Rational management of labor refers to the most significant areas of practical obstetrics, since errors in predicting the outcome of labor through the birth canal often lead to the development of birth injury to the mother and fetus. Modern research methods and rational management of childbirth have led to a decrease in perinatal mortality. However, despite these achievements, the incidence of birth injury and subsequent disability of newborns is still at a level that is not acceptable for the XXI century.

The purpose of the research was to study the structure and outcome of the generic injury of the fetus.

Materials: Literature of foreign and domestic authors within the period from 2003 to 2018.

Methods: Systematic analysis and synthesis of literary data.

Conclusion: Despite the decline in perinatal mortality, the problem of disability of children, as well as violations of the quality of life due to birth trauma, remains relevant. This requires further study, the introduction of new diagnostic and clinical and prognostic technologies aimed at reducing birth injuries. Prevention of birth injury should be based on timely prenatal diagnosis of fetal macrosomia, determination of the optimal method of delivery, exclusion of iatrogenic factors of aggression during birth through the birth canal.

Background: The prevalence of varicose veins of small pelvic veins in women of reproductive age varies widely – from 5.4 to 80 %, due to the low specificity and low sensitivity of clinical diagnostic techniques, and the absence of biomarkers that can be used to identify the formation and progression of varicose veins of small pelvic veins in women.

Aims: To identify changes in the levels of parameters of the system “lipid peroxidation – antioxidant protection” with the development of varicose veins of the pelvis in women, as well as the possibility of their diagnostic use.

Materials and methods: We examined 200 women with clinical signs of varicose veins of small pelvis. Control group included 30 women without any pathology of venous system. Treatment group included 137 women with varicose veins of small pelvis: with mild degree of severity – 39 women, with moderate degree of severity – 65 women, with severe degree of severity – 33 women. We performed comparative analysis of lipid peroxidation – antioxidant defense system in women with and without varicose veins of small pelvis taking into account the severity degrees of pathological process.

Results: We obtained the most informative indices for lipid peroxidation – antioxidant defense processes in blood of women with varicose veins of small pelvis: concentration of diene conjugate (DC) for the mild degree of severity of pathological process, lipid hydroperoxide (LHP), DC and malonic dialdehyde (MDA) – for the moderate and severe degree of severity, and also changes in the activity of antioxidant enzymes with increase of the severity of the disease. Assessment of the level of catalase (Cat) and glutathione peroxidase (GP) showed their highest informative value at the mild degree of severity. Concentrations of glutathione reductase (GR), glutathione S-transferase (GST) and reduced glutathione (GSH) are more statistically significant markers for severe forms of pathological process.

Conclusions: Our research showed the relevance and advisability of the studying the levels of lipid peroxidation – antioxidant defense indices in women with varicose veins of small pelvis. We registered the highest diagnostic value of DC, Cat and GP in the beginning of the disease and of LHP, DC, MDA, GR, GST and GSH – at severe forms of the pathological process. We obtained reference values for DC, MDA, Cat, SOD and GP concentration that can be considered as the predictors of the development of varicose veins of small pelvis.

The prevalence of obesity in recent years has assumed the character of a non-communicable epidemic. Wherein, the standard approaches for its treatment are not always successful. Meanwhile, obesity remains one of the main causes of the formation of a number of some serious diseases, such as cardiovascular, diabetes, cancer, etc. and death from them. In search of alternative and more adequate methods of obesity treatment and preventing its complications, recent studies are aimed at further identifying new associations and revealing the pathophysiological mechanisms underlying excessive weight gain. It should be noted an increasing amount of chronobiological studies that raised awareness of the key role of the body’s circadian rhythms and its main regulator, melatonin, responsible for the temporary organization of the main physiological (including metabolism) processes throughout the 24-h day, in the development and progression of obesity. This review is devoted to the consideration of mutually directed interactions between the circadian system and metabolism; attempts have been made to explain the role of sleep-wake cycle disruptions in the excess accumulation of adipose tissue and the formation of obesity and its comorbidities, as well as detailed therapeutic principles based on normalizing disruption of body clocks using time-coordinated approaches to food intake, physical activity, the effects of non-drug methods and pharmacological substances (chronobiotics), which represents a novel and promising ways to prevent or treat obesity and associated diseases.

