In recent years, the growth of urogenital infections, often transforming into chronic forms, is one of the most common causes of reproductive damage in women. The aim of the research was to study the structure of immune dysfunctions in patients with chronic urogenital infection. A one-stage observational study of 80 women of reproductive age with chronic urogenital infections was carried out. The control group consisted of 40 healthy women-donors. The main outcome of the study was the severity of the immunocomprometry of the female. The contents of different subpopulations of lymphocytes (CD3+, CD4+ and CD8+ T-lymphocytes, CD20+ B-), phagocytic activity of granulocytes and monocytes were determined, the migration index, the migration inhibition index, and the exponential function were calculated. The complex of immune dysfunctions established in such patients included a decrease in the number of T-cells and, primarily, CD4+ lymphocytes and their low mitogenic reactivity, an increase in the proportion of natural killer cells, a decrease in the number of actively phagocytic neutrophils and monocytes, the last hydrogen peroxide, an increase in the production of IgA and IgG. Typical were combinations of these violations. Conclusions: T-lymphocyte-monocyte immune deficitiency with the activation of the humoral link and the defectiveness of phagocytosis is a distinctive characteristic of chronic urogenital infection.

Sideropenia by the end of pregnancy takes place in all mothers without exception. Moreover, the selective administration of iron preparations, in contrast to the routine, makes it possible to avoid hemochromatosis, frequency of which in the general population makes from 0.5 to 13 %. The aim of the study was to optimize the individual strategy for the prevention of iron deficiency in physiological pregnancy. A prospective pre-experimental study was conducted, the criterion of inclusion in which was the mother's extragenital and obstetrical pathology during the first half of pregnancy, a burdened obstetric and gynecological anamnesis. The study group of 98 women with a physiological pregnancy in the period of 20 to 24 weeks was recruited by simple random selection. Serum ferritin, hemoglobin, and serum iron were used to estimate iron deficiency. In the latent stage of iron deficiency against a background of monthly correction with Fenules® in a dose of 90 mg of elemental iron per day, there was a significant increase in ferritin and iron in the blood rotor. In healthy mothers, during the gestational period of 20-24 weeks, a regularity arises in the replenishment of iron status, especially in the case of repeated pregnancy, which is successfully satisfied during the month of Fenules® intake in doses of 45 mg or 90 mg per day with a serum ferritin level of, respectively, 30 up to 70 μg/l or less than 30 μg/l.

Preeclampsia (PE) is a life-threatening complication of pregnancy associated with a high rate of maternal and perinatal morbidity and/or mortality. This study was aimed at evaluation of total and fetal cell-free DNA (cftDNA and cffDNA) in maternal plasma to assess whether this could represent a reliable predictive marker of early, late PE and whether intrauterine growth restriction (IUGR) as seen in PE is associated with levels of cell-free DNA. Diagnostic criteria for fetal growth retardation are calculated from the results of blood test results obtained in 26-36 weeks of gestation. We performed a PCR assay to compare the cftDNA and cffDNA concentration in maternal plasma among 3 groups of pregnant women. These included 119 women with overt PE (47 - early PE, 72 - late PE), 24 women at risk for the disease who developed PE (8 -early PE, 16 - late PE), and 30 controls. CffDNA quantification is a promising marker for early preeclampsia prediction. Cut-off value of 0,87 ng/ml for cffDNA (87.5 % sensitivity and 66,67 % specificity). Since the increase in cftDNA and cffDNA seems to be related to the presence IUGR in pregnancies which are complicated with early PE. Thus, it suggests that cftDNA and cffDNA could represent a potential biomarker of IUGR among individuals with early PE.

The aim of the study was to investigate the effectiveness of tiotropium bromide in patients with severe persistent asthma under conditions of real clinical practice. The study group included 20 outpatients who, despite the maximum volumes of basic therapy, maintained an uncontrolled course of the disease. In addition to previous therapy, patients were given tiotropium bromide 5 mg per day. The study lasted five months. During this period, clinical symptoms, the presence of exacerbations of asthma, spirometry parameters, the level of disease control according to the questionnaire Asthma Control Questionnaire™ (ACQ-5) and the quality of life of patients were monthly evaluated. It has been found that the inclusion of tiotropium bromide in the treatment regimen causes a significant improvement in asthma control, the ACQ-5 index decreased by 48 %. There was also a significant dynamics of postbronchodilation FEV1 and quality of life indicators. None of the patients had a worsening of the disease during the observation period. However, in order to achieve a therapeutic effect, systematic tiotropium bromide therapy was required for at least three months. The results obtained confirmed the positive effect of tiotropium bromide on the control of asthma and the quality of life.

