At present, Uzbekistan is at a initial stage of development and reform, and universities are more concerned about university English education due to its talent development strategy and social needs. The university English curriculum has made periodical achievements in the past 10 years of reforms, but there are also some problems, such as curriculum content is monotony, curriculum classifications are similar, teaching objectives are not clear, and the form of courses evaluation is single, teaching method is outdated. To solve these problems, the researcher puts forward the following suggestions according to needs analysis theory, and make a research to non-English majors, the curriculum of university English must be based on the development of students' English proficiency, the teaching content should reflect the characteristics of majors, teachers need to update their teaching concepts, innovate teaching methods, combine classroom teaching with the second class learning. establish a scientific curriculum evaluation system and strengthen the promotion role of formative evaluation. Therefore, learners’ needs should be integrated to make a purposeful adjustments to the university English curriculum.
Активное выявление болезни или преболезненного состояния у лиц, считающихся или считающих себя здоровыми, то есть скрининг подразумевает использование специальных диагностических тестов и методик, способных быстро диагностировать признаки заболевания или факторы риска его возникновения. В мире насчитывается 285 млн. слабовидящих и 39 млн. слепых, причем лица 50 лет и старше составляют 56% и 82% соответственно [1], что связано с появлением таких офтальмологических заболеваний, как возрастная макулярная дегенерации (ВМД) и глаукома.
Ushbu maqolada bugungi axborotlashgan jamiyatda oʻqitishning zamonaviy didaktik vositalarini kengroq joriy etish muhimligi, xorijiy (rus) tili darslarida foydalanish uchun hozirda kompyuter dasturlarining keng doirasi taklif etilganligi, ushbu dasturlar orqali yaratiladigan multimedialar audiovizual axborotni qayta ishlashning zamonaviy usullarini qo‘llash hisobiga o‘qitish samaradorligini oshirish va o‘qitishni intensifikatsiyalash imkoniyatini ta’minlashi haqidagi fikrlar bayon etilgan.
Age-related macular degeneration (AMD) is a progressive disease characterized by damage to the central zone of the retina, leading to blindness and disability, which is a medical and social problem. The aim of the study is to improve the organization of medical care for AMD by creating an electronic program for clinical examination of a patient with AMD.
The implementation of English language policies in modern society varies across different regions, countries, and institutions. English is widely recognized as a global language and is often used as a medium of communication in various domains, including business, education, science, technology, and international diplomacy. Many countries have adopted English as a medium of instruction in schools and universities. English language proficiency may be a requirement for admission to certain educational programs or for obtaining academic qualifications. This article is about the English language policy implementation in modern Uzbekistan.
Topicality and demand of the subject of dissertation. In the world lat days chanchcd structures of trauma, increase the number of heavy combined traumas, which resulting in more heavy nature of simultaneous injuries of three , four or more anatomical regions, which creates difficulties in determining of the order of care and surgical tactics in patients with combined traumas of the facial skeleton bones (CTFSB). The syndrome of mutual burdening injuries of various anatomical regions, variety, hcavity and speed of the development of pathological process did difficulty of diagnosis of the CTFSB. Complexity of the clinical picture, features of the progress of post-traumatic shock, the development of traumatic disease cause difficulties which arise in the course of examination of patients and put tasks to the experts to find new ways of developing diagnostic algorithms and early surgical treatment of the CTFSB.
Frequency of CTFSB ranges from 34,8 to 63,3%. Fractures of orbit has been observed with an extremely high frequency (98%) in CTFSB, injury of the orbit is accompanied by damage of the eyeball and its subsidiary bodies has been observed in 66 % of eases. Consequences of eye injuries arc becoming the leading cause of disability and in 50% of eases could cause permanent loss of vision. By reason of death combined trauma take the third part after coronary heart diseases. Frequency of disfiguring defects and deformities of face occurs in 12 and 57%, disability in CTFSB reaches up to 23%. CTFSB, combined with TBI, causes up to 60% of deaths.
The causes of unsufficient results is non-availability of a diagnostic algorithm, which includes the most informative research methods, determining the order of interaction and priority of work of doctors of various specialties in CTFSB.
In some eases, requires specified an indications, character, scope, sequence and timing of surgical interventions, depending of the objective assessment of heaviness of injuries to various anatomical regions, prognosis criteria, the nature and heaviness of life-threatening consequences of combined trauma. The research work earned out within the framework of the achievement of the set by the Decree of the President of Republic of Uzbekistan “About measures on the further deepening reform the health care system” November 28, 2011, № PD-1652, maintenance of high-quality medical aid to the population under modem requirements and standards.In this regard the need for the development of algorithms of diagnosis and early methods of surgical treatment of patients with CTFSB constitute one of the important criteria demand the theme of dissertation.
