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Unlabelled: The paper presents the system for intelligent analysis of clinical information. Authors describe methods implemented in the system for clinical information retrieval, intelligent diagnostics of chronic diseases, patient's features importance and for detection of hidden dependencies between features. Results of the experimental evaluation of these methods are also presented., Background: Healthcare facilities generate a large flow of both structured and unstructured data which contain important information about patients. Test results are usually retained as structured data but some data is retained in the form of natural language texts (medical history, the results of physical examination, and the results of other examinations, such as ultrasound, ECG or X-ray studies). Many tasks arising in clinical practice can be automated applying methods for intelligent analysis of accumulated structured array and unstructured data that leads to improvement of the healthcare quality., Aims: the creation of the complex system for intelligent data analysis in the multi-disciplinary pediatric center., Materials and Methods: Authors propose methods for information extraction from clinical texts in Russian. The methods are carried out on the basis of deep linguistic analysis. They retrieve terms of diseases, symptoms, areas of the body and drugs. The methods can recognize additional attributes such as "negation" (indicates that the disease is absent), "no patient" (indicates that the disease refers to the patient's family member, but not to the patient), "severity of illness", disease course", "body region to which the disease refers". Authors use a set of hand-drawn templates and various techniques based on machine learning to retrieve information using a medical thesaurus. The extracted information is used to solve the problem of automatic diagnosis of chronic diseases. A machine learning method for classification of patients with similar nosology and the methodfor determining the most informative patients'features are also proposed., Results: Authors have processed anonymized health records from the pediatric center to estimate the proposed methods. The results show the applicability of the information extracted from the texts for solving practical problems. The records ofpatients with allergic, glomerular and rheumatic diseases were used for experimental assessment of the method of automatic diagnostic. Authors have also determined the most appropriate machine learning methods for classification of patients for each group of diseases, as well as the most informative disease signs. It has been found that using additional information extracted from clinical texts, together with structured data helps to improve the quality of diagnosis of chronic diseases. Authors have also obtained pattern combinations of signs of diseases., Conclusions: The proposed methods have been implemented in the intelligent data processing system for a multidisciplinary pediatric center. The experimental results show the availability of the system to improve the quality of pediatric healthcare.

The paper presents results of a comprehensive analysis of the cardiovascular diseases (CVD) situation, both in the global and Russian contexts. It introduces original data illustrating the declining mortality rate from CVD, and the diminishing contribution of these diseases to overall mortality rate--globally and, to a larger extent, in developed countries. The paper also analyses the reasons for continuing CVD epidemic in Russia. Based on factual evidence, it argues that those include insufficient expenditures on treating CVD patients, and critically inadequate funding of prevention programmes. Unsatisfactory use of these funds to subsidise Russian regions (without taking into account their actual needs determined by the CVD mortality rate) only makes the problem worse. Through modelling, "average" efficiency of the Russian health care system in reducing CVD mortality was revealed. The paper describes various scenarios for future development of the Russian CVD situation. In the context of innovation-based scenario, the advantages of technologicalforesight are analysed; specifically, the authors summarise major S & T development trends in the health sector (using data of the Russian S & T Foresight 2030), which could significantly contribute to stopping the CVD epidemic in Russia.

Microsporidiosis is an ubiquitous opportunistic disease that usually appears in immunocompromised patients: AIDS patients or organ-transplant recipients. The infectious agents of disease are fungi-related obligate intracellular parasites - microsporidia. Alongside with Cryptosporidium and Cytomegalovirus, these parasites are the most common causative agents of diarrhea in HIV-infected patients. Intestinalform of microsporidiosis has been mostfrequently observed, but microsporidia can affect almost any organs of the human body, eyes, lungs, muscles, organs of the nervous system. The present paper overviews the current data on the etiology, pathogenesis, epidemiology, clinical presentation, diagnosis and treatment methods of microsporidiosis.

The scope of bibliometric research is focused on academic output of the Russian Academy of Medical Sciences (RAMS) in 2011 by analyzing the data extracted from the Web of Science database and InCites application Research Performance Profile of RAMS. Using these analytical tools trends in dynamics of publications and citing of the RAMS researchers were calculated and the level of scientific output in some biomedical subject areas was estimated. Studies revealed the great importance of international collaboration and international coauthorship for RAMS in producing papers published in established scholarly journals. Basic metrics of scientific performance that should be required to achieve the goals declared in the recent governmental policy papers were measured for RAMS institutions as well. Another problem investigated in this research is the problem of low citedness ofRAMS journal papers indexed in WoS. Factors and reasons influenced on low citedness were discovered In conclusion authors set out priorities and reasonable goal-oriented efforts to achieve better results in publication activity.

