Tubal-peritoneal infertility ranks first among the reasons for carrying out IVF in the Irkutsk region. The effectiveness of assisted reproductive technologies programs in particular, programs of in vitro fertilization depends on many factors. In addition to the quality of embryos - factor that is almost impossible to influence, the effectiveness of IVF depends on the presence of persistent foci of infection in women with infertility. A retrospective analysis of 83 patients with an established diagnosis of primary infertility, tubal-peritoneal factor, the average age of 35.8 ± 1.5years, the duration of infertility averaged 4.5 ± 1.3 years, the level of Anti-Müllerian hormone (AMG) is not lower than 1 ng/ml (sufficient ovarian reserve), after unsuccessful attempts of application of methods of assisted reproductive technologies (one or more inefficient IVF program). Mostly, patients had normal indices of body mass index. We preformed a retrospective analysis of 83 cases histories of patients of "Mother and child" clinic, Irkutsk, with established diagnosis of primary infertility with tubal-peritoneal factor and composed a clinical profile of a patient. All patients were examined for genital tuberculosis, which was diagnosed in 12 women (14.4 %). Genital tuberculosis as a hidden source of infection has no pathognomonic symptoms and difficult to diagnose, so the presence of indirect signs should alert the obstetrician-gynecologist for early diagnosis of this disease. For early and timely detection of genital tuberculosis in women with reproductive disorders, active implementation of an expanded list of risk factors in the outpatient stage is necessary.

Hypothalamic dysfunction is the most common pathology of the puberty and is accompanied by obesity in 39 % of adolescent girls. Obesity is one of the main causes of reproductive function disorders leading to decrease infertility in women. The aim of the study is to assess the gynecological health of reproductive age women with hypothalamic dysfunction in puberty and to determine the mechanisms of the primary infertility formation. We conducted a prospective study of adolescent girls with hypothalamic dysfunction (n = 170) from 2000 to 2013 year. According to the screening criteria, fertility was assessed in 86 women of reproductive age, a comparative characteristic was performed in fertile women (n = 46) and in women with primary infertility (n = 21). PCOS (38.1 %), absence of ayellow body in one of the ovaries (71.4 %), a decrease in serum progesterone by 2 times, an increase in ERa/PGR by 2.3 times and activity of NF-kB by 1.4 times in the endometrium were detected significantly more often in women with primary infertility with hypothalamic dysfunction in puberty in comparison with fertile women. The level of ERa and PGR in the endometrium decreased with increasing activity of NF-kB and BMI. The relationship between the activity of NF-kB and BMI in both study groups was established.

Aim: to determine the method of uterine closure in the planned caesarean section, optimizing its involution and reducing local inflammation. Material and methods: a prospective randomized controlled trial. 135 pregnant women undergone planned caesarian section were examined. We applied different methods of uterine closure: in Group 1 (36 women) - one-row continuous blanket Reverdin's suture; in Group 2 (39 women) - one-row continuous Schmieden's suture; in Group 3 (28 women) - two-row continuous Schmieden's suture; and in Group 4 (32 women) - separate two-row sutures (2^nd row - inverted U-shaped). Results. The most aggressive in the severity and duration of the local inflammatory reaction is Schmieden's technique. A two-row suture has the most pronounced delaying effect on the uterine involution. We found a one-row continuous blanket Reverdin's suture to be the optimal method of uterine closure. Conclusion: In comparison with Schmieden's sutures (one- or two-row) or with a two-row interrupted suture, using a one-row continuous blanket Reverdin's suture in uterine closure after planned caesarian section is characterized with quicker involution of the uterus and suture areas above it, with less expressed and shortened inflammation, and with fewer complications.

Introduction. The incidence of multiple sclerosis (MS) is two times higher in women, and the debut of the disease falls on young reproductive age, which makes the problem urgent. Purpose: to assess the characteristics of the reproductive health of women with MS in different age periods. Material and methods. A prospective study was carried out in parallel groups and a case-control study of women of early and late reproductive age with a reliable diagnosis of MS. Results. During pregnancy, there was a significant decrease in the frequency of exacerbations of MS in comparison with the pre-gravity period; voluntary infertility and childlessness is registered in 21.3 % and 32 % of women, respectively. An increase in the concentration of follicle stimulating hormone (FSH) means an increase in the degree of disability on the Expanded Disability Status Scale (EDSS) and the duration of the disease. The decrease in the concentration of dehydroepiandrosterone sulfate (DHEA-S) corresponds to a higher degree of disability on the EDSS scale and the duration of the disease. Conclusion. Pregnancy has a protective effect on the clinical course of MS. Infertility in most cases is voluntary, but at the same time hypergonadotropic condition and hypoandrogenia are observed in women with MS already in the early reproductive age, which interferes with the steroid synthetic function of the ovaries and can cause impaired fertility.

