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In this article the formation of A. S. Bartenev as a medieval scholar is considered against a broad background of institutional changes and reform of the system of higher education and postgraduate studies in the USSR in the second half of the 1920s – first half of the 1930s. The development of the system of academic training in the field of medieval studies took place under the direct influence of the scholars of the “old” school, who sought to adapt the traditional requirements for qualifying essays to the new conditions. Thus, they established continuity in the development of science.

Background. A lot of brain damage including traumatic brain injuries during war can lead to persistent cognitive disorders and followed impaired functioning in everyday life. The main focus in dealing with such disorders is made on the neuropsychological (cognitive) rehabilitation. Patients psychoeducation aimed to creating an adequate internal picture of the disease and increasing self-awareness of deficits and behavior is considered as the first and the most important step in their rehabilitation process. Yet, to date the theoretical and methodological foundations of psychoeducation are not clear formulated and developed so it makes this stage of the cognitive rehabilitation not much effective. Objective. Review and analysis of the research literature in the fields of clinical psychology and neuropsychology concerning implementation of psychoeducation for neurological patients, as well as discussion of relevant issues in this problematic area. Results. The literature review has shown that “psychoeducation” was first officially recommended for severe mental illnesses and continues to develop in the modern system of psychosocial rehabilitation for psychiatric and psychosomatic patients as a special type of psychosocial intervention in the structure of their treatment and rehabilitation process. Various authors particularly highlight the learning aspect of psychoeducation, associated with the patient's mastery of methods for recognizing the manifestations of his cognitive deficits and behavioral disorders. Conclusions. Psychoeducation should be implemented in the practice of neuropsychological (cognitive) rehabilitation. In order to advance research and practice of psychoeducation for improving the effectiveness of cognitive rehabilitation, it is necessary to develop it as a typical educational process where each stage should be matched with adequate tools and practices. In addition, psychoeducation should be linked to the treatment process and to specific therapeutic and rehabilitation goals.

Background. The purpose of the work is to develop, implement and test a projection method for comparing methods of focusing electromagnetic fields passing through a dielectric partially shielded half ball. Material and methods. The Galerkin method is implemented for the vector integro-differential equation of the diffraction problem; basic vector functions in a three-dimensional solid and a parameterized nonplanar screen are determined; a parallel algorithm for solving the problem using the MSMPI library is implemented. Results. Various options for shielding the half ball in order to focus the electric field inside the body were compared. Conclusions: the most effective method of focusing the wave in the proposed arrangement of the screen-body system has been selected.

The subject of this article is the international law enforcement practice developing in relation to the concept of investment. The formation of this practice takes place in numerous decisions of investment arbitration. The Salini test plays an important role in this practice, which is an investment arbitration decision that has become the flagship of the development of the practice of applying international investment law and its principles.The purpose of the article is to identify trends in the decisions of investment arbitration, in which the concept of investment is interpreted, as well as in the doctrinal justification of approaches to this problem.The methodology of the study is a comparative legal analysis of those concepts that are the basis of the Salini test, as well as competing theories with it.Main results. The reason for the appearance of the Salini test was the impossibility of a total consensus of states regarding the legal formalization of the concept of "investment". This impossibility has an objective character, since the investments of resources in one or another sphere have such significant differences that they cannot be taken into account within the framework of a single legal paradigm. In addition, the subjective factor is also important for the formulation of this concept, since states endowed with different roles – either as recipients of investments or as investors have divergent interests that cannot be realized within the framework of a single legal approach.Conclusions. Investment arbitration has to a certain extent demonstrated the ability to overcome the differences that exist between different states regarding the key concept of investment law. It was in the arbitration decisions, and above all in the Salini test, that the signs of the key concept of investment law were identified, which together constitute its content. The content of the Salini test is that the concept of investment is formulated based on the identification of the following criteria: (1) investment of assets; (2) a certain duration of the investment of assets; (3) risky nature of investments; (4) significant economic importance for the recipient state.In addition, the author of the article comes to the conclusion that, despite the fact that the Salini test accumulated the main legal ideas about the regulation of investment activity, the amorphous nature of the concept of investment determines a high degree of its uncertainty in relation to specific situations. This provokes a continuation of the discussion regarding legally significant investment criteria.

Background. Kidney involvement is a common manifestation of the systemic autoimmune rheumatic diseases. Kidney biopsy is the gold standard for the diagnosis of kidney diseases, however this method has not yet become the standard-of-care in rheumatology practice. Aim. To assess the diagnostic value of kidney biopsy in the management of patients of the rheumatology department. Materials and methods. In this retrospective observational study we analyzed the medical documentation including kidney morphology findings in the patients of the Department of Rheumatology at Tareev Clinic of Internal Diseases. All patients included in the research had signs of kidney involvement and had undergone needle biopsy of the kidney or re-evaluation of the kidney tissue received previously. Results. From June 2016 to October 2021, 3110 patients were admitted to the rheumatology department. Among them 63 (2%) underwent kidney biopsy and were included in the study. Twenty (32%) were male. Mean age was 42.513.9 years. The most common preliminary diagnoses before kidney biopsy were ANCA-associated vasculitis (n=17), systemic lupus erythematosus (n=12), and AA-amyloidosis associated with inflammatory joint diseases (n=7). In 14 (27%) patients diagnosis was unspecified at the time of biopsy. Among 49 patients with established preliminary diagnosis morphological findings were in line 38 (78%) with the pre-liminary diagnosis. However, in 11 (22%) patients morphological findings resulted in the change of the diagnosis. In all 14 patients with unspecified condition kidney biopsy helped to establish clinical diagnosis. Ultrasound evaluation demonstrated hematoma formation in 18 (31%) patients, and among them two required blood component transfusions. Conclusion. Our study demonstrates significant value and safety of kidney biopsy in the patients with autoimmune rheumatic conditions. We suggest that kidney biopsy should be implemented in the management of this category of patients.

