The review presents the basic ethical principles and rules of laboratory animal research. Modern ethics of humane treatment of animals should be based on a properly designed experiment to obtain high-quality results. Science is developing in the direction of minimizing the use of animals in experiments, if it is possible to obtain similar results by alternative methods.

Some aspects of studying of bioelectric indicators of function of a brain and cardiovascular activity at a natural hypothermia of a pig organism at temperature – 40 °C and below in the experimental conditions are presented in article.

The article presents the results of an experimental study, the purpose of which was to study changes in the cellular composition of the blood of rats depend of their exposure time to cold. The obtained results indicate that the cold affects the activity of cells that provide nonspecific and specific immune responses.

It is shown that the exposure of rats in our experiment for 7 to 30 days had a fairly long-term effect, as it led to suppression of the activity of monocytes and neutrophils. However, we observed an increase in the number of leukocytes on day 14, which may be due to a short-term stimulation of leukocytopoiesis. The number of lymphocytes in our study remained elevated throughout the experiment, maximally increasing by 7 and 30 days. We were also able to demonstrate a decrease in the number of platelets, which was an appropriate reaction of the body in response to cold exposure, as platelets take a direct part in the repair processes observed when the tissue is damaged by cold, and also improve the migration of leukocytes to the focus of inflammation. An increase in hematocrit was also established, which is one of the signs of a reaction to cold stress.

Thus, the present study revealed patterns of changes in the cellular composition of peripheral blood during cold stress in the experiment, which were expressed in the features of the reaction from erythrocytes, platelets and leukocytes.

In this article, modern ideas about the structure of skin integuments of animals of different age groups are revealed. The features of the structure of the epidermis in sexually mature and immature animals are described. It is shown that the age-related changes in the dermis are associated with a decrease in the number of fibroblasts, a decrease in the amount of collagen and a change in its structure.

Large animals that inhabit in regions with a cold climate tend to flow into hypobiotic states. These states are distinguished by reduced level of metabolism, that along with high thermal insulation of the body allow them to save energy resources and reduce feed intake in winter. In general, the dynamics (from summer to winter) of a number of physiological and biochemical indicators is largely similar to the dynamics of these indicators in hibernators. For the first time, it was found that the fraction 1-10 kD from the brain of a yakut horse, a yakut cow, a northern reindeer, an elk and a brown bear has hypometabolic, hypothermic, cardiotropic and central effects similar to those of similar fractions from the tissues of hibernators. The most promising sources for isolating and studying the structure of peptides responsible for the organization of hypobiotic states are the brain tissues of yakut horse and brown bear.Analyzing the influence low negative temperatures in annual vital function of hibernators and big mammals, authors come to Conclusion that extraordinary stability of animals it is not only developed ability of creating high heat insulation but against that background also of starting peptides regulation, which take part in decreasing of metabolism, and consequently of powers inquiry.

The purpose of this research was to study the possibility of using a mixture of phytoadaptogens for the correction of the body’s compensatory responses to the conditions of low temperatures.Experiments have been conducted on experimental animals (50 white mongrel rats-males weighing 180-200 g) in accordance with generally accepted methodological approaches. Research of cold adaptation reactions of experimental animals have been conducted by using the model of a long cold action with appropriate climatic chamber.It was established experimentally that in doses of 150-300 mg/kg daily of the studied mixture has a strong antioxidant effect in the conditions of cold stress on warm-blooded organism. The research allowsusing a mixture of phytoadaptogens as а regulator of adaptive reactions of the organism when exposed to low temperatures.

The data of arterial pressure of 91 residents of the Arctic zone of the Republic of Sakha (Yakutia) from the position of «golden ratio» was investigated. It was revealed that the most harmonious blood pressure is found in the Chukchi and Yukagirs, and it is confirmed by the highest percentage of those with a diagnosis «healthy».

We investigated 200 employees of the diamond mining company who worked in cold condition from 2 to 8 hours a day. Reliable correlations have been revealed to prove the effect of cold on weight, body mass index, waist volume and hip volume. Cold exposure increased expression of genes markers of browning. These results provide evidence pointing to PMBCs as an easily obtainable material.

