90 research outputs found

    Improving the production technology of drilling and blasting operations by blasting of high ledges

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    In modern economic conditions, the issue of improving the efficiency of mining enterprises is very relevant. One of the key processes isdrilling and blasting operations (DBO), which determine the efficiency of the entire complex of mining operations. One of the main methods of controlling the explosion energy is the diameter of the blast wells. According to the recommendations of prof. B N Kutuzov the diameter of blast wells is correlated with the fracturing and strength of the exploding rocks. With increasing blockage and rock strength to achieve the required quality of explosive crushing preference is given to drilling equipment with a small diameter of wells. By blasting of high ledges, especially large-block rocks with a strength coefficient of more than 15 on the M M Protodyakonov scale; the use of high-performance drilling equipment for drilling small-diameter blast wells is difficult. This is due to the fact that the calculated value of the resistance line along sole (RLAS) does not pass the safety condition for drilling the first row of wells. In this regard, the paper proposes and justifies the use of extensions of the lower parts of wells using mechanical expanders. Β© Published under licence by IOP Publishing Ltd

    Synthesis of Fatty-Acid Ethanolamides from Linum catharticum Oils and Cololabis saira Fats

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    Ethanolamides of polyunsaturated fatty acids (9Z,12Z,15Z-octadecatrienoic; 5Z,8Z,11Z,14Z,17Z-eicosapentaenoic; and 4Z,7Z,10Z,13Z,16Z,19Z-docosahexaenoic) and mixtures of ethanolamides of fatty acids from natural fats (oils) were synthesized. It was found that the polyunsaturated fatty acids did not isomerize under the proposed conditions for aminolysis of the ester bond. Conditions for analyzing the complicated mixtures of ethanolamides of fatty acids by HPLC-MS were determined.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41528/1/10600_2004_Article_495514.pd

    ROLE OF MESENCHYMAL MULTIPOTENT STROMAL CELLS IN REMODELING OF BONE DEFECTS

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    Ability of mesenchymal multipotent stromal cells (MSCs) to differentiate into several types of mesenchymal tissues allows to consider these cells the main candidates for creating tissue engineeringΒ constructions for regenerative medicine. MSCs promote integration of bio-implants into the native bone and stimulate osteogenesis. MSCs are characterized by immunomodulatory properties, due to inflammation control and modification of immune cells. MSCs affect not only the in vivo immune response by preventing immunological rejection of implanted tissue engineering designs, but it can also influence the bone tissue immunity. MSCs play an important role in bone regeneration, by regulating the osteoblastic generation, and suppressing activity of inflammation effectors and osteoclastogenesis. Some pre-clinical and first clinical trials of bone bio-implants colonized with MSC, demonstrate promising outlooks for this strategy in order to obtain tissue engineering constructions for bone regeneration

    Measurement of the response of a gallium metal solar neutrino experiment to neutrinos from a [Formula Presented] source

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    The neutrino capture rate measured by the Russian-American Gallium Experiment is well below that predicted by solar models. To check the response of this experiment to low-energy neutrinos, a 517 kCi source of [Formula Presented]Cr was produced by irradiating 512.7 g of 92.4%-enriched [Formula Presented]Cr in a high-flux fast neutron reactor. This source, which mainly emits monoenergetic 747-keV neutrinos, was placed at the center of a 13.1 ton target of liquid gallium and the cross section for the production of [Formula Presented]Ge by the inverse beta decay [Formula Presented] was measured to be [Formula Presented] The ratio of this cross section to the theoretical cross section of Bahcall for this reaction is 0.95 Β±0.12 [Formula Presented] (theor) and to the cross section of Haxton is 0.87Β±0.11 (expt)Β±0.09 (theor). This good agreement between prediction and observation implies that the overall experimental efficiency is correctly determined and provides considerable evidence for the reliability of the solar neutrino measurement. Β© 1999 The American Physical Society

