The article is devoted to the problem of perioperative blood replacement in selective surgery by the way that is based on the principle of normalization of transcapillary exchange with use of different variants of autologous blood components storage. Main method of blood replacements is hypervolemic hemodilution with use of crystalloid and colloid solutions. But in conditions of acute massive blood loss this method allows to provide maintenance of effective hemodynamics for a short period of time only. This method is used without taking effectiveness of transcapillary exchange of a patient into account and. its main feature is 3 times exceeding of infusion medium volume over blood loss volume. These case is accompanied by the transfer of liquid from bloodstream to interstitial space and. hypostasis of the latter, that shows itself in functional disorder of target organs and. in formation of syndrome of polyorganic insufficiency: respiratory syndrome, hepatargia, disorder of transitory function of gastrointestinal tract etc. Thereupon the most preferable and. righteous is the method of blood replacement that is based on the principle of normalization of transcapillary exchange taking volemic coefficients of transfused solutions into account. Advantages and. features of this method include decrease of volume of infusion medium to the level equal to the blood loss volume; absence of hypostasis of interstitial space; exclusion of possibility of development of polyorganic insufficiency syndrome. Techniques of storage of autologous blood components were used to increase effectiveness of this method and. to minimize using of donated blood components. As the result of the research we determined that the most effective is single storage of autologous blood in volume of 10 % of circulation blood volume 3 days before the operation. This blood has anti-ischemic action, stimulate erythropoiesis, resolve functional state of hemostasis system. Another one effective technique of this method is return of drainage secretion that is almost similar to the venous blood of patient by its composition, except for thrombocytes. Return of drainage blood is safe for the patient and isn't accompanied by any reactions or organs injuries. High clinical effectiveness of this method of blood replacement is proved by the possibilities of patient to keep effective stontaneous breathing without artificial pulmonary ventilation even at blood loss volume of 90 % of circulation blood volume.

The article presents the results of intraoperative duplex ultrasonography (DUS) at the endovascular interventions (EV) in patients with occlusive-stenotic injuries of lower limb arteries. 48 segments of planned endovascular interventions (30 superficial femoral arteries and 18 popliteal arteries) were examined with use of common methods on ultrasound portable devise Unison 2-03 with 7,5 MHz linear sensor at all stages of endovascular treatment. The evaluation of hemodynamic indices of blood flow such as peak systolic velocity (PSV), ending diastolic velocity (Ved), medium, velocity of blood flow (Vm), resistivity index (RI), pulsatility index (PI), systole/diastole ratio (S/D) and. degree of stenosis of femoral-popliteal segment arteries before, during and. after X-ray-endovascular interventions was carried out. At intraoperative ultrasound duplex scanning patients had. significant (р < 0,001) decrease if PSV, Ved, Vm. and. the degree of stenosis in comparison with the results of the research before endovascular interventions. Also we registered significant (р < 0,001) decrease of PSV, Ved, Vm. and. the degree of stenosis in patients at ultrasound duplex scanning after endovascular interventions in comparison with the results of the research before operative treatment. There were no significant differences between those indices at ultrasound duplex scanning during and. after endovascular interventions. It was showed that evaluation of condition of lower extremities arteries during ballon angioplasty and. stenting with use of ultrasound duplex scanning allowed, to plan optimum volume and. to improve the results of endovascular operation in each patient individually. At that restoring of geometry and. artery lumina, accuracy of stent positioning, full compliance of stent diameter and. artery in problem zone, absence of stenosis at all or presence of residual stenosis < 25 % and. restoring of main blood flow without local increases of blood flow velocity were the criteria of successful endovascular interventions on femoral-popliteal segment arteries.

Valgus deformation of a toe is the most common orthopedic pathology of a human. This pathology prevails in women, especially of elderly age. According to the data of different authors, the ratio between men and women is from 70—80 % to 20—25 %. Basing on the existing level of technologies of treatment of valgus deformation of a toe increase of effectiveness of treatment due to total correction of the deformation, stronger fixation of osteotomed fragments, especially at the osteoporosis, restoration of full and. painless range of motions in metatarsophalangeal and. interphalangeal joints and. also decrease of a risk of intraoperational fracture of fragments became an objective. We analyzed the results of surgical treatment of valgus deformation of a toe and. varus deformation of toe instep bone in 82 patients of 20—60 years. 92 operations in patients with II—III degree of deformation were carried out. 52 patients with II degree of deformation and. 30 patients with III degree of deformation were operated with use of our method. The article presents the results of treatment of valgus deformation of a toe and. varus deformation of toe instep bone in 82 patients by proposed method. Use of this method allows to eliminate valgus deformation of a toe, to restore congruence in metatarsophalangeal joint with the shift of sesamoid complex, to correct varus deformation. of toe instep bone, to eliminate external rotation of a toe by longitudinal cuneiform osteotomy of proximal fragment on the external surface of a toe instep bone at once. Our surgical method allows to reach strong fixation of the bone fragments after osteotomy especially at the osteoporosis, to restore full and. painful range of motions in metatarsophalangeal and. interphalangeal joints. It becomes possible to have good cosmetic effect and. to improve quality of life of patients.

