Purpose of the study. Studying the dynamics of growth factors (GF) in urokinase (uPA)-deficient mice with chronic neurogenic pain (CNP) and B16/F10 melanoma.

Materials and methods. Levels of VEGFA, VEGFC, sVEGFRl, sVEGFR3, IGF1, IGF2, TGFp1 and FGF21 were determined by ELISA in tumors, perifocal tissues (PT) and the skin of male and female С57 BL/6 mice (with a normal genome, n = 75) and C57BL/6-Plautm1.1BugThisPlauGFDhu/GFDhu mice (uPA-deficient animals, n = 46) at 3nd week of the carcinogenesis and CNP.

Results. The skin of intact uPA-deficient mice demonstrated higher GF levels than in C57BL/6 mice, but VEGF-А and TGF-p1 in males (unlike females) were 4.4 and 5 times lower than in C57BL/6 males. This changes were generally similar in the skin of C57BL/6 mice with CNP. uPA-deficient females showed elevated GF in PT, especially VEGF-А and IGF1 — by 21.5 and 8.1 times, respectively in simultaneously CNP and growth of the melanoma. uPA gene-knockout males had similar changes in GF, although less marked. The levels of all studied GF in tumor tissue were lower than levels in PT in both males and females, except for VEGFA in males — 5.6 times higher in tumor tissue. Changes in PT of C57BL/6 mice were similar: maximally increased levels of all GF, especially VEGF, IGF and TGF-p1 — in females on average by 6.2, 15.9 and 5.5 times, respectively, in males by 9.4, 5.9 and 6.7 times, respectively, compared to the skin levels. While the absolute values of GF concentrations and the intensity of changes were higher than in uPA-deficient mice.

Conclusion. In general, skin levels of GF in intact uPA-deficient mice were similar to the levels in mice without uPA-deficient with CNP. The GF dynamics was analogous in mice of both lines at simultaneously CNP and growth of the melanoma, but the intensity of changes in mice without uPA-deficient was significantly higher implying a synergic effect of CNP and paracrine influence of melanoma on the GF levels.

Purpose of the study. Studying the components of the cascade of plasminogen (PG) regulator in the skin of intact uPA (urokinase plasminogen activator) gene-knockout mice and in a model of chronic neurogenic pain (CNP).

Materials and methods. The study included 76 mice divided in groups depending on the gender, presence or absence of uPA gene knockout and CNP. A CNP model was created by sciatic nerve ligation; levels and activity of components of PG activation cascade were studied by ELISA using standard test systems.

Results. Intact uPA-deficient C57BL/6-PlautmI.IBug-ThisPlau6FDhu/GFDhu mice differed from C57BL/6 mice by a decreased level of PG regulators, excluding plasmin in all mice, PG in males and urokinase receptor (uPAR). uPA-deficient mice with CNP showed continuing decrease in levels of plasminogen regulators, except for uPAR in all mice, PG in males and the activity of plasminogen activator inhibitor-1 (PAI-1-act) in females.

Conclusion. Almost the entire cascade of PG regulators was inhibited in intact uPA-deficient mice of both genders, compared to C57BL/6 animals, except for uPAR in females, PG in males and plasmin in all animals. In CNP, PG regulators in uPA-deficient mice were inhibited compared to the background, excluding uPAR in males and females. The comparison with C57BL/6 mice demonstrated that the CNP model resulted in the uPA system state very similar to that in intact uPA-deficient C57BL/6-PlautmI.IBug-ThisPlau6FDhu/GFDhu animals. In C57BL/6 mice with CNP, levels of uPA were reduced by 2 orders of magnitude, relative to the norm, with the almost complete depletion of uPA activity. uPA gene knockout results in a persistent suppression of the system of PG regulators which is practically not affected by CNP, except for the uPAR level, and causes changes similar to that in the CNP modeling in normal mice.