In recent years, a number of researchers have paid increased attention to the phenomena directly related to the sociocultural mode of ruling. However, in the domestic historiography only the Middle Ages (e.g. Boitsov, Polskaya, Voskoboynikov, Khachaturyan) are closely studied in this aspect, while antiquity remains without researchers’ attention, although it is the basis of the formation of medieval monarchies. Moreover, modern historians developing the concept of «Late Antiquity» originally focused their attention on the cultural, religious and social spheres of Late Antique society, while they were little interested in the political and institutional history of the Late Roman Empire, and accordingly there was a lack of research on these issues. Consideration of the titles of the Roman emperor allows us to bridge the mentioned gaps observed in historiography.Based on the analysis of a set of numismatic and epigraphic sources dating from the 3rd to 5th centuries, the author shows changes in the titles of Roman emperors during this period. In particular, a conclusion is made about the gradual disappearance of the title imperator, which already under the heirs of Constantine almost ceased to be used. At the same time the main title becomes dominus noster, which was gradually included in the official name since the emperors of the III c. There is also a gradual disappearance of victory acclamations, epithets pius felix invictus, references to republican posts, and the title Caesar. However, we observe the appearance of the word victor et triumphator and the addition of the epithets semper or perpetuus to the title augustus.These changes in the titles are explained by the shift in emphasis from the exaltation of the emperor’s personality with the help of specific epithets to emphasizing the impersonal and absolute character of imperial power, expressed in the theatrical rituals of Late Antiquity.

Helicobacter pylori is considered to be one of the significant reasons of formation of gastroduodenal pathology. Data on the role of H. pylori in the development of extragastric diseases are confirmed by a positive effect of eradication on peripheral blood changes. In spite of this fact both aspects are still not revealed. However, undoubtedly that H. pylori persistence on gastric epithelium creates conditions for chronic local and systematic inflammation. The aim of the sur- vey was the analysis of literary data about bacterial factors in the development of iron-, vitamin B12-deficiency anaemia and thrombocytopenic purpura included by the international consensus into the circle of evedences for diagnosis and treatment of H. pylori. Material and methods. There was accomplished search of literature sources with the help of data bases PubMed, CyberLeninka, eLibrary, Google Scholar. The results of our analysis specify mechanisms of cer- tain blood diseases pathogenesis in association with H. pylori. Multiple roles of virulent strains of pathogen in anaemia and thrombocytopenic purpura include: development of erosive and ulcerative lesions of mucosa, hypoacidity, chron- ic inflammation and autoimmune response. Data about these changes in haematological syndromes and independent eradication effects on blood parameters normalisation, are controversial. Н. pylori host iron competition theory has not been found convincing confirmation. Conclusions. It is necessary to study more deeply the connection of H. pylori and haematological diseases. The dietary research and application to maintain the mucous integrity and bacterial adhesion prevention are perspective.

The article describes a clinical case of viral pneumonia associated with COVID-19 of the only lung, it developed in the patient 30 days after pleuropneumonectomy which was done to manage fibrous cavernous pulmonary tuberculosis. The favorable course of COVID-19 was due to its timely detection and initiation of treatment, and possibly, it was due to using anti-tuberculosis chemotherapy containing antibacterial drugs that prevented nosocomial infections.

This paper highlights the problem of chronic constipation, their epidemiology, etiology, clinical features in some concomitant diseases, diagnostics and approaches to therapy with a focus on sodium picosulfate preparations. Based on several scientific papers, an analysis of a group of sodium picosulfate preparations was performed, indications, dosage, efficacy and possible side effects were considered. The paper also provides a clinical example of managing a patient with chronic constipation. Who received therapy with sodium picosulfate. Constipation is a violation of the act of defecation less than 3 times a week or more than three days. At the same time, it is possible to say about chronic constipation if such symptoms persist for 6 months. To date, the discussion about constipation as a nosological unit continues. The study of the epidemiology of constipation in various scientific sources indicates the wide spread of this disease. The diagnosis of “Constipation” is based on the Rome Criteria IV adopted in 2016. By origin, constipation can be primary and secondary, and among the factors provoking them are not only gastroenterological diseases, but diseases of other organ systems, as well as environmental factors and the intake of certain groups of medicines. Therapy of chronic constipation is carried out both medicamentally and non-medicamentally (surgical methods today have no proven effectiveness). The analysis of sodium picosulfate preparations proved their effectiveness and safety, which was also noted in our clinical case.

Non-alcoholic fatty liver disease, or NAFLD – is a pathology that usually has a metabolic cause and is not caused by excessive alcohol consumption. NAFLD is the most frequent chronic liver disease worldwide and is accompanied by a high financial burden for the patient and the healthcare system. NAFLD is generally considered a “benign disease” with low progression to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Nevertheless, due to the large number of affected patients, the prevalence of cirrhosis of the liver has gradually increased, and in fact it represents the third cause of liver transplantation in the world. Moreover, even if the frequency of HCC in patients with NAFLD is lower than in patients with HCV/HBV cirrhosis, the absolute number of HCC associated with NASH is higher due to the higher number of patients with NAFLD. It is likely that the importance of this disease will continue to grow in the future, when new treatments and prevention programs for hepatitis C and B reduce the size of viral liver infections. Many aspects of the disease have yet to be solved. It is very important to understand the mechanisms underlying the occurrence and development of NAFLD, the features of the clinic and diagnosis, as well as the tactics of management and treatment of patients with non-alcoholic fatty liver disease. It is important for patients to get a complete understanding of NAFLD so that they can play an active role in the treatment of their disease.

The problem of comorbidity becomes especially relevant in the conditions of demographic aging of the population. In recent years the number of studies devoted to diagnostic and treatment features of comorbidities, especially in elderly and senile patients, has increased. In spite of this fact, until now there are no clear recommendations for the management of comorbidities in the therapeutic practice.The article is devoted to the presentation and discussion of a clinical case of a comorbid patient with arterial hypertension. The stages of the performed diagnostic search with verification of the clinical diagnosis and the tactics of the prescribed pharmacotherapy are presented. On the basis of the presented data it is shown that exacerbation of one of the chronic diseases of the patient’s general comorbid background may significantly increase the severity of the general pathology and in its turn will determine the prognosis and influence the treatment tactics. The complexity of this case is that the patient has chronic single kidney disease in the stage of chronic renal failure. In analysing this case, it is also important to note the difficulties in the choice of drug therapy, as this situation poses significant limitations in the use of many drugs. This is a challenge that every clinician faces on a daily basis, regardless of clinical experience and medical knowledge. Only a multilevel approach will enable comprehensive medical and social care to be organised for patients with co-morbidities with chronic diseases, provide follow-up not only during exacerbations but also during remissions, contribute to the prevention of exacerbations and complications, which will consequently improve prognosis and quality of life.

