The work presents the analysis of changes of statistical parameters, hemodynamic and cardiac rhythm variability in dynamics depending on sedation level according to the bispectral index in patients undergone intravenous anaesthesia in painful endoscopic procedures. Heart rate variability is a reliable and sensitive method for evaluation of functions of the autonomic nervous system. Registration and interpretation of heart rate variability reflects the activity of the autonomic nervous system in such diseases as intracranial hypertension, stroke, and brain trauma. As a "gold standard" assessment of the level of anesthesia we used the original methodology for the evaluation of bioelectrical activity of the brain based on electroencephalogram - "Bispectral index" - BISPECTRAL INDEX (BIS], demonstrating the degree of sedation of the patient on a dynamic curve from 100 % to 0 %. Assessment of heart rate variability, hemodynamic profile, and the BIS was carried out in three phases of research: phase 1 - before the introduction of anaesthesia (baseline]; phase 2- after administration of drugs for anesthesia; phase 3 - the end of the procedure, recovery of consciousness (post anesthesia]. Depending on the BIS, values for all patients were allocated to three levels of sedation: the first level corresponded to the patient's state of consciousness or light sedation, the second and third - to deep anesthesia. A mathematical model of light and deep levels of anesthesia based on the discriminant analysis contingency options.

The aim of the study was to prove the efficacy of the treatment regimen for patients with colorectal cancer with metastatic liver involvement. The regimen included a combination of colon and liver resection, methods of local destruction and chemotherapy. There were 126 patients with colon cancer and metastases in the liver involved in the study. All tumors were adenocarcinomas of the intestinal type. Metastases in the liver affected both lobes of the liver. In the main group (64 patients), resection of the large intestine and liver resection were carried out. During the operation, radiofrequency ablation of the remaining metastases and chemoembolization of the portal vein were performed. In the postoperative period, systemic chemotherapy and chemoembolization of the hepatic artery were prescribed. In the control group (62 patients), surgery was performed on the large intestine and systemic chemotherapy was performed. Complications of the operation occurred in 18 patients (28.1 %) in the main group and 10 in patients (16.1 %) in the control group (p = 0.004). Median disease-free survival in the main group was 9.01 months, in the control group - 5.01 months (p = 0.001). Median overall survival in the main group was 13.8 months, in the control group - 9.8 months (p = 0.004). One-year overall survival in the main group was 60.93 %, in the control group - 41.93 %, two-year in the main group -17.18 %, in the control group - 6.45 %. In the control group, there were no three years survivals, and in the main group, the three-year overall survival was 4.68 %.

Cicatricial tracheal stenosis is an urgent matter in thoracic surgery and otolaryngology. The main causes of cicatricial stenosis of the trachea is orotracheal intubation, tracheostomy and neck injuries with damage to the trachea. One of the factors that complicate this disease course is addition of nosocomial infection. We conducted a retrospective study of medical records of 33 patients treated in the thoracic surgery department of Irkutsk Regional Clinical Hospital diagnosed with cicatricial stenosis of trachea for the period from 2011 to 2013. 75 % of patients with cicatricial stenosis of trachea were men of working age up to 50 years old. We evaluated the results of bacteriological examination of detachable tracheobronchial tree. The bacteriological examination of the patients with cicatricial stenosis of trachea often exhibited hospital microflora in the form of Pseudomonas aeruginosa, Streptococcus viridans, Staphylococcus aureus. Associations of microorganisms represent this microflora in 84.4 %. During the antibiotic sensitivity examination, the low effectiveness of commonly used antimicrobials was revealed. The choices in treatment of the patients with cicatricial stenosis of trachea are: colistin, polimeksin, imipenem, meropenem, vancomycin, sulperazon. These results indicate that microbiological monitoring is necessary to detect major pathogens and their antibiotic resistance level at cicatricial stenosis of the trachea.

