The review presents data on the types of vaccines designed to prevent the development of a new coronavirus infection (COVID-19). The procedure for inclusion in the register of funds for use in emergency situations is considered. National regulatory authorities may decide to use vaccines before they are approved by the World Health Organization (WHO) due to the very lengthy registration process. The vaccines approved for use in the Russian Federation, their features, studied efficacy and safety data are listed. Data on the minimum frequency of serious adverse reactions arising from the use of vaccines against COVID-19, which are not comparable with the high frequency of deaths from this disease, are presented. The reasons for the need to develop their own vaccines are listed: the need to quickly vaccinate a huge number of the population during a pandemic, even before WHO registers in the register of funds for use in emergency situations, delays in the receipt of vaccines from countries where they are produced, the potential threat of leakage of pathogenic viruses and bacteria from biological laboratories, ensuring the economic security of the country during pandemics. Conclusions. There are a sufficient number of safe and effective vaccines against COVID-19 in the Russian Federation, developed using various technologies. In view of the ongoing pandemic of a new coronavirus infection, the use of vaccines is of great preventive importance for building individual and collective immunity. The successful development of domestic vaccines in the Russian Federation is important from the point of view of the epidemiological and economic security of the country.

Relevance. Soft tissue sarcoma is a heterogeneous group of relatively rare types of tumors, which demonstrates a huge variety of anatomical localization and histopathological characteristics. The rarity of soft tissue sarcomas combined with a variety of subtypes, forms of growth, progression and frequency of relapses makes it difficult to study them, make a correct diagnosis and early referral of patients for specialized care.

The purpose of study. To analyze the problem of differential diagnosis of malignant and benign soft tissue neoplasms.

Materials and methods. In the course of the work, current literary sources of domestic and foreign authors on a given topic were analyzed.

Results. Since it is absolutely impossible to determine the clinical features of the presented sarcoma, soft tissue tumors showing any of the following signs are considered malignant until the opposite is proven: increasing in size, >5 cm, deeply located and/or painful. The greater the number of these clinical signs present, the higher the risk that the soft tissue tumor will turn out to be malignant; at the same time, an increase in size is the best individual indicator. It is worth noting that the absence of concomitant constitutional symptoms, such as fever, chills, night sweats or unintentional weight loss, should not reduce the doctor's suspicion of malignancy.

Conclusion. In order to avoid erroneous diagnoses, a standardized diagnostic approach should be followed, starting from the moment of collecting the patient's medical history, clinical examination and ending with the use of appropriate imaging methods and biopsy.

Introduction. The study of the anatomy of the maxillary sinuses using computed tomography (CT) techniques is an important area of scientific research. The most developing technique that allows you to move from planar images to a picture that clearly represents the shape of the anatomical structure and topographic-anatomical relationships is 3D-modeling.

Purpose. Analyze the forms of the maxillary sinuses using 3D-modeling using the Autoplan APK.

Materials and methods. The primary analysis included 260 studies, from which 80 studies were subsequently selected. The studies were carried out on Aqulion 32 (Toshiba, Japan) and Revolution EVO 128 (GE, Russia) computed tomographs. MSCT was performed on patients aged 22 to 84 years. The average age of patients in the study group was 52.31±3.18 years. To stratify the patients of the study group by age groups, the age periodization scheme of the Institute of Age Physiology of the Russian Academy of Medical Sciences (1969) was used.

Results. The analysis of the shape of the maxillary sinuses showed that the trends in the prevalence of different types of their forms are almost the same, both in the general analysis of the shape of the maxillary sinuses in the study group, and in the isolated analysis of the right and left maxillary sinuses.

Conclusion. To conduct a full study of the shape of the maxillary sinuses allows only their three-dimensional modeling, it also allows you to move from linear dimensions to volumetric measurements by highlighting all the elements of the volumetric image that relate to the sinus cavity. The study of the shape of the maxillary sinuses is a modern problem with the lack of a unified approach to the process of segmentality and interpretation of the results. With regard to otorhinolaryngology, three-dimensional reconstructions of images semi-accepted on the basis of computed tomography are effective in assessing the choice of the type of surgery that is most acceptable in a particular patient.