Changes in lipid metabolism, depending on the length of residence in the North, in the winter season in the non-indigenous population of Yakutia, aged 18 to 62 years, were examined. It was revealed that the adaptation of the organism to the North conditions is accompanied by changes in lipid metabolism. In the first year of residence in the North in the blood serum high cholesterol is compensated by increasing the content of HDL cholesterol and APO A-I. This is indicated by the coefficient of atherogenicity, which varies within the limits of normal values. At residence in the North from 2 to 5 years lipid metabolism indicators correspond to normal values; after 5 years - there is an increase in the level of cholesterol and atherogenicity coefficient due to an increase in LDL cholesterol.

One-stage population studies of biochemical markers of the lipid transport function of the indigenous population in the Arctic, Central and Southern zones of Yakutia have been carried out. An increase in the content of triglycerides and cholesterol and atherogenic fractions of lipids in the population from the north to the south was noted. Atherogenic changes in lipid metabolism are more pronounced in the arctic Yakuts, than in Dolgans, living in the same zone, and Evens of the Southern zone, which indicates a lower susceptibility to a disadaptive change in lipid metabolism in the Dolgans and the Evens.

The authors report their study on the intensity of lipid peroxidation processes and the state of antioxidant protection in patients with cold trauma of varying severity. It was established that in the organism of patients with frostbite of extremities, the intensity of free radical oxidation and the level of antioxidant defense depended on the degree of frostbite.

Clinical and biochemical studies were conducted in 151 people, 81 of whom were patients with a cold trauma of varying severity, who entered the burn department of the Republican Hospital №2. The control group included 70 practically healthy people. The material of the study was fasting venous blood samples, drawn from the ulnar vein.

The parameters of the intensity of free radical lipid oxidation (malonicdialdehyde, diene conjugates) and antioxidant protection (low-molecular antioxidants, activity of superoxide dismutase, catalase, glutathione peroxidase, glutathionereductase) were determined by spectrophotometric methods. Clinical and biochemical parameters in blood serum were determined on the biochemical automatic analyzer CobasMiraPlus (Roche).

In the body of patients with frostbite of the extremities of the first and second groups, a significant increase in the parameters of lipid peroxidation - MDA and DC - is observed. In patients of the second group, the intensity of lipid peroxidation processes was higher than in patients of the first group.

The state of the body’s antioxidant defense depends on the severity of the injury. In patients of the first group, the activity of SOD is increased by 8 times, CAT by 1.3 times, HP by 1.7 times, and GR activity decreased by 1.9 times in comparison with the control. The concentration of LMWA increases 2.1 times, and the content of ascorbic acid decreases by 1.2 times. In patients of the second group with respect to control, the activity of SOD increases 12.6 times, catalase 1.1 times, HP 1.5 times, and GH activity decreased 2.8 times. The content of LMAO increases 1.5 times, and the level of ascorbic acid in the blood decreases 2.4 times.

The shift in the prooxidant-antioxidant equilibrium toward the intensification of free radical reactions is also indicated by an increase in the coefficients: KSOD / CAT, KSOD / HP. The values of the coefficients (KSOD / CAT, KSOD / GP) depend on the severity of the cold trauma.

The state of antioxidant protection of the body in patients with coronary heart disease, depending on ethnicity in the North, was under study.

It was revealed that dyslipidemia in patients with coronary heart disease is characterized by an increase in the level of triglycerides in blood. Dysadaptation to the northern conditions occurs due to the activation of lipid peroxidation processes, which is caused by the accumulation of malonicdialdehyde and is accompanied by inhibition of the antioxidant potential of the organism.