The research by gas-fluid chromatography of content of monounsaturated oleic acid in peripheral blood (plasma, membranes of erythrocytes) of pregnant women who had. worsening of chronic herpes-virus infection with IgG antibodies titre to herpes simplex virus of the 1^st type 1 : 12800 was realized to study antioxidant activity of this compound. As the result it was determined that worsening of herpes-virus infection with high-intensive course (IgG antibodies titre to herpes simplex virus of the 1^st type 1: 12800) was accompanied, by the decrease of concentration of the acid both in plasma (1^st trimester — 15 % 2^nd trimester — 9 %, 3^rd trimester — 20 % in compariso, with control values) and in the membranes of erythrocytes (1^st trimester — 12 %, 2^nd trimester — 10 %, 3^rd trimester — 17 % in comparison with control values) and. is compensatory mechanism, aimed at the decrease of damaging action of products formed as the result of activation of lipid peroxidation processes. Therefore pregnant women with worsening of herpes-virus infection (IgG antibodies titre to herpes simplex virus of the 1^st type 1: 12800) have disorders in antioxidant activity caused by low level of oleic acid that leads to the changes of inhibition and. aggravation of processes of radical-production that have damaging action on structural components of the membranes of erythrocytes by their destruction. Consequently we can suppose that monounsaturated oleic acid has great contribution in antioxidant activity of blood and. can be endogenous biologic antioxidant and. reactive oxygen species invader in conditions of aggravation of chronic herpes-virus infection at the activation of lipid peroxidation processes and. low concentration of α-tocopherol. That's why the treatment of pregnant women with this pathology will be more successful if antioxidants are included in complex of drug therapy together with drugs normalizing lipid exchange that promote favorable outcome of pregnancy and. delivery

The article is devoted to the study of influence of critical hypotension on the development of postoperative hepatic failure. The results of treatment of 54 patients who had. anatomical and advanced anatomical resections of a liver were analyzed. Also the causes that lead to the postoperative hepatic failure such as volume of intraoperative blood loss, duration of intraoperative hypotension were analyzed. As the result of the analysis of obtained data on the influence of studied parameters (volume of blood loss, duration. of vascular isolation and presence of intraoperative hypotension) on the development of hepatic failure in postoperative period we supposed that the most unfavorable prognostic sign of its appearance is an episode of critical decrease of arterial pressure during the operation. Thus even at massive blood loss hepatic failure doesn't always appear, whereas critical intraoperative hypotension causes its development. Taking into consideration data on the state of central hemodynamics at the performing of anatomic resections of liver we determined main approaches to the infusion-transfusion therapy during excluding of liver from blood circulation for the prophylactics of its reperfusion injuries. It was established that prophylactics and timely correction of critical intraoperative hypotenstion that is the main factor of development of postoperative hepatic failure should be considered as the key moments of intraoperative protection of hepatocytes.

There have been a clinical-roentgenological research of influence of chronicle fluorine intoxication on the change of periodontium structures which in conditions of hyperfluorosis have systemic character and predetermine certain clinical-roentgenological manifestations and development of pathological processes in periodontum. The research has been performed basing on clinical-roentgenological manifestations of fluorosis observed both in population of ecologically adverse regions and. in workers of plants and with the help of comparative analysis of the results received during the study. Analysis of the obtained data of clinical-roentgenological changes of periodontum. at chronic fluorine intoxication showed that in the first (control) group observed manifestations stayed within the limits of age changes in this region. In the second group pathological signs were marked during the second time period. (6—10 years), henceforth clinical picture of affected periodontium structures became aggravated. In workers of chemical production because of more intense accumulation of fluoric compounds in structures of periodontium clinical signs of it affection are displayed in the first and. avalanche-like grow in the second and the third time periods, whereas destructive-dystrophic changes in periodontium have more generalized and. irreversible character. The dynamics of revealed clinical-roentgenological manifestations happening in structures of periodontium shows that with the increase of time of residence on the territory and length of service on the manufacture, destructive-dystrophic processes in those structures become more extended.

The authors conducted retrospective analysis and study of materials of their own clinical researches of stomatological morbidity both of population of the ecologically adverse region and. workers of manufactures connected with fluorine outburst into environment. Analysis of stomatological morbidity was performed in two variations: 1) retrospective analysis of out-patient charts over 2000—2008; 2) analysis of own clinical observations over 2007—2010. 1245 out-patient charts of two groups (the first one — residents of Irkutsk, the second. — residents of Angarsk) were retrospectively analyzed. Depending on nosological form and. degree of manifestation of stomatological pathology all obtained material was divided in three main parts: teeth affection (I), pathology of tunica mucosa of mouth. (II) and. lesions of periodontium. (III). In population of the ecologically affected region (the second and. third groups) lesions of parodontium, were found to increase in numbers depending on duration of residence or length of work. At the same time in this category of patients we marked the increase of more generalized forms (generalized periodontitis, periodontosis) of affections. In the third group on the background of lessening of periodontitis and nidal periodontosis diagnostics there is growth of destructive-dystrophic changes in periodontium, the intensity of which is directly proportional to increasing of time of exposition of pathogenic factor. And, as a consequence, the number of more generalized forms of stomatological pathologies increases, which correspondingly demands working out and. introducing into practice up-to-date systems of treatment-diagnostic and. preventive measurements for this category of population.

The article presents literary data on the clinical course, diagnostics and treatment of Rasmussen's encephalitis in children. Epileptic attacks at Rasmussen's encephalitis are resistant to the anti-convulsion therapy and. progressing cerebral atrophy collateral to the motor disorders are revealed at magnetic resonance imaging. Used methods of conservative treatment are various and. include anti-epilepsy and antiviral medicines, ketogenic diet, plasmapheresis, immunosuppression and. transcranial magnetic stimulation. Surgical treatment is presented. by functional hemispherectomy. The article presents clinical case of 14 years old. girl with Rasmussen's encephalitis. In the beginning of the disease antiviral medicines and. steroid therapy (acyclovir, dexamethasone) were used. Later various methods of physical rehabilitation and. operative methods for removal of spasticity were used. At preoperative stage polytherapy including carbamazepine, lamotrigine and topiramate were used. Course of postoperative period was complicated by the development of refractory focal epileptic status and. series of attacks. After functional hemispherectomy polytherapy with use of leviracetam, topiramate and. valproate was selected. At the backgrould of complex therapy the positive effect in the form of decrease of frequency of attacks more than 75 % was noted.

