Aim. To study prevalence and etiological structure of urinary tract infections (UTIs) in pregnant women with type 1 diabetes mellitus, to assess sensitivity of various methods of UTIs detection.

Materials and methods. 192 pregnant women with type 1 diabetes mellitus (DM1) were examined. The presence of a urinary infection was assessed by detection of nitrites, leukocyte esterase in general urinalysis and by bacteriological culture with the use of the classical and "DipStrik" express method.

Results. UTI has been detected in 57.3%. The frequency is as follows: asymptomatic bacteriuria (> 105 cfu /ml) (ABU) – 35.9% (n=69), acute pyelonephritis – 19.8% (n=38), acute cystitis – 1.6% (n=3). The proportion of low ABU (102-104 cfu/ ml) is 16.1% (n=31). Escherichia coli prevailed in the structure of pathogens of UTI: in ABU – 66.7%, in pyelonephritis – 78.9%. Then goes Enterococcus faecalis: in ABU – 14.5%, in pyelonephritis – 13.2%; and then Klebsiella: in ABU – 7.2%, in pyelonephritis – 5.3%. Other pathogens (Streptococcus agalactiae, Staphylococcus aureus, Proteus) were less common. Sensitivity of the nitrite test to detect UTI was 30%; sensitivity of leukocyte esterase detection for low ABU was 22.6%, for ABU – 52.2%, for pyelonephritis –71%. Sensitivity of the express method "DipStrik" with reference to classical bacteriological culture was 98%.

Aim. to create a classification of posttraumatic deformities of the thoracic and lumbar spine.

Materials and methods. 124 patients with posttraumatic deformities of the thoracic and lumbar spine were treated. The patients were operated on during the period of 6 months to 14 years from the moment of injury. The operations were carried out in the period of 2003-2017.

Results. A classification has been developed based on three orthopedic features. The classification offers 80 variations of post-traumatic deformities of the thoracic and lumbar spine. Variations of deformities are indicated by three symbols: a digit, a letter, a digit, for example: 4.B.1 or 2.E.3, etc.

Conclusion. The created classification systematizes variations of posttraumatic deformations of the thoracic and lumbar spine according to three orthopedic features. The classification can be a subject of discussion of interested specialists. In the future, the classification will be the basis for the algorithm for surgical treatment of patients with posttraumatic deformities of the thoracic and lumbar spine.

Aim. To determine factors on the background of which there is the formation of polyps in patients of reproductive age. 

Materials and methods. We examined 75 patients of reproductive age with endometrial polyps, analyzed the anamnesis, ultrasound and histology data.

Results. The average age was 31,77±3,56, average BMI 27,4±3,2 kg/m2; there were more than half patients with extragenital pathologies (gastrointestinal tract diseases in 57,33%; endocrine diseases in 52,0%; cardiovascular system – 44,0%); heavy menstruations were in 78,66% patients, infertility – 100%.

Conclusion. The determination of risk factors of developing endometrial polyps in reproductive age contributes to the choice of tactics of management of these patients.

Aim. To study risk factors of infertility in combination of polycystic ovary syndrome and external genital endometriosis. 

Materials and methods. There were 4 clinical groups: 1 group – 31 patients with combination POCS and EGE (26,5%); 2 group – 33 patients with POCS (28,2%), 3 group – 32 patients with EGE (27,35%), and 4 group – 21 healthy patients (17,95%), who were hospitalized for operative sterilization (control group). The patients’ anamnesis, gynecological, and reproductive amanuensis and clinical parameters were estimated in all patients.

Results. Combined gynecological pathology: young age, high frequency of childhood infections during prepubertal and pubertal period. In combined gynecological pathology there were irregular menstruation 1,6 times more often, in 61,29% – painful, and in 58,06% – heavy menstruation. Androgenic dermatopathy among the patients of 1 group was present in 87,1% as an acne, and as an oily seborrhea in 41,94%, R=0,46.

Conclusion. Patients with combined pathology have the most unfavorable reproductive anamnesis.

Aim. To study the dynamics of the anxiety state in patients with temporomandibular joint (TMJ) join disks dislocation and the effectiveness of conservative treatment in terms of the quality of life of these patients.

Materials and methods. The state of anxiety in patients with dislocations of the TMJ joint discs was studied using a Spielberger questionnaire. The efficacy of conservative complex orthopedic dental treatment of these patients was assessed using the OHIP-49 questionnaire (Slade, G.D., Spencer, A.J. Oral Health Impact Profile, 1994). The data wasprocessed using the program "STATISTICA 6.0" and "Microsoft Office Excel".

Results. It has been revealed that in patients with dislocations of the joint discs of the TMJ, the level of anxiety is higher than in those who have no signs of the TMJ dysfunction. In patients with signs of uncontrolled dislocation of the joint meniscus, the level of anxiety is higher than in people with other forms of TMJ dysfunction. A high level of personal anxiety persists after dental treatment and can become one of the main causes of relapses of TMJ dysfunction. The OHIP-49 index has revealed deterioration in the quality of life in patients with dislocations of the joint discs of the TMJ. It should be noted that in patients with uncontrolled dislocations of the joint menisci, deterioration in the quality of life is more pronounced.

Conclusion. Thus, the proposed conservative orthopedic dental treatment can improve the quality of life of patients with dislocations of the joint discs of the TMJ and reduce the level of situational anxiety n these patients.