A significant role of neurology for medicine and society is caused by severity of clinical presentations and consequences of the nervous system diseases, as well as by huge economic burden related to neurological pathology. The paper presents a review of the current state and prospects for the development of socially most important fields of modern neurology, among which one can list studies of cerebrovascular, neurodegenerative, demyelinating and hereditary disorders, discovery of molecular mechanisms of their pathogenesis, and improvement of the methods of treatment, neurorehabilitation and prophylaxis on the basis of new medical technologies. An essential link between clinical and basic research in expanding the existing knowledge about the structure/functions of the brain in normal conditions and different-type pathological processes is stressed.

The paper reports results of sociological analysis of satisfaction of the patients with the medical care provided in in-patient facilities of Arkhangelsk and Vologda regions and Komi Republic. The authors distinguish three groups of factors (professional, organizational, informational) that determine the patients' content with the quality of medical services. The study revealed the generally low level of patients' satisfaction estimated based on selected criteria for medical aid and services.

The paper describes dynamics, distribution and morbidity rate during the 2009 A(H1N1)v influenza epidemic in Russia. The epidemic appears to have been especially severe in the cities of the Far-East and Siberian Federal Districts where the average morbidity rate ranged from 6.4% to 19.2% (mean 10.3%) and the epidemic duration from 7.8 to 8 weeks. In less affected Southern and Central Federal Districts A(H1N1)v influenza occurred in 5.7% of the population. Schoolchildren aged 7-4 years showed the highest morbidity rate of 28.8%. The age group of 18-53 years accounted for 79.4% of the total lethality. Viral isolates were genetically stable and exhibited 98.9% hemagglutnin (HA) homology with reference viruses. None of the strains had an amino acid substitution at position 275 of neuraminidase (NA) responsible for resistance to oseltamivir. Towards the end of the epidemic, the viral population displayed a significant rise in the number of strains containing mutations in 4 genes (4 HA, 2 NA, 2 PB2 and 1 PA mutations respectively). 26.7% of the viral isolates obtained in the end of the epidemic had D222G substitution responsible for tropism of viruses to lung tissues. Epidemiologically, the 2009 A(H1NI)v influenza epidemic is described as moderate based on the absence of pathogenicity determinants typical of both A(H1N1) influenza virus of 1918 and A(H5N1) virus. The paper compares the 2009 epidemic with those caused by A/Honkong/68 and A/USSR/ 90/77 viruses. The necessity of classification for the discrimination between A(H1N1) subtype viruses is emphasized.

The paper deals with the strategy of training specialists in preventive medicine and improvement of their professional skills for the management of activities aimed at the maintenance of adequate population health status and prevention of adverse effects of environmental factors. Integration of managerial issues into curricula and teaching courses for preventive medicine specialists may be instrumental in upgrading their professional level.

The paper deals with health problems of working-age population in the Russian Federation. According to foreign and domestic experts reduction of the able-bodied population and its fraction in the general population will be accompanied by ageing of labour force in the nearest two decades. Despite the growth of life expectancy in 2006-2007 demonstrated by disability, mortality and life expectancy indices for the age group of interest, its health status is considered to be critical. Mathematical simulation of mortality rates allowed for the assessment of potential years of life lost (PYLL) from leading causes of death among active working population. The data obtained provide a basis for the elaboration of medical and social programs aimed at increasing life expectancy. The most essential role in current negative tendencies in the health of active working population belongs to the deterioration of work conditions and safety at industrial enterprises coupled to low efficiency of occupational health prevention system accounting for the significantly reduced accessibility of health services. Restoration of occupational health system in Russia is of crucial importance. Experts of the Institute of Occupational Health have elaborated a draft National Action Plan designed to improve health protection of labour force in this country; its implementation would help to solve demographic problems and increase the amount and quality of labour force.

This paper presents results of observational, clinico-epidemiological, and catamnestic studies including 856 adolescents and youths attending schools, professional and higher education institutions in Moscow. The data are analysed in terms of the prevalence, structure, and dynamics of different borderline psychic states depending on age. The frequency of "premorbid" psychic abnormalities in adolescents is shown to be 52.6% compared with 15.46% in youths. It is argued that subclinical psychic disorders in adolescents have more favourable prognosis and should be regarded as adaptive reactions to the processes associated with physiological pubertal crisis. Recommendations are proposed for differential primary and secondary prophylaxis of age-related premorbid psychic states.

This paper summarizes results of research carried out at the Institute of Hygiene and Health Protection of Children and Adolescents during the last 15 years. Specifically, it presents data of longitudinal studies involving 1-5-form schoolchildren residing in Moscow. Dynamic studies of morbidity and physical development in 1-2-grade schoolchildren suggest stressful effect of adaptation to increasing teaching loads. In-depth studies of senior schoolchildren conducted in 1989-2005 revealed long-standing unfavourable trends in their health status including marked deterioration of functional activities and physical development, increased prevalence of chronic diseases, and changes in the overall morbidity structure. Main schooling-dependent risk factors are identified, such as excess academic loads and authoritarian teaching style (responsible for psychoemotional stress), hypokinesia, and malnutrition during school hours. Incidence of certain diseases and functional disorders among adolescents is shown to correlate with the use of alcohol and tobacco.