The aim of this review is analyze the literature data on the role of the circadian system key element - melatonin in the regulation of the sleep-wake cycle in menopausal women. It is shown that the melatonin level defined in a variety of biological fluids (blood, saliva, urine) depends on age, sex, race, and chronotype. It is detected that morning melatonin can be used as a biological marker for determining human chronotype. Most studies indicate that melatonin decreases with age, and that in women this hormone level is lower than in men. For sleep disorders, lower values of melatonin are revealed, although the results of the studies are ambiguous. Also, the studies show the shift of hormone secretion peaks in the early morning hours. The dependence of circadian rhythm of melatonin secretion on the climacteric phase has been revealed. This determines different approaches to the therapy of sleep disorders. It is extremely important to study the role of melatonin as an adaptogen of the female reproductive system because climacteric syndrome is the realization of a violation of the adaptation of the woman's organism in conditions requiring increased activity of the adaptive system of the body and sleep disorders are common in menopausal women.

The article presents the results of the research of lipid peroxidation (LPO) and activity of components of antioxidant protection (AOP) in men of reproductive age with primary and secondary infertility, living on the territory of Buryatia and have abnormalities in spermogramme. Aim: to study the frequency structure of male infertility, the features of the system lipid peroxidation-antioxidant protection in men with normospermic and pathospermia Buryat and Russian nationality. A retrospective analysis was performed in 562 men of Russian and Buryat nationality, residing in the territory of the Republic of Buryatia. Study groups were as follows: 204 - Buryat, 358 - Russian. In this study we used clinical and laboratory methods and the statistical analysis of the obtained data. Study the contents of products of lipid peroxidation (LPO) and activity of components of the antioxidant protection (AOP) was studied in 113 infertile men (71 Buryat, 42 Russian). Group of infertile men were divided into a group with normospermia and pathospermia. High rate of male factor infertility in men of Russian and Buryat populations was found. No difference was found for frequency and structure of reproductive disorders in men depending on ethnicity. The frequency of male factor in infertile marriages and structure of the causes of male infertility and made comparisons based on ethnicity. Was found the presence of oxidative stress in patients with pathospermia. The findings suggest about the unfavorable pro-and antioxidant status of men with pathospermia, both Russian and Buryat populations. The differences indicate a different degree of activity of metabolic processes in infertile men of different ethnic groups.

This article discusses modern ideas about the structure of biological membranes, presents their basic physicochemical properties, and describes composition and structure of phospholipids from the chemical point of view. Plasmatic membrane has unique receptor-signaling functions regulating essential cellular processes, damage to which can lead to cell death. The article introduces such features of membrane lipids and proteins as fluidity or ability to lateral shift, their permeability and phase conditions; describes the effects of cholesterol on phase transitions, fluidity, elasticity, permeability and mechanical strength of the bilayer. The paper discusses transmembrane or lateral asymmetry of lipid membranes, how it is supported, and what functions it has. Different configurations of hydrocarbon chains of fatty acids and their value are considered. Because the development of various pathological processes and conditions accompanied by molecular biological changes of cell membranes, it primarily concerns erythrocyte membrane, as they are composed of many easily-oxidized phospholipids and they come in contact with relatively high concentrations of oxygen, it is important to examine the role of erythrocyte lipid layer. The impact of various damaging factors on the tissues of cells and organs triggers the universal response as consequence of such molecular mechanisms as intensification of lipid peroxidation, activation of endogenous phospholipases and proteases, reduced activity of antioxidant defense system of the cell.

We studied clinical characteristics of pneumonia associated with therapeutic failure. The research was based on the materials of the therapeutic department of the Angapov Republican Clinical Emergency Hospital of Ulan-Ude for the period of 2013-2015. 7449 patients were treated in the department for three years, 462 of them died (6.3 %). 154 cases of deaths from pneumonia were registered during that period. Patients who died of pneumonia were primary men - 53.2 %, older than 40 years - 85.8 %, had bilateral lung damage - 58.4 % and severe comorbidities. Only 27.2 % of them had a primary diagnosis of pneumonia. In other cases, pneumonia was a concomitant disease and occurred in patients with chronic alcohol intoxication in more than half of these cases. A direct correlation has been established between the number of deaths and the age of patients in the group of people with a primary diagnosis of pneumonia; bilateral lung damage was observed in 54.1 % of patients in this group. In another group, where pneumonia was a complication of the underlying disease, the highest mortality was observed in the age group 40-59 years (43.8 % of cases) - among working-age people. 17.6 % of patients who died were younger than 40 years; they were injection drug users and had HIV. 59.9 % of patients in this group had a bilateral lung damage. At the moment of admission patients had a primary diagnosis of toxic action of ethanol - in 42.0 %, chronic obstructive pulmonary disease - in 18 %, liver cirrhosis - in 7 %, acute poisoning - in 10.7 % of cases.