CIinicodiagnostic researches included. 73 patients with dysplastic coxarthrosis who were examined and treated in orthopedic ward of Scientific Center of Reconstructive and. Restorative Surgery SB RAMS during 2001-2010 years. The aim. of the research is to specify clinic-radiologic criteria of hip joint with dysplastic changes at the arthrosis of III-IV degree. The diagnosis was set on the basis of clinicodiagnostic criteria. The main signs that characterize dysplastic joint were: anteversion of femoral neck; deflection of acetabulum anterior from sagittal plane; disorder of center of the head in horizontal plane; change of cervical-diaphyseal angle and. the angulation of acetabulum (more than 60°). Acetabulum becomes shallow and. head's embedding into it is Iess than 1/3 (1/2 as a norm). Main clinical manifestations of all examined patients were bending-adduction and rotation contractures of hip joints, shortening of extremities concerned with pathoIogic process, stabIe pain syndrome, gross Iimping with disorder of support function of extremity and Iocomotor act of waIking. In aII 73 patients we reveaIed. different disorders of anatomic interreIations of components of hip joint that are typicaI for grave forms of dyspIastic coxarthrosis. Ensuring of stabiIity of an impIant is extremeIy important at totaI hip joint repIacement. Prediction of measures of postoperative compIications prevention that allow to determine right tactics of operative treatment is the first to reaIize. If the indices of dyspIasia (ratio between thickness of acetabuIum's bottom and its depth) at dyspIastic coxarthrosis of III-IV degree is Iess than 0,6, it's possibIe to predict appearance of instabiIity of hip component of an impIant. VaIues of these indices can be used for forming impIant bed at the pIacing of impIant cup without additionaI ways of fixation.

Expressed asymmetry (54,8 ± 14,37 — 58 ± 6,54 %) of blood flow on the injured extremity was revealed at rheography of peripheral blood flow in all patients with shin bones fractures complicated with local form of chronic traumatic osteomyelitis. The most significant decrease of regional blood flow in injured segment of extremity was revealed in patients with long terms of fracture knitting. Terms of knitting of shin bones fractures depend on the degree of decreasing of regional blood flow in injured segment of extremity. Risk factor of slow knitting of fractures complicated with osteomyelitis is decrease of rheorgraphic index on the injured extremity to 0,016 ± 0,001 ohm. Radioisotope and. ultrasound researches allowed to reveal changes of peripheral blood flow on the injured extremity equivalent to the disorders at posttrombophlebitic disease and. chronic venous insufficiency in patients with shin bones fractures complicated by chronic traumatic osteomyelitis. Larger disorders of blood circulation with simultaneous lesion of superficial and. deep venous systems were registered in distal segments of injured shin at chronic traumatic osteomyelitis. Pathological changes of blood circulation aren't registered in intact extremity.

Injury of rotator cuff tendon is a common cause of pain and dysfunction of shoulder joint. The aim. of this study was to evaluate clinical efficiency of surgical treatment of patients with old total rupture of rotator cuff tendon. 63 patients were operated in clinic of Scientific Center of Reconstructive and. Restorative Surgery SB RAMS during 2007—2012. Average age of the patients was 47,6 ±2,1 years. Patients were randomized into two groups of clinical comparison. Patients of the first group had open reinsertion of rotator cuff tendons with transosseous sutures. Patients of the second group had the same procedure with use of an additional metal construction. The observation period differed from 3 months to 5 years (26 ± 5,1 months in average). As the result of the research positive results were in 83,1 % and 82,4 % of cases respectively at the assessment with use of UCLA scale. Reinsertion of full rupture of rotator cuff tendons in spite of risk of trauma of operative treatment is an operation. of choice that gives maximum prospects to the restoration of patients' capability. But analyzed technical defects of known methods caused the creation of a new method of surgical treatment of old injuries of rotator cuff tendon and. the device for its realization.

Urgency of the research was determined by insufficiency of information in modern literature about microbiological structure antibiotic sensitivity of main pathogens of urinary tract infection among capable people in conditions of hospital. The aim. of the research was to increase effectiveness of antibiotic therapy of stationary infections of urinary tract in conditions of north. The results of stationary examination of 1109 capable patients (males and. females) with infections of urinary tract from 1998 to 2009 years were studied. Data of microbiological examination is based on 700 bacteriological urine analyses. Antibiotic sensitivity of uropathogens was determined by disc-diffuse method. Structure of stationary infections of urinary tract in groups of patients of one sex was quite equal, but at the same time there are significant differences between groups of males and. females. Lately infections of urinary tract caused by intrahospital pathogens that are non-sensitive to common antibiotics (Proteus, KIebsieIIa and. Pseudomonas родов) started to be revealed, in patients arriving from other hospitals. It demands using reserve antibiotics. This underscores urgency of monitoring of uropathogens spectrum, and. their antibiotic-sensitivity for each hospital that has respective possibiIities. It was reveaIed. that chronic pyelonephritis with concomitant urolithiasis is the main nosoform in capable peopIe in conditions of north, in the structure of stationary infections of urinary tract. Acute and uncomplicated chronic pyeIonephritis and. aIso acute and. chronic cystitis more than twice prevaiI among femaIes in comparison, with males. The most important pathogens of stationary infections of urinary tract are: S. epidermidis, S. saprophyticus S. aureus for men; E. coIi, S. еpidermidis S. saprophyticus and. S. aureus for women at uncompIicated infections of urinary tract and. E. coli, S. saprophyticus, S. epidermidis for women at compIicated infections of urinary tract. Main uropathogens in researched, contingent had. higher sensitivity in vitro for gentamycin ofIoxacin, and Iower sensitivity — for cefotaxime, ceftriaxone and. ciprofloxacin. The most of resistant cuItures for antibacterial preparations that are the most frequently used for the treatment of infections of urinary tract is among E. coli, the Ieast part — among S. aureus.