The paper reports analysis of the "Russian Cross" demographic phenomenon characteristic of the present-day Russia, that is a marked excess of mortality over the birth rate leading to the reduction of the country's population at a rate of 750-800 thou people per year. The main causes and factors of excess mortality are considered with reference to deaths from infectious (viral and microbial) diseases. Experts of the Russian Academy of Medical Sciences proposed the working concept of the research program "Avoidable population mortality from infectious diseases in 2010-2020". Its implementation envisages the use of up-to-date information and computer technologies including mathematical and computer simulation of morbidity and mortality processes in outbreaks and epidemics of infectious diseases. The use of computer-assisted technologies is illustrated by the example of smallpox epidemics. They permit to promptly analyse and prognosticate excess mortality from infectious diseases by applying new diagnostic tools and medicinal products. This approach is proposed for the evaluation of the effectiveness of different projects in the framework of the above program. Its realization requires the development of three special information (computer-aided) systems designated Projects, Infections, and Prognoses.

Historical data concerning description and identification of etiology of tick-borne spotted fever in Russia are presented in the paper. Review of studies shows that by uncovering the etiology of tick-borne spotted fever in the Russian Far East, an emerging disease may be discovered. Another, different from classical Rickettsia sibirica, bacteria causes spotted fever there. The application of described methods resulted in first isolation of etiological agent of far-eastern spotted fever, Rickettsia heilongjiangensis, strains from patients.

The paper presents the results of research work carried out in Eye Trauma Department during the last 30 years, covering in particular new issues in penetrating wound management and astigmatism prevention, original methods of foreign body removal, some approaches to eye transplantation, the pathogenesis and treatment of eye burn disease, surgical treatment of close eye injury, and research performed in collaboration with the center of disaster medicine Zaschita.

The development of the safest and, at the same time, efficient methods of cataract surgery, is not only a topical task of medical science and practice, but also, taking the demographic situation into account, a solution to a social problem. The article describes the main achievements of academician S. N. Fyodorov's school in the field of cataract surgery with intraocular lense (IOL) implantation. Special attention is paid to the key components of cataract extraction technique named "small incision surgery", which is based upon the use of ultrasmall surgical approaches with self-sealing ability and no need for suturing. The main advantages and disadvantages of various types of cataract lense fragmentation, including ultrasound emulsification, mechanic and hydraulic fragmentation, and laser destruction, are described. Topical issues concerning cataract extraction technique under the conditions of complicating ophthalmopathology including the weakness of ciliary zonule system, high-degree myopia, glaucoma, pseudoexfoliative syndrome, small pupil, past injuries and eye surgery, are outlined. The paper also reflects a new qualitative step in the development of intraocular aphakia correction technique under modern conditions. Basic requirements to design parameters and IOL materials are determined from the position of reestablishing the accommodative function and fine visual functions. Ways of IOL design improvement are described especially for their application in non-standard and complicated cases.

The paper contains methodical basis of ecovirological zoning in the analysis of the problem of interrelation between climatic changes and the activity of natural nidi of arboviral infection. The authors offer an original hieroglyphic system of cartographic signs of arboviruses and a map of prevalence of arboviruses in various landscape zones of Noth Eurasia (within the boundaries of the former USSR.) They analyze the three main cartographic approaches to ecovirological zoning of natural territorial complexes, which imply analysis of a ralation to a landscape, conjugated component analysis, and paleographic reconstruction analysis.

The article covers scientific hygienic positions in forming and solving the acute scientific and technical problem of dealing with waste. The given problem is topical due to growing amount and diversity of waste and relatively small knowledge of ecological, medical and biological aspects of the problem. The paper covers the entire "life cycle" of waste, chiefly industrial and communal, as the most diverse and potentially dangerous to the environment. Special attention is paid to neutralization and recycling of waste for its application as secondary material in various branches of national economy. Having critically analized the results of complex studies, the authors conclude the article with outlining the prospective tasks of research for scientific and practical institutions of sanitary surveillance of Russian Federation Ministry of Health.

Described in the paper are the results of research, experiments and designing of individual protection means for medical personnel attending the patients with extra dangerous infections under the conditions of Meltzer boxes. The authors elaborated pressure suits that can protect the medical personnel from being infected by microbe aerosols. The testing of the mentioned protection suits in infection hospitals of Moscow, Elista, Rostov-on-Don and of other cities was positively assessed.