Background. Currently more than 119 obesity-related polymorphisms is known to participate in adult obesity. One of them is LEPR Q223R. Many researches shown association of this polymorphism with adult obesity. However, the role of LEPR Q223R in adolescent overweight and obesity is the matter of dispute. Aim: to determine association of polymorphism Q223R of LEPR gene with some biochemical and hormonal measurements of blood in female adolescents with normal weight and with overweight and obesity. Materials and methods. A total of 103 female adolescents (14-17 years of age) was examined. All girls were divided into 2 groups: 43 girls with normal weight (SDS BM 10.311 ± 0.585), and 65 girls with overweight and obesity (SDS BMI 2.255± 0.739) (р < 0.0001). Height, weight, BM1, SDS BM1 were measured. Laboratory tests included triglycerides, total cholesterol and its fraction, TTH, free thyroxin and leptin. All girls were genotyped on carrier of LEPR Q223R. Statistical analysis was provided by software Statistica 8.0 using nonparametric Mann - Whitney methods and Chi-square test with Yates correction. Results. Significant association of carrying RR-genotype with increase of SDS BM1 (p = 0.006), THS (p = 0.006) and decrease of free thyroxin was shown in control group. Conclusion. Our results showed the association of R-allele with increase of SDS BM1, THS and decrease T4 free in control group.

Obesity is one of the five global health risks; it is a worldwide problem. Mortality of obesity is 2.6 million per year. Recently, obesity is considered as a neurobehavioural disorder with defects appetite control. The central dopamine system regulates eating behavior. The cause of obesity is the diminished dopaminergic neurotransmission, which provokes an increase of food stimulus that leads to an increasing of the body mass index (BM1). 1n this case, the main candidate genes will be genes of dopamine type 2 receptors: dopamine receptor D2 (DRD2), D3 (DRD), D4 (DRD4). The article focuses on the DRD4 gene. The latest literature data about the relationship of various polymorphic variants of the DRD4 gene with eating disorders, overweight and obesity are analyzed. 1t has been clarified, that the 48bp VNTR is the main and most significant polymorphism. One part of the researches shows a positive correlation of the tandem repeat VNTR DRN4 gene with overweight, obesity, eating disorders, including the DRD4-S and DRD4-L alleles. The other part denies the correlation of the tandem repeat VNTR DRN4 gene with these indicators. Perhaps the contradictions are due to differences in research design, as well as ethnic, gender and age differences in cohorts, and due to the fact, that in vitro changes do not always correspond to changes in vivo.

To find out what is the role of some environmental factors in the formation of a heterogeneous viral population, the analysis of the distribution of tick-borne encephalitis virus (TBEV) genotypes in different types of landscapes of Eastern Siberia has been carried out. In our study, it was shown that TBEV area in all investigated landscapes of Eastern Siberia is represented not only by TBEV of genotype 3, absolute dominance of which is noted in the studied regions, regardless the landscapes where the foci are located, but also by strains of other genotypes. The relationship between genotypes 1,3 and "polytypic" strains with a certain type of landscape and the degree of their development by man has not been established. The prevailing number of strains of TBEV genotype 5 is isolated from the material collected in the Transbaikalia, in the landscapes of the mountain taiga. They, as well as the strain of genotype 4, are found in the foci, where joint circulation of several TBEV genotypes is noted. The strains of TBEV genotype 2 were revealed in the landscapes of plains and plateaus taiga and insular steppes and forest steppes of the southern part of the Baikal region. Moreover, the detection of RNA of TBEV genotype 2 in the "polytipic" 763-87 and 765-87 strains isolated in the floodplain and forest-steppe landscapes of the Barguzin hollow does not exclude the possibility of circulation of TBEV genotype 2 in the Transbaikalian foci. The greatest genetic heterogeneity of TBEV is observed in natural foci located along Lake Baikal and in the southeastern part of Transbaikalia.

Since ixodid ticks and their feeders (vertebrates) form the basis of the tick-borne encephalitis virus (TBEV) population, it was interesting to obtain a genetic characteristic of strains isolated from various sources in the territory of Eastern Siberia. In our study, it was found that the circulation of TBEV of genotypes 1, 2, 3, 5 and "polytypic" strains in the territory of Eastern Siberia is maintained both by the main vectors (I. persulcatus ticks) and by their feeders (small and large mammals, birds). The distribution of genotypes in strains groups from ixodid ticks and vertebrates varied. TBEV strains of genotypes 1 and 2 were significantly more often isolated from rodents, and genotype 3 from ixodid ticks (p < 0.05). Isolates of genotype 3 (85.5 %) prevailed in the group of strains isolated from ixodid ticks, of which 29.6 % belonged to "Vasilchenko", and 25.6 % to "Zausaev"subgenotypes. Genotypes 1 and 2 were represented by single isolates (3.3 % and 1.3 %, respectively). Among strains isolated from warm-blooded hosts, the proportion of genotype 1 was 35.3 %, genotype 2 -11.8 %, genotype 3 - 35.3 %. More than half of genotype 3 strains (58.3 %) were related to "Vasilchenko" subgenotype, and the strains of "Zausaev" subgenotype were not detected. The obtained data suggest that ixodid ticks and warm-blooded animals are amplifiers of TBEV of genotypes 3 and 1, respectively. The certain differences in the phenotypic characteristics of strains isolated from ticks and warm-blooded animals have been revealed. It has been found that strains isolated from ticks are more homogeneous in their antigenic characteristics, less heterogeneous in S-feature than strains isolated from warm-blooded sources. The strains isolated from warm-blooded animals demonstrate somewhat greater resistance to warming but reducing the reproduction of the virus at 42 °C, and have greater virulence compared to strains isolated from ticks.

