One of the most important directions of strategic development of a medical university is the integration of educational and scientific work into clinical practice. The implementation of this direction is possible if there is a Clinic in the structure of the medical university – a separate multidisciplinary medical structural unit of the 3rd level of medical care, which is the leading clinical and research base of the medical university. The article analyzes the results of the activities of the University Clinic, presents the development program of the University Clinic and measures to achieve the target model for the development of the University Clinic.

The aim o of the study is to assess the trends and forecast of the epidemiological process of HIV infection among women in the Chelyabinsk region. Materials and methods. Data from the reporting forms of the Chelyabinsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases, data from the ASODOS electronic database software, data from epidemiological investigations. Results and conclusion. The data obtained demonstrate an increase in the impact of HIV infection on the mortality rates of the working-age population, especially in the context of a declining population in the region. At the present stage, a decrease in the incidence of HIV infection in a highly affected region has been established. This fact is largely associated with the widespread use of antiretroviral therapy. However, mortality rates tend to increase, due to the insufficient effectiveness of measures aimed at attracting this group of patients to medical observation and treatment.

Issues related to the medical care of patients in large medical institutions are mandatory for a high level of quality control and safety of medical institutions. The aim of the study was to develop organizational and methodological proposals for organizing advanced training of pharmacovigilance organizations based on the analysis of regulatory legal acts in the field of pharmacovigilance and the results of a survey of top officials of organizations. Material and methods. Analytical method of selective study and analysis of the regulatory legal acts of the Russian Federation regulating the work of medical organizations in the field of pharmacovigilance, Sociological method of direct online research (Internet survey) of the opinions of 89 prospective persons involved in research of organizations in the Chelyabinsk region for the period June-September 2022 according to the criteria to evaluate the development work of pharmacovigilance organizations. Results and samples. Local regulations should be registered that regulate the procedure for registering, collecting and sending information about serious and unforeseen adverse events in the use of drugs in Roszdravnadzor, the duties of the person responsible for pharmacovigilance in a medical organization, the participation of a forensic medical organization with Roszdravnadzor, a checklist (list of checklists ) to conduct an internal audit of the work of a medical organization on pharmacovigilance.

The aim is to conduct a comparative analysis of the cost of the "unit effect" of emoxypine, ethoxidol and mexidol used to reduce the manifestations of depression, reduce the severity of clinical symptoms at the stage of postoperative radiation treatment of patients with uterine cancer.
Materials and methods. The pharmacoeconomical analysis was performed in accordance with the "Methodological recommendations for calculating costs during clinical and economic studies of medicines" and provided for the determination of the position of the study and the list of costs, as well as the time period of cost accounting and cost calculation.
Results. As a result of clinical and economic analysis, it was found that in all cases, mexidol is characterized by the lowest cost-effectiveness ratio. This concerns the calculation of "CER" based on the dynamics of the integral indicator BDI and the total indicator "Pressure of complaints" of the Giessen questionnaire. In all cases, the use of emoxypine proved to be the most costly.
Conclusion. In the case of assessing the dynamics of the integral indicator BDI, the "cost per unit of effect" of emoxypine was 3-6 times higher than the corresponding indicators of mexidol and ethoxidol. And when assessing the dynamics of the total indicator "Complaint pressure" of Giessensky, this indicator for emoxypine was 3-4 times higher than similar values for mexidol and ethoxidol.

The aim of this study was to determine the most effective approach to the treatment of patients with continued growth of brain glioma. Material and methods. The study included 200 patients with progression of primary brain glioma, who, since 2001. to 2021 treatment was carried out on the basis of the Chelyabinsk Regional Center for Oncology and Nuclear Medicine. The mean age was 47.86±11.47 years. The ratio of men and women is 1:1. Reoperation was performed in 46 patients. In 125 cases, continued growth of high-grade glioma was diagnosed, and in 40 patients progression of low-grade glioma was noted. And a group of patients with the transformation of low-grade glioma into high-grade glioma was separately identified. Repeated radiation therapy was performed in 140 patients of them: 17 patients received a course of neuronal therapy in mono mode and in 23 patients in combination with external beam radiation therapy; 45 patients underwent stereotactic radiotherapy (STRT) using the CyberKnife machine; in 55 cases - remote radiation therapy. In 60 patients, the choice of treatment was chemotherapy with Temozolomide (n=45) and Bevacizumab + Irinotecan (n=15). Results and conclusions. Thus, the median overall survival (OS) of patients with progression of high-grade glioma was 36 months, the 1-year OS was 96.0%; 2-year-old - 59.4%. Specific overall survival method - 15 months. OS rates in the group of patients with progression of low-grade brain glioma, as expected, were significantly higher and amounted to 130 months, 1-year OS rates were 97.4%; 5- year-old - 80.3%. Specific overall survival method - 60 months. But the indicators of the specific OS method in patients with transformation were significantly lower -15 months, with OS indicators of 98 months. We noted a trend towards an increase in OS in re-operated patients in all subgroups. Depending on the type of radiation therapy: the highest indicators of the method of specific RH were found during the implementation of STLT and combined photon-neutron therapy for 23 months. and 47 months. (p>0.05). in the subgroup of high-grade glioma and 60 months. and 72 months. in patients with continued growth of low-grade brain glioma (p>0.05). In patients with transformation of low-grade glioma into high-grade ones, the specific OS was higher during chemoradiotherapy compared with patients who received only chemotherapy for 32 months. and 12 months. respectively (p>0.05). Thus, the most optimal approach for the treatment of patients with continued growth of primary glial brain tumors is reoperation. The method of choice for a repeated course of radiation therapy can be stereotactic radiation therapy or a combined course of photon-neutron therapy. Treatment of patients with transformation of low-grade glioma to high-grade glioma should be carried out as for primary malignant glioma and include a repeat course of chemoradiotherapy.