Purpose of research is improvement of the diagnostic tactics and therapeutic interventions in patients with acute combined injuries of the facial bones according to the severity and location of the injury.
Scientific novelty of disscrtational research consists in the following: revealed the structure and features provide consistent care to patients with combined injuries in Republic of Uzbekistan;
The sequence of diagnostic and therapeutic measures, depending on the patient's general condition with CTFSB first determined by using created CT program "ADIL
developed innovative methods for early reduction and fixation of bone fragments in CTFSB;
identified endogenous factors, affecting on the wound process, disclosed the mechanisms of post-traumatic complications in CTFSB;
proved, that at 2 - 3rd days after the injury occurs the depression of cell and humoral immunity in the blood. Increases the level of proinflammatory cytokines, reduced the level of anti-inflammatory cytokine (in 2,8 at patients with heavy commonl condition. Increased levels of pro - and reducing anti - inflammatory cytokines is a poor prognostic factor in the development of inflammatory complications (bone wound suppuration, osteomyelitis of the jaw bones, soft tissue abscess);
patients with CTFSB at 2 - 3rd days after the injury occurs the depression of the content of protein and micronutrients (calcium, potassium and phosphorus) in the blood, which is a prognostic factor of the development of complications;
a scheme was developed for integrated medical correction of endogenous factors affecting on the development of posttraumatic complications;
1. CTFSB in 100% of cases combined with TBI, in 27.7 % with injuries of skeleton and internal injuries. In the diagnosis and treatment of patients with CTFSB should participate resuscitator, maxillofacial surgeon, neurosurgeon, ophthalmologist, and otolaryngologist. Primary debridement of wounds, reduction and fixation of bone fragments in patients in compensated state should be done within 3 hours after injury, while at subcompensated state - during the first day, and at the decompensated state - within 3 days.
2. With the CT program "ADIL" can determine the overall condition of patients in a short time. The most informative diagnostic criteria arc the general condition of patients, level of consciousness, hemodynamic stability, shock index and temperature gradient. The severity of the general condition of patients is directly dependent on the localization of the fracture of the facial bones. Multiple fractures of the upper and middle areas of the face arc the most serious injury in patients.
3. Patients with CTFSB in compensated and subcompensated state emergency surgical aid and diagnostic procedures should be performed in full volume (maxillofacial surgery, traumatology, neurosurgery, surgery, ophthalmology and otorhinolaryngologist), including the reduction and fixation of bone fragments in the first day. To patients with CTFSB in state decompensated should be performed at least diagnostic procedures, limiting the amount of emergency surgery. Reduction and fixation of bone fragments should be done after the restoration of function of vital organs and systems.
4. The method of choice for the treatment of depressed large bone fragments of facial bones is a titanium distractor, the use of which gives a good clinical and functional outcome.
5. When depressed fracture of the zygomatic arch application of the developed device will allow us to produce reduction and fixation of bone fragments in the early stages (within one day) with a good cosmetic result.
6. At patients with CTFSB in posttraumatic period (7- 14th day.) there arc a deep depression of CD3, CD4 cell composition, humoral factors and secretory immune system, increased necrosis factor CD95, increasing the levels of proin-flammatory (IL-6 ) and a decrease - anti- inflammatory (IL -10) cytokines. On 9-10th day reduced total protein, calcium, potassium and phosphorus in the blood .
7. Reduction of cellular and humoral immunity, increased proinflammatory cytokine and tumor necrosis factor, reducing the anti-inflammatory cytokine , the protein concentration in the blood, calcium, potassium and phosphorus arc predictors of complications.
8. Application of complex drug therapy within the 1-3 days after the injury with the inclusion of immune ( immunomoduline, ribomunil ), enzyme ( Voben-zym ) drugs osteoplastic materials allows to correct the violation of homeostasis, also used to prevent complications.
Сердечно-сосудистые заболевания (ССЗ) и психоэмоциональные расстройства - обычное явление. Пациенты с ССЗ, а именно с хронической коронарной болезнью сердца чаще страдают психоэмоциональными расстройствами, чем население в целом. У людей с психоэмоциональными расстройствами больше шансов в конечном итоге разовьется сердечнососудистые заболевания, а также у них более высокий уровень смертности, чем у населения с изолированным психоэмоциональным расстройством. Пациенты с сердечно-сосудистыми заболеваниями, которые также находятся в психоэмоциональном расстройстве, имеют худший исход, чем пациенты, не страдающие психоэмоциональными расстройствами. Существует ступенчатая взаимосвязь: чем тяжелее психоэмоциональное расстройство, тем выше последующий риск смерти и других сердечно-сосудистых событий [4].
