The article presents the results of the reorganization of the military-sanitary institutions of the Red Army and training of medical personnel in the first years of World War II. The main achievements of military surgeons, therapists, epidemiologists, military doctors-organizers to improve medical care during the war are specified. It is noted that the introduction of the principles of military-field medical doctrine and advanced scientific developments in the broad practice of military doctors has significantly reduced sanitary losses in the Red Army. Mass heroism and selfless work of medical workers helped to win the Great Patriotic War.

Myocardial infarction, stroke and venous thromboembolism, which are based on vascular thrombosis, are the leading causes of death in the entire world. Most often, these diseases develop with the aging of the human body. With age, changes in the hemocoagulation system occur, such as an increase in the level of fibrinogen, factors VIII and IX and other procoagulants without a proportional increase in anticoagulant factors, a decrease in the number of platelets and an increase in their activity, a decrease in the activity of fibrinolysis, and endothelial dysfunction develops. All this leads to an increase in the intensity of intravascular coagulation and the development of thrombosis.

Тhe study of CACNA1C gene expression is relevant both in the practice of a physician and cardiologist, as well as an obstetrician-gynecologist, in psychiatry, neonatology, and gynecological oncology. The clinical effects of impaired expression of the CACNA1C gene depend on its penetrance and can determine such clinical conditions as cardiac arrhythmias and conduction, up to the development of sudden death, premature birth, arterial hypertension or hypotension, autism, schizophrenia. The relationship between the decrease in CACNA1C gene expression in smooth muscles and the development of genital prolapse, as well as the symptom complex “weakness of the stromal-muscular component”: arterial hypotension, 22.6–30%, myopia — 40.6%, violation of heart rhythm and conduction — 64.2% (sinus arrhythmia — 12.3%. WPW syndrome — 12.3%, early repolarization syndrome — 10.9%, incomplete blockade of the right bundle of His — 28.7%, mitral valve prolapse — 88%, varicose veins — 39.5%, pelvic floor protrusion and relaxation — 50%, joint hypermobility — 48.8%, grade 2 scoliosis — 33%, flat foot 3 degrees — 73.8%, hypotonic intestinal dysfunction — 50–60%, asthenic body type (30%), tendency to muscular asthenia, tendency to functional isthmic ikalnoy deficiency during pregnancy (23%), rapid and swift childbirth (37.6%).
A study of the level of CACNA1C gene expression will help substantiate treatment tactics in a number of clinical conditions.

Introduction. There are reports of the effectiveness of taurine in patients with cardiovascular diseases. A wide range of this drug action due to its regulatory effect on various types of metabolism. However, there is no enough information about the possibility of taurine use in the treatment of patients with postinfarction cardiosclerosis (PIC).
Goal is to study the mechanisms of action and clinical efficacy of taurine in the treatment of patients with stable angina after myocardial infarctio.
Material and methods. 95 patients with PIC and exertional angina II and III functional class, which were randomized into 2 groups: the main group — 48 patients (65.8±7.2 years) to whom taurine was added to standard therapy (Dibikor, PIKPHARMA Russia, 750 mg/day); comparison group — 47 patients (63.6±6.9 years) who received standard therapy and placebo. The duration of treatment is 3 months, the duration of observation is 6 months. Evaluated the dynamics of clinical, instrumental and laboratory characteristics.
Results. It was found that the addition of taurine to basic therapy contributes to the treatment effectiveness of patients with PIC who have not undergone myocardial revascularization, which is manifested by significant improvements in indicators: subjective status (decreased fatigue, complaints of palpitations, dyspnea, frequency of strokes), echocardiographic parameters (an increase in the ejection fraction), bathmotropic and chronotropic functions of the myocardium (decrease in the number of ventricular and supraventricular extrasystoles, normalizing the variability of heart rate), lipid profile. It has been established that the use of taurine in the complex treatment of patients with PIC is safe and not accompanied by side effects.
Conclusion. Taurine is advisable to include in the complex treatment of patients with angina pectoris who have had a myocardial infarction in order to improve the myocardial inotropic function, enhance the antiarrhythmic and lipid-lowering effects of basic therapy. The recommended dose of taurine is 750 mg per day for at least 3 months.

Introduction. The increase of morbidity results from both an increase of life expectancy of the population, and influence of various risk factors contributing to development and increase of heart failure. The combination of several atherogenic mechanisms (abdominal obesity (AO), insulin resistance (IR), arterial hypertension (AH), hyperglycemia, dyslipidemia), combined as «metabolic syndrome» (MS), causes a more rapid development of CHF.
Material and methods. The research finding of 74 patients with class II–III of CHF, including 37 patients (50%) with MS, are presented. The age structure of the pathology, severity of clinical course, data of laboratory and instrumental examination in various groups of patients were evaluated. A special program included an echocardiographic test with an assessment of various myocardial parameters.
Results. Research materials find out a number of characteristics of CHF clinical course (its earlier development and severe course) in patients with MS. Echocardiographic tests reveal an increase of heart chambers sizes, thickness of left and right ventricle, pulmonary hypertension. Myocardium morpho-functional changes are more significant in patients with CHF and MS than in those without MS. An increase in leptin levels, a marker of obesity, fibrosis and inflammation, has been found. Leptin, CRP and high-sensitive troponin in patients with MS significantly exceeded those in patients with CHF. Correlations of leptin levels, adiponectin, CRP and left ventricular mass, thickness of epicardial fat (TEF), ejection fraction were established.
Conclusion. Materials of the research indicate the important role of inflammatory and dysmetabolic processes in development and progression of CHF in patients with MS.