Purpose of the study. To analyze the treatment long-term results of patients with cervical cancer (CC) depending on the clinical and morphological characteristics of the disease.

Patients and methods. 75 patients with stage I cervical cancer at the age of 21 to 76 years, were included in this retrospective study. All patients have been operated at the first stage of treatment in the Orenburg Regional Clinical Oncology Center from 2008 to 2013. Patient data was obtained from patient card and the "cancer-register". The statistical analis of the results was performed using the Statistica 6 software.

Results. Recurrence of disease was detected in 7 patients and 7 patients died after treatment. 5-year relapse-free survival (RFS) and overall survival (OS) were 90,3%. 5-year RFS was: 95.2% and 66.0% — in depth of invasion of 10 mm or less and more than 10 mm (p=0.0004); 94.4% and 89.5% — in stages IA and IB (p>0.4) and 80.6% and 97.6% — in the presence and absence of adjuvant radiation therapy (p=0.002), respectively. 5-year OS was: 96.7% and 47.0% — in depth of invasion of 10 mm or less and more than 10 mm (p=0.00001); 97.0% and 84.2% — in stages IA and IB (p=0.07); 80.6% and 97.6% — in the presence and absence of adjuvant radiation therapy (p=0.02), respectively. There were no recurrence in 11 patients with IB stage, who did not receive adjuvant RT and, but ones were observed in 6 patients with stage IA — IB, who received the adjuvant RT.

Conclusion. These results indicate that the use of only clinical and morphological factors is not sufficient to accurately assess of the CC prognosis and the search for new markers of the CC recurrence risk has not lost its relevance.

Purpose of the study. The purpose of the study was to assess the level of seroprevalence and the frequency of detection of serological markers of acute herpesvirus infection in patients with PGBT in comparison with those in patients with chronic non-tumor diseases.

Materials and methods. Before conducting antitumor therapy, the blood serum of 42 patients with PGBT (the main group) was studied. The comparison group consisted of 137 patients with chronic non-tumor diseases. Antibodies of classes M and G to herpes simplex virus types 1, 2 (HSV-1,2), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpes virus type 6 (HHV-6) were determined by ELISA using JSC "Vector-Best" reagent kits.

Results. Among patients with PGBT, seropositive for HSV-1,2 were 95.2%, CMV — 92.9%, EBV — 100%, HHV-6-40.5% of patients. No statistically significant differences in seroprevalence and the presence of markers of acute infection (IgM) were found either in comparison with non-tumor diseases or depending on the malignancy grade. Antibodies to HSV-1,2, CMV and EBV in patients with gliomas were significantly more often found in the medium range, and in the comparison group — in the high values of coefficient of positivity (CP) for IgG. In all the studied groups, antibodies to HHV-6 were determined statistically significantly less frequently than to other herpes viruses.

Conclusion. The absence of statistically significant differences in seropositivity between groups of patients and their presence between pathogens is most likely a reflection of general trends in the population, and the question of the involvement of various representatives of the Herpesviridae family in neuro-oncogenesis of primary glial brain tumors still remains open.

Purpose of the study. To evaluate  the effectiveness  of the regional  cervical cancer screening  program by (LB) liquid‑based cytology.

Materials and methods. The geography of screening includes 54 medical units of the Rostov region, where patients are taken swabs from the cervix. HPV positive patients with abnormal PAP smears are invited to the Regional cervical pathology  center (RCPC) for diagnosis and treatment.  LB cytology, the HPV test RealTime PCR, colposcopy  with video recording, biopsy of the cervix by the method of loop excision or electroradiographic conization.

Results. From 2014 to 2017, 188 641 cytology tests were performed. Cervical cancer was revealed in 189 women — (0.1%), H‑SIL and ASCH in 566 (0.3%), 377 ASCUS (0.2%), L‑SIL in 23014 (12.2%), absence of intracellular lesions or malignancy (NILM) in 164495 (87.2%). 2162 HPV — positive women aged 18 to 69 years were invited to the RCPC gynecologist for examination.  Treatment  by conization  (622) and excision  (830) of the cervix was performed  in 1452 patients,  H‑SIL and CIS were revealed in 1162 women (78%).