To predict outcomes of tuberculosis we investigated the viability of Mycobacterium tuberculosis (MTB) in relation to drug resistance of strains and clinical manifestations of tuberculosis. During the study on solid Löwenstein - Jensen medium, we determined the speed, growth rate and drug resistance of MBT in 5945 cultures, isolated from the sputum of patients with pulmonary tuberculosis - residents of the Irkutsk region (2193 -from newly diagnosed patients, 3752 - from previously treated patients). The criterion of high viability of MBT was the growth rate of >100 colonies over < 30 days, average viability - < 100 colonies over > 20 days; and low viability corresponded with the growth rate of < 20 colonies over > 30 days. 2171 cultures (36.5 %) had high viability of MBT strains, 3021 (50.8 %) - low, and 753 (12.7 %) cultures had average degree of viability. A high degree of pathogen viability was more often determined in newly diagnosed patients with tuberculosis of intrathoracic lymph nodes (all patients with HIV-infection without antiretroviral therapy), fibrotic-cavernous and infiltrative tuberculosis. Among previously treated patients with tuberculosis the high viability of MBT was often determined in patients with fibrous-cavernous and infiltrative tuberculosis, and caseous pneumonia. Cultures from previously treated patients with tuberculosis of intrathoracic lymph nodes had low degree of viability. The number of drug-sensitive strains was 1992, drug-resistant ones - 3953, including 1430 strains with multidrug resistance. We have found that 37.5 % drug-resistant strains associated with a high degree of viability (multidrug resistance - 38.5 %), it's was more often than the drug-sensitive (35.4 %; p < 0.01).

The microflora of the vagina plays an important role and should be regarded as a kind of ecological system that reacts to any changes in the state of the woman's body. Clinically expressed genital infections are etiologically associated with opportunistic microorganisms. In the pathogenesis of dysbiosis, an important role is played not only by quantitative and qualitative changes in microflora, but also by the "pathogenic potential" of microorganisms. The aim of the work was to reveal genes of pathogenicity in strains of Enterococci of the vaginal biotope of women of the studied groups. The study involved 102 women with reproductive disorders. The main group - women with chronic endometritis (CE), (n = 63), mean age - 31.0 ± 5.3. The diagnosis of chronic endometritis was made on the basis of morphological signs of histological examination of vacuum suction biopsy. The comparison group consisted of 39 women, representative by age; in this group the diagnosis was not confirmed by the results of the histological study of the endometrium. It has been established that enterococcal strains isolated only in women with reproductive disorders and chronic endometritis are a reservoir of genetic determinants of pathogenicity factors (efaA and asa1 (12.5 %) and sprE (37.5 %)).

Tick-borne encephalitis (TBE) is a widely known viral disease that is transmitted through the bites of ixodid ticks. In severe cases, it leads to disability or death of the patient. The causative agent of the TBE is the tick-borne encephalitis virus (TBEV), which belongs to the Flaviviridae family. Despite the great importance of TBE in human pathology, currently the only way to prevent and treat this disease is a donor immunoglobulin, which has a number of significant disadvantages. In this paper, we analyzed modern literature on the detection of antiviral properties of herbal preparations and assessed the possibility of using them to search for new drugs against TBE. In general, the published works can be divided into two areas of research - the study of whole plant extracts and the study of the biological activity of the purified extract components. The most informative results can be obtained under certain conditions; for example, the study of both water extracts of plants and extracts with organic solvents, fractionation of the initial preparations with the detected antiviral activity followed by the concentration of the target substance; identification of an antiviral agent to obtain standardized drugs and preclinical testing in laboratory animals and cell cultures. This approach made it possible to identify three substances - hebulinic acid, panicalagin and baikalein - possessing inhibitory activity against Dengue flavivirus. The article discusses the possibility of using these substances against TBEV and the optimal algorithm for searching for antiviral agents in plant preparations.

In the Republic of Kazakhstan there are three types of areas with different cholera infection risk levels for people. Within cholera epidemiological surveillance the cholera strains are annually isolated from people and the environment. In this research, we studied the cholera strains isolated in Kazakhstan for 2013-2015 and they were selected for this study. All cholera strains were locally isolatedfrom people and the environment except one toxigenic imported strain of V. cholerae 01 lnaba which had genes of ctxAB, tcpA. The study showed that there were V cholerae strains which were atypical by their agglutination abilities and sensitivity to cholera phages. It can complicate the cholera laboratory diagnostics especially the diagnostics of V. cholerae О1 and for timely recognition of cholera it is necessary to carry out the diagnostics combined with molecular and genetic methods. For the study of antibiotic sensitivity or resistance we use eight antibacterial preparations. Cholera strains isolated in Kazakhstan did not have antibiotic resistance to the studied preparations. But the cholera strain brought from Pakistan was resistant to ciprofloxacin. The lack of strong resistance of local strains to the antibacterial drugs studied is encouraging in terms of conducting aetiotropic therapy. However, the possibility of entering of antibiotic-resistant strains into Kazakhstan obliges regularly to monitor strains for their sensitivity to antibacterial drugs.