This review presents data on changes in the physiology of sleep during reproductive aging. It is noted that insomnia and obstructive sleep apnea syndrome (OSAS) are the main sleep disorders. The results of foreign and domestic studies in the field of free radical oxidation during sleep deprivation in animal models are presented, indicating the dependence of processes on the duration of sleep deprivation. The largest number of studies of free radical processes in a person with somnological pathology was carried out in the study of OSAS. Blood, urine, saliva, condensate of exhaled air can be biomaterial for determining the parameters of free radical oxidation. It was shown that the intensity of oxidative stress depends on the severity of OSAS, as evidenced by the positive correlation of the level of active products of thiobarbituric acid, the products of oxidation of proteins and carbonyl groups with the apnea/hypopnea index, determining the development of not only oxidative, but also carbonyl stress in patients with a severe degree OSAS. Biomarkers such as thioredoxin, malondialdehyde, superoxide dismutase, and reduced iron have shown a more stable relationship between increased oxidative stress and OSA. Despite the results obtained, the question of the association of oxidative stress and hypoxia in OSA remains debatable, which is associated with the opposite results of some studies. Insomnia, which occurs mainly in females, is accompanied by a high level of end products of lipid peroxidation with a decrease in the activity of antioxidants such as paraoxonase, an enzymatic component of the glutathione system. Along with this, menopausal women present low levels of uric acid, which correlates with high scores of the Pittsburgh sleep quality index questionnaire. Recent studies have identified an association between the activity of the «lipoperoxidation – antioxidants» system and the Clock 3111T/C gene polymorphism in menopausal Caucasian women, indicating the protective role of the minor allele.

Background. The benign nature of the gastric ulcer, determined during the initial video esophagogastroduodenoscopy (VEGD) in the presence of a hemorrhage or under the conditions of unstable hemostasis, is not a permanent characteristic of the pathological process, since most examinations do not include multifocal biopsy due to the danger of recurrent bleeding.

Objectives: to evaluate the inflammatory changes, regenerative abilities of the peri-ulcer area and to predict malignization in the nearest post-hemorrhagic period.

Methods. The work contains the examination data (VEGD, brush biopsy, morphological and immunohistochemical examinations) of 49 patients urgently admitted to the surgery with gastrointestinal bleeding, and further verification of gastric ulcer. Entry criteria were bleeding of the ulcer in the gastric mucosa, located in the antrum or the lesser curve with low risk of recurrent bleeding (Forrest 2C), presence of Helicobacter pylori.

Results. Brush biopsy allowed determining the benign nature of ulcerative lesions in 98 % of the patients during the two-day period following the first VEGD. Morphological study revealed dysplasia at the edge of ulcerative lesion with first signs of regeneration in 14.3 % of the patients. In the presence of dysplasia, we noted a vibrant response (+++) with COX-2 (×400), even if the ulcerous defect was smaller than 1.0 cm.

Conclusion. Considering our results, it is necessary to develop a strict algorithm for dynamic follow-up of patients with gastric ulcers, complicated by bleeding.

Background. Development of nutrient media ensuring the maximum growth rate of pathogens of dangerous infectious diseases while preserving their biological properties is extremely important. A promising direction in this area seems to be the use of synthetic microbial growth biostimulants.

The aim of the work is to study the possibility of improving nutrient media for the cultivation of Listeria and Staphylococcus using a biologically active compound tris(2-hydroxyethyl)ammonium 4-chlorophenylsulfanylacetate.

Materials and methods. The object of the study was experimental nutrient medium for the cultivation of Listeria used for the culturing of the test strain Listeria monocytogenes 766. As a comparison medium, commercial medium Fraser broth to which agar was added at a concentration of 1.5 %, was used. The test strain Staphylococcus aureus ATCC 6538-P (FDA 209-P) was cultivated on meat-peptone agar with 1% glucose. The compound tris(2-hydroxyethyl) ammonium (4-chlorophenyl)sulfanylacetate at a concentration of 10–4 wt. % was studied as a growth stimulator. A nutrient medium without a stimulant served as a control. The specific activity of nutrient media (germination rate, medium sensitivity, growth rate and stability of the main biological properties of microorganisms) was evaluated by the microbiological method.

Results. Studies have shown that the addition of a growth stimulator to nutrient media contributes to the growth of colonies (by 10–50 %) and a decrease in the time of their development. When growth stimulator was added to the nutrient medium for the cultivation of Listeria, the initial growth of colonies of the L. monocytogenes 766 test strain after 12 hours of cultivation and growth of colonies of the test strain S. aureus ATCC 6538-P after 6 hours of cultivation on the meat-peptone agar with 1% glucose was observed.

