This review provides research data on drugs made on the basis of polypeptides isolated from different animal organs. They initiated the development of drugs of a peptide origin. Besides, a group of pharmaceuticals (peptide complexes), created at the Military Medical Academy named after S.M. Kirov (Thymalin, Epithalamin, Cortexin, Prostatilen, Retinalamin) under the supervision of V.Kh. Khavinson in the 80–90-ies of the 20th century has been described. At present, pharmacologists focus on isolation of short di-, tri-, tetrapeptides, identification of their primary structures and subsequent synthesis from amino acids (Thymogen, Vilon, Pinealon, Vesugen, Epitalon, Bronchogen, Cardiogen, etc.). The results of cutting edge investigations of peptide influence on various functions of an organism, gene expression and protein synthesis have been presented. A molecular mechanism of a peptide-DNA interaction has been depicted. Short peptides have been revealed to regulate gene expression, protein synthesis, chromatin state and promote telomeres elongation. Peptides regulate targeted differentiation of pluripotent cells and decrease their replicative ageing. Animals administered with peptides showed a decreased tumor incidence, normalized melatonin level and an increased average life span. To summarize the above, it is worth noting further prospects of studies aimed at creation of novel drugs on the basis of short peptides with targeted regulation of certain gene groups and protein synthesis which underlies the development of pharmacogenomics as fundamentals for future therapy.

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

The progressing system sclerosis (PSS), M34.0 according to IСД-10 — an autoimmune disease with characteristic spastic vascular reactions as Reynaud’s syndrome and obliterating endarteritis with ischemic violations at which the specific frustration which are followed by activation of a fibrosis and excess adjournment of collagen in fabrics develop. The progressing current of PSS leads to development of irreversible fibrous changes of skin, the musculoskeletal device, internals (lungs, heart, a digestive tract, kidneys), to malfunction of bodies, an disability of patients with the general bad forecast of a disease. Thanks to modern therapy severe damage of kidneys, meets at PSS more rare and changes in lungs in a clinical picture come to the forefront. Early diagnostics of PSS and the differentiated approach to treatment of a disease can change the course and prognosis of the disease considerably.

Gastric cancer is one of the most common malignant neoplasms in humans. Helicobacter pylori (H. pylori) infection, high salt intake, low consumption of fresh fruits and vegetables, and smoking are a few best-known risk factors for gastric cancer. Back in 1965, Lauren P.A. proposed to clasify gastric carcinomas in three histological types: intestinal, diffuse, and mixed. This classification is still relevant nowadays, allowing to predict the surgical intervention extent, chemotherapy regimen and the course of the disease. This paper reviews mixed-type gastric carcinomas, which, in comparison with other types, is characterized by senior age (over 65 years) of the patients, a larger tumor size, pronounced local tumor invasion, and a high frequency of metastasis found both in the lymph nodes and in other organs, which determines the relevance of this topic. The search of literature was performed using Scopus and Web of Science databases in PubMed platform, Elibrary was used for the search among articles in Russian. Further in-depth studies of the mixed-type gastric carcinoma in the context of its morphological histological tumor components, as well as the oncogenesis mechanisms are necessary, because they may help in diagnosing the tumor in its early stage and in predicting the outcome more accurately and choosing the appropriate management strategy, that is, determining the extent of the surgical manipulation and further drug therapy, taking into account tumor molecular characteristics and its PD-L1 status, which in the long run will significantly affect the five-year survival of the patients.

