Pathological processes in the pre-reactive period of cold injury have not been studied.

The purpose of this study is to assess the morphological and biochemical parameters of blood in the body of patients in the pre-reactive period of cold injury.

Material and methods. We examined patients with cold injury in the pre-reactive period. Determined: diene conjugates, malonic dialdehyde, the total content of low molecular weight antioxidants, superoxide dismutase activity, catalase,glutathione peroxidase, glutathione reductase, using a SPECORD 40 spectrophotometer. The serum biochemical parameters in the serum were determined by biochemical automator analysis. Statistical processing of the data was performed using IBM SPSS Statistics 19.

Results and discussion. Features of the biochemical profile of blood in the pre-reactive period of cold injury in the human body are an increase in concentration of glucose and triacylglycerides in blood, an increase in transaminase activity, as aresult of inflammatory and destructive processes, a decrease in the cholesterol concentration in the blood of patients. At the same time, the pre-reactive period of cold injury is characterized by an increase in monocytes compared with the control, which, in combination with hypoxia, leads to an intensification of lipid peroxidation processes. In addition, the antioxidant protection in the pre-reactive period in the body of patients increased slightly.

Conclusion. According to the results of our research, already at the stage of the pre-reactive period of cold injury there is a significant intensification of free radical lipid oxidation processes.

Background. High predisposition to sunburn in childhood and associated increased risk of malignant skin tumors development, decrease with age. There is a likelihood of a relationship between the described trends and dynamic age related changes in functional state of melanocytes and melanin.

Aim: to evaluate the level of melanin in the skin in children of different age. Materials and methods. The study involved 78 children aged from 7 to 17 years, without any disorders of skin pigmentation. Three groups of observations were formed: Group 1 - 28 children from 7 to 9 years, Group 2 - 25 children from 10 to 12 years, Group 3 - 25 children from 16 to 17years. The melanin level was evaluated in the skin of face, body and extremities using mexametry.

Results. The highest level of skin melanin was observed in forearms and lower legs in all age groups (up to 28.3 ± 10.8, 23.3 ± 8.6 and 26.7 ± 10.6 c.u. in Group 1, 2 and 3 respectively), the lowest - in cheeks and chest (up to 8.0 ± 4.7, 4.4 ± 3.4 and 9.5 ± 4.1 c.u. in Group 1, 2 and 3 respectively). There were relationships between skin site and level of melanin, but no relationships between level of melanin and gender or age.

Findings. The level of melanin in the skin in children aged from 7 to 17 years is individual and depends on the location of the skin area, but does not depend on gender or age. The distribution of melanin in the skin is stable and does not change over time.

Background. Brain lesion is one of the most common extrahepatic manifestations of chronic HCV infection. To date, its main clinical and neurometabolic features have been established. However, the morphological picture of HCV-associated cerebral changes and peculiarities of viral molecular markers expression in brain matter remain poorly understood. This significantly limits the possibilities of pathological diagnosis of this disease.

Aims. To study the morphological picture of brain lesion during chronic HCV infection and to determine the peculiarities of immunohistochemical (IHC) expression of the HCV NS3 antigen in brain matter.

Materials and methods. The study was performed on autopsy brain of 40 patients who died in the outcome of HCV infection and 15 patients died without signs of mental pathology. Complex of pathomorphological and ICH methods was used.

Results. It was demonstrated that morphological picture of brain lesion in chronic HCV infection is represented by nonspecific dystrophic, inflammatory and proliferative changes, the severity of which varies significantly depending on the brain departments (p < 0.001). Expression of the NS3 marker is found in all studied brain regions and shows the highest intensity in white matter of cerebral hemispheres and in brain stem (p < 0.05). The ICH reaction of NS3 is manifested in microglia cells, vascular endothelium, inflammatory infiltrate cells and in periventricular ependyma cells. Using correlation analysis method it was found that NS3 expression formed the strongest correlations with such categories as CD68 expression, microgliosis, and axonal degeneration. This allows considering they are the main factors by which HCV realizes its deleterious effect on the brain.

Conclusion. Characteristic morphological changes of the brain in chronic HCV infection were studied. The features of ICH expression of the NS3 in various parts of the brain are established. The results can be used to improve pathological diagnosis of brain lesion in chronic HCV infection.

Vibration disease occupies one of the leading places among occupational diseases. The development and course of vibration disease is accompanied by disorders in immune system.

Aim of the study is to provide a comparative assessment of cells with markers of the early (CD25+) and late (CD95+) stage of lymphocyte activation and to compare them with the phenotypic composition of lymphocytes in patients with vibration disease.

