Aim. To show the significance of the department of propedeutics of internal diseases in the structure of higher medical education and its role in the education of medical personnel in Kuban Medical University since its establishment. The article is devoted to the work of one of the oldest departments of Kuban State Medical University − department of propedeutics of internal diseases, − which was founded in 1922. The discipline taught in the department is one of the key stages of internal diseases studying. During the existence of the department, such prominent figures of medical science of the Kuban worked there: N.N. Niyibizi, K.M. Rutkevich, P.I. Budarin, K.A. Patsevich. The historical path of the department in many ways reflects the history of the University, the region and the country.

Conclusion. The staff of the department has made a significant contribution to the development of healthcare of Krasnodar region and continues work on the training of doctors.

Aim. Conduct the analysis of modern literature on the etiology and pathogenesis of inflammatory periodontal diseases.

Materials and methods. Analysis of literature in the last 5 years in E-library and PudMed systems.

Results. The leading role of parodontopathogenic microflora in the emergence of periodontitis is demonstrated. The data of studies confirming that the occurrence of inflammatory periodontal diseases is caused not only by the action of the microflora of the dental plaque as the main parodontopathogen but also by a number of local and general factors reducing the resistance of the whole organism and determining the prevalence and nature of the inflammation in the periodontium.

Conclusion. The etiology and pathogenesis of periodontal diseases are rather complex, diverse, and have not been fully disclosed to date. The researches in this field are conducted on the regular and the methods of diagnosis and treatment are improving.

Aim. A review of the literature on the effect of the antitumor treatment on the dental status of patients with malignant neoplasms of the oropharyngeal region.

Materials and methods. A study of Russian and foreign literature of recent years in the databases of RSCI, Scopus, Web of Science, Pubmed.

Results. The condition of the organs and tissues of the oropharyngeal region in patients with malignant neoplasms during the antitumor treatment depends on the therapy used and the general state of body.

Conclusion. Combined treatment of malignant neoplasms of the oropharyngeal region causes immediate, early, delayed damage and reactions, which is necessary to control at each stage of the antitumor treatment to improve quality of the subsequent prosthetic rehabilitation of patients.

Aim. The analysis of literature data on the peculiarities of immunity in physiological pregnancy and its complications, as well as the possibility of correction of fertility disorders using muramyldipeptide.
Recent deterioration of reproductive health is largely due to socio-economic stresses and unfavorable environmental conditions, leading to a significant increase in immunopathological states, an increase in the incidence of women and men of reproductive age, increasing frequency of infertility, complicated pregnancy and neonatal diseases. Genital tract infections are one of the causes of disorders of immune and reproductive functions of women, in this connection, so that the knowledge of the fastgrowing immunology of reproduction and their clinical implementation take on particular significance. Analysis of literature data allows us to consider an important outcome of the immunological discoveries of the last years a change of opinion on the issue of infectious diseases treatment and the role of drugs as activators of innate immunity, among which an important role is given to a synthetic analogue of a component of bacterial wall – muramyldipeptide (glucosaminilmuramilpentapeptide, GMDP) as an active domestic active principle of a medicinal product with a known molecular mechanism of action. This review presents recent data, including results of research showing the clinical and immunological efficacy of GMDP in reproductive function disorders.

Conclusion. Analysis of published data on long-term practice of application of immunotropic drugs based on muramyldipeptide (GMDP) in the therapy of a number of gynecological diseases, as well as in programs preconception preparation of women of reproductive age, evidence of high clinical and immunological efficacy of immune modulating therapy, as well as on the possibility of expanding clinical indications for the directional correction of innate immunity through GMDP.

The status of patients with nose bleedings (NB) depends not only on the volume of blood loss, but also on the degree of compensation for hypoxia accompanying hemorrhage.

Aim. The main aim of our research was to study the antioxidant properties of blood serum and the intensity of LPO processes in erythrocyte membranes of patients with epistaxis of varying severity.

Materials and methods. 82 patients with nose bleeding of varying severity were examined. The antioxidant activity of the blood serum of patients was studied by the chemiluminescence method induced by divalent iron ions. The processes of lipid peroxidation were studied by evaluating the activity of antioxidant defense enzymes – superoxide dismutase (SOD) and total peroxidase activity in blood erythrocytes, as well as the content of the final product of LPO-malonic dialdehyde (MDA) in erythrocytes.