For the first time an analysis of the frequencies of alleles polymorphismof the gene UCP1-rs1800592, UCP2-rs659366 and UCP3-rs2075577were studiedthe Yakuts (n=281) and the Chukchi’s (n=39) populations, living in the extreme climate of Eastern Siberia.The Yakut population was divided into three groups: northern (N.YAK), viluysk (V.YAK) and central Yakuts groups (C.YAK).From project of «1000 Genomes», information was received on the frequencies of the studied polymorphisms for Chinese – CHB (n=103), CHS (n=108), CDX (n=99), Japanese – JPT (n=104), Vietnamese populations– KHV (n=101).In general, the frequencies of the studied polymorphisms were analyzed in nine populations of Asia (n=835), living in different climatic zones. Populations living in the subarctic (CHU, N.YAK) and on the border of the temperate and subarctic climate (V.YAK, C.YAK) were merged into the group «Northern Asia». Populations living in the temperate (CHB), subtropical (JPT; CHS; CDX) and subequatorial climate (KHV) were joined into the «Southern Asia» group. Comparative analysis showed that the frequency of the allele A rs1800592 (UCP1) in the group «Northern Asia» (61.8%, CI: 56.8-66.7%), did not statistically differ (p>0.01) from the «Southern Asia» group (53.4%, CI: 49.4-57.4%). The frequencies of allele T rs659366 (UCP2) in the group «Northern Asia» (49.5%, CI: 44.5-54.6%), as compared with the group «Southern Asia» (41.5%, CI: 37.7-45.5%), also statistically differences not found (p>0.01). It was found that the frequency of allele A rs2075577 (UCP3) in the group «Northern Asia» (66.7%, CI: 61.8-71.4%) was much higher in comparison with the group «Southern Asia» (42.3%, CI: 38.4-46.3%) (p<0.01). The increased frequency of allele A rs2075577 of the UCP3 gene in populations of Yakuts and Chukchi’s living in low temperature conditions, in comparison with other populations of Asia, can be associated with random population effects, or indicate the presence of adaptation mechanisms associated with thermoregulation.

In this paper, we analyzed the polymorphism rs738409 of the adiponuclein gene (PNPLA3) among the indigenous inhabitants of the North of the Republic of Sakha (Yakutia). Under the constant influence of low temperatures, the human body needs a high level of energy metabolism, which in turn is accompanied by a significant consumption of lipids. Epidemiological data indicate the frequent combination of type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) characterized by accumulation of lipids both in the hepatocytes themselves and in the intercellular space. Recently, great importance is attached to the genetic conditionality of NAFLD.

Temperature is the most important environmental factor affecting humans and animals. The effect of low temperatures on biological objects depends on the degree of phylogenetic maturity of the organism and is realized through various mechanisms including in vitro and in vivo conditions. The report discusses the mechanisms of cold and ischemic damage to biological objects, examines the mechanisms of damage to tissues and organs after heating, and cryoprotection products of biological objects. Particular attention is paid to preparations of pharmacological protection of tissues with antioxidant properties from cold ischemia.

The article presents an analysis of literature data on the effect of cold on human health, the structure of the immune system, and the properties and effects of natural adaptogens.

In general, the general cryogenic climatic parameters of the Far North create uncomfortable conditions for human existence and affect people’s health. In extreme conditions, protective mechanisms and adaptive alteration of the body can lead to disruption – maladaptation. A whole series of pathological phenomena develops.

In modern conditions, the development of adaptogens from local raw materials for enhancing the body’s resistance, prevention and treatment of immune response disorders in low temperature conditions of the Sakha (Yakutia) Republic is a priority area.

The effect of the vitamin-mineral complex and one-day koumiss on the imbalance of the LP-AOS organism of athletes of Yakutia was studied. It is established that in winter during the period of intense physical activity the intake of the vitamin and mineral complex helps to reduce the intensity of lipid peroxidation and has a supporting effect of the body’s antioxidant defense during the 20-day period. The antioxidant effectiveness of koumiss in summer is manifested by an increase in the activity of the enzymatic link already on the 10th day of administration and is an effective means for accelerating the body’s recovery processes.

The article presents an analysis of mortality from total body hypothermia in the Sakha (Yakutia) Republic for the period from 2006 to 2015. Dynamics shows persistent trends of reducing deaths from the defined causes, the frequency of which depends on the place of residence (territorial zone), the season of the year, the age and length of stay.

The clinical manifestations of atherosclerosis in the indigenous and non-indigenous population in a group of patients with CHD older than 60 years, living in the Far North, were studied. The highest frequency of myocardial infarction has been identified (at the time of the survey) among the group of patients of senile age (75 years). The frequency of myocardial infarction and angina pectoris decreases as the age increases. The gender disparities have been observed on clinical manifestations of angina pectoris that can be clearly monitored in the indigenous group. The analysis of five-year survival observation revealed the senile age, myocardial infarction and higher class of angina pectoris to be the most relevant factors of mortality in the group of people over 60 years of age.