Changes in the state of health of people of the older generation may not invest in age-sex ratios and reduce sanogenetic mechanism that determines the structure of the disease. With the help of sample population technique, using a representative, stratified sampling and analytical discussion we studied indicators of physical development and the characteristics of the disease in adults 45-59 years old according to the medical records for the years 2015-2016 in the city of Novosibirsk. Content of the study was data from the official statistical registration forms (N 025/u-04, N 025-12, N 131/a) of 300 patients 45-59 years. The analysis showed that the portion of individuals of the older age group with standard indicators such as body build, blood pressure, heart rate and respiratory movements, recognized in the Russian Federation made from 13.7 to 26.3 %. While adults of this age, with asthenic and hypersthenic body type, made respectively 28.3 and 56.3 %. The share of contingent having bradycardia accounted for 26.0 %, tachycardia - 52.3 %. The proportion of persons with low and high blood pressure level was 11.3 and 75.0 %, respectively. Patients with bradypnea were determined in 24.4 %, with tachypnea - 49.3 %. Among adults of 45-59 years, the most common disorders were noninflammatory diseases of female genital organs, diseases of male genital organs and dorsopathies. The contingent prevailed with a mild (55.0%) and severe (40.0%) degrees of severity of the disease, requiring a health check-up. The revealed changes in the health of the older generation will determine the relevance of diagnostic, curative and preventive measures taking into account regional peculiarities.

The Republic of Cuba is a popular destination for Russian tourists and about 30-50 thousands of Russian citizens visit Cuba annually. However, the recreational activity is often associated with the risk of Ixodid ticks bites and infection with tick-borne pathogens. According to published literature, the fauna of the hard tick in Cuba is represented by nine species including Ixodes capromydis, Amblyomma albopictum, A. cajennense, A. dissimile, A. quadricavum, A. torrei, Dermacentor nitens, Rhipicephalus sanguineus and R. (Boophilus) microplus. Five of these species, i.e. A. cajennense, A. dissimile, D. nitens, R. sanguineus and R. (Boophilus) microplus, were reported as human parasites. Ticks are spread over the most part of the island territory. Several tick-borne pathogens should be considered as a potential threat for the bitten humans in Cuba, including Borrelia burgdorferi sensu lato, Rickettsia sp., Anaplasma sp., Ehrlichia sp., Coxiella sp., thogotovirus and Crimean-Congo hemorrhagic fever virus. Implications for the epidemiology of tick-borne infections in the Russian Federation are discussed.

Background. The problem of viral hepatitis C in the modern world is rather acute for public health service. The patients themselves, their striving for recovery, desire to have the quality of live on the same level as a healthy person has and the understanding of the necessity to obey the a doctor's recommendations play the significant role in the successful treatment of this disease. The aim of the given work is the study of the quality of life and the adherence to treatment of young people with chronic viral hepatitis C and the following analysis of the results. Materials and methods. In the process of research, 138 men at the age of 18-45 with chronic viral hepatitis were examined. The verification of the diagnosis occurred on the basis of international classification of chronic hepatitis (Los Angeles, 1994), and also 1CD10 (B17.1), besides, the HCVRNA for more than 6 months was also taken into account. Twenty-five apparently healthy men 18-45 years old were included in this group. The quality of life was clarified with the help of short form of the adapted Russified specialized questionnaire "Medical Outcomes Study, Short Form" (SF36 Health Study Survey). Statistical data processing was carried out with the use of application package "Statistica for Windows", version 7.0. Results. The minimum index in the group of the patients with chronical viral hepatitis C was the index of social activity (SF) - 46.2 ± 0.8 points. In this group, the index of physical pain (BP) was at its maximum. The study of the adherence to treatment depending on the quality of life stays acute. Conclusions. During the course of this work, the peculiarities of the quality of life scales were determined according to the SF-36 Health Study Survey among the patients with chronic viral hepatitis C and the correlations with the adherence to treatment.