Materials and methods. The study includes men aged 36-60 years with vibration disease from exposure to local vibration (26 people) and from combined exposure to local and general vibration (28 people).

Results. The most pronounced changes in the system of lymphocyte apoptosis are observed in patients with vibration disease from the combined effects of local and general vibration, manifested by the increase in the number of CD25+ and CD95+-lymphocytes. Increase of quantity of CD25+ at patients with a vibration disease from impact of local vibration and from the combined impact of local and general vibration is caused by increase in their number on lymphocytes what the direct correlation dependence between quantity of CD25+-lymphocytes and the number of CD3+, CD4+, CD8+, CD16+, CD20+-lymphocytes testifies to.

Conclusions. In patients with vibration disease from the combined effects of local and general vibration, the increase in the number of CD95+ is due to an increase in their density on mature T-lymphocytes, as evidenced by the inverse relationship between the level of CD95+ and the CD3+-lymphocytes. The obtained data should be taken into account in order to develop new effective methods of prevention, treatment and prediction of the course of vibration pathology. 

Introduction. Osteochondrosis of the cervical spine is a very common disease that causes a significant decrease in the quality of life of patients. In the case of pronounced changes in the cervical spine with osteochondrosis, there is a violation of blood circulation in the cerebral cortex, which leads to pronounced clinical symptoms.

The aim of this study was to identify a correlation between bioelectrical activity and cerebral hemodynamics in patients with osteochondrosis of the cervical spine.

Materials and methods. The examination involved 25 patients of the neurosurgical department who received conservative treatment for exacerbation of osteochondrosis of the cervical spine, and 25 volunteers without a history of diseases of the spine and joints. The cerebral bioelectrical activity and blood flow indicators were recorded in the pool of the common carotid and vertebral arteries.

Results. In the main group and the clinical comparison group, the rheographic index and the peripheral vascular resistance index were studied, which characterize both the volume pulse blood filling of the vascular bed and the tone of small and medium caliber arteries. At the same time, the EEG rhythm indices were analyzed: а-, в-, S-, and в-waves. An analysis of the intersystem interaction of bloodflow indices and the biopotentials of the cortical rhythm of the brain in the main group showed a mismatch in the intra-system connections, which corresponds to the period of the general stress of the body. An analysis of the correlation between the indicators of electroencephalography and rheoencepha-lography in the control group revealed a stable system of correlation between the indicators, showing intersystem and intrasystem consistency and reflecting a high level of reserve capacity of the body and the state of steady adaptation to adverse factors.

Conclusion. The use of simultaneous recording of cerebral hemodynamics and brain biopotentials in patients with osteochondrosis of the cervical spine will allow clinicians to correctly assess the functional state of the central nervous system and to prescribe adequate treatment in a timely manner.

Pain in the spine is one of the most common pathological conditions and holds the second place in terms of disability throughout the world. Pain syndrome has a great influence on the functional capabilities of the spine and the professional activity of a person, and that carries a serious social and economic problem. The main causes of pain in the spine are: pathology of the intervertebral discs and the zygapophysial joints; dynamic instability of the spinal motor segment; spondylosis; stenosis of the spinal canal and dural sac with compression of the neurovascular structures; spondylolisthesis; osteoporotic compression fractures of the vertebrae; infectious diseases of the spine, etc. In connection with the aforementioned, of particular interest to clinicians is the pathology of the zygapophysial joints (spondylarthrosis), its diagnosis, and targeted ethiopathogenetic treatment using puncture surgical technology in the treatment of facet syndrome. This paper presents the results and features of puncture surgical technology in the treatment of facet syndrome in degenerative-dystrophic lesions of the zygapophysial joints of the lumbar spine. The analysis is based on 55 sources of literature of domestic and foreign authors. The article presents data on the anatomical and topographic features of the zygapophysial joints, their biomechanics, innervation and their function. The ethiopathogenetic features of pain during degeneration of facet joints are considered. The effectiveness of the use of methods of using radio and laser denervation of the zygapophysial joints in the treatment of facet syndrome is analyzed. The materials of the article describe the methods of using chemodeception, cryodestruction, and intra-articular administration of hyaluronic acid preparations.

The purpose of the study: assessment of the use of laser vaporization of the disc with hernial protrusion on the lumbar spine and its effectiveness in the treatment of pain.