    The russian-american gallium experiment (sage) cr neutrino source measurement

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    The solar neutrino capture rate measured by SAGE is well below that predicted by solar models. To check the overall experimental efficiency, we exposed 13 tonnes of Ga metal to a reactor-produced 517 kCi source of 51Cr. The ratio of the measured production rate to that predicted from the source activity is 0.95+/-0.11statstat+0.05/-0.08systsyst. This agreement verifies that the experimental efficiency is measured correctly, establishes that there are no unknown systematic errors at the 10% level, and provides considerable evidence for the reliability of the solar neutrino measurement. Β© 1996 The American Physical Society

    Preliminary results from the Russian-American Gallium Experiment Cr-neutrino source measurement

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    The Russian-American Gallium Experiment has been collecting solar neutrino data since early 1990. The flux measurement of solar neutrinos is well below that expected from solar models. We discuss the initial results of a measurement of experimental efficiencies by exposing the gallium target to neutrinos from an artificial source. The capture rate of neutrinos from this source is very close to that which is expected. The result can be expressed as a ratio of the measured capture rate to the anticipated rate from the source activity. This ratio is 0.93 + 0.15, - 0.17 where the systematic and statistical errors have been combined. To first order the experimental efficiencies are in agreement with those determined during solar neutrino measurements and in previous auxiliary measurements. One must conclude that the discrepancy between the measured solar neutrino flux and that predicted by the solar models can not arise from an experimental artifact

    CO-EXPRESSION OF MEMBRANE-BOUND TUMOR NECROSIS FACTOR-Ξ± RECEPTORS IN MAJOR SUBPOPULATIONS OF IMMUNOCOMPETENT CELLS IN HEALTHY INDIVIDUALS AND PATIENTS WITH RHEUMATOID ARTHRITIS AS WELL AS BRONCHIAL ASTHMA

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    A pleiotropic cytokine TNFΞ± is an important inflammatory mediator of a number of diseases; its biological functions are fulfilled through two different receptors, TNFR1 and TNFR2. Changes in the ratio between these types of receptors shifting the balance between the pro-apoptotic and proliferation signaling pathways play a crucial role in eliciting the cell response to TNFΞ±. The pathological processes in the body can alter the levels of TNFR1 and TNFR2 expression on the cells involved in disease development. Therefore, this study was aimed at investigating the level of co-expression of type 1 and 2 TNFΞ± receptors in the major subpopulations of peripheral blood cells in patients with rheumatoid arthritis (RA) and bronchial asthma (BA). The greatest changes in the percentage of cells expressing TNFR1 and TNFR2 were revealed for the B-lymphocyte subpopulation. For the T-lymphocyte subpopulation, there were some differences in the percentage of cells expressing exclusively TNFR1 in RA and BA patients compared with those in healthy subjects, as well as between the RA and BA groups. A higher percentage of double-negative monocytes was observed in patients with BA and RA compared to healthy subjects. These findings indicate that the coexpression profile of TNFR1 and TNFR2 receptors in patients with RA and BA differ within these groups as well as compared to that in healthy subjects. These immune cell populations are actively involved in the pathogenesis of both rheumatoid arthritis and bronchial asthma, so the results may indicate that these cells might show different responses to TNFΞ± as the percentage and the number of receptors on their surface vary

    Measurement of the response of a gallium metal solar neutrino experiment to neutrinos from a 51Cr source

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    The neutrino capture rate measured by the Russian-American Gallium Experiment is well below that predicted by solar models. To check the response of this experiment to low-energy neutrinos, a 517 kCi source of 51Cr was produced by irradiating 512.7 g of 92.4%-enriched 50Cr in a high-flux fast neutron reactor. This source, which mainly emits monoenergetic 747-keV neutrinos, was placed at the center of a 13.1 tonne target of liquid gallium and the cross section for the production of 71Ge by the inverse beta decay reaction was measured to be (5.55 +/- 0.60 (stat.) +/- 0.32 (syst.)) x 10^(-45) cm^2. The ratio of this cross section to the theoretical cross section of Bahcall for this reaction is 0.95 +/- 0.12 (exp.) +/- 0.03 (theor.) and to the cross section of Haxton is 0.87 +/- 0.11 (exp.) +/- 0.09 (theor.). This good agreement between prediction and observation implies that the overall experimental efficiency for the solar neutrino measurements is correctly determined and provides considerable evidence for the reliability of the solar neutrino measurement.Comment: 20 pages including figures in two column forma