Conclusion. Thus, the addition of a growth biostimulator tris(2-hydroxyethyl)ammonium 4-chlorophenylsulfanyl acetate at a concentration of 10–4 wt. % in the nutrient medium accelerates the growth of Listeria and Staphylococcus, allows to reduce the time of issuance of the analysis result in half.

Aim: to study mental state of gynecological oncological patients, their attitude to the existing disease and quality of life.

Material and methods. The study was conducted on the basis of the City Clinical Hospital No. 1 of Novosibirsk. The main group (17women aged 29 to 60 years) included patients with ovarian cancer, cancer of the external female genital organs, and uterine cancer; the comparison group was comprised of 20 people aged 29 to 63 years without a history of cancer.

Results. In gynecological oncological patients, dissatisfaction with their own bodies is more pronounced; they perceive their body distorted, which may be due to the characteristics of the disease and the specifics of treatment. Patients with gynecological cancers have a more pronounced subjective feeling of loneliness, but it is at the upper limit of the norm, which may mean the fact that these patients turn in upon themselves, in their experiences, as well as the feeling of something lost in their inner world. Patients with gynecological cancers showed an average level of quality of life and low indicators of the mental component of health, which indicates reduced functioning and a significant effect of the patient’s physical and emotional state on daily activities.

Conclusion. The mental state of the cancer patient, his ability to withstand stress, his attitude to the existing disease affect the treatment process and further quality of life.

Background. Suicidal behavior in schizophrenia correlates with the severity of productive and negative personality symptoms.

Aims. Study of the clinic, the effectiveness of psychopharmacotherapy of paranoid schizophrenia and schizotypal disorder with the presence of suicidal behavior.

Material and methods. Patients with paranoid schizophrenia, episodic type of course (n = 19) and schizotypal disorder (n = 15) were studied, in the clinical picture of which various variants of suicidal behavior were revealed. Clinicalpsychopathological, clinical-anamnestic, and psychometric methods were used.

Results. Suicidal behavior in patients with an actual attack of paranoid schizophrenia was represented by suicidal intentions to avoid persecution (42.1 %), exposure to “voices” with an order to end their lives (36.8 %), and suicidal attempts (21.1 %). In patients with schizotypal disorder, suicidal thoughts were detected (84.6 %) in the form of loss of meaning in life, and suicidal attempts (15.4 %). Psychopharmacotherapy of suicidal behavior in schizophrenia and schizotypal disorder included the use of antipsychotics (atypical and traditional), antidepressants, tranquilizers, and normotimics. Among patients with paranoid schizophrenia, a decrease in the overall score of the PANSS scale was detected by day 14 of therapy (p < 0.05). The effectiveness of therapy was due to the reduction of delirium, verbal hallucinosis, and deactualization of suicidal behavior. Among patients with schizotypal disorder, a statistically significant decrease in the overall score of the PANSS scale was observed by 21 days of therapy (p < 0.05). The favorable dynamics was characterized by a decrease in manifestations of depression, suicidal thoughts, loss of interests.

Conclusion. Combined therapy (antipsychotic, antidepressant, normotimic) helps reduce mental disorders and suicidal tendencies in patients with schizophrenia and schizophrenic spectrum disorders.

Background. Bacillus anthracis is a microorganism that causes anthrax. Because of irrational therapy, this particularly dangerous infectious disease leads to a systemic spread of bacteria in the body through histohematological barriers. Bacilli entering the brain subsequently lead to hemorrhagic meningitis. Despite intensive antibiotic therapy, that kind of meningitis is difficult to cure and therefore highly lethal. Studying characteristics of anthrax’s isolates of different origin and genotype is an actual area of research.

The aim of the study is searching for pathomorphological and histological changes in the brain regions of experimental animals with anthrax infection, caused by B. anthracis with different plasmid spectrum.

Materials and methods: The study was conducted on 200 certified white mice, three B. anthracis strains were used as research objects: B. anthracis I-323 (рХО1^– /рХО2^– ), B. anthracis I-275 (рХО1^- /рХО2^- ), and B. anthracis I-217 (рХО1⁺ / рХО2^– ). The material for histological examination was the brain of mice, embedded in paraffin, and then sections were prepared using a microtome and stained with hematoxylin-eosin and Nissl toluidine blue. The degree of neuronal damage was assessed by calculating the semi-quantitative factor and determining the average size of the neuron nuclei, and the numerical density of cells in 1mm² was studied. Microphotography and quantitative analysis was performed using the Motic Images Plus 2.0 application package. Statistical processing of the results was performed using the program “Statistica 6.0”.