Results. It has been established that the potential of antioxidantprotection of serum and formed elements of blood is one of the most important links in the pathogenesis of NB.

Conclusion. High capacity of antioxidant protection can significantly reduce the risk of irreversible changes in erythrocytes and the development of clinical signs of deep tissue hypoxia in patients with epistaxis.

Aim. To study anamnestic data and characteristics of gestation course and labor of patients with preterm rupture of membranes and ill-timed discharge of amniotic fluid.

Materials and methods. Analysis of 68 case reports. 48 case reports of women with preterm discharge of amniotic fluid (PDAF) at full-term pregnancy were included into the study group, 20 case reports of women with timely discharge of amniotic fluid at full-term pregnancy (TDAF) − control group.

Results. The prevalence of abortion, miscarriage, gynecological and extragenital pathology in past medical history was revealed in patients with ill-timed discharge of amniotic fluid. In women with this pathology an operative maternity aid and medical induction of labor were often applied.

Conclusion. Our results indicate the need to consider the impact of not only individual risk factors on pathologic rupture of membranes and discharge of amniotic fluid, but the complex influence of risk factors. The findings also suggested that careful pre-conceptional preparation and the timely detection and prevention of complications in pregnancy, and treatment of extragenital pathology, can lead to a decrease in serious complications such as preterm rupture of membranes and thereby reduce the percentage of operative maternity aid.

Aim. Our aim was to study the interaction and interdependence between the depth of the frontal part of the dental arches and their gnathic and dental types.

Materials and methods. The materials of the research were the results of measurements of the frontal part of the dental arches of 87 people aged 18-25 with a complete set of permanent teeth, physiological occlusion and various gnathic and dental types of dental arches. Measurement and calculation of the depth of the frontal sections of the dental arches was carried out according to the Korkhaus method using tables and correction factors. Gnathic type of dental arches (mesognathic, dolichognathic, brachygnathic) was determined by the dental index (Dmitrienko S.V., 2015). The types of dental system (normodontia, macrodontia, microdontia) were calculated from the sum of the width of the crowns of the upper teeth.

Results. Anthropometric studies of gypsum models of jaws made it possible to establish that the shape of the frontal part of the dental arch is determined exclusively by its gnathic type. In people with mesognathic form of dental arches, regardless of the size of the frontal teeth, the calculated values according to the Korkhaus method coincide with the true parameters of the depth of the anterior part of the dental arch. In patients with brachygnathic form of dental arches, the parameters of the depth of the anterior part of the dental arch are statistically significantly greater than the calculated values of Korkhaus. In people with dolichognathic form of dental arches, the depth of the frontal part of the dental arch is statistically significantly less than the calculated values of Korkhaus.

Conclusion. An in-depth study of the variability of the structure of the shape of the dental arches of the upper and lower jaws in the projection on the gnathic facial types, due to their anatomical and topographical proximity and morphological unity, is of fundamental theoretical importance. The individual features of the maxillofacial region, which are of great practical importance in the diagnosis of pathological changes in the dentition, interpretation of the radiographic data, will not only improve existing conservative and surgical methods for treating patients in the dental profile, but also minimize the likelihood of immediate and distant complications.

Aim. To summarize the current experience of diagnosis and treatment of pregnant women with acute abdomen.

Materials and methods. Analysis of treatment results of 183 pregnant women with acute abdomen in the conditions of two multidisciplinary hospitals in Krasnodar. The most common urgent surgical diseases in pregnant women are acute appendicitis, cholecystitis and its complications, acute pancreatitis, acute intestinal obstruction.

Results. Diagnosis of diseases, providing the contingent of patients, is quite difficult, and often takes a long time, significantly worsening the prognosis for both the mother and the fetus. The ultrasound examination of the abdominal cavity in all patients makes it possible to clarify the diagnosis and adjust the treatment tactics. When doubting the diagnosis, it is necessary to perform diagnostic laparoscopy.

