Aim. The aim of the work is to develop the tactics for the treatment of complicated colon cancer (tumor perforation, tumor bleeding, acute obturation obstruction).

Materials and methods. The clinical development included 324 patients with urgent complications of colon cancer. 269 patients were operated urgently and immediately, 56 operations were deferred. The diagnosis was based on anamnesis, clinical, laboratory and special research methods (ultrasound, CT, EGD, colonoscopy, histological examination).

Results. Postoperative mortality in urgent complications of colon cancer was 3.5%.

Conclusion. The rationale for the choice of method and volume of surgery, depending on the location and nature of complications of colon cancer, is provided.

Aim. The study was conducted to expand the variety of ways for surgical treatment of chronic ischemia of lower limbs complicated by the involvement of the femoropopliteal and pedidial arterial segment.

Materials and methods. The experience of surgical interventions in 43 male patients aged 52-75 suffering from chronic ischemia of lower limbs complicated by the atherosclerotic involvement of the femoropopliteal and pedidial segment has been summarized. According to the classification by A.V. Pokrovskiy, ischemia of the 3rd stage has been determined in 24 patients (55,8%), while ischemia of the 4th stage complicated by necrosis of the toes (critical ischemia) has been determined in other 19 patients (44,2%). All examined patients have undergone the reconstructive interventions using the prepared lateral subcutaneous vein of the upper extremity as a shunt.

Results. During the first day after the operation, the regression of pain syndrome as well as the warming of the lower extremity was indicated in 93% of patients. In 8-12 days after the reconstructive operation, the patients have undergone the 15 necrectomy or toe amputation. In the nearest postoperative period (less than 6 months) no thrombotic complications in the reconstructed segment have been determined. Within the observation period from 6 months to 5 years the bypass patency has been preserved in 71% of patients; ischemia of the 2nd B type has been revealed in all patients with the preserved bypass patency by the clinical examination.

Conclusion. Despite the “forced” character of usage of the prepared V. cephalica due to the absence of “traditional” venous shunts as well as the labor intensity of the method, it allows to expand the variety of ways for surgical treatment of patients suffering from chronic ischemia of lower limbs of the 3rd-4th stages complicated by occlusive involvements of the femoropopliteal and pedidial segment.

Aim. Determine the threshold values of quantitative indices of chorionic volume flow in pregnant women with thrombophilia in the first trimester of pregnancy for the prediction of miscarriage and evaluate the effectiveness of anticoagulant therapy.

Materials and methods. Ultrasound examination of the embryo and extraembryonic structures with volume reconstruction of the chorion and determination of quantitative indices using VOCAL program − vascularization index (VI), flow index (FI), vascularization flow index (VFI) in women with thrombophilia from 7th to 10th of the week of gestation.

Results. The analysis of the quantitative parameters VI, FI and VFI in pregnant women in the first trimester showed high reliability (p<0.001) in the value of VI and VFI in pregnant women with thrombophilia without treatment and in the pregnant control group, as well as in pregnant women with thrombophilia before and after anticoagulant therapy. Among the most informative parameters for assessing the chorion vascularization in predicting miscarriage VFI≤7,80 has highest value for negative outcome. Index VI due to the very high specificity (SP = 82.6%) better more informative for predicting a favorable outcome.

Conclusion. The use of the proposed method allows us to identify a risk group for predicting miscarriage in the first trimester in pregnant women with thrombophilia and promptly prescribe anticoagulant therapy and evaluate its efficiency. 

Aim. The study was conducted to determine the informative significance of the uterocervical angle for prediction of preterm birth using the ultrasound cervicometry at 16-20 weeks of pregnancy.

Materials and methods. 340 pregnant women aged 20-35 were examined at 16-20 weeks of pregnancy using the ultrasound cervicometry and by measuring the uterocervical angle. The interrelation analysis of the pregnancy outcome (preterm birth or birth at term) was carried out depending on the cervical length and the uterocervical angle value at 16-20 weeks of pregnancy. 

