The article represents analysis of publications devoted to the development and implementation of Outcomebased healthcare and Value-based medicine principles in the healthcare. The basic steps and problems associated with the transition to this system are described.

Objective. To evaluate clinical outcomes of labour induction in patients with gestational diabetes (GD) regarding the choice different delivery tactics.

Design and methods. The cohort retrospective study including 443 patients with gestational diabetes had given birth during 2014 and 2015 was conducted on the base of Federal North-West Medical Research Centre due to two different local clinical protocols, respectively. The patients were subdivided into two groups: first group — 251 women with GD (2014), second group — 192 (2015). Labour outcomes of the labour outcomes were estimated in each group.

Results. Complications of labour such as dysthyroidism (p=1) and fetal distress (p=0,236) did not significantly differ between groups after induction of labour: 7% (3 of 43) and 9,3% (4 of 43) — in the first, 7,7% (2 of 26) and 11,5% (3 of 26) — in the second group, respectively. Clinically important is the fact that uterine inertia was twofold lower in the second group comparing to the first one: 7% (3 of 43) and 15,4% (4 of 26), respectively, that ii however not statistically significant for this size of data selection (p=1). The rate of diabetic embryopathy (p=0,341), macrosomia (p=0,364), urgent caesarean section (p=0,694) did not significantly differ between groups.

Conclusion. Lengthening of expectant management in patients with GD in the absence of other indications for earlier delivery has led to the decrease in labour complications. Single standard tactic probably cannot be regarded as an appropriate choice for labour at 38-39 weeks for all patients with GD, such tactic should be used in the risk group for antenatal fetal death.

The analysis of the results of the implantation of a shunt system between the lateral ventricle and the transverse sinus in hydrocephalus in children, the treatment of which the use of other CSF-shunting operations proved ineffective or impractical.

Materials and methods. 50 patients aged from 2 months to 17 years, with decompensated internal hydrocephalus was performed anastomosis between the lateral ventricle and the transverse sinus, through the implantation of the valve low-pressure system or a programmable system with low values of the valve settings. The result of operations is determined by evaluating the dynamics of quantitative clinical and manifestations of hydrocephaly and hypertensive syndrome.

Results. In all cases, it was a severe ventriculomegaly and hypertensive syndrome. In all cases, the use of ventriculoatriostomy and ventriculoperitoneostomy proved ineffective or impractical. As a result of the treatment, stabilization of the patients, and the manifestations of decompensated hydrocephalus regression was achieved in 38 of 50 children (76%). In the remaining 12 patients on the background of a functioning shunt preserved manifestations of hydrocephalus, a condition seen as hypodraige. According to our data, hypоdraige manifestations were more common in cases where the venous pressure was high and equal to us certain values liquor pressure in the patient.

Conclusion. Ventriculo-sinus transversal shunt may be the method of choice for the treatment of decompensated hydrocephalus in cases where the application of classical operations is not advisable. We consider it appropriate intraoperative assessment of venous pressure in the sinus, as well as the correlation with intraventricular pressure.

From the modern perspectives biocompatibility is a feature of the whole system «tissue engineered graft — recipient’s body». Adequate and predictable performance of this system is determined by all its components (recipient’s body, material, cells) to the same extent. Biomaterials for tissue engineered grafts shouldn’t be toxic, immunogenic and thrombogenic. At the same time, the efficiency of graft depends on the functional state of recipient’s body, tissues and cells. In this case studies of the influence of biomaterials on the viability and functional activity of different cell types become crucial. This review focuses on common modern approaches to in vitro assessment of the viability, adhesion, migration and induction of oxidative stress and inflammatory potential of different types of cells in response to the contact with biomaterials.

This literature review considers the cellular markers of endothelial damage as a new diagnostic and prognostic marker of cardiovascular risk the emphasis is on endothelial dysfunction as a key element in the development of systemic inflammatory response and activation of coagulation in patients after acute cardiovascular events.

Objective. The aim of this work was to examine influence of the geomagnetic storms on the hemodynamic parameters and heart rate variability in normotensive rats.

Design and methods. Studies were conducted in Wistar male rats. Registration of systolic blood pressure, beat-to-beat interval and components of heart rate variability were conducted in the days of the geomagnetic storm and in the days, when the Earth’s magnetic field was calm.

Results. We found that, in the days of geomagnetic disturbances sympathetic component of spectrum of heart rate variability decreased, simultaneously we observed a tendency to increase of blood pressure and average of heart rate.

Conclusions. We have suggested, that decline in activity of the sympathetic nervous system contributes to maintain of a normal level of hemodynamic constants during geomagnetic storm.

Background. Sex hormones are involved in pathogenesis of cancer of the reproductive organs; however, their role in the development of other cancers is poorly studied.

Objectives. Study of metabolism of sex hormones in the testes, prostate, tumor (TR), metastases (MTS) and blood serum (BS) at the early stages of liver metastasis.

Material and methods. The study included 28 white out bred male rats. Levels of estradiol (E₂), total testosterone (T), prolactin (PRL) and progesterone (P₄) were studied in the liver by radioimmunoassay, and free testosterone (fT), estrone (Е₁) and sex steroid-binding globulin(SSBG)were studied by ELISA 1-2 weeks (before TR occurrence in the spleen) and 5 weeks (before MTS occurrence in the liver) after the injection of TR cells into the spleen.

Results. Appearance of TR in the spleen was preceded by increased Е₁ (by 3.4 times) and fT (by 2.5 times) and decreased P₄ (by 4.5 times) in week 1 and increased PRL (by 1.7 times) and decreased fT (by 3.4 times) in week 2. Already formed TR showed E₁ increase (by 8.8 times). Occurrence of MTS was preceded by increased E₂ (by 1.2 times) and decreased P₄ (by 3.1 times) in the liver.

Conclusions.E isthe main element of the hormonal profile of primary TR. Е₁creates conditions for the formation of the metastatic field in the liver where later MTS develop.

We show the utility of morphological method for evaluation of biodistribution of chitosan nanoparticles administered into an organism. Grocott methenamine silver staining was conducted with paraffin-embedded sections of liver, lung, brain and spleen (male Wistar rats, 250-300 g, n = 4) obtained 2 hours after intravenous injection of 1 mL suspension of chitosan nanoparticles at a concentration of 2 mg/mL. The average size of chitosan nanoparticles was about 100 nm (fraction ranging from 15 to 200 nm was 90%). It has been shown for the first time that the histochemical reaction can be used to identify chitosan nanoparticles into cells and tissues. Thus, Grocott silver staining enables to evaluate the biodistribution, cellular internalization and biodegradation of chitosan-containing drug delivery nanosystems.