As the body ages, free radical processes intensify and the risk of various age-related diseases increases, including memory impairment, as exchange processes in nerve cells deteriorate. The internal antioxidant system, capable of neutralizing free radicals, is not always able to cope with the growing load, and then the supply of antioxidants from outside is necessary. A source of biologically active substances possessing antioxidant activity are plant extracts possessing a pronounced therapeutic effect combined with a minimum of side effects. The purpose of our study was to study the learning and memory of the offspring of rats that received aqueous plant extracts as an additional load. The study of the learning and memory of the offspring of rats that received aqueous plant extracts of Ginkgo biloba, Centella asiatica, Eleutherococcus and a mixture of aqueous extracts of Ginkgo biloba and Centella asiatica was performed on 4-month-old animals, obtained in an experiment from 15 males and 50 females, which in the course of 30 days water extracts were obtained in a dose of 30 mg/100 g of body weight in a volume of 1 ml. The study was carried out with the help of the test "Passive escape with negative (painful) reinforcement". Conclusions: the offspring of rats that received as an additional load intragastric mixture of aqueous extracts of Ginkgo biloba and Centella asiatica are characterized by the best indicators of learning and memory, compared to the offspring of animals of the control group, and rats that received aqueous extracts of Ginkgo biloba, Centella asiatica and Eleutherococcus separately.

In the literature, the treatment of patients with Achilles tendon ruptures begins with diagnosis and diagnosis. Depending on the classification of Achilles tendon rupture, treatment tactics are determined. From our point of view, the existing classification of Achilles tendon ruptures does not sufficiently reflect and systematize the approach to surgical treatment, which served as a more detailed study and addition to the existing classification of Achilles tendon ruptures.

Thermography and electroneuromyography parameters were studied in 34 patients with vertebrogenic pain syndrome associated with lumbar spine stenosis. All patients were treated in the neurosurgical department of the Irkutsk Scientific Centre of Surgery and Traumatology. We determined the changes in temperature values in the lumbar spine and lower extremities under the condition of disorder in peripheral nerves functional state.

Purpose of the study: to evaluate the parameters of thermography and electroneuromyography in patients with lumbar spine stenosis.

Materials and methods. The article presents the results of thermography and electroneuromyography of 34 patients with severe pain syndrome associated with degenerative stenosis of the lumbar part of spinal canal in preoperative period. Thermal-imaging study was carried out using a thermovision camera SVIT-004, the study of the peripheral nerves function of the lower extremities was carried out using the Neuromian-1-04 neuromyoanalyzer. The skin temperature recording points corresponded to the projection of stimulating and pickup ENMG electrodes on the spinous processes of the LIV, LV, SI vertebrae and paravertebrally.

Results. Thermography parameters in patients with degenerative lumbar spine stenosis on the pain side were higher than on the intact side at all measurement points by 1–2 °C. At the same time, electroneuromyographic parameters in these patients indicated a decrease in the activity of the peripheral and central motor apparatus.

Conclusion. The change in thermography parameters in patients with lumbar spine stenosis in the lumbar part and the area of pain irradiation in the lower extremities occurs alongside with the disorder of the peripheral nerves functional state.

Introduction. Throughout history, humanity has lived and developed in accordance with its biological rhythms, which provided the adaptation of the body to the factors of external and internal environment, ensuring the normal synchronous functioning of all its components.

The purpose of this work was to study the stressful influence of circadian rhythms disturbance on patients with metabolic syndrome (MS) under conditions of dark deprivation.

Material and methods of investigation. We selected patients with MS and disturbed circadian rhythms – a total of 102 people (all men) from among those who constantly work at night, in whom a decrease in melatonin levels was recorded at the preliminary stage. According to the set objectives, 102 patients (young age according to WHO criteria) were divided into three groups of 33, 37 and 32 persons according to the criterion "duration of influence of dark deprivation and MS history duration": 0–5, 5–10 and over 10 years. In the first group the mean age was 30.1 ± 1.4 years, in the second group – 36.5 ± 1.5 years, in the third group the mean age did not exceed 40.3 ± 0.9 years. Melatonin levels (as confirmation of circadian rhythm disturbances) in blood serum were studied in all study participants using Melatonin ELISA immunoassay kit (IBL, Germany).

Results and discussion. Normally, when blood cortisol is measured before 10 a.m., its average value varies in a wide range from138 to 635 nmol/l. The increase up to 700 nmol/l is admitted, which is regarded as a negative influence of external factors during the examination. However, one should keep in mind that during evening measurements, cortisol levels in men may normally decrease to 80 nmol/l.

