Aim. To explore preventive measures aimed at risk factors that affect the development of chronic non-communicable diseases of people working in enterprises.

Materials and methods. The study was based on questionnaires completed by employers and leaders of trade union organizations.

Results. Forms of preventive measures and incentives were suggested for employers to encourage workers to form and be committed to a healthy lifestyle.

Conclusion. Implementing of preventive actions used in enterprises to promote and preserve health of people working in the territories of the South and North Caucasian FD is only possible when the employers and managers of the trade union organization have a responsible attitude to this issue.

Aim. To find out gender features of anthropometric characteristics, to define average index value of stress resistance of young teenagers living on the territory of Krasnodar Krai and the Republic of Kabardino-Balkaria.

Materials and methods. Data on body height, weight, arterial blood pressure and pulse of 140 children (70 girls and 70 boys) at the age of 13,2±1,6 years living in the Republic of Kabardino-Balkaria as well as 137 children (70 boys and 67 girls) at the age of 13,4±0,1 year living on the territory of Krasnodar Krai (The Belorechensk and Crimean Districts) are collected and subjected to the statistical analysis. The appropriate number of heartbeat, total body area, the level of endured stress were determined by the formulas developed by Yu.R. Sheykh-Zade. Digital material is processed by the method of variation statistics in the Microsoft Excel program.

Results. The carried-out statistical analysis showed that anthropometric parameters are lower in thirteen-year old boys living in the Republic of Kabardino-Balkaria than in inhabitants of various parts of Krasnodar Krai: body weight (47,63±1,75 and 52,56±1,02 kg respectively), body area (14279,54±176,54 and 15109,95±181,67 cm2 respectively), index of body weight (19,12±0,21 and 20,43±0,30 c.u. respectively). Girls at the age of thirteen living in the Republic of KabardinoBalkaria have lower physiological parameters in comparison with inhabitants of Krasnodar Krai: the appropriate number of heartbeat (68,31±0,54 and 70,78 ±0,39 min-1 respectively), stress resistance index (1,14±0,23 and 1,28±0,05 c.u. respectively).

Conclusion. Gender differences of anthropometric and physiological parameters in children of the early teenage period between the stated regions (Krasnodar Krai and the Republic of Kabardino-Balkaria) are determined.

Aim. To estimate the effect of reflexotherapy and standard pharmacological therapy on quality of life in patients with chronic tension-type headache (CTTH).
Materials and methods. 95 patients (16 men and 79 women) with CTTH have been taken as the object of research. All patients were divided into two clinical groups. Patients of group 1 received amitriptyline 35-70 mg/day and tolperisone 450 mg/day. Patients of group 2 were assigned to 2-4 courses of injecting reflexotherapy according to the suggested methodology. The intensity of headache was assessed on the basis of scores on the Visual Analogous Scale (VAS). The quality of life was evaluated in all the patients with the aid of the SF-36 survey.
Results. In both clinical groups there was decrease in quality of life in all scales except physical function (PF). All patients positively evaluated the results of the treatment. The intensity of pain reduced to 1,7±0,78 points (p<0,05) in the 1st group and 1,65±0,79 (p<0,05) in the 2nd group. As a result of the treatment, quality of life improved significantly in all scales except social function (SF). This index didn't statistically differ in both groups (p>0,05).
Conclusion. CTTH significantly affect physical and mental components of patients’ health. The results obtained from the study showed the potential use of injecting reflexotherapy as treatment for CTTH.

Aim. To improve the diagnosis of allergic skin diseases in children
Materials and methods. 135 children aged from 2 to 6 with atopic dermatitis were examined during exacerbation. They were on inpatient treatment in the skin and venereologic department of the Regional skin and venereologic dispensary and the Department of Allergology of the Regional children's clinical hospital. At the same time, 103 people (the main group) had uncomplicated course of the disease, 32 patients had complications of atopic dermatitis in the form of secondary infection. The control group consisted of 29 children aged 2 to 6. Neopterin in serum was determined by enzyme-linked immunosorbent analysis using test kits "Neopterin ELISA" (Germany). Statistical reliability of the obtained data was evaluated using The Student's test.
Results. Atopic dermatitis in children, regardless of clinical manifestations, is accompanied by an increase in the content of neopterin in serum. The nature of the increase in the level of neopterin is determined by the duration of the disease, while its highest values are characteristic of the prolonged course of the process (over 4 years).
Conclusion. The determination of neopterin in children with atopic dermatitis is a promising laboratory method for assessing the severity of dermatosis, monitoring and forecasting the further course of the process, as well as evaluating the effectiveness of therapeutic measures.

