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Key words: obstructive sleep apnea syndrome, prevalence, police, rescuers.

For reference: Golenkov AV, Kurakina NG, Naumova TV, Vecherkina VI. Sleep apnea screening results in security agency and establishment employees. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 11-13. DOI:10.20969/VSKM.2019.12(4).11-13.

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DOI: 10.20969/VSKM.2019.12(4).19-23

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DOI: 10.20969/VSKM.2019.12(4).29-35

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DOI: 10.20969/VSKM.2019.12(4).35-38

 LIFESTYLE AND QUALITY OF LIFE IN FIREMEN IN UDMURT REPUBLIC

KOBYLYATSKAYA IRINA A., ORCID ID: https://orcid.org/0000-0002-4104-1007; full-time postgraduate student of the Department of disaster medicine and life safety of the Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: kolybri@gmail.com

SHKATOVA ELENA Y., ORCID ID: https://orcid.org/0000-0003-2027-6277; D. Med. Sci., professor, the Head of the Department of disaster medicine and life safety of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: army@igma.udm.ru

MOKHOVA LUDMILA YA., ORCID ID: https://orcid.org/0000-0002-7121-1265; internal service colonel, the Head of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

FILIMONOV ALEXANDER M., ORCID ID: https://orcid.org/0000-0003-3797-9526; C. Med. Sci., lieutenant colonel of internal service, the Head of the Hospital of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru 

Aim. The aim of the research was to study social and hygienic features and quality of life in firemen in the Udmurt Republic. Material and methods. Survey according to the method of continuous research was conducted in order to obtain information on social and hygienic factors that affect health in 169 male firemen using an original questionnaire «Social and hygienic characteristics of employee of the Ministry of Emergency Situations», which includes 68 questions. Analogue of the universal questionnaire «SF-36 Health status survey» in Russian language was used to assess the quality of life. The survey was conducted according to the principle of voluntary informed consent. Statistical data analysis was carried out. It included absolute and relative value calculation, indicator statistical significance and difference determination. Student criterion was applied in the course of the study with a probability of 95,0% for biomedical research. Results and discussion. Lifestyle analysis in firemen allowed us to present a social hygienic portrait: this is a man aged (30,7±6,2) years, who often has a secondary specialty (47,0%) or a higher education (35,3%), he is married (59,7%), keeps regular balanced diet with hot food consumption (85,3%), is engaged in physical training in his spare time. The adverse factors identified include non-compliance with the daily and rest regimen (75,3%), adherence to bad habits – smoking (34,7±5,8)% and drinking alcohol every weekend (24,3±3,2)%. Significant decrease (t=2,31, p<0,05) in integral quality of life indicator was revealed in 3,8% of the firemen with work experience of more than 5 years. Conclusion. Identified risk factors and features of the work of firefighters in the Udmurt Republic can lead to chronic disease exacerbation. Modern medical and preventive measures and commitment to a healthy lifestyle would help to preserve and strengthen the state of health and professional longevity.

Key words: firemen, lifestyle, quality of life.

For reference: Kobylyatskaya IA, Shkatova EY, Mokhova LYa, Filimonov AM. Lifestyle and quality of life in firemen in Udmurt Republic. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 35-38. DOI: 10.20969/ VSKM.2019.12(4).35-38.

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12. Shkarin VV, Denisenko MK, Blagonravova AS. Epidemio- logicheskoe issledovanie osobennostej rasprostraneniya alkogolizma v Nizhegorodskoj oblasti [Epidemiologicalstudy of the distribution of alcoholism in the regionof Nizhny Novgorod]. Medicinskij al’manah [Medical Almanac]. 2016; 43 (3): 136-143.

STRELNIKOVA MARIA V., a person assigned to prepare a thesis for a candidate of science degree without completion of postgraduate training program on research and teaching science, South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovsky str., 64; recourse teacher physician of the Department of quality control and safety of medical activities of Chelyabinsk Regional Clinical Hospital, Russia, 454076, Chelyabinsk, Vorovsky str., 70

SINEGLAZOVA ALBINA V., ORCID ID: 0000-0002-7951-0040; D. Med. Sci., the Head of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: sineglazovaav@mail.ru

SIGITOVA OLGA N., ORCID ID: 0000-0001-8983-245X; D. Med. Sci., professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: osigit@rambler.ru

Abstract. Aim. The aim of the study was to evaluate the features of therapeutic comorbidity in acute coronary syndromein men. Material and methods. A total of 98 men hospitalized for acute coronary syndrome were examined (74% with myocardial infarction and 26% with unstable angina). Therapeutic diseases were diagnosed based on the results of analysis of the data from questionnaire of the integrated program for chronic noncommunicable disease prevention (Countrywide integrated noncommunicable disease intervention (CINDI), 1996), medical documentation and laboratory diagnostic data. All patients underwent emergency coronary angiography. Results and discussion. Primary comorbid condition in men with acute coronary syndrome was represented by such diseases as arterial hypertension (n=80; 82%), lipid metabolism disorders (n=78; 80%), constitutional obesity (n=22; 22%), chronic kidney disease (n=14; 14%), peptic ulcer in the stomach and/or duodenum (n=11; 11%) and impaired fasting glycemia (n=10; 10%). Multiple disease incidence in men with acute coronary syndrome was 83,5% (n=81), while 1 and 2 disorders were seen in 16,5% (n=16). In case of multiple diseases, coronary artery stenosis ≥ 75% was diagnosed 3 times more often than in 1 and 2 disorders (CI 95% 1,022–9,772). Direct correlation was obtained between the number of coronary artery stenoses ≥ 75% and the number of internal organ diseases that are present simultaneously (rs=0,248; p=0,014). Conclusion. Multiple diseasesin acute coronary syndrome occur in 83,5% of men and they are represented by combination of coronary heart disease with arterial hypertension, obesity, gastric and/or duodenal ulcer, disorders of lipid and carbohydrate metabolism. The presence of multiple diseases in men with acute coronary syndrome is associated with severity and number of severecoronary stenosis.