Conclusion. tests such as LB cytology and HPV testing, their optimal multiplicity and sequence allow timely detection and treatment of precancerous cervical epithelium lesions.

Purpose of the study. The purpose of the study was to find the difference between local levels of VEGF, EGF, IGFI and IG- FII in tumor and intact tissues in adenocarcinoma of the stomach (AC) and signet-ring cell carcinoma of the stomach (SRCC).

Materials and methods. Levels of VEGF, EGF, EGFR, IGF-I and IGFII were determined by ELISA in tumor and intact gastric tissues of 15 AC patients and 10 SRCC patients (T_2-3N_0-2M₀, G2-3), mean age 62.8±2.38 years.

Results. Levels of IGF-I, IGF-II and VEGF in intact gastric tissues were similar at AC and SRCC, but EGF and EGFR levels at AC were higher than at SRCC. Level of VEGF in AC tumor tissue, compared to intact gastric tissue, increased by 2.3 times and IGFI and IGFII decreased by 2.1 and 1.8 times, respectively. Tumor tissue of SRCC showed the increased level of EGF (by 2.9 times) and EGFR (by 1.8 times), tissue of SRCC was characterized by the activation of system of EGF and IGF, but not VEGF. Tissue of AC demonstrated the stimulation of VEGFA neoangiogenesis.

Conclusion. A significant difference was observed in the levels of VEGF-A, IGF-I and IGF-II and components of the EGF system in gastric tumors and visually intact tissues in G2-G3 AC and SRCC. The higher activity of the EGF and IGF systems in SRCC is probably associated with diffuse growth characteristics and the origin from neuroendocrine cells, which serves as an autocrine/paracrine regulation of invasive growth. AC with solid structure is more in need of neoangiogenesis carried out mainly by the VEGF system.

Purpose of the study. The objectives of the research are to evaluate the potential toxicity of Bacteriosens when administered to animals once only («acute» toxicity) or repeatedly («chronic» toxicity) and to study its biocompatibility with blood components.

Materials and methods. Bacteriosens is the medicine on the basis of photoactive compound of mezo-tetra (3-pyridyl) bacteriochlorin with λ_max of 747 nm. Ex vivo study of its biocompatibility with blood components included the evaluation of the impact of the solution on the coagulability of non-stabilized venous blood. The in vitro method of detecting erythrocyte osmotic resistance to hemolytic ability of Bacteriosens was used. The «acute» toxicity was studied in F₁ hybrid mice (CBA x C57Bl/_6j) and non-bred rats, male and female, after single intravenous and intraperitoneal injections of Bacteriosens. The «chronic» toxicity was studied in non-bred rats, male and female, and Soviet Chinchilla rabbits after multiple intravenous injection of the drug (over the period of 14 days). Time period before toxicity-induced death of animals, clinical signs of intoxication, and the impact of the medicine on the inner organs and body systems were evaluated using physiologic and pathophysiologic, clinical, and laboratory methods.

Results. Incompatibility of non-stabilized rat blood with Bacteriosens after the incubation with the medicine in concentrations varying from 0.5 till 0.005 mg/ml has not been discovered. The aquatic solution of Bacteriosens should be injected into animals and later on into humans slowly or by drip feed in concentrations not exceeding 0.5 mg/ml. A single injection of Bacteriosens in doses from 5.0 to 50.0 mg/kg and from 1.3 to 20.8 mg/kg to mice and rats (male and female), respectively, was tolerated by the animals satisfactorily. No toxicity-induced deaths or skin phototoxicity have been detected. The studied doses of Bacteriosens in mice 25-250 times exceeded the calculated equitherapeutic dose for humans, and in rats, 6.5-104 times. Bacteriosens in total doses from 18.2 to 72.8 mg/kg and from 8.3 to 33 mg/kg administered as multiple intravenous injections for 14 days to rats and rabbits respectively, did not induce the death of the animals and demonstrated no toxic impact on blood, liver, kidneys, heart, hemostasis system, or central nervous system. The drug did not adversely affect carbohydrate and lipid metabolism.