We studied the carbohydrate metabolism in patients with chronic obstructive pulmonary disease (COPD) using glucose tolerance test (GTT) and were evaluated using this test to improve diagnosis of carbohydrate metabolism disorders (CMDS). Found that COPD patients with the exception of the risk factors listed in recommendations of who and the International diabetes Federation (IDF), GTT identifies NDU significantly more often than in the assessment of glucose of blood plasma on an empty stomach, this confirms the hypothesis put forward earlier by the authors of this work about the significant role of COPD in the pathogenesis of CMDS and in particular type 2 diabetes mellitus (DM2). This indicates the appropriateness of assigning COPD to the risk group for DM2, and, consequently, performing GTT in this cohort of patients. At the same time, GTT is a simple and fairly informative method of diagnosing CMDS and can be used as a screening method regardless of the fasting blood glucose level. It was also found that the prevalence of glucose tolerance disorders is much less common in Western Europe than in Eastern Europe, which is close to the values of our data.

106 patients with axial spondylarthritis (SpA), 98 patients with knee joints osteoarthritis (OA) and 136 patients with rheumatoid arthritis (RA) are included in research. At all patients are investigated polymorphism of cytokines genes TNFА (rs361525, rs1800629 rs1800630), IL1β (rs1143627), IL4 (rs2243250), IL6 (rs1800795), IL10 (rs1800872, rs1800872), IL17(rs2275913, rs763780), vascular endothelial growth factor gene VEGF (rs3025039, rs699947), matrix metalloproteinases genes MMP2 (rs2438650), MMP3 (rs3025058), MMP9 (rs3918242). Genetic attributes which meet various frequency among patients with RA and which are never revealed in group of SpA or OA patients, and alternative attributes which in one case are not revealed among patients with RA, and frequently come to light among patients with SpA or OA are allocated. These attributes alternativeness allows to use them with a high degree of reliability as additional laboratory criteria of the differential diagnosis at early stages of joints diseases development.

Goal. Evaluation of the effectiveness of combined indirect revascularization in the treatment of critical ischemia in patients with occlusive stenotic lesions of the arteries of the foot, lower leg and thigh.
Material and methods. The analysis of the comprehensive examination and treatment of 40 patients with chronic critical ischemia of the lower extremities of stage III as a result of atherosclerotic lesions of the femoral-popliteal and ankle-foot segments was carried out. Patients according to the treatment technology were divided into 2 statistically homogeneous groups of 20 people each. Patients in the first group underwent standard lumbar sympathectomy, and patients in the second group underwent combined treatment.At the first stage, sympathectomy was performed, and at the second stage, after 2–3 months, bone marrow autologous cells were transplanted with the total volume of 48 ml from 10 points along the inner and from 10 points along the outer surface of the thigh and lower leg and from 4 points on the foot in each intertarsal space. Bone marrow cells were harvested from the ilium. The effectiveness of treatment after 7 days, 6 and 12 months was evaluated by the dynamics of the rheographic, ankle-brachial, photoplethysmographic indices, the distance of painless walking, and after 6 and 12 months - by the clinical status and quality of the life patients.
Results. In patients of the second group, compared with the first after 12 months, the arterial blood flow and microcirculation were significantly higher: rheographic index — 0.26, ankle-brachial index — 0.2, photoplethysmographic — 7.1%, painless walking distance — by 32 m. The use of combined treatment made it possible to achieve clinical status in the form of moderate and minimal improvement after 6 months in 19 (95%), and after 12 months in 18 (90%) patients, whereas after performing standard sympathectomy in 16 (80%) and in 10 (50%) patients, respectively.In the remote period, after 12 months, the limb was saved in the second group in all 20 (100%), and in the first group in 17 (85%) patients. In patients of the second group compared with the first after 12 months, a statistically significant increase in the physical component of health by 8.2% was revealed, and the mental component of health by 5.1%.
Conclusion. Combined indirect revascularization can normalize microcirculation in the ischemic limb and achieve positive dynamics of the disease.

Nowadays, according to WHO, about 350 million people worldwide suffer from chronic obstructive pulmonary disease (COPD). It takes second place among all not infectious pathologies according to world statistics. The place and socio-economic significance of COPD in the structure of pulmonological pathology in the Rostov Region was determined. The necessity of correct interpretation of the concept of COPD, application of uniform diagnostic criteria, standardization of epidemiological and economic researches necessary to assess the true damage caused by this disease is confirmed.

Individualized medicine is developing conception of modern medicine which aimed for overcoming of weakness of evidencebased medicine. Genetic tests weren’t able to improve outcomes of overwhelming majority of diseases. The role of patient’s interests and position, optimal physiological parameters, physiology of symptoms, comorbidity, psychosomatics, environment, chronomedicine, and prognosis in optimal treatment of patient are discussed in the article.

Since the emergence of the profession of a surgeon, as one of the most complex and dangerous types of activities, there have been various norms and rules governing the behavior of doctors. In the process of development of medicine and society, the control of the surgeon’s actions, including ethical and moral standards, religious and regulatory legal acts, changed, passing from the death penalty to full release from liability for failure in treatment or in the event of the patient’s death. Public and state control over the doctor’s activities led to a gradual improvement of the legislation, however, even now new aspects of medical activity that need legal regulation are emerging.