The review reflects the features of the structure and function of the arteries. The physiological mechanism of the formation of the pulse wave is described, and various levels of arterial pressure in the aorta and peripheral arteries are explained. Disorders of hemodynamics with a change in resilient-elastic properties of arterial vessels are described. Amplification and augmentation - factors modifying the pulse wave are presented. Also the paper describes the main methods of measuring arterial stiffness at the local, regional and system level, the advantage of direct measurement of the parameters related to the stiffness of the arterial wall, and the method of assessing the local and regional rigidity of the arteries. Separately, a method for determining pulse wave velocity in the carotid-femoral region was presented. Data of age impact on the structure and function of the arteries are presented. As it has been shown it is necessary to study parameters characterizing arterial rigidity in obese children, since this disease increases the incidence of cardiovascular complications in both adults and children. The relationship between the stiffness of arterial vessels and obesity children is considered. Various results of studies of arterial stiffness in children with obesity are presented. The lack of a consensus on the use of method of arterial vessels rigidity studying in childhood patients shows the need for further study of vascular remodeling and factors that may affect the structure of arteries in obese children.

The body mass index (BMI) is one of the key and at the same time simple and significant indicators of the state of the human body. Both large and small quantities of BMI is associated with high morbidity. The aim of the study was to analyze microecological disorders of intestinal biocenosis in children of different ages using the value of BMI as the criterion of comparison. We researched scatological material from 158 children and adolescents aged from 5 to 17 years (77 boys and 81 girls). The material was divided into three comparison groups depending on the BMI value: group 1 - body mass deficit (n = 34); group 2 - patients having body mass excess (n = 37); group 3 - with normal body mass (n = 87). It has been shown that more than 80 % of children with different BMI value were recorded to have dysbiotic disturbances of the intestinal microbiota of degrees 1 and 2. However, in the group of children with normal body mass, frequency of detection of intestinal dysbiosis was significantly lower; in the group of children with underweight dysbiotic disorders were found significantly more often than in overweight and obese children (p < 0.05). In children with body mass deficit we observed not only increasing concentration of opportunistic pathogenic bacteria, but also an increased occurrence of representative of Enterobacteriаceaе. family. 58.8 % of cases had two- and three-component associations of opportunistic pathogenic bacteria, which is an indication the expressed violations of the intestine microbiocenosis formation. The data obtained show that,you can use BMI, an important criterion reflecting the severity of the disease, in the assessment of intestinal microflora in combination with other studies.

Purpose: to study intellectual activity and memory of elementary schoolchildren who endured intranatal hypoxia and to define primary defect and secondary disturbances of their brain activity. Materials and methods: the neuropsychological research of memory and intelligence in 32 children aged 7-8 years with the history of intranatal hypoxia is conducted (group A). As an including criterion we considered Apgar scale assessment less than 7 points on the first and the fifth minute of life. The control group (group B) included 32 children with a perinatal lesion of the central nervous system whose Apgar scale assessment on the first and the fifth minute of life made 7 and more points. During our research we used methods of observation, experiment, and conversation. Results. In children who endured intranatal hypoxia the following pathological states dominated against the background of asthenia: retarded development of static functions, postural disorder, a cardiopathy, enuresis, accident and chaotic character of visual active thinking, inactivity of mental processes, mental deficiency, disturbed relations between mental activity programing and control of its execution, defective short term and verbal memory. Conclusion: primary defect in children who endured intranatal hypoxia is connected with organic lesion of diencephalic brain structures, with secondary depression of frontal lobes integrative functions and, as a result, with the inadequate organization of visceral and behavioural functional systems. In the neuropsychological syndrome structure increases the importance of diencephalic disturbances along with depression of orientational and exploratory activity, motivation for task performance and control function of attention and speech over the process aspect of activity. Disturbances of voluntary regulation consist in difficulties of forming and realization of programs, disorders in control over ongoing and ultimate results.

The article deals with the important issue in the field of consultative psychiatry - comorbid depressive disorders in patients with cardiovascular diseases. Depression is highly prevalent in cardiac patients. Patients with coronary artery disease, heart failure, atrial fibrillation and those undergoing implantable cardioverter-defibrillator placement are at increased risk for elevated depressive symptoms and for major depressive disorder. In patients with heart diseases, depression is chronic, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. At present, pharmacologic and psychotherapeutic interventions appear to be safe and effective at reducing depressive symptoms in patients with cardiovascular diseases and may impact cardiac outcomes. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with cardiovascular diseases. In this review, we summarize the evidence linking depression to increased risk of cardiovascular diseases and worse patient outcomes. The paper presents a review of the literature on the physiologic mechanisms implicated in the connection between depression and cardiovascular diseases. Impaired adherence to health behaviors and adverse physiological effects of depression, including inflammation, endothelial dysfunction, platelet hyperactivity, and autonomic nervous system abnormalities, may link depression with adverse cardiac outcomes. Future studies in this direction with involvement of cardiologists and psychiatrists should be held.

