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The purpose of the study. To study the effect of Mexol's drug on the level of factors regulating neurogenesis.

Material and methods. The study is performed on Wistar rats. Focal cerebral ischemia was reproduced by endovascular occlusion-repertension of the right middle brain artery according to the J. Koizumi method (1986). The duration of occlusion was 60 minutes. During the start of reperfusion of animals, saline or Mexidol at a dose of 50 mg/kg were once introduced once intravenously. After 4, 8 hours and 24 hours after the start of reperfusion in the ischemic hemisphere, the relative number of molecules regulating neurogenesis was estimated by Western-Blot. Additionally, 24 hours after the start of reperfusion, the size of the cerebral infarction was analyzed after painting with a 1% solution of 2.3.5, -rypheniltetrazoli.

Results. When modeling occlusion-reperture of the medium brain artery, the volume of necrosis in the affected hemisphere of animals, which was introduced by the physiological solution, was 37.75 ± 7.46%, the administration of Mexidol at a dose of 50 mg/kg led to a decrease in necrosis to 20.48 ± 2.33% (p = 0,0006). Modeling Occlusion-Reperterposition of the middle cerebral artery was accompanied by the activation of neurotrophic factors IGF-1, NGF and vascular factor of VEGF. A single intravenous administration of Mexidol at a dose of 50 mg/kg during reperfusion was accompanied by a more significant increase
in the level of neurotrophic factors IGF-1, NGF, BDNF and VEGF in the ischemized area of ​​the brain compared to the introduction of saline, which leads to an increase in neuro-regeneration for all surveillance periods (4, 8 hours and 24 hours and 24 hours and 24 hours and 24 hours and 24 hours and 24 hours and 24 hours and 24 hours and 24 hours and 24 hours After reperfusion), the marker of which is tubulin-3.

Conclusion. The results indicate that Mexidol not only has a protective effect on neurons, but can also stimulate neuroregeneration, increasing the level of basic regulatory molecules.

Keywords: Mexidol, ethylmethylhydroxypirinate, acute cerebrovascular disorders, neurogenesis, hematoencephalic barrier.

Resume. In patients with FC II angina pectoris, a positive high correlation between the number of angina attacks and a high level of anxiety was proved. Features of the effects of ethylmethylhydroxypyridine of succinate on personal anxiety symptoms, the number of angina attacks, the level of blood pressure, as well as the frequency and nature of the heart rhythm, and indicators of variability of heart rhythm were revealed.

Key words: coronary heart disease, angina pectoris, anxiety.

Key words: cardiovascular comorbidity, neuro-, cardioprotection, energy correction, Mexidol.

The goal is to develop an algorithm for neuroprotective treatment during the dispensary observation of railway workers with primary open -angle glaucoma (s) based on the evaluation of the effectiveness of the phased use of intravenous and tablet forms of the drug Mexidol.

Material and methods. The study included patients - workers of various professions of the Russian Railways company with stages I - III with a compensated level of intraocular pressure (IOD). Mexidol was prescribed 250 mg intravenously drip for 5 days in a daily hospital mode, then an outpatient basis 125 mg 3 times a day for 3 months. In the first, second and third visits, patients conducted a comprehensive ophthalmological examination using high -tech control methods.

Results. Analyzed data from 58 patients (96 eyes). A reliable improvement of perimetry indicators, optical coherent tomography was received only to the third visit, at the end of the course of treatment with a tablet form of Mexidol. In patients with the I - II stage of the disease, the greatest effect of neuroprotective therapy was noted.

Conclusion. The results obtained during the study allow us to recommend the appointment of patients with soup both combined therapy with Mexidol - injection and tablet forms, and long (3 months) isolated use of the tablet form of the drug. Neuroprotective therapy with Mexidol is most effective in the early stages of the disease.

Key words: glaucoma, neuroprotective therapy, Mexidol, dispensary observation.

The influence of the nature of the atherosclerotic stenizing lesion on the clinical picture of cognitive impairment (KN) has not been sufficiently studied.

The purpose of the study is to assess the effect of the degree and localization of the atherosclerotic stenosis process on cerebral perfusion and the state of cognitive functions.