Aim. To analyze options for treatment tactics for open fractures of bones, implemented in a regional trauma system in the
Krasnodar Territory.
Materials and methods. Retrospective analysis includes the results of treatment of 82 patients with polytrauma and severe open fractures of the shin bones aged from 18 to 60 years, of whom 23 in unstable or critical condition, hospitalized in 2016-2017 in the Scientific Research Institution – S.V. Ochapovsky Regional Clinical Hospital № 1.
Results. Treatment tactics for patients with severe polytrauma and open fractures type IIIA and B according to the classification of Gustilo-Andersen adopted in trauma center of level I, reduces the total number of infectious complications to 9,09% for fractures of type III A and 53,84% of IIIB fractures compared to option treatment strategies adopted in trauma centres II, III where the level of infection reaches 58,06% fractures type III A and 93,75% of IIIB fractures. The typical mistakes made in primary surgical treatment in patients with polytrauma and severe open fractures were revealed: incomplete revision of the wound with leaving foreign bodies, non-viable soft tissues, unstable fixation of the fracture with the help of a skeletal traction system, incomplete external fixation of the fracture with a device or plaster bandage, suturing of the wound with relaxing skin incisions during soft tissue swelling, absence of drains or passive drainage of the open fracture.
Conclusion. The usage of primary surgical treatment in a reduced volume, with the application of VAC-dressings, in patients with polytrauma and severe open fractures of the limb bones can reduce the overall incidence of infectious complications.

Aim. To assess the adaptive capacity of newborns who have had intrauterine blood transfusions.
Materials and methods. The study included 40 newborns who underwent intrauterine intravascular blood transfusion due to hemolytic disease of the fetus RH-factor.
Results. The percentage of antenatal fetal losses in hemolytic disease is significantly reduced. Intravascular blood transfusion allowed the fetus to prolong the pregnancy for at least 32 weeks. Survival of newborns with hemolytic disease has significantly increased. Conducting intrauterine blood transfusions leads to a decrease in the frequency and multiplicity of postpartum blood transfusions.
Conclusion. With timely delivery and adequate use of high-tech methods of treatment, both intrauterine and postnatal, it is possible in 88% of cases to preserve the life of the newborn with satisfactory rates of physical and neuropsychological development.

Aim. To evaluate the effectiveness of the developed special sports complex in the prevention of hypodynamia and obesity among firefighters-rescuers.
Materials and methods. A survey of 490 men with no history of chronic infectious and non-infectious diseases aged 20-59 was conducted. 328 people were the main group, 162 people were the control group. The baseline data included anthropometric development indicators, bioimpedance test results, the extraction of biochemical blood test results; the body mass index (BMI) and the ratio of waist and hip circumference were determined. A questionnaire was conducted to identify hypodynamia (according to the IPAQ questionnaire) and the nutrition structure (according to the questionnaire on the food label literacy questionnaire, past). Both questionnaires were adapted to the Russian Federation. Statistica for Windows 8.0 was used for statistical processing. We used a comparison of the means of the Student method. To compare the values expressed in percent, the method of inverse trigonometric Fisher transformations was used.
Results. We have developed and proposed for firefighters-rescuers, included in the main group, special sports complexes, which were used for 6 months. These complexes represent additional physical training by the developed method. There are two of them: one with an emphasis on the prevention and rehabilitation of people with osteochondrosis of the lumbar spine, and the other for cervical and thoracic localization, including with a syndrome of shoulder-scapular periarthritis.
Classes were held 3 times a week, the duration of 1 session was 45-50 minutes. The choice of the complex was carried out at the request of firefighters-rescuers. The first complex was selected by 52 people. Based on the results of the study, against the background of the use of sports complexes, there was a 2-fold decrease in the incidence of obesity. Such a high efficiency is due to the fact that obesity of the I degree prevailed among the firefighters-rescuers. In addition, the frequency of occurrence of dyslipidemia, hyperglycemia, and hypodynamia decreased.
Conclusion. The use of this sports complex can reduce the risk factors for development of disability among rescue firefighters by preventing hypodynamia and reducing the incidence of hyperglycemia and dyslipidemia, as factors in the development of obesity.