A promising direction in the selection of the optimal dose of warfarin is pharmacogenetic typing, taking into account concomitant pathology and taking of other medications. The aim is to analyze the results of pharmacogenetic typing with the selection of an individual maintenance dose of warfarin in patients with atrial fibrillation, prosthetic heart valves, as well as in those who had a history of deep vein thrombosis or pulmonary embolism. Material and methods. For the period from 2013 to 2021, at the Center for Personalized Medicine of the Clinic of South Ural State Medical University (Chelyabinsk), 159 patients underwent a pharmacogenetic study (genotyping and determination of a combination of gene alleles) with the selection of an individual dose of warfarin. Indications for referral for pharmacogenetic typing were transferred deep vein thrombosis and pulmonary embolism in anamnesis, atrial fibrillation, prosthetics of heart valves. Results and conclusions. Maintenance adjusted doses of warfarin were different for certain genotype variants. The highest average values of an individually selected maintenance dose of warfarin were selected for patients with a polymorphism of the VKORC1 gene with a combination of GG alleles, the minimum average values of an individual selected maintenance dose of warfarin were observed in patients with a polymorphism of the CYP2C9 * 3 gene with a combination of AC alleles and the VKORC1 gene with a combination of AA alleles.

The aim of the study is to teach the characteristics of the level of melatonin in the different nature of the pain syndrome and the chronobiological type of women with ovarian endometriosis. Material and methods. A prospective cohort study of 62 women with ovarian endometriosis was performed. The level of 6-SOMT (ELISA), the severity of pain (VAS), the qualitative characteristics of pain (the McGill questionnaire), the chronobiological type of women (the Horn-Ostberg test modified by Prof. S.I. Stepanova) were determined. Statistical processing - IBMSPSSStatistics 19. Results. The level of melatonin in women with pain syndrome and ovarian endometriosis depends on the chronobiological type. the lowest value of melatonin in ovarian endometriosis and the presence of pain in women of moderate morning and moderate evening chronotypes.

The arm of the study is to based on the study of the features of the family and personal history of women with preeclampsia, to identify the most significant risk factors for this pathology. Material and methods. A retrospective cohort study was conducted using the method of continuous sampling of birth histories of 95 women who were delivered in the Clinic of the South Ural State Medical University of the Ministry of Health of Russia (Chelyabinsk) in 2021. The family and personal anamnesis of women, pregnancy outcomes were studied (the results were obtained by analyzing medical documentation: the dispensary book of a pregnant woman, the history of childbirth). Results and conclusions. Preeclampsia is associated with a family history of overweight/obesity, low socioeconomic status (secondary education, unemployed status), a woman's past preeclampsia, chronic arterial hypertension, and overweight/obesity. A protective factor was the status of an employee. Using the Preeclampsia Prediction History Scale (NICE, 2019), the rate of correct preeclampsia prediction was 59.1% (50% for severe preeclampsia), 44.8% false positive, and 40.9% false negative (50% for severe preeclampsia). ). A low frequency of prevention of preeclampsia in the high-risk group was noted - 56.4%.

The modern approach to the conservative treatment of abdominal aortic aneurysms is aimed at non-surgical aneurysms (small aneurysms, subaneurysmal aortic dilatation) in order to slow growth and prevent complications, primarily rupture. Most of the drugs used (statins, doxycycline, roxithromycin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers) show good results in the experiment, but not in real clinical practice. The most significant fact of recent years is the data on the effect of metformin on the stabilization of aortic aneurysmal transformation. Despite the evidence base, the correction of arterial hypertension and blood lipids is an obligatory element in the treatment of patients with aneurysms of all parts of the aorta. A healthy diet, moderate physical activity, and antiplatelets in patients with AAA reduce the risk of cardiovascular events, but not the rate of aneurysm growth.