Aim. The main aim of the study was to develop a pathogenetically grounded varicocele model and to compare it with the well-known one.

Materials and methods. 30 male mongrel laboratory rats were divided in 3 equal groups, in the 1st group Saypol technique was performed, in the 2nd – one-time partial ligation of both spermatic cords with following testicles abdominisation. The 3rd group was the control one. There was a gonadectomy with following histological investigation on the 7th, 15th and 30th days. 

Results. Group 1 was presented with adhesions in abdominal cavity and hydronephrosis in all rats. The changes in the spermatic veins and testicles were reached both in the 1st and 2nd groups with more signifi ones in the 2nd group by the 15th day. There were phlebectasia, tunica media thinning, infl infi of the testicles with spermatogenous epithelium and mature germ cells necrobiosis, in some cases also arterial vessels proliferation and even spermatogenesis recovery.

Conclusion. Thereby, the use of the suggested technique is more grounded from the technical, economical and pathogenetic points of view.

Goal. To determine multiple factors influencing the development of anomalies of labor activity to optimize the examination of pregnant women after 37th week of gestation.

Materials and methods. 308 pregnancies that resulted in delivery of term fetuses complicated by various anomalies of labor activity have been monitored. 154 patients have been selected and divided into 4 clinical groups: group 1. 27 pregnant women (17,54%) with pathological preliminary period; group 2. 39 pregnant women (25,32%) with rapid birth; group 3. 41 pregnant women (26,62%) with uterine inertia and group 4. 47 pregnant women (30,52%) with discoordination of labor activity 

Results. Rank correlation, characterizing the redistribution of muscle mass of the anterior wall of the uterus during childbirth has been identified. The change in the level of energy consumed for birth labor in patients with anomalies occurs on the background of low level of stress tolerance and changing IRAS.

Correlation analysis allows us to determine the level of glucose, which correlates with interleukin levels, and pH levels which also correlate with levels of interleukin. Both glucose, and pH correlate with the anomalies of labor activity. A strong correlation has been identified between the thickness of the anterior wall of the uterus and the level of interleukins.

Conclusion. After 37th week of pregnancy, while defining the level of stress tolerance in the groups of pregnant women, threatened by the development of anomalies of labor activity, the calculation of the IRAS on the background of the laboratory determination of glucose, blood pH and thickness of the anterior wall of the uterus, will allow forming an individual plan of delivery and reducing obstetric and fetal injuries

Aim. To increase the effectiveness of treatment of patients with chronic generalized periodontitis by using bacteriotoxic phototherapy with subsequent surgical treatment with the use of osteoplastic material bio-gene.

Materials and methods. 60 people were observed: 30 people in the main group, and 30 people in the control group. All patients of the main group before the surgical treatment underwent bacteriotoxic phototherapy with photosensitizer "fotolon", diluted according to the instruction. Then followed a surgical treatment of chronic generalized periodontitis with the use of an osteoplastic material Bio-Gen. Patients of the control group were treated with a well-known conservative method. The state of microcirculation of periodontal tissue was studied in all patients applying the method of laser Doppler flowmetry. The composition of microflora of the contents of periodontal pockets was determined before and after the treatment.

Results. As a result of our comprehensive treatment of chronic generalized periodontitis (the main group) with the use of bacteriotoxic phototherapy with ‘fotolon’ with subsequent surgical treatment with the use of osteoplastic material bio-gene after 12 months, the data of laser Doppler flowmetry showed an improvement in the microcirculation of periodontal tissues. After the treatment, a significant decrease in the number of microorganisms was observed. There was no significant improvement in the microcirculation of periodontal tissue in the control group of patients, as well as any decrease in the number of basic parodontopathogenic species of microorganisms.

Conclusion. Combined application of bacteriotoxic phototherapy and surgical treatment with the use of osteoplastic drug bio-gene in the treatment of chronic generalized periodontitis demonstrates a pronounced therapeutic effect, which consists in improvement of microcirculation of periodontal tissues. Microbiological research in all patients after the treatment showed high efficiency of this method in relation to the main types of parodontopathogenic microorganisms.

Aim. Characterization of the changes in expression of cell adhesion molecules and complement receptors in the transplanted heart rejection using computer morphometry to improve the quality of endomyocardial biopsy diagnostics.

Materials and methods. Endomyocardial biopsies of 20 patients undergoing cardiac transplantation were used. Histological sections were stained using a standard procedure with hematoxylin and eosin, as well as an indirect immunohistochemical method with the ABC detection system against CD21 and CD31. The area of the positive reaction was estimated with computer morphometry.

Results. All biopsies are divided according to the degrees of rejection as follows: degree 0R – 8 samples, 1R – 10 samples, 2R – 7 samples, 3R – 4 samples. CD21 expression is 0.31% in samples with 0R, 1.09% at 1R, 2R rejection of 2.01%, and for 3R – 4.15%. The area occupied by CD31-positive cells is 3.49% in 0R, at 1R rejection this index decreases by 1.3 times, in biopsy samples with 2R this index is 1.8 times less, and for samples with 3R it decreases by 2.6 times.

Conclusion. Evaluation of CD21-positive cells in the myocardium allows us to predict cardiosclerosis, as well as a tendency to a chronic clinical course of the rejection. Expression of CD31 makes it possible to assess condition of the microcirculatory vessels in the graft, which is also important for the heart failure prevention.