Material and methods. We analyzed the effectiveness laser vaporization in 230 patients with degenerative-dystrophic diseases of the lumbar spine (protrusions and hernias of the intervertebral discs) treated in the neurosurgical department of the Irkutsk Scientific Centre of Surgery and Traumatology for the period from 2011 to 2018. There were 122 men and 108 women. The average age of the patients was 41 years. The duration of the disease before surgical treatment is 11 ± 3 weeks. Clinical and neurological examination revealed lumbalgia in 102 patients (44.3 %), lumbar ischalgia in 98 (42.6 %) and radiculopathy in 30 patients (13.1 %). Median hernias of the intervertebral discs were revealed in 130 patients (56.4 %), lateral hernias - in 41 (17.8 %) and protrusions - 59 (23.8 %). The leading localization of the pathological process was the L_IV-L_V segment (138 patients, 60 %). Assessment of the effectiveness of surgical treatment was carried out using VAS and Macnab scales.

Results. In 100 % of cases were laser vaporization was applied a decrease in the intensity of the pain syndrome was achieved in terms of up to 3 months. The analysis of the long-term results of this treatment in 124 patients from 3 months to 3 years by Macnab scale revealed excellent results in 25 (20.1 %) patients, good results - in 50 (40.3 %), satisfactory - in 42 (33.8 %), and unsatisfactory results - in 7 (5.6 %) cases.

Conclusion. Thus, laser vaporization of hernias of the intervertebral disc is effective in the treatment of pain, which does not stop with conservative treatment for 4-6 weeks; with a hernia of up to 6 mm; with a median localization and with no signs of sequestration.

Background. Macular edema is considered as a risk factor for a significant decrease in the visual acuity and quality of life of the patient, regardless of its cause. The search for the causes of macular edema in some cases should include an interdisciplinary approach and laboratory studies to correctly determine its etiology and management tactics for such patients. Therefore, the differentiation of the etiology and pathogenesis of macular edema at the stage of diagnosis determines the possibility of preserving not only visual functions, but in some cases the patient's life.

Aim: to present clinical cases of macular edema associated with central retinal vein thrombosis of various etiologies.

Materials and methods. A prospective study of individual patients with macular edema associated with thrombosis of central retinal vein or its branches was conducted in real clinical practice. All patients underwent a standard ophthalmological examination, as well as optical coherence tomography, and a patient with suspected macroglobulinemia underwent a biochemical blood test.

Results. In the first clinical case, macular edema was associated with an exudative form of retinal arterial macroaneurysm. The patient underwent direct laser coagulation of retinal arterial macroaneurysm. 6 months after direct laser coagulation of macroaneurysm, the best corrected visual acuity of the left eye was 1.0. The fundus - macroaneurysm, retinal edema, solid exudates are not ophthalmoscopic. In the second clinical case, macular edema, thrombosis of central retinal vein is associated with Waldenstrom disease. Follow-up and treatment of the underlying disease by a hematologist were recommended.

Conclusion. Thus, macular edema proceeding against the background of central retinal vein thrombosis and its branches, having atypical symptoms in the form of ring-shaped deposition of hard exudates, exudative retinal detachment, the presence of a bilateral process, as well as resistance to anti-VEGF therapy require a careful collection of the patient's medical history and the presence of other ophthalmic vascular pathology.

The discovery of the first typical antipsychotics in the 1950s had revolutionized the treatment of many severe mental illnesses. This discovery opened the door for radical humanization and deinstitutionalization of the whole psychiatry. It also served as an impetus for the emergence of a new science, called psychopharmacology. This signaled the beginning of an era of widespread use of psychopharmacotherapy in psychiatry. However, the use of typical antipsychotics has been associated with many side effects, including severe ones, such as severe extrapyramidal syndrome, neuroleptic-induced deficit syndrome, cognitive impairment, and neuroleptic malignant syndrome. This necessitated the development of methods for correction or treatment of such side effects.

Over the past decades, a number of new antipsychotics have been synthesised and approved for clinical use. Those new drugs are considered to belong to the group of so-called «atypical antipsychotics». This group, as a whole, has an improved tolerance and safety profile compared to older, conventional antipsychotics. In particular, these new drugs less often cause exactly the aforementioned side effects. Nevertheless, the problem of antipsychotic side effects and their correction is still far from being resolved. Some patients experiencing certain side effects from antipsychotic therapy do not get adequate relief from the standard pharmacological correction of those side effects.

This fact stimulated our interest in the study of the possibilities of using electroconvulsive therapy as an alternative or adjuvant method for the correction of some side effects that can arise during antipsychotic therapy. In this article, we thoroughly discuss the existing evidence base regarding the effectiveness and safety of the use of electroconvulsive therapy as a corrector for certain side effects that can occur during antipsychotic therapy.