Aim.To develop a technique for the detection and separation of abacavir, lamivudine, zidovudine, both individually and combined with adaptol, azaleptin, analgin, amitriptyline, haloperidol, melipramine, neuleptil, phenobarbital, fluoxetine, and chlorprotixen using high performance liquid chromatography (HPLC).
Materials and methods. A column filled with ProntoSIL-120-5-C18 AQ was used, eluting with A [0.2 M lithium perchlorate − 0.005 M perchloric acid] − water (5: 95); eluent B is acetonitrile. Chromatography conditions: a linear gradient of the solvent is 3700 μl from 5 to 70% at a flow rate of 100 μl / min. The temperature of the column was 40°C. The results were processed with the help of the computer program MultiChrome (ZAO Ampersend, Moscow).
Results. The method of separation and detection of combinations of abacavir, lamivudine, zidovudine with adaptol, azaleptin, analgin, amitriptyline, haloperidol, melipramine, neuleptil, phenobarbital, fluoxetine and chlorprotixene by reversed-phase high-performance liquid chromatography was developed.
Conclusion. The developed technique allows detecting abacavir, zidovudine, lamivudine with the help of the HPLC method after isolation from urine separately or at combined poisonings with adaptolom, azaleptinom, dipyrone, amitriptilinom, galoperidolom, melipraminom, neuleptilom, phenobarbital, fluoxetine and hlorprotiksenom

Aim. To evaluate the dynamics of cytokine status (IL-1ß, IL-4, IL-6, IL-10) and hormonal profile (cortisol, ACTH, β-endorphins) in patients with stable angina II-III functional class in the course of standard treatment and combined use of TES-therapy.
Materials and methods. All patients were divided into 2 groups: 1st (n=30) therapy of angina according to the Protocol and 2nd (n=30) combined therapy of angina according to the Protocol and TES-therapy.
Results. The results showed that normalization of the studied cytokines level in patients of the 1st group is not improved.
In the 2nd group of patients statistically the levels of the studied cytokines was significantly decreasing (p≤0.01) and the levels of ACTH, cortisol and β-endorphin were significantly (p≤0.01) increasing.
Conclusion. The obtained results suggest that TES-therapy conducted in the 2nd group of patients, contributes to the correction of cytokine imbalance and hormonal profile, which indicates the necessity of its inclusion in standard therapy of angina.

Aim. Increasing of efficacy of special medical care to patients with inflammatory intestinal diseases by means of the new organizational approaches to diagnostics and treatment.
Materials and methods. An analysis of treatment of 79 patients with inflammatory intestinal diseases in City clinical hospital Nr 2, Krasnodar from 2010 to 2012 and Regional clinical hospital Nr 2 Ministry of Health care of Krasnodar Region from 2012 to 2017 is presented. 46 patients (58.2%) had ulcerative colitis, and 33 patients (41.8%) had the Crohn’s disease.
Results. The conservative therapy was administrated to all patients depending on inflammation severity after additional examination and diagnostics. Due to the absence of therapeutical efficacy, different kinds of surgery were carried out. 34 operations were performed on patients with ulcerative colitis (12 urgent ones and 22 elective ones), 22 operations were performed on patients with Crohn’s disease (17 elective ones and 5 urgent ones).
Conclusion. An opportunely performed surgery with the use of the low-invasive technologies on the patients with inflammatory intestinal diseases allowed diminishing a frequency of surgical complications and decreasing of lethality

Aim. Evaluation of the role of vascular remodeling in the formation of structural phenotypes of osteoarthritis (OA).
Materials and methods. 62 patients with OA aged 65,9±8,8 years and 18 volunteers without clinical and roentgenologic signs of OA aged 60,7±7,9 years were examined. All patients underwent magnetic resonance imaging of knee joints. To analyze the structural changes in the tissues of the knee joint, the WORMS protocol was used for magnetic resonance imaging. The thickness of the vascular wall, the external diameter, the vascular index (VI) were measured – the ratio of the diameter of the lumen of the vessel to the thickness of the popliteal artery (PA) wall, the branch of the upper lateral artery (LA), the medial artery of the knee (MA).
Results. The analysis of the parameters of the arteries of the knee joint showed that with a subchondral OA phenotype, the thickness of the PA wall is statistically significantly larger than the cartilage phenotype, and the vascular index of the PA is significantly higher in the group of the cartilaginous phenotype. The upper LA wall was significantly thicker in the subchondral OA phenotype. VI of the upper LA was significantly lower in patients with a subchondral phenotype compared with the cartilaginous phenotype. The thickness of the MA wall was also larger with a bone phenotype, and VI with a cartilaginous phenotype.
Conclusion. The results of the study showed the relationship between vascular remodeling and structural progression of OA. Changes in the vascular wall adversely affect all joint tissues, leading to their remodeling. It was established that the degree of vascular remodeling determines the formation of structural OA phenotypes. Severe vascular changes are associated with the subchondral OA phenotype.