Aim. To study the functioning of the prooxidant-antioxidant system and immune defense in the treatment of dental caries in children with psychoneurological disorders in different age groups.

Materials and methods. Biological material for the study was oral fluid of patients with tooth decay, with neuropsychiatric disorders (n=84 children) and without comorbid pathology (n=47 children), the control group was 45 people. An evaluation of the severity of the disturbances in the prooxidant-antioxidant system in the oral fluid was carried out by determining the intensity of chemiluminescence in the maximum and the area of the outbreak, as well as the overall antioxidant activity characterizing the state of the antioxidant system. Among the indices of the enzyme link of antioxidant protection, the activity of superoxide dismutase, catalase was determined, and in addition, the integral index of the functioning of antiradical protection enzymes was calculated. Investigation of the state of local immune defense was carried out by determining the content of proinflammatory and pro-inflammatory interleukins, and also assessing the level of lactoferrin.

 Conclusion. The functioning of the prooxidant-antioxidant system and the regulation of immune defense in children with psychoneurological disorders in different age groups have a number of characteristics with which the clinical indices correlate. The use of complex dental care ("Multistep" regulations) allows more complete rehabilitation of patients and achieving significantly better results in normalizing the biochemical state of the oral fluid.

Aim. Improvement of surgical treatment results of patients who underwent cystectomy and orthotopic bladder replacement with an intestinal reservoir by forming antireflux ureterocystoanastomosis.

Materials and methods. With the help of this method we have performed 18 surgeries on patients aged 50-68. The period of treatment has been from 1 to 48 months. Indications for surgery: bladder cancer сT2NoMo. All reservoirs have been formed with the application of the intestine detubularization principles. The follow-up of the patients was conducted after 1, 3, 6, 12 months and further after six months. Anatomical and functional state of the urinary reservoir, the upper urinary tract (ultrasound, spiral computed tomography with contrast, mictional cystourethrography and dynamic radioisotope renography) was checked and controlled; laboratory tests were done.

Results.Theobtainedpreliminarydataarenotinferiorineffectivenesstoothermethods. Concavitiesureterocystoanastomosis has full patency and all the functions of the antireflux mechanism.

Conclusion. The developed method of ureteroneocystostomy has a reliable antireflux mechanism that allows using it in situations when it is necessary to perform the transplant of one or both ureters into the intestinal reservoir.

Aim.To determine the transcranial electrostimulation effect on stress resistance of students, according to N.V. Kirsheva, N.V. Ryabchikova test.

Materials and methods. 127 medical students (50 boys and 77 girls aged from 19 to 22) were observed. All the students were practically healthy. They were divided into the main group (78 people) and the comparison group (49 people). The students of the main group underwent transcranial electrostimulation (TES): 22 people got 2 sessions a week, 56 people got 5 sessions a week. The level of stress resistance in the main group was determined according to N.V. Kirsheva, N.V. Ryabchikova test before and after TES. In the comparison group, the level of stress resistance was determined the same way. TESs were conducted with the Transair-03 apparatus. The results of the study were determined for the normal distribution using the computer program "STATISTIKA 6.0" and processed with parametric methods.

Results. In the comparison group subjects had moderate and low levels of stress resistance. There were no significant changes in the levels of stress resistance in the initial state and a week later. After two TES sessions the number of students with average level of stress-resistance decreased by 3 people, and the number of students with high level of stress resistance increased by 3 people. There were no statistically significant differences in the level of stress resistance. During five TES sessions the level of stress resistance in 26 people increased from medium to high. Number of points after TES decreased by 10.3%, which indicated an increase in the level of stress resistance. No gender differences were taken into account. The interpretation of the test results by NV. Kirsheva, N.V. Ryabchikova showed high level of stress resistance in 13 subjects at a level "above average", "high" in 2 subjects. After 5 TES sessions, 15 subjects had "higher than average" level, 19 subjects had "high" level, 7 subjects had "very high" level.

Conclusion. Thus, there is a reliable increase in stress resistance in practically healthy medical students of both sex at the end of the academic year after 5 TES sessions a week. Subjects who had medium and high levels of stress resistance before TES got high level of stress resistance after TESs, which also changed qualitatively: "proper high level" increased and "very high level" of stress resistance appeared.

Aim. To determine the correlation between the degrees of ventricular rate (VR) change achieved as a result of drug therapy and life quality in elderly patients with permanent atrial fibrillation (AF).

Materials and methods. The study included 54 patients aged 82.3±7.1 (M±SD) diagnosed with permanent AF and a selected strategy of long-term VR control. The symptoms in all patients enrolled in the study required adjustment of VR control. Patients’ life quality was assessed based on the questionnaire "Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) Questionnaire" and "EQ-5D-5L" system with a visual analogue scale (EQ-VAS): before selecting the drug therapy for VR control and after its administering. The study included patients who underwent beta-blocker VR-reducing therapy. According to VR value, patients were split into 2 subgroups: with the baseline VR value > 90 beats per 1 minute (beats/min) and a reversible bradycardia (< 60 beats/min) caused by an inadequate dose or an improper combination of control drugs in whom the "adequate control range" (60-100 beats/min at rest) approved by 2016 ESC recommendations was successfully achieved by beta-blocker dosage adjustment. The dynamics of patients’ VR values was observed by electrocardiography at rest – the degree of VR changes against the therapy background was expressed in percentage of the original value. The correlation analysis was made between the degree of VR changes resulting from drug treatment and the degree of life quality indicators improvement in patients (increase in scores of the AFEQT questionnaire and EQ VAS, expressed as a percentage of baseline values).