Conclusion. Bacteriosens when administered as a single dose or as multiple injections in the range of studied doses did not have adverse toxic effect on mice, rats, and rabbits. The studied doses of Bacteriosens in rats 91-364 times exceeded the calculated equitherapeutic dose for humans, and 41-165 times, in rabbits.

Purpose of the study. To evaluate the efficacy and tolerability of nivolumab in oncologic patients in real-life clinical seffings.

Patients and methods. Analysis included 114 patients aged 26-96 years with melanoma (n = 64), non-small cell lung carcinoma (NSCLC) (n = 37) and metastatic colorectal cancer with high levels of microsatellite instability (MSI-H mCRC) (n = 13), receiving immune checkpoint therapy with nivolumab (3 mg/kg every 14 days). All patients underwent comprehensive examination including CT/chest radiography, CT/MRI/ultrasound of abdominal organs or PET-CT of the whole body and other investigations if necessary. Efficacy of treatment was assessed after every 6 courses on treatment or in case of signs of clinical progression. Treatment response was assessed using iRECIST 1.1 criteria.

Results. Among patients with metastatic melanoma positive for BRAF gene mutation, receiving immune therapy objective treatment response was registered in 13.6%, tumor control — in 27.2%. In the group of patients, negative for BRAF gene mutation objective response was achieved in 27.5%, tumor control — in 41.4% patients. None of mCRC patients in our group achieved objective response, stable disease was observed in 30.8% of patients, progression — in 38.5% and unconfirmed progression — in 7.7% of patients. In NSCLC group complete response was observed in 2.7%, partial response — in 2.7%, stabilization — in 27.1%, unconfirmed progression — in 5.4%, progression — in 29.7% of patients. Safety analysis revealed the following significant adverse reactions: thyroiditis (n = 3), pneumonitis of 3 grade (n = 1), hepatitis of 3 grade (n = 1) and arthritis of 2 grade (n = 1). In 4 patients adverse reactions required treatment delay and prescription of glucocorticoids.

Conclusion. Nivolumab treatment in real-life clinical practice is associated with a lower prevalence of adverse events compared to the results of clinical trials.

Purpose of the study. To study the possibilities of computed tomography in assessing the immediate antitumor effect of preoperative prolonged chemoradiotherapy in patients with primary and recurrent gastric cancer.

Materials and methods. Twenty nine consecutive patients with locally advanced and recurrence cancer of the stomach, who underwent CT for the assessment of tumor response of neoadjuvant chemoradiotherapy of gastric cancer, were prospectively enrolled in our study. All patients underwent the method of neoadjuvant chemoradiotherapy developed in our Center. MDCT was performed before chemo-radiotherapy and 3.5-5 weeks after its completion.

Results. Among the patients with primary gastric cancer (n = 24) it is necessary to explore three aspects: symptoms of the tumor response, tumor size and structure.

CT allowed very clearly follow the symptoms of the tumor response. On the prechemoradiotherapy CT, two tumors were diagnosed as cT0-3 stage, 22 tumors as cT4. After the chemoradiotherapy 13 tumors were diagnosed as cT0-3 stage, 11 tumors as cT4 stage (x²=11,6; p<0.01).

We analyzed the quantitative parameters, which included the maximal wall thickness perpendicular to the gastric lumen and the maximal square of the tumor. The maximal wall thickness (p<0.001) and the maximal area of the tumor (p<0.001) decreased significantly in postchemoradiotherapy scans compared to the baseline.