Conclusions. Thus, dark deprivation in patients with metabolic syndrome leads to the formation of a stress response. Maximum changes occur after 10 years of disturbance of regulatory mechanisms and lead to a pronounced imbalance between the sympathetic and parasympathetic nervous system, increased vascular tone and changes in the profile of blood pressure during the day towards the predominance of Non-dippers and Night-peers, which increases the risk of progression of metabolic syndrome symptoms.

Purpose: to study the dynamics of the incidence of chronic tonsillitis in the population of the Samara region for 2018-2021.

Materials and methods: retrospective analysis of information on the number of diseases registered in patients living in the service area of a medical organization with a first diagnosis based on the data of the annual reporting forms No. 12, No. 14 for 2018–2021.

Results. The primary incidence of chronic tonsil disease is highest in children aged 0 to 14 years and tends to increase in primary incidence in 2021. There is a positive trend in the form of a decrease in the number of children with CMD. Compared to 2018, the number of patients with CMD in 2021 decreased by 35%. In all age groups there is a decrease in the prevalence of cases of chronic diseases of the tonsils.

Conclusions. CMD occupies the 4th place in the structure of respiratory diseases in the age group from 0 to 14 years, while in other age groups this pathology ranks sixth. The primary incidence of CBM is highest in children (0–14 years old) and adolescents (15–18 years old). The prevalence of CBM is also high in children and adolescents and is almost 9–15 times lower in adults (18–60 years old) and persons over 60 years of age. However, in the group of adults (18–60 years old) the number of patients registered in the dispensary is quite high.

Relevance and goals. Treatment of patients with acute myeloid leukemia has traditionally been highly intensive and includes induction therapy using cytarabine and anathracyclines. In addition to new opportunities in the treatment of acute myeloid leukemia, the problem of toxicity of high-intensity therapy in elderly and young somatically burdened patients is quite acute. International clinical trials of phases I-III demonstrated a combination of high efficacy and acceptable hematological toxicity of combinations of hypomethylating agents and venetoclax in the first line of therapy, as well as in the treatment of resistant forms and relapses of acute myeloid leukemia in the older age group, which contributed to the study of the effectiveness of combinations of hypomethylating agents and venetoclax in the treatment of similar groups of young comorbid patients. In this work, we evaluated the efficiency of a combination of hypomethylating agents and venetoclax and overall and disease-free survival in patients with acute myeloid leukemia in routine practice.

Methods. In the period from October 2017 to December 2021 on the basis of the Department of Hematology No. 11 and the Department of Bone Marrow and Hematopoietic Stem Cell Transplantation No. 56 of the Botkin Hospital (Moscow, Russia) 33 patients with acute myeloid leukemia received venetoclax therapy in combination with decitabine or azacitidine: 14 (42%) men and 19 (58%) women, median age was 60 years (23–83 years). In 42% (14 of 33) of cases, the regimen was prescribed for resistant course or relapse of acute myeloid leukemia and in 61% (20 of 33) as induction therapy. Three patients (15%) out of 19 from the group of newly diagnosed acute myeloid leukemia received this treatment regimen in the first line, taking into account the ECOG status 3-4. By August 2022, 13 (39%) patients are alive, 20 (61%) people have died. Overall survival, the rate of complete remission and complete remission with incomplete recovery, the rate of achieving negativity of minimal residual disease, the frequency of hematological toxicity and infectious complications were assessed. Statistical data processing used: frequency analysis using contingency tables (Fisher's exact test), survival analysis using the Kaplan-Meier method.

Results. Complete remission and complete remission with incomplete recovery were achieved in 72.72% (24 of 33) of patients. In the group of primary acute myeloid leukemia, remissions were observed in 80% (16 out of 20) of cases, in the group with resistant course or recurrence of acute myeloid leukemia in 67% (8 out of 12) (p = 0.3). Determination of minimal residual disease by flow cytometry after the 1st course was performed for 54.54% (18 of 33) patients, while negativity was stated in 84.2% (14 of 18 patients) cases. In both groups, the incidence of hematological toxicity and infectious complications are comparable to those according to the literature data. The median follow-up was 9.5 months (1–47). Median overall survival was 39 months, 2-year overall survival was 63%, and overall 4-year survival was 39%. The disease-free survival rate was 33%.