Conclusion. The use of minimally invasive technologies in the treatment of pregnant women can reduce the frequency of surgical and associated perinatal complications, promote the prolongation of pregnancy, and reduce maternal and perinatal mortality.

Aim. The article presents features of tooth loss in adults, in view of their age, gender and place of residence.

Materials and methods. During the dental examination 3329 (1760 men and 1569 women) adults aged 18 to 102, living in urban and rural areas of Krasnodar Krai of the Russian Federation, features of tooth loss, in view of participants’ age, gender and place of residence were studied. Needs in dental prosthetics of adults was also assayed.

Results. During the clinical studies age and gender characteristics of tooth loss across urban and rural population of Krasnodar Krai of the Russian Federation were discovered. In all age groups, regardless of place of residence, the tendency to the loss of a greater number of teeth was observed in men. In the elderly, senile age and among long-livers the total tooth loss was more frequent in women.

Conclusion. Analysis of tooth loss in adults of different age groups showed that in order to improve dental health of the adult population of towns and villages regardless of their place of residence it is required to improve prevention program which should address not only children and adolescents but also adults, including elder age groups.

Aim. The aim of this study was to asses changes of adhesion molecules (L-selectin, neopterin and interleukin-6) in patients with adenomyosis-related infertility during the therapy.

Materials and methods. 49 patients with infertility caused by adenomyosis were examined and divided into 3 clinical groups: 1 group – 26 patients (35,1%) and 2 group – 23 patients (31,1%) with adenomyosis-associated infertility; 3 group (control) – 25 patients (33,8%). Adhesion molecules detection was performed by enzyme immunoassay (EIA). Visual evaluation scale was used for estimating of clinical aspects of adenomyosis.

Results. The diagnostic utility of L-selectin for monitoring the adenomyosis therapy effectiveness was shown. The difference between L-selectin levels before and after treatment was statistically significant, the correlation coefficient (R) reached 0,584. The gestagens application is preferable due to reliable normalization of L-selectin levels and decrease in intensity of algomenorrhea (in the 1st group – 1,3 times less, than in 2nd group) and dyspareunia (in the 1st group – 2,2 times less, than in the 2nd group) on visual evaluation scale.

Conclusions. Adenomyosis not accompanied by a significant increase in the production of systematic inflammatory response markers (neopterin and IL-6), the increase of adhesion molecules (L-selectin) indicates the imbalance of endothelial-thrombocyte-leukocyte interaction.

Aim. To estimate efficiency of inhalation ozone therapy at rehabilitation of newborns who had suffered from intrauterine hypoxia.

Materials and methods. The complex clinical laboratory research of the antioxidant status of 150 newborns was conducted. The control group included 30 almost healthy newborns whose mothers had no somatic diseases and were characterized by physiological gestation course. The group of comparison was presented by 45 newborns whose mothers had secondary chronic placental insufficiency and received drug treatment without the course of ozone therapy. 75 newborns whose mothers received ozone-air mixture inhalations along with traditional therapy entered into clinical group. The erythrocytes of newborns’ dark blood taken right after the birth were chosen as a material for the research. The activity of superoxide dismutases (SOD), catalases, glutathione peroxidases (GPO), glutathione reductase (GSR), glucose-6-phosphate dehydrogenase (G6PD), as well as concentration of the restored glutathione (GSH) were assayed.

Results. It was established that the compensatory and adaptive reactions providing elimination of the reasons of oxidizing stress development due to the stimulating influence of ozone on activity of antioxidant protection enzymes were formed in newborns of clinical group.

Conclusion. In this regard, the offered scheme of the ozone therapy can be recommended for a complex rehabilitation of pregnant women with the chronic secondary placental insufficiency against the background of cardiovascular diseases.

Aim. To study the hydrolases of the gastric aspirate of newborns and to estimate the digestive potential of their digestive systems at full-term and preterm gestational age.

Materials and methods. Samples received from 76 full-term (37-41 weeks of gestation) and preterm (27-36 weeks) neonates have been studied in the course of this research. Lipase, α-amilase, the alkaline phosphatase, α-1- antitrypsin, pepsinogens I and II have been found in the supernatant of aspirate of the gastric content taken on an empty stomach.