62 patients of 10—18 years (14,6 ± 2,1) with essential arterial hypertension duration of disease from 0 to 5 years were examined. Control group included. 62 almost healthy children who are compared to the children of main group by age and sex. Daily monitoring of arterial pressure during 24 hours with use of portable device for AP monitoring Oscar 2 for Medilog Prima system, was included in complex of examination of all the patients. During daily AP monitoring multiple neuropsychological testing was carried out. State of interhemispheric asymmetry in daily cycle was estimated. 3 times — in the morning with the beginning of daily monitoring, in the afternoon (6—7 p.m.) and next morning after night sleep (9—11 a.m.). Estimation of sensomotor asymmetry included manual, visual and. aural asymmetry and. also legs asymmetry. The research of peculiarities of organization of circadian rhythm of interhemispheric asymmetry in children and. teenagers with essential arterial hypertension showed, high lability of interhemispheric interrelations. At this fluctuation of lateral signs during 24 hours at multiple testing of oatients with arterial hypertension differed from the data of control group. Normally there was rotation of functional activity of left and. right hemispheres in "day — night" cycle and. at arterial hypertension this rhythm disappeared and primary prevalence of functional activity of right hemisphere appeared. In our opinion high lability of interhemispheric asymmetry and desynchronization of daily rhythm are the consequences of pathological changes connected with worsening of functional abilities of structures of left (dominant) hemisphere and. further rebuilding of integrative activity of central neural system. From the other hand high lability and weakly expressed interhemispheric asymmetry in combination with changes of circadian rhythms of interhemispheric interrelations in compensatory processes lighten more significant including of structures of left hemisphere in realization of cognitive activity. Consequently this condition of interhemispheric interrelations can be also compensatory mechanism capable to relieve correction of cognitive functions disordered as the result of the disease.

Patient T., 43 years old arrived in clinic with complaints to the pains in lower thir of the right shin, limitation of movements in right ankle joint, inability of using right lower extremity. An. operative treatment was realized in clinic: suture of rupture of Achilles tendon by Cuneo with plastics by the tendon of long plantar muscle. In 4 weeks plaster immobilization was removed, the patient started measured loading of operated extremity with additional cane support. In 6 weeks full load on operated extremity was allowed and the patient returned to work. In 2 months patient received repeated trauma. During the examination local painfulness in the area of operative intervention was revealed. At the palpation it was revealed that integrity of plantar muscle tendon isn't broken. Control MRR of right shin was made: as the result of control examination the injury of plantar muscle tendon wasn't revealed. Immobilization of operated extremity in neutral position of a foot by functional brace was recommended to the patient. Measured, loading with additional additional cane support was approved. In 2 weeks the immobilization was removed, function of operated extremity is fully restored. Conclusion: if proposed method allows to start earlier loadings and. to decrease possibility of repeated rupture of reconstructed plantar muscle tendon in the most active period of rehabilitation.

In order to study the specific features of central nervous system reaction to restoration of the cranial vault bone defects by distraction, osteosynthesis method, the electroneuromyographic examination was performed in 28 patients of 16—62 years (average age — 40,1 ± 2,6 years) with pyramidal syndrome in late recovery or residual period, of the disease (severe brain injury cerebral stroke). The main trends in electroneuromyographic indice — "cerebrospinal index" — in patients during the replacement process of post-traumatic or simulated cranial vault bone defects using transosseous distraction osteosynthesis were analyzed. The specific features of the central nervous system responses to surgical treatment, age, etiology, the brain structures initial lesion severity and disease duration were studied. As the results of the research it was established that replacement of defects of calvarium bones by transosseous distraction osteosynthesis in patients with consequences of craniocerebral trauma or stroke had. more intensive positive influence on motor zones of cerebral cortex, that shows itself in increase of effectiveness of motor control, in middle age people, at traumatic etiology of disease, at moderate pyramidal insufficiency and. at remoteness of the disease up to 1 year. Obtained data is expedient to take into account at primary selection of patients for operative treatment.

The method, of determination of the thiodiglycolic acid. (TDGA) in urine using gas-liquid chromatography on the capillary column HP-5 with the flame ionization detection was developed and. certified. Optimal conditions for chromatography were chosen: the conditions for preparing the samples with use of chemical derivatization by methanol followed by the liquid. — liquid microextraction were optimized; the metrological studies were performed. We used gas chromatograph AGILENT 7890A with flame-ionization detector (FID) equipped with autosampler AGILENT 7693 which allows to regulate the depth of chromatographis springe needle immersion into the vial. The control of the chromatograph and. the autosampler functions as well as the collection, and. processing of the chromatograms are realized by the software programme GC ChemStation. Following reagents and. materials were used to prepare the samples and. model solutions: thiodiglycolic acid. (TDGA) (98 % Aldrich), dimethyl ether of TDGA, ethyl acetate (extra pure), methanol (e.p.), sulfuric acid (chemically pure), natrium sulfate (chemically pure), distilled water, urine samples free of TDGA. Preparation of the sample includes derivatization with methanol in the presence of sulfuric acid, as well as the liquid-liquid, microextraction of the TDGA dimethyl ether with ethyl acetate and. centrifuging. The identification, of TDGA dimethyl ether on the chromatogram, was realized with use of absolute time of retaining that was controlled by the comparison, and. imposing of received chromatograms with two chromatograms of model TDGA mixtures in the urine of different concentrations as well as with the chromatogram of model mixture of TDGA dimethyl ether in ethyl acetate. The calibration curve was received with use of five model TDGA solutions in water. The range of the concentrations determined, in the urine was 0,4-90 μg/cm³ the interalaboratory precision S was 0,065 and. the accuracy (P = 0.95) was 15 %. The thiodiglycolic acid contents was studied in the employees of the main departments of the polyvinyl chloride production. It was found that content of this metabolite may depend on the duration and the dose of exposure. The highest concentrations of TDGA in the urine are typical for the departments of production of vinyl chloride from 1,2-dichloroethane.