Conclusion. The combination of hypomethylating agents and venetoclax showed good efficacy and fairly high overall survival in patients of all age groups, both for primary acute myeloid leukemia and for relapses and resistant forms, regardless of previous therapy. Given the moderate hematological toxicity, as well as the relatively low rates of infectious complications during therapy, including the rather low mortality rates in case of COVID-19 infection in comparison with those on the background of high-intensity courses of therapy for acute myeloid leukemia, this scheme can be widely used not only in patients of the older age group, but also in young comorbid patients.

Purpose of the study: due to the intraoperative technique of treating the stump of the main bronchus with a high-energy laser LSP-30 during pneumonectomy, to increase the effectiveness of the treatment of patients with destructive widespread pulmonary tuberculosis.

Materials and methods. The results of treatment of 112 patients were analyzed. All patients underwent lung removal due to widespread destructive tuberculosis. Patients were divided into main and control groups. The first group, the main one, consisted of 58 patients selected prospectively with a high risk of bronchopleural complications, of which 63.8% (n = 37) of patients had signs of hemoptysis and episodes of pulmonary hemorrhage, which required urgent and sometimes emergency surgical intervention. In 36.2% (n = 21) of patients, limited empyema of the pleural cavity without bronchopleural fistulas was determined radiographically. All patients of the main group after the stage of lung removal before the formation of a stump, the mucosa of the main bronchus was irradiated with a high-energy laser LSP-30 with a wavelength of 930 nm. 54 patients of the control group, selected retrospectively, in whom the course of the fibroticcavernous tuberculosis passed without complications and the HA stump after pneumonectomy was formed without the use of laser irradiation. There were no endoscopic signs of active tuberculous inflammation of the tracheobronchial tree in patients of both groups. A number of patients, in the main group in 5.2% (n = 3) and in the control group in 3.7% (n = 2), showed signs of scarring of the bronchus after tuberculosis. These patients, as part of preoperative preparation, underwent endoscopic biopsy of the main bronchus mucosa in the scar areas, and only after histological confirmation of the absence of active tuberculous inflammation, pneumonectomy was performed.

Results. Pronounced post-thoracotomy pain syndrome in 5.2% (n = 3) of patients in the main group and in 9.3% (n = 5) of patients in the control group, for the relief of which narcotic analgesics were used for a long time. Progression of respiratory insufficiency, as a result of accession of nonspecific pneumonia of the only lung in 5.2% (n = 3) of patients of the main group and in 7.4% (n = 4) of patients of the control group, which was resolved by additional resuscitation and avoided mortality. Formation of residual pleural cavity on days 7–21 of the postoperative period in 6.9% (n = 4) of patients in the main group and in 1.8% (n = 1) of patients in the control group in the apex of the hemithorax, which required several sessions of thoracocentesis for the complete elimination of residual pleural cavity. The formation of a pulmonary hernia and the displacement of the mediastinal organs towards fibrothorax, in 5.2% (n = 3) of patients in the main group and in 1.8% (n = 1) in patients of the control group, this complication is the main manifestation of postpneumonectomy syndrome. Progression of tuberculosis in the only lung in 5.2% (n = 3) of patients of the main group and 3.7% (n = 2) of patients in the control group. This complication was revealed radiographically, despite the anti-tuberculosis therapy carried out in the postoperative period in accordance with the sensitivity of Mycobacterium tuberculosis, identified from the surgical material. Intrapleural bleeding in the early postoperative period was detected in 3.7% (n = 2) of patients in the control group, and no such cases were detected in the main group. All cases of intrapleural bleeding in the control group were urgently stopped.

Conclusions. The effectiveness of surgical treatment of patients with widespread destructive pulmonary tuberculosis in the volume of pneumonectomy using intraoperative laser treatment of the mucosa of the main bronchus was 98.3%, while in the control group, where the intraoperative technique was not used, it was significantly lower – 87.1% (p < 0.01). A high percentage of cases of histological detection of an inflammatory process on the resection line is a scientifically substantiated confirmation of the need for intraoperative laser treatment of the main bronchus mucosa by the proposed method in patients with widespread destructive tuberculosis during pneumonectomy.