Background: Currently, training of the gait function for patients with cerebral stroke using the biofeedback technology is an independent, effective, and promising method. The most common training and exposure parameters are the gait speed, cycle length, and cadence. However, the application of basic and more complex types of selective training using wearable sensor technology is rare due to the technological complexity of their use for biofeedback. Aims: To study the possibility of using the biofeedback training technology with a targeted effect on one of the basic parameters characterizing the symmetry of walking, the duration of the support period, in patients in the early recovery period of cerebral stroke. Methods: We examined 12 patients who underwent a course of biofeedback training to harmonize the period of support during the early recovery period of hemispheric cerebral stroke in the middle cerebral artery basin. The biomechanics of voluntary walking was investigated before and after the training. The spatio-temporal parameters of walking, kinematics of movements in the hip, knee, and ankle joints, and the maximum EMG amplitudes of the main muscle groups responsible for walking were recorded. The classical clinical scales were also used. The biofeedback training on a treadmill consisted of 10 sessions; the duration of the support period was the training parameter. Results. As a result of the treatment, a significant improvement was noted according to the UpGo clinical scale and Hausers walking index. The differences in the trained support phase after the treatment are not significant and demonstrate positive changes. The kinematics of movements in the joints also demonstrates relatively small, but significant changes for the knee joint. For the hip joint, no dynamics in the parameters values is observed; the joint function does not change significantly, and the amplitude asymmetry remains unchanged. For the knee joint, the greatest dynamics is observed for the main swing amplitude and its phase. Conclusion: The study has shown that the purposeful biofeedback training of the gait function using the support period to reduce the functional asymmetry in this parameter, and also has a positive effect on other gait parameters.

The formation of the institute of postgraduate studies in history in the USSR in the 1930s is examined in the article. The sources used are published legislative acts, journalistic materials, archival data. The relevance of the study is due to the fact that the proposed problem was often considered in the context of the history of scientific and scientific and educational institutions or exclusively through regulatory legal acts without taking into account the practice that actually existed and developed under the influence of the community of scientists. Using the materials of curricula for the training of graduate students of Moscow University, Leningrad University, the Institute of History of the Academy of Sciences of the USSR, as well as using the individual plans of graduate students, the author proves that the older generation of historians sought to integrate pre-revolutionary standards and mechanisms for training dissertation candidates into the new conditions of Soviet power. It is stated in the article that, despite the publication of numerous decrees, instructions, rules by government structures in relation to the institute of graduate school in the 1930s, there were no clear recommendations on the nature of the process of training scientific personnel. Supervisors of post graduate students, as a rule, themselves determined the scope of requirements for applicants. The author reveals the relative freedom of historians in determining the conditions and scientific criteria for entering the scientific community of neophytes.

The research is devoted to the study of the specificity of disorders of written speech in efferent motor agraphia, depending on the functional orientation of writing. The theoretical prerequisite for the work was the functionalist approach developed in the direction of cultural-historical psychology. The goal of the study: to reveal the variability of writing disorders in efferent motor agraphia in the conditions of different types of written speech performance in terms of functional orientation. The study used ecological tasks, which were developed in the culture of everyday writing activities, and traditional diagnostic tasks aimed at assessing separate writing operations. The study involved 22 patients with post-stroke efferent motor agraphia, 13 of them were men, the average age was 55,0±8,0 years. Nineteen patients had higher education, 3 — secondary education. The results of statistical calculations did not reveal significant differences in any of the types of errors at the level of individual words. The analyzed types of written errors were revised in favor of syntactic ones. Intraindividual analysis using nonparametric criteria revealed differences in 5 types of syntax errors. The obtained differences are explained by the choice of certain writing strategies that meet the written task assigned to the patient. The analysis shows the need to take into account not only the various instrumental components of speech and structural units of the language, in particular, syntax, but also functional changes manifested at the level of pragmatics.

Background: Tandem Gait (TG) testing is known as a clinical method for studying the walking function with complicated coordination. The precise biomechanical walking parameters in this test remain poorly investigated. Moreover, TG is a modified locomotion of walking. In general, walking is a highly automated movement. TG introduces a component of voluntary control into it. Aims: A study of functional and biomechanical symptoms in children after the treatment for the posterior fossa tumor in the long term. Methods: The study involved 15 healthy subjects aged 12 to 35 years (20.47.2), among them 4 men and 11 women control group. The group of patients comprised 33 children who had a tumor of the posterior cranial fossa (HF) at the age of 7 to 17 years (12.33.1), of these 15 boys and 18 girls, who were admitted for rehabilitation treatment to the "Russkoe pole" Rehabilitation Center. A study on the TG kinematics was performed with the Optitrack system. Results: The results showed asymmetry in the duration of the step cycle and an increase in its duration proportional to the severity of the functional state. The pelvic movements showed different abnormalities. The flexion-extension movements in the hip joints were characterized by an extension lag at the end of the transfer period and a slight decrease in the amplitude, which probably became more pronounced with an increase in the degree of the motor impairment. The movements in the knee joints demonstrated two main phenomena: an increase in the flexion setting of the joint and a decrease in the amplitude of the main swing flexion. In addition, there was a delay in the maximum of the swing flexion. The kinematic parameters of the TG of the examined patients, in contrast to the control group, are not stable. This is, presumably, due to the fact, that normally such a modification of walking is easily automated and does not require voluntary control. In patients with SCF, each step in the TG mode requires additional voluntary control, and under these conditions, the stability and repeatability of a movement are dramatically reduced. Conclusions: In contrast to the routine clinical version of the test, the analysis of the movement biomechanics allows one to present an accurate qualitative and quantitative characterization of functional disorders. According to our research, motor function disorders develop at various levels of the musculoskeletal system. The degree of their severity is in a good agreement with the expert assessment of the patient's functional state.

The definition of gastritis is based on the histological features of the gastric mucosa. This is not the erythema observed during gastroscopy, and there are no specific clinical manifestations or symptoms that determine it. The modern classification of gastritis is based on time (acute and chronic), histological features, anatomical distribution and the main pathological mechanisms. Acute gastritis will develop into chronic if left untreated. Helicobacter pylori (H. pylori) is the most common cause of gastritis worldwide. However, from 60 to 70% H. pylori-negative subjects with functional dyspepsia or non-erosive gastroesophageal reflux were also found to have gastritis. H. pylori-negative gastritis is considered when a person meets all four of these criteria: negative triple staining of biopsies of the gastric mucosa, no history of treatment of H. pylori. In these patients, the cause of gastritis may be associated with tobacco smoking, alcohol consumption and / or the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids. Other causes of gastritis include autoimmune gastritis associated with antibodies of serum anti-parietal and anti-internal factor; organisms other than H. pylori, such as Mycobacterium avium intracellulare, Herpes simplex and Cytomegalovirus; gastritis caused by acid reflux; Rare causes of gastritis include collagen gastritis, sarcoidosis, eosinophilic gastritis and lymphocytic gastritis. The clinical picture, laboratory studies, gastroscopy, as well as histological and microbiological examination of tissue biopsies are important for the diagnosis of gastritis and its causes. Treatment of gastritis caused by H. pylori leads to the rapid disappearance of polymorphic-nuclear infiltration and a decrease in chronic inflammatory infiltrate with gradual normalization of the mucous membrane. Other types of gastritis should be treated based on their etiology.