CT texture analysis after the completion of radiochemotherapy showed that the primary tumors became more homogenous with the multilayer pattern, especially in the peripheral portion of the residual tumor, a marked enhancement of the mucosal layer of the stomach in 17 of 24 patients (71%) in the arterial phase and in 20 of 24 patients (83%) in the portal and/or venous phases.

Accurate measurement of the tumor before and after the therapy allowed the evaluating the response to therapy by RECIST 1.1 criteria. Among the patients with recurrent gastric cancer partial response was observed in 2, stable disease in 2, progressive disease in 1.

Conclusion. CT significantly improves capability of neoadjuvant therapy response evaluation in patients with gastric cancer. It is necessary to explore three aspects: symptoms of the tumor response, tumor size and attenuation.

Purpose of the study. Concussion does not cause any lesions available for visualization using computed tomography and magnetic resonance imaging. However, it can cause changes at the microstructural level, which can be detected by the diffusion-tensor imaging. The purpose of this study is to identify the effect of acute concussion on diffusion parameters in the corpus callosum, corticospinal tract, and thalamus in children.

Patients and methods. Fractional anisotropy and the apparent diffusion coefficient were determined in 11 patients with a diagnosis of concussion (41 ± 19 hours from the moment of injury) and in 11 healthy subjects. Philips Achieva dStream 3T magnetic resonance imager was used. Diffusion tensor imaging data were processed in the Philips Intellispace Portal program in the Fibertrack section.

Results. Fractional diffusion anisotropy significantly increases and the apparent diffusion coefficient decreases in the thalamus of patients with concussion. In corpus callosum there is a growth trend in fractional anisotropy.

Conclusion. The detected changes indicate the initial stage of cell edema in the thalamus caused by concussion. Diffusion-tensor imaging is the only magnetic resonance imaging method which may be sensitive to this pathology.

Purpose of the study. To evaluate changes in the oral cavity in patients with squamous cell carcinoma of the oropharyngeal region after radiation therapy.

Materials and methods. The study included 70 patients with oropharyngeal squamous cell carcinoma. All patients underwent external beam radiation therapy. We used dose fractionation mode: 5 fractions per week, single focal dose — 2G. The severity of oral mucositis was assessed using the RTOG evaluation scale.

Results. Patients with carcinoma of the oropharyngeal region before the start of the main treatment had pathology of hard tooth tissues (CPU-14.62±1.08), gingival inflammation (PMA-41.71±4.98), periodontal inflammation (CPITN-2.54±0.62). After the end of radiation therapy, oral mucositis was detected in all patients (100%). We found changes in the negative side for all indicators of dental status indices compared to primary CPUs-15.26±0.90; CPITN-3.36±0.58; PMA-49.75±5.28 (p<0.05). Clinical signs of oral mucositis begin to appear as early as 7 days after the start of radiation therapy, RTOG=1,5. After 3 weeks, patients develop severe mucosal lesions with fibrinous plaque and severe pain syndrome (RTOG=3.0), requiring intensive drug therapy (p<0.05).

Conclusion. In connection with the early appearance of post-radiation oral mucositis, preventive and therapeutic measures to improve the regeneration.

Purpose of the study. The reasons for the unsatisfactory results of surgical treatment of patients with celiac artery compression syndrome (CACS) and the role of repeated interventions allows to achieve a lasting improvement in most of them. The purpose of the study is to clarify the reasons for the unsatisfactory outcomes of surgical treatment of patients with CACS and the nature and significance of repeated operations.

Patients and methods. From 860 patients with CASC who were operated on over the past 25 years 82 patients were selected with unsatisfactory treatment results. Initial conventional abdominal surgery was performed in 26 (31.7%) patients without a positive outcome before decompression of celiac artery (DCA). Primary operations were performed in 82 patients with proven CASC, of which 69 (84.1%) had DCA in open approach, isolated in 43 (52.4%) and combined in 26 (31.7%). Embolization of PDA aneurysm in one (1.2%) patient. In other medical institutions 15 (18.3%) patients were operated, among them 3 (3.7%) patients had DCA in open approach, in 4 (4.9%) laparoscopic DCA, in 6 (7.3%) angioplasty and emergency stenting and two (2.4%) reconstructive operations, all technically and clinically unsuccessful.

