An attempt to systematize the experience of creating a barrier – free environment in Samara, one of the megacities in Russia, has made. In the course of work, field surveys carried out. The following priority areas for the implementation of universal design methods identified: housing, social infrastructure and a set of elements of urban utilities. In them, the consumer properties of buildings and territories have a decisive influence on the overall assessment of the quality of the urban environment. The examples are given and the difficulties of creating a barrier-free environment in new residential compounds and universities, as well as in the objects of the municipal sphere of the city analyzed. The conclusion that the process of introducing the principles of formation of a barrier-free environment has a rather low pace has made. This is not in line with the city’s sustainable development objectives. The question of the development of local urban planning regulations and design standards, which will allow the transition to the massive use of the principles of universal design, has raised.

The study is devoted to urgent problems of developing the underground space of cities. The article considers urban underground spaces as a reserve of additional area, due to which it is possible to increase comfort and improve the quality of life of people. The issues of lack of free urban land are studied, and the possibility of organizing multilevel, convenient and safe pedestrian-transport communications in the urban environment is also being considered. The innovative approach to solving this issue requires an integrated approach, taking into account the variety of factors affecting the formation of the underground structure of urban space. Based on the theoretical and practical experience in the design and construction of underground structures, the positive and negative sides of the development of the underground space were formulated. The use of underground space in cities demonstrates the possibility of a comprehensive solution to a wide range of urban, economic and environmental problems.

The level of natriuretic peptide is regarded as a prognostic predictor of postoperative heart failure in modern cardiac surgery, and moreover, this hormone is included in the standards of its early diagnosis around the world. This study was conducted at the Irkutsk Cardiac Surgery Center. The results of treatment of 78 patients were analyzed in order to determine the relationship between the dynamics of brain natriuretic peptides and the course of the early postoperative period in operations with artificial cardiopulmonary bypass. Patients were divided into three groups according to the level of natriuretic peptide elevation in the postoperative period. The study proved the dependence of the postoperative period on the multiplicity of the increase in the level of natriuretic peptide B-type.It was found that the higher the rate of increase in the hormone, the lower the numbers of the cardiac index in the postoperative period, longer duration of inotropic support (p > 0.05) and higher doses of adrenomimetics (p > 0.05). The duration of mechanical ventilation was also longer in the groups where a high level of natriuretic peptide was recorded (p > 0.05). Thus, the multiplicity of natriuretic peptide elevation can be a prognostic criterion for the postoperative period in cardiac patients. It is important to note that a single determination of the level of natriuretic peptide should not be used as a marker of postoperative heart failure and this study confirmed the necessity to monitor the dynamics of brain natriuretic peptide’s level in the perioperative period in patients operated with extracorporeal cardiopulmonary bypass.

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