The article presents retrospective analysis of complications of surgeries for non-organ-confined retroperitoneal tumors. The study includes information about 236 patients operated between 1996 and 2016 in Irkutsk Regional Cancer Center. All patients were divided into two groups: main group (n = 102] with resection of non-organ-confined retroperitoneal tumors in extended and combined version, and control group (n = 134] with isolated removal of tumor. The patients, who received combined version of operations, are presented in two groups (mono-organ resection group (n = 50] and multi-organ resection group (n = 52]]. Postoperative deaths and complications in these groups were analyzed. Clavien - Dindo classification was used in examining the structure of postoperative complications. 1t was established, that postoperative complications occurred in 44 (19 %] cases. The most frequent ones were intra-abdominal bleeding (3.8 %], wound infection (3 %], femoral nerve neuropathy (2.1 %] and abscess of abdominal cavity or small pelvis (2.1 %]. Among patients with isolated removal of non-organ-confined retroperitoneal tumors, post-operative complications made 14 % (16 cases]. Post-operative complications in the group with extended and combined resection of non-organ-confined retroperitoneal tumors reached 23 % (28 cases]. Accordingly, it was established that enhancing volume of surgery substantially increases frequency of post-operative complications (p = 0.02]. Surgical treatment of non-organ-confined retroperitoneal tumors involve developing post-operative complications of third degree, according to Clavien - Dindo classification. The complications demand invasive manipulation for their management. While examining the structure of extended and combined operations, in comparison with mono-organ resections, multi-visceral resections do not substantially increase the number of post-operative complications (p = 0.903). Most of complications were controlled and their timely management led to full recovery of patients.

In cases of complex differential diagnosis of benign melanocytic neoplasms, dysplastic nevi and skin melanoma, clinical visual inspection and superficial dermatoscopy do not always allow an accurate diagnosis, which is especially important in cases of suspected skin melanoma. In recent years, the method of confocal microscopy has been used for noninvasive skin examination. In the present study, 15 patients with suspected melanoma skin were examined by the method of confocal laser scanning microscopy in cases of complex differential diagnosis (18 melanocytic neoplasms in total). In 8 cases of melanocytic neoplasms, dysplastic nevus was diagnosed. In 10 patients, skin melanoma was diagnosed, which was subsequently confirmed by histological examination of the material obtained after surgical excision. Conducting a comparative analysis of the total incidence of signs of dysplastic nevus showed the unreliability of the confocal microscopy method for differential diagnosis of dysplastic nevus and skin melanoma with orientation only on confocal-microscopic signs of dysplastic nevus. For differential diagnosis of skin melanoma, the presence of the main criteria of malignancy is sufficient: cellular atypia at the site of the dermo-epidermal junction and the disturbance of the papillary architecture of the basal layer. At detection of at least one of these criteria, a diagnosis of skin melanoma was made, which in all cases was confirmed by the results of histological examination. The inclusion of confocal microscopy in the diagnostic algorithm for examining patients with melanocytic skin lesions suspected of melanoma makes it possible to improve the diagnosis of melanoma in the early stages, since the greatest difficulty is the differential diagnosis of dysplastic nevus with early melanoma.

Background. The inconsistency of data about psychological profile of adolescents with essential arterial hypertension (EH), as one of the most important factor in the pathogenesis of this disease, causes the relevance of searching the relationship between psychological traits and features of the circadian blood pressure (BP).organization. The aim of this study was to study the association between personality characteristics and parameters of 24-hour blood pressure monitoring in adolescents with EH. Materials and methods. We carried out an investigation of 14-17 year old (15.92 ± 1.12) Caucasian male patients with EAH (n = 110) in clinic Scientific Centre for Family Health and Human Reproduction Problems. Psychological testing and ambulatory blood pressure monitoring (ABPM) have been carried. Results. In our study were determined some most significant psychological features which associated with different ABPM parameters and EH stabilization. Increased hypertension, manifested in excessive activity, irritability, anger and intractability, is associated with the stabilization of EH in adolescents. The ability to express emotions verbally or physically (including a constructive way) protects the cardiovascular system from excessive fluctuations of night blood pressure. Psychological profile with the leading pattern of anxiety-aggressive affect suppression (irritation, touchiness, anxiety, introversion) mainly influence to the time of hypertension and average daily level of blood pressure. Conclusion. Adolescents with EH with certain emotional and personal characteristics need to be treated by the differentiated psychotherapeutic interventions. These conditions are necessary for early prevention of complications of cardiovascular circadian organization disorders.