Aim. The aim of the study was to reveal features of vegetative dysfunction syndrome in children with exacerbation of asthma.
Materials and methods. 86 children with asthma of various severity, aged 6 to 18, were examined in this study. All patients underwent a comprehensive clinical and laboratory examination, which included anamnesis collection, physical examination, and laboratory tests, cardiointervalography study at rest and after clinoorthostatic sample. The received cardiointervalograms were processed using the software of the ANKAR-131 and Statistica 12.0 for Windows.
Results. Statistically significant increase in heart rate [as well as indicators of the Mo and AMo (p=0.001)] were recorded in patients due to clinoorthostatic sample. Indicators of stress index in children in the period of exacerbation of the disease amounted to 119.36±17.93%/s×s. The vegetative balance was in equilibrium at rest (the index of vegetative equilibrium was within 156.48±21.30%/s), while the shift in the direction of the predominance of the sympathetic department was noted after a minor orthostatic load. The increase of corresponding values of the vegetative index and the adequacy index of the regulatory processes were recorded after the sample (95.56±5.89%/s). Our studies have shown that the more severe the disease, the more significant the changes in patients vegetative parameters.
Conclusion. It was established that activation of the sympathetic regulation department and centralization of heart rate

Aim. Justification of control of reconvalescence and individual rehabilitation in women who underwent severe preeclampsia (PE). Materials and methods. A prospective, non-randomized, controlled, open-label, nosocomial study was conducted in the period of 2016-2017. 170 women participated: 100 women with severe preeclampsia (32 – with early, 68 – with late), 70 women with moderate preeclampsia. Inclusion criteria: pre-eclampsia, singleton pregnancy, which occurred spontaneously in the natural menstrual cycle. Exclusion criteria non-obstetric pathology, by competing with the severity of pre-eclampsia, multiple pregnancy without fetal cephalic presentation, pregnancy due to assisted reproductive technologies, obstetrical pathologies, necessitating premature delivery or emergency. Results. In 70% of women the gestational age was premature. 53% of women with PE were primiparous and primgravida. Due to the atypical course of PE the time interval from the suspicion of PE to its clinical verification and delivery could reach 35 days, on average – 5,88±8,76 days before being transferred to the perinatal center. Time spent in the Perinatal Center before delivery was 3.43±2.3 days for early PE, 1.9±2.28 days for the severe late PE and 3.29±2.36 days for mild PE, was comparable. In women with severe PE critical (urgent) dysfunction of the organ (s) were diagnosed: signs of moderate pulmonary hypertension, interstitial pulmonary edema, hydrothorax; stagnant phenomena of both lungs; moderate hydrocephalus; dilatation of the left atrium; diffuse changes in the liver, pancreas, kidney parenchyma; paranephric discharge; hydroperitoneum; hydrothorax; hydropericardium. Critical multiple organ disorders due to PE in combination with delivery by cesarean section after delivery demanded staying in the intensive care ward within 2.6±1.84 days in severe PE and 1.0±1.41 days in moderate PE (p>0.05). 24% of women with severe PE after delivery under the supervision of ultrasound performed a vacuum-aspiration of the contents of the uterine cavity. The maximum time spent in the Perinatal Center after delivery was 7.65±2.34 days (5-13 days). The outpatient visits to an obstetrician-gynecologist varied from the 7th to the 15th week after the delivery. In 26% of women changes remained in the fundus (retinopathy, retinal angiopathy) and 35% - neurological symptoms (encephalopathy) of varying severity. In 16% of women d arterial hypertension with values of diastolic pressure more than 90 mm Hg was preserve. Conclusion. It is necessary to ensure the rehabilitation of women who have undergone severe PE, not only after delivery in a perinatal center, but also at an outpatient stage under supervision of related specialists. In the presence of fertile plans, individualized pregravid and preconception preparation is required with consideration of the nature of the scar on the uterus undergone instrumental uterine evacuation, specialized supervision by related professionals.

Aim. Study of pathological changes in the inner ear in the modeling of sensorineural hearing loss in laboratory animals.
Materials and methods. A pilot study involving 27 laboratory animals − white outbred rats – was conducted. Modeling of sensorineural hearing loss was conducted by exposing them for 10 days to broadband noise of 90 dB, vibration and simultaneous immobilization of laboratory animals divided into 3 groups according to exposure conditions. The development of hearing loss was confirmed by the results of the registration of delayed caused emissions and emissions at the frequency of distortion products. After removing rats from the experiment histological medication from animals cochlear was produced and they were studied by the method of light microscopy.
Results. In animals exposed to noise and vibration effects on the background of immobilization, the formation of persistent sensorineural hearing loss was achieved, which was confirmed by objective registration of violations of auditory function, and also by the results of morphological study of cochlear of the temporal bones of animals. More pronounced histological changes were noted in animals exposed to noise and vibration on the background of immobilization compared with the group of rats which were exposed only to noise impact and immobilization without applying vibration. Dystrophic and destructive changes in the structures of the spiral organ, signs of apoptotic way of cell death in the inner ear were detected. In addition, pronounced changes occurred in the spiral ganglia.
Conclusion. Modeling of sensorineural hearing loss in laboratory animals on the basis of noise and vibration exposure in terms of immobilization leads to the formation of persistent sensorineural hearing loss, as evidenced by functional and morphological methods. Pathological changes in the inner ear show themselves through dystrophic and destructive changes in the spiral organ, including apoptosis of cells, and especially in the spiral ganglia. The use of this noise-vibration model of hearing loss can be a promising basis for future studies of drugs for the treatment of sensorineural hearing loss.