Results. The results of the study indicate the significant decrease in the hydrolase content in the gastric aspirate of preterm infants in comparison with full-term infants as well as the decrease in the initial digestive potential at the preterm gestational age. These results update the digestive potential definition din labor as the diagnostic one in the trophological prediction of newborns development.

Concluson. The initial digestive potential of the digestive system of a newborn is characterized by hydrolase contents in his/her gastric aspirate. At the preterm gestational age the digestive potential of the digestive system is variously decreased for different hydrolase systems. The estimation of the initial digestive potential of newborns is promising for choosing strategies in breast, mixed and bottle feeding.

Aim. To study changes in the parameters of thromboelastometry and hemostasis system coagulation component in women with uncomplicated pregnancy and women with manifestations of thrombophilia in the perinatal period.

Materials and methods. The analysis of thromboelastometry and coagulogram parameters of 408 women was conducted. The subjects were conventionally divided into following groups: A - women without pathology of hemostasis (n=152), B – women with clinical manifestations of thrombophilia (n=256). The examination was carried out at various times of the perinatal period.

Results. In patients with thrombophilia, significant changes in coagulation potentials, characterized by hypercoagulation, thrombinemia and a decrease in the reserve of natural anticoagulants, and a decrease in fibrinolysis activity were noted. The most significant changes in hemostasiological parameters were indicated in the process of labor.

Сonclusion. The studied parameters of coagulogram and thromboelastometry should be used in assessing the risk of thrombotic complications and the rationale for antithrombotic therapy.

Aim. To carry out a comparative study of the features and shift tendency of individual indicators of the antioxidant system in patients with hypothyroidism and COPD of various phenotypes. 79 patients suffering from COPD III and IV were examined at the age of 60 to 80 years (men and women) who were hospitalized in the pulmonology department of the Regional Clinical Hospital No. 2 in Krasnodar, along with 47 patients suffering from hypothyroidism.

Materials and methods. The state of the blood antioxidant system was assessed by the activity of erythrocyte catalase and superoxide dismutase, the level of reduced thiol groups of erythrocytes, and the amperometric index of the total antioxidant activity of blood plasma. The activity of catalase was studied in the hemolysate of erythrocytes according to the method of Beers R.

Results. It was established that there were significant changes in the functioning of individual links of the antioxidant protection system in patients with COPD and hypothyroidism, as well as the stress in the system in general. At the same time, enzyme activity of the antioxidant system of erythrocytes varies in multidirectional ways, whereas the indices of the cellular and extracellular non-enzyme links of the endogenous antioxidant system change in a unidirectional way towards the decrease, which may indicate a significant activation of free radical oxidation processes and partial depletion of the low-molecular antioxidant blood link.

Conclusion. The revealed imbalance in the pro-/antioxidant system requires the introduction of drugs with antioxidant activity into therapeutic regimens. In patients with COPD, hypoxia and chronic inflammation may provoke oxidative stress, while in patients with hypothyroidism –decrease in the level of basal metabolism and anabolic processes in general.

Aim. The aim of our work was to study the results of surgical treatment of patients with the temporary pedicle flaps grafting in the recovery of shed skin cover.

Materials and methods. 97 cases of the flaps use for the treatment of 92 patients aged from 9 months to 63 years were analyzed. All patients were treated in the Burn Unit of the Scientific Research Institute – S.V. Ochapovsky Regional Clinical Hospital №1 with thermal, electrical, and mechanical injuries and their consequences within 2006-2017.

Results. “Acute” flaps grafting was performed in 58 (63%) patients (61 flaps), prefabrication of flaps was performed in 34 (37%) patients (36 flaps). From the migration of the flap to its modeling, the patients underwent the immobilization of interconnected areas of the body. This period was from 24,1±1,8 to 40.9±13.7 days and depended on the characteristics of the flap and its preliminary preparation. Artificial syndactylies were made in 24.4% cases of hands surgeries. It required additional surgical correction later.

Conclusion. Despite the duration and multiple stages, temporary pedicle flaps grafting sometimes remains the only feasible method of surgical treatment aimed at correction of defects of the skin and preservation of deep anatomical structures.

