Vol 64, No 1 (1983)

Одной из актуальных проблем, поставленных перед системой здравоохранения на XXVI съезде КПСС, является воспитание врача с высокими нравственными принципами строителя коммунизма. Научно-методологической основой решения всех вопросов, связанных с врачебной этикой, служит марксистско-ленинское понимание морали. К. Маркс и Ф. Энгельс уделяли большое внимание вопросам морали, выявлению ее роли в новом бесклассовом обществе. Ф. Энгельс писал, что мораль истинно человеческая, стоящая выше классовых противоречий, станет возможной лишь на такой ступени развития общества, когда не только будет уничтожена противоположность классов, но изгладится и след ее в практической жизни ^[1]. Дальнейшее развитие проблемы коммунистической морали получили в трудах В. И. Ленина, особенно в его произведении «Задачи союзов молодежи». Выступая на III съезде комсомола, В. И. Ленин раскрыл основные принципы коммунистической морали, дал широкую программу нравственного воспитания молодежи, выделил действенный характер морали нового общества. «В основе коммунистической нравственности— подчеркнул В. И. Ленин,— лежит борьба за укрепление и завершение коммунизма»^[2]. Из этого высшего принципа коммунистической морали вытекают и все остальные нормы морали нашего общества, такие как коммунистическое отношение к труду, выполнение общественного долга и т. д.

The results of the study of the relationship of all indicators of pulmonary gas exchange in 188 patients with chronic nonspecific lung diseases with obstructive process are presented. It is shown that the cause of respiratory insufficiency and arterial hypoxemia in these diseases are violations of ventilation-diffusion-perfusion relations.

Of the group of children who had been in contact with an unknown source of tuberculosis infection for no more than 6 months, 35.1% were infected and 9.4% of children became ill with intra-thoracic tuberculosis. This situation is interpreted as a local outbreak of the disease during the endemic period of tuberculosis caused by an unknown source of infection in children with reduced specific immunity.

In patients with acute staphylococcal pneumonia, which occurred against the background of chronic obstructive bronchitis, pronounced changes in the immunological reactivity of the body were revealed, manifested by a decrease in the ability of T-lymphocytes to blast transformation, inhibition and deregulation of the interaction of T- and B-immune systems, a decrease in nonspecific protection factors. The effectiveness of the use of targeted immune drugs and retabolil in the complex treatment of patients has been established. In addition, their use reduces the possibility of sluggish lingering pneumonia.

Based on the results of the study of hemostasis and kallikrein-kinin system indicators in patients with atherosclerotic occlusion of the arteries of the lower extremities, an increase in kinpnoobrazovatelny function and increased fibrinolysis were established while maintaining a high thrombotic potential of the blood. In complex therapy for uncomplicated course of the disease, it is necessary to include activators of the kallikrein-kinin system (padutin, delminal, etc.), and in complicated course — inhibitors (anginin, prodectin).

The effect of enzymatic modification of the protein part of thromboplastin on its interaction with factors VII and V. was studied. It has been shown that the effect of papain on apoprotein disrupts the interaction of these factors with thromboplastin, resulting in the formation of a factor X activator with less activity than before modification.

The dynamics of blood 5'-nucleotidase activity and the state of the hemocoagulation system were studied in 47 patients with acute traumatic brain injury. An increase in the activity of blood 5'-nucleotidase was found in all observations, directly correlating with the degree of intravascular activation of the blood coagulation system. It is assumed that the main cause of these shifts is the arrival of thromboplastin from the foci of destruction of brain tissue, an indicator of which is the increased activity of 5'-nucleotidase of blood.

Based on mathematical modeling, a method for a comprehensive assessment of the fundus elements is proposed. With the help of a computer, the average statistical indicators of the elements of the optic nerve disk in 240 people were calculated. Quantitative differences were revealed in groups of healthy individuals with glaucoma and with optic nerve atrophy. A correlation analysis of statistical data is recommended to clarify the pathogenesis of specific glaucomatous atrophy of the optic nerve.

The rosette formation method determined the content of T- and B-lymphocytes of venous blood in 16 patients with extrahepatic cholestasis. The number of T-lymphocytes in extrahepatic cholestasis is reduced, and B-lymphocytes are increased. The proportional dependence of this decrease on the increase in the level of direct bilirubin in the blood has not been established.