The investigation is directed at studying peculiarities of the coping behavior of students with disabilities. The author using the sample of 200 students with and without disabilities studies differences in expressiveness of various strategies of coping behavior with the help of Leontyev Viability Test, Ways of Copying Behavior by S. Folkman & R. Lazarus and E. Heim's coping test. The author concludes that in general the students with health peculiarities rarely take responsibility for the events in their life (z = -2.92; p < 0.01), rarely analyze the situations and their possibilities (z = -1.99; p < 0.05) and more often try to distance from the problems (z = 2.34; p < 0.02). According to our data obtained such students have problems with coping-strategies in the cognitive sphere (z = 2.15; p < 0.05). In addition, the subjects with health issues demonstrate problems with coping strategies in the cognitive sphere. We also revealed the coping strategies peculiarities of those disabled since childhood and of those who became handicapped later. The peculiarities of coping behavior of the latter ones are, first of all, the prevailing of the nonadaptive coping strategies mostly escaping (z = -3.4; p < 0.01) and low level of hardiness (z = -5.61; p < 0.01). The data obtained are planned to be used in the sphere of rehabilitation of the handicapped subjects in the higher and secondary professional schools.

Background. According to the existing concept of risk factors, the outcome of hip arthroplasty (HA) is affected not only by the quality of the prosthetic work, but also by the presence of one or more concomitant diseases. Purpose of the study - to perform a frequency analysis of co-morbidities in patients who underwent revidion HA, depending on the timing of its conduct. Materials and methods. On the basis of the endoprosthesis clinic at the Novosibirsk Research Institute of Traumatology and Orthopedics, a continuous sample of data was performed from medical records of patients (n = 667), who underwent revision HA in the period of 2013-2015. Primary HA was performed in various medical institutions in Russia and abroad in the period of 1992-2015. The cases of revision Ha were divided according to the terms of their implementation: postoperative (up to 2 months, n = 11), early remote (more than 2 months but less than 5years after HA, n = 371) and late remote (more than 5 years, n = 285). Variable coding and matrix creation, frequency analysis, average and relative risk (RR) calculation were performed. Results. The RR of postoperative and early revision intervention after HA is calculated depending on the presence of concomitant diseases. As a reference group, cases of late revision HA are taken. Calculation of the RR showed that the presence of concomitant diseases increases the risk of failure of the endoprosthesis in the postoperative period (in diabetes mellitus type 2 - 4.3 times, with excessive body weight and obesity - 2.0, with diseases of the nervous system - 3.9, liver - 2.8, veins of the lower extremities - in 2.9 and with chronic anemia - 3.7 times). The risk of undergoing revision HA in the early remote period is 1.7 times higher in the presence of concomitant malignant neoplasm than in the late remote period (p < 0.1). RR decreases with ischemic heart disease, chronic pyelonephritis, cholelithiasis and other pathology of the musculoskeletal system, i.e., revision interventions are performed in these patients much later. Conclusions. When analyzing the concomitant pathology, significant differences in the incidence of chronic diseases were found depending on the timing of the revision HA. Chronic diseases, which are risk factors for early failure of the endoprosthesis, have been identified. In cases when the risk of complications is high due to comorbidity it is more appropriate to refuse from the operation altogether.

Background. Currently at bacterioscopic diagnosis of tuberculosis there is a large number of errors that is associated with a number of problems that can be solved by automated analysis of microscopic images of sputum. Automated image analysis usually consists of several stages: image segmentation and identification or recognition of objects in the image. The article examines the first of these stages - segmentation. The aim of the study was to investigate the possibility of segmenting a digital image of a microscopic preparation sputum, stained by the method of Ziehl - Nielsen, using wavelet transform Mexican Hat. Materials and methods. As research material we used 830 digital images obtained by microscopy of sputum smears stained by the method of Ziehl - Nielsen. For the automated segmentation of images we used two-dimensional wavelet transform of Mexican Hat Wavelet. Results. During the study we defined the optimal value of the a parameter, which is the only varying parameter of a wavelet Mexican Hat, and carried out the run-time evaluation of the wavelet transform digital microscopic images of sputum stained by the method of Ziehl - Nielsen. Conclusions. The conclusion is made about possibility of using two-dimensional wavelet transform Mexican Hat digital microscopic images of sputum stained by the method of Ziehl - Nielsen, for segmentation of these images.