Aim. To broaden the understanding of chronic endometritis (CE) pathogenesis on the basis of the reception study of steroid hormones and markers of cell proliferation/apoptosis in its different types depending on the nature of microbial colonization of the uterine mucosa.

Materials and methods. A group of 345 patients with early reproductive losses (non-developing pregnancy, spontaneous abortion, artificial abortion, in vitro fertilization (IVF) failure for up to 6 months after intrauterine intervention) who had histologically revealed chronic endometritis was prospectively examined. The following studies were performed: microbiological (PCR diagnostics, bacteriological examination of the cervical canal, mucous uterus); instrumental (hysteroscopy). Vacuum suction biopsy of the endometrium was performed on the 7th-9th days of the menstrual cycle (m.c.) during hysteroscopy and on the 22nd-24th days of the m.c. with the purpose of clarifying the condition of the mucosa, including pathomorphological examination. CE verification was carried out with macrotypes identification (hysteroscopic evaluation of mucosal thickness, in the dynamics of the cycle, and its color – the presence of hyperemia or pallor, focal or diffuse hyperemia, micropolyps, vascular responses): hyper-, hypoplastic and mixed. Immunohistochemical study of the endometrium included evaluation of the expression of estrogens and progesterone receptors (Dako, Denmark), marker of mucosal proliferation (Ki-67) and apoptosis (CPP32).

Results. Inflamed mucous uterus remodelling is realized in pathomorphosis and homoeokinesis characteristics of each macro-type caused by the variability of the balance of the processes of cell proliferation and apoptosis. The morphological basis of the hyperplastic macrotype is dystrophic-atrophic changes of the endometrium, mixed type reveals alternation of sites of dystrophy and fibrosis, hyperplastic – induction of micro-polypoid growths on the background of a lymphocytic infiltration of the mucosa. The rate of uterine mucosa cellular renewal in CE cases is detected by the activity of persistent infections in the endometrium: with endometrial dystrophy – the diagnostic titers of opportunistic strains (Escherichia coli, enterococcus, anaerobes, bacteroides), with mucosal mosaicism – mycoplasmas and their associations with HSV2 and opportunistic strains, with hyperplastic macrotypes – chlamydia, HSV2 and their combinations.

Conclusion. The study of signalling chain markers of control over proliferative cascades at the endometrial level in comparison with the response to the introduction of a pathogenic infection and morphological transformations promotes the expansion of the concept of pathogenetic CE variants, and therefore, the choice of differentiated therapy for the purpose of restoring the fertile potential after reproductive losses.

Aim. To study the electrolytic composition and state of the prooxidant-antioxidant system of the oral fluid after dental implantation.

Materials and methods. 25 patients suffering from the partial edentia (the 2nd group of 13 patients with 1-3 teeth missing and the 3rd group of 12 patients with 4-6 teeth missing) and 20 healthy volunteers (the 1st group) took part in the study. The non-stimulated oral fluid was collected using the Ti Grade 4 implants during their first visit and 6 months after the dental implantation. The electrolytic composition, content of products of oxidative biomolecular modification and the activity of antioxidative protection enzymes of the oral fluid have been studied.

Results. It has been demonstrated that in partial edentia the level of sodium ions in the oral fluid increased 3-5 times while the level of iron ions increased 5-11 times. At the resampling of the oral fluid after the performed dental implantation the decrease in iron content down to the control indices has been determined in both groups of patients. In 6 months after restoration of denture by means of the dental implants the significant changes in the oxidative metabolism of the patients’ oral fluid have been revealed. So the content of products of oxidative biomolecular modification in the oral fluid of the patients suffering from partial edentia with 1-3 teeth missing decreased to the indices similar to those of the control group; in patients with 4-6 teeth missing the level decreased by 26% in comparison with the indices of the same group before treatment. The catalase activity of oral fluid in the second group decreased by 52% after treatment which can be associated with the production increase in hydrogen peroxide and the accompanying decrease in necessity of enzyme functioning. After the dental implantation against the background of the decreased indices before treatment the activity of glutathione peroxidase increased in the 2nd group 2,1 times and in the 3rd group 1,7 times reflecting the partial restoration of the protective potential of the oral fluid.