Clinical course of dental caries during pregnancy has some peculiarities. However, significant differences in indicators to characterize oral hygiene and teeth soft plaque cariogenicity between the studied groups have not been revealed. In analyzing the prevalence of caries resistance levels allocation among pregnant women aged up to 30 years the representatives of high, average, and low resistance levels have been noticed. In the group of pregnant women aged above 30 years the patients with average, low, and very low levels of caries resistance have been presented. During the observation period, some caries resistance worsening has been determined in both age groups. Herein there was changing the average level into the low one, as well as the low level into the very low one at the age group above 30 years. In the age group up to 30 years the transition of the high level caries resistance to the average one, but the average level into the low level has been occurred. In this connection, there is the assumption that tissue resistance of teeth enamels likely to be primarily determined by its physicochemical parameters caused by genetics. The role of oral fluid as the medium surrounding teeth is likely to have importance. Advanced studying the oral cavity organs and tissues state in pregnant women allowed to implement a strategy of individualized approach to the early dental caries diagnostics in such category of patients, and to determine their stomatological curing peculiarities.

Kawasaki disease (KD) is a rare disease and its etiology is unknown. The majority of patients with KD are children under the age of 5. The injury of the coronary arteries (CA) in the acute period of the KD is accompanied by the formation of giant aneurysms of the proximal coronary arteries. In 16 % of patients, the course of KD may be complicated by acute myocardial infarction (AMI). Mortality with the first AMI is 22 %, with a repeated one - 66 %, and with the third - 87 %. The average period between the debuting of KD and the operation is 8 years. There is no data about the operation in the early stages of KD and with AMI. There are very few observations of successful operations of the left anterior descending artery (LAD) with using of to left anterior descending (LIMA), in children with KD since the age of two were published. This report presents the clinical case of the successful off-pump coronary artery bypass of LAD with using LIMA in an infant aged 5.5 months with KD. The operation was performed in a less than 1 month from the onset of the disease and 12 days by the AMI. After 7.5 months after the operation, the restoration of blood flow in the LAD and the termination of competitive blood flow through the graft are noted. In 8 years after the operation, the child develops according to age.

The purpose of the research was to study the features of voluntary attention ontogenesis in adolescents with essential hypertension (EH) in age-gender aspects. Materials and methods. We examined 98 adolescents with EH aged 10-18 years (59 males and 39 females). EH was diagnosed with 24-h ambulatory blood pressure (BP) monitoring using monitor Oscar 2 for OXFORD Medilog Prima. Ninety-seven healthy age- and gender-matched individuals were controls. All participants were divided into 3 age groups (10-12 years, 13-15 years and 16-18 years old). All children underwent a neuropsychological examination with the use of standard tests. All the differences were considered significant at p < 0.05. Results. There were no statistically significant differences in voluntary attention parameters in adolescents 10-12 years old in both the main and the control group. However, hypertensive adolescents aged 13-15 years had significantly decreased voluntary attention level in comparison with age-matched individuals in controls. Adolescents in this group spent much more time on testing and admitted a significant number of errors. In the group of older adolescents (16-18 years), the differences between the main and the control group continued to increase. Hypertensive girls have a tendency with better voluntary attention parameters than hypertensive boys. When comparing the tests results between the age groups of hypertensive patients, a tendency to their deterioration as the disease progresses is noted. Conclusion. The results of this study indicate the formation of a rigid pathological functional brain system in the ontogenesis in hypertensive adolescents with the development of brain structures decompensation and voluntary attention impairment.