Results. After DCA in open approach 51 (73.9%) patients of 69 patients had normal celiac artery flow. 4 patients had unresolved stenosis of the celiac artery and 15 relapsed its stenosis, one of them with residual stenosis after DCA twice, which amounted to 0.5% and 1.7%, respectively of 860 patients. Repeated operations were performed in 51 (62.2%) patients out of 82 to restore the celiac artery in 28 (34.2%), among them 4 (4.9%) in combination with interventions on the abdominal organs. Abdominal operations with concomitant diseases of the gastrointestinal tract with normal flow in celiac artery in 21 (25.6%).Scalenotomy in two (2.4%). Of 28 patients, re-revascularization of the celiac artery was successful as a result of open decompression in 7 out of 8, bypass surgery in 9 out of 10 and balloon angioplasty and with stenting in two out of 7. One had an effective primary DCA and the other resected PDA aneurysm. 19 patients out of 25 showed a good result after operations on the abdominal organs.

Conclusion. The unsatisfactory results of surgical treatment of patients with CASC are associated with inadequate restoration of celiac artery restenosis and/or concomitant diseases of the abdominal organs. Repeated vascular operations are mainly: decompression of celiac artery in open approach, bypass surgery and balloon angioplasty and stenting, and/or abdominal mainly: cholecystectomy, NissenFP, and Strong surgery are of primary importance in the treatment of patients with CASC.

One of the processes that accompany the aging of the body and the decline in the quality of life of older people is sarcopenia or loss of muscle tissue and the associated restriction of mobility. The identification of this condition in patients at the stage when there is only an initial decrease in muscle mass without a decrease in muscle strength is of great importance for determining the cause of the disease and the timely start of treatment. This review describes the capabilities of the methods of radiation diagnosis in assessing the quantity and quality of muscle tissue and their shortcomings from the standpoint of verification and dynamic observation of sarcopenia. The lack of a unified standard for the instrumental diagnosis of this pathology and the alertness of specialists regarding sarcopenia during routine examination is one of the main reasons for the insufficient detection of muscle loss in the cohort of elderly patients. This review is of interest to a wide range of clinical physicians and radiologists, who are found in their practice with patients of older age groups.

The article reviews the literature data on the problem of connective tissue dysplasia and attempts to clarify it's role in the mechanisms of herniogenesis in the anterior abdominal wall. Hernia carriers are presented as patients with systemic pathology of the connective tissue, which made it possible to reinterpret the high frequency of occurrence among them comorbid hernial defects of chronic multiorgan and polysystem disorders and present a range of possible complications during the early and late postoperative period. The questions about the need for a more accurate diagnosis of external and visceral signs of connective tissue dysplasia in hernias according to accepted diagnostic schemes are considered. The possibilities and results of histological and laboratory methods of verifying the level of severity of undifferentiated connective tissue pathology were studied. Generalized experience of methods of surgical treatment of external abdominal hernia, considering the presence of connective tissue among dysplasia patients.

Echinococcosis is a severe parasitic disease with a fecal-oral mechanism of the pathogen transmission. It caused by the introduction into the organism and development in the body of the larval stage of tapeworm of the genus Echinococcus, with the formation of parasitic cysts in the liver, lungs, kidneys and other organs. Kidney echinococcosis ranks seventh in frequency after echinococcosis of the liver, lungs, peritoneum, omentum, muscles, spleen, and ranges from 1.5 to 5% relative to echinococcal lesions of other organs. It is necessary to use data from the epidemiological history, determination of blood antibodies to echinococcus by enzyme immunoassay, ultrasonography of the kidneys and the abdominal cavity, radiography of the lungs, review and excretory urography, nephroscintigraphy, x-ray computer and magnetic resonance imaging for the diagnostics of kidney echinococcosis. The article presents a clinical case of theechinococcal lesion in the left patient's kidney. The final diagnosis was made during the operation (left nephrectomy). It indicates some difficulty of diagnostics of this disease. Antiparasitic chemotherapy was performed in the postoperative period. Subsequent dynamic observation of the patient revealed no recurrence of echinococcosis.