The reasons of high mortality and of low life expectancy among Russian citizens as well as their sharp fluctuations observed in the 90-ies were explained differently by researchers, however, no attempt was made to analyze the impact made by a huge inflow of immigrant from the republics of the former USSR and "close abroad" in any case studies. In this paper we point at the fact that the mortality statistics and life expectancy in Moscow were influenced, at least for as long as 12 years, by a systemic error, which made the mortality index higher and the life expectancy lower, among Muscovites, due to overestimates of the absolute number of died Muscovites and to underestimates of the city residents. The 2001 life expectancy of men and women in Moscow calculated on the basis of data, from which non-residents who died in the capital were deleted, was 64.7 and 75.0, respectively, but not 61.7 and 73.5 as represented by the official statistics. The maximum negative effect of death cases of non-residents exerted on the life expectancy coincides with the overall mortality peak value in Moscow: life expectancy of Muscovites for 1994 estimated without accounting of the mortality rate for non-residents turned out to be 3.2 years higher for men and 1.5 years higher for women. Supposedly, the Russian mortality statistics is not nation-wide in line with the actual state of affairs. However, the influence of the discussed systemic error in Russia's regions can be expected to be less pronounced since the level of immigration in Moscow is most probably by far higher.

Information about changes in the modern taxonomy of intracellular bacteria conditionally united within the nomination of "Rickettsioses" is presented in the paper. Due to a total hobby related with keeping home animals (pets), cats and dogs, apart from the cattle, joined the natural ecological cycles of rickettsioses stimulation. The morbidity of rickettsioses of the acaroid group has been persistently growing; like in case with other pathologies (Lyme's disease) involving the acaroid transfer factor, its obvious "urbanization" is pronounced. Absolute and relative morbidity indices in respect to rickettsioses, which are epidemiologically important for Russia, are presented. The modern knowledge database concerning the rickettsioses makes it possible to control the epidemic process for this infection category. It is noteworthy, that Prowazek's rickettsiosis of its both forms (i.e. the epidemic and relapsing ones), which does not have an independent cycle of circulation of its stimulator in wild nature, and unlike the acaroid group rickettsioses, turned into a socially controllable infection. It will be totally eliminated, during 10-15 years, both in Russia and the CIS countries. The practitioners are well supplied with a variety of drugs of tetracycline and fluorine-quinol groups, which makes it possible to arrest the infection process in patients rapidly and effectively and to prevent the lethal cases. A low incidence rate of rickettsioses, including Q fever, within the general infection morbidity, and taking into consideration the availability of methods for effective therapy and prevention, makes one consider a comprehensive vaccination against the discussed group of infections to be irrational. Obviously, such vaccination must be still applied in respect to a limited number of persons from among high-risk groups and for two or three varieties of rickettsioses only (i.e. Prowazek's rickettsioses, Rocky Mountain spotted fever and Q fever). Live vaccines, obtained on the basis of attenuated and recombined strains (which have a full-scale set of specific antigens), are recommended.

The significance of a law-making process is substantially increasing under the conditions of intensified expansion of the scope of standard legal regulation in the field of human health care in the Russian Federation. The authors state that any law-making process should begin with the definition of the subject-matter of a future law, its role and value in medical law creation and also indicate that the choice of the subject-matter of a future law is of priority and the most important stage of its preparation from the points of both contents-rich and standard legal views. Moreover, the paper presents main groups of issues that can determine the subjects of sociomedical laws and states the basic rules how reflect systemic relations in legislation. The paper shows it important to create a code of laws in the field of health protection for legal assurance of health public reforms.

The paper analyzes the parameters of epidemiological surveillance of nosocomial pyoseptic infections (NPSI) at surgical hospitals. It considers its basic concepts and presents the authors own findings. Particular emphasis is laid on guidelines for detecting NPSI cases and on epidemiological surveillance. A method of a follow-up is proposed to solve problems in the informational and analytical support of surveillance.

The paper deals with the situation associated with some substances, as described by the UNEP/Chemicals as priority persistent toxic, in the Russian Federation. Among them, lead was shown to head the list of them and its blood levels may be greater than the recommended allowable level of 10 micrograms/dl in almost 2 million children in different regions of the country. Exposure to mercury and cadmium is of local character, but some regions (the Irkutsk Region, Bashkiria, Vladikavkaz, V. Pyshma) showed specific changes in human health. Among persistent organic pollutants (POPs) there are polychlorinated biphenyls (PCBs) extensively used in the transformers, which present the greatest hazard. These substances were found to be of significance as a risk factor (OR = 1.7, 95% CI 0.9-1.3) for female infertility in the town of Serpukhov where PCB-containing capacitors were manufactured. Reproductive and endocrine disorders (higher incidence of abortions, infertility, late gestoses, cryptorchidism, retarded male sexual development, etc.) are common in the residents of Chapaevsk (Samara Region), one of the world's most dioxin-contaminated towns. In the female residents of this town, the highest global concentrations of dioxins were recorded in the breast milk and blood (43.3 and 24-75 pg TEQ/g fat, respectively). The ambient air in the most industrial towns of Russia was demonstrated to contain increased benz(a)pyrene, but there is very little analytical environmental and epidemiological evidence for the carcinogenic effect of these substances by taking into account of the factor of smoking. The population of many cities and towns in Russia is at risk for consumption of drinking water containing excess water disinfection products. Special preventive programs to reduce the adverse effects of the above persistent toxic agents should be elaborated and introduced.