With osteochondrosis of the lumbar spine and L₃, L₄ lesions, local overloads of the spinal-motor segment lead to disruption of the functioning of the biokinematic chain "spine-lower limbs". Gonarthrosis is considered as an independent disease requiring surgical treatment. We have not found on the functional state of the peripheral neuromotor apparatus, with taking into account segmental radicular manifestations in patients with grade 3-4 gonarthrosis. We examined the tibial and peroneal nerves, and H-reflex in 51 patients undergoing treatment at the clinical department of traumatology and orthopedics of ISCST In all examined patients we revealed changes in the function of the peripheral nerves of the lower limbs (increase in the threshold values of the M-response to 24.8 mA (norm - 16 mA), a decrease in the direct muscle response amplitude to an average of 0.6 mV (norm - 2.0 mV), a decrease in the rate impulse up to 37-39 m/s (norm - 40 m/s), all changed were more pronounced on the affected limb. The revealed changes in ENMG indices could be due to both degenerative changes in periarticular tissues and radicular syndrome in lumbar osteochondrosis. Changes in reflex excitability were observed in combination with prolapse of the H-reflex in the majority of patients. The data obtained indicate damage to the roots and spinal motoneurons in L₃-L₄-L₅ and a change in the functional state of the peripheral nerves of the lower limbs, indicating a single pathogenetic mechanism of degenerative processes in the knee and spine.

Spine injuries in children are of great social significance. Currently, the incidence of spinal cord injuries in children has increased; this is due to the use of modern imaging devices (digital X-ray examination, CT, MR1) at the prehospital and hospital stages. For children, compression fractures of the vertebral body, which are associated with serious injuries to the musculoskeletal system, are more characteristic. Compression fractures of vertebral bodies (1-2 %) with improper treatment can lead to aseptic necrosis of the vertebra, kyphoscoliosis and other pathological conditions, which often results in disability. When X-ray diagnosis of fractures of transverse and spinous processes, one should consider additional ossification points, which can be mistaken for fractures. Also, differential diagnosis should take into account congenital wedge vertebrae and other abnormalities of vertebral development, which can be mistaken for fractures. The publication presents the results of a comprehensive examination and treatment of 85 children with spine trauma. The age of the examined was from 3 months to 16 years. In 20 cases, we detected compression fractures of the spine at different levels (cervical - 1, upper-thoracic - 4, medium-thoracic - 10, lower-thoracic - 2, lumbar - 3). In 25 cases, a rotational subluxation of the C₁ vertebra was diagnosed, in 3 - a traumatic rupture of the intervertebral disc, in 29 - a fracture of the coccyx. Complicated injuries of the spine accompanied by lesions of the spinal cord and roots were noted in 7 patients. Given the anatomical and physiological features of spine injuries in children, conservative methods of treatment were predominantly used.

To study Mycobacterium tuberculosis (MTB) genotypes circulating in the Sakha Republic (Yakutia), molecular genetic analysis of multidrug-resistant MTB was performed using real-time PCR-test. The study showed predominance of Beijing genotype with resistance to isoniazid caused by mutations in kat G gene alone (86.2 %), in both kat G and inh A genes (10.3 %), or in inh A alone (3,5 %). In this work, we studied variations in serum isoniazid concentration in patients with multidrug-resistant tuberculosis, using different routes of drug administration: regional lymphotropic, intravenous infusion (IV), intramuscular injection (IM), and oral. Blood samples were obtained 1.5, 6, and 9 hours after administration of the drug. Levels and variations of isoniazid serum concentrations were assessed at intervals, using high-performance liquid chromatography (HPLC). For assessing the efficiency of treatment, patients were divided to four groups according to isoniazid administration routes. The study established that serum isoniazid concentrations observed with regional lymphotropic administration, were initially the lowest (4.2 mg/L), compared to IV infusion, IM, and oral administration routes (8,12.5, and 17.1 mg/L, respectively), but showed slower reduction of concentration. It was also noticed, that after 9 hours, the serum concentration of isoniazid was reliably higher in regional lymphotropicgroup, than in the rest of study groups (2.2 vs. 0.8 mg/L). Higher therapeutic effect of intralymphatic drug administration could be explained by the formation within the regional lymphatic network of a localized area around the site of injection containing enhanced concentration of isoniazid and allowing extended drug release into bloodstream, resulting further in prolonged drug biotransformation.