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 LIPOPROTEIN METABOLISM INDICATORS IN YOUNG PATIENTS WITH ARTERIAL HYPERTENSION

PLEKHOVA NATALIA G., ORCID ID:0000-0002-8701-7213; SCOPUS Author ID: 6603245380; D. Bio. Sci., the Head of Central research laboratory of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: pl_nat@hotmail.com

NEVZOROVA VERA A., SCOPUS Author ID:6603425593; D. Med. Sci., professor, director of the Institute of therapy and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, e-mail: nevzorova@inbox.ru

RODIONOVA LARISA V., postgraduate student of Institute of therapy and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: larisa_90.08@mail.ru

LAGUREVA ALEXANDRA V., junior researcher of Central research laboratory of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: sandy767@mail.ru

MASLENNIKOVA KSENIA K., student of faculty of public health of Pacific State Medical University, Russia, Vladivostok, 690002, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: ksenia9299@gmail.com

TSYGANKOV MIKHAIL A., student of faculty of general medicine of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: mikhail.tsygankov@gmail.com

DUBOV VITALY S., student of faculty of general medicine of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: mikhail.tsygankov@gmail.com

Abstract. Aim. The aim of the study was to establish the significance of biochemical atherogenic indicators in hypertension risk identification. Material and methods. Serum lipoprotein spectrum was evaluated in participants of «Epidemiology of cardiovascular diseases in different regions of the Russian Federation (ESSE-RF)» multicenter observational study in Vladivostok. Among those there were healthy people (692 persons) and young patients with identified arterial hypertension (AH, 209 persons). Results and discussion. It was shown that cholesterol, high and low density lipoprotein values and apoprotein ratio (Kapo) of the examined patients did not significantly differ depending on the age or gender. Significant difference was revealed in relation to cholesterol coefficient indicator Kchol (F<0,05). In studied male group atherogenicity indicators can be considered as a diagnostic criterion for identifying the risk of hypertension, depending on age. In young women (20–30 years old) serum lipoprotein spectrum did not correlate with the risk of arterial hypertension. Whereas in older women, statistically significant disease development markers included cholesterol level (F=0,03), low-density lipoproteins (F=0,03), and Kchol (F=0,02). It has been established that there are no gender differences in arterial hypertension risk development markers in patients older than 40 years. Statistically significant indicators are cholesterol, low-density lipoprotein and Kchol. Conclusion. Thus, it is possible to use the following indicators as cardiovascular disease risk markers, respectively, according to the degree of importance. Those are cholesterol atherogenic coefficient (Kchol); low-density lipoprotein cholesterol and total cholesterol.

Key words: arterial hypertension, cholesterol, lipid profile, obesity, smoking.

For reference: Plekhova NG, NevzorovaVA, Rodionova LV, Lagureva AV, Maslennikova KK, Tsygankov MA, Dubov VS. Lipoprotein metabolism indicators in young patients with arterial hypertension.The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 44-51. DOI: 10.20969/VSKM.2019.12(4).44-51.

1. Korenev NM, Bogmat LF, Yakovlev IM. Ateroskleroz, et al. Arterial’naya gipertenziya u podrostkov: faktory stabilizacii i progressirovaniya [Arterial hypertension in adolescents: factors of stabilization and progression]. Zdorov’e rebenka [Child Health]. 2014; 3: 6-11.

2. Titov VN, Amelyushkina VA, Rozhkova TA. Inoj vzglyad na diagnostiku giperlipoproteinemii, holesterin lipoproteinov nizkoj plotnosti i dejstvie statinov (lekciya) [A different look at the diagnosis of hyperlipoproteinemia, low density lipoprotein cholesterol and the effect of statins (lecture)]. Klinicheskaya laboratornaya diagnostika [Clinical Laboratory Diagnostics]. 2015; 1: 27-38.

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 CURRENT ISSUES OF SPECIAL EMERGENCY SERVICE OPERATION IN FOREIGN COUNTRIES

KOBYLYATSKAYA IRINA A., ORCID ID: 0000-0002-4104-1007; full-time postgraduate student of the Department of disaster medicine and life safety of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: kolybri@gmail.com

SHKATOVA ELENA YU., ORCID ID: 0000-0003-2027-6277; D. Med. Sci., professor, the Head of the Department of disaster medicine and life safety of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: army@igma.udm.ru

MOKHOVA LUDMILA YA., ORCID ID: 0000-0002-7121-1265; internal service colonel, the Head of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

FILIMONOV ALEXANDER M., ORCID ID: 0000-0003-3797-9526; C. Med. Sci., lieutenant colonel of internal service, the Head of the Hospital of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