Results. The most expressed direct correlation was observed between the degree of VR reduction achieved as treatment effect in patients with baseline VR > 90 beats/min with percentage increase of the total score of AFEQT questionnaire. Of all subject subgroups of this questionnaire, "Symptoms" and "Daily Activity" subgroups were the most apparent to correlate with VR decrease. The reverse correlation was observed between the degree of VR increase after selecting the adequate control therapy in patients with baseline VR < 60 beats/min and improvement of the total AFEQT score as the treatment outcome. The strongest reverse correlation was observed between VR increase percentage and score improvement in "Daily Activity" subgroup. The correlation between the EQ-VAS score increase in EQ-5D-5L system and VR change level due to therapy was insignificant, and that can be justified by the non-specific nature of this life quality assessment tool and the dominance of underlying disease impact on patients' answers.

Conclusion. As a result of the study, the correlation relationship was established between the degree of VR change and life quality improvement in elderly patients with permanent AF after selection of VR control therapy. For the baseline VR value > 90 beats/min, this relationship is positive. For reversible bradycardia, the correlation between the degree of VR increase as a treatment result with life quality improvement in elderly patients is negative. The most significant life quality improvement after therapy adjustment was achieved with VR value increase by a minimum of 8.3%. The survey examination of elderly patients while selecting the VR range, life quality assessment is appropriate to be included according to AFEQT questionnaire score that correlates with VR value (the total score, the scales "Symptoms" and "Daily Activity").

Aim. The aim was to study the morphological characteristics of the testes of experimental animals during the period of pronounced senile changes at artificial suppression of the immune system.

Materials and methods. The study was carried out on 60 white rats with pronounced senile changes. Immunosuppression was modeled by cyclophosphamide at a dosage of 1.5 mg/kg body weight intramuscularly for 10 days. The rats were taken out from the experiment under ether anesthesia at 1, 7, 15, 30 and 60 days after discontinuation of the drug administration. The organs were weighed, the relative mass was calculated, the linear dimensions were determined, the volume of the organ was calculated from the volume formula of the ellipsoid. The larger and smaller diameters, the area of the convoluted seminiferous tubule, the height and the area of the epitheliospermatogenous layer were measured, the spermatogenesis index was calculated, the amount of the sustentocytes and interstitial endocrinocytes, and the volume of their nuclei were determined.

Results. Statistically significant differences in the data were established on the 15th and 30th days of the observation, whereas on the 1st, 7th and 60th days there were no significant differences. The conclusion. In response to long-term immunosuppression, there is an active reaction from the testes of the animals during the period of pronounced senile changes. Statistically significant differences in the organometric parameters are due to the direct cytotoxic effect of cyclophosphamide on rapidly dividing organ cells and systemic hormonal imbalance. The data of micromorphometric examination, as well as cytometry and kariometry, confirm the results of organometry and are explained by the disregulation of local immune and endocrine homeostasis of testes after prolonged immunosuppression.

Aim. To assess the efficiency of combined antihypertensive therapy in patients with arterial hypertension and obesity depending on the polymorphism of CYP2C9 gene.

Materials and methods. Patients with uncontrolled arterial hypertension (1-2 stage) and obesity were included in our study. They were randomized by the method of "converts" into two groups: the first group (n=70) took the fixed-dose combinations of the valsartan and amlodipine and the second group took the fixed-dose combinations of the perindopril and amlodipine. Blood pressure of all patients was measured according to the recommendation for diagnosis and treatment of arterial hypertension (ESH/ESC, 2013) before and after 8 weeks of the initial treatment. All tested people had venous blood sampling succeeded by DNA extraction and amplification in real time mode polymorphic variants CYP2C9 gene. The improvement of health self-esteem by QALY was determined like increase of index from initial by 10 % and more.

Results. It is shown that people with heterozygosis polymorphisms *1/*2 and *1/*3 reached the target level of arterial blood pressure after 8 weeks of combined therapy of valsartan and the amlodipine (93,1% against 57,1% respectively). In addition to the above, the frequency of reaching the target level of the arterial blood pressure in the group of tested people who get angiotensin II receptor blocker and calcium-channel blocker was for certain higher among the patients with polymorphisms *1/*2 and *1/*3 in comparison with the polymorphic variants CYP2C9 gene (91,3% against 57,1% respectively). The improvement of the health self-esteem by QALY of the tested patients with polymorphisms *1/*2 and *1/*3 CYP2C9 gene is seen more often between the patients of the first group than between patients of the second group (95,6% against 66,7% respectively).

Conclusion. Determined interrelation between the efficiency level of the combined antihypertensive therapy with the CYP2C9 gene polymorphism can be considered in cases of insufficient effect of assigned therapy or the uncontrolled character of the arterial hypertension. In our opinion, appropriate personalized correction of therapy will contribute to its optimization relating to the patients with arterial hypertension and obesity.

Aim. To assess the efficiency of combined antihypertensive therapy in patients with arterial hypertension and obesity depending on the polymorphism of CYP2C9 andCYP11B2 genes.