Epidemiological process of tuberculosis (TB) in the Sakha Republic (Yakutia) has been characterized by growing incidence of M. tuberculosis (MTB) multidrug-resistance (MDR). This study aimed to explore the incidence of primary MDR in patients with pulmonary TBin Yakutia from 2011 to 2016. Rates of primary MDR (including extensively drug resistant (XDR) cases) incidence were analyzed in new patients with sputum- and/or culture-positive pulmonary TB for Yakutia, Yakutsk, rural regions of Yakutia, and 5 major territorial zones of Yakutia, through theyears 2011 to 2016. We observed an increase from 23 % to 25 % in the proportion of pulmonary TB among primary MDR cases in Yakutia, for the study period. In 2016, this proportion was 1.1 times higher than in Russia (23.4 %), but lower than in the Far East Federal District (25.7 %). In Yakutsk, the same proportion has increased by half (from 24.2 to 35.4 %); in rural regions, on the contrary, it decreased by half (from 21.9 to 14.9 %). Primary MDR percentages among new cases of pulmonary TB decreased in South Yakutia and West Yakutia zones (by factors of 6.7 and 1.6, respectively); same proportions in the Arctic and Central Yakutia zones changed insignificantly. In East Yakutia zone, no case of primary MdR was detected in 2016. XDR cases among new pulmonary TB cases were solitary in 2011, detected only in Yakutsk. During the study period, incidence of XDR among new pulmonary TB cases increased from 0.5 % to 1.7 %, and cases with primary XDR were detected in Yakutsk and Arctic zone.

The analysis of the results of surgical treatment of hyperparathyroidism in 63 patients on dialysis replacement renal therapy is presented. A total of 63 primary and 4 secondary (for recurrence) surgical interventions were performed including 12 (17.9 %) - subtotal parathyroidectomy, 8 (11.9 %) - total parathyroidectomy with autotransplantation (type I), 43 (64.2 %) - total parathyroidectomy with removal of the central cellular tissue of the neck, the superior mediastinum and upper horns of the thymus gland with autotransplantation (type II); 3 (4.5 %) - secondary total parathyroidectomy type II and 1 (1.5 %) - secondary parathyroid adenomectomy. With the use of intraoperative monitoring of intact parathyroid hormone, 15 (22.4 %) operations were performed. In the postoperative period from 1 to 134 months, the patients had a decrease in blood levels of calcium, phosphorus and intact parathyroid hormone. Postoperative hypoparathyroidism was detected in 38 cases (56.7 %) of 67 observations: in 5 cases after subtotal parathyroidectomy, 5 - after total parathyroidectomy type I, and 28 - after total parathyroidectomy type II. The permissible level of parathyroid hormone was reached in 13 (19.4 %) cases: 1 - after subtotal parathyroidectomy, 11 - after total parathyroidectomy type II and 1 - after parathyroid adenomectomy. Persistence and relapse of the disease were revealed in 16 observations: 6 - after subtotal parathyroidectomy, 3 - after total parathyroidectomy type I and 7 - after total parathyroidectomy type II. When using intraoperative monitoring of intact parathyroid hormone, there are: 1 observation with the development of the persistence of the disease, 3 - with the permissible level of parathyroid hormone and in 13 cases - with the development of hypoparathyroidism. Based on the results of a comparative analysis of the results of surgical intervention, depending on the type of operation, total type II parathyroidectomy is justified for the prevention of the development of persistence and recurrent HTT (p = 0.01).