Results. Preterm birth before 37 weeks occurred in 32 patients (9.4%). The average value of the uterocervical angle at 16-20 weeks was 104,2±0,9 degrees in case of preterm birth and 92,3±2,7 degrees in case of birth at term. While analyzing the interrelation of the uterocervical angle value and preterm birth, it was found that the frequency of preterm birth with the uterocervical angle of >105º was 81.2% and 16,9% in case of birth at term (OR 21,333 [CI 8,363-54,418], p<0,05).

Conclusion. The uterocervical angle is a prognostically significant criterion for predicting preterm birth with the sensitivity of 81.3% and the specificity of 83.1%. The diagnostic effectiveness of the test was 83,1%.

Aim. The study was designed for the theoretical analysis of the somatotypological characteristics of people of the second childhood, adolescent, youthful and mature age periods and their importance for sports orientation.

Materials and methods. In course of the theoretical analysis, the search was performed in Scopus, eLIBRARY and PubMed databases using the keywords “somatotype”, “morphometry”, “somatometry”.

Results. The presented materials are considered from the ecological, geographical, ethnical and territorial perspectives that have a significant impact on the constitutional heterogeneity of the population. The features of the somatotypological characteristics of boys and girls participating in various sports are being specified. Concluding the analysis of the literature, it can be stated that in a number of studies, certain ratios of the main body types were observed in healthy individuals of various ethnical and territorial groups. However, upon closer acquaintance with this material, significant contradictions are revealed regarding the nature and the degree of manifestation of these shifts, and, in some cases, even mutually exclusive statements are made.

Conclusion. In view of the above, it is possible to conclude that further systematic study of these issues is needed.

Aim. The research was conducted to study the structure (variants, sexual and age characteristics) and manifestations of articular syndrome in children with juvenile idiopathic arthritis in Krasnodar.

Materials and methods. There was conducted a retrospective analysis of 89 case histories in patients aged 2-15 diagnosed with juvenile idiopathic arthritis for the first time.

Results. As a result of the study, the following variants of juvenile idiopathic arthritis were diagnosed: oligoarticular – in 62 patients (69,6%), polyarticular – in 24 patients (27%) and systemic – in 3 children (3,4%). Group 1 consisted of 62 patients with oligoarticular variant, and group 2 consisted of 24 patients with polyarticular variant. In the sexual aspect, there were 1,5 times more girls than boys among all the studied children. There are also a higher number of the females within the groups. The average age of the onset of the disease in all patients with juvenile idiopathic arthritis was 8,9±0,4 years. In group 1, the average age was 9,6±0,5 years, in group 2 – 7,4±0,4 years. In children with oligoarticular variant of the disease, knee and ankle joints were more often involved in the process. In group 2, the pathological process involved both large joints and small joints of the hands and feet. Leukocytosis, accelerated erythrocyte sedimentation rate and positive results of immunological studies were more often detected among the children of the second group. On the radiographs, cartilage and bone changes were found in 9% of patients.

Conclusion. Among the patients with juvenile rheumatoid arthritis, the residents of Krasnodar, the oligoarticular variant dominates (69,7%), the polyarticular RF-negative variant is in second place (25,8%), the systemic variant is in third place (3,4%), and the polyarticular RF-positive variant is in last place (1,1%). In the sexual aspect, there were 1,5 times more girls than boys among all the patients. The onset of the joint syndrome mainly occurs in early school and puberty age. The articular syndrome was manifested mainly by the arthritis of the knee, ankle joints, and the polyarticular variant was also manifested by the arthritis of the wrist joints and small joints of the hands and feet. Among the patients, the signs of humoral activity and immune inflammation were more characteristic of the polyarticular variant. At the onset of disease, the changes of cartilaginous and bony tissues of the joints were identified by the radiography only in 9% of cases.

Aim. The research was conducted to evaluate the possibilities of the "Thrombodynamics" test in the integrated monitoring of the blood coagulation system and the choice of the method of prophylaxis of thromboembolic complications in the postoperative period in surgical patients.