In the article, based on the study of local food raw materials and traditional food, the necessity of optimizing the structure of the population’s nutrition and improving the quality of food products under low-temperature conditions is substantiated. The set of factors influencing the increase of interest of food industry enterprises in the output of national specialized products is considered.

Production of northern house and trade animals, gifts of the nature differs a high nutrition value as contains a large amount of proteins, fats, mineral substances, vitamins and the biologically active agents (BAA). Therefore, meat and milk of the Yakut cattle, the Yakut horse, a reindeer, meat of trade animals and fishes, wild berries and wild-growing food plants of Yakutia are the most valuable national wealth on which rational use the special attention has to be paid.

In the Far North, one of the main environmental risk factors is the cold, which lasts for 8 months. The problem of the effect of cold on the human body has always been and remains relevant. Annually, about 3,000 people around the world are frozen to death, of which about 200 cases take place in Yakutia.

The article describes a unique case of resuscitation of a frozen patient, which gives grounds to revise algorhythm of actions in relation to frozen patients, both from medical and legal points of view

Objective: to establish the morphometric changes in the seminal vesicles of rats of the reproductive period at the conditions of prolonged systemic immunosuppression.

Material and methods. The study was carried out on 60 white rats of the reproductive period, obtained from the vivarium of laboratory animals of the SI LPR «ST. Luke Lugansk State Medical University». The immunosuppressive state was modeled by administration of cyclophosphamide at a dosage of 1.5 mg/kg body weight intramuscularly tenfold. The rats were taken out from the experiment by decapitation under ether anesthesia on 1, 7, 15, 30 and 60 days after the end of the drugs administration. The organs were weighed, the relative mass was calculated, the length, width and thickness were determined by means of a caliper. The volume of the organ was established by the method of water displacement in a graduated cylinder containing distilled water. At the microscopic level, examined the height and width of epithelial cells, their volume, and also the larger and smaller diameters and the volume of the cell nuclei. Volumetric values were calculated from the formula for the volume of an elongated ellipsoid of revolution.

Results of the study. Statistically significant decrease in all studied organometric parameters occurred both at the early (7, 15 days) and late observation periods (30 days). Micromorphometric parameters after cyclophosphamide administration also decreased with respect to the control group at similar times. The size of the nuclei and their volume decreased on 7, 15 and 30 days: the larger and smaller diameters significantly decreased by 3.99%, 4.98%, 8.38% and 3.22%, 6.56%, 8, 06% respectively. The parameters of the volume of the nuclei of the epithelial cells of the seminal vesicles of the animals of the control groups significantly exceeded the data of the experimental rats at the same time by 7.07%, 11.02% and 15.77%. At 1 and 60 days, statistically significant differences between the parameters studied were not established.

Conclusions. Statistically significant changes in organometric parameters of the organ are noted both at the early (7, 15 days) and late observation periods, which indicates the direct influence of cyclophosphamide on the biosynthetic processes in the organ. Micromorphometric changes, as well as the results of cyto- and karyometry, confirm the organometric data and indicate the development of local disturbances in the morphogenesis of seminal vesicles caused by disregulation of the endocrine-immune homeostasis of the organ.

Autosomal recessive deafness 1A is one of the most frequent hereditary diseases in the Republic Sakha (Yakutia). The diagnosed features of spectrum and frequency of pathogenic variants in the GJB2 gene by the patients with congenital hearing loss allow applying routine DNA diagnostics in medical practice. In the article some bioethical issues of DNA testing of autosomal recessive deafness-1A are discussed.

We studied the specific weight of biliary pancreatitis in the structure of patients with cholelithiasis. Based on the results of the studies, the cause of the occurrence of biliary pancreatitis -cholelithiasis and its diagnostic signs in the form of rapidly increasing hyperbilirubinemia and an increase in the level of ALT with a history for more than 20 years is proved.

The aim of our work was to assess the effectiveness using of the combination of a hepatoprotector phosfogliv and immunomodulator cycloferon on the state of functional and morphological parameters of microcirculation in patients with non-alcoholic steatohepatitis (NASH) after infectious mononucleosis (IM).