The article presents the materials on the characterization of the indices of mortality among 15-19 years old. teenagers and. youth, in Siberia as well as the most important factors that influenced the change of these indices during 1991-2009 (on the example of the Irkutsk region). It was showed that main determinants of increase of the mortality rate of studied, group of people were social-economic shifts in the country among which the changes in the social-cultural environment had. the leading role. The aim. of the research was to study of peculiarities of changes of mortality of 15-19 years old. teenagers and. young people in conditions of Siberia during 1991-2009 years and. to reveal main determinants of these changes (on the example of Irkutsk region). Index of total mortality of boys during the researched period was 60 % higher than average indice in Russia, the one of girls was 37,8 % higher. As the result of the analysis of factors of environment, conditions of life and. indices of public health we determined that unfavorable dynamics of morbidity and. mortality was connected with social-economic transformations in the country and. with life level decrease in particular. In our opinion effect of social-economic transformations on the formation of early mortality of people was mediated by the condition of psychosocial ill-being of the society that included two components - psycosocial stress and. psycological health disorders. In this social-demographic situation it's necessary for educational and. public health institutions to elaborate and. introduce effective system of medicoprophylactic measures in the institutions of general education. This system's main component is developement of motivation, skills and. necessity of healthy life style in schoolchildren, formation of negative attitude to the smoking, alcohol, abused drugs and. prevention of formation of suicidal behaviour.

The article presents the data of study of repeated disability of adult population of Irkutsk region after dorsopa-thies in 2005-2011, the intensive index was calculated for 10000 population. From 2375 (in 2006) to 1606 (in 2011) people were repeatedly considered to be disabled in consequence of dorsopathy. The level of repeate disability was the highest in 2006-2007 years (12,1) and during following years it decreased to 8,4 per 10000 population. In Irkutsk region the levels of repeated disability in consequence of dorsopathy were higher than in Russian Federation and. in Siberian Federal district. The prevalence of disabled people able to work over the people of pension age was registered in the structure of repeated disability. However the level of repeated disability due to dorsopathy of capable people 1,6 times decreased and. the one of people of pension age 4,3 times increased. Due to this in 2005-2011 we registered decrease of difference between the levels of repeated disability in capable and. pension ages. In 2005 the level of repeated disability of capable people was 9,8 times higher than the one of people of pension age and. in 2011 it was only 1,4 times higher. Decrease of level of repeated disability due to dorsopathies from 2008 at the expense of disabled people of capable age and. also low number of disabled people of pension age due to dorsopathies before 2006 were cоnnected with statutory acts of that period of time. In dynamics we regisered improvement of structure of repeated disability after dorsopathies by the severity index that is probably connected with decreased oportunities of rehabilitation of these type of disabled people. Significan increase of number of disabled people of the III group - more than 80 % in latest 4 years (2008-2011). Number and. specific weight of disabled people of the II group wasn't high and. 2,6 times decreased. Quota and. number of disabled people of the I group were constantly insignificant during all the analyzed period.

Mercury has gonadotropic and mutagenic effects on the Mammalia organism. This fact indicates the possibility of appearance of the mercury exposure effects on the offspring whose parents were exposed to this toxicant. The sublimate effects on the development of the first generation offspring from male and female outbred rats exposed to this substance were studied. Sublimate solution. (0,05 mg of mercury for 100 g of animal's body weight) was injected subcutaneously to outbred rats during 6 weeks. After ending of the injections these rats were mated with intact rats for getting the posterity. The examination of albino rats posterity had two stages. The first stage was to study the development of sensor-motional reactions on the first and. the tenth days of life. The second stage included the research of zoosocial behavior of sexually mature rats and. their activity in open field. Also the posterity was weighted for estimation of physical development. Obtained, materials of the researches were elaborated with use of methods of nonparametric statistics (Mann — Whitney U-criteria). At the analysis of the results of the experiment we revealed statistically significant differences in body weight and. motive activity of animals of experimental group in comparison with control group. Decrease of body weight in posterity of experimental male rats was revealed and. there were no differences in maturation of sensor-motional reflexes in their first days of life. Increase of body weight and motional activity was revealed in posterity of female rats with sublimate intoxication in comparison with control values. Changes of body weight and. behavior were registered in sexually mature posterity. Increase of body weight in comparison with control group was registered at the weighing of experimental animals. Depression of motive, position-finding, research and zoosocial activity was revealed in posterity of experimental male rats. Depression of motive, position-finding and. research activity was revealed in male posterity of experimental female rats and. strengthening of position-finding and. research activity was revealed in their female posterity.