Materials and methods. 80 patients with obesity and concomitant uncontrolled medicamentally arterial hypertension (1-2 stage) were included in our study. These patients took the fixed dose combination of the valsartan and amlodipine in a dose of 80-160/5-10mg per day. Blood pressure of all patients was measured by the procedure mentioned in the recommendations for diagnosis and treatment of arterial hypertension (ESH/ESC, 2013; РМОАГ, 2010) before and after 8 weeks of treatment. All tested people had venous blood sampling succeeded by DNA extraction from leukocytes. The amplification of the polymorphic variants CYP2C9 andCYP11B2 genes was performed in real time by means of primers and probes (Synthol, Russia) and Taq Man method (allele discrimination).

Results. It is shown that the patients with *1/*2 variant of CYP2C9 gen reached the target level of the arterial blood pressure more often than patients who had polymorphism *1/*1 (92,8% against 47,3%) while analyzing the efficiency of the treatment with account of the polymorphic variants of CYP11B2 gene the reaching of the target level of the arterial blood pressure was seeing more often in the case of mutant polymorphism *2/*2 then in the case of *1/*2 polymorphism (76,5% against 50%). It was also determined that the accurate predominate of *2*2 polymorphism CYP11B2 gene over other its variants was seeing among the patients with more frequent polymorphism of CYP2C9 − *1/*1 who reached the target level of the arterial blood pressure after 8 weeks of the therapy.

Conclusion. The interrelation between the antihypertensive combination of valsartan and amlodipine with the polymorphism of CYP2C9 and CYP11B2 genes witch was determined in our study can be considered in cases of the treatment of the patients who suffer from arterial hypertension and obesity. Probably, new usage of the genetic testing results as one of the individualized medicine direction may promote the optimization and effectiveness of the combined medical treatment among the patients with arterial hypertension and obesity.

Aim. The main aim of our research is to study the effectiveness of anti-VEGF therapy in the treatment of retinal vein occlusions.

Materials and methods. The study included 124 patients aged between 23 to 66, an average of 54.3±8.9 years old who were on an outpatient and inpatient treatment in the ophthalmologic department of the V.K. Gusak Institute of Emergency and Reconstructive Surgery from 2011 to 2016. We have formed two groups. The comparison group included 66 patients who received standard therapy in the form of local anticoagulant and anti-edematous therapy, disaggregants. To improve microcirculation and with a decongestant purpose, rheopolyglucin was administered intravenously, and intramuscular injections of actovegin were prescribed with an antihypoxic purpose. With edema of the macula and the development of newly formed vessels – laser coagulation, intravitreal or subtenon introduction of trimacionolone. The main group included 58 patients who, in addition to standard therapy, were given the drug Eilia (aflibercept) intravitreally 2 mg in 0.05 ml. Treatment with aflibercept for intravitreal injections started with one injection once a month for the next five months, with a further transition to one injection every two months, with no monitoring required between the injections.

Results. When post-thrombotic neovascular glaucoma occurred, the concentration of TGFα in the lacrimal fluid increased by 1.7, and TGFβ by 28-fold. When the branch of the central vein of the retina is occluded according to the ischemic type, the systolic and diastolic blood flow velocity in the retina decreases. With coherent optical tomography with the function of angiography, admission in both groups showed significant macular edema, non-perfusion zones of the retina, a decrease in the density of the capillary network in the inner layers of the retina in angio-OCT, and 3 patients with angio-OCT visualized newly formed vessels in the nonperfusion zone.

Conclusion. In the group with the use of anti-angiogenic drugs, earlier restoration of the visual fields and reduction of neoangiogenesis were noted.

Aim. To study the dynamics of survival of patients with colorectal cancer in the Krasnodar region for the period of 2006-2015

Materials and methods. Patients are divided into groups: registered in 2006, 2009, 2012, 2015. According to the Regional Population Cancer Registry, a comparative analysis of the long-term outcome of treatment of 9,741 patients was conducted by groups.

Results. In patients with newly diagnosed colorectal cancer for the past 10 years, a significant increase in the three-year observed, as well as a three-year and five-year adjusted survival rate over the entire follow-up period, was obtained. For all stages of the disease and overall, the observed and adjusted survival rates declined for the first four years after the diagnosis was established, this result was most significant in patients with stage III and IV cancer. An unfavorable prognosis of survival was obtained in patients with stage IV: one-third survive less than a third of patients, the five-year life expectancy in this group was 9.8%.

Conclusion. Improving the survival rates of patients with colorectal carcinoma indicates an increase in the effectiveness of providing specialized care for patients with colorectal cancer in the region

Aim. To determine the significance of the study of neopterin as a marker of the endo-genetic toxicity syndrome in patients with myocardial infarction on the background of chronic obstructive pulmonary disease.

Materials and methods. 64 patients with cardiovascular and respiratory pathology and 29 somatically healthy individuals of the Astrakhan region as the con-controlling group were examined. Patients were divided into 3 groups: the first 20 patients with myocardial infarction, the second group – 21 patients with chronic obstructive pulmonary disease and the third 23 patients with a combination of these diseases.