The paper presents the technique of the reconstruction of the bulbar and membranous urethra in the occurrence of strictures and sphincter-stenosis. The method uses an autologous graft and has potential advantages over the bulboprostatic anastomosis. Objective. To develop a method of helping patients with existing urethral anastomoses, with a damaged neck of the bladder and a risk of subsequent incontinence, wishing to maintain the erectile function. Materials and methods. 35 patients underwent 36 reconstructions of the urethra from August 2013 to July 2017, 11 - after previous urethral plastics, 14 - after prostate surgery (4 - after radical prostatectomy), 7 - suffered from a urethral distraction defect. The age of the patients was 58.17 ± 12.2 years. The median follow-up period was 525 (341; 813) days. The average length of urethral strictures was 15 (10; 15) mm. The average diameter of the urethra in the stricture zone was 1.4 ± 0.56 mm. Reconstruction with the use of a buccal mucosa graft is performed intraurethrally through corpus spongiosum using magnifying optics. Results. The overall efficacy of the primary reconstruction in 35 patients was 94.2 %; the repeated reconstruction in two patients was successful. All patients underwent the comprehensive monitoring of the results, the average follow-up period was 654 days, the average relapse-free period was 447 days. All patients preserved continence and erectile function Conclusion. The proposed technique showed a high efficiency in reconstruction of the bulbar and membranous urethra.

The effect of preventive administration of the complex phytopreparation "tetraphyton" has been studied in experiments on rats. Tetraphyton developed on the base of Tibetan formula is the dry extract derived from species of plant material: roots of Inula helenium L., roots of Zingiber officinale Roscoe, fruits of Elletaria cardamomum (L.) Maton, offshoots of Caragana spinosa (L.) Wall. ex Hornem., characterized for the content of phenolic compounds, flavonoids, terpenoids. The preventive course introduction of tetraphyton in a dose 100 mg/kg for 7 days before experiment increases the potential for physical performance, increasing overall physical endurance against a background of intense physical exertion by 73 % (p < 0.05), prevents fatigue. It is shown that increase in the physical performance of rats in the experimental group is due to increase in the efficiency of the energy supply system in skeletal muscles and myocardium: a significant increase in the content of ATP (by 13 % and 2.5 times); decrease in lactate and pyruvate content (by 33 and 30 %; p < 0.05); increased glycogen content in the liver by 23 %, blood glucose by 19 %. The increase in catalase, SOD, and gSh levels (5 %, 19 %, 79 %; p < 0.05) indicates an increase in the power of the antioxidant defense of the organism and causes the cytoprotective effect of tetraphyton, confirmed by a decrease in fermentemia (lactate dehydrogenase, kreatinphosphokinase - 49 % and 43 %; p < 0.05). The main molecular-cellular mechanisms of the actoprotective action of the phytoadaptogen is the inhibition of the lipid peroxidation of cell membranes and a significant increase in the capacity of the endogenous antioxidant enzyme system that promotes the preservation of the integrity of skeletal muscles and the myocardium. This is due to the presence of phenolic compounds in the chemical composition that have direct antiradical action and increase the power endogenous antioxidant system.

In our research, we evaluated the effectiveness of the device for the valve compression anastomoses formation in animals. The implant is made of the titanium nickelide alloy (TiNi) in the form of two loops of the TiNi wire. In the area of the bent turns, compression is not carried out, the tissue is not squeezed, and later the valve is formed in the zone of anastomosis. Twenty-six antireflux biliodigestive compression anastomoses on the small bowel have been created during the experiment. They include 13 choledochojejunostomies and 13 cholecystojejunostomies. We studied the terms of the compression devices failure, the mechanical and biological durability of these anastomoses, the primary permeability of anastomoses and carried out the microscopic examination of the compression suture. We proved that all valve compression anastomoses created with TiNi shape-memory implant have been mechanically and biologically tight. The compression devices were eliminated from the zones of anastomoses on the 7th-8th day after the surgery in all cases. The microscopic examination showed the insignificant development of sclerosis in the compression zone and full adaptation of all organ layers. The created valve reduced the reflux of intestinal contents that lessened the probability of development of acute and chronic cholangitis in the postoperative period. The use of the TiNi implant allows to carry out the operation twice quicker. Such anastomosis has high physical durability and low bacteriological permeability. The new way of the formation of valve biliodigestive compression anastomoses allows to create stronger and more reliable anastomoses and prevent the development of typical complications.