MEDVEDEV MAKSIM S., ORCID ID: 0000-0002-8567-501X; 2nd year student of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: mister.redspike47@yandex.ru

Abstract. There are two types of natural disasters: emergency situations and major natural disasters, which differ in theamount of assistance provided. There are special structural units for safeguarding interests and protecting the rights ofthe citizens and territories in all countries. Aim. The aim of the research was to study the principles of work organization in special emergency services in foreign countries as well as the current health related issues in professionals operatingin such services. Material and methods. The data was studied and the analysis of modern foreign research publications on special service management in emergency situations was carried out. Results and discussion. The Federal Emergency Management Agency is a division of the United States Department of Homeland Security that manages disaster response efforts that local governments are not able to cope with, acting as a coordinating and advisory structurethat regulates federal and municipal ministries and agencies to preserve economy and social structure of the state incase of emergency situations or disasters of peaceful time, as well as in martial law. The issue of the state of health in emergency response personnel is given special attention, since the quality of functional duty performance would depend on this. There is a significant increase in the incidence of the diseases of the musculoskeletal system and connective tissue, circulatory system and digestive organs, with age. The authors indicate the most common symptoms related to harmful factor exposure, such as runny nose, irritation in the eyes and throat, hoarseness, shortness of breath, and, as a consequence, development of acute and chronic sinusitis and chronic obstructive pulmonary disease. It was noted that the risk of respiratory diseases increases with duration of service, even several years after the emergency is eliminated. It was revealed that after elimination of the consequences of the terrorist attack from September 11, 2001 in the World Trade Center in New York, the number of retirements for disability increased by 47,0%. The most common causes leading to disability have been identified. Those are respiratory diseases, mental and behavioral disorders, as well as injuries, poisoning and other certain consequences of exposure to external factors. Negative social and economic consequences and professional longevity reduction require additional medical and preventive measures for specialservice employees. Conclusion. Thus, foreign countries have a developed emergency service system. In order to solve emerging problems when organizing assistance to the victims in our country, it is necessary to take international experience into account and, if appropriate, to consolidate the efforts in order to successfully resolve emerging issues taking the rights of the citizens of the affected party as a priority.

Key words: firemen, health, special emergency services in foreign countries.

For reference: Kobylyatskaya IA, Shkatova EY, Mokhova LYа, Filimonov AM, Medvedev MS. Current issues of special emergency service operation in foreign countries. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 59-63.DOI: 10.20969/VSKM.2019.12(4).59-63.

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5. Stewart A, Marlow R, Campeau D, Russell T, Ryan J.The evolution of response and management training atthe FEMA Center for Domestic Preparedness. Journal of Emergency Management. 2019; 17 (1): 53-60.

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UDC 616.127-002-022:578(048.8)

 VIRAL MYOCARDITIS IN CARDIOLOGIST PRACTICE

OSCHEPKOVA OLGA B., ORCID ID: 0000-0002-9845-0266; the Head of the Department of cardiology of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia for Tatarstan Republic, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: oschepkova.kazan@mail.ru

TSYBULKIN NIKOLAY A., ORCID ID: 0000-0002-1343-0478; C. Med. Sci., associate professor of the Department of cardiology, roentgen-endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36, e-mail: kdkgma@mail.ru

FROLOVA ELVIRA B., ORCID ID 0000-0002-4653-1734; C. Med. Sci., Deputy Head for diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: frolova.67@mail.ru

RUDNITSKAYA LILIYA A., ORCID ID: 0000-0002-5559-3722; student of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

Abstract. Aim. The features of modern concepts related to epidemiology, etiology, pathogenesis and diagnosis ofviral myocarditis are presented from the perspective of practical medicine. Material and methods. Review of researchmedical articles on viral myocarditis. Results and discussion. Myocarditis is one of the most common types of non- coronary heart disease. It results from inflammatory changes in the myocardium, manifested by clinical symptoms,functional disorders and changes in the structure of heart tissue. The most common causes of myocarditis are viralinfections, autoimmune diseases, toxic and drug effects. The complexity of practical diagnosis of myocarditis does not allow obtaining accurate data on its prevalence. The pathogenesis of myocarditis is diverse and includes infections, physical factor effects, and hypersensitivity. A special feature of viral myocarditis is the possibility of combined direct lesion in the myocardium with an infectious agent leading to autoreactive state development. Viral infections can createmyocardial damage both in the course of the primary disease and as its complication. Conclusion. Viral myocarditis is a common complication of seasonal acute respiratory viral infection outbreaks and it remains a significant public health problem. The epidemic nature of such infections, wide coverage in the population, more severe course in young children and in elderly patients, requires timely diagnosis and treatment of a large number of such patients. Late detection of myocarditis can have adverse consequences and makes prognosis less favorable. The difficulties in diagnosis are related to low specificity of the most typical symptoms and to invasiveness of the studies that can ultimately solve thediagnostic dilemma. Biopsy is less preferred comparing to magnetic resonance imaging in the diagnosis of myocarditis.Key words: myocarditis, viral infection, pathogenesis, diagnostics.

For reference: Oschepkova OB, Tsybulkin NA, Frolova EB, Rudnitskaya LA. Viral myocarditis in cardiologist practice. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 68-74. DOI: 10.20969/VSKM.2019.12(4).68-74.