The state of cellular and humoral immunity was studied in 80 patients with chronic nonspecific salpingoophoritis. At the stage of remission of the process, a comprehensive allergological examination was carried out. Bacterial sensitization was diagnosed in 41 patients, 19 of them —monovalent, mainly to staphylococcus, 22 - in polyvalent combinations. Sensitization determined the nature of changes in the indicators of specific immunity and the features of the clinical course of the disease. Differentiated therapy was carried out taking into account the altered reactivity by the method of specific hyposensitization with bacterial allergens and levamisole. Sustained remission was obtained.

According to the literature [22, 31, 33, 35], the main attention of researchers in spinal injury was paid to the study of changes in the bone base of the spine, their ligamentous apparatus and the state of the spinal cord.

Spontaneous rupture of the kidneys is a formidable complication of hemorrhagic fever with renal syndrome, usually occurs against the background of severe acute renal failure, sharply aggravates the already serious condition of patients, being a frequent cause of their death. Surgical treatment of such patients was previously considered contraindicated.

Treatment of perforated ulcers of the stomach and duodenum currently remains an urgent task of emergency surgery, since it is associated with the severity of this pathological process and the need for urgent surgery at any time of the day.

The UASSR is actively working on the early detection of cervical cancer and precancerous diseases of the female genital area with the use of a cytological examination method during preventive examinations. The number of cytological studies increased from 29 thousand in 1969 to 430 thousand in 1980, as a result, the proportion of actively identified patients with cervical cancer among newly registered increased from 23.3 to 89.1%- Over the same period, the incidence of this localization of cancer per 100 thousand. the population decreased by 2 times, and the number of neglected cases among women newly registered decreased by 6 times.

The diagnostic capabilities of modern research methods (laparoscopy, ultrasound echography, the concentration of steroid hormones in peritoneal fluid, blood plasma, urine) were studied in order to identify and analyze the causes of infertility of unclear genesis.

The analysis of complex clinical and radiological examination (X-ray, radiography, tomography, bronchography, bronchoscopy) of 64 patients with lung and mediastinal diseases in combination with transthoracic aspiration biopsy is presented. The details of the survey methodology are noted. Clear puncture results were obtained in 70.3%. The technique is simple and can be recommended for wide use in thoracic departments.

The basic principles of the work of offices (receptions) for the immunoprophylaxis of infectious diseases in modern conditions are highlighted. For the immunization of children with altered reactivity, gentle methods of immunization of DPT, DS, AS anatoxin and the appointment of hyposensitizing agents are proposed. The purpose of the offices is to reduce the number of non-immunized children.

Imported cases of malaria have been noted in the TASSR over the past 3 years. During the medical care of patients, a number of mistakes were made that could lead to the occurrence of local cases of the disease. In order to preserve epidemiological well-being in the republic, it is necessary to carry out a full range of preventive and anti-epidemic measures.

The problem of thrombosis remains extremely relevant for clinical practice and continues to attract the attention of scientists around the world working in various fields of theoretical and clinical medicine. Therefore, the II All-Union Conference on Antithrombotic Therapy was attended by prominent therapists, surgeons, physiologists, biochemists, pharmacologists, pathologists from the USSR, GDR, Czechoslovakia, VNR, USA, Germany. Sweden, Austria. At 11 meetings, a wide range of issues related to new approaches to antithrombotic therapy and new ideas about the process of intravascular blood clotting were considered.

On 30/IX—2/X 1982, a plenum of the problem commission "Allergology and Clinical Immunology" of the Scientific Council on Immunology of the USSR Academy of Medical Sciences was held in Kazan.The plenum was organized by the Ministry of Health of the USSR, the USSR Academy of Medical Sciences, the Research Institute of Immunology of the USSR Academy of Medical Sciences, the Ministry of Health of the RSFSR, the Ministry of Health of the TASSR, the Kazan Medical Institute, Kazan GIDUV, Kazan Research Institute of Epidemiology and Microbiology, the Scientific Society of Pathophysiologists of the TASSR.