В основу статьи положен анализ взаимосвязи характера и частоты возникновения алкогольной болезни печени и потребления пациентом алкоголя. Представлены данные о зависимости уровня смертности, обусловленной циррозом печени, от уровня потребления алкоголя в Европе и России. Указывается, что алкогольная болезнь печени относится к распространенным заболеваниям, выявляющимся у 10-25% мужского населения большинства развитых стран. Связь между смертностью от цирроза печени и уровнем среднедушевого потребления алкоголя была строго доказана и наблюдалась в различные периоды времени и в различных регионах мира. The article is based on the analysis of the relationship between the nature and frequency of alcoholic liver disease and the patient’s alcohol consumption. Data on the dependence of the death rate due to cirrhosis of the liver on the level of alcohol consumption in Europe and Russia are presented. It is indicated that alcoholic liver disease is a common disease that is detected in 10-25% of the male population of most developed countries. The link between mortality from cirrhosis and the level of per capita alcohol consumption has been strongly proven and observed in different time periods and in different regions of the world.

В статье рассмотрены вопросы эпидемиологии, диагностики, клиники и лечения относительно редкого заболевания - феохромоцитомы. Приведено собственное наблюдение успешного лечения феохромоцитомы в многопрофильном стационаре. The article deals with the issues of epidemiology, diagnosis, clinic and treatment of a relatively rare disease- pheochromocytoma. We present our own observation of successful treatment of pheochromocytoma in a multi-specialty hospital.

В литературе последних лет обращено внимание на гендерные особенности результатов лечения острого коронарного синдрома. Авторами выполнен анализ сравнительной эффективности консервативного и инвазивного лечения у 619 женщин с нестабильной стенокардией и инфарктом миокарда. Сделан вывод, что инвазивная тактика лечения женщин с ОКС является методом выбора. The aim is the assessment of efficacy of conservative and interventional treatment of acute coronary syndrome (ACS) in women. Conclusion. Invasive strategy for the treatment of ACS in women, like in men, has a higher efficacy compared with the conservative strategy: mortality with medical therapy in patients with unstable angina was 3.3 times higher, and the patients with myocardial infarction are 4.3 times higher than in patients who had coronary angioplasty with stenting.

Authors analyzed a five years experience of the diagnosis and treatment of peripheral arterial aneurysms in the Center of vascular surgery of the multidisciplinary military hospital. Authors give the assessment of different diagnostic instrumental methods and demonstrate results of surgical treatment. The possibility and effectiveness of endovascular-traumatic method of surgical correction of this pathology of lower limb arteries are given.

Retroperitoneal surgical approach is the main component of operative intervention. This approach predetermines quality of surgical operation and the risk of intraoperative complications, an opportunity of their prevention. Lymphadenectomy is the unique method allowing authentically to confirm cancer in the lymph nodes and to evaluate a stage of disease. Endoscopicsurgical nephrectomy is the operation that keeps advantages of minimally invasive surgical approach in the majority of kidneys diseases without loss of quality of surgical treatment.

Tactics of alcoholic liver disease treatment is defined in accordance with lesion level. Differentiated approach to these patients can significantly improve the efficiency of diagnosis, treatment and rehabilitation. At the stage of cirrhosis it is necessary to focus on prevention and treatment of complications. Patients with compensated cirrhosis and subcompensated improved survival achievable Propafenone S-ademetionine (geptral, Geptor). The article presents the results of our study demonstrating a significant decrease in serum bilirubin in patients on background intravenous S-ademetionine. Practicability of stage system creation of medical rehabilitation of patients with alcoholic cirrhosis is approved.

Considered the introduction to the health practice of the remote medical help by the information and Communication Technologies to improve the quality of diagnostics of dermatological patients in the remote garrisons. Developed the scheme and the map of teleconsultation, and also defined indications for its conduct. Given the example of online consultation resulted in a diagnosis of pathomimics (Munchausen's disease), and in the recommendations for survey and treatment of the patient. It is concluded that the development of remote consultation of the patients needing dermatovenereological medical care from any health care facility will bring closer the highly specialized dermatovenereological assistance to the remote garrisons and will significantly save the cost of such assistance.

The aim of the present study was to investigate the relationship of C-peptide levels with insulin, resistance; components of metabolic syndrome and cardiovascular disease in patients with diabetes mellitus type 2. The study included 98 patients with diabetes mellitus type 2, who were divided into two groups by the level of C-peptide. The first group consisted of 54 patients with elevated levels of C-peptide; the second group consisted of 44 patients with normal levels of C-peptide. Our study has shown a positive correlation between C-peptide levels and a body mass index (BMI), triglyceride levels and the triglyceride/high-density lipoprotein ratio. Correlation analysis also allowed identifying a statistically significant association of the HOMA-2-IR-C-peptide with a BMI, triglycerides and the triglyceride/high-density lipoprotein ratio. In the group of patients with elevated levels of C-peptide found in practically all components of metabolic syndrome, as well as a high incidence of arterial hypertension and ischemic heart disease. The study shows that the detection of the C-peptide level is preferred in comparison with insulin for assessment of insulin resistance, presence of metabolic syndrome and can be used in type 2 diabetic patients for early detection of cardiovascular risk.