We examined 78 patients with a diagnosis of fatty liver disease after infection mononucleosis in age from 19 to 46 years, divided into two groups. The main group included 40 patients who received as therapy combination of drugs phosphogliv and cycloferon. The comparison group consisted of patients (n=38) who received conventional NASH treatment. To examine the state of microhemodynamics we used the slit lamp universal ml-2M, morphometry of capillaries of the nail bed capillaroscope carried the M-60 A.

For MCR morphological study we calculated indices of vascular, intravascular, extravascular disorders and General (integrated) conjunctival index using the formula KI. = КІ1+КІ2+КІ3. In the result, it was found that patients with fatty liver disease was due to infectious mononucleosis there are significant violations on the part of all departments of the MCR. Standard treatment for patients with this comorbid pathology improves morphological and functional parameters of microcirculation, but not effectively and rapidly than the combination of phosphoglyceride and cycloferon. So, using the combination of hepatoprotector phosphogliv and immunomodulator cycloferon in patients with fatty liver disease after infectious mononucleosis authentically significantly contributes the elimination of the phenomena of stasis and sludge syndrome in the arterioles and capillaries, and accelerate blood circulation.

The article discusses the results of the use of ACDE (Automated complex of dispensary examinations) in the regions of the Republic of Sakha (Yakutia). In the course of the work, the main organizational approaches were identified in the study of the health status of children, and the most advantageous use of automated complexes of dispensary examinations in the Republic of Sakha (Yakutia) was identified to improve the quality of preventive examinations.

The aim of the study was to evaluate the effectiveness of vasoactive therapy with synthetic somatostatin analogues from acute esophageal variceal bleeding in patients with hepatic cirrhosis with portal hypertension syndrome.

Material and methods. The study is based on a retrospective analysis of the results of a comprehensive treatment of 57 patients with cirrhosis and portal hypertension syndrome who were on treatment at the emergency surgical department of the Republican Hospital №2 − the Center for Emergency Medical Care of the Republic of Sakha (Yakutia) in the period from 2015 to 2017.All patients were divided into two groups. The first group consisted of 23 (40,4%) patients, who only used the Sengstaken-Blakemore probe to stop from acute esophageal variceal bleeding. The second group of the study comprised 34 (59,6%) patients who, together with the Sengstaken-Blakemore probe installation, used synthetic somatostatin analogues in complex intensive therapy.

Results.The presented clinical experience of the use of synthetic somatostatin analogues in complex therapy from acute esophageal variceal bleedingto recommend their wide use in the practice of urgent surgical clinics.

Conclusion. The introduction of complex intensive therapy from acute esophageal variceal bleeding in patients with hepatic cirrhosis with the syndrome of portal hypertension of synthetic somatostatin analogues allowed to reduce the overall lethality to 10,7%, and to reduce the risk of rebleeding by 17%.

The purpose of the study is to show the significance of high mortality of men as one of the most problematic issues in the sphere of mortality. The main characteristics of the excess mortality of males identified using the methods of demographic data analysis on the dynamics of mortality rates by individual age groups, gender breakdown, by selected causes of death. A sufficient number of problematic issues present in the sphere of mortality. This is a relatively high proportion of deaths in working age, maintaining the structure of causes of death substantial relative weight of deaths from accidents, poisonings and injuries, i.e. external causes.Although the positive dynamics in reducing the proportion of these causes of death in the total number of deaths observed, however, these causes of death consistently occupy 2nd place after diseases of the circulatory system.

Male overmortalityof men is one of the significant problems in the field of mortality and has economic consequences, e.g., loss of the working population, and social (from the point of view of family life). In recent years, the mortality rate in men was constantly higher than in women. Male overmortalityis stored in the active working ages; in the working age index of high mortality of men is much higher than a similar index in the general population. The highest rates are added to these causes of death external causes of death, suffering from consumption and chronic alcoholism. Mortality due to external causes is significant growth potential for the life expectancy as one of the integral indicators of demographic security. In this regard, the reduction of mortality from external causes should be one of the major events in the regional demographic policy in the sphere of mortality.