Intensive research on the chemistry of borohydrides and the creation of high-energy fuels led to the discovery of a completely new type of organoboron compounds, which were collectively called carboranes. Taking into account the scope of application of organoboron compounds in various branches of human economic activity, we present for publication the quantitative data of a toxicological study of the higher isomer of carboranes of isopropyl meta-carborane at the level of a single injection into the laboratory animals through the mouth and lungs. Background. Supplementing data on toxicity and the hazard of organoboron compounds requires the study of the response of the organism to the action of isopropyl meta-carborane. The purpose of the study: identification of possible features and specificity of the toxic effect of carboranes on the example of isopropyl meta-carborane. Methods. The object of the study is nonlinear laboratory animals: rats, mice and rabbits contained in standard vivarium conditions, with observance of the rules of humane treatment of animals. Traditional methods of research (physiological, hematological, morphological) have been used. Statistical processing of data was carried out using the programs «Microsoft Office Excel 2007» and «Biostat». Differences were considered statistically significant at p < 0.05, using a parametric test. Results. Acute toxicity parameters were obtained, which allowed the substance to be classified as moderately hazardous (3rd hazard class according to GOST12.1.007), which does not have selective irritant, pneumotoxic andfibrogenic effects. Conclusion. Thus, the predominant influence of the substance is established objectively with a single exposure to the blood system as its toxicological feature, and its effect on spermatozoa is a specificity of the action, which stimulates the study of this carborane under conditions of chronic administration to the animals.

The results of a toxicological study of isopropyl meta-carborane with its repeated (chronic) administration to rats, mainly in the form of inhalations, are presented for the first time to fill in the missing information on the toxicology of carboranes that have found wide application in various fields of human economic activity. The aim of the study was to identify the characteristic features of the organism's response to repeated exposure to the substance, as well as the possible specificity inherent in boron compounds. Methods. Along with numerous typical methods of preventive toxicology (physiological, hematological, biochemical, morphological), the methods for evaluation of possible mutagenic (dominant lethal mutations, chromosomal aberrations) of gonadotoxic and embryotoxic effects were used. Statistical processing of data was carried out using the programs "Microsoft Office Excel 2007" and "Biostat". Differences were considered statistically significant at p < 0.05, using a parametric test. Results. The conducted investigations established signs of the toxic effect of the substance, mainly at the level of high concentrations, with a change in behavioral responses and against this background, an increase in the activity of ATPase and a decrease in SDGase activity in the brain homogenate, as well as hematological (anemia, phagocytosis), biochemical (increased catalase activity, ALT activity in liver homogenate and serum levels), physiological (increase in oxygen consumption) and pathological parameters. At the same levels of exposure, an increase in postimplantation death of embryos, a decrease in the motility of spermatozoa, a decrease in the ability of females to survive live embryos were found. Conclusion. On the basis of the data obtained, isopropyl meta-carborane is classified as polytropic, but under conditions of multiple (chronic) inhalation administration to animals with a pronounced gonadotoxic effect that does not appear when exposed to a concentration of 3 mg/m³.

A clinical case of an atypical course of neuroendocrine tumor (NET, insulinoma) of the tail of the pancreas is described. The histologic classification of WHO (2010) according to TNM and ENETS and AJCC is recognized worldwide. Of all pancreatic NET, insulinoma accounts for the highest number of cases, 1-2 people per million population per year. In the treatment of NET surgical methods dominate. We present the clinical observation of a 63-year-old patient with atypical clinic who was repeatedly examined in the city hospitals. At the final stage, in the Chita State Medical Academy of Chita, the tumor of the pancreatic tail (insulinoma?) was diagnosed. The patient was operated. The tumor conglomerate including pancreatic tail, spleen and fragment of the left dome of the diaphragm with regional lymph nodes and fiber was intraoperatively detected and removed. The revision operation did not reveal any distant metastases. The macro preparation was a dense tumor of gray-white color, emanating from the tail of the pancreas with sprouting into the spleen and the left dome of the diaphragm. The postoperative period was severe, it was difficult to adjust carbohydrate metabolism. Histological conclusion: the tumor consists of adenoid-like trabecular, lobular, solid structures from relatively monomorphic mean sized cells with rounded nuclei and well expressed eosinophilic cytoplasm. Disseminated vascular invasion was noted. A belated diagnosis caused by an atypical variant of NET led to the involvement of the spleen and the left dome of the diaphragm, accompanied by metastases to the regional lymph nodes. Timely diagnosis of NET and subsequent treatment remains a difficult and complex task; it is necessary to consolidate the efforts of endocrinologists, oncologists, surgeons, radiologists and pathomorphologists.