Вполне возможно, что психоэмоциональные расстройства является лишь маркером более тяжелых сердечно-сосудистых заболеваний, которые пока невозможно выявить с помощью имеющихся в настоящее время исследований.Однако, учитывая повышенную распространенность психоэмоциональных расстройств у пациентов с сердечно-сосудистыми заболеваниями, вероятна причинно-следственная связь с сердечнососудистыми заболеваниями, вызывающими более выраженными психоэмоциональными расстройствами, или с депрессией, вызывающими более частые сердечно-сосудистые заболевания, и худшим прогнозом для сердечно-сосудистых заболеваний. Было описано много возможных патогенетических механизмов, которые правдоподобны и вполне могут быть важны [2,3].
Однако, независимо от наличия причинно-следственной связи, психоэмоциональные расстройства является основным фактором качества жизни и сама по себе требует профилактики, выявления и лечения. Психоэмоциональные расстройства после острого сердечного приступа обычно является расстройством адаптации, которое может улучшиться спонтанно при комплексном кардиологическом лечении. Дополнительные стратегии ведения пациентов с сердечными психоэмоциональными расстройствами включают программы кардиологической реабилитации и физических упражнений, общую поддержку, когнитивно-поведенческую терапию, прием антидепрессантов, комбинированные подходы и, возможно, программы лечения заболеваний.
Наличие нескольких факторов риска может свидетельствовать о более важном общем риске, чем значительное увеличение от нормальных значений одного фактора риска. Современные тенденции стратификации риска у пациентов с ишемической болезнью сердца поляризованы между использованием простых данных и комплексных показателей, традиционных данных и новых факторов риска, общевалидных показателей и персонализированных показателей, в зависимости от характеристик пациента, типа ИБС, степени воздействия на предложенную терапию. Вся известная информация и методики могут быть интегрированы в сложную систему оценки риска.
Current epidemiological situation in morbidity and mortality in the world is characterized in the article, main social and economic indicators supporting spread of infectious agents are presented, principles, concepts and main provisions of WHO Expanded Program of Immunization (EPI) and three stages of EPI are presented. Topical issues of specific protection (vaccination) are highlighted, missed opportunities and ways to overcome them are shown. Attention is drawn to three main sources of evolutionary formation of human infectious diseases and various points of view concerning causes and mechanisms of evolutionary transformation by changing mechanism of transmission of microorganisms to the main host - microorganism are discussed.
SUMMARY
According to the World Health Organization (WHO), every year about 2 billion people fall ill with infectious diseases in the world. At the same time, infectious diseases account for almost 25% of all deaths, and in developing countries this figure reaches up to 45%. Thus, infectious diseases remain one of leading causes of death in the world. According to the WHO, out of about 50% of million people, 16-17 million die from infection and only 10 million from cardiovascular diseases. Out of 10 main causes of death on earth, 7 are somehow associated with infectious diseases.
Subjects of the research: 1066 patients with peritonitis.
Purpose of the research: improvement of the results of treatment of the patients with peritonitis by determination of the prognostic significance of clinical-metabolic parameters in the estimation of severity of patients condition, flow and outcome of the disease.
Methods used in the research: clinical, microbiological, biochemical methods of investigation, mathematical statistics and mathematical modeling.
Results obtained and their novelty
1. The prognostic significance of clinical-anamnestic, microbiological, laboratorial- instrumental and metabolic data has been determined on the basis of the correlational interrelation between metabolic parameters and bacterial contamination in patients with peritonitis
2. When the actions of NIDE (UIDI) RC and GI are studied in clinical conditions it is shown, that their combined application during the operation and postoperative periods considerably decreases the culture growth in peritoneal exudates and improves metabolic parameters.
3. On the basis of the method of mathematical modeling, programs arc proposed to estimate the severity of patient s condition and predictability of flow, the outcome of disease in the patients with peritonitis.
Practical significance
1. The special features of the disturbance of metabolic parameters dependent on the bacterial contamination have been established, which makes it possible to reveal the patients with high risk of development of complications.
2. It is proven that the application of the infra-R emitters in combination with the traditional treatment in patients peritonitis contributes to more favorable flow of the disease and to reduction of postoperative complications and lethality.
3. Two programs have been created with the methods of mathematical modeling which allow: 1) To estimate severity of the patients condition on the basis of clinical-anamnestic, laboratorial- instrumental, metabolic and microbiological data;
2) To predict the complications of the disease; 3) To predict the healing of the postoperative wound; 4) To identify the indications for NIDE (UIDI) applications.
Level of induction: method of application of narrow-spectrum infrared distant emitters in peritonitis is used in surgical department of the Clinical Hospital of Emergencies and Casualties, Г' Municipal Clinic Hospital and in Central Military Clinical Hospital named after P.F. Borovskiy.
Region application: Surgery.