Choosing a surgical method of treatment of postnecrotic pancreatic cysts is an extremely urgent problem these days. With developing technologies and increasing number of minimally invasive methods of treatment, diagnostic capabilities tend to improve. Whereas traditional methods of surgical treatment do not lose their relevance, recent studies optimize the indications for their implementation, which in turn reduces the frequency of the nearest and distant postoperative complications. The article deals with the questions of conservative therapy of postnecrotic cysts, indications and choice of a method of surgical treatment. It covers the methods of minimally invasive surgery, the application of which allows achieving excellent clinical results of treatment The authors pays particular attention to the recent tendency of using several methods of minimally invasive treatment describing that the combination of minimally invasive internal and external drainage has shown its effectiveness. It should be noted that performing intervention data from the position of pathogenetic treatment helps to achieve a good clinical result. The data on the success of combined drainage of postnecrotic cysts are few, which requires confirmation by a large number of publications. Thus, the high incidence of acute pancreatitis, the lack of diagnostic algorithms and clear indications for a wider range of existing methods of surgical treatment of postnecrotic pancreatic cysts leaves a field for subsequent studies and observations.

Choosing a surgical method of treatment of postnecrotic pancreatic cysts is an extremely urgent problem these days. With developing technologies and increasing number of minimally invasive methods of treatment, diagnostic capabilities tend to improve. Whereas traditional methods of surgical treatment do not lose their relevance, recent studies optimize the indications for their implementation, which in turn reduces the frequency of the nearest and distant postoperative complications. The article deals with the questions of conservative therapy of postnecrotic cysts, indications and choice of a method of surgical treatment. It covers the methods of minimally invasive surgery, the application of which allows achieving excellent clinical results of treatment The authors pays particular attention to the recent tendency of using several methods of minimally invasive treatment describing that the combination of minimally invasive internal and external drainage has shown its effectiveness. It should be noted that performing intervention data from the position of pathogenetic treatment helps to achieve a good clinical result. The data on the success of combined drainage of postnecrotic cysts are few, which requires confirmation by a large number of publications. Thus, the high incidence of acute pancreatitis, the lack of diagnostic algorithms and clear indications for a wider range of existing methods of surgical treatment of postnecrotic pancreatic cysts leaves a field for subsequent studies and observations.

Extracts of Asparagus cochinchinensis (AC) have antitumor, antiinflammatory, and immunostimulatory effects. The neurobiological mechanisms underlying the effects of AC have not been sufficiently explored. Thus, we performed in vivo experiments to characterize potential therapeutic effects including anti-ischemic and antidepressant activities. In addition, the concentrations of TNF-a and 1L-6 cytokines in blood plasma were measured. In the tail suspension test immobility time was significantly reduced after acute and chronic administration of AC in the dose of 100 and 200 mg/kg which suggests antidepressant activity without effect on body core temperature. After subchronic treatment, the immobility time was significantly different (p < 0.0001). Compared with saline-injected controls, immobility time was reduced in animals treated with 100 mg/kg (p = 0.002) and 200 mg/kg (p < 0.001) respectively. Chronic treatment with AC extract did not change body temperature (p = 0.06). In a pilot study, we measured the effect of subchronically-administered AC extract on infarct size after middle cerebral artery occlusion (MCAO). 1nfarct size in the selected slices is lower in the hippocampus (control -125.9 ± 8.7 μm³; AC - 55.9 ± 22.6 μm³) and striatum (control - 53.8 ± 13.7 μm³; AC -19.7 ± 14.5 μm³) in the animals pretreated with AC. Both cytokines were measured in plasma samples collected from control animals and the experimental groups significantly differed in 1L-6 and TNF-a plasma concentrations. Statistical analysis revealed a significant effect of surgery (control and MCAO; p = 0.006). As regards TNF-α and 1L-6 plasma concentration, there were no differences between the groups (surgery MCAO and treatment AC). This is the first evidence that extract from Asparagus cochinchinensis exerted protective effects in the in vivo MCAO model. However, extract did not effect on the increased levels of cytokine including TNF-α and IL-6.

Background. The retrospective assessment of key indicator levels and their trends at the start point of new strategy realization for tuberculosis control in Russia is an important predictor of the global program implementation to reduce the burden of this infection. Materials and methods. We analyzed incidence, prevalence and mortality among general and children population in Russian federal districts, in European and Asian regions, and in countries having a common border with Russia. Results. Presented material confirms the wide spread of tuberculosis in Russia, where the average annual incidence rate for 2005-2015 was 71.9 ± 2.5 0/0000, which attributes Russia to average-burden country. The most important characteristic of the studied period was a stable decreasing tendency of the key TB indicatorsformed by 2015. However, enormously uneven distribution of TB incidence, prevalence and mortality in some federal districts reveals different starting points of the regions. Relatively favorable territories include Central and Crimean Federal Districts, and the most unfavorable are Siberian and Far Eastern Federal Districts. The TB incidence significantly increases from West to East. Revealed unfavorable increasing tendency of children TB in combination with the trend described above indicates active transmission of TB infection in the Asian part of Russia. We also revealed the likelihood of mutual influence of migratory exchanges of Russian border regions and neighboring countries, which most strongly manifests on territories with low and medium TB incidence rates.