The paper presents data on the variants of human immunodefficiency virus type 1 (HIV-1) currently circulating in Russia. The subtype A HIV-1 variant dominating is shown to be most widespread among drug-injected users in the most regions under study. By using the results of an analysis of 1,464 blood samples taken in the past 4 years in 69 subjects of the Russian Federation, the authors have estimated that this HIV-1 variant is responsible for 93% of all HIV-infection cases in the country. The greatest regional genetic diversity was observed in Moscow and its mean (2.35(1.59) was found to be comparable to that (2.41(1.85) in the whole country. Penetration of the subtype A IV-1 variant early detectable among drug-users into other risk groups was noted.

The paper gives the results of hygienic studies which determine some priorities in formation of unfavourable sanitary conditions of potable water supply in a number of Russian Federation areas. A tendency is shown towards an increase in the content of chemicals with organoleptic and sanitary and toxicological hazards (3-17% rate of increase) in underground and surface water sources, a frequency growth of finding non-standard, by the epidemiological criteria (25%), water test characteristic of areas with intensive industrial and agricultural enterprises. There are risk factors found in the quality of potable water at the stages of water preparation (chlorination) and transportation (corrosion) for human health; data of fundamental studies are given, on hygienic substantiation of ecologically pure methods of water treatment (UV disinfection). Scientific developments have provided the basis for systematizing a number of considerations for basic documents for a law on water protection quality, by revealing and predicting the processes affecting the quality of potable water, improving adequate laboratory water quality monitoring.

The paper gives data on trends in the prevalence of mental disease and disorders incidence in old age groups for 10 years (1984-1994) and analyzes whether macro- and microsocial factors can affect mental health in the elderly. Clinical and epidemiological surveys of 1109 examinees aged 60 years and older residing in a limited Moscow area have yielded morbidity rates for mental disease and disorders (including those by sex and age) in the population. Diagnoses was rated according to the International Classification of Disease (ICD-10). Varying mental disorders and nosological entities (without taking into account abnormalities) were found in 36.6% of examinees, including 6.1% with psychotic states, i.e. proper psychoses and clinical mental deficiency. Comparison of the results of two studies. One study was carried out in the 1980s and the present one performed 10 years later, that is, within the period of socioeconomic changes in the country, is indicative of a considerable growth of the morbidity rates in nonpsychotic forms of psychopathology of cerebrovascular genesis and psychogenic affective disorders among the Moscow elderly population. A correlation between the incidence of psychic pathology at an elderly age and different socioenvironmental factors has been studied. There are significant differences in accumulation of stress-induced life events in elderly patients with different psychopathology types. The obtained results confirm the author's assumption that the growth of psychic disorder morbidity rates, specifically, in non-psychotic forms of mental diseases of cerebrovascular genesis and psychogenic affective disorders in the past decade may be caused by increased stress-induced load on elderly people both in connection with unfavorable socioeconomic conditions of the reform epoch and a frustration of their outlook stereotypes. In the authors' opinion, their hypothesis on the correlation between the increase in the incidence of some psychogeriatric diseases and the frequency of stress-induced factors, needs further testing, in particular, by way of prospective population clinical and epidemiological studies.

The paper presents a comprehensive analysis of the experience gained by the Russian Surgery Research Center over 40 years in improving the qualification of physicians and middle-level medical workers. It outlines teaching methods, shows the efficiency of flexible and mobile technologies in improving the qualification of medical staff, which are based on an individual differential approach to each student and which are oriented to satisfy the needs of a specific health care facility that has sent a specialist to be trained, provides evidence for that it is expedient and effective to improve the qualification of medical staff on the basis of a research institution, by taking into account the fact that the students will introduce new methods and technologies into practical public health care.

The paper presents summarized data on the metabolism of selenium and approaches to justifying physiological requirements for this micronutrient. The studies dealing with the levels of selenium in different foodstuffs have indicated that they are lower in the foods made in Russia than in those made in foreign countries, which leads to its insufficient dietary intake in Russia's population, in poor ecological regions in particular. Experimental studies have revealed that organic selenium compounds exert a beneficial effect on the metabolism of priority food pollutants, such as mycotoxins and N-nitrosoamines.

The paper presents a brief review of successful cooperation of the Russian Academy of Medical Sciences (RAMS) with the World Health Organization (WHO) in developing biomedical research and promoting the scientific bases of public health. This cooperation is effected in different forms. The work of 30 WHO collaborating centers on the basis of 18 RAMS Research Institutions plays the leading part in this cooperation. The paper contains specific data on the activities of these centers in the field of medical research, scientific publications, education, and training of medical staff for Russia and other countries. The financial support given by the WHO to its collaborating centers is now very limited, but scientific information, medicaments, and equipment which can be received by the centers from this Organization are very valuable.