    ΠœΠΈΠ½ΠΈΠΌΠΈΠ·Π°Ρ†ΠΈΡ стоимости примСнСния ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… лСкарствСнных ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠ² Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» + умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ ΠΈ ΠΎΠ»ΠΎΠ΄Π°Ρ‚Π΅Ρ€ΠΎΠ» + тиотропия Π±Ρ€ΠΎΠΌΠΈΠ΄ для Π±Π°Π·ΠΎΠ²ΠΎΠΉ ΠΏΠΎΠ΄Π΄Π΅Ρ€ΠΆΠΈΠ²Π°ΡŽΡ‰Π΅ΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ хроничСской обструктивной Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π»Π΅Π³ΠΊΠΈΡ… тяТСлого ΠΈ ΠΊΡ€Π°ΠΉΠ½Π΅ тяТСлого тСчСния

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    The recently introduced novel drug combinations for the treatment of COPD are based on long-acting beta-agonists (vilantererol / umeclidinum bromide) and long-acting anticholinergics (olodaterol / tiotropium bromide). In addition to their beneficial clinical effects, these medications have an impact on COPD treatment costs. Minimizing the costs of highly effective medications is necessary to improve the public medical care and drug supply.Objective: to identify the key differences between vilantererol / umeclidinum bromide and olodaterol / tiotropium bromide, and evaluate the ways of minimizing health budget expenditures.Materials and methods. We used the available information from research, clinical trials, and instructions for medical use to conduct a cost analysis that was based on the prices for these medications at different levels of drug supply. As a result, the impact on the healthcare budget was determined under conditions of choosing the least expansive medication and adding vilantererol / umeclidinum bromide in the list of VED.Results. According to the network meta-analysis, when compared with mono-component drugs, vilantererol / umeclidinum bromide showed a more favorable effect on cardiovascular events, as well as a more pronounced effect on the volume of forced exhalation in the first second (FEV1). For the olodaterol / tiotropium bromide combination, no such trend was seen. The costs of 12-month therapy with vilantererol / umeclidinum bromide and with olodaterol / tiotropium bromide were 27,541 and 36,120 rubles, respectively (a difference of 24%). The average direct medical costs were 32,753 and 41,333 rubles per patient per year, respectively. If the vilantererol / umeclidinum bromide combination is added to the VED list and the manufacturer’s maximum selling price is registered at the level of the reference countries, the savings can reach 3-5%.Conclusion. In patients with severe and extremely severe COPD, and also when COPD monotherapy in patients without severe symptoms (FEV1 β‰₯50%, CAT <10 scores, mMRC <2) or with mild to moderate symptoms (FEV1 β‰₯50%) is not effective, the use of vilantererol / umeclidinum bromide in place of olodaterol / tiotropium bromide is more promising in terms of minimizing health budget spending.