Results. In patients with chronic obstructive pulmonary disease in combination with infarction of myocardium revealed the highest values of neopterin in blood serum in comparison with patients with monoiodotyrosine and somatically healthy individuals. Comparison of the values of neopterin with a number of recognized clinical and laboratory markers of endogenous intoxication revealed a positive correlation with heart rate, lactic acid, leukocyte index of intoxication and the ratio of neutrophils/leukocytes.

Conclusion. In the course of the study, the clinical diagnostic value of the study of neopterin as a marker of endogenous intoxication in patients in Parkton myocardial on the background of chronic obstructive pulmonary disease has been proved.

Aim. To assess the features of diurnal blood pressure profile, arterial stiffness and central aortic pressure in patients with arterial hypertension (AH) and prediabetes.

Materials and methods. The study included 118 patients with AH, 38 without prediabetes, 80 with prediabetes, 48 of them patients with impaired fasting glucose and 32 patients with impaired glucose tolerance. Prediabetes was determined by the results of an oral glucose tolerance test. All patients underwent 24-hour blood pressure monitoring the main parameters of arterial stiffness and central aortic pressure were determined using the BPLab Vasotens complex of OOO «Petr Telegin» (Russia).

Results. The obtained data showed that in patients with hypertension and prediabetes there were recorded increased levels of systolic and pulsatile blood pressure in the brachial artery and aorta, a more pronounced "pressure load" was detected compared to patients without prediabetes. At night, the level of diastolic blood pressure in the brachial artery and aorta, the diastolic pressure time index was higher than in patients with AH without prediabetes. Pathological type of the "non-dipper" curve was detected 2.5 times more often in patients with AH and prediabetes. Moreover, the pulse wave velocity, the augmentation index in the brachial artery and aorta characterizing the stiffness of the vessel wall were significantly higher in hypertensive patients with prediabetes.

Conclusion. Thereby, in patients with AH in combination with prediabetes, unlike patients without prediabetes, there were more pronounced changes in the parameters of the diurnal blood pressure profile, arterial stiffness and central aortic pressure including the pulse wave velocity, the augmentation index and pulsatile pressure which are known to be sensitive indicators of target organ damage and are associated with an increased risk of developing cardiovascular and cerebrovascular complications.

Aim. The purpose of the study is to evaluate the clinical effectiveness of the use of the domestic preparation for deep fluoridation "Fluor Lux" (TechnoDent, Russia) in prevention of enamel caries.

Materials and methods. The clinical studies have been conducted on the basis of the Department of Therapeutic Dentistry and the Dental Polyclinic of the FSBEI HE KubSMU of the Ministry of Healthcare ofRussia. In total, 50 volunteers aged 20-30 with different levels of oral hygiene have taken part. To estimate the effi of remineralizing action with the preparation for deep fl "Fluor Lux", (TechnoDent), volunteers have undergone the enamel resistance test (ER-test) according to V.R. Okushko and the acid biopsy of the enamel according to the method of V.K. Leontiev and V.A. Distel. The comparison of the indices of the acid enamel biopsy and the enamel resistance test in the study groups has been carried out using the Student's test. 

Results. One of the determining factors for the effectiveness of the enamel remineralization is the adherence to the individual oral hygiene. The results of the acidic enamel biopsy and the enamel resistance test in the first group of patients with the hygiene level OHI-S = 0-1,67 have indicated the effectiveness of the use of the drug "Fluor Lux" remedy (TechnoDent, Russia) for deep fluoridation of the enamel in the caries prophylaxis program. In the second group of patients (insufficient and poor OHI-S levels = 1,7-3), in 3 months, no statistically significant changes in the estimated parameters have been detected. The level of total calcium (Ca²⁺) in the enamel biopsy samples has decreased, but these changes have been statistically insignificant (p>0,05). The content of the inorganic phosphonate (PO4)³unlike Ca²⁺ has significantly decreased in the enamel biopsy samples (p*<0,05). The changes in the ER-test have been statistically insignificant (p>0,05).

Conclusion. Thus, the obtained results of the study make it possible to recommend the deep fluorination with the "Fluor lux" remedy (TechnoDent, Russia) in order to increase the effectiveness of prophylaxis of caries enamel. However, one of the determinants for the effectiveness of enamel remineralization is the adherence to the individual oral hygiene.

Aim. To assess the effectiveness of preventive, diagnostic and therapeutic work of the oncological service of Krasnodar Region, analyze the epidemiological features of morbidity, mortality, indicators reflecting the diagnosis (the proportion of early detection, neglect) in patients with melanoma skin cancer for the period 2007–2017, and the survival of cancer patients in Krasnodar Region for the period 2007–2016.

Materials and methods. Subjects of the study were patients with newly diagnosed melanoma skin cancer in Krasnodar Region for the period 2007–2017. Using an automated information and analytical system the Population Cancer Registry, survival of 3 961 patients with melanoma skin cancer for the period 2007–2016 was analyzed. Standardized rates of morbidity and mortality were calculated according to the accepted world standard with the same age groupings. Statistical processing of data according to the studied indicators was carried out using statistical software packages Statistica. The reliability of the difference in the relative indicators was determined by the t test of the Student, the significance level was adopted as p <0.05.