Vasopressin and its receptors play a key role in maintaining homeostasis in physiological and pathophysiological conditions. As a result, the vasopressin system has become an important target for both diagnostic and therapeutic use in a number of diseases. Kopeptin, C-terminal part of vasopressin prohormone. Copeptin has come to be seen as an important marker for identifying high-risk patients and predicting outcomes for various diseases. This improves the clinical value of commonly used biomarkers and risk stratification tools. The area that could benefit most from the introduction of the copeptin measurement in practice is cardiovascular disease. Determination of the level of copeptin becomes a fast and reliable method of differential diagnosis, especially in acute coronary syndromes. A special role in the diagnosis of acute myocardial infarction (AMI) is given to the combination of copeptin and troponin. According to available sources, such a combination eliminates AMI with very high sensitivity and negative predictive value. Moreover, elevated levels of copeptin correlate with poorer prognosis, and a higher risk of side effects after AMI, especially in patients with heart failure.

Due to the high efficiency of glucagon-like peptide-1 (GLP-1) receptor agonists therapy in only a part of patients, the search for predictors of response to the treatment is a relevant problem.
Purpose. The purpose is to compare the efficacy of liraglutide and exenatide therapy in obese patients with type 2 diabetes mellitus (T2DM) and to evaluate the predictors of response to glycated hemoglobin (HbA1c), weight and lipids reduction.
Material and methods. The study included 47 patients with type 2 diabetes and obesity who received GLP-1 receptor agonists therapy. 26 patients were treated with liraglutide, 21 patients were treated with exenatide. We measured the parameters of carbohydrate and lipid metabolism, the levels of hormones involved in glucose and lipids metabolism and in appetite regulation. Blood pressure was measured. These parameters were evaluated at baseline and after 24 weeks of treatment.
Results. Patients receiving exenatide therapy showed a tendency towards more frequent HbA1c level reduction by 1% or more (60% versus 30.4%, p = 0.07). The effects of liraglutide and exenatide on weight and waist circumference were comparable. When assessing the predictors of response to the therapy, a more pronounced decrease in HbA1c level (by 1% or more) was in the patients with a higher initial HbA1c level (8.7 (8.2; 9.7) versus 8.2 (6.9; 8.7)%, p = 0.04), as well as with a higher initial GLP-1 level (0.12 (0.05; 0.17) versus 0.040 (0.01; 0.09) ng/ml.) A more significant decrease in the triglycerides (TG) level was detected in patients with a higher level of glucose-dependent insulinotropic peptide (GIP) before therapy (409 (316.0; 431.4) pg/ml in patients who reduced TG level by 30% or more and 331.5 (324.9; 367.1) pg/ml in patients with a lower decrease in TG level). Among the studied parameters, no predictors of body mass reduction were revealed.
Conclusion. Measurement of HbA1c, GLP-1, GIP level may be useful to predict the efficacy of GLP-1 receptor agonists therapy.

Multiple endocrine neoplasia type 1 (MEN-1) is the most common cause of the hereditary type of primary hyperparathyroidism (PHPT). If a family type of PHPT is suspected, a dynamic monitoring of patients and their close relatives should be carried out throughout their lives. We present a clinical case of a family in which four members of a pedigree were diagnosed with familial isolated hyperparathyroidism (FIHP). The diagnosis was changed to MEN-1, because it appeared that one of the patients had pancreatic neuroendocrine tumor. Molecular genetic study of MEN1 by direct by means of Sanger sequencing revealed that six family members had a new heterozygous mutation in exon 9: s. 1252 G> T p. D418Y.