Introduction. The frequency of hip arthroplasty is steadily increasing throughout the world and, although this operation has become routine, the likelihood of postoperative complications reaches 4.3 % [1]. The most dangerous of them are infectious lesions in the area of the endoprosthesis and adjacent tissues. At the same time, in addition to the threat of generalization of the infectious process, there are functional disorders in the joint area and a general deterioration in the quality of life of the patient. Timely diagnosis and treatment of the infectious process and related disorders can minimize the adverse effects of infection.

Target. The purpose of this review is to analyze modern methods for diagnosing and treating periprosthetic infection resulting from hip replacement.

Materials and methods. The subject literature was searched using the PubMed and Google Sholar databases.

Results. The main methods for diagnosing periprosthetic infection include histological and bacteriological examination of the biopsy specimen, determination of sensitivity to antibiotics, blood, and synovial fluid analysis for the content of leukocytes, IL-6, CRP, PCR diagnostics of infectious agents. Treatment consists of re-intervention and/or antibiotic therapy.

Conclusion. The most optimal method for diagnosing periprosthetic infection is a bacteriological study of biopsy specimens taken intraoperatively. The preferred method of treatment is determined by the severity of the infection, the degree of involvement of tissues adjacent to the prosthesis, the comorbid background, the nature of the infectious agent, and includes repeated revision surgery.

Introduction. One of the rare complications following hip arthroplasty is periprosthetic joint infection (PJI). Two-stage revision arthroplasty is the gold standard in the treatment of deep periprosthetic infection of large joints, providing high probability of infection process resolution as well as functional recovery of the limb and elimination of pain syndrome.

Aim: to improve the treatment results of patients with periprosthetic infection after primary hip arthroplasty.

Materials and Methods. 121 patients (62 patients in the main group and 59 in the control group) after primary hip arthroplasty were included in the study. In the main group, treatment was performed using a two-stage technique with implantation of a preformed spacer and our proposed algorithm. In the control group, treatment was performed using a homemade spacer and without using the developed algorithm.

Results. When using our developed treatment algorithm, a good result in the treatment of UTI was achieved. The infectious process was controlled in 80.6 % of cases, as compared with 64.4 % in the control group, which is comparable with the data of domestic and foreign literature.

Conclusion. Treatment of patients with periprosthetic infection should be performed only in specialized centers that perform all stages of treatment, have all necessary instruments, an equipped operating room, necessary drugs in the hospital pharmacy, experienced staff and equipped bacteriological laboratory, as well as many years of experience of surgeons with these patients.

Background. Arthroplasty is the most common surgical treatment for patients with end-stage knee arthrosis. From 2 to 7% of those operated on are patients with rheumatoid arthritis. The inflammatory process in the joint, low rehabilitation potential, long-term therapy with hormonal and genetically engineered biological agents, poor bone quality form a high risk of periprosthetic infection. In this group of patients, the saprophytic microorganism Candida albicans more often forms biofilms on endoprosthesis components, which presents difficulties in the treatment of periprosthetic infection.

Aims: demonstration of a clinical case and rationale for the treatment of periprosthetic knee infection caused by Candida albicans using a revision implant with an anti-biofilm coating.

Materials and methods. A clinical case presents the results of examination and treatment of a 46-year-old patient with secondary gonarthrosis on the background of rheumatoid arthritis with developed periprosthetic infection are evaluated. Surgical treatment was carried out by two-stage sanitation, using as part of the spacer an implant coated with silver-doped two-dimensionally ordered linear-chain carbon, against the background of etiotropic intravenous treatment with fluconazole.

Results. The likely cause of the development of a fungal periprosthetic infection is a decrease in the activity of the immune system against the background of taking cytostatics and hormonal drugs in combination with the frequent uncontrolled use of antibacterial drugs. The choice of surgical tactics in favor of a two-stage revision is justified by the isolation of a «difficult to treat» Candida albicans. Timely diagnosis and the chosen method of treatment in combination allowed to no recurrence during the observation period of 12 months after the 2nd stage of revision.

Conclusions. The results demonstrate the effectiveness of a spacer coated with silver-doped two-dimensionally ordered linear-chain carbon at the stage of sanitation for the treatment of periprosthetic infection caused by the «difficult to treat» Candida albicans.