The article considers the interpretation of the Late Roman empire by pre-revolutionary and Soviet researchers. The subject attracted special interest in the antiquity rarely. Nevertheless it was covered in some detail, especially in the pre-revolutionary period. Despite the fact that the period of the Late Roman Empire became the object of careful attention of scientists, work that covered all spheres of the late-antique society was not created. However many aspects of the life of the society of the end of the III-V centuries were covered in pre-revolutionary historiography as a whole. Soviet historians continued the socio-economic direction in the study of the history of the Late Roman Empire, attempting to include it in the last stage of the "slave revolution". The period of late antiquity (III-V centuries) was assigned a decisive role in this theory, since the social struggle was to be exacerbated precisely during this period. The political aspect of the dominant was interpreted by domestic historiographers as an absolute military-bureaucratic monarchy, which began to take shape even during the Principate period, and finally took shape in the fourth century.

The article deals with the issues of the sudden appearance of white-stone construction in the middle of the XII century in the North-East of Russia, in the Vladimir Principality, which are practically not affected by science. The purpose of the study is to identify the most likely sources that influenced the process of origin and formation of the unique style of Vladimir-Suzdal architecture during the reign of Andrei Bogolyubsky (1157–1177). The research methods were reduced not only to the analysis of the Old Testament texts, with which the Great Vladimir Prince was well acquainted and admired their heroes during the construction of his white-stone churches, but also to the identification of the peculiarity of the current situation, individual facts of the prince's activity and the nature of his character, which became an active incentive to the introduction of white stone instead of bricks, which took a sacred character for Andrey Bogolyubsky. The result of the study is as follows: first, the symbolism of the white color, drawn from the biblical testaments of the consubstantial God, became the leitmotif for the architectural creations of the Vladimir prince; second, the perceived Old Testament building traditions stimulated the growth of original forms of Vladimir-Suzdal white stone architecture, which have no close analogies in the entire area of neighboring countries. In the light of the current inclusion of white stone buildings in the UNESCO World Cultural Heritage, the aspect of their study not only brings scientific novelty to the already established interpretation, but also entails a rethinking of the practical orientation of restoration and restoration work on them.

Introduction. In megacities, the use of organs obtained from those who died as a result of sudden out-of-hospital cardiac arrest (OHCA) for transplantation is one of the promising ways of addressing the problem of organ donor shortage. In St. Petersburg, the model of transition from life support via extracorporeal membrane oxygenation (ECMO) of patients after OHCA to ECMO life support for organs of potential donors was tested for the first time.Materials and methods. In order to implement the program, round-the-clock ECMO and transplantation teams were organized at the inpatient emergency ward of Pavlov First St. Petersburg State Medical University. Interaction with the St. Petersburg City Emergency Station, St. Petersburg was established. The protocol of work with potential donors brought to the hospital after a sudden circulatory arrest was developed, approved by the ethics committee, and implemented in clinical practice. This was the first in Russia and in international practice. Between 2017 and 2020, 67 patients with sudden OHCA were brought to the inpatient emergency ward. In 4 (5.97%) cases, advanced cardiovascular life support was successful, and 11 (16.42%) patients became effective donors. Mortality among this group of patients without subsequent postmortem donation was 77.61% (52 patients).Results. Liver transplantation from non-heart-beating donors (NHBDs) whose blood circulation was restored by ECMO (ECMO NHBD) was performed in 5 recipients who were in severe condition against the background of liver failure. In 1 (20%) case, there was severe liver allograft dysfunction for 33 days with subsequent complete restoration of function. Kidney transplantation was performed in 22 patients. Immediate graft function occurred in 10 (45.45%), while delayed function occurred in 12 (54.55%) patients. Kidney graft survival was 86.4%, kidney graft recipient survival was 95.5%, liver graft recipient survival was 80%, and the follow-up period was 24.1 ± 7.15 months.Conclusion. The use of ECMO to save the lives of patients with sudden OHCA can be implemented in conditions of a high degree of organization and synchronization of the work of the city emergency medical station and the emergency department of a multidisciplinary hospital. If cardiopulmonary resuscitation with ECMO (ECMO CPR) fails, it is possible to launch the ECMO NHBD donor program. Long-term outcomes of liver and kidney transplantation from ECMO NHBD are consistent with those using organs from brain-dead donors. Widespread implementation of the new organ donation model will increase the availability of transplant care.

Background: According to numerous studies, from 30% to 50% of patients with chronic heart failure (CHF) are resistant to cardiac resynchronization therapy (CRT) and cardiac contractility modulation (CCM), despite their careful selection in accordance with current guidelines. It is of interest to study neurohormones characterizing myocardial (NT-proBNP) and fibrosis (sST2) as potential additional markers of CHF patients' “response” to CRT and CCM.Aim: To evaluate the potential to use NT-proBNP and sST2 biomarkers in CHF patients combined with transthoracic echocardiography (Echo) and contrast magnetic resonance imaging (MRI) parameters of the heart to predict a positive response to CRT and CCM devices.Materials and methods: The study included 51 patients (41 men, 10 women) aged 58 ± 12 years (26 to 79 years) with ischemic heart disease post acute myocardial infarction (n = 22) or non-ischemic cardiomyopathy (n = 29), left ventricle (LV) ejection fraction (EF) < 35%, and CHF II–III NYHA functional class despite ≥ 3 months of optimized medical therapy. The patients were assessed by serum biomarkers NT-proBNP and sST2 measurements, transthoracic Echo, and contrast- enhanced cardiac MRI. After the diagnostic assessment, CRT defibrillators (CRT-D) were implanted to 39 patients and CCM to 12 patients. After prospective follow-up of the patients for 18 to 24 months, predictors of the response to each device type were analyzed in univariate, multivariate, and ROC analysis.Results: The response to CRT-D was found in 21 (54%) patients, to CCM in 7 (58%) patients. Multivariate analysis showed the following predictors of the response of patients to CRT-D were: 1) sST2 < 50 ng/mL, 2) NT-proBNP < 3900 pg/mL, 3) < 3 LV segments with fibrosis (by MRI) and 4) anteroposterior dimension of the left atrium < 4.8 cm (by Echo). Any 2 of these 4 characteristics made it possible to predict the response to CRT with an accuracy of 87% (sensitivity 90%, specificity 83%). The predictors of the response to CCM were: 1) sST2 < 30 ng/ml, 2) LV end diastolic diameter < 78 mm (Echo), 3) age < 56 years, 4) body mass index < 27 kg/m2. Any 2 of these 4 characteristics predicted the positive response to CCM with an accuracy of 92% (sensitivity 86%, specificity 100%).Conclusion: The preoperative sST2 level was the only universal marker of the response to either CRT (< 50 ng/mL) or CCM (< 30 ng/mL) devices in CHF patients with reduced LVEF. The results indicate the potential for improved efficacy of these devices with their earlier implantation after the onset of the heart disease, as well as provided that maximal control CHF in these patients has been achieved.