Aim. Improvement of the quality of medical services provided due to a precise organization of the health care quality management system, based on the implementation of the requirements of existing regulatory documents determining expert work and its subsequent automation.
Materials and methods. The quality management system in the institution is based on an active multifunctional organizational structure able to respond quickly to the detection of defects in providing medical care through the use of computerization of all areas of its activities. The automated control system of the diagnostic and treatment process proposed by us allows moving from the formal compliance with requirements established by the current regulatory documents to full management of the quality of medical care in the institution through comprehensive automation of the structure of internal quality control of medical care that ensures monitoring of all directions of the institution with the formation of automated accounting and reporting forms.
Results. The introduction into the practical work of an automated quality management system for providing medical care made it possible to reduce by 5 times the time for obtaining of operative medical information, to reduce defects caused by poor registration of medical documentation by 46%, to reduce the unjustified delay of patients in the hospital by 10%, to reduce the number of cases of repeated hospitalization , due to inadequate inpatient medical care by 11%, to minimize delays at medical sub-commission for the extension of sick leave almost to zero cases.
Conclusion. The automated control system of the diagnostic and treatment process proposed by us, in contrast to the existing ones at the present time, allows us to move from formal compliance with requirements established by the current normative documents to full-fledged management of the quality of medical care in the institution through comprehensive automation of the internal quality control structure of medical care providing monitoring of all activities of the institution and achievement of the recommended regulatory documents criteria of quality of medical care.

Aim. To define significant ultrasound and magnetic resonance imaging markers in diagnostics of the depth of chorion invasion in myometrium in pregnant women after Cesarean section was carried out.
Materials and methods. 68 pregnant women from 28 to 32 gestation weeks with Caesarian scar and placenta on the front wall of uterus were retrospectively studied. Pregnant women were divided into 4 groups depending on histologic verification of placenta invasion depth. MRI and ultrasound assessment of the lower uterine segment was carried out and the most significant US and MRI markers of placenta accreta were distinguished. Subsequently, the received results of the research were processed by algorithms of factor analysis with calculation of informativeness of each marker and with determination of the forecast of placenta accreta.
Results. As a result, group I of pregnant women scored within 0-0.9 conventional units, in group II – 1-3 conventional units, in group III – the score was 3.1-5.0 conventional units, in group IV – 5.1-7.0 conventional units. In groups III and IV are characterized by the fact of signs combination. In group III the combination of 2 signs was detected in 65% of cases, of 3 signs – in 25% of pregnant women.
Conclusion. The most informative marker of ultrasound diagnostic of placenta accreta was determination of venous lacunas in its suprabasal part (0.42), in case of MRI it was the assessment of the bladder wall (0.45). The sensitivity and specificity of ultrasonography were 86.2% and 84.8%, in MRI they were 96% and 94.4% respectively.

Aim. To examine cases of diagnose setting for cerebral commotion after road accidents within Krasnodar city, to justify the diagnose, to analyze the level of harm committed.
Materials and methods. A retrospect analysis has been done to 353 expert reports and forensic medical examination acts issued after road accidents which involved medically documented cerebral commotion. Analyzed cases have been detected by continuous sampling. Conditions taken into consideration: sex, age, circumstances, time, type of accident and type of involvement for injured people, localization and type of injury, reasons for cerebral commotion rejection from experts diagnose.
Results. As a result, 199 cases have missed cerebral commotion as experts diagnose – 63.3% of these cases missed data for dynamic neurological examination of the person aggrieved, 30.7% of cases didn’t contain objective evidence of cerebral commotion, in 3.5% of cases medical outpatient card was not provided for examination by the investigator, in 2.5% of cases cerebral commotion diagnose was cancelled by clinicians after dynamic patient follow-up. In 39% of cases cerebral commotion was diagnosed in pedestrians, in 20% of cases in car drivers, in 19% of cases car passengers were injured. In nine cases (6%) there was an accident involving motorcyclists and cyclists, 4 (3%) cases were passengers of public transport. 77% of the injured people received medical care in a hospital, 23% – on an outpatient basis. In 78% of cases with cerebral commotion there were injuries of soft tissues of the head, fractures of the skull bones were revealed in 14%. Light damage to health on the grounds of a short-term disorder is established in 45% of cases, harm to health of average severity – in 20%, serious harm – in 31%, harm to health was not determined in 4%.
Conclusion. The obtained results indicate that the diagnosis of cerebral commotion is established based on anamnesis and complaints, it doesn't reflect the objective symptoms of concussion. Dynamic monitoring of the course of craniocerebral trauma is not ensured, necessary laboratory and instrumental diagnostics are not carried out. It leads to the impossibility of taking this diagnosis into account when conducting forensic medical examination because of its unreasonableness.