This article is devoted to the discussion of cardioembolic complications of anthracycline cardiomyopathy. The article describes a clinical case of cardiotoxicity caused by aggressive neoadjuvant chemotherapy in a patient with breast cancer and complicated by the development of cardioembolic ischemic stroke.

Chronic lateral ankle instability is an extremely common disease in the active working population. Unfortunately, the study of this pathology in children and adolescents receives very little attention in the modern literature, although they also suffer from manifestations of ankle instability. We present a clinical example of surgical treatment of a 15-year-old patient suffering from chronic lateral ankle instability. The result of treatment after one year of observation was regarded as excellent. The symptoms of the disease were stopped, the patient has no restrictions in household activities and returned to the level of motor activity that was before the injury.

The article presents the results of liver transplantation in five HIV-infected recipients with irreversible liver damage. It is shown that four of them survived in the long-term period and are observed in a stable condition, and the only death in the recipient was not related to the HIV infection. The experience in the treatment of these patients was summarized. Analysis of the first results of liver transplantation in HIV-infection in Russia shows its validity and clinical efficacy. The only lethal case is connected with the initial extremely grave condition of the recipient and his age. Two cases of surgical traumatism, lack of consistent vaccination in the preoperative period, as well as lack of patients with hepatocellular cancer, small number of observations are obvious drawbacks of our first experience and should be corrected in the future. The success of a complex and multidisciplinary program of organ transplantation in HIV infection is impossible without participation of HIV-infectionists in the transplantation team.

The aim of the study is to construct a kinetic equation of zero-order ethanol elimination with first-order absorption, taking into account the presystemic metabolism of ethanol, with the possibility of determining the errors in estimating the parameters of the model, as well as the implementation of the model in the format of a computer program. Analytical mathematical modeling of the kinetics of a single oral intake of ethanol has been performed. A mathematical model of the kinetics of a single intake of ethanol with its zero-order elimination, absorption and first-order presystemic metabolism has been developed. A method is proposed for estimating the limiting absolute errors of the kinetic parameters of the constructed model based on the summation of the partial contributions of the initial physical quantities. The complex of the developed computational procedures is implemented in the format of the «Alcohol Calculator V 1.0» computer program. The conclusion is made about the expediency of using the developed information and computing technology in the forensic medical expert assessment of acute alcohol intoxication.

The present work is devoted to the study of the scientific and life path of professor anatomist Emrullah Adyshirinovich Adyshirin-Zadeh (1920–2017), one of the founders of the Samara and Russian morphological school. A review of his main scientific works and educational and methodological publications is given.

The right of every person to free movement, choice of place of stay and residence is guaranteed by the UN Convention on the Rights of Persons with Disabilities [1], the Constitution of the Russian Federation [2] and the Law of the Russian Federation of 25.06.1993 No. 5242-1 "On the right of Citizens of the Russian Federation to freedom of movement, choice of place of stay and residence within the Russian Federation" [3]. The priority direction of the State's social policy is to provide all citizens with equal opportunities for access to social, economic, and cultural values, guaranteeing all members of society respect for the individual and respect for everyone's rights. In order to realize their civil rights and duties, disabled people need the support of society and the state. To integrate disabled people with impaired mental functions into society, the indicators of activity and participation of disabled people living in inpatient social service institutions and families based on the International Classification of Functioning, Disability and Health (ICF) were studied. This study is necessary for further selection of citizens with impaired mental functions for accompanied accommodation and determination of the type of escort.

Aim. Research of indicators of activity and participation of disabled people living in inpatient social service institutions and families.

Materials and methods. The study of activity and participation indicators was conducted in social service institutions of the population of St. Petersburg. The study involved a multidisciplinary team consisting of employees of the G.A. Albrecht Federal State Budgetary Research Center of the Ministry of Labor of Russia and employees of the CSRIDI (teachers, AFC specialists, psychologists, orderlies). The selection of the Center's clients living in families and graduates of inpatient social service institutions who currently live independently was carried out. The study involved 27 people with impaired mental functions of working age (from 17 to 43 years). Methods and principles of medical and social assessment are used to assess the abilities of persons with mental disorders. Interviewing (interviewing) of the surveyed persons, their relatives and guardians, employees of the PSNI. Documentary data collection (collection of necessary information on the documents of the examined persons). Medical assessment of the condition of the examined persons. Expert assessment of the abilities of persons with impaired mental functions using diagnostic tools by a multidisciplinary team. The data from the clients' documentation was recorded in the developed personal cards. General scientific methods (content analysis, analytical, system-structural, comparative, statistical) and methodological methods of systematization, comparison, generalization, interpretation using the standard Excel-7.0 software package for IBM PC are applied.