Results. For the period from 2007 to 2017, there has been a significant trend towards an increase in the incidence of melanoma skin cancer of the population of Krasnodar Region. The incidence of melanoma skin cancer in Krasnodar Region is higher than the average for the Russian Federation, which may be due to the presence of an increased level of insolation. During the analyzed period there has been a decrease in the indicator of neglect. With the increase in the stage of melanoma skin cancer, the survival rates both in general among all the diseased and among patients of working age are decreasing. The highest rates of observed and adjusted survival in patients with melanoma skin cancer reduce in the first three years from the date of diagnosis. The indicators of the observed and corrected survival of men of working age with melanoma skin cancer are lower than in women of working age. The indicators of the observed and corrected survival of women of working age with melanoma skin cancer are higher than among the population of all age groups.

Сonclusion. The study showed a high level of early diagnosis and quality of treatment for patients with melanoma skin cancer in the Krasnodar Region, as positive trends in the rates of observed and adjusted survival of patients were noted.

Aim. The aim of the research was to study the features of mild cervical dysplasia (CIN I) and determine the management of patients with such abnormal cytological results found in cervical screening against bacterial vaginosis and HPV infection. Materials and methods. The study included 252 patients aged 19 to 35. Ill-defined cells were detected during cytological screening. All patients were divided into 2 groups. The first group consisted of 93 patients with ASC-US cytological Bethesda classification results. The second group included 159 women with LSIL cytological Bethesda classification results. PCRdiagnostics was performed to determine qualitative and quantitative composition of genital tract microflora. The presence of 16th, 18th, 31st, 33rd, 35th, 39th, 45th, 51st, 52nd, 56th, 58th, 59th types HPV was detected. Patients with HPV-infection underwent widened colposcopy with evaluation of the grade of abnormal colposcopy findings.

Results. In the 1st group the bacterial vaginosis was diagnosed in 83,9% of women, HPV – in 39,7%, trichomoniasis – in 7,5% of patients. In the 2nd group bacterial vaginosis was diagnosed in 64,8% of patients, HPV – in 78,0%, trichomoniasis – in 2,5%. In the 2nd group the incidence of abnormal colposcopy findings was twice higher than in 1st group. Patients underwent uterine cervix biopsy. Biopsy material was subjected to histological investigation. In the 1st group (n=22) 50,0% of patients had mild cervical dysplasia (CIN I), 9,1% – had moderate cervical dysplasia (CIN II). In the second group (n=61) 68,8% of patients had mild cervical dysplasia (CIN I), 9,83% – had moderate cervical dysplasia (CIN II). Patients of both groups were treated for 3-6 months. They underwent control cytological and microbiological studies after the treatment. The recurrence of bacterial vaginosis was 4,3% in 1st group and 14,0% in 2nd group. In 1st group 16,43% of patients had HPV positive test; it was positive in 19,5% of women of 2nd group. LSIL cytologicalBethesda classification results were in 1 (1,1%) patient in the 1st and in 5 (3,1%) patients in the 2nd group.

Conclusion. Bacterial vaginosis is an additional factor of progression of dysplasia in patients with HPV positive test. Patients with LSIL and ASC-US cytological Bethesda classification results need correct antibiotic therapy which should be followed by control cytological studies and HPV test. These are the main ways of cervical cancer prevention.

Aim. To conduct a comparative analysis of existing methods for measuring the angles of inclination of tooth and determining the torque of teeth with orthognathic occlusion.

Materials and methods. Inclination angles were measured in 137 patients with physiological occlusion and the standard values of the torques of permanent teeth. Four methods of investigation were used to measure tooth torques. In the first method, the angle of the inclination formed by the occlusal plane and the conditional middle vertical of the tooth was measured by the protractor on the incisions of the plaster models of the dentition rows. The second method, which allows evaluating torques and teeth angulation at the same time, was carried out with the aid of the «Arco-zet» apparatus of «Scheu Dental GmbH». As the third method of research, the technique of analyzing images of cone-beam computed tomography was used, on which linear and angular reference points were applied. The fourth method of investigation was based on the results of scanning gypsum models with a laser scanner "ORAPIX" with the subsequent creation of a digital three-dimensional image and the formation of a virtual Set-Up model in the file "ORAPIX" 3Txer 2.5.0.

Results. All methods of measuring the angles of teeth in the vestibular-lingual direction can be applied both in the applied and in the clinical aspect. Determining the torques of permanent teeth using the morphometry of gypsum models of dentition and instrumentation method is characterized by laboriousness, length of studies, and also the presence of errors in measurements. Methods for analyzing images of cone-beam computed tomography and using the virtual diagnostic SetUp model in the ORAPIX file 3Txer 2.5.0 are high-tech, precise, and reproducibility and interpretation of the results allows using the available angular and linear parameters for assessing the effectiveness of conducted orthodontic activities at all stages of treatment.

Conclusion. The introduction into clinical orthodontics derived from research boundaries reference values and confidence intervals inclination angles of the upper teeth, the lower jaw, as well as tilt incline of teeth of antagonists will reduce the time required for the early stage diagnosis and increase the effectiveness of the test results of orthodontic treatment. Improvement of existing methods of diagnosis of dentoalveolar anomalies has led to the creation of high-tech, precision, computerized measurement methods, the introduction of which will allow not only minimizing errors associated with instrumental measurement techniques in the structures of the maxillofacial region, but, due to the predictability of orthodontic treatment, achieving optimal functional – aesthetic results.

