paediatric health care delivery and escort of children of the Command of the Red Army during their evacuation from Moscow in 1941. Data on foundation of kindergartens of People's commissariat in 1942-1943, their support and foundation of children's department in the hospital is given. Special subdivision governed by the head of child care institutions of the hospital was formed for managing child care institutions.

[REGRESSION OF ATHEROSCLECROTIC LESIONS: MEDICAMENTAL AND ALIMENTARY FACTORS].

The article reports results of clinical studies aimed to elucidate the influence of medicines on the size and density of atherosclerotic plaques in the walls of coronary and cerebral arteries. The phenomenon of regression of atherosclerotic lesions in the survivors of Leningrad siege during a long period of starvation is analyzed. The influence of inhibitors of angiotensin-converting enzyme on apoptosis of smooth muscle and foam cells of atherosclerotic plaques in the sanological mechanisms of atherosclerosis is discussed. The concept of natural regression of atherosclerosis is formulated and the necessity of development of the methods for is pharmacological activation are formulated.

[SELFLESSNESS OF BESIEGED LENINGRAD: PROBLEMS OF MOTHERHOOD AND CHILDHOOD (ON THE OCCASION OF THE 72ND ANNIVERSARY OF LIFTING THE SIEGE)].

A review of documents on the peculiarities of obstetric and gynecological care in besieged Leningrad is presented with special reference to the data about the number of children born during blockade and their health status in the first months of life, the work of maternity hospitals, their number and personnel. The term «military time amenorrhea¼ coined during blockade is discussed.

[HISTORY OF THE NAVAL MEDICAL ACADEMY].

The article presents information on the history of the Naval Medical Academy (NMA), the preconditions of its creation, the composition of the faculty of Naval Department of the 1st Leningrad Medical Institute, of the 3rd Leningrad medical Institute andfirst teachers of NMA.

[E.S.BOTKIN, A SPECIMEN OF FIDELITY TO PROFESSIONAL DUTY AND OATH OF LOYALTY, AN EXAMPLE OF COURAGE AND HONOUR OF THE RUSSIAN DOCTOR].

Evgeny Sergeevch Botkin, son of the legendary Russian internist Sergey Petrovich Botkin, was a court physician for Tsar Nikolai II. After Nikolai abdicated the throne on 15 March (2 March in the Julian calendar) 1917, E.S. Botkin felt it was his duty to accompany the Romanovs into exile to Siberia and continued to selflessly treat the crown prince Aleksey, other members of the Romanov family and all those who applied for his advice. He was shot together with the Romanovs in the basement room of the Ipatiev house, Ekaterinburg, remaining loyal to professional duty and the word given to the Emperor.

[A new light on professional fitness expertise of patients with highly curable arrhythmia after hi-tech methods of treatment].

The peculiarities of a clinical course, results of pharmacological and interventional treatment in 447 patients with noncoronary cardiac arrhythmias were analyzed. A definition highly curable cardiac arrhythmia is introduced. The high efficiency and safety of the method of radiofrequency ablation in patients with highly curable cardiac arrhythmias that allows soldiers to leave the military service, as well as to enter military service under the contract. Proposed implementation of the control medical examination to conduct endocardial electrophysiological study and the subsequent medical examination to determine the category of fitness for military service not earlier than 6 months after surgery.

[Successful correction of congenital heart defects: multiple defects and atrial septal aneurysm].

A case of congenital cardiac disorder with multiple defects in the secondary interventricular septum and atrial septum aneurysm in a young serviceman is reported. Plastic surgery of the atrial septum with a good clinical outcome included closure of the defect with a flap harvested from the autopericardium under conditions of artificial blood circulation and warm blood cardioplegia.

[The Central Military Hospital of the People's Commissariat for Defence during the Great Patriotic War].

The article is devoted to activity of the Central Military Hospital of the People's Commissariat for Defence during the Great Patriotic War. The research is based on declassified orders of PCD and orders of the chef of hospital. Authors presented the role of the hospital in organization of medical aid for officers of PCD, members of their families, Red Army soldiers, junior and senior Red Army commanders; the role of the hospital in organization of medical facilities for combat army; medical supply for evacuation of family members of PCD's officers ( en route and in evacuation places); delivery of child health care to children of officers of PCD in the hospital and education in kindergartens of PCD.

["1st Therapeutic Red Cross Hospital" during the civil war].