Aim. The goal of the study was to assess the impact of peripheral chemoreflex sensitivity on the rate of critical incidents in extensive abdominal operations.
Materials and methods. The study included 176 patients who underwent major abdominal surgery under combined anesthesia. On the eve of surgery, sensitivity of peripheral chemoreflex was determined in all subjects. Sex, age, initial physical status, cardiovascular risk were also registered. During anesthesia hemodynamic, respiratory and metabolic critical incidents were registered.
Results. In total, 158 critical incidents were observed. They were significantly more common in patients with high sensitivity to peripheral chemoreflex (72% vs. 48%, p<0.05). The structure of critical incidents was dominated by hemodynamic, primarily hypotension, and its frequency was 2 times higher among patients with high sensitivity of peripheral chemoreflex.
The logistic regression showed that factors associated with the risk of critical incidents are high sensitivity of peripheral chemoreflex, increased age, and initially high grade of ASA scale.
Conclusion. Hemodynamic incidents are the most common in major abdominal surgery; risk factors for their development are high sensitivity of peripheral chemoreflex, increased age and deterioration of the initial physical status.

Aim. Determination of diagnostic significance of pro − and anti-inflammatory cytokines in early prognosis of posttransplant renal failure in patients with chronic renal disease.
Materials and methods. In the peripheral blood of patients with chronic kidney disease 6 hours before kidney transplantation, multiplex analysis using Simplex ProcartaPlex panel (Bioscience, USA) and xMAP technology (principle of flow cytometry) was used to estimate the content of 10 cytokines: 7 proinflammatory (IL-1b, IL-6, IL-12p70, IL-27, IL-17A, IL-18) and 3 antiinflammatory (IL-1RA, IL-4, IL-13). Identification of HLA-antibodies was carried out with the help of multiplex immunological analysis, using test systems (Gen-Prob, USA), flow analyzer Luminex 200 xMAP technology (bimolecular reactions on the surface of microspheres).
Results. The limited diagnostic significance of HLA-antibodies is due to the fact that their detection in the posttransplantation period can be either in the development of acute graft rejection, or in the favorable course of the period after the operation. Meanwhile, the determination of a number of blood cytokines before kidney transplantation allows predicting post-transplantation rejection. In particular, certain criteria favorable course of the period after kidney transplantation by absence of HLA antibodies in patients with chronic renal failure can be considered as the initial (within 6 hours of transplantation) low levels of IL1β, IL6, IL17а. Prognostically the increase in the blood levels of proinflammatory cytokines − IL6, IL17a and anti-inflammatory IL1-RA is a significant marker of acute rejection of a transplanted kidney. Along with this, it is important to note that the appearance of HLA antibodies in patients with a favorable course of the post-transplantation period is associated with an initially elevated level of proinflammatory cytokines such as Il1ß and IL6.
Conclusion. Diagnostic value of the evaluated cytokines at the pre-transplant kidney patients determines the feasibility of the inclusion of evaluation of the serum concentration of IL1β, IL6, IL17a, IL1-RA in the programme of pre-transplant laboratory tests .

Aim. To compare proportion of different microorganisms in neonatal intensive care units and to assess bacterial susceptibility to antimicrobial agents.
Materials and methods. Microbiological monitoring was carried out in neonatal intensive care units (NICU) №1 and №2 of Perinatal center of Krasnodar Region clinical hospital №2.
Results. The results of microbiological monitoring demonstrated significant difference in proportions and susceptibility of detected microorganisms.
Conclusion. The detected differences determine the need to develop protocols of empirical antimicrobial therapy separately for each medical unit.