The complex of measures to reduce the high mortality of men should include the units on the improvement measures of a medical nature,and also the block of measures of primary prevention (the formation of self-preservation behavior, healthy lifestyles), the unit of measures for creation of safe habitat.

739 epizootics of anthrax were registered in 244 stationary disadvantaged settlements on the territory of the republic.

In the present work there are modern data on epizootological epidemic monitoring of anthrax in the central and southern economic zones of the Republic of Sakha (Yakutia), which significantly clarify the quantitative and qualitative aspects of the indicated problem. Thus, the maximum number of epizootics of anthrax (numerator) and disadvantaged settlements (denominator) is registered in the areas of the central economic zone (323/109), and their respective minimum values are in the areas of the south economic zone (2/2). It has been determined the intensity of death of domestic animals by species, the number of registrations at disadvantaged settlements, the prevalence and periodicity of epizootics by area of the zone.

Attention is focused on an episode associated with the possible, specific, infectious and epidemiological danger of group burials of people.

The data of the primary disability of the adult and children population in the Republic of Sakha (Yakutia) are presented, what is more in the context of districts / uluses over a ten-year period (2007-2016). The percentile method revealed the levels of primary disability: high, above average, medium, below average and low, which for clarity were painted in appropriate colors. The analysis revealed trends in the dynamics of indicators of primary disability (PD), as well as administrative-territorial entities, where it is better or worse PD level separately among the adult and child population. In addition, the structure of the main causes of disability and distribution to disability groups is presented.

The most common reason for the development of chronic obstructive pulmonary disease (COPD) is the damage to airways and lungs caused by tobacco smoking. About 15% of all long-time smokers develop a clinically significant obstructive pulmonary disease. In 80-90% of all cases the development of COPD is connected with smoking. Total incidence of COPD (per 1000 people) in 2008-2014 in Russia, Far Eastern Federal District and the Sakha Republic (Yakutia) in comparison is 5-5,3-6,3-6,8-8-8,6-8,2 in the Sakha Republic, 3,7-4,2-4,7-4 in the Far Eastern District and 3,7- 3,9-4,1-3,7 in Russia. The number of COPD cases in the Sakha Republic over time remains high compared to the Far Eastern District and Russia, despite the low density of population.The total number of respiratory system diseases (RSD) in 2014 (preliminary data) was 74,115; pneumonia – 2,308; chronic bronchitis – 19,438; COPD – 5,740; bronchial asthma – 8,773. 2014 saw a decrease in cases of pneumonia by 334 patients as compared to 2010. The number of COPD cases increased by 1,354 patients, and the greatest increase was in the number of bronchial asthma cases – by 2,542 people. (Absolute numbers per Yakutsk Republican Medical Information and Analysis Centre data, 2014).The aim of our research was to study COPD risk factors among the citizens of Yakutsk working in dusty and polluted environments and chemical companies, as well as the people who have a bad habit of smoking.We conducted surveys and examined respiratory functions (spirometry). We examined 70 people living in the City of Yakutsk who had respiratory complaints, were subject to occupational hazards, or were long-time smokers.In order to study the COPD risk factors, we used ‘A Patient’s Questionnaire’ developed by the Pulmonology Research Institute of Russia’s Federal Medical-Biological Agency, Moscow. The questionnaire contains 22 questions to identify risk factors and respiratory symptoms. We also used a self-actualisation test to evaluate the impact of COPD on the health status of a responder. This test on chronic obstructive pulmonary disease (COPD) can be used for a simple and reliable evaluation of the health status of patients who have the disease. It is used in conjunction with other diagnostic methods and allows for a relatively simple evaluation of COPD’s level of impact on health status. This test is used to evaluate the impact of COPD on the well-being and everyday life of a patient.The most common symptoms among the COPD patients included: a cough of over 3 months – 71.4%, productive cough – 52.8%, a feeling of compressing chest pain – 32.8%, exertional dyspnoea – 75.7%, weakness – 52.8%.Common causative risk factors include smoking, i.e. those who have a history of smoking of over 10-20 years, and occupational hazards, i.e. work in chemical companies and in dusty, polluted environments.Examination of respiratory functions using spirometry showed that 40 patients (57%) had light respiratory dysfunction, 25 (36%) had moderate respiratory dysfunction, and 5 (7%) had severe respiratory dysfunction.The results of self-actualisation test show that COPD has an insignificant effect on the quality of life of 51 surveyed people (73%), has a moderate effect on the quality of life of 16 people (23%), and has a serious effect on the quality of life of 3 people (4%).All 100% of examined people have clinical aspects of COPD and respiratory dysfunction that corresponds to spirographic classification of COPD.