Β Π’ ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΡƒ вошли соврСмСнныС ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Π΅ лСкарствСнныС ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Ρ‹ (Π›ΠŸ) для лСчСния хроничСской обструктивной Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π»Π΅Π³ΠΊΠΈΡ… (Π₯ΠžΠ‘Π›) Π½Π° основС Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ Π΄Π΅ΠΉΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΡ… Π±Π΅Ρ‚Π° агонистов (ДДБА) ΠΈ Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ Π΄Π΅ΠΉΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΡ… Π°Π½Ρ‚ΠΈΡ…ΠΎΠ»ΠΈΠ½Π΅Ρ€Π³ΠΈΠΊΠΎΠ² (ДДАΠ₯): Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» + умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ ΠΈ ΠΎΠ»ΠΎΠ΄Π°Ρ‚Π΅Ρ€ΠΎΠ» + тиотропия Π±Ρ€ΠΎΠΌΠΈΠ΄. Π˜Ρ… ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΡ‚ ΠΊ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡŽ исходов Π₯ΠžΠ‘Π›, Π½ΠΎ Ρ‚Π°ΠΊΠΆΠ΅ ΠΎΠΊΠ°Π·Ρ‹Π²Π°Π΅Ρ‚ влияниС Π½Π° Π±ΡŽΠ΄ΠΆΠ΅Ρ‚. ΠœΠΈΠ½ΠΈΠΌΠΈΠ·Π°Ρ†ΠΈΡ стоимости высокоэффСктивных Π›ΠŸ являСтся пСрспСктивным Π½Π°ΠΏΡ€Π°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ ΡΠΎΠ²Π΅Ρ€ΡˆΠ΅Π½ΡΡ‚Π²ΠΎΠ²Π°Π½ΠΈΡ лСкарствСнного обСспСчСния.ЦСль – ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΠΈΡ‚ΡŒ ΠΊΠ»ΡŽΡ‡Π΅Π²Ρ‹Π΅ различия ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… Π›ΠŸ Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» + умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ ΠΈ ΠΎΠ»ΠΎΠ΄Π°Ρ‚Π΅Ρ€ΠΎΠ» + тиотропия Π±Ρ€ΠΎΠΌΠΈΠ΄, Π° Ρ‚Π°ΠΊΠΆΠ΅ направлСния ΠΈ ΠΎΠΆΠΈΠ΄Π°Π΅ΠΌΡ‹Π΅ ΠΎΠ±ΡŠΠ΅ΠΌΡ‹ ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°Ρ†ΠΈΠΈ Π·Π°Ρ‚Ρ€Π°Ρ‚ Π±ΡŽΠ΄ΠΆΠ΅Ρ‚Π° здравоохранСния.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Научный ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΎΠ½Π½Ρ‹ΠΉ поиск ΠΈ Π°Π½Π°Π»ΠΈΠ· Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² клиничСских исслСдований, свСдСний ΠΈΠ· инструкций ΠΏΠΎ мСдицинскому ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡŽ, Π°Π½Π°Π»ΠΈΠ· стоимости Π½Π° основС ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ ΠΎ Ρ†Π΅Π½Π°Ρ… Π›ΠŸ Π½Π° Ρ€Π°Π·Π½Ρ‹Ρ… уровнях лСкарствСнного обСспСчСния. ΠžΠΏΡ€Π΅Π΄Π΅Π»ΡΠ»ΠΈ Ρ€Π°Π·ΠΌΠ΅Ρ€ экономии Π±ΡŽΠ΄ΠΆΠ΅Ρ‚Π° систСмы здравоохранСния ΠΏΡ€ΠΈ Π²Ρ‹Π±ΠΎΡ€Π΅ Π½Π°ΠΈΠΌΠ΅Π½Π΅Π΅ Π·Π°Ρ‚Ρ€Π°Ρ‚Π½ΠΎΠ³ΠΎ Π›ΠŸ, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΏΡ€ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠΈ Π›ΠŸ Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» + умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ Π² ΠΏΠ΅Ρ€Π΅Ρ‡Π΅Π½ΡŒ Π–ΠΠ’Π›ΠŸ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. По Π΄Π°Π½Π½Ρ‹ΠΌ сСтСвого ΠΌΠ΅Ρ‚Π°-Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΡ€ΠΈ сравнСнии с ΠΌΠΎΠ½ΠΎΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ‚Π½Ρ‹ΠΌΠΈ Π›ΠŸ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ»Π° + умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ ΠΈΠΌΠ΅Π»ΠΎ Ρ‚Π΅Π½Π΄Π΅Π½Ρ†ΠΈΡŽ ΠΊ Π±ΠΎΠ»Π΅Π΅ благоприятному ΠΏΡ€ΠΎΡ„ΠΈΠ»ΡŽ сСрдСчно-сосудистых событий, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΊ Π±ΠΎΠ»Π΅Π΅ Π²Ρ‹Ρ€Π°ΠΆΠ΅Π½Π½ΠΎΠΌΡƒ влиянию Π½Π° объСм форсированного Π²Ρ‹Π΄ΠΎΡ…Π° Π² ΠΏΠ΅Ρ€Π²ΡƒΡŽ сСкунду (ΠžΠ€Π’1); для ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Ρ†ΠΈΠΈ ΠΎΠ»ΠΎΠ΄Π°Ρ‚Π΅Ρ€ΠΎΠ» + тиотропия Π±Ρ€ΠΎΠΌΠΈΠ΄ Ρ‚Π°ΠΊΠΎΠΉ Ρ‚Π΅Π½Π΄Π΅Π½Ρ†ΠΈΠΈ выявлСно Π½Π΅ Π±Ρ‹Π»ΠΎ. Π‘Ρ‚ΠΎΠΈΠΌΠΎΡΡ‚ΡŒ Π³ΠΎΠ΄ΠΎΠ²ΠΎΠ³ΠΎ курса Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π›ΠŸ умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ + Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» ΠΈ Π›ΠŸ ΠΎΠ»ΠΎΠ΄Π°Ρ‚Π΅Ρ€ΠΎΠ» + тиотропия Π±Ρ€ΠΎΠΌΠΈΠ΄ составила 27541 ΠΈ 36120 Ρ€ΡƒΠ±. соотвСтствСнно (Ρ€Π°Π·Π½ΠΈΡ†Π° Π² 24%). Π‘ΡƒΠΌΠΌΠ° прямых мСдицинских Π·Π°Ρ‚Ρ€Π°Ρ‚ составила 32753 ΠΈ 41333 Ρ€ΡƒΠ±. Π² срСднСм Π½Π° ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° Π² Π³ΠΎΠ΄ ΠΏΡ€ΠΈ использовании умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄Π° + Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» ΠΈΠ»ΠΈ ΠΎΠ»ΠΎΠ΄Π°Ρ‚Π΅Ρ€ΠΎΠ» + тиотропия Π±Ρ€ΠΎΠΌΠΈΠ΄Π° соотвСтствСнно. ΠŸΡ€ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠΈ ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Ρ†ΠΈΠΈ Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» + умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ Π² ΠΏΠ΅Ρ€Π΅Ρ‡Π΅Π½ΡŒ Π–ΠΠ’Π›ΠŸ ΠΈ ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰Π΅ΠΉ рСгистрации ΠΏΡ€Π΅Π΄Π΅Π»ΡŒΠ½ΠΎΠΉ отпускной Ρ†Π΅Π½Ρ‹ производитСля ΠΈΠΌΠΏΠΎΡ€Ρ‚Π½ΠΎΠ³ΠΎ лСкарствСнного ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π° Π½Π° ΡƒΡ€ΠΎΠ²Π½Π΅ Ρ€Π΅Ρ„Π΅Ρ€Π΅Π½Ρ‚Π½Ρ‹Ρ… стран экономия ΠΌΠΎΠΆΠ΅Ρ‚ ΡΠΎΡΡ‚Π°Π²ΠΈΡ‚ΡŒ 3-5%.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π’ Π³Ρ€ΡƒΠΏΠΏΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π₯ΠžΠ‘Π› тяТСлого ΠΈ ΠΊΡ€Π°ΠΉΠ½Π΅ тяТСлого тСчСния, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΊΠΎΠ³Π΄Π° монотСрапия Π₯ΠžΠ‘Π› Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π±Π΅Π· Π²Ρ‹Ρ€Π°ΠΆΠ΅Π½Π½Ρ‹Ρ… симптомов (ΠžΠ€Π’1 β‰₯50%; БАВ <10 Π±Π°Π»Π»ΠΎΠ²; mMRC <2) ΠΈ/ΠΈΠ»ΠΈ с Π»Π΅Π³ΠΊΠΈΠΌ ΠΈ срСднСтяТСлым Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ΠΌ (ΠžΠ€Π’1 β‰₯50%) Π½Π΅ являСтся достаточно эффСктивной, использованиС Π›ΠŸ Π²ΠΈΠ»Π°Π½Ρ‚Π΅Ρ€ΠΎΠ» + умСклидиния Π±Ρ€ΠΎΠΌΠΈΠ΄ вмСсто Π›ΠŸ ΠΎΠ»ΠΎΠ΄Π°Ρ‚ΠΎΡ€ΠΎΠ» + тиотропия Π±Ρ€ΠΎΠΌΠΈΠ΄ являСтся Π±ΠΎΠ»Π΅Π΅ пСрспСктивным Π½Π°ΠΏΡ€Π°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°Ρ†ΠΈΠΈ Π·Π°Ρ‚Ρ€Π°Ρ‚ Π±ΡŽΠ΄ΠΆΠ΅Ρ‚Π° здравоохранСния.
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