Chronic kidney disease (CKD) is independent factor of progression of ischemic heart disease (IHD). In that case, it is important to know the peculiarities of diagnosis and treatment of IHD in patients with CKD. The importance of this problem is increasing due to increase of patients with CKD. Cardio-vascular morbidity in patients with CKD is higher than in patients with other diseases. Myocardial revasculization may lead to significant improvement of survivability in patients with CKD. Among the prevention and treatment facilities the Vishnevsky Central Military Clinical Hospital N 3 is a leader in preforming the myocardial revasculization. The authors gave an example of successful coronary artery bypass surgery in patient with IHD and end-stage of CKD. Development of modem medical technologies, systematization of experience and knowledge allow in XXI century to consider CKD as non-absolute contradiction to elective surgery in case of different forms of IHD, including the end-stage of CKD (dialysis treatment). It is advisable to perform the myocardial revasculization in patients with the end-stage of CKD in specialized multi-field hospital, where can provided not only cardiosurgical and cardiological treatment but also specialized treatment for neurological patients, including haemodialysis and hemofiltration.

The article is dedicated to the 45-year history of combat casualty care in the Vishnevsky Central Military Clinical Hospital N 3. In the echelon system of medical care the Vishnevsky Central Military Clinical Hospital N 3 ranks the echelon (level) N 3. Specialists of the hospital, along with a medical and preventive activity, practice methodological, educational and innovative activity, participate in different scientific forums. Temporary duty assignment to the combat, human-made disaster and natural disaster areas is a real functional test. 64 physicians have an extreme situation experience. The Vishnevsky Central Military Clinical Hospital N 3 is a clinical base of department of surgery, advanced physician training department, combat casualty care department of the Institute for advanced physician training of Mandryka scientific and educational clinical center. For the purpose of reducing the terms and improving the quality of medical care it was suggested to make the integration connections with leading hospitals of the Ministry of Defense of the Russian Federation.

The article is dedicated to the history of the Vishnevsky Central Military Clinical Hospital N 3. N.M.Nevskiy, the head of the 2nd Central military clinical hospital n.a. P. V. Mandryka, suggested to groud a military diagnostic and treatment complex in the countryside. It was caused by the exceeding demand for hospitalization for military personnel. The new hospital was built in 4 years and launched on 20 June 1968. The Central military clinical hospital of n.a. P. V.M andryka was transformed to the staff N 27/705 with 925 beds. This staff consisted of main treatment department with 655 beds (Krasnogorsk), branch of the 1st hospital with 120 beds (Moscow), branch of 2nd hospital with 100 beds and sanitary department with 50 beds (Bolshevo, the Moscow Region). In 1970 branch of the 1st 2nd hospitals were excluded from the staff. The name of hospital was changed for "Central clinical military hospital". In 1976 hospital was named after the prominent military surgeon A.A. Vishnevsky. Nowadays hospital is a multi-field medical and preventive treatment facility, one of the highest technological medical centers of the Armed Forces of the Russian Federation. This hospital provides a qualified medical treatment for servicemen, their families and other categories of employee of the Armed Forces. Hospital consists of 18 specialized centers, 110 diagnostic and treatment departments, 1 outpatient hospital and 6 branches.

Alcohol--is the main causative factor of cirrhosis among the population in Russia. The primary prevention must be focused on exception of consumption of heavy doses of alcohol hepatitis and B vaccination. There are no healthy doses of alcohol. Secondary prevention means the use of the hepatoprotectors. List of hepatoprotectors and also amount of money spent to the purchase of these hepatoprotectors increase constantly. But, unfortunately, alongside with it, increases the mortality from hepatic disorders. Effectiveness of the most hepatoprotectors (such as Essential phospholipids, milk thistle) equals to the effectiveness of placebo.

Spanning 45 years team of the Vishnevsky Central Military Clinical Hospital N 3 has achieved high results and made the Vishnevsky Central Military Clinical Hospital N 3 one of the best medical centers of Russia providing state-of-the art care for patients with cardiovascular diseases. Nowadays the Center of interventional radiology and treatment provides all methods of roentgen-endovascular interventions on coronary, peripheral, cerebral vasculature, veins and bile ducts. The center has modern diagnostic and treatment equipment: digital angiography system with 3-dimensional angiography, 3D-navigation and CT angiography. Annually, about 1500 diagnostic coronarography and about 500 percutaneous coronary interventions are performed in the hospital. More than a half of peripheral arterial intervention is endovascular. The examples of such operations as single-step iliac artery stenting, inferior vena cava thrombectomy, embolization of a dural arteriovenous fistula of the posterior cranial fossa, percutaneous transhepatic paracentetic cholangiostomy are given.

The authors show that the prophylaxis of local complications after femoral artery cannulation consists of proper technique of puncture, careful site selection for puncture, usage of closure devices and external compression. The authors also underline that it is necessary to pay special attention to patients receiving anticoagulant or antiaggregant therapy. Despite the rarity, occurrence of inguinal canal hematoma after the X-ray contrast angiography and X-ray endovascular surgery is a serious complication that can prolong recovery. For a complete recovery after femoral artery paracentesis it is necessary to provide a bed regime, to apply a compression band and to monitor a medical state during the first day.