The paper describes basic scientific and practical results obtained in the past decade at the Research Institute of Neurology, Russian Academy of Medical Sciences, in the following areas: cerebrovascular diseases, degenerative and demyelinating diseases of the nervous system. Particular attention is paid to the development of national criteria for brain death, a concept of structural and functional levels of the vascular system, that of brain pathology in atherosclerosis and essential hypertension, rapid methods for evaluating neuronal apoptosis, a new method for diagnosing prionic diseases caused by a classical viruses, and a new method for histochemical diagnosis of the degree of reparative peripheral nerve processes in polyneuropathies and to the discovery of two new hereditary nervous system diseases, to direct DNA diagnosis of torsion dystonia, Wilson-Konovalov disease, Friedreich's disease, to the setting up of a national representative family register and DNA data bank for monogenous hereditary diseases, to the development of indications for craniocerebral bypass of cerebral vessels in multiple occlusions of great cerebral arteries and indications for programmable plasmapheresis in a number of autoimmune diseases of the nervous system, to the development of rehabilitative programmes for stabilogram biocontrol, markers of an active embologenous atherosclerotic plaque in the arteries supplying blood to the brain, etc.

The paper shows how Academician B. V. Petrovsky's scientific school has been set up and how it has developed. Three stages of its development are identified: 1) the establishment and formation of the school on the basis of the department, the development of large areas of surgery (cardiovascular, thoracic, and esophageal surgeries) in 1951 to 1963; 2) the development of the school within the research institute-department system, the setting up of its branches, specialized services in the country, organizational and methodological management of its related research institutes in 1963 to 1989; and 3) the present period marked by the design and introduction of high technologies, the development of topical research problems (transplantation of the heart and liver, including related, miniinvasive surgery, computer-aided monitoring, telemedicine, as well as staff training). Four world's priorities of the school are noted. They included as follows: diaphragmatic plasty on a vascular pedicle for various abnormalities; the world's richest experience in surgically treating gunshot wounds of the large blood vessels during military actions; discovery of the physiological mechanisms of the function and properties of the valve-aorta complex of the human aortic root; the design and successful clinical application of nitinolic memory prostheses to endoprosthesis. The paper predicts how surgery will develop in the 21st century.

The paper outlines the history of cancer chemotherapy in our country, starting with the 1950s marked by the first studies made by L. F. Larionov to design cancer chloroethylamine drugs and by studies by N. N. Blokhin who initiated their clinical studies at his headed Institute of Cancer Experimental Pathology and Therapy, USSR Academy of Medical Sciences (now the N. N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences). The historically established leading role of this center in the development of cancer chemotherapy in Russia is greatly determined by the fact that the country's first specialized department of chemotherapy headed by V. I. Astrakhan was founded in 1960, which has become a center that conducts clinical trials of new Russian and foreign cancer drugs and trains cancer chemotherapeutists. Intensive development of the problem, collaboration with the country's leading research institutions and international cooperation have promoted the development of clinical chemotherapy for cancer diseases, which is an essential component of multimodality treatment in cancer patients now. Alkylating agents, antimetabolites, antitumor antibiotics, taxanes, topoisomerase I and II inhibitors, antiestrogens, antiandrogens, aromatase inhibitors, LH-RH agonists, cytokines. There are prospects for development of basically new approaches to drug therapy for cancer diseases in terms of latest data on the molecular biological features of tumor growth.

The paper analyzes the structural efficiency of the therapeutical and preventive care system and the changes that occurred in the population's health in the Russian Federation in the 1990s. It shows that the reforming processes theoretically elaborated in detail and reflected in "The Concepts of Public Health and Medical Science Development in the Russian Federation" (1997) are slowly under way or almost absent and the structural efficiency of the entire therapeutical and preventive care system remains lower than it has been expected. The paper presents promising lines of structural and functional changes in public health.

S. V. Prozovsky's works are of general biological significance as they show that there can be most bacteria that are two forms having various structural arrangements: one bacteria have a wall, the others have no, such as L-form ones. The paper shows the importance of persistence of bacteria as L-forms in the pathogenesis of different infectious diseases. Mechanisms that determine the long-term persistence of Mycoplasmas in the infected organisms are explored.

The paper presents the results of the studies of gastric cancer (GC) associated with Epstein-Barr virus (EBV) among the patients residing in 4 geographical regions. In situ hybridization (ISH) techniques revealed that 49(11.4%) of the 430 examinees were EBV positive (EBV+), the virus-specific marker mRNA-1 of EBV, EBER-1) was found to be present in 80-100) of tumor cells. The proportion of EBV(+)-associated GC cases in different geographic regions ranged from 7.3 to 15%. These tumors were predominant in males (15%) as opposite to females (5.5%). Histological types most common among EBV+ tumors and their location in the stomach are also described. Serological findings indicated that the increased anti-EDV antibody response in 70% of GC cases coincided with the presence of the viral genetic information detected by ISH. In contrast to a humoral response to EBV, a humoral response to Helicobacter pylori was equal both in patients with EBV(+)- and EBV(-)-associated gastric tumors. Further molecular biological analysis of EBV isolates from virus positive and virus negative GC may answer the question whether there are really the so-called tumor and non-tumor variants of EBV.