Varicose disease is the most common vascular pathology of lower extremities that causes development of chronic venous insufficiency (CVI). Modern Russian pharmaceutical market of medicines external application used in phlebology is mainly presented by expensive imported medicines. That's why development of original Russian high-effective and. available medicines for prevention, and. treatment of chronic venous insufficiency is an actual problem of medical and. pharmaceutical sciences. Pharmacologically active substance 'Asgular®" that has hypolipidemic and anticoagulant activity was developed in A.E. Favorsky Irkutsk Institute of Chemistry SB RAS as the result of chemical modification of polysaccharide of Siberian larch. Original pharmaceutical compositions (preparation. "Asgular®") in solid and. liquid medicinal forms for external application in forms of hydrophilic gel and rectal capsules with hydrophilic gel were developed on the basis of that active substance. Veinprotective effect of "Agsular®" preparation was studied on the models of vascular pathology. It was determined. that antiinflammatory activity and. anti-transudative effect — decrease of vessels' permeability and increase of their walls' tone — were of most importance in the mechanism of veinprotective effect of the preparation "Agsular"®. Anti-inflammatory activity is developed in decrease of intensity of neutrophil infiltration in wound, area and. in anti-exudative effect that is presented by the decrease of stroma and cell hypostases. Thus our researches indicates prospectivity of use of "Agsular'® preparation for prevention and. treatment of chronic venous insufficiency and varicosis in particular.

In experiment reproduced model of multiple skeletal trauma (fracture of bones of right forearm and lift shin) with stabilization of fragments with external fixation devices in 35 Chinchilla rabbits. All manipulations were realized, at general anesthesia. Standard treatment included anesthesia, antibiotic prophyliaxis and. infusion therapy by common method. Decrease of metabolism activity was registered in the first group of laboratory animals at the standard treatment. That's why besided strandard treatment dexamethasone and adrenaline in average recommended doses was prescripted in the second group of rabbits in postoperative period for correction of posttraumatic hypobiosis. Laboratory control in several hours after the injection confirmed stable increase of level of corticosteroids in blood but it wasn't possible to register increase of concentration of adrenaline. Correlation analysis was realize to study the connection between the contentration of endogenous hormones in blood and. metabolism activity in rabbits in conditions of multiple skeletal trauma. At the consideration data as one array we determined high-significant (р < 0,001) direct moderate correlation between the values of rectal temperature and. the concentration of free thyroxine in blood (r_s = 0,414), this connection was strong on the 3^rd day after trauma (r_s = 0,833; р < 0,001). Also indirect moderate correlation between values of rectal temperature and. the concentration of cortisol in blood of laboratory animals was registered (r_s = 0,49; р < 0,001). The results of study of influence of adrenaline and. noradrenaline on the indices of metabolism activity weren't statistically significant. Obtained data allowed to make a conclusion about importance of endocrine activity of thyroid gland in the formation of adaptation strategy.

The most important requirement to Achilles tendon suture is its ability to hold loading both in postoperative and. in rehabilitation period. The research was aimed, at the comparison of strength of classic intertendon suture of Achilles tendon and. primary plastics of Achilles tendon by plantar muscle tendon. 60 unfixed (cadaveric) Achilles tendons and 60 plantar muscle tendons were used in experimental research. Further parameters were registered: age, measurements of Achilles and long plantar muscle tendons (length, width, thickness). The first step was to determine the tensile of intact Achilles tendon; the second was to determine the tensile double Polyester N 6 suture; the third — to determine tensile of plantar muscle tendon; the fourth — to determine tensile of Achilles tendon reconstructed with, use of proposed method. As the result of the experiment further conclusions were drawn. 1. Force that causes rupture of Achilles tendon decreases with age of a person that proves degenerative theory of Achilles tendon injury indirectrly. 2. Force that causes rupture of intact Achilles tendon (Ме) is 161,0, of double Polyester N 6 suture — 5,0, of tendon of plantar muscle folded up in four is 22,5; of Achilles tendon reconstructed with use of proposed method is 32,0. 3. Tensile of primary plastics of Achilles tendon sutured with use of proposed method is 6.4 times more than tensile of classic suture (Polyester N 6).

Acute respiratory distress syndrome (ARDS) was reproduced in nonlinear male rats by intratracheal instillation of 45—55 thousand, lysate rat neutrophils (method patented in RF); the control group was injected with saline solution. The animals were taken from the experiment at 1, 3 and 6 days, the expression of matrix metallopro-teinase-9 (MMP-9) by cells of the lungs was determined, by immunohistochemistry at each days. The expression of MMP-9 was found in neutrophils, macrophages, fibroblasts, endothelium and. type 2 alveolocytes in the both groups. In the control group the expression, of MMP-9 was found equally low in the all cells, except type 2 alveolocytes. It was decreased in type 2 alveolocytes on day 6. A significant increase in the expression of MMP-9 was found in neutrophils, macrophages, fibroblasts endothelium and type 2 alveolocytes in the exudative stage of ARDS. In the proliferative stage the expression of MMP-9 was high in all the cells, decreasing only in type 2 alveolocytes. In the fibrotic stage of expression of MMP-9 returned to the level of the control group in macrophages, type 2 alveolocytes, the endothelium; in neutrophils and fibroblasts it remained high.

The objective of the work was to study the expression of endothelin in experimental myocardial infarction, and. to assess the impact on its altered concentrations of growth factors. The study was performed on a model of myocardial infarction. The experiment was conducted, on 150 female Wistar rats. Five groups of animals were studied: control group, the increased concentration FGF2 and. VEGF, the decreased concentration of FGF or VEGF. Excretion of animal experiments were conducted in the period from 1 to 30 days. The heart of the experimental animal was fixed in a solution of 10% neutral formalin. His-tochemical staining was used. Primary antibodies to endothelin ET-1/2/3 (H-38) rabbit polyclonal IgG (Santa Cruz, Cat. N Sc-98727, Lot # G2209). We determined that in control group there was a stain on endothelin in the area of myocardial infarction from the 1^st to the 7^th day with a peak on day 3. The use of growth factors increased the staining of the border and. infarct zones on the 1^st to the 14^th days with a maximum of day 3. The use of antibodies to growth factors reduced the stain of the in farcted area early after myocardial infarction (days 1 to 3), to the 7^th day of the stain intensity increases sharply, reaching a maximum, and. to the 14^th day again declined. Thus, we established the dynamics of expression of endothelin in the myocardium when the ischemic injury and. heart attack, as well as the significant stimulatory effect of growth factors FGF2 and. VEGF on the expression of endothelin in the area of ischemic damage at experimental myocardial infarction.