Introduction. The problem of gastric ulcer is of particular socio-economic importance and has a tremendous impact on the quality of life of people. The relevance of our study is due to an increase in the incidence of peptic ulcer in the population, the variability of the clinical picture depending on the age category of patients, and the peculiarities of the treatment of this gastrointestinal pathology.The aim of the study is to study the features of the course of gastric ulcer in different age groups of patients under dispensary supervision in the outpatient department of the State Budgetary Healthcare Institution of the Republic of Moldova “Republican Clinical Hospital No. 5” in the period from 2017 to 2020.Materials and methods. A retrospective analysis of outpatient records of 100 patients of different age groups with gastric ulcer who were under dispensary observation at the outpatient clinic of the Republican Clinical Hospital No. 5 in Saransk in 2017– 2020 was carried out. Statistical analysis of the data obtained was carried out using the Microsoft Office Excel program.Results and discussion. It was found that gastric ulcer is more often observed in middle-aged and elderly patients and is accompanied by blurring of the clinical picture of the disease, in contrast to young people, who have vivid clinical manifestations of this disease. Ulcerative defects in young and middle-aged patients are more often small in size and are located mainly in the area of the stomach angle, and in elderly and senile patients, ulcers are localized mainly in the cardiac region, can be gigantic and often lead to the development of complications (primarily gastrointestinal intestinal bleeding).Conclusions. The blurring of the clinical picture, the absence of pathognomonic symptoms in elderly patients determine the late diagnosis of gastric ulcer, which ultimately leads to a high incidence of complications requiring surgical intervention. In clinical practice, it is necessary to take into account these features of the course of peptic ulcer disease in elderly patients and to prescribe the necessary complex of laboratory and instrumental studies and preventive therapy in a timely manner.

Industry is one of the important sectors of the economy of any country in the world. At the same time, statistics show that the industrial complexes of many countries are developing unevenly, with periodic changes in the structure and volume of production under the influence of many internal and external factors. Ukraine's industrial complex is also undergoing spatial and structural distortions, but these trends do not always correspond to those formed in the world's leading countries in the direction and pace of change, although today the industrial complex of Ukraine is the most important structural part of Ukraine's economy, a third of fixed assets and more than 30% of the employed population. As one of the largest spheres of social production in the country, industrial production determines the level of its socio-economic development, the specialization of the economy and the extent of participation in the territorial division of labor. Properly chosen strategy for the development of industrial production, the appropriate volume and structure of production, a reasonable volume of sales allows all participants in production to achieve their financial goals. This is due to the importance of studying the activities of industrial enterprises. The article constructs nonlinear models of multiple regression, which describe the main trends in industrial production, the effect of external and internal factors on the economic performance of industry in general and industrial enterprises in the western region of Ukraine. It is established that innovative transformations in industrial production have led to the renewal of fixed assets and have had a positive effect on the dynamics of economic results. At the same time, this process was accompanied by a reduction in the number of people employed in industry. It is revealed that the influential factors of the external environment include economic conditions of management, and among the factors of the internal environment – the management of innovation and innovation activity of economic entities. It is recommended to expand the set of tools at the expense of distribution-lag, autoregressive, simulative and other econometric models to describe the relationship between the economic performance of enterprises and factor characteristics.

The object of the study was a hoard of Roman coins discovered to the Southwest of the Melnikovo—Kashtanovka highway. He was buried in a wooden box with bronze handles. The treasure consisted of brass coins of the Italic minting. Most of them are significantly worn out. Many coins are so badly worn that they have lost significant weight. But, judging by the fact of their discovery in the treasure, they continued to be appreciated. We come to the conclusion that the object of our research was not a collection of metal objects valued for the material from which they were made. It is a treasure of money, made up of well-known means of payment in the region. We believe that Roman brass coins came to the region in abundance under the emperors of the “golden age” in exchange for amber. We conclude that the population of the Sambian-Natangian culture valued the change money of the Roman coinage as a means of payment and accumulation.

Background: The standard of the surgical treatment for arthrosis of the knee joint (KJ) at the later stages is total arthroplasty, which allows relieving the pain and eliminating the existing deformity. However, there are not enough data on the long-term results after the surgery that is important for understanding the dynamics of the recovery and predicting the result. Aims: Study of clinical, functional, and biomechanical symptoms in patients after total arthroplasty of the knee joint in the long-term period. Methods: 22 patients after knee joint replacement and 20 relatively healthy adults (control group) were examined in long-term periods. The biomechanics of walking was studied at an arbitrary pace. The temporal characteristics of the gait cycle, shock loads and movements in the hip joints (HJ) and KJ were recorded. We recorded the time characteristics of the walking cycle, shock loads and movements in the hip joint (HJ) and KJ. The patients were divided into two subgroups according to the results of the biomechanical study. The patients from subgroup 1 had good functionality with a swing amplitude of the knee joint of 50 degrees or more, the movement algorithm was preserved. The patients from subgroup 2 had a swing amplitude of up to 50 degrees, the movement algorithm was impaired. Results: The temporal characteristics of the waking cycle of knee arthroplasty patients did not differ significantly from the control group in the long term. Abduction-adduction and rotation movements in HJ and KJ show a decrease in the amplitudes, more pronounced in the second subgroup. The main changes in the kinematics of the hip joint are characterized by a decrease in the range of motion and a longer extension time during the support period, which was found for both sides, especially in the second subgroup. The greatest changes were observed in the kinematics of the knee joints movements. They included a decrease in the amplitude of all the movements, not only on the endoprosthesis side, but also on the opposite side. Conclusions: There is no complete restoration of the knee joint function after total arthroplasty in the long term. The function of both lower limbs is symmetrically decreased. The fact of functionally different (less severe and more severe) results may be associated with the initial functional state of the joint before arthroplasty or with the subsequent period of rehabilitation.