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 PATHOGENETIC MECHANISMS OF ALCOHOLIC CARDIOMYOPATHY DEVELOPMENT

FADEEV GRIGORIY A., ORCID ID: 0000-0002-0213-8631; Deputy Head, physician of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: Dr.GrigoryFadeev@yandex.ru

TSIBULKIN NIKOLAY A., ORCID ID: 0000-0002-1343-0478; C. Med. Sci., associate professor of the Department of cardiology, roentgen-endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36

MIKHOPAROVA OLGA Y., the Head of offic for functional diagnostics of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: olga-mihoparova@rambler.ru

TUKHVATULLINA GALINA V., ORCID ID: 0000-0002-7949-0457; the Head of Clinical diagnostic laboratory of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

Abstract. Aim. The aim of the study was to characterize the modern concepts of alcoholic cardiomyopathy developmentpathogenetic mechanisms. Material and methods. Review of research medical publications on alcoholic cardiomyopathypathogenesis and clinical manifestations. Results and discussion. Long time alcohol abuse is one of the common causes of cardiovascular mortality, along with smoking, hyperlipidemia, and hypertension, which is associated with the prevalence of alcohol dependence. Every third adult had at least one period of excessive alcohol consumption during one’s lifetime. The treatment cost in such patients is ten times higher than such in ones with the heart failure. A common effect of alcohol on the cardiovascular system is alcoholic cardiomyopathy, which remains asymptomatic for a long time, but at the final stage of the disease it is manifested by progressive heart failure. Alcoholic cardiomyopathy is expressed in an increase in the heart chamber size, mainly in the left ventricle, diffuse myocardial hypokinesis development, and a decrease in its integral contractility. Complications of alcoholic cardiomyopathy can be heart rhythmdisturbances and thromboembolism. The leading causes of increased cardiovascular morbidity and mortality in peoplewho consume alcohol are the factors leading to heart failure development. The main ones are viable cardiomyocyte loss, common cardiosclerosis, and a decreased function in the remaining contractile elements. Conclusion. The maindamaging mechanism of alcohol exposure to the myocardium is metabolic disorders in the cardiomyocytes, leading to their irreversible dystrophic changes and cardiosclerosis. An increase in cell active oxygen radical amount not only destroys it chemically, but also initiates and completes apoptotic cell death process through intracellular signaling system modification.

Key words: alcoholic cardiomyopathy, pathogenesis, heart failure, apoptosis.

For reference: Fadeev GA, Tsybulkin NA, Mikhoparova OY, Tukhvatullina GV. Pathogenetic mechanisms of alcoholic cardiomyopathy development. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 74-80. DOI: 10.20969/ VSKM.2019.12(4).74-80.

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DOI: 10.20969/VSKM.2019.12(4).80-85

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  EARLY ANASTOMOSITIS AFTER STOMACH RESECTION

ILLARIONOVA IRINA N., ORCID ID: orcid.org/0000-0002-8939-9980; postgraduate student of the Department of general surgery and oncology of Chuvash State University named after I.N. Ulyanov, Russia, 428034, Cheboksary, Moskovsky ave., 45, tel. 8-960-051-66-11, e-mail: isha53@mail.ru

IGONIN YUVENALY A., ORCID ID: orcid.org/0000-0001-6662-2900; C. Med. Sci., associate professor, the Head of the Department of general surgery and oncology of Chuvash State University named after I.N. Ulyanov, Russia, 428000, Cheboksary, Gladkov str., 23, tel. 8-987-670-39-72, e-mail: Yuvig54@gmail.ru

Abstract. Aim. The aim of the study was to analyze the published data on the subject of post-gastro-resectionanastomositis in gastric cancer. Material and methods. Analysis of current medical research articles devoted to theincidence, diagnosis and treatment of post-gastro-resection anastomositis was carried out. Results and discussion.According to various data sources the incidence of anastomositis after gastrectomy ranges from 5 to 61%. The factors related to anastomositis are narrow gastrojejunoanastomosis or coarse ligature anastomosis in the wound, multi-row suturing, and allergic inflammatory infiltration in the area of anastomosis. For the treatment of post-gastro- resection anastomositis in the postoperative period, adequate anesthesia is required to prevent catabolic processes and fluid-electrolyte imbalance, especially potassium loss. Enteral nutrition in the early postoperative period is difficultdue to depression digestive function resulting in indication for early intestinal tract stimulation. There is evidence of lymphostimulation effectiveness in the early postoperative period. Conclusion. Anastomositis in gastric cancer and itsinconsistency, being a multifactorial disease, requires development of new methods of surgical treatment, as well as local endoscopic types of treatment in order to minimize repeated surgical interventions. Early diagnosis of post-gastro- resection anastomositis contributes to quality of life improvement in patients and faster digestive function restoration.Key words: gastric cancer, gastrectomy, anastomositis.

For reference: Illarionova IN, Igonin YuA. Early anastomositis after stomach resection. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 86-89. DOI: 10.20969/VSKM.2019.12(4).86-89.