The article presents the results of the examination, of albino rats in the test of extrapolation deliverance (TED) after sublimate intoxication, and madopar-125 injection with previous sublimate intoxication. The aim. of the work was comparative study of conduct of albino rats with sublimate intoxication and at the influence of ma-dopar-125 in combination with sublimate intoxication, in TED. We used TED method in the research that allows to study cognitive abilities of an animal in stress situation. The results were processed with, software package Statistica 6.0 with use of non-parametric Mann — Whitney parameter. Sublimate was introduced subcutaneously in form, of physiological solution in dose 2 mg/kg during 3 days. In 3 days after ending of sublimate explosion we introduced, physiological solution to the rats of the first group 60 minutes before testing and. the rats of the second, group had intraperitoneal introduction, of madopar-125 that was suspended in 0,9 % NaCl with 125 mg/ kg tween-80 in dose 0,6 ml/100 g of animal's body weight. Animals of control group had physiological solution in the same regimen. It was revealed that in 4 days after the ending of sublimate introduction to albino rats experimental animals in comparison with intact ones had significant increase of number of aversive reactions. After sublimate explosion almost one third of albino rats didn't dive under cylinder's edge. In experimental rats average and total duration of immobilization increased while average duration of clambering on cylinder's walls decreased. Latent period of first movement increased sharply both after toxic influence and after introduction of madopar-125 to the rats with sublimate intoxication in comparison with control animals. Introduction of madopar-125 to the rats with sublimate intoxication completely disturbed conduct of deliverance: no animals dove under cylinder's edge. Albino rats with madopar-125 introduction had significant increase of clambering on cylinder's walls in comparison with animals exposed by sublimate without madopar-125 introduction. Besides the number, average and total duration of aversive reactions in form of jumps in comparison, with control group and with rats after sublimate explosion without pharmacological influence significantly increased.

At the same time optima organization and. measures of treatment of extra-urogenital forms of chlamydiosis aren't developed yet and. this problem is needed to be solved. The article presents scientific basis of necessity of developement of complex of measures and. main directions that contribute to the organization of medical aid. for the people with infections of upper respiratory tract associated with chlamydiosis. 1827 people were examineds. First group included. l8—60 years old. employees of several enterprises (846 people) and. 3—17 years old. children attending kindergarten and school (483 childern). Second group included patients of ENT-ward of institute's clinics with, inflammatory pathology of upper respiratory tract (498 people) of 3—60 years old. including 246 childern and. 252 adults. Programme of optimization of medical aid. for people with chlamydia infection of upper respiratory tract that included complex of measures with directions divided into 4 main parts (organization and. performing, information. and. analytics, treatment, diagnostics and. prophylactics, study and. methodology). This programme can be the basis of development of system of medical aid for people with respiratory chlamydiosis by public health service agencie of Russian Federation subjects that contributed to the increase of effectiveness of treatment, diagnostic and. preventive measured. Algrorhythms of diagnostics developed by the authors are offered to use as diagnostic standards of chlamydia infection of upper respiratory tract for phycisians of different duties (otolaryngologists, therapeutists, pediatritians, phycisians of common duty, infectionists etc.).

The risk of emergency situations in the sphere of sanitary-epidemiological welfare associated with diseases dangerous for population varies for different municipalities of a region of Russian Federation. Therefore a differentiation of a region for three types of territories (A, B, C) is necessary. Adequate number of sanitary protection measures is determined for each type of territories. The purpose of this study was the development of methodical reception for differentiation of a region of Russian Federation. Point scoping of criteria of external and. internal epidemiological risks for each of municipality is proposed as this method. Criteria of external epidemiological risk allow to take into account the probability of the importation of infectious diseases, requiring measures for sanitary protection of the territory. Criteria of internal epidemiological risk reflect both actual and. potential dangers: morbidity, the registration of particular nosologic forms of diseases in animals and. detection of pathogens in the living and. non-living environment objects. Assessment of internal risk is carried out in the analysis of information about epizootic and. epidemiological situation of infectious diseases, the list of which is proposed, with, consideration of their epidemiological significance and. can be used for any Russian Federation region. According to the results of total assessment of risks for each of municipalities the complex index of epidemiological risk (CIER) is determined. On the basis of CIER the territory type (A, B, C) is determined. Type A, B or C defines for the municipality the volume of measures for sanitary protection of the territory on the basis of a sufficient level for preparedness of forces and means of public health institutions. The method, based, on the assessment of external and. internal epidemiological risks, that allows to differentiate the region of Russian Federation, at municipal level for risk of diseases dangerous for people, is proposed, as the result of this work. A new methodical approach, will contribute to the increase of the preparedness of public health, institutions to emergency situations in the sphere of sanitary-epidemiological welfare associated, with, diseases dangerous for people.