Materials and methods. 123 patients were operated for acute surgical pathology of abdominal organs. The "Thrombodynamics" test was used in a complex assessment of the state of the blood coagulation system. After the statistical processing by the methods of variation statistics, the results were used to predict the risk of the occurrence and changes in the volume of therapy for thromboembolic complications, taking into account the current understanding of the thrombodynamic properties of the fibrinous clot. Correction of the hemostasis system was based on "Russian Clinical Recommendations for the Diagnosis, Treatment and Prevention of Venous Thromboembolic Complications" approved by the Expert Meeting on May 20, 2015.

Results. It was found that 101 (82.1%) patients had abnormalities in the blood coagulation system after the surgery for acute abdominal cavity diseases complicated by peritonitis. We established the direct dependence of the predicted risk of thromboembolic complications on the degree of severity of secondary peritonitis. 52 (42.3%) patients needed a correction of thromboprophylactic therapy, which made it possible to exclude the occurrence of venous thromboembolic complications.

Conclusion. The use of the "Thrombodynamics" test in the complex evaluation of the qualitative characteristics of the blood coagulation system in surgical patients with a complicated course of the disease in the perioperative period makes it possible to objectively assess the risks of the thromboembolic complications and to correct a thromboprophylactic therapy to exclude the thromboembolic complications. 

Aim. The aim was to evaluate the epidemiological situation of dermatomycosis and scabies in Krasnodar region, to identify the tendencies and the development trend of the epidemiological situation, as well as the main directions of work retrospectively and in the dynamics of 2013-2017.

Materials and methods. Statistical data forms №9, №34 in the last five years, which shape the incidence of contagious dermatoses in Krasnodar region, were used in the study. The morbidity rate of the population of the region is indirectly linked to macroeconomic and social objective and subjective processes in the society.

Results. The analysis of the incidence of infectious skin diseases (hereinafter – ISD) shows a negative trend for scabies and major dermatomycosis, with the exception of mycosis of the feet and hands, in the studied five-year period. Structural analysis shows the ratio of sex-age categories of patients with different nosologies: the prevalence of the feet and hands mycoses in adult female patients and microsporia in male children. The link between the number of cases of contagious skin diseases and the territorial gradation of patients was considered. Conclusion. A retrospective analysis of the epidemiological situation of dermatomycosis and scabies in Krasnodar region was conducted. Gender, age and territorial aspects of contagious dermatoses, and the development trends were identified over the analyzed period. The factors contributing to the spread of contagious dermatoses were studied: climatic features of the southern region of the Russian Federation, migration flows, and socio-economic declines. The prospects of preventive work include raising public awareness and joint activities with non-medical services with an emphasis on active detection.

Aim. The research was designed to assess the capabilities of the microcomputer tomography method with the subsequent image analysis and determination of the mineral optical density of demineralized areas to improve the early diagnosis of fissure caries of permanent molars after the eruption.

Materials and methods. Using a high-resolution X-ray microtomograph “Skyscan 1176” (“Bruker”, Belgium) followed by post-processing and analysis of the obtained tomograms, 75 molars of children aged 8-11 were removed by orthodontic indications. Of the total number of teeth removed, research groups were formed – teeth without signs of demineralization and teeth with carious lesions in the stage of white, light brown, brown and black spots. In the reconstructed 2D and 3D images were identified the zones in the outer (0.05-0.5 mm), middle (0.75-1.25 mm) and inner (1.5-2.0 mm) thirds of the thickness of the enamel layer followed by the computation in the CTvox program (3.3.0-1403, Bruker-micro CT) of the averaged X-ray (mineral) density indicators.

Results. According to the tomograms of the teeth of the studied groups, the average indicators of the mineral optical density of the intact teeth enamel were identified as well as the average indicators of teeth with various types of carious lesions within the enamel. The following sequence was revealed in descending order of the parameters of optical density: healthy enamel (2.47±0.12 g/cm3) – caries in the white spot stage (2.41±0.11 g/cm3) – caries in the light brown spot stage (2.32±0.07 g/cm3) – caries in the brown spot stage (2.18±0.12 g/cm3) – caries in the black spot stage (1.81±0.12 g/cm3). Identifying the correlations between the color of carious lesion and mineral density of tooth enamel broadens the understanding of the mechanisms of the development of caries pathogenesis and contributes to the improvement of therapeutic and preventive measures aimed at improving caries resistance.

Conclusion. The use of microcomputer tomography in combination with other special methods characterizes fissure caries as a sequential, gradually progressing destructive process of hard tooth tissues (from focal demineralization to cavity formation), which establishes the relationship between the intensity of internal disturbances and external damage.

Aim. The study was conducted to evaluate the intensity of oxidative disorders in women suffering from a complex course of chronic endometritis and salpingo-oophoritis.

Materials and methods. The study was performed on 85 women divided into 3 groups: the control group – relatively healthy patients (n=30), the 2nd group – the patients suffering from chronic endometritis (n=29), the 3rd group – the patients suffering from a complex course of chronic endometritis and bilateral salpingo-oophoritis (n=26). The indices of chemiluminescence induced by the hydrogen peroxide were determined in the blood plasma and the mixed oral liquid. The content of products of oxidative modifications reacting to the thiobarbituric acid was determined in the erythrocyte meal and the mixed oral liquid.

Results. The evaluation of the content of the product of oxidative modifications in biomolecules as well as the level of luminal-dependent chemiluminescence induced by the hydrogen peroxide revealed the intensification of free-radical processes in blood and the mixed oral liquid of patients suffering from inflammatory diseases of small pelvis. The index of the thiobarbituric value and the maximal chemiluminescence flash increased by 60-70% in the blood of patients from the 2nd-3rd groups. The area of chemiluminescence flash of the blood plasma in patients suffering from chronic endometritis increased by 73%, while in patients suffering from a complex course of chronic endometritis and bilateral salpingo-oophoritis it was significantly higher – by 2.1 times. The increase in the value of the maximal chemiluminescence flash by 45% and the chemiluminescence area by 43% was detected in the mixed oral liquid of the patients from the 3rd group, while the increased value of only chemiluminescence area (by 42%) was revealed in patients of the 2nd group.

Conclusion. The results of the performed study revealed that the intensity of oxidative processes on the local and systemic levels in patients suffering from a complex course of chronic endometritis and double salpingo-oophoritis was significantly higher than in patients suffering from an isolated course of endometritis.

Aim. The research was designed to study the renoprotective properties of erythropoietin derivatives on the kidney ischemiareperfusion experimental model.

Materials and methods. The renoprotective properties of asialo erythropoietin (0.4 μg/kg and 2.4 μg/kg 30 minutes before the induction of ischemia) and carbamylated darbepoetin (50 μg/kg 24 hours before the ischemic stimulus) were studied in comparison with erythropoietin and darbepoetin in a series of experiments on male Wistar rats on a 40-minute bilateral model of renal ischemia-reperfusion. The renoprotective properties were evaluated by the results of biochemical markers of acute kidney injury, the dynamics of glomerular filtration rate and fractional sodium excretion, as well as the severity of microcirculatory disorders.

Results. It was found that the prophylactic use of asialo erythropoietin (dose-dependent) and carbamylated darbepoetin leads to a decrease in the serum concentration of markers of acute renal damage, an increase in the glomerular filtration rate, a decrease in fractional sodium excretion, and a decrease in microcirculatory disorders.

Conclusion. Asialo erythropoietin and carbamylated darbepoetin have the pronounced renoprotective properties and are the promising agents for the prevention and treatment of acute kidney injury.

Aim. The study was designed for the optimization of the approaches to the diagnosis and management of women with background diseases and tumor pathology of the vulva.