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  MORBIDITY ANALYSIS IN INTERNAL AFFAIRS OFFICERS INVOLVED IN CIVIL ORDER PROTECTION DURING THE XXIX WORLD WINTER UNIVERSIADE IN KRASNOYARKS IN 2019 IN TERMS OF INTERNAL AFFAIRS OFFICER TEAM FOR ALTAI TERRITORY

VYUN OLEG G., ORCID ID: 0000-0003-1040-7552; the Head of the Center for psycho-physiological diagnostics of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66, e-mail: caducei_22@mail.ru

ANTONOV YURI A., the Head of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66

PODZOROVA ALINA V., the Head of organizational and methodical department of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66

KHOROSHILOV ALEXEY A., deputy Head of the State sanitary and epidemiological surveillance of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66

KOCHKINA ANASTASIA G., ophthalmologist of military physician board of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66 

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DOI: 10.20969/VSKM.2019.12(4).93-99

1. Prikaz Minzdravsocrazvitiya Rossii ot 12.04.2011 No 302n «Ob utverzhdenii perechnej vrednyh i (ili) opasnyh proizvodstvennyh faktorov i rabot, pri vypolnenii kotoryh provodyatsya obyazatel’nye predvaritel’nye i periodicheskie medicinskie osmotry (obsledovaniya), i Poryadka provedeniya obyazatel’nyh predvaritel’nyh i periodicheskih medicinskih osmotrov (obsledovanij) rabotnikov, zanyatyh na tyazhelyh rabotah i na rabotah s vrednymi i (ili) opasnymi usloviyami truda» [Order of the Ministry of Healthcare and Social Development of Russia of 12.04.2011 No 302n «On approval of the lists of harmful and (or) occupational hazards and works, during which mandatory preliminary and periodic medical examinations (examinations) are carried out, and theprocedure for mandatory preliminary and periodic medicalexaminations (examinations) of workers engaged in heavy work and work with harmful and (or) hazardous working conditions»]. 2011.

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  THE ROLE OF ROUTINE MEDICAL EXAMINATIONS IN OCCUPATIONAL AND CORPORAL DISEASE PREVENTION

FADEEV GRIGORY A., ORCID ID: 0000-0002-0213-8631; Deputy Head of Clinical Hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: Dr.GrigoryFadeev@yandex.ru

GARIPOVA RAILA V., ORCID ID: 0000-0001-8986-8030; SCOPUS Author ID: 54904191000; D. Med. Sci., associate professor of the Department of hygiene and occupational medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: railyagaripova@mail.ru

ARKHIPOV EVGENY V., ORCID ID: 0000-0003-0654-1046; SCOPUS Author ID: 56997299700; C. Med. Sci., associate professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: jekaland@mail.ru

MIKHOPAROVA OLGA YU., the Head of office for functional diagnostics of Clinical Hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: olga-mihoparova@rambler.ru

BERKHEEVA ZUKHRA M., C. Med. Sci., associate professor of the Department of preventive medicine and human ecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: kgmu_profpat@mail.ru

OSHCHEPKOVA OLGA B., the Head of the Department of cardiology of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: oschepkova.kazan@mail.ru

SAFINA KADRIYA R., the Head of Republican Center for Occupational Diseases, Russia, 420036, Kazan, Lechebnaya str., 7

Abstract. Aim. The aim of the study was to assess the effectiveness of routine medical examinations in the Republic of Tatarstan for 2016–2018 according to the final acts submitted to the Republican Center for Occupational Diseases of the Ministry of Health of the Republic of Tatarstan. Material and methods. Analysis of annual reports from 45 territories of the Republic of Tatarstan for 2016–2018 was performed. Results and discussion. Annually, 300 536 employees approximately undergo routine medical examinations in the Republic of Tatarstan. The average medical examination coverage is 97–98%. In 2018 not a single suspicion of occupational disease was detected in 34 municipalities of the Republic of Tatarstan (2016 – 21, 2017 – 22) during routine medical examinations. Private medical organizations practically do not detect occupational diseases. Suspicion of occupational disease was established in only one organization out of 12 that submitted the final acts to the center of occupational diseases. In 2018 the cases of occupational diseases were registered in 15 administrative territories (2016 – 24, 2017 – 22). Outpatient examination and treatment in 2018 was recommended in 17,8% of the examined workers (2016 – 16,2%, 2017 – 18,6%), inpatient examination and treatment – in 0,35% (in 2016 – 0,23%, in 2017 – 0,5%). Health resort treatment was indicated in 5,5% of examined workers (6,2% and 6,8%). Specialist follow up was recommended for 16,7% of workers (15,2% and 16,2%). Conclusion. At present, routine medical examinations neither reveal the early signs of occupational diseases, nor suspected ones that have been acquired. Among common diagnosed corporal diseases there are nutrition and metabolic disorders, diseases of the circulatory, blood, and urinary system. Thus, with a high degree of certainty, it can be concluded that it is necessary to change the approaches to routine medical examinations introducing more thorough quality control.

Key words: routine medical examinations, occupational diseases, occupational medical care.

For reference: Fadeev GA, Garipova RV, Arkhipov EV, Mikhoparova OY, Berkheeva ZM, Oshchepkova OB, Safina KR. The role of routine medical examinations in occupational and corporal disease prevention. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 99-105. DOI: 10.20969/VSKM.2019.12(4).99-105.