Results of 25 total endoprosthesis operations in patients with defects of the elbow joint of various ethiology are analysed. The endoprostheses produced by Endoservis (Russia] and Coоnrad/Mоrrey Zimmer (USA] were used. The technique of operation and postoperative rehabilitation is described in the article. The estimation of results of treatment was performed by «the Estimation of surgery of an elbow» (American Shoulder and Elbow Surgeons (ASES] Assessments; Richards R.R. et al. 1994]. Radiographically the results of treatment were estimated by the method of X-ray stability of the implants by O.A. Kudinov, V.l. Nujdin. The majority of patients undergoing arthroplasty of the elbow joint for its defects were of young age (40-45 years], and that has left its mark on the technology of operation and maintenance of the patients in different periods after surgery. The analysis of results of treatmentfor 1 year until 1-15 years after the operation was carried out. Good and excellent results, were received in 68 %, satisfactory - in 30 %. The unsatisfactory result of endoprosthesis surgery took place in 8 % of operated (2 patients]. It has been established that the endoprosthesis replacement for elbow joint defects in high-tech surgery is definitely an alternative to traditional methods of treatment, and in most cases should be seen as a method of choice for treatment of this disease.

Aim: safety evaluation of modified stair climbing test in the physical rehabilitation program for patients with old acute myocardial infarction. Materials and methods. Score of physical rehabilitation indices, its effectiveness and safety, comparison of physical rehabilitation indices of patients with AMI without reperfusion treatment and patients who had reperfusion interventions (bare-metal stents - in 21 persons, fibrinolysis - 1 patient, fibrinolysis and percutaneous coronary intervention - 1 patient) were estimated for 43 patients (6 women and 37 men) with old AMI using modified loading tests (stair climbing test and test with six-minute's walk). Results. HR (heart rate) fell short of submaximum values during modified stair climbing test in patient population. The condition was monitored using continuous ECG monitoring apparatus «Kardiotekhnika-04» (СС «Incart», Saint-Petersburg) None of patients showed ischemic changes of ST-segment. No significant differences were revealed in exercise tolerance between patients with old acute myocardial infarction with Q-wave who experienced stenting and patients with acute myocardial infarction without Q-wave. Results of six-minute's step test after the hospital rehabilitation stage completion show exercise tolerance increasing. Conclusion. Modified stair climbing test conducting for intensification of physical rehabilitation using subjective control was safe in examined patient population. According to six-minute's step test results, the exercise tolerance increased during rehabilitation process.

The present article discusses the characteristics and significance of content violation of key pro-inflammatory cytokines IL-8, TNFa, MCP-1 and key anti-inflammatory cytokine IL-10 during pro-inflammatory stage in patients with chronic heart failure (CHF), determined by dilated cardiomyopathy (31 patient) and in CHF patients with coronary heart disease (CHD) (29 patients). EIA method with enzyme immune test systems (ZAO "Vector Best") and analyser ACCESS was used to assess the content of cytokines in the blood. The results of the study showed significant reduction of IL-8, increase of TNFa, MCP-1 and IL-10. Violation of adequate response of cytokines in pro-inflammatory stage enables to consider this disorder as a pathogenic unfavorable factor, leading to CHF progression in patients with dilated cardiomyopathy and CHD. Comparison of the parameters of cardiac hemodynamics, differential white blood cell count and correlation results proves that heart failure in patients with dilated cardiomyopathy and CHD have similar pathogenic origins of chronic inflammatory process. Imbalance of IL-8, TNFa, MCP-1 and IL-10 does not provide protection from inflammatory and bacterial antigens. In case of inadequate and protracted inflammatory reaction, decreased cytokine-producing leukocyte function can destroy myocardium. Results of correlation analysis prove violation of linear connection andformation of atypical correlations between TNFa and TNFa monocytes and neutrophils, IL-8 and monocytes, TNFa and IL-10, IL-10 and lymphocytes, IL-10 and TNFa, IL-8 and IL-10. Increased production of TNFa, MCP-1 in combination with decreased IL-8 and increased IL-10 indicates staging violation accompanied by delay of transition of pro-inflammatory stage into anti-inflammatory one.

