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Objective: to develop tactics for the differential diagnosis of paraneoplastic neuromuscular syndromes in patients at the outpatient level.Materials and methods: the study included 50 patients with classical neuromuscular paraneoplastic syndromes (experimental group) and 50 patients with neuromuscular syndromes of non-paraneoplastic nature (control group). All patients underwent a comprehensive laboratory and instrumental examination at the Regional Consultative and Diagnostic Center of the Ministry of Health of the Rostov Region from 2014 to 2018.Results: the evaluation of clinical differences in patients of the experimental and control groups was created. When comparing the laboratory parameters, it was revealed that the SFMC, D-dimer, CRP-2 levels significantly increased in patients with paraneoplastic lesions (p <0.05). In the experimental group, a significant increase in the amplitude of the M-response from the sensory nerves (> 5.25 mV) was noted. Based on obtained data, differential diagnosis algorithms for patients with studied neuromuscular lesions at the outpatient level have been developed.Conclusions: the conducted study allows the implementation of non-serological diagnostics algorithms for classical neuromuscular paraneoplastic syndromes in outpatient practice.

Purpose Optimization the ocular surface after LASIK Methods Assessed the ocular surface, tear film and tear production before and after optimization in patients after two‐step LASIK in 4 groups. Group 1 (A) ‐ high myopia and low degree of astigmatism ‐ (43), aged 18 to 35 years, group 2 (B) ‐ medium myopia and low degree of astigmatism – (32), aged 18 to 35 years, group 3 (C) ‐ myopia medium or high and medium degree of astigmatism – (37), older than 35 years, group 4 (D) ‐ hypermetropia medium or high and medium degree of astigmatism ‐ (32), older than 35 years. The criteria for preoperative drug correction of refractive surgery to the stage were the following diagnostic blocks: clinical data in diagnosis of dry eye and corneal status, corneal thickness, the definition of clinical refraction, including patient age, antioxidant and immune activity of tears. Results The use of moxifloxacin 0.5% and tear lubricants (such as preparation containing hydroxypropylguar and sorbitol or hydroxypropylguar) in groups A and В, and the use of tear lubricants (such as preparation containing hydroxypropylguar and sorbitol or hydroxypropylguar) in groups C and D after LASIK reduces residual astigmatism and the number of complications refractive surgery. Conclusion We found the dependence tear lubricants choice for optimizing the ocular surface after LASIK from the indices of corneal status, corneal thickness, the definition of clinical refraction, degree of astigmatism, including patient age, antioxidant and immune activity of tears. Pathogenetically substantiated using of preparations containing hydroxypropylguar and sorbitol or hydroxypropylguar after LASIK reduces the degree of residual aberrations.