Patients and methods. 123 patients were examined (65 men and 58 women) aged 50 to 75 years old, having stenoses of brachiocephalous arteries at least 40%, without arterial hypertension, diabetes mellitus or other systemic vascular pathology. The structural state of the substance of the brain and the state of cerebral blood flow were evaluated using magnetic resonance imaging and magnetic resonance angiography. To determine the changes in the white matter, the P. Scheltens scale et al. The localization and degree of the stenosis process was evaluated by extracronal and transcranial duplex scanning by the method of extracranial and transcranial. Prince was determined using a set of neuropsychological scales. The Hamilton depression was also used.

Ascension and discussion. Most of the brachiocephalous arteries examined against the background of atherosclerosis revealed varying severity of the Prince. The most severe KNs were associated with the defeat of the parietal and frontal lobes. A reliable deterioration of cognitive functions was observed as the percentage of stenosis increases: with stenosis in the carotid system, more severe KNs were observed than with stenosis in the vertebral basin. In addition, in patients with combined stenosis and tandem stenosis, more pronounced KN were noted compared to patients with stenosis of the same artery. It is shown that cerebral atherosclerosis is one of the main risk factors for the development of Prince. The influence of not only degrees is noted, but also to a greater extent localization of stenosis on the occurrence of KN, accompanied by the development of perfusion deficiency in specific vascular pools. Determining the nature of the stenosis process will allow to predict the development of KN in patients with atherosclerosis and choose the appropriate treatment tactics.

Key words: atherosclerosis; stenosis of brachiocephalous arteries; Cognitive disorders.

Target. To study the factors that determine the commitment of optimal therapy of elderly patients with chronic heart failure (COM) observed on an outpatient basis.

Material and methods. In an open, comparative simultaneous, incomplete study, 80 patients with heart failure at the age of ≥60 years were included. The comparison group consisted of 40 patients (18 men and 22 women) with diseases of the cardiovascular system without heart failure. Patients were evaluated by the Comorbidity index, laboratory and echocardiographic parameters, a 6-minute walk test, cognitive status, adherence to treatment, and a two-photon X-ray absorption was carried out. The criteria of senile asthenia was considered the presence of 3 signs according to the Frail scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of Weight).

Results. The committed treatment was 40% of patients with heart failure and 75% - comparison groups (p <0.001). In a single-factor analysis, a relationship of adherence to treatment with the level of cognitive status by the Mini-Mental State Examination questionnaire is established-the ratio of chance (OS) 1.5; 95% confidential interval (DI) 1.2-1.9 (p <0.001), senile asthenia-Osh 3.5; 95% DI 1.3-9.5 (p = 0.011), osteoporosis-Osh 2.98; 95% DI 1.0-8.9 (p = 0.050), Cherlson coomorbitability-Osh 1.21; 95% DI 1.0-1.5 (p = 0.050).

Conclusion. 40% of outpatient patients with heart failure at the age of ≥60 years were committed to treatment. Multiple concomitant pathology, impaired cognitive status, osteoporosis, senile asthenia have a negative effect on commitment to the treatment of older people with heart failure.

Key words: commitment to treatment, elderly age, heart failure, senile asthenia, osteoporosis.

Target. To study the cognitive status in elderly patients with arterial hypertension observed in clinical conditions.

Material and methods. The study included 356 patients; The average age is 74.9 ± 6.1 years, 80.4% of them are women. To evaluate cognitive functions before and after treatment, neuropsychological testing using MMSE - a brief scale for assessing mental status was performed; watch drawing test; The test of literal and categorical associations.

Results. In the group of patients <80 years, the severity of cognitive disorders by MMSE correlated with blood pressure (blood pressure): for systolic blood pressure (r = -0.22, p = 0.0003), for diastolic blood pressure (R = -0,13, p = 0.03), i.e. In patients with higher blood pressure, low points were noted on the scale of assessing the cognitive status based on the results of the correlation analysis of Spearman. While in group ≥80, both correlations were insignificant, for systolic blood pressure (r = -0.05, p = 0.64), for diastolic blood pressure (r = -0.13, p = 0.25).