Liver resection is the standard in the treatment of patients with the local uncomplicated intrahepatic bile duct cancer. Systemic chemotherapy is prescribed in the presence of distant metastases. Difficulties in a choice of the treatment method come up when one or several factors are revealed: the tumor spread towards the surrounding structures, multiple liver lesions, lymph nodes involvement signs. The complications presence manages treatment strategy too. The case describes the possibilities of an individual multimodal approach in a treatment strategy for the patient with locally advanced liver cholangiocarcinoma complicated by obstructive jaundice, cholangitis, cholangiogenic abscesses. The surgical approach was approved as the main one. Methods of interventional radiology, chemotherapy, radiation therapy were applied when necessary. The mentioned above treatment strategy allowed us to achieve good results in this difficult clinical case. The patient is alive for more than four years from the time of surgery, signs of progression are not currently defined.

The article deals with the opinion of patients about different activities of medical organizations. It was established that opinion of patients about the activities of medical organizations depends on many factors, among which the most important were the place of residence, social status, level of education, material security and others.

Purpose of the study. To study the satisfaction of patients with chronic dermatoses with the medical care they receive in a metropolis.

Materials and methods. The satisfaction of patients with chronic dermatoses with the quality of the services provided in dermatovenerological clinics was studied on the basis of a questionnaire survey of 412 patients living in Moscow. Results. It was established that 74.0% of patients were satisfied with the quality of dermatological care, 19.6% were more likely satisfied than not, 5.8% were more unsatisfied than yes, 0.6% were not satisfied. The attentive and friendly attitude of medical personnel to patients in polyclinic and inpatient departments of specialized medical organizations noted in 91.7% of respondents, inattentive — in 0.6% and found it difficult to answer — 7.7%. The majority of respondents (97.8%) rated the schedule of doctors as convenient and waiting time for a dermatovenerologist's appointment in the clinic is not long (96.8%).The minimum proportion of patients (1.3%) indicated a refusal to conduct the necessary in their opinion examinations and treatment.

Conclusion. The majority of patients were satisfied with the specialized care received and practically had no difficulties visiting specialized medical organizations in view of their sufficient number in different areas of the city.

Ultrasound diagnostics is not just a screening method, but is a tool that plays an important role in making the correct final diagnosis. Due to this, the demand for ultrasonic examinations has increased significantly in recent years.

Purpose of the study. Study of age-related particularities of ultrasonic examinations prescription and passage in multi-discipline hospital by children.

Materials and methods. The analysis of medical records for 1435 patients aged from 0 to 18 years, who underwent ultrasonic examination in multidiscipline hospital, was conducted.

Results. The majority (61.4%) of pediatric patients of hospital received medical services within the framework of high-tech medical care. The significant proportion (32%) were children, who were examined and treated under compulsory health insurance system. Paid medical services accounted for 5.8% and voluntary health insurance — for 0.8%. It was established that newborn children significantly (p<0,05) were more often referred for ultrasonic examinations from pediatric, urological and surgical departments. In the first year of life the ultrasonic examinations were need to patients from pediatric, rheumatology and urological departments. This trend continued in subsequent periods. In the same time, the proportion of pediatric patients from gastroenterological departments increases in primary school age. The conducted analysis also showed that with increasing of the children age referred ultrasonic examinations, the proportion of patients from Nephrology, cardiology, dermatology and rheumatology departments increases while from urolog¬ical and surgical departments — decreases.