The paper presents the results of genetic and epidemiological study of populations in 5 Russian regions: the Kirov, Kostroma, and Bryansk Provinces, Krasnodar Territory, and the Republic of Mari El. The total size of the study population was over 1.5 million. Random inbreeding (Fst) in all Russian rural populations was significant and varied from 0.34 x 10(-3) to 7.6 x 10(-3). The prevalence rates for autosomal dominant (AD) disorders ranged from 0.22 to 3.93 per 1000. The load of autosomal recessive (AR) disorders varied from 0.17 to 2.01. The prevalence rates for AD and AR disorders was twice lower in the urban populations than those in the rural ones. The prevalence of X-linked recessive disorders was 0.33 per 1000 males. An analysis was made to examine the correlation between inherited diseases and Fst. The Pierson correlation coefficient was 0.81 and 0.87 for AD and AR disorders, respectively. The regression suggested that genetic differentiation of the populations with genes for hereditary disorders is partially related to gene drift. This suggestion was proved by genetic geographical mapping analysis. The similarity in the patterns of genetic distance distribution for all 3 genetic systems was revealed by the correlation coefficients between the maps for neutral genetic markers and the genes of AD and AR disorders which were equal to 0.67 and 0.65. There was the highest correlation coefficient between the maps of genetic distances for the genes of AD and AR disorders (Rs = 0.88).

The paper deals with the history of immunology, the contribution of Nobel prize winners to its progress. It analyzes the achievements of immunology and its contribution to the development of basic biology, biotechnology, medicine, and agriculture. The greatest attention is paid to latest developments which are of high scientific, social, and economic values. These include the interpretation of the structure of immunoglobulins, the mechanisms responsible for the development of immunological responses, as well as hybridome immunobiotechnology, advances in immunogenetics, immunopharmacology, clinical immunology. The Russian developments of priority are the design of new-generation immunotoxins, the clinical use of the new-generation immunomodulators having a controlled structure, such as polyoxidonium, an nontoxic biodegraded synthetic polymer that has an immunostimulating action and detoxifying activity, the discovery of bone marrow bioregulatory molecules, the design of myelopid, their based immunomodulator showing its analgetic opiate-like action, the isolation, purification, synthesis, and characterization of individual myelopeptides (MP-1 to MP-6) which are constituents of myelopid.

The paper summarizes the results of the long-term study of the epidemiology of rheumatic diseases, which has been carried out by the Institute of Rheumatology. The main directions of the study are the development and improvement of diagnostic criteria, the prevalence and incidence of rheumatic diseases among urban and rural populations, at industrial enterprises, in different ethnic groups, genetic and environmental risk factors, disability, the development and introduction of preventive and rehabilitative programmes of drug therapy, etc. A number of combined national programmes was carried out. The paper presents specific results of their implementation.

The paper gives a brief account of the stages of formation and development of rheumatological care in the country, which are closely related to the researches and practical activities of the Institute of Rheumatology.

The paper shows the role of Academician B.V. Petrovsky and his scientific school in the development of extracorporeal circulation, as well as his ties with S.S. Bryukhonenko (1890-1960), the founder of extracorporeal circulation in Russia. Heart-lung apparatuses were designed with the participation of collaborators of the Surgery Research Center (SRC), Russian Academy of Medical Sciences. A short account is given of the principal aspects of extracorporeal circulation, which have been studied at the SRC, such as protective blood flow distribution, centralization of circulation, the optimal perfusion rate, criteria for adequate extracorporeal circulation, control of blood coagulation and acid-base state, blood concentration, extracorporeal circulation with autooxygenation, hyperbaric perfusion, normothermal perfusion with continuous warm blood cardioplegia).

The paper presents information on the studies on the elucidation of the etiopathogenetic role of Chlamydia and Yersinia infections in reactive arthritis, which have been made at the Institute in the past decades. Among them it mentions the first experiments and subsequent findings of detection of both Chlamydia and DNA in joint tissues in urogenic arthritis, those of identification of altered minor forms of this microbe in chronic types, which mimic in vitro persistent Chlamydia infection. The clinical experience gained by the Institute in treating Chlamydia-induced urogenic arthritis with high-dose antibiotics is reported. In addition to detailed studies of the clinical manifestations and outcomes of Yersinia-induced arthritis, long-term follow-ups have examined an association of clinical and serological manifestations with HLA B27 carriage; it is suggested that there is a partial similarity between this antigen and Yersinia antigens. Pronounced changes have been found in the mucosa of the intestine and its microflora in enterogenous reactive arthritis and a treatment with bifidum-containing drugs proposed. A variety of clinical and serological manifestations of Lyme borreliasis detected in the endemic areas of Russia is described. The specific features of rheumatological manifestations of this disease are comparable with those observed in the USA and Europe.

