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Experts, who support the idea of expanding the functions of nurses, the main obstacles to its implementation see in the stereotypes that the chief physicians and the medical community as a whole have about the purely secondary role of the nursing staff, as well as the corresponding attitudes of the nurses themselves. Regarding the standard of the capital's nurse, experts agree that the main emphasis should be on the development of universal competencies, attention to deontological and ethical issues.The article deals with changes in the human resources potential in the Russian health care system, which are the result of the reform of the medical sphere carried out in recent years. The COVID-19 pandemic, which began in early 2020, exposed significant shortcomings of the Russian healthcare reform, showing serious problems in the shortage of specialists, hospital beds, protective equipment, ventilators, tests, and medicines. The reduction of hospital beds and the number of infectious diseases doctors in order to increase the average salary in healthcare has led to the inability of the Russian healthcare system to cope with the spread of coronavirus infection without involving residents, professors, teachers and students of medical organizations. At the present stage of development, the issues of combating the spread of coronavirus infection, mobilization and professional training of medical workers are of particular relevance. Nevertheless, despite the results of the health care reform, which led to a massive reduction of medical organizations in our country, the number of doctors per 10,000 people in 2018 was 47.9 employees, over the past 20 years, has not changed much in the direction of reduction. In our view, we should not talk about a global reduction in human resources in healthcare. The existing personnel problems in healthcare are the low qualification of medical personnel and the General shortage of specialists in the labor market.Health insurance issues are an important area of social interaction between different troupes of the population in the Russian Federation. This article discusses aspects of the current state of the market of medical voluntary and compulsory insurance in the Russian Federation. For this purpose, the article provides a comparative analysis of the concepts of "compulsory health insurance" and "voluntary health insurance". Also data are given on studying the market of medical insurance in Russia in recent times, and presents forecasts of researchers in the development of health insurance in the perspective up to 2020 in addition, the highlighted trends in the costs of financing health care. The problems of the Russian compulsory and voluntary medical insurance market and possible ways of their development are considered.Diabetes is a leading cause of end-stage renal disease. Therefore, prevention of renal dysfunction is an important treatment goal in the management of diabetes. The data of landmark cardiovascular outcome trials of sodium-glucose cotransporter-2 (SGLT2) inhibitor showed profound reno-protective effects. The Korean Diabetes Association and the Korean Society of Nephrology reviewed clinical trials and performed meta-analysis to assess the effects of SGLT2 inhibitors on the preservation of estimated glomerular filtration rate (eGFR). We limited the data of SGLT2 inhibitors which can be prescribed in Korea. Both eGFR value and its change from the baseline were significantly more preserved in the SGLT2 inhibitor treatment group compared to the control group after 156 weeks. However, some known adverse events were increased in SGLT2 inhibitor treatment, such as genital infection, diabetic ketoacidosis, and volume depletion. We recommend the long-term use SGLT2 inhibitor in patients with type 2 diabetes mellitus (T2DM) for attenuation of renal function decline. However, we cannot generalize our recommendation due to lack of long-term clinical trials testing reno-protective effects of every SGLT2 inhibitor in a broad range of patients with T2DM. Momelotinib ic50 This recommendation can be revised and updated after publication of several large-scale renal outcome trials.The increase in the exposure to carbon nanotubes (CNTs) and their incorporation into industrial, electronic, and biomedical products have required several scientific investigations into the toxicity associated with CNTs. Studies have shown that the metabolism and clearance of multiwalled CNTs (MWCNTs) from the body involve biotransformation in the liver and its excretion via the kidney. Since oxidative stress and inflammation underlines the toxicity of MWCNT, we investigated the ameliorative effect of kolaviron (KV), a natural antioxidant and anti-inflammatory agent, on hepatorenal damage in rats. Exposure to MWCNTs for 15 days significantly increased serum activities of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and lactate dehydrogenase thereby suggesting hepatic dysfunction. Kidney function, which was monitored by urea and creatinine levels, was also impaired by MWCNTs. Additionally, MWCNTs markedly increased myeloperoxidase activity, nitric oxide level, reactive oxygen and nitrogen species, and tumor necrosis factor level in both tissues. However, KV in a dose-dependent manner markedly attenuated MWCNT-induced markers of hepatorenal function in the serum and MWCNT-associated inflammation in the liver and kidney. Also, MWCNTs elicited significant inhibition of superoxide dismutase, catalase, glutathione peroxidase, and glutathione-S-transferase activities. There was a significant diminution in glutathione level (GSH) and enhanced production of malondialdehyde (MDA) in MWCNTs-exposed rats. KV treatment was able to significantly increase the antioxidant enzymes and enhance the GSH level with a subsequent reduction in the MDA level. Taken together, KV elicited ameliorative effects against hepatorenal damage via its anti-inflammatory and antioxidant properties. Thus, KV could be an important intervention strategy for the hepatorenal damage associated with MWCNTs exposure.Enrichment of neurally derived extracellular vesicles of several cell-types from plasma for protein quantification longitudinally in living patients with Alzheimer's disease has permitted the development of a tentative temporal framework of initiating events, progression mechanisms, and amplification processes. Interactions of beta-amyloid peptides with an elevated level of their normal prion protein dendritic receptor and of phospho-tau species with their synaptogyrin-3 synaptic vesicle receptor replace excessive production and accumulation of neuropathic proteins as the major initiating events. Synaptic dysfunction and microvascular angiopathy are confirmed as early progression mechanisms of decreased neuronal network connectivity, hypoxia, altered blood-brain barrier, and neurocellular degeneration. Neurally derived extracellular vesicle protein abnormalities also reveal a range of later amplification processes that encompasses insulin resistance, lysosomal defects, decreased survival factors, increased reactive oxygen species, and excessive neuroinflammation.