The article presents the documentary information about the founding, the establishment and early years of the 1st Therapeutic Red Cross Hospital - in the future - Mandryka Central Military Clinical Hospital of the Ministry of Defence of the Russian Federation. Presented the work of the Hospital during the dificult period of the Civil War, typhus epidemic, famine and devastation. Specified its staffing structure, command, medical and administrative staff, travel and accommodation till the moment of the deployment in the Silver Lane in Moscow.

[Possibilities for targeted therapy of neuroendocrine tumours].

The treatment of patients with neuroendocrine tumours and hormonally active distant metastases traditionally included surgical removal of the primary neoplasm, embolization of metastases in the liver, therapy with somatostatin analogs and interferon-alpha to prevent excessive production of regulatory peptides (carcinoid and other endocrine syndromes). Patients with neuroendocrine pancreatic tumours were also treated with alkylating chemotherapeutic drugs including streptosocin and temozolomide. The results of such treatment are far from being satisfactory. Recent progress in the treatment of such patients is due to radiotherapy using somatostatin analogs. Moreover, large-scale randomized studies demonstrated the effectiveness of targeted preparations acting on receptors of vascular growth factors and ripamycin target inhibitors ofmammals. Results of the studies on comparative effectiveness of targeted drugs for combined therapy of neuroendocrine tumours are presented.

[The role of insulin resistance in pathogenesis of arterial hypertension].

Arterial hypertension (AH) is a major challenge facing modern medicine. High frequency of AH patients with excess body mass and disturbances ofcarbohydrate metabolism is attributable to their common pathophysiological mechanisms underlain by insulin resistance and resulting compensatory hyperinsulinemia. The authors review modern concepts of AH development in patients with insulin resistance associated with enhanced blood insulin level and increased production of catecholamines playing an important role in AH pathogenesis mediated through sympathetic stimulation of heart, vessels while kidneys. Insulin resistance contributes to AH largely by activating sympathoadrenal system while increased glomerular filtration of glucose is accompanied by its back absorption together with sodium in proximal tubules. It results in hypervolemia and enhanced content of sodium and calcium in vascular walls which leads to their spasm and a rise in the total peripheral vascular tension (TP VT). Insulin promotes fibroblast proliferation and vascular smooth muscle cells via stimulation of tissue growth factors and collagen synthesis in atherosclerotic plaques. The concomitant narrowing of the vessels further increases TPVT. It in turn decreases renal blood flow and thereby activates renin-angiotensin-aldosterone system and development of AH.

[Coronary calcinosis. State-of-the-art].

Atherosclerosis and coronary heart disease are the main causes of disablement and mortality in most developed countries. Clinical studies showed the relationship between coronary calcinosis and atherosclerotic lesions, the calcinosis area accounting for roughly 1/5 of the atherosclerotic plaque area. Calcinosis is quantitatively characterized by the calcium score determined by multispiral and electron-beam computed tomography. High calcium score suggests an increased risk of cardiovascular complications. Their treatment awaits further assessment since a number of studies revealed differential effect of various medicines on coronary calcification.

[24-hr monitoring arterial pressure in outpatients with cardiovascular risk factors in the Far North].

AIM: To study peculiar features of daily AP rhythm and profile in men with cardiovascular risk factors residing in the Far North. MATERIALS AND METHODS: The study included 115 servicemen divided into 3 groups (hypertensive disease (HD), hypertonic type neurocirculatory asthenia (NCA) and risk factor of cardiovascular diseases other than AH). HD was diagnosed based on multiple AP measurements and 24-hr monitoring. RESULTS: HD was associated with elevated mean AP, load indices and AP variability All patients had pathological type of morning dynamics. Normal daily rhythm of systolic AP (SAP) was documented in 66.1% of the patients with HD and in 68% with cardiovascular risk factors without AH. Normal daily rhythm ofdiastolic AP (DAP) was recorded in 63.5% of the patients with HD and in 72% with cardiovascular risk factors without AH. In group 2, normal daily rhythms of SAP and DAP were found in 44 and 56% of the cases respectively. CONCLUSION: Men residing in the Far North under conditions of anomalous photoperiod need medicamentous correction of AP regardless of AH type. Ambulatory BP monitoring should be preferred for the assessment of the efficacy of antihypertensive therapy.

[Clinical significance of pointed medicamental and non-medicamental therapy in the staged combined treatment of radiculopathies].

We analysed the results of the treatment of 4205 patients with different forms of vertebrogenic radiculopathy. They suggest the efficacy of differential application of graduated medicamental therapy, reflexo- and physiotherapy depending on the period of clinical course of the disease.