Acute disorders of cerebral circulation are one of the main causes of premature mortality, as well as a deep and prolonged disability of the population. The aim of this study was to evaluate the effectiveness of simulator "Ergofartuk", developed in the Neurology Department N 2 of Republican Clinical Hospital named after N.A. Semashko, in the rehabilitation of stroke patients. We performed a comparative analysis of neurological status of 170 patients treated in the Department from 2013 to 2015. All patients received the course of pharmacotherapy basic for the Neurology Department, and went through rehabilitation activities. Patients of one group had the "Ergofartuk" rehabilitation program. In the research, the following scales were used: NIHSS, Rankin, Rivermead and Frenchay. It was found that in all patients at the time of release, average tests results on NIHSS, Rankin, and Rivermead scales were not significantly different. The average score on Frenchay scale in the group of patients used "Ergofartuk" simulator was 21 % higher than that one of patients who took only basic curative and rehabilitative measures. Thus, in patients with acute disorders of cerebral circulation the use of the "Ergofartuk" simulator accelerates the process of recovery of fine motor skills and wrist skills.

The article presents the essence of draft of the Guidance of good manufacturing practices of biomedical cell products (BMCP) (GMP/GTP guideline) harmonized with the international requirements, which contains the basic quality and safety standards of clinical application of these products. These regulations prescribe the requirements for institutions engaged in one or more stages of BMCP production and allow to avoid any risk of contamination of cells, tissues and finished product. The aim of this work is to develop a methodology for BMCPs' quality assurance framework. Materials and methods. The main subjects of research are national and international laws and regulations, publications on quality assurance systems of cell products, problems of BMCP manufacturing and validation. Results. The draft Guidance of good manufacturing practices of BMCP (GMP/GTP guideline), including specific requirements to donor determination, biomaterial sampling and its transportation to the manufacture, to risk management system, traceability system, to processing, definition of minimally manipulated BMCP, requirements to incoming control, continuous in-process control and control of finished BMCP, to pharmacovigilance system were developed. Specific features of the manufacture of test products for non-clinical and clinical studies are described. Assessment elements for certification prior to release of each batch of test BMCP were clarified. Recommendations on the introduction of a product coding system according to ISBT 128 Standard are given in this work.

Currently, there is no normative document at the federal level that determines the format of the organization of internal control of medical care quality in a medical organization. The system of standardization in the sphere of public health of the Russian Federation remains incomplete. In this regard, in the multidisciplinary medical organization, innovative approaches have been developed and implemented in the management of the medical care quality and ensuring the safety of medical activities: the development of a number of local regulatory documents; strengthening the expert institute (setting up a department for quality control and safety of medical activities); increasing the role of the internal expertise of the quality of medical care; standardization of medical care; improving the organization of work of middle and junior medical links; strict adherence to the three-stage internal quality control with the obligatory presence of self-control when monitoring the quality of work of medical, middle and junior medical personnel. The authors show the dynamics of the main indicators of the quality of care at the stages before and after the introduction of new approaches to improve the internal quality control of medical care. The presented data testify to the effectiveness and expediency of the proposed measures.

Authors analyzed the normative legal documents that at different stages determined the general procedure for organizing the provision of high-tech medical care and the sources of its financing. Statistical data on the provision of hightech medical care for the population of the Russian Federation on the profile of "dermatovenerology" are presented. The authors have shown in dynamics that since the release of high-tech medical care as a separate type of medical care (1992), there is the change in the number of medical organizations that provide this type of medical care in the Russian Federation. The authors outlined the main problems of low accessibility and provision of the population of certain subjects of the Russian Federation with this type of medical assistance. The list of nosological forms on the profile of "dermatovenerology" remains extremely insufficient for today, the severity of the course and approaches to treatment of which can be attributed to the number of high-tech medical care. The experience of the work of the federal medical organization in the provision of high-tech medical assistance on the profile of "dermatovenerology" is presented. Proposals have been formulated to improve the quality, availability and improvement of the model for providing high-tech medical care to patients with the most severe dermatoses. The analysis of the literature data, normative legal documents and the experience of the medical organization of federal subordination is presented. The review of step-by-step development and increase of accessibility of high-tech medical aid on the profile of "dermatovenerology" was conducted.