Based on the empirical research, the article considers the correlation of national and ethnic identities of the youth of Saint Petersburg. The authors conclusions are based on a series of sociological studies conducted in 1996, 2011 and 2019 by the Laboratory of Ethnic Sociology and Psychology of the Faculty of Sociology of the Saint Petersburg State University under the guidance of Z.V. Sikevich and also on the data of other researchers studying similar issues in different Russian regions. The authors present their interpretation of the structure of national identity and typology of ethnic identities; consider the following forms of correlation of national and ethnic identities - dominant ethnic identity, ethnic radicalism, dominant national identity, ethno-national radicalism, ethnic and national indifference; focus on the rank of national identification in the system of group identities and on the indicators of national consolidation; use content analysis to identify the symbolic interpretations of the words Russia, citizen and patriot; analyze contradictions in the national identity of the youth. The article presents the following most important findings of the study: 1) national (civil) identity dominates other forms of social identification of the youth; 2) in the structure of social identities, confessional identity is insignificant, while there is negative distancing towards representatives of Islam; 3) ethnic and ethno-national radicalism is typical for men; 4) compared to 2011, the positive trend of statist attitudes and the negative trend of critical attitudes to power are obvious; 5) the perceived norm and attitudinal behavior of the youth are not quite consistent; 6) gender affects the level and type of both ethnic and national identity.

The article reveals the concept of "development of economic entity" and the formation of the concept of "one", "two" and "many" criteria for assessing its development. The development of the enterprise is considered as a process of acquiring new qualitative, quantitative or structural properties that involves changing the parameters of its state. The system is transformed through the growth, activation or structuring of the constituent elements. It is determined that growth (horizontal, vertical, diversified) involves the expansion of the size of the enterprise, its potential and scale of activity. Activation occurs due to the increase of business activity of enterprise, through the establishment and strengthening of communication with the contact audience (suppliers, customers, regional community, etc.). Restructuring is characterized by the rebuilding of relationships in the system and changes in enterprise management, i. e. the choice of a new leadership style, modernization of the organizational structure of management, and so on. The developed conceptual model for assessing the development of economic entity is based on the understanding of development as a threefold essence of potential, functional activity and effectiveness. Changing any of these elements affects development and characterizes it. An inherent property of enterprise development is the advancement of the rate of change of indicators of functional activity in relation to the pace of change of efficiency and potential. Based on the definition of development as a permanent process, which is always associated with the emergence in time of something qualitatively new or a new combination of existing elements, which leads to the formation of a new result, a triangle of development of economic entity is formed. Stages of the enterprise development assessment have been developed. The criteria for assessing the development of economic entity are defined.

At present, it is widely recognized that machine perfusion allows for a decreased rate of delayed function of the renal graft and of the risk of liver graft early dysfunction. The aim of the review is to present the actual changes of the donor pool related to prevailing numbers of donors by expanded criteria, to determine the prospects of expanding of the available donor pool based on their selection, as well as development of functional rehabilitation and modification at tissue, cell and molecular levels with the help of perfusion technologies. The article presents the state-of-the art view on the mechanisms of ischemic-reperfusion injury of donor organs, delineates the trends in the maintenance of their viability, and gives the literature data on the role and outlook of perfusion methods in organ transplantation. The authors provide the rationale for a comprehensive systemic approach to the assessment of the functional status of a donor organ with any baseline parameters and discuss a number of theoretical provisions on the implementation of a personalized perfusion approach to ensure the availability of transplantation care.

Alcohol abuse with resultant alcoholic liver disease (ALD) are a leading cause of morbidity and mortality worldwide. Due to absence of clinical symptoms of the disease in the early stages, it is diagnosed in the later stages with higher complications and mortality rates. Diagnosis of ALD requires a better determination of life history and prognostic factors, as well as the search for reliable non-invasive techniques. Early detection of alcoholic steatohepatitis in primary care settings and subsequent interventions will facilitate the satisfaction of this requirement. Despite some important advances in understanding the pathogenesis and clinical features of ALD, the past 40 years have not seen significant advances in the therapy. The long-term alcohol abstinence is the main therapy for ALB patients, regardless of the disease stage. It is associated with improved clinical outcomes across the ALD spectrum: from asymptomatic early cases to complicated severe cases. Clinical ultimate outcomes depend on the ALD stage. The ultimate outcomes are associated with normalisation of abnormal laboratory test results and reduction in liver fibrosis in compensated patients. These ultimate outcomes can be monitored using non-invasive tools, but current medical interventions are largely limited and ineffective. Supportive therapy forms the basis of the treatment, it is worth paying special attention to combined herbal medicines as less toxic ones with single contraindications and consistent with the desire of many patients to use natural preparations.

Technological features of the growth of single crystal silicon carbide inevitably create condi-tions for the formation of crystal structure defects in them. A method is proposed for recognizing and analyzing a dislocation structure of single crystal silicon carbide based on the use of optical microscopy and a direct distribution neural network. The method was tested on homoepitaxial lay-ers of 4H-polytype silicon carbide. Software has been developed that allows building maps of the dislocation structure distribution over the surface of single crystal silicon carbide. The software was tested on digital images of the surface of silicon carbide epitaxial layers. The accuracy of recognition of dislocation structure was 95%. The dislocation mapping is used in the development of process technologies for reducing their density during the growth of single crystals.

The article describes a clinical case of successful treatment of a patient with disseminated bilateral fibrous cavernous tuberculosis and extensive drug resistance, with preserved sensitivity to only one anti-tuberculosis drug; the fifth chemotherapy regimen and pleuropneumonectomy were used.

Background: The goal of our study is the comparative analysis of the effect of fluoroquinolones on the chicken leukogram. Materials and methods: In the study we used Ciprofloxacin, Ofloxacin, Levofloxacin, Moxifloxacin, Norfloxacin, Enrofloxacin. For the study we made seven groups, thirty-five chickens in each group. The control set was given pure drinking water throughout the experiment; each of the experimental groups was given water with one of the above-mentioned antibacterial fluoroquinolone drugs, the dosage being 200 mg per liter. The blood samples were collected with cardiac punctures on the first, third, fifth, seventh and ninth days after the withdrawal of the drug. The leukogram contains the total number of leucocytes and the content of separate cell types and their total numbers. Results: The valid changes in the number of pseudoeosinophils do not show clear tendencies, such changes are observed once under the influence of each drug on different days of the research. On the seventh and the ninth days after the drug withdrawal all the fluoroquinolones except Ofloxacin caused lymphopenia. Ciprofloxacin is the only tested drug, the usage of which does not cause valid changes in the number of monocytes. Those groups that receive Enrofloxacin or Ofloxacin have a short period of eosinophilia. Levofloxacin, Enrofloxacin, Ofloxacin cause refractory basophilia. Conclusion: The application of antimicrobial fluoroquinolone drugs in the course of ten days results in changes in the ratio of different kinds of leucocytes in chicken blood, but at the conclusion of the experiment every value in the leukogram returns to physiological standard.