The mechanism of development of neuropsychological disorders and the assessment of predictors of their development in patients with multiple sclerosis (MS) are insufficiently studied. Prediction of comorbid depression in this category of patients is of great interest and is aimed at personalized medical care for patients with optimal personal and environmental adaptation of the patient with MS.
Objective. To study the predictors of the development of depressive syndrome and to develop a mathematical model for predicting comorbid depression in patients with multiple sclerosis living in the northern region.
Material and methods. A standard neurological examination was conducted in 149 patients with reliable MS who lived in the northern region, including an assessment of the severity of MS disability on the EDSS scale. All patients underwent neuroimaging (magnetic resonance imaging — MRI) of the brain and spinal cord. The Beck Depression Scale was used to identify depressive disorders.
Results. The prevalence of depressive disorders in patients with MS in the studied population of patients in the northern region was 35%. In terms of severity, the identified comorbid depression ranged from subdepression to moderate depression. According to the results of the study, it can be stated that the predictors of the development of comorbid depressive disorders in MS are signs of brain atrophy; chronic intoxication (tobacco smoking and alcohol abuse); foci of demyelination (the semi-oval center, corpus callosum); neurological symptoms in the form of paresis, paralysis, cerebellar symptoms (nystagmus); presence of frontal dysfunction (phonetic associations, selection reactions simple and complicated).
Conclusion. Comorbid depressive manifestations in MS patients living in the northern region occur in 35% of patients and are a multidisciplinary problem. In order to reduce the effect of depressive manifestations on the main symptoms of the disease, adherence to therapy and improve the quality of life indicators in patients with MS, it is necessary to influence neurological symptoms and psychological state, paying special attention to the prevention of depression in these patients.

To evaluate possibilities of aspirin-induced gastroduodenopathy treatment in the patients with chronic ischemic heart disease by means of applying the internal endogenous prostaglandins stimulant.
 Material and methods. 340 patients suffering from chronic coronary heart disease and receiving a long-term acetylsalicylic acid (ASA) therapy were examined on the base of the cardiovascular care unit of The Nizhny Novgorod Regional Clinical Hospital named after N.A. Semaschko. There were evaluated frequency, nature and severity of the aspirin-induced gastroduodenopathy. The patients with coronary heart disease and aspirin-induced gastroduodenopathy were divided in two groups. In the first group of patients there was applied rebamipide therapy (in a single daily dose 300 mg) in combination with the proton pump inhibitor (PPI) — pantoprazole. In the second group there was applied only pantoprazole therapy. For the purpose of specification of AIG pathogenetic mechanisms development, all the examined chronic coronary heart disease cases were tested on the prostaglandin E2 (PGE2) level in blood serum before the therapy beginning and after the treatment. The control group was formed of chronic coronary heart disease patients showing no AIG evidence. Statistical processing of the received data was fulfilled with the program «Statistika 10.0».
Results. AIG was registered in 15% out of 340 chronic coronary heart disease patients. According to the endoscopic examination erosive disease of the body and antrum prevailed among the patients. The PGE2 level in the blood serum was significantly lower (р = 0,00087) in these patients in comparison with the control group. In association with PPI and rebamipide mixed therapy, esophagogastroduodenoscopy results showed no pathological findings in gastrointestinal mucosa and statistically significant (р = 0,00067) blood serum PGE2 level growing in all the treated patients. As a result of exclusive PPI therapy there was marked positive dynamics in endoscopic view in 19 out of 25 patients and a tendency to normalization of PGE2 level in the blood serum. However, PGE2 level growing was insignificant.
Conclusion. The presented research demonstrates the possibility of AIG treatment with the use of internal endogenous prostaglandins stimulant — rebamipide in complex with proton pump inhibitor PPI therapy.

Russian medical science has made a significant contribution to solving complicated and important problems that faced with medical service of the Armed Forces of the USSR during the Great Patriotic War. The forms of organizing the scientific activities of scientists in the interests of the front were different. First of all, the following should be noted. This is the unification of the efforts of medical scientists of the country in the work of the Academic Medical Councils under the Chief of the Main Military Sanitary Directorate of the Red Army and the Chief of the Medical-Sanitary Directorate of the Navy, as well as the Scientific Medical and Hospital Councils of the USSR People’s Commissariat of Health. The plenary meetings of these authoritative scientific bodies dealt with the most important problems of medical evacuation, sanitary and hygienic and antiepidemic support, discussed new methods for treating the wounded, the results of the medical service’s activities during this or that period of the war, its new tasks, etc. Focusing on the leading scientists Representatives of all major healthcare sectors, the councils had been contributing to the development, testing and implementation of the latest achievements in medical science in practice.