Aim. To study the severity of cognitive and psychoemotional disorders in the outcome of treatment of the patients with cerebral aneurysms ruptures, who were admitted in a compensated condition.
Materials and methods. 57 cases are analyzed in the article. These are the cases of patients who were operated on in an acute state of aneurysmal subarachnoid hemorrhage. The severity of their state when they were admitted was 1-3 according to the Hunt-Hess scale. Depending on the results of treatment, the patients were divided into 2 groups: the first included 37 patients with excellent immediate results of treatment on the inverted Glasgow outcome scale (GOS 1), the second included 20 patients with moderate and severe disability (GOS 2-3).
Results. The patients with moderate and severe disability as immediate results of treatment have a lower quality of life than patients with excellent results, due to the presence of severe headache, anxiety and depression disorders.
Conclusion. The decline in the quality of life of patients with moderate and severe disability as immediate results of treatment of the cerebral aneurysms ruptures requires a rehabilitation therapy.

Aim. To establish the features of the spectrum and antibiotic resistance of bacterial agents isolated from wounds in patients with diabetic foot syndrome.
Materials and methods. In 2016-2017 a retrospective cohort study was carried out on the basis of the archive of the municipal budgetary healthcare institution «City clinical hospital №6» in Chelyabinsk with analyzing the data of the medical cards of patients who were at the department of purulent surgery in 2015 with various forms of diabetic foot syndrome. The main data for the study were taken from the results of bacteriological studies. To determine the antibiotic susceptibility of the isolated flora, a diffusion method was used with discs with antibiotics. The classification proposed by Wagner F.W. was used to determine the prevalence and depth of the lesion of diabetic foot syndrome (1979). The statistical processing of data was carried out using Excel 12.0 (Office 2008), the level of significance of the results was evaluated by calculating the two-sided exact Fisher test (F) using the calculator on the site «Medical Statistics» (URL: http://medstatistic.ru/calculators/calchi.html).
Results. In the studied group of patients with diabetic foot syndrome the infectious process caused by one bacterial agent was most often encountered. The most common causative agent isolated from the wound defects was S. aureus. The tendency to develop resistance against antibiotics, widely used in clinical practice, is more pronounced in representatives of gram-negative flora.
Conclusion. The obtained data generally coincide with the results of studies in the field of the microbial spectrum of the wounds in diabetic foot syndrome determined by other authors, but the predominance of monoinfections over bacterial associations in this studied population requires further study.

Aim. To analyze modern literature dealing with the issues of finding highly informative modern methods of early diagnostics of malignant tumors of thyroid.
Materials and methods. The study of recent Russian and foreign literature in the databases RSCI, Scopus, Web of Science, Pubmed has been carried out.
Results.This article represents statistical information on the prevalence of this disease, age and gender peculiarities, modern international cytological classification of thyroid – Thyroid Bethesda Classification. The article shows diagnostic values of ultrasound, elastography, dopplerography, as well as fine needle aspiration biopsy with the subsequent cytological, immunocytochemical study, and molecular-genetic research. The advantages and disadvantages of existing methods of diagnostics of cancer of thyroid have been analyzed. High sensitivity and specificity of molecular genetic studies, which increases with application of diagnostic panels has been observed.
Conclusion. Modern science has many methods for early diagnosis of malignant forms of thyroid disease, but none of them meets the modern requirements of practical health care. It justifies the importance of further search for sensitive, specific and available diagnostic methods of thyroid cancer.

Aim. To reflect the theoretical foundations and create a minimum set of practical skills of diagnostic and treatment interviewing in psychiatry.
Materials and methods. To achieve this goal a thematic selection of scientific literature sources of both classical and modern domestic and foreign authors was carried out. In addition, the authors focused on the rich personal experience of interviewing, which allowed choosing and describing the most effective, practically significant methods and methods of clinical diagnosis in psychiatry in the form of psychiatric interviewing.
Results. The factors that determine the nature and content of the interview: place, time, participants of the interview – doctor and patient have been described and analyzed. The analytical description of the main psychotechnologies which are used by the psychiatrist (psychotherapist) in the course of interview is given: establishment of contact, technology of hearing of and listening to the patient, technology of asking questions, technology of a pause and silence, technology of tactile contact, technology of using humour, advice, recommendation, interpretation, technology of finishing the interview and its structuring.
Conclusion. Clinical interview is the main diagnostic and psychotherapeutic tool of a psychiatrist, and especially of a psychotherapist. The diagnostic effectiveness of a psychiatric interview is determined by the extent to which the information obtained in the course of it is structured into a diagnostic concept, the therapeutic effectiveness is determined by the extent to which the patient accepts the concept of understanding by the doctor of his painful condition (achieved compliance).