The results of the study showed that the brain of infected mice shows signs of hemorrhagic leptomeningitis, the manifestations of which are more pronounced in mice infected with weakly virulent plasmid strains of B. anthracis and fallen mice.

Conclusion. Multicomponent exotoxin and specialized proteins, encoded in the pathogenicity plasmid of microorganisms, allow B. anthracis to easily overcome histohematological barriers and cause severe septic anthrax. The results obtained during the study supplement the available information on the pathogenesis of anthrax and indicate the need for further research in this direction.

Background. Detection of the pathogenicity factors is one of the actual directions in studying of the anthrax causative agent. First of all, it includes the presence of tripartite toxin, capsule and the related structural and regulatory genes. Their presence or absence is defined by structural changes in cellular structure of blood and immunocomplex organs of a macroorganism.

Objective: To conduct a comparative analysis of subpopulational structure of marrow and peripheral blood cells at anthrax infection in experimental animals and to trace dynamics of the infectious process caused by Bacillus anthracis of different genotypes.

Methods. Comparative examination of subpopulational structure of red marrow and peripheral blood cells of white mice in dynamics of the infectious process caused by B. anthracis of different genotypes was conducted. Also, neutrophil maturing index and leucoerythrocytic correlation were calculated in red marrow. Degree of manifestation of neutrophil pathological granularity was revealed in peripheral blood smears stained by the Freifeld’s method. Statistical processing of the received data was conducted using the computer program “Statistics”, version 6 (Novosibirsk). Authentic results were considered if the error probability was less than 0.05 (р < 0.05) in relation to the control.

Results. It is revealed that alterations in white mice infected by B. anthracis strains with the same set of plasmids are significantly various.

Conclusion. The resulted data permit to assume that the distinction of pathological alterations in peripheral blood and red marrow is probably connected with the other factors of the pathogen invasiveness like enzymatic activity, ability to adhesion and many others.

Currently, morbidity and mortality from chronic diffuse diseases of the liver and cirrhosis continue to increase worldwide. The difficulty of stabilizing the process with pharmacological agents, lots of restrictions for liver transplantation, the palliative character of the surgical correction of complications determine the urgency of finding various ways to stimulate liver regeneration, including surgical ones. Most of the known methods of surgical stimulation of regeneration are quite traumatic, and their stimulating effect is short-lived. The methods associated with cellular technologies are mostly expensive, ineffective, or poorly understood. In the experimental study, the effect on the parenchyma of a healthy and cirrhotic liver clips for clamping parenchymal organs exerting different unit pressure on the tissue was studied. The object of the study was laboratory rats with a healthy liver and animals with simulated cirrhosis. The animals were operated on with the imposition of titanium nickelide clips on the liver. Changes in the liver were studied 3, 7, 14, and 28 days after the surgery by histological examination of various parts of the liver. It was established that the clip with a lower specific pressure did not cause tissue necrosis, led to atrophy of the marginal part of the liver, also increased hepatocytes and binuclear hepatocytes were observed in the bulk of the liver. A decrease in the proportion of connective tissue was also observed in groups with liver cirrhosis. Thus, we consider it possible to use clips with a certain specific pressure on the tissue as a method of stimulating the reparative properties of the liver in chronic diffuse diseases and cirrhosis of the liver

Health of the population of the Russian Federation is an indicator of national safety. Therefore, one of the priority directions of state policy organization of events, providing preservation and increase in level of somatic health of citizens of the Russian Federation is considered. In this context, one of powerful methods of management of activity of the person is muscular work, long-term adaptation to which causes formation of a number of the effects having improving and preventive orientation. In this connection in recent years, the attention of experts and patients to the various systems of improving trainings increases, and the need for them in all of age groups of the population stimulates active development of their various forms and the fitness services industry. At the same time, achievement of necessary result demands understanding of both regularities of formation of adaptation reactions of an organism when using of the existing arsenal of physical activities, exercises, and the basic principles of their realization taking into account conclusions and recommendations of evidential medicine. These are organizational and methodical features of planning of training programs and styles of concrete occupations, the choice and dispensing both classical forms of physical activity, and options of technologies of fitness taking into account exercises potentially dangerous to the musculoskeletal device especially at children. Within the above-stated positions, the real material in a format of lecture statement is made and presented.