The article presents a review of the literature about the genetic factors of predisposition to autoimmune to thyroid disorders, the main of which are diffuse toxic goiter and autoimmune thyroiditis. Studies of recent years have made it possible to establish that genetic factors make a significant contribution to the development of the autoimmune process in autoimmune to thyroid disorders.

The literature review is based on the analysis of sources covering the relevance, etiology, pathogenesis, classification, and modern methods of surgical treatment of appendicular peritonitis in children. The issues for further study of this problem are considered.

In pediatric surgery at the moment there is no single point of view in the treatment of common forms of appendicular peritonitis in children. One of the reasons is the absence of a single criterion for assessing the severity of peritonitis. Each surgeon has his own opinion and measure of evaluation. We believe that assessing the severity of the peritonitis course with scoring and its use in the choice and extent of surgical intervention will reduce the postoperative complication, reduce the number of unreasonable conversions, and, if necessary, give indications for laparotomy and laparostomy. Determination of criteria for assessing the severity of peritonitis is an effective method in the choice of operational tactics for treating peritonitis, which allows to minimize the subjectivism of the surgeon, optimizes the approach to therapeutic tactics in appendicular peritonitis in children.

Today, there is a high significance of the consequences of injuries and diseases of the musculoskeletal system economically, medically and socially because of the high costs of treatment and rehabilitation, as well as a long period of incapability to treatment or permanent disability. There is a significant increase in the incidence of degenerative-dystrophic diseases of large joints everywhere. According to the literature, 9 to 13% of the world’s population suffers from osteoarthritis. Incorrect or untimely treatment can quickly lead to aggressive surgical interventions. The article describes modern approaches to injectable therapy of the knees injuries and diseases.

The article presents an overview of the main socio-hygienic and medico-biological risk factors of congenital heart defects (CHD) in children. Determination of risk factors is essential in estimating and forecasting the frequency of CHDin the population.

After 2016 at the medical universities of the country training of students takes place according to new educational standards. Training of students in medical schools until 2016 did not allow senior students to participate in the provision of medical care, and graduates - to work as doctors, as in the learning process too little attention was paid to practice. For the purpose of practical teaching methods in the educational process of training of students of medical Institute was developed and implemented a new course« Vaccinal prevention in Pediatrics». It is important to emphasize that shape the students ‘ competencies should be focused on the semantic component of the leading types of medical activities. So, in the educational process constructed on the basis of the competence approach, a kind of dependency between knowledge and skills, subordination of the acquired knowledge and professional skills. This, in turn, contributes to the fact that education is for student personal and meaningful. We have developed a working program of discipline and teaching discipline to meet all required competencies. In accordance with the prepared and approved for publication guidelines and instructions for students. Particular attention was paid to organization of independent work of students, which is one of the most important components of the educational process and the condition for the development of competence of students. Independent work implied the use in the preparation of students to classes of situational tasks and tests designed for each lesson.

The test in the discipline included the control of acquired practical skills.

The introduction of new clinical disciplines promotes the acquisition of professional knowledge and skills.

The main clinical problem of patients with chronic myeloproliferative diseases are thrombotic complications causing death and invalidism. Possible long-term latent course of these diseases, comorbid cardiovascular pathology increases the risk of fatal complications. This article presents a clinical case of chronic myeloproliferative disease in a 57-aged man, who first manifested with acute Q-positive myocardial infarction. The patient successfully underwent recanalization, transluminal balloon angioplasty with stenting of the anterior descending coronary artery. Based on thrombocytosis and bone marrow examination he fulfill the diagnosis of essential thrombocythemia. During follow-up of three years, the progression of disease is observed with the development of secondary myelofibrosis. The diagnosis is confirmed by bone marrow histology and taking into account high risk of recurrent thrombotic complications, he administered with cytoreductive and antiplatelet therapy.