Phenolic compounds of plants have a wide spectrum of pharmacological action. A number of effective herbal medicines and biologically active additives have been developed on the basis of raw materials and natural polyphenols. The sources of phenolic compounds are plants of the genus Bupleurum L. In Russia Bupleurum scorzonerifolium used in folk medicine. Infusions and decoctions were taken for diseases of the liver, gall bladder, topically as an anti-inflammatory agent. The composition of phenolic compounds in the above-ground organs of the B. scorzonerifolium studied by HPLC on the device "GILSTON". Samples of raw materials (above-ground organs) were collected in the southern areas of the Irkutsk region. For the analysis of the herb B. scorzonerifolium 70% extract ethyl alcohol was used. Separation was performed on substances Kromasil C18 column (4,6 x 250 mm, 5 micron). Detection was carried out using a UV detector "GILSTON" UV/VIS model 151, at a wavelength of 254 nm. In comparison with standard samples we identified 8 flavonoids (prevailing - izoquercetin, hyperoside, izoramnetin-3-glucoside), 5 aromatic acids (predominantly acid - cinnamic, gallic, chicory). The study established the content of epicatechin, catechin, epigallocatechingallate, coumarin. For the first time the content of acids - coffee, chlorogenic, gallic, chicory, cinnamon; flavonoids - vitsenin, lyuteolin-7-glucoside, isoramnetin-3-glucoside, apigenin; epicatechin, catechin, epigallocatechingallate; coumarin -was established in B. scorzonerifolium.

A plant of the genus Bupleurum L. is being introduced into medical practice and being used in traditional medicine as an anti-inflammatory agent in diseases of the gastrointestinal tract, treatment of diseases of the liver and gall bladder. In folk medicine, infusionfrom the herb Bupleurum scorzonerifolium Willd. is used externally for inflammatory diseases of the eyes and skin diseases. B. scorzonerifolium is widespread and abundantly grows in the area of Ural Mountains, Altai, Tuva, in the Krasnoyarsk region, Baikal region, and Buryatia. Detection of phenolic compounds in B. scorzonerifolium was performed using qualitative analytical reactions. Studying the composition of flavonoids and phenol carbonic acids was carried out by paper chromatography. We established that the leaves of B. scorzonerifolium contain quercetin, kaempferol, rutin, hyperoside and isorhamnetin, stems - quercetin, kaempferol, rutin and isorhamnetin, flowers - quercetin, hyperoside and rutin. The leaves, flowers and stems found to contain caffeic, chlorogenic and ferulic acids. The quantitative content of tannins was determined by permanganometry method, flavonoids and phenol carbonic acids -by spectrophotometric method. The maximum quantity of phenolic compounds is detected in leaves and flowers. Thus, as a medicinal plant, the grass B. scorzonerifolium can be recommended for harvesting during the flowering period.

The modern model of infusion pharmacotherapy in hospitals involves a process-based approach, the most important "input" of which is the manufacturing of infusion admixtures and the control of infusions preparation. In Russian hospitals, production of drug admixtures is carried out by nursing staff in inappropriate conditions and with equipment unappropriated for this type of activity. In accordance with the normative documentation, manufacturing of infusion admixtures should be reserved for hospital pharmacies. Only in pharmacies it is possible to organize a manufacture complex of infusion admixtures of adequate quality under aseptic conditions. For the extemporaneous manufacturing of infusion admixtures in hospital pharmacies of the Russian Federation we have developed technological complex, which included: development of information database "Interaction of injectable drugs"; development of technological schemes of manufacturing of infusion mixtures; selection of necessary equipment; development of a system of quality control of infusion admixtures. The information database is a search engine that allows to estimate the composition of the recipe on the compatibility of components. The typical scheme of production areas of hospital pharmacy allows you to place required for aseptic manufacturing equipment with minimal costs. Step by step instruction on mixing the components of the recipe eliminates contamination in product. The system of quality control confirms the high quality of infusion admixtures. Overall, this technological complex ensures quality, efficiency and safety provided to patients of the hospital infusion therapy.