Background. Ulcerative colitis is a colon disease accompanied by a systemic inflammatory response with the development of oxidative stress, which leads to structural and functional changes in cell membranes. There are no data on the qualitative and quantitative changes in the protein components of the cytoplasmic membrane in ulcerative colitis under the influence of the antioxidant, membrane-stabilizing drug Mexidol.

The article presents the data of our own research, the purpose of which is to study the nature of changes in protein components in the erythrocyte membrane in vitro when exposed to Mexidol (the active substance is oxymethylethyl peridine succinate) in patients with ulcerative colitis during an acute attack.

Materials and methods. The study involved 51 patients with ulcerative colitis during the exacerbation period and 30 clinically healthy individuals comparable by sex and age. Ten major protein components of the erythrocyte membrane were evaluated.

Results. As a result of the regression analysis, it was shown that in the group of clinically healthy individuals, almost all structural proteins are to varying degrees linked to proteins by glucose transporters and the enzyme glutathione-S-transferase and in patients with ulcerative colitis, the connection of protein components of membrane channels with spectrines is lost. Incubation of red blood cells of patients with ulcerative colitis in a solution of Mexidol in vitro did not affect the protein components of the erythrocyte cytoplasmic membrane. At the same time, in ulcerative colitis patients there was a restoration of spectrin connections with anion transport proteins and a glucose transporter, which were not detected in the initial state.

Conclusion. The effect of Mexidol in vitro on the erythrocyte membranes of patients with ulcerative colitis was accompanied by the restoration of structural and functional protein bonds, which can be considered as a beneficial effect of this drug on the erythrocyte membrane under the conditions of the studied pathology.

Preventive drainage of the abdominal cavity after gastrointestinal surgery is widely used. However, debates about the need for abdominal drainage have not subsided so far.

The aim of the study: to establish the effect of the duration of the use of drains on the development of postoperative complications in the experiment.

Materials and methods. For the experiments, male Wistar rats weighing 220-250 g at the age of 9 months were used. A mid laparotomy was performed, then the serous-muscular layer of the cecum was opened, 1 cm long, followed by suturing the wound with a self-twisting suture, and the parietal peritoneum of the right lateral canal was sized 1.5х1.5 cm. A silicone catheter was installed. The study was conducted in two groups. In the first group, the drainage was removed after 24 hours, in the second - after three days. The study was conducted on the 3rd, 7th, 14th and 30th day, 6 animals in each group/at each term. The severity of the adhesive process in the abdominal cavity, the presence of an inflammatory process in the peritoneum, and hematological parameters were evaluated.

Results. It was established that the severity of the adhesion process in groups in all periods of observation was comparable. The severity of purulent-inflammatory processes in the abdominal cavity on the 14th and 30th day was significantly lower when installing drainage for 1 day than 3 days.

Conclusion. A study with the installation of drainage in the absence of infection of the peritoneum showed that the duration of the installation of the drain adversely affects the incidence of purulent-inflammatory changes in the abdominal cavity, which must be taken into account when planning the use of drainages in abdominal surgery.

The industrial cities of Irkutsk region are a type of socio-ecological systems, the population of which for a long time lives under the combined influence of adverse technogenic and socio-economic factors.

The aim of the study was to assess the characteristics of the general incidence of the population of industrial cities in the Irkutsk region (Angarsk, Shelekhov) in the first and second decades of the XXI century.

Methods. The morbidity indicators for the appeal of the population for medical care presented by healthcare institutions in statistical form N 12 were analyzed. We evaluated the characteristics of diseases detected for the first time inlife (primary incidence). To identify trends in the dynamics of morbidity indicators, the method of regression analysis (linear and quadratic functions with a free term) was used.

Results. In the dynamics of the general indicator of the primary incidence in both studied cities, no tendencies for steady growth or decrease were revealed. At the same time, in the dynamics of indicators for some classes of diseases, there were statistically significant trends in the increase in incidence (classes of diseases of the musculoskeletal system, diseases of the genitourinary system, respiratory diseases), as well as trends in the decrease in incidence (classes of infectious diseases, neoplasms and skin diseases).

Conclusion. The changes in the structure of primary morbidity that have occurred over 14 years indicate pathomorphism of the pathology, for which the population is seeking medical help. An increase in the prevalence of diseases of the musculoskeletal system, diseases of the genitourinary organs and others among the population can be caused by both the aging processes of the population and changes in lifestyle (especially young people) that occur under the influence of negative factors of the sociocultural environment and others.