The objective: to analyze literature and to compile the most accurate and complete view of lactic acidosis and specific parameters of its treatment in anesthesiology and resuscitation practice. Result. Lactate levels are commonly evaluated in critically ill patients. Hyperlactatemia is defined as a lactate level >2 mmol/L and it is common in the critical care setting. Hyperlactatemia and lactic acidosis may develop due to increase in lactate production, a decrease in lactate clearance, or a combination of both. The current review provides an overview of pathophysiology of lactate elevation followed by analysis of different etiologies of hyperlactatemia in critically ill patients.Additionally, approach to differential diagnosis and treatment of elevated lactate levels in this category of patients is discussed.

The conception of the project-oriented formation of the enterprise development program is developed in the article. The definitions of key concepts of enterprise development are considered. The graphical model of visualization of potential of the enterprise is developed. The dual character of the enterprise in the development process, which manifests itself in its understanding as an object of innovative transformations under the influence of internal and external factors, and a subject whose activity is aimed at achieving economic, social, environmental and image results, is determined. The purposes and results of development of the enterprise are determined. The results of activity of economic entities of Ukraine for 2014-2018 are presented. It has been determined that the emergence of economic outcomes is indirectly influenced by social, environmental and image outcomes, at least through preferences from consumer and staff loyalty and partnerships in the business environment. It has been defined that forming an enterprise development program in terms of a multitude of the optimization criteria that reflect the development goal, availability of project alternatives and limited resources is a complex and multifaceted task. The multicriteria optimization model of forming an enterprise development program is constructed, which belongs to a class of linear variables models with discrete variables, which can be solved by standard software tools. The model’s information support consists of the normative data characterizing of the projects and expert evaluations of the results of their implementation. It is determined that solving the problem of polycriteria in the project-oriented formation of the enterprise development program can be reached by finding a Pareto-effective solution by the methods of compromise programming (uniform optimization, concessions, penalty assessments, etc.).

The research is devoted to the study of writing errors in patients with Broca’s aphasia performing the human-specific writing tasks. The object of the study is writing, the subject – disorder of writing in Broca’s agraphia. The aim of the research was to identify the most specific types of errors in writing language, depending on the cultural and historical significance of the actualized functions of writing language in Broca’s aphasia. Used instruments include classical neuropsychological assessment as well as specially developed experimental tasks aimed at actualization of cultural-historical functions of writing (communicative, mnestic and regulatory functions). Nonparametric Chi-square Friedman and Wilcoxon T-criteria used for pairwise comparison of data and analtysis of the distribution of errors. The study involved 22 patients with organic brain damage due to ischemic stroke in the basin of the left middle cerebral artery. Shown that the most specific grammatical errors were syntactic errors such as breaking of the sentence boundaries, omissions of independent and functional words, disorders of concordance and execution. Diversity in the performance of writing tasks that are similar in neuropsychological component structure but differ in functional purposes are explained by the choice of different strategies of writing. However, the general pattern is the dominance of the semantic content of the text over its formal structuring, expressed in grammatical rules. The research confirms that when studying agraphia, it is important to consider both structural (speech act operations) and functional (cultural and historical specific) aspects of writing.

Background. The coronavirus pandemic was the biggest test for the global eco-nomy. Most of the developed world powers were not ready to face this infection. The main means of combating COVID-19 – vaccination – is facing resistance from some members of society. The low rates of vaccination in Russia and a significant number of its opponents make it possible to characterize the problem of positioning vaccines and the vaccination campaign itself in Russia as significant, and the study of this problem as relevant. Materials and methods. The methodological basis of the study was the source-based method, as well as the survey method. A sample population was formed and an appropriate questionnaire was developed. The sample population was 250 people. Results. The reasons preventing the active vaccination of the population from COVID-19 in Russia are identified, and ways to solve the problem of an unsuccessful vaccine positioning campaign are proposed. Conclusions. The problem of positioning Russian vaccines as a commodity on the national market is the key problem of the Russian vaccine market. The need to build public confi-dence in COVID-19 vaccines is an effective marketing tool in solving this problem.

Background. The size of international trade in services is of particular relevance as an indicator of the level of economic development, openness of the economy and the scale of international cooperation. Materials and methods. The study was based on official statistics on the development of foreign economic relations of the Penza region in the sphere of trade in services. The implementation of the research goal was achieved through the use of methods of statistical and comparative analysis. Results. Based on the analysis of international trade in services in the Penza region for 2018–2019. the most demanded services on the international market, produced and purchased in the region, are revealed, the ratio and dynamics of exports and imports for a number of international services are revealed. Conclusions. Trade in services is one of the most promising areas of foreign economic activity in the region and requires the development and activities of relevant institutions and activities aimed at supporting and intensifying this activity.

Russian Society of Cardiology (RSC)With the participation: Eurasian Association of Therapists (EUAT), Society of Specialists in Heart Failure (OSSN), Russian Scientific Medical Society of Therapists (RNMOT), Russian Society of Pathologists, Russian Society of Radiologists and Radiologists (RSR)Endorsed by: Research and Practical Council of the Ministry of Health of the Russian Federation

Constipation (constipation, obstipation) is a symptom in which the frequency of the act of defecation is less than 3 times a week and is accompanied by the release of solid, scanty feces with a feeling of incomplete emptying of the rectum and often requiring additional effort. World health organization in the « International statistical classification of diseases and health-related problems. ICD-10 « refers to constipation diseases (code K59. 0). At the same time, gastroenterological organizations such as the world organization of gastroenterologists and the American gastroenterological Association take a different position, emphasizing that constipation is not a disease, but a symptom. Most often constipation affects young children and the elderly (over 60 years). The feeling of difficulty in emptying the bowel, the impossibility of relief, despite persistent straining, the need to apply additional, stimulating the release of the rectum from the feces, actions (pressure on the perineum, the side walls of the anus, the vagina). The constant state of insufficient emptying of the rectal ampoule often leads to the development of perineal prolapse syndrome. Chronic constipation is diagnosed in cases where the frequency of stool becomes less than 3 times a week, defecation is significantly difficult and requires pronounced efforts, the consistency of the stool is dense, tubercular, there is a feeling of incomplete liberation of the rectum from feces. Constipation is a very common digestive disorder among the population, the tendency to constipation can lead to the development of serious proctological diseases, so this problem has a high degree of social significance. Due to its prevalence and pronounced deterioration in the quality of life of patients, chronic constipation is isolated in an independent syndrome, and currently the problem of constipation is actively studied by proctologists, gastroenterologists and other specialists. This article is devoted to the main issues of modern therapy of constipation.