Adhesive process in the abdominal cavity was simulated in Wistar rats, which were divided into two groups: the main one - simulation of adhesive process in the abdominal cavity and introduction of 3 ml of saline into the abdominal cavity; the controls - simulation of adhesive process in the abdominal cavity and introduction of 3 ml of new antiadhesive preparation. The mechanism of drug action bases on the ability to inhibit the growth of connective tissue in the adhesion area by effecting the activity of mitogen-activated protein kinases. Examination of peripheral blood indices was performed at eight time points during the period from 2 hours to 28 days. The concentration of red blood cells in the peripheral blood in both main and control groups decreased moderately in the early postoperative period (2 hours, 6 hours and 12 hours), and this rate was significantly lower in the control group as compared to the main one by 12 hours term. Later the index restored to normal. Hemoglobin concentration in the peripheral blood was higher in the main group than in the control one, the differences were significant in 2 hours, 3 days, 28 days. The level of hematocrit in the main group was higher than that in the controls during the entire follow-up period; the difference was maximal to the final term of experiment (28 days). The level of leukocytes in peripheral blood of the main group rats did not exceed the normal value for the given species of animals throughout the follow-up period. The number of eosinophils in the peripheral blood of the rodents of both groups did not differ at every period of survey. Thus, the introduction of the drug reduced the severity of leukocyte response to injury, improvement in postoperative hemoglobin and hematocrit levels.

Adhesive process in the abdominal cavity was simulated in Wistar rats. The animals were divided into two groups: the main one - simulation of adhesive process in the abdominal cavity and introduction of 3 ml of saline into the abdominal cavity; and the controls - simulation of adhesive process in the abdominal cavity and introduction of 3 ml of new antiadhesive preparation. We evaluated biochemical parameters at eight time points during the period from 2 hours to 28 days. The introduced drug for adhesion prevention did not affect the protein-synthetic function of the liver: the blood level of whole protein was the same in both groups and remained within the normal range throughout the follow-up period. The blood level of creatinine, which is the end product of protein metabolism reflecting the renal excretory function, was within normal values in both groups throughout the observation period. Significant differences between the groups were noted only on the 28th day of the experiment: in the main group creatinine level was higher as compared to the control group (p = 0.014), but remained within the normal range. The same pattern was observed when evaluating the blood urea level, which reflects the renal excretory function - the blood urea level remained normal in both groups throughout the experiment. Hence, the new antiadhesive drug does not produce toxic effect on liver and kidneys in a single intraperitoneal introduction in experiment. Biochemical indices are the same as in single intraperitoneal infusion of saline.

Background. Functional disorders of the gastrointestinal tract represent one of the most urgent problems among children in the first year of life. Aim: to determine the peculiarities of microbiocenosis of large intestine in children with varying degrees of dysbiotic conditions of the gastrointestinal tract. Materials and methods. Material for the study included 354 coprological samples isolated from children with functional disorders of the gastrointestinal tract. Depending on the degree of dysbiotic disorders of the colon, the children were divided into comparison groups: group 1 - children with grade 1 dysbiosis (n = 15), group 2 - 45 children with grade 2 dysbiosis, group 3 consisted of 149 children with grade 3, and group 4 consisted of 145 children with grade 3 of dysbiotic disturbances and K. оxytoca vegetation. Identification was performed by standard methods. Results. All four groups were characterized with changes in the qualitative composition of the indigenous biota with predominance of E. coli with atypical properties (haemolytic (up to 26,7 %) and labourmigration activity (to 33,3 %)). Groups with grade 3 dysbiosis were characterized by the presence of aggressive symbiotes in diagnostically significant concentration of S. aureus, Clostridium spp., Candida spp., Enterobacter spp., Proteusspp., P. aeruginosa. Conclusion. The emergence of Klebsiella oxytoca in the colon of children is an evidence of the violation of compensatory-adaptive reactions of the organism, which in turn is characterized by a decrease and a change in the qualitative composition of the indigenous biota by connecting the more aggressive representatives of the bacterial agents.