1. Prikaz Minzdravsocrazvitiya Rossii ot 12.04.2011 No 302n «Ob utverzhdenii perechnej vrednyh i (ili) opasnyh proizvodstvennyh faktorov i rabot, pri vypolnenii kotoryh provodyatsya obyazatel’nye predvaritel’nye i periodicheskie medicinskie osmotry (obsledovaniya), i Poryadka provedeniya obyazatel’nyh predvaritel’nyh i periodicheskih medicinskih osmotrov (obsledovanij) rabotnikov, zanyatyh na tyazhelyh rabotah i na rabotah s vrednymi i (ili) opasnymi usloviyami truda» [Order of the Ministry of Healthcare and Social Development of Russia of 12.04.2011 No 302n «On approval of the lists of harmful and (or) occupational hazards and works, during which mandatory preliminary and periodic medical examinations (examinations) are carried out, and theprocedure for mandatory preliminary and periodic medicalexaminations (examinations) of workers engaged in heavy work and work with harmful and (or) hazardous working conditions»]. 2011.

2. Amirov NKh, Berkheeva ZM, Yakupov EZ, et al. Sovre- mennye problemy medicinskogo nablyudeniya zarabotayushchimi v neblagopriyatnyh usloviyah truda[Current problems of medical observation of workers in unfavourable labour condition]. Kazanskij medicinskij zhurnal [Kazan medical journal]. 2003; 84 (5): 386-387.

3. Kretov AS, Bushmanov AY, Mamonova EY. Metodika ocenki riska razvitiya hronicheskogo professional’nogo zabolevaniya i medicinskih protivopokazanij [Method of chronic occupational disease development risks assessment, and medical contra-indication]. Medicina truda i promyshlennaya ekologiya [Russian Journal of Occupational Health and Industrial Ecology]. 2015; 9: 78-79.

  BEHAVIORAL MODEL FACTOR ANALYSIS IN EXPERIMENTAL ANIMALS WITH DIFFERENT STRESS REACTIVITY

PERMYAKOV ALEKSANDR A., ORCID ID: 0000-0001-5196-0448; C. Med. Sci., associate professor of the Department of human physiology of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: aa-permyakov@mail.ru

ISAKOVA LARISA S., ORCID ID: 0000-0003-4780-8720; D. Med. Sci., professor, the Head of the Department of human physiology of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: lisakova18@mail.ru

MOKHOVA LUDMILA YA., ORCID ID: 0000-0002-7121-1265; internal service colonel, the Head of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

FILIMONOV ALEXANDER M., ORCID ID: 0000-0003-3797-9526; C. Med. Sci., lieutenant colonel of internal service, the Head of the Hospital of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

Abstract. Aim. The aim of the research was to study behavioral reactions in rats via «open field» test and to create various stress-reactivity group ethological models in animals using factor analysis method. Material and methods. Theexperiments were performed on 167 white outbred rats in the open field test. Factor analysis of behavioral indicators on the distribution of stress resistance degree in different groups of animals was applied. Results and discussion.Physiological behavior and motivation mechanisms of group and individual stress-resistance were investigated in rats in «the open field» test using integrated multiple statistical processing method application. Under conditions of minor stress, the functional value of search activity in «the open field» is being determined by dominant motivation, which is being developed according to the animal’s background emotional state, which is a balance of fear and anxiety. It is being realized as a search motor activity. Each of the four groups of animals different in terms of stress-resistance showed various numbers of factor connections and its own individual correlated set of behavioral traits, creating an ethological profile specific for every group. Conclusion. Comprehensive behavioral indicator assessment allows dividing experimental animals into groups according to degree of prognostic stress-resistance, forecasting individual stress- reactivity for every animal, and also identifying basic group and individual motivations that form stress-induced behavior.

Key words: behavior, motivation, stress-resistance, «open field» test, factor analysis.

1. Grigor’yan GA, Gulyaeva NV. Stress-reaktivnost’ i stress- ustojchivost’ v patogeneze depressivnyh rasstrojstv: rol’ epigeneticheskih mekhanizmov [Stress-reactivity and stress-resistance in the pathogenesis of depressive disorders: the role of epigenetic mechanisms]. Zhurnal vysshej nervnoj deyatel’nosti imeni IP Pavlova [IP Pavlov Journal of higher nervous activity]. 2015; 65 (1): 19-27.

2. Umryuhin AYe. Mikrodializnoe issledovanie mozgovyh nejrohimicheskih mekhanizmov rezul’tativnogo povedeniya u povedencheski aktivnyh i passivnyh krys [Microdialysis studyof brain neurochemical mechanisms of effective behavior inbehaviorally active and passive rats]. Zdorov’e, demografiya, ekologiya finno-ugorskih narodov [Health, demography, ecology of Finno-Ugric people]. 2015; 4: 56-59.

3. Takahashi A, Nishi A, Ishii A, Shiroishi T, Koide T. Systematic analysis of emotionality in consomic mouse strains established from C57BL/6J and wild-derived MSM/Ms. Genes, Brain and Behavior. 2008; 7: 849–858.

4. Tanaka S, Young JW, Halberstadt AL, Masten VL, Gey- er MA. Four factors underlying mouse behavior in an open field. Behavioural Brain Research. 2012; 233 (1): 55-61.

5. Koplik EV. Metod opredeleniya kriteriya ustojchivosti krys k emocional’nomu stressu [Method for Determining the Rat Resistance to Emotional Stress Criteria]. Vestnik novyh medicinskih tekhnologij [Journal of New Medical Technologies]. 2002; 9 (1): 16-18.

6. Sudakov KV, Umryuhin PE. Sistemnye osnovy emocional’nogo stressa [Systematic foundations of emotional stress]. Moskva: GEOTAR-Media [Moscow: GEOTAR- Media]. 2010; 112 p.