Currently, the most actual problem in daily work of a surgeon is to get satisfactory results of the surgery, and to decrease the quantity of different complications, such as: recurrence of diseases, inflammatory and infection damage of operating wounds.
The most difficult for surgery treatment are urological diseases associated with the decrease of tissue vascularization, which leads to common fibrosis and the prevalence of soft tissue scarring, consequences of the radiation therapy.
Impaired wound healing is usually associated with lack of adequate blood supply, decrease of regenerative properties, increase of pro-inflammatory mechanisms. Platelet rich plasma is able to produce a lot of different growth factors, which stimulate neoangiogenesis, cytokines and сhemokines secretion, initialization of inflammatory cascade. These features lead to activation of regenerative mechanisms and growth of new blood vessels. In the present time, several forms of platelet rich plasma with different biological activity have been studied. The methods of its preparation and activation have been described. In this work the modern information of platelet rich plasma will be described in details.

Aim. To show the diversity and severity of clinical symptoms, a large range of diagnostic search, as well as difficulties in therapy in a 10-year-old patient with systemic manifestations of juvenile scleroderma.
Materials and methods. A retrospective analysis of the anamnetic data, the course of the disease, laboratory and instrumental data, as well as the ongoing therapy of a 10-year-old patient with juvenile systemic scleroderma was carried out.
Results. The patient was diagnosed with multiple typical sclerodermic foci of irregular shape, with different stages of lesion (edema, induration and atrophy). Joint damage was noted in the form of pseudoarthritis interphalangeal joints of hands with the formation of sclerodactily and right ankle joint. As a result of computed tomography of chest, signs of interstitial lung disease by the type of fibrous alveolitis have been revealed. After verification of the diagnosis, the patient was prescribed basic therapy: methylprednisolone and cyclophosphane.
Conclusion. A clinical case of the debut of juvenile systemic scleroderma with rapidly progressive, widespread skin lesions, involvement of the musculoskeletal system and the development of fibrous alveolitis is presented. Due to intensive and long-term pathogenetic therapy (glucocorticoids, cyclophosphamide), the patient's condition was stabilized and the progression of interstitial lung disease was stopped.

Aim. To demonstrate peculiarities of clinic features, difficulties of diagnostics and treatment of eosinophilic esophagitis using a clinic case.
Materials and methods. The investigation of the clinic case in young woman with eosinophilic esophagitis is presented. The diagnosis was established 6 years after the manifestation of the disease on the stage of complications developed (esophageal stricture). A complex examination included endoscopy, morphologic methods and consultations with adjacent specialists (llergologist, ENT). Drug therapy was carried out by system and topical corticosteroids according to recommendations of Russian gastroenterological association from 2013.
Results. The right diagnosis was established by the assessment of the clinic feature of dysphagia with revealing of mucosal eosinophilic infiltration during histological study of esophageal mucosal biopsies. The elimination diet and corticosteroid therapy improved the clinic course of the disease considerably. However, there were no signs of morphological changes of esophageal wall recovery. As a result, the patient needed to be treated and managed constantly. Based on the literature data the authors described variations of natural history of the disease, discussed the approaches to supporting therapy, and revealed group selection criteria of the patients most of all needed to anti-relapsing therapy.
Conclusion. Eosinophilic esophagitis is a chronic immune-antigendependent inflammatory disease of the esophagus with insufficiently investigated etiopathogenesis. A number of questions concerning this disease need to be studied (clinical course, possibility of long-lasted remission and self-recovery, duration of corticosteroid therapy, etc).

Aim. To demonstrate a clinical case of acute gastric volvulus and to give a brief literary review of the disease.
Materials and methods. A 12-year-old child who has applied for acute abdominal pain, repeated vomiting, with typical signs of obstruction of the upper gastrointestinal tract.
Results. After the clinical and instrumental examination, the child was urgently operated. With laparotomy, the patient was diagnosed with acute secondary gastric volvulus with necrosis and perforation, against the background of a true left-sided diaphragmatic hernia, severe pancreatic lesions. The patient had a suturing of the stomach defect, diaphragm plastic, thorough sanitation and drainage of the abdominal cavity. The postoperative period was very difficult, due to complications of the underlying disease. As a result of the treatment, the patient was discharged in satisfactory condition.
Conclusion. The clinical case confirms the severity of this nosology, accompanied by serious consequences. In our case, the patient recovered, but diagnostic errors and developing complications in acute gastric lavage often lead to death.

Aim of the study. Generalization of scientific research of workers of City clinical hospital № 2, later named Regional clinical hospital № 2.
Materials and methods. Scientific reports and publications of researchers were analyzed. The main directions of scientific research were selected.
Results. The article presented main stages of establishment and development of multifield hospital, summarized strategic directions of scientific research.
Conclusion. The carried out analyses revealed that Regional clinical hospital № 2 was a multifield patient care, scientific and educational institution with 35-year working experience. The workers of the hospital actively develop advanced scientific medical technologies for special and high-tech care in different diseases and pathologic states.