The article discusses diagnostics and differential diagnosis of chronic autoimmune pancreatitis combined with IgG - associated cholangiopathies, including with lesions of other organs, as in IgG4-systemic diseaseT

Aim. Based on the analysis of the scientific literature sources, the authors aimed to summarize and present the existing information about the role of parathyroid hormone-related protein (PTHrP) in pathogenesis of disorders of bladder contractile function.

Materials and methods. Analysis of literature in databases Google Scholar, Scopus, Web of Scence, PabMed for the whole time period of studying the stated problem.

Results. In the recent years, one can observe a growing interest to dysfunction of bladder with insuffi contractile activity of detrusor. The low level activity of bladder can be often observed, while its diagnostics and treatment remain problematic. The existing ideas about the role of parathyroid hormone-related protein (PTHrP) in regulation of bladder’s functional condition are based on the results of few and mostly experimental research studies. It is proved that PTHrP secretion is induced in bladder as a result of bladder stretching, and prevents spontaneous contraction of detrusor’s smooth muscles, which has PTH/PTHrPreceptors, and also reduces contraction amplitude of bladder. It was stated that increased PTHrP secretion in response to the stretching smooth muscles is a part of autocrine effect, relaxing the bladder during its fi The existing scientifi data show that PTHrP is a unique endogenous detrusor relaxant, which functions by means of PTH/PTHrP-receptors located in bladder. It is assumed that PTHrP can also have a paracrine effect on vessels that regulate the blood fl bladder fi or can change neural activity. Thus, PTHrP is a powerful endogenous relaxant of bladder contraction, while autocrine or paracrine mechanisms of this effect are physiologically relevant processes happening in bladder. It is assumed that disturbed binding PTHrP with its receptor can be part ofpathogenesis of bladder disorders. In our opinion, the infl of chronic high PTHrP level in blood fl on the detrusor muscle structures can be also considered as one of the reasons that cause functional insuffi of bladder. This assumption is based on comparison of the PTHrP-effects on the bladder functional condition, presented in the experiment, as well as in the few clinical studies. Direct infl targeting the interaction of PTHrP with its specifi PTH/PTHrP-receptor is considered as a potential therapeutic approach to treat pathological conditions related to disorder of bladder contractile function.

Conclusion. The literature survey covers general ideas about functional insufficiency of bladder, as well as information about the role of PTHrP in its development. The studied problem is rather relevant and frequent in the population, and besides being seen as a urological pathology, it is associated with a considerable reduction of the quality of life for patients. More detailed clinical studies will let us specify the diagnostics criteria of this syndrome and develop the schemes for pathogenetic therapy.

A retrospective analysis of the world mortality of divers in water was carried out. It is shown that irrespective of the country of origin, the main cause of death is drowning, which is the result of other fugitives behind it. One of these states is panic which develops because of low stress resistance. It is proposed to conduct a study of the stress resistance of divers in the pre-start period to assess their regulatory and adaptive capabilities and with the issuance of subsequent recommendations on the possibility of diving at a given time.

Aim. To acquaint practical health care doctors with clinical display, modern diagnostic methods and treatment techniques of patients with uncommon genetically determined vascular disease, mainly affecting lower limbs vessels – KlippelTrenaunay syndrome.

Materials and methods. The retrospective analyses of anamnesis data, clinical course, laboratory results and instrumental research methods are made, treatment techniques of patients are determined.

Results. Klippel-Trenaunay syndrome is a form of systemic genetic phleboangiosis. Anomaly is diagnosed at birth based on clinical symptoms or infant development, when typical symptoms of diseases are visible. Promptly made instrumental research helps to estimate affection severity of bloodstream, to specify concomitant anomaly in order to choose the most effective treatment method (conservative or surgical).

Conclusion. Knowledge of clinical display, differential diagnostics and prompt treatment techniques for patients with Klippel-Trenaunay syndrome are performed, these data are important for all levels of medical aid to save life quality.

Aim. To present a clinical case of pregnancy and delivery in infants with a favorable outcome for mother and fetus. Materials and methods. Individual medical cards of pregnancy have been studied, examination and delivery of a patient with a rare severe extragenital pathology – miastenia have been carried out.

Results. Favorable outcome of pregnancy and delivery, both for the patient and her newborn baby.

Conclusion. Despite the fact that myasthenia gravis is a severe disease with an unpredictable disease course, delivery in such cases can be favorable. For positive outcome, dynamic monitoring of the obstetrician and neurologist is required throughout pregnancy and postpartum periods, including patients in compensation stage. Cooperative management of such women and timely correction of deviations in the course of the disease can lead to the birth of healthy generation as a result of which such patients won’t be deprived of joys of motherhood. 

The article presents the results of the historical and biographical research of the personality of the outstanding scientist, innovator of the methods of treatment of temporomandibular joint diseases – Yuri Artemovich Petrosov.

The development of neurosurgery in the Kuban region is connected with the work of Professor V.A. Polyansky, who implemented in practical health care vertebral angiography for tumors of posterior cranial fossa, first in the Northern Caucasus, deleted cysticercus of IV ventricle of the brain. Principles of peritonitis treatment and infusion therapy described by V.A. Polyansky in the 70s of the 20th century, have not lost their relevance to the present day. In addition to surgical interventions and development of optimal methods of abdominal drainage, peritoneal dialysis, infusion therapy and parenteral nutrition were used; methods of dealing with paralysis of the gastrointestinal tract and an increase in intraabdominal pressure were examined.