Background. Hantavirus infections are one of the most important zoonotic diseases in the Russian Federation. However, the pathogenicity of Hantaviruses circulating in Siberia is still unknown. The aim of the study was to assess the incidence of Hantavirus infection in patients with fever of unknown origin from Irkutsk region and adjacent territories. Materials and methods. Serum samples collected in 2016 from individuals with symptoms of health deterioration were screened by ELISA to investigate possible Hantavirus infection, in addition to tick-borne infections. Depending on date of tick bite specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to tick-borne encephalitis, borreliosis and Hantavirus were tested by ELISA or screened by PCR for tick-borne encephalitis, borreliosis, human granulocytic anaplasmosis and monocytic erlychiosis RNA/DNA. Results. Out of 92 serum samples, 6.5 % were positive for hantavirus-specific antibodies, which is at least twice higher than the seroprevalence among healthy people in the Irkutsk region. IgM and IgM+IgG antibodies were found in 5.4 % of cases, while IgG antibodies - in 1.1 % of cases. The clinical symptoms among sero-positive patients were fever, skin lesion, fatigue syndrome, headache and lymphadenitis. IgM antibodies to borreliosis were found in two hantavirus sero-positive cases. Lung tissues from small mammals captured in 2016 were screened by ELISA for the presence of Hantavirus antigen. Hantaviral antigen was detected in 6.3 % of 48 samples. Conclusions. Thus, present and previous studies demonstrate existence of natural foci of Hantavirus infections in addition to tick-born infections in the territory of the Irkutsk region.

The distribution of Mycobacterium tuberculosis and scope of tuberculosis morbidity in the world are extremely considerable. Among regions with high burden of tuberculosis (according to the World Health Organization data for 2015) Mongolia is one of the most disadvantaged countries. This research was continuation of studying of phylogenetic structure of M. tuberculosis for the determination of evolutionary and migration processes in pathogen's northeastern population and was devoted to the study of the spatial distribution of epidemically significant genotypes and subtypes, circulating in central and border (northern and southern) Mongolia. The DNAs of 309 clinical isolates of the pathogen were genotyped by the 24-locus MIRU-VNTR and LSP methods. Strains of the Beijing lineage were additionally analyzed for the presence of specific SNPs and its 24-MIRU-VNTR profiles were compared with reference database of M. Merker et al. (2015). The study indicated significant predominance of strains of the Beijing lineage (subtype CC4). This genotype is characterized by high frequency of clustering, which indicates its epidemic danger and the relatively recent introduction of «successful» strains into the territory of Mongolia. Also, a relatively homogeneous distribution structure of genotypes and subtypes of the pathogen was revealed within the studied region, which differs from the structure of the Russian population of M. tuberculosis by its subtypical composition. Thus, we assuming that CC4-strains of the Beijing lineage spread into Mongolia from neighboring East Asian regions, most likely from the Northern provinces of China (Inner Mongolia) or nearest neighboring countries of Southeast Asia.

The clinical cases of rare, genetically heterogeneous cardiomyopathy are described - the left ventricular noncompaction (LVNC) cardiomyopathy for four children (three boys and one girl) in age from two months to 6 years. Description of echocardiography signs is presented in accordance with modern diagnostic criteria. Noncompaction of the left ventricle is recognized in three patients, of the left and right ventricle - in one. In three patients out of four, LVNC was a separate disease, and yet in one it was associated with neurofibromatosis type 1, in combination with dilatation of coronary arteries and pericardial effusion. Three of four patients were admitted with congestive heart failure (CHF) of New York Heart Association (NYHA) functional class 3-4 (FC), and one - with CHF 2 FC. The echocardiograms are brought with description of characteristic features of LVNC (hypertrabecularity, spongy myocardium on the apex of the left ventricle, typical correlation of incompact and compact layer from 2.0 to 2.6). All four patients received treatment for CHF (diuretics, beta-blockers, captopril, in one case - digoxin); two out of four got antithrombotic therapy (aspirin, warfarin). Results of follow-up observation of the patients are described with the estimation of echocardiography signs, including dilatation of coronary arteries. Left ventricular ejection fraction - both by Simpson and Teicholz - increased in two patients, with therapy of chronic heart failure at a follow-up visits over > 5 years simultaneously with the decline of severity of CHF. Another two patients have been examined from 2 months to 5 years and have had CHF 3 FC; their left ventricular ejection fraction increased too, but cardiomegaly and right ventricular heart failure preserved.

This article describes a rare case of suppurative lesions of the kidney in the girlyounger than one year. She suffered from acute respiratory disease, and prolonged fever. In the blood and urine there were inflammatory changes. The ultrasound examination of the urinary system was carried out, which showed expansion of the right renal pelvis. According to the results of the survey the child was diagnosed with pyelonephritis and transferred to our clinic. Ultrasound exam performed in the Department of Nephrology revealed multiple focal formations of the right kidney up to 2.0 cm. When using a color Doppler to check for damage, the blood flow in them was not recorded, which indicated the inflammatory changes. The right kidney was enlarged compared to the left one, with increased echogenicity of the parenchyma. The paranephral fiber on the right kidney was thickened, heterogeneous structure contained a single liquid inclusion. Ultrasound specialists made a conclusion about there was an abscess of the right kidney - paranephritis. The child was operated. The revision of the right kidney revealed multiple abscesses; the puncture was performed of large focal masses and pus was removed from the paranephral fiber.