Software failures are a tangible and imminent problem in enterprise software systems. Failures are usually detectable via monitoring threshold values of some critical indicators. At the same time, failure prevention or mitigation is often not possible due to a lack of time for any actions before a failure. It is necessary to predict failures in a timely manner using application status logs. For this purpose, different approaches to failure prediction have been studied, and one of them is based on the detection of foregoing anomalies in data on states of applications. The paper proposes several machine learning approaches to anomaly detection for failure prediction. The best results of failure prediction have been achieved with the gradient boosting method over decision trees with application of the sliding window method and excluding pieces of time series prior to anomalies in log data. This allows finding failures in considered data at a reasonable time before the system fails. In case of a lack of labeled data for training, an unsupervised approach using isolating forests and an automatic data labeling approach are proposed.

Knee arthroplasty (KAP) is a cost-effective and reliable treatment for knee osteoarthritis with the predicted increase in demand. Clinical assessment systems for the effectiveness of rehabilitation do not fully reflect the recovery process, but the evaluation of biomechanical gait parameters is most objective.Objective: to study of the changes in the biomechanical gait parameters after KAP for osteoarthritis.Subjects and methods. A total of 54 patients (31 women and 23 men; mean age, 63.86+1.69 years) were examined an average of 3.94+1.40 months after KAP at the Ivanovo Regional Hospital for War Veterans. A control group consisted of 49 people (28 women and 21 men; mean age, 34.6+8.8 years). Walking performance was studied three times: at admission, one and two weeks after the end of a cycle. Gait parameters were recorded using a Stedis feedback walking simulator (OOO “Neurosoft”, Ivanovo, Russia) in the Assessment package (Registration certificate No. РЗН 2018/7458 dated 08.07.2018). The results were processed using the standard biomedical statistical methods at a significance level of 5%.Results and discussion. In the early recovery period, the patients’ walking after KAP was characterized by decreased speed, by the symptoms of unloading, and by a slight lower extremity functional asymmetry. The revealed phenomena were suggestive of both positive changes in the recovery process as a whole and the normalization of the temporal pattern of a step cycle. It was established that walking speed and the double support period of gait were not restored 3 months after KAP. The main biomechanical changes were non-specific and were associated with reduced walking speed. It was suggested that physical therapy should be aimed mainly at increasing the stride length when controlling dynamic loads. The criterion for the effectiveness of rehabilitation was to reduce asymmetry when walking.

Phonoarthrography, vibration arthrography are non-invasive methods for assessing the condition of cartilage and the knee joint as a whole based on the sounds made by the joint movement. Acoustic sensors (accelerometers, microphones) are attached to the knee to measure the knee joint noise both in control groups (young adults and elderly subjects) and in patients with knee osteoarthropathies. Different authors propose different methods for attaching sensors, documenting and analyzing the joint sounds. The identified specific features allowed distinguishing between asymptomatic knee joints and those with osteoarthropathies. Acoustic signals were recorded and processed, and their frequency characteristics were determined and classified. The classification effectiveness correlated with the existing diagnostic tests and hence phonoarthrography and vibration arthrography can be qualified as a useful diagnostic aid.

The relevance of the research is determined by the growth of cases of abdominal tuberculosis (AT), which is difficult to diagnose. Aim. Identify clinical features and possibilities of timely AT diagnosis. Materials and methods. Medical reports of 116 AT patients. The results of clinical, microbiological, immunological, radiological, endoscopic and morphological studies were analyzed. The results. AT proceeded under the mask of ulcerative colitis and Crohn's disease (26.3%), alcoholic and biliary hepatitis (11.8%), lymphoproliferative and oncological diseases (61.8%), often generalized against the background of HIV-infection. The duration of the diagnostic search for disease verification exceeded 3 months due to incorrect (erroneous) interpretation of intoxication (26.3%) and radiological pattern in the lungs (23.7%), non - application and late application of laparoscopy (39.5%). Conclusion. When diagnosing AT, it is necessary to consider the peculiarities of its clinic and to conduct timely laparoscopy.

Purpose of the study: to examine sensibility of baroreceptors and the autonomic nervous in the passive orthostatic test in patients with chronic impairment of consciousness due to severe brain damage and determine their role in the rehabilitation process.Materials and methods. The study included 30 patients with long-term impairment of consciousness due to severe brain damage (group 1), 10 of them being in the vegetative state (VS) and 20 being in the minimally conscious state (MCS). Craniocerebral trauma was the main cause of severe damage in that group (53% of patients). The comparison group included 24 patients with focal neurological symptoms caused predominantly — 79.2% of cases — by cerebrovascular disorders (group 2). The control group (group 3) consisted of 22 healthy volunteers of a comparable age. All measurements were done with the help of a Task Force Monitor 1030i (CNSystem, Austria) in the course of passive orthostatic test at 0°–30°–60°–0°. Changes in the power of low-frequency (LFS) and highfrequency spectrum (HFS) of heart rate variability and baroreceptors sensibility (BRS) were analyzed. Statistical analysis was carried out using Statistica-10 software. Significance of inter-group differences on unrelated samples was determined by the Mann–Whitney U-test. Differences between groups were considered significant at P 0.05.Results. Maximal background values of BRS were found in the control group. In group 1 and 2 patients, considerable decrease of that index was noted, which was proportional to the brain damage severity. Similar dynamics was observed for the indices of autonomic nervous system sensibility (LFS and HFS). The main trend of orthostatic changes of BRS, LFS, and HFS was characterized by progressive decrease of the indices with increase of the patients’ angle of tilting and their return to the baseline level after the patients were put back into the horizontal position. 4 patients of group 1 (14%) displayed signs of orthostatic disorders upon tilting to 30°: in 3 cases, orthostatic hypotension was observed, and in one case the postural orthostatic tachycardia syndrome (POTS) was diagnosed. Those patients differed by lower BRS and higher sympathetic system activity (LFS) vs. the same indices of other patients in that group.Conclusion. Patients with chronic impairment of consciousness during the post-comatose period after a severe brain damage display a significant decrease of baroreceptors sensibility and autonomic nervous system disorders manifesting in significantly lower activity of the sympathetic and parasympathetic systems. The prominence of such disorders is associated with brain damage severity. Their risk of developing orthostatic hypotension during tilting towards a vertical position is higher in patients who have lower baroreceptors sensibility, and this should be taken into account beginning the process of their verticalization.