Conclusion. Patients of elderly and senile ages with arterial hypertension should have a differentiated approach to the level of blood pressure depending on age and the presence of cognitive disorders, an integrated approach to therapy in these patients can prevent further progression of cognitive status worsening.

Key words: arterial hypertension, cognitive impairment, dementia, elderly.

The purpose of the study is to study the state of cerebrovascular reactivity (CVR) and structural changes in the substance of the brain in patients with moderate cognitive disorders.

Patients and methods. 385 patients aged 57 to 79 years with moderate vascular cognitive disorders (SKN) were examined. The relationship of clinical variants of SKN and depression with the volume and localization of ischemic damage to the brain substance, as well as with the state of CVR in various vascular pools at the stage of inclusion in the study and after 20 months, has been studied.

Results. The connection of the neuropsychological profile and the severity of the SKN with the features of structural damage to the substance of the brain was revealed, but to a greater extent with a decrease in the CVR in the carbon arteries (SA) system and a combined decrease in the CVR in the CA and the verteba -basial basin (VBB). The association of the frequency of development of depression with the localization of ischemic damage in the frontal lobes and a decrease in the CVR in CA on the left, as well as a combined decrease in the CVR and VBB, has been established.

Conclusion. The state of the CVR, determined in various vascular pools, can serve as an early prognostic sign of developing SKN or depression.

Key words: vascular cognitive impairment; cognitive and emotional disorders; Cerebrovascular reactivity.

Changes in the cognitive sphere during aging in the Russian population are not understood enough.

The purpose of the study is to evaluate the dynamics of indicators of cognitive functions (KF) in two serial dimensions over 9 years in the city population of medium, elderly and senile age and their relationship with the level of education.

Patients and methods. The random population sample of men and women is 45–69 years old, residents of Novosibirsk (n = 9360; the Hapiee project) was examined. CF testing is performed by standard methods. A repeated examination was carried out in a random subsidiary (n = 1663) included in this analysis. The average observation period was 8.8 years (SD = 1.1).

Results and discussion. In the test on semantic fluency of speech, a dynamic decrease was revealed in all age groups, more pronounced in women than in men (p <0.001). Persons 70 years and older have a negative dynamics of memory indicators, semantic speech activity and concentration of attention (p <0.001). In persons with primary (8th and less classes of high school; 6%) and professional (26%) levels of education, a high speed of reducing indicators in the test of delayed reproduction (p = 0.011; 0.038) was revealed than in persons with higher education (35%). Conclusion. It was established that the dynamic reduction of the KF begins at the age of 55–59 years, it is more pronounced in a group of people 70 years and older. The age regression of the memory function was accelerated by participants with a low level of education.

Keywords: cognitive functions; age dynamics; cognitive decrease; The level of education.

Vascular depression is a very frequent and serious complication of cerebrovascular diseases. Vascular factors play an important role in the formation of affective disorders. Depression, in turn, also has a negative impact on the course of cardiovascular pathology, contributing to its progression, worsens the quality of life of patients, reduces functional activity, increases mortality, increases the risk of stroke. The diagnosis of vascular depression is confirmed by the detection of leulyoaaresis on an MRI, while the hyperinatheism of the deep parts of the white matter is important. Very important features of vascular depression are the presence of cognitive impairment and increasing the risk of dementia.

The main forms of cognitive disorders (KN) are characterized by significant variability of the connection of morphological changes and clinical manifestations. One of the promising concepts explaining these features is the modern model of the cognitive reserve. The concept of a cognitive reserve, most widely used in the context of dementia, is often used to explain the mechanisms of the stability of the functional systems of the brain to the development of neuropathological changes. The mechanisms that ensure the functioning of the cognitive reserve are normal and during the pathology of the brain are the activation of neuronal relationships of the brain. Therefore, persons with a higher efficiency of neuronal connections and the ability to form alternative neuronal networks and, accordingly, the formation of cognitive strategies in response to an increase in cognitive load are characterized by a higher level of cognitive reserve. The modern concept of a cognitive reserve opens the prospects for explaining the causes and mechanisms of the development of KN, and also justifies the possibilities of using alternative strategies for their correction.

Key words: cognitive reserve; brain reserve; Alzheimer's disease; Dementia.