Conclusion. The tendency to the normalization of functioning of the prooxidant-antioxidant system and the electrolytic exchange in the oral fluid of patients suffering from the partial edentia after the dental implantation has been demonstrated.

Aim. To study the antidiarrhoeal activity of montmorillonite-based enterosorbent on the model of serotonin-induced diarrhea.

Materials and methods. The study was performed on laboratory mice of both genders, acute diarrhea was induced by intraperitoneal injection of serotonin hydrochloride at a dose of 0.32 mg/kg, enterosorbent as an aqueous suspension was administered orally in a wide range of doses 30 minutes prior to serotonin administration. Within 4 hours, the time of diarrhea onset, the number of defecations, the fluid content in the fecal masses was considered. Morphological examination of the small intestine was carried out.

Results. The administration of serotonin led to the development of diarrhea in 100% of animals in 12,8±1,2 minutes, the number of defecations increased 2,5 times compared to intact animals and was 19,5±0,5 times within 4 hours, the fecal masses were predominantly wet and liquid. The use of enterosorbent under the Crim_04 cipher in the maximum dose led to a delay in the development of diarrhea to 73,6±4,1 minutes, a reduction in the number of defecations to 9,4±0,1 and a significant inspissation of stool. The antidiarrhoeal effect of enterosorbent was confirmed morphologically.

Conclusions. Montmorillonite-based enterosorbent under the laboratory cipher Crim_04 has a dose-dependent antidiarrhoeal activity in the modeling of serotonin-induced diarrhea.

Aim. To demonstrate basic mechanisms of dimephosphon operation on skin microhaemodynamics.

Materials and methods. The study of dimephosphon effect on blood microcirculation of skin in outbred male rats included registration of perfusion index, mean square deviation, variation coefficient; determination of the amplitude of blood flow oscillations in different frequency range (by laser doppler flowmetry method).

Results. Dimephosphon stimulates oscillatory and non-oscillatory skin microhaemodynamic indiсes indicating the increase of peripheral tissues perfusion and blood flow modulation in microvessels due to endothelium functional activity increase, peripheral resistance decrease, increase of blood flow to the nutritive microvessel channel and venous outflow improvement.

Conclusion. Vasoactive properties of dimephosphon are manifested in its ability to affect vascular and extravascular regulatory processes of blood microcirculation of skin. Microvessel endothelium and its metabolic activity associated with NO release are the most sensitive to dimephosphon effect. The ability to increase endothelium NO production is the basic mechanism of dimephosphon vasodilatory action.

Mast cell is a traditional cell for wound healing, but their content in the wound after transplantation of autoand heterofibroblasts and dermal equivalent on the basis of these cells remains poorly studied.

Aim. To study the morphological structure, collagen formation, angiogenesis and content of mast cells in biopsy materials of the newly formed epidermis and dermis on the 12th day of their recovery in a model ischemic wound after administration of auto- and heterofibroblasts and after transplantation of dermal equivalent with heterofibroblasts.

Materials and methods. The study was performed on 28 white mature mice of the C57 / B1 line aged up to 1 year. 0.4 ml of suspension with 1.33 million fibroblasts in growth medium DMEM F12 (Lonza) and in dermal equivalent were administered around and into the bottom of skin surgical model wound in the scapular region. The scar was embedded in paraffin and stained with hematoxylin and eosin, according to Weigert-Van Gieson, and kit for mast cells staining (Biovitrum).

Results. On the 12th day epidermis is thicker after introduction of autofibroblasts, but it is more differentiated after transplantation of dermal equivalent with heterofibroblasts. Angiogenesis is also most active after the administration of autofibroblasts. Fibroblasts production of collagen fibers in granulation tissue, angiogenesis and the content of functionally active mast cells indicates the most favorable influence of autofibroblasts transplantation on the wound healing.

Conclusion. The effect of dermal equivalent with heterofibroblasts differs from exposure autofibroblasts by several percent: the area of collagen fibers – by 2%, the area of blood vessels − by 5%, the index of degranulation of mast cells – by 4%.