Conclusion. The distribution of hospital pediatric patients who underwent ultrasonic examination, by its types, sources of findings and the frequency of re-hospitalizations depends on the age of children.

In oncology, one of the leading places belongs to breast cancer. This problem is particularly significant in the current situation, when the issue of reproductive health of the female population is acute lyuped in connection with the unfavourable demographic trends in our country. Early diagnosis of precancerous diseases and initial stages of cancer is possible only with active search of patients among practically healthy people. However, despite the availability of breast for examination in adult clinics, malignant tumors of these locations are often found with considerable delay. The most important factor in the success of early diagnosis of oncopathology is the work of primary health care physicians. However, there have been no studies on the quality of early diagnosis of breast cancer in urban women in modern seffings. Purpose of the study. to study the quality of early diagnosis of breast cancer in urban women by doctors of adult polyclinics. Materials and methods. Adult clinics №.1, 2, 3, 4, 5, 6, 7, 8, 11, 12 of Ivanovo have been identified as the basis of the study. The study was conducted in 2018. The program of the study included the use of methods: expert, sociological, mathematical and statistical. Surveillance units: a woman with a malignant breast formation living in the city; case of detected and confirmed malignant breast formation. A retrospective analysis of 600 expert opinions was carried out, the survey method on the questionnaire studied women's satisfaction with premorbid prevention in the adult clinic and the availability of early diagnosis of breast cancer (100 patients). The data were processed using applied computer programs. Results. It has been established that the main causes of late diagnosis of breast cancer in urban women are: untimely treatment of the patient in a medical and preventive institution, deviations from the standard of examination of women for oncopathology, errors in diagnosis, features of the course of the disease (lightning or latent form), non-compliance with continuity in the management of the patient.

Conclusion. Analysis of expert opinions on advanced cases of breast cancer showed that the bulk of the defects detected are preventable and are associated with low cancer of doctors and failure to fully and properly perform the standard of examination oncopathology.

Purpose of the study. Was to assess the variations of the incidence rate and Stage I proportion of screened malignant neoplasms (MNs) before and after the implementation of All-National Dispensarization of certain groups of the adult population (DCGAP) based on data from the Arkhangelsk Regional Cancer Registry (AOCR).

Materials and methods. Anonymous data were taken from the AOCR database about all cases of each of the index MNs (colon, rectum, lung, mammary gland, cervix, uterus, ovary, prostate, and kidney) from 2000 to 2018. The change over time of the number of new cases, crude, age-standardized incidence and the proportion of Stage I, were estimated. The intervention value of the DCGAP was considered positive if a change in the linear trend of selected indicators was detected with segmented regression between 2012 and 2014.

Results. The final sample included 46146 cases of MNs. The annual number of new cases and crude incidence for all taken for the analysis MNs from 2000 to 2018 have been increasing. After standardization by age, an increase in incidence was observed for all index MNs, except for lung cancer. In the segmented regression model, this increase for majority MNs was monotonous with an annual percentage change (APC) from 1.5% (for ovarian cancer) to 5.0% (cervical cancer). In prostate cancer, a change of the linear trend of age-standardized incidence with an increase of 8.5% per year was detected in 2012. The proportion of Stage I did not change or increased monotonously after the introduction of DC¬GAP in uterus, ovarian, and colon cancers. An increasing change of the trend of annual Stage I proportion was found in colorectal cancer since 2010, breast cancer since 2011, cervical cancer since 2013, prostate cancer since 2014, kidneys since 2006 with APC by 7.5%, 9, 6%, 9.6%, 40.3%, 13.4%, respectively.

Conclusion. Diagnostic tests used in the framework of the DCGAP are sensitive to the detection of early stages of cancer of the breast, cervix, and prostate; for colorectal cancer and kidney cancer, their value is doubtful. The effectiveness of early diagnosis is not confirmed for the lung, uterus, ovarian cancers. For screening-sensitive MNs, an analysis of mortality and survival is necessary.