The past 2 decades in our country has been marked by the population's poorer health status, the obvious tendency for the incidence of many somatic and mental diseases to increase. The problem of somatogenic mental diseases and disorders diagnosed in the presence of a somatic disease merits particular attention. The paper considers the background of psychosomatics and somatopsychiatrics, presents the authors' own findings of the mental status in patients with chronic lung diseases. Various somatic disease-detected psychopathological syndrome relationships most common in the treatment of visceral diseases are systematized. Emphasis is laid to the fact that the differentiation of proper mental and somatic diseases, the elaboration of the optimal treatment policy is possible only if therapeutists work in close cooperation with psychiatrists. Principles in the complex therapy of psychopathological disorders in patients with somatic diseases are given.

The paper analyzes official statistics on infectious diseases, data on the course and outcomes of infections which have been most common in the region in the past 20 years. It shows that the epidemiological situation has deteriorated, the incidence of severe and complicated forms and mortality due to infectious diseases have increased. Great emphasis is laid on the epidemics of dysenteria and diphtheria in the past years. The etiological, clinical and epidemiological features of acute viral hepatitis are discussed. The HIV infection situation is assessed. The paper shows it necessary to improve outpatient diagnosis of infections, to rigorously implement a programme for vaccine prevention, to develop adequate etiotropic and pathogenetic therapeutic techniques for infectious diseases.

Many years' experience with complex supervision of the environmental radiation situation, the specific features of the population's physiological and health status after radiation accidents (the Chernobyl, Kyshtym and other accidents). The paper emphasized the necessity of having a knowledge of the specific features of the influence of a radiation factor (and its components) on establishing the radiation dose for the population due to the environmental peculiarities of the radiation background in different regions and abnormal zones of the Earth. The paper provides evidence for the need to apply an environmental and physiological approach to working out the standards of radiation doses for the inhabitants of post-accident polluted areas. To this end, a concept of the regional standard of exposure is proposed for different regions of the Earth with regard to the specific natural radiation background, technogenic and medical "additives" on making diagnostic and therapeutical efforts by using X-rays and radiation therapy. A new concept is offered to develop the life-support systems in the areas exposed to radiation contamination, whose main goal is to minimize radiation exposures with regard of data on each area-specific data on the regional standard of the pre-accident radiation background, technogenic background, medical additives and prediction of future radiation doses. Exposure of the population to radiation is minimized by reasonably operating its components and making special life regimens in the contaminated areas.

The past 3 years have been marked by great changes in the sociohumatarian sector of medical education in Russia. They are associated with the introduction of biomedical ethics teaching. The Meeting on Philosophic Problems of Medicine (Academy of Medical Sciences, 1996) indicates that this subject is taught at the departments of philosophy of Russia's medical higher educational establishments. At the same time there are real trends for bringing biomedical ethics to medical law and for vanishing the former subject in some special subjects. The paper analyzes the reasons for these trends and concludes that with the introduction of new biomedical technologies and the new medical legislation, it is the significance of biomedical ethics as a regulator of physician-patient relations, as a form of protection of a physician's personality which especially increases, which requires its special and individual study and teaching.

The paper analyzes the present health status of the population, including mortality of able-bodied individuals, examines the changes in age-specific mortality rates. This also gives the results of studies into the causes of increased deaths from various unfavourable exposures to occupational, environmental, socioeconomic and other factors. The paper also presents epidemiological cohort surveys of workers exposed to lead and outlines the objectives and tasks of the section "Environmental Epidemiology" of the Environmental Control Project.

The paper presents statistic data on the Russian females engaged in national economy and its individual industries, results of studies into the reproductive health of working women (their health during pregnancy and nonpregnancy, gynecological morbidity). It also gives data on the relationship of reproductive health with the factors of production.

The paper provides evidence for the need of creating new social mechanisms of nation's health promotion as a factor that influences the stability and well-being of society. To accomplish these tasks, health should be regarded as a polysystem concept that includes 1) a developing human being as a source of nation's intellectual resources; 2) economy as a tool for social welfare; 3) ecology as a predictor of the influences of working conditions; and 4) social policy as a a mechanism of controlling the priorities of prevention and treatment. New principles of new management organizational forms for health protection have been developed to implement the stated theoretical points.

The paper reviews the most important and topical information on prionic diseases in the medical and veterinary context. It gives data on bovine sponge-like encephalopathy and other new prionic infections in animals, as well as on a new type of the Greutzfeldt-jakob disease. The common pathology, pathogenesis, and transmission of the infections of this group, a prionic concept of their etiology, constituents of present-day epidemiological survey are generalized. Some most tasks of medical and veterinary importance, which are most essential to Russian science, are worded in the conclusion.