The object of the study. People with disabilities with impaired mental functions who need accompanied accommodation.

The subject of the study. Assisted living services required by disabled persons with impaired mental functions.

Results. According to the results obtained, 6 (22.2%) people with impaired mental functions have no restrictions in autonomy, which means they do not need periodic or constant support. It is possible for them to use periodic patronage in order to identify difficult life situations. The rest of the persons with mental disorders have different degrees of difficulties of the person's autonomies and need support of different frequency. Of these, 5 (18.5%) have minor difficulties with facial autonomy, 8 (29.6%) have moderate difficulties, 5 (18.5%) have severe difficulties with facial autonomy, and 3 (11.2%) have significant limitations of facial autonomy and need constant care. It is worth noting that three disabled people with impaired mental functions, two of whom, according to the results of the study, were in the group of persons with severe difficulties of facial autonomy, and one with moderate difficulties of facial autonomy have significantly pronounced disorders of neuromuscular, skeletal and movement–related functions, which is why they constantly need help when moving. At the same time, they have mastered secondary general education, can read, count, performs written and oral commands, is able to maintain a conversation, is able to build interpersonal interactions. To clarify the degree of violation of the person's autonomy and the need for support in the presence of restrictions on independent movement, the b760 domain "Control of voluntary motor functions" and the domains of the "Mobility" section were calculated separately.

Discussion. The development and implementation of an assessment system for disabled people based on the study of indicators of functioning, activity and participation of citizens with impaired mental function with an assessment of medical and social factors affecting their livelihoods and an assessment of the degree of autonomy of persons living in inpatient social service institutions and families will solve questions about the form of life of citizens suffering from mental disorders, and organize work on their employment.

Conclusions. Depending on the indicators of activity and participation of disabled people living in inpatient social service institutions and families, based on the provisions of the international classification of functioning, disability and health, it allows you to determine the degree of expression of a person's autonomy, the volume and duration of support services.

The Russian Federation ratified in 2012 the Convention on the Rights of Persons with Disabilities, adopted by the UN General Assembly in 2006. In this regard, the study of measures taken by the Russian Federation to create conditions for persons with disabilities and children with disabilities to lead an independent lifestyle, for the scientific substantiation of subsequent measures and the development of relevant legal regulations to ensure the ability of disabled people to lead an independent lifestyle in their chosen place of residence and integration into the local community in the constituent entities of the Russian Federation is extremely relevant.

The purpose of the study is to scientifically substantiate the legislative, regulatory and methodological support for the realization of the rights of people with disabilities to lead an independent life, involving the choice of a place of residence, integration into the local community.

Research methods: comparative legal, logical, historical, statistical. Research material: international legal acts, federal and regional legislation on providing disabled people and children with disabilities with the opportunity to lead an independent lifestyle, data on the number of disabled people living in stationary social service organizations.

Research results. A non-complex elaboration in the legislation of the Russian Federation and the constituent entities of the Russian Federation of issues of providing disabled people with the opportunity to lead an independent lifestyle has been established, specific shortcomings in the legal regulation of issues of ensuring the possibility of leading an independent lifestyle of disabled people have been identified at the federal and regional levels, normative and methodological acts have been developed that made it possible to start working out issues providing conditions and mechanisms for the implementation of an independent lifestyle for disabled people in their chosen place of residence, a positive trend has been established in the introduction of new technologies for the preparation and organization of assisted living for disabled people in a number of constituent entities of the Russian Federation as part of pilot projects. Based on the results obtained, the draft Concept and the Set of Measures were developed to expand the opportunities for disabled people to lead an independent lifestyle in their chosen place of residence.

Conclusion. In the country, at the federal and regional levels, the implementation of the provisions of the Convention has been carried out, expanding the realization of the rights of disabled people to lead an independent life in the local community and consistently creating conditions for the disabled to lead an independent lifestyle, introducing innovative technologies for preparing people with disabilities for independent living and monitoring of their implementation.