The article reviews in details regulating documents of Ministry of Public Health of Russian Federation, Russian Academy of Medical Sciences, resolutions of the Government of Russian Federation concerning providing high-technology medicine in traumatology and. orthopedics and. prospects of development of organizational problems on the realizing of high-technology medicine. High-technology medicine is the complex of treatment and. diagnostics medical services, that are realized in hospital conditions with use of complex and. (or) unique resource-demanding medical technologies. Hightechnology medicine is provided under the standards of medical aid approved by the orders of Ministry of Public Health of Russian Federation for federal special-purpose medical institutions providing high-technology medicine and is financed by federal budget. Selection of patients and their referral to the Commission of the subject of Russian Federation is realized by Medical commissions of medical organizations where patients are treated and observed after recommendations of doctor in charge on the basis of the excerpt from medical documentation of the patients. In 2013—2014 development of the further problems on the providing of high-technology medicine is planned: optimization of kinds of high-technology medicine, development of innovative technologies, training of the personnel, licensing of medical organization taking into account providing kinds of high-technology medicine, development of information-analytical system of high-technology medicine, united choice of medical organization. for providing high-technology medicine by the doctor and. the patient. In 2015—2020 the transfer of high-technology kinds of medicine in the system of compulsory medical insurance is planned. 55 billions rubles a year are needed for the development of resource-demanding technologies including transplantation, complex kinds of prosthetics, robotized and innovative technologies. Organization, in federal state institutions special bed funds providing permanent innovative development of medical aid. is prognosed.

The article presents the data on epidemiological situation on acute enteric infections on the territories of Bashkortostan Republic different by anthropogenic loads on the environment. Higher degree of implication of children, especially ones of early age, in this process mostly on anthropogenically polluted territories both at definite and at indefinite variants of them. Rotavirus infection was the leader in ethiological aspect among children and. salmonellosis was the leader among adults. Low degree of ethiological decoding of pathogens of acute enteric infections of almost all researched territories. The necessity of widespread practical application in public health service of high-specific molecular methods of laboratory diagnostics of acute enteric infetions for the enhancement of system of epidemiologic control.

Postoperative hypoparathyreosis to present day is actual problem of surgical tyreodology. In spite of significant changes in approaches to the treatment of thyroid gland diseases, improvement of technical supplying of operating rooms, use of magnifying optics the frequency of development of postoperative hypoparathyreosis is still high. Traditional therapy of hypoparathyreosis by calcium and. vitamin D preparations has number of disadvantages and. doesn't always allow to provide good quality of life for patients. The article presents and. discusses modern, conceptions of authors about causes of development, existing ways of prevention and correction of postoperative hypoparathyreosis. Transplantation methods are considered prospective because parathyroid glands functions are directly replaced by parathyroid hormone. Scientists study influence of transplantation of parathyroid glands during many years. Autotransplantation is the most common method of transplantation of parathyroid glands, has low effectiveness and that's why it's offered to improve the results by choosing of transplantation zone. Ways of preparation of transplants, necessity of cryopreservation and microencapsulation of the cells, choice of optimum modes and. technical approaches are discussed during the study of allo- and xenotransplantation. Most of existing methods are experimentally proved but before now there's no united standard technique of replacement of parathyroid glands functions with use of transplantation that explains interest to this problem.

The article discusses methodical peculiarities of using descriptive statistics for variable in different scales taking into account partition law and. presents the analysis of conditions of transfer of revealed sample regularities to the universe. The aim. of the work was to describe methods and. peculiarities of using descriptive intragroup statistics. It was determined that choice of parameters of descriptive statistics was based on two principles: 1) adduction of set of descriptive characteristics of central trend, value of dispersion and form of distribution in studied group; 2) adduction of confidence intervals of parameters of sample distribution in case of normal (or connected with normal) partition law. It was concluded that at the description of primary data it is necessary to adduct histogram of primary data imposed on the graph of chosen partition law; full description of observed data in groups with description of sample method of their obtaining; parameters and. criteria that prove rejection or choice of partition law; values of parameters of universe (in case of normal distribution).

Systematic analysis of literature concerning treatment of patient with chronic posttraumatic instability of shoulder joint in historical aspect was realized. Main tendencies of development of surgical orthopedics including evolution of both palliative and. reconstructive surgical methods for shoulder joint were revealed. On the basis of more than 50 literature sources we managed to estimate progress of scientific researches from the point of view of evidence-based medicine. By the end of 1980s main directions in correction of described nosology which were determined by the level of device-dependent visualization were formed. Necessity of brand new change in mini-invasive surgery of deep and chronic injuries of shoulder joint structures according to the literary data caused, future creation of a new direction based on advanced extended data of pathogenesis of shoulder joint instability.

The review is devoted to the analysis of cognitive disorders in patients with essential arterial hypertension. (EAH). Some brain disorders that cause the formation of cognitive defect at arterial hypertension are described. There are some data about peculiarities of cognitive disorders in children and. adolescents with EAH. In some articles EAH is considered as a risk factor for disorders of memory and. other cognitive functions, especially in middle-aged and. elderly people, and. there is statistically significant negative connection between the levels of systolic and. diastolic blood pressure and. indices of cognitive disorders. The development of leucoariosis is often the basis of these disorders at arterial hypertension, that causes formation of syndrome of disconnection between cerebral cortex and. basal ganglions. It is accompanied by the decrease of attention concentration, increased wasting of psychic processes, memory disorders, emotional and behavioral disorders. The most typical syndrome in this case at subcortical brain lesions in patients with EAH is decrease of memory with progressive mnestic defect. Method of one-photon emission tomography in patients with hypertension encephalopathy showed decrease of perfusion of focal character in the projection of temporal lobes of brain in 87,8 % of examined. patients. Hypoperfusion in left temporal lobe was accompanied by the decrease of aural-vocal memory. Cognitive disorders (voluntary attention, short- and. long-term memory and. also worsening of mathematical and creative possibilities) were already registered at the stages of EAH formation in adolescent age. In this age also functional insufficiency of diencephalic formations in brain, disorders of cortical-subcortical connections, presence of signs of decelerating of functional maturing of interhemispheric interrelations and. frontal lobe of brain were found. Thus on the basis of literary data we can suppose that EAH is independent factor of risk of development of cognitive dysfunction in all age groups.