The present work reviews the evolution of the traditional medicine in Buryatia; the contribution of Oriental medical schools and the Russian experience of herbal treatment were emphasized. This convergence process was developed in virtue of the geopolitical situation of the Republic. The evolution of the tradition and contribution of ethnic medical schools was schematically presented in the article. The aim of the work was to substantiate the originality of the Buryat traditional medicine. The data elucidating the pervasion of Eastern traditions due to the influence of Buddhism and the experience of the Russian settlers are given in the article. Peculiarity of the traditional medicine in this region involves the use of indigenous plants, original formularies and healing technologies. Approach to health and illness, principles of diagnostics and specific methods of treatment remain common to Eastern medical traditions. The article provides insight into the main findings of the study of this tradition. They include such aspects as the translation of written sources, development of new technologies and methods for the treatment and prevention of some diseases, new medicinal preparations and health-improving means recommended for practical use. Besides, there have been discussed the prospects for integration of rational methods and means from the array of the traditional medicine of Buryatia with modern medical and pharmaceutical technologies.

The article is an example of individual approach to medical-social examination (MSE) of the patient with eosinophilic granulomatous with polyangiitis (EGPA) that represents the difficulty in the absence of a strictly regulated order of the criteria in systemic vasculitis. Implications of illness at the patient were presented by bronchial asthma, a bilateral hydrothorax, pericarditis, displays of polyneuropathy, and eosinophilia. Therapy by Prednisolonum of 40 mg in within a year has not allowed to achieve reduction of process activity. The hydrothorax recurred. There were signs of central nervous system impairment; the psychiatrist diagnosed organic emotional and labile disorder of vascular genesis with moderate emotional-volitional and mnestic-intellectual decrease. When conducting MSE there were difficulties at quantitative assessment of disturbances, due to the lack of EGPA in the annex to the existing order. Therefore, the decision to establish the second group of disability has been made by specialists of MSE bureau. As the patient suffers from recurrent hydrothorax, a pulmonitis, persistent obstruction of bronchi of average degree of expression, the anoxemia that is indirectly determined by depression of a saturation of oxygen to 94 %, expressed respiration dysfunction (70 %) has been established, as well as impairment of CNS and the peripheral nervous system. The forecast for convalescence is adverse. The forecast for life - rather favorable, because the heart and kidneys are not affected.

We conducted a 13-year observation of 9 patients with total and partial IgA deficiency. The age of children in primary treatment was 3.0 ± 0.2 years on average. The observation was carried out on the basis of the outpatient service of Irkutsk State Regional Children's Clinical Hospital. The examination included immunological, clinical-allergic and functional methods of research. To assess the humoral link of the immune system, serum Ig concentrations of classes A, M, G (mg/dl) were determined in the first 3 years annually, and then every 2-3 years. As a result, it was found that among the patients with IgA immunodeficiency, boys predominate over girls in a ratio of 3.5:1. With a partial IgA deficiency detected at an early age, the majority of patients have normalization of their IgA level, but sometimes there is a transformation into a selective IgA deficiency with an increase in the number of clinical markers of this condition. With a selective deficiency of IgA detected at an early age, half of the patients have normalization of the IgA level by the age of adolescence, but another half still maintain a significant decrease in serum IgA. Clinical manifestations in the majority of observed children with selective IgA deficiency included atopic respiratory diseases - bronchial asthma and allergic rhinitis, in one case - diabetes mellitus. In some children, the selective deficiency of IgA was asymptomatic.