7. Percov SS, Grigorchuk OS, Koplik EV, Abramova AYu, Chekmareva NYu, Chekhlov VV. Sostoyanie organov- markerov stressa u krys s raznoj povedencheskoj aktivnost’yu pri mnogokratnyh stressornyh vozdejstviyah [The state of the organs-markers of stress in rats with different behavioral activity with multiple stress effects]. Byulleten’ eksperimental’noj biologii i mediciny [Bulletin of Experimental Biology and Medicine]. 2015; 160 (7): 25-29.

8. Majorov OYu. Ocenka individual’no-tipologicheskih osobennostej povedeniya i ustojchivosti intaktnyh belyh krys-samcov na osnove faktornoj modeli normal’nogo etologicheskogo spektra pokazatelej v teste «otkrytoe pole» [Evaluation of individual-typological features of the behavior and stability of intact white male rats based onthe factor model of the normal ethological spectrum ofindicators in the open field test]. Klinicheskaya informatika i telemedicine [Clinical informatics and telemedicine]. 2011; 7 (8): 21-32.

9. Permyakov AA, Eliseeva EV, Yudickij AD, Isakova LS. Povedencheskie reakcii u eksperimental’nyh zhivotnyh s razlichnoj prognosticheskoj ustojchivost’yu k stressu v teste «otkrytoe pole» [Behavioral reactions in experimental animals with different prognostic resistance to stress in the open field test]. Vestnik Udmurtskogo universiteta; Seriya Biologiya; Nauki o Zemle [Bulletin of Udmurt University; Series Biology; Earth Sciences]. 2013; 3: 83-90.

10. Koplik EV, Salieva PM, Gorbunova AV. Test «otkrytogo polya» kak prognosticheskij kriterij ustojchivosti krys linii Vistar k emocional’nomu stressu [The “open field” test as a prognostic criterion for the resistance of Wistar rats to emotional stress]. Zhurnal vysshej nervnoj deyatel’nosti imeni IP Pavlova [IP Pavlov Journal of higher nervous activity]. 1995; 45 (4): 775-781.

11. Permyakov AA, Yudickij AD. Programma obrabotki eksperimental’nyh dannyh pri testirovanii zhivotnyh v «otkrytom pole» [Program for processing experimental data when testing animals in an “open field”]. Issledovaniya v oblasti estestvennyh nauk [Researches in Science]. 2013; (9): http://science.snauka.ru/2013/09/5973.

12. Permyakov AA, Eliseeva EV, Yuditsky AD, Isakova LS. Faktornyj analiz povedeniya eksperimental’nyh zhivotnyh v teste «otkrytoe pole» [Factor analysis of the behavior of experimental animals in the open field test]. Prikladnye informacionnye aspekty mediciny [Applied informational aspects of medicine]. 2015; 18 (1): 91-97.

  THE ROLE OF LABORATORY PARAMETERS IN A LONG-TERM PROGNOSIS IN PATIENTS WITH MYOCARDIAL INFARCTION WITH DIFFERENT LOCALIZATION ST SEGMENT ELEVATION

KHARISOVA ENZHE КH., ORCID: 0000-0002-4890-4768; postgraduate student of the Department of сardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-950-946-80-89, e-mail: cardiorean@mail.ru

Abstract. Aim. The aim of the study was to evaluate the role of laboratory parameters in long term survival in patients with myocardial infarction with different localization ST segment elevation. Material and methods. The study included998 patients with myocardial infarction with ST segment elevation aged from 25 to 92 years. Mean duration of observation was (302,7±170) days. The patients were divided into 4 groups depending on the localization of myocardial damage. In the 1st group the patients had combined lesions of the lateral and upper parts of the left ventricular wall. In the 2nd group – left ventricle lower wall, in the 3rd group – left ventricle anterior wall, in the 4 group there was a circularmyocardial infarction. Results and discussion. Coronary artery stenosis according to Gensini scale in groups 1 and 2 (489 patients, left ventricle lower wall myocardial infarction) was Me 59 (26; 87,5) points and Me 66,5 (53; 91) points, respectively (p<0,001). After adjusting for gender, the differences resembled. Hospitalization duration in groups 1 to 4, was respectively (in days): Me 12 (9; 14), Me 12,04 (11; 12), Me 11,8 (11; 12), Me 12,7 (12; 14), p=0,29. High mortality rate was registered in group 1 – (4,8±2,1)%, compared with the other three (2,5±1,5)% group 2, (2,8±1,7)% group 3 and (3±1,7)% group 4, p=0,84. Survival was effected by an increase in creatinine, both upon admission (above 94,4 μmol/L,p=0,03; OR – 1,01; 95% CI 1,004–1,008) and repeatedly (above 96,8 μmol/l; p<0,001; OR – 1,01 95% CI 1,02–1,04), KSH (p<0,001; OR – 1,8; 95% CI 4,25–9,6). No statistically significant relationship of laboratory parameters and survival was seen in groups 1 and 4. In group 2 it was glucose over time (higher than 6,9 mmol/l; p=0,037, OR – 1,1; 95% CI 1,1–1,6), creatinine (higher than 97 μmol/l; p<0,001; OR – 1,01; 95% CI 1,02–1,03). In anterior myocardial infarction with ST-segment elevation group, cardiogenic shock upon admission 5 times increased the risk of death (p=0,005; OR – 1,67; 95% CI 5,7–19,6). After adjustment for age, the difference in overall survival remained statistically significant (p=0,052; OR – 0,99; CI 1,6–2,58). Conclusion. Age younger than 45 years and older than 75 years, a lesion in the left ventricle anterior wall, the history of diabetes mellitus, serum creatinine level above 97 μmol/l, blood glucose level above 7 mmol/l, natriuretic peptide level above 150 ng/ml were predictors of adverse outcomes in the long-term periodand after adjusting for gender.