Women of childbearing age without cardiovascular risk factors have low risk of acute myocardial infarction. Pregnancy has been shown to increase the risk of myocardial infarction compared to the risk in non-pregnant women of similar age. Acute myocardial infarction during pregnancy or postpartum period as a rule develops due to coronary spasm or non-atherogenic thrombosis or spontaneous coronary dissection. Thrombosis is most likely related to hypercoagulable state of pregnancy and postpartum period. It is worth considering the importance of defects of coagulation, such as Leiden factor, protein C, protein S, antithrombin III and mutations of propter genes. There is also the significant role of antiphospholipid antibodies in young women. We present the clinical case of acute ST-elevation myocardial infarction in 34-years old woman without traditional cardiovascular risk factors, which was developed after childbirth due to non-atherogenic left anterior coronary artery thrombosis. Her coagulation profile showed normal results for antithrombin III, protein S, prothrombin gene mutation, factor V Leiden and antiphospholipid antibody syndrome. At the same time the protein C activity decreased to 43 % as well as trombophilia genetic markers MTHFRC677T, MTRR 66A>G, ITGA2:807 C>T and ITGB:1565 T>C genetic polymorphisms were revealed.

The paper presents a case report of diagnosis and treatment of external supravesicalis hernia after operation on the inguinal hernia in the volume of laparoscopic transabdominal preperitoneal plastic. A man, 49 years old, re-enrolled by recommendation from the polyclinic with a diagnosis "recurrence of the inguinal hernia on the right". Ten months before the patient had undergone laparoscopic transabdominal preperitoneal plastic surgery on the right inguinal hernia. Due to the high BMI (34.5 kg/m²) and objective doubts about the relapse, computed tomography of the abdominal cavity with intravenous contrasting was performed, which revealed a hernial protrusion in the suprapubic region. There was no intraoperative defect detected in the area of previously performed hernioplasty, but the test confirmed peritoneal protrusion medially to the lateral umbilical fold. After mobilization of the peritoneum of this region, a hernial defect was found about 2.5 cm in diameter, formed by the medially pyramidal muscle, from below the pubic bone and laterally by the rectus abdominal muscle. The contents of the hernia was urine fat. A mesh (5 x 7 cm) denture was installed with stapler fixation. The patient was discharged on the third day after the surgery. The follow-up period was about 12 months. Data for recurrence of hernia or dysuric phenomena were not found.

In this article, we present the main points on which modern medicine relies in the diagnosis of diseases and health. The treatment of the concept of health, the essence of which is its multicomponent, is considered. Sensitive age periods of ontogenesis, the main components of physical health and their dynamism in its formation are listed, the role of morphofunctional features and energy potential of the organism, the regulation of the activity of physiological systems, as well as their interaction with environmental factors with respect to the change in the level of somatic health are highlighted. Since "health" is perceived as an integral category, its study should be systemic, considering both the morphofunctional features of the individual and all kinds of adaptive activity of physiological systems. The need for a quantitative assessment of the person's physical health at different stages of ontogenesis is explained, since only their comprehensive study with qualitative indicators contributes to the most complete understanding of the essence of the processes that are taking place. In this context, as an example, the results of the author's research in the field of diagnosing the somatic health of children are presented using her own developed algorithm, when each level of physical health is a completely independent model, differing at least one by its component and having an appropriate value.

One of the most effective methods in the system of medical rehabilitation is the use of physical exercises to restore patients after diseases and injuries. Muscle loads are an integral part of physical therapy, various health programs, and, finally, sports. All these types of motor activity, depending on the goal pursued, are based on certain principles of choice, purpose and dosage of physical exercises, taking into account their physiological substantiation of the effect on the body under various nosological forms So, any violation in a different link of the neuroreflex pathway of the motor stimulus leads to a change in the process of realization of the body's response to physical exercises. In this connection, it is important and necessary to have a clear understanding of the mechanism of the action of muscle activity, the variability of the formation of locomotion and their effects, the classification of exercises, the approaches used in the construction and conduct of both individual procedures and the course of physical rehabilitation, a qualitative realization of the tactics of managing patients with private methods of their recovery. Besides, it is always necessary to take into account currently allocated physical exercises, so-called potentially dangerous for the body and, therefore, requiring careful correlation with the nosological form of the disease in which they are used.