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2. Ubrich R, Barthel P, et al. Sex differences in long-termmortality among acute myocardial infarction patients:Results from the ISAR-RISK and ART studies. PLoS ONE. 2017; 12 (10): 1–17. DOI: 10.1371/journal.pone.0186783

3. Smilowitz NR, Mahajan AM, et al. Mortality of Myocardial Infarction by Sex, Age, and Obstructive Coronary Artery Disease Status in the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines). Circulation: Cardiovascular Quality and Outcomes. 2017; 10 (12): e003443. DOI: 10.1161/CIRCOUTCOMES.116.003443

4. Yamashita Y, Shiomi H, et al. Cardiac and Noncardiac Causes of Long-Term Mortality in ST-Segment-Elevation Acute Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention. Circulation: Cardiovascular Quality and Outcomes. 2017; 10 (1): e002790. DOI: 10.1161/CIRCOUTCOMES.116.002790

5. Aggarwal NR, Patel HN, et al. Sex Differences in Ischemic Heart Disease: Advances, Obstacles, and Next Steps. Circulation: Cardiovascular Quality and Outcomes. 2018; 11 (2): 1–15. DOI: 10.1161/CIRCOUTCOMES.117.004437

6. Pusuroglu H, Cakmak HA, et al. The prognostic value of admission red cell distribution width-to-platelet ratio in patients with ST-segment elevation myocardial infarctionundergoing primary percutaneous coronary intervention.Cardiologia. 2015; 34 (10): 597-606.

7. Bacigov HA, Sajfutdinov RG. Prognosticheskoe znachenie lejkocitoza pri infarkte miokarda [Prognostic value of leukocytosis in myocardial infarction]. Kazanskij medicinskij zhurnal [Kazan medical journal]. 2010; 91: 2–4.

8. Abdrahmanova AI, Amirov NB. Infarkt miokarda pravogo zheludochka vo vrachebnoj praktike [Right ventricle myocardial infarction in medical practice]. Vestnik sovremennoj klinicheskoj mediciny [The Bulletin of Contemporary Clinical Medicine]. 2016; 9 (3): 62—69.

9. Lew J, Sanghavi M, et al. Sex-Based Differences in Cardiometabolic Biomarkers. Circulation. 2017; 135 (6): 544–555. DOI: 10.1161/CIRCULATIONAHA.116.023005

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  CORONARY ARTERY RESTENOSIS RISK FACTORS IN EMERGENCY OR PLANNED STENTING

SHAMES DENIS V., ORCID ID: orcid.org/0000-0002-7613-836X; postgraduate student of the Department of cardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: denshames@mail.ru

Abstract. Aim. The aim of the study was to assess the differences in in-stent restenosis predictors in emergency orplanned stenting. Material and methods. The study included 438 patients. Inclusion criteria were patient age 45–74 years, coronary angiography and native coronary artery emergency or planned stenting, repeated coronary angiography and restenosis. The patients were divided into two groups: the patients with acute CHD types and the patients with chronic CHD. Control group of patients who did not differ in diagnosis, but had no restenosis in a previously installed stent, was recruited for each study group. 73 patients were included in the studied group of patients who underwent emergency stenting. The control group with the absence of restenosis on repeated CAG consisted of 67 people. The study group with restenosis after planned stenting was 145 people; the control group of patients united 153 people. Results and discussion. Platelet-lymphocyte ratio (OR – 1,043), total cholesterol (OR – 1,016), coronary atherosclerosis index Gensini (OR – 1,06) and the number of simultaneously implanted stents (OR – 2,64) were predictors of restenosis inside the stent for emergency coronary artery stenting. The following restenosis predictors were found for the patients with planned stenting: diabetes mellitus (OR – 4,3), hyperlipidemia (OR – 2,5), RDW (OR – 1,9), Gensini index (OR – 1,1), fibrinogen (OR – 2,61), and simultaneously implanted stent number (OR – 1,58). Patient age groups did not demonstrate any significance, both in predictor analysis for emergency stenting, and in such for planned stenting. Conclusion. Risk factors for coronary artery restenosis after emergency stenting are platelet-lymphocyte ratio, total cholesterol, and severity of coronary atherosclerosis. Risk factors for coronary artery restenosis after planned stenting are the width of the red blood cell volume range, fibrinogen, coronary atherosclerosis severity, simultaneously implanted stent number, diabetes, and hyperlipidemia. When comparing the groups of patients who underwent emergency or planned stenting,the age of patients did not appear as a predictor of restenosis.

Key words: coronary heart disease, restenosis, bare metal stents, drug elusive stents, risk factors.

For reference: Shames DV. Coronary artery restenosis risk factors in emergency or planned stenting. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 116-123. DOI: 10.20969/VSKM.2019.12(4).116-123.

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