Materials and methods. The study involved more than a thousand and a half patients from different regions of Russia and CIS countries with precancerous and tumor pathology of the external genitals. A variety of methods were used in the primary diagnosis and monitoring in the treatment and observation, ranging from the banal examination, palpation, laboratory studies and ending with modern morphological studies, CT, MRI and PET diagnostics.

Results. The characteristic differences in the background processes of the vulva were revealed, which allowed us to divide them into two groups: the first group – the pathological process occurs against the background of dystrophic changes in the tissues of the external genitals; the second group – the dermis and subcutaneous fat are not changed. Clear morphological criteria of two variants of changes are accompanied by a significantly different clinical picture. Conservative measures had low efficiency in the pathology of the vulva with a neurodystrophic process. Carrying out a photodynamic therapy and laser vaporization is justified only in young and middle-aged women with precancer. It was found that the high efficiency of surgical treatment is combined with a large number of early and late postoperative complications, which in itself causes discomfort, pain, dysuric phenomena, and dyspareunia. It is possible to reduce the frequency of postoperative complications and improve the functional and cosmetic results of the treatment only with the use of reconstructive plastic surgery. We have developed and widely implemented the methods of closing wound defects in everyday practice and evaluated their effectiveness.

Conclusion. Over the past 20 years, a lot of work has been done to address the topical issues related to the diagnosis and treatment of background processes, precancer and vulva cancer. However, at present, there is no center where theoretical issues are studied at a serious level, conservative and invasive methods of treatment are developed, and educational and methodical work with doctors is carried out. Without proper attention to these issues, this problem is unlikely to be solved in the near future, both from theoretical and practical points of view.

Aim. The research was designed for clinical and laboratory characteristics and treatment of respiratory mycoplasma pneumonia in adult patients hospitalized to the infectious diseases hospital of the city of Krasnodar.

Materials and methods. The frequency of occurrence and the nature of the clinical symptoms confirmed by ELISA analysis of mycoplasma pneumonia in 35 patients, who were treated in the State Budgetary Establishment of Public Health Services “Specialized Clinical Infectious Hospital” of Krasnodar, were retrospectively analyzed.

Results.Mycoplasma pneumonia in hospitalized patients of Krasnodar is more common in young men during the cold season and occurs in moderate form. When ranking the clinical symptoms, it has been established that the priority signs of the disease are acute onset, febrile temperature, symptoms of lesions of the upper respiratory tract, increased CRP, dry coughing and relative monocytosis in the general blood test that can be considered the suggestive symptoms of the disease. Antimicrobial drugs from the macrolide, fluorinated quinolone and tetracycline groups, either as a monotherapy or in the combination, were prescribed for the patients with mycoplasma pneumonia.

Conclusion. The frequency of occurrence and the absence of pathognomonic symptoms of mycoplasma pneumonia make it advisable to include an enzyme immunoassay for antibodies to “atypical” pathogens in the examination algorithm of patients with any pneumonia, which will provide more accurate diagnosis and correction of etiotropic therapy.

Aim. The study was conducted to improve the results of the surgical treatment of acute calculous cholecystitis occurring against the background of diabetes mellitus.

Materials and methods. In course of our study, we analyzed the treatment results of 687 patients with acute calculous cholecystitis. Depending on the presence of diabetes, all patients were divided into two groups. The main group with concomitant diabetes mellitus included 68 (9,9%) patients, whereas the control group without diabetes included 619 (90,1%) patients. Laparoscopic cholecystectomy was performed on 636 (92,6%) patients, and open cholecystectomy was performed on 51 (7,4%) patients. 

Results. According to the histological study, the greatest number of destructive forms occurs in patients with concomitant diabetes, operated after 24 hours. The least postoperative complications occur in patients of both groups operated from 12 to 24 hours. However, the incidence of complications is 4-5 times higher in patients with diabetes mellitus. Postoperative complications in patients with acute calculous cholecystitis occurring on the background of sugar diabetes were observed after open cholecystectomy in 33,3% of cases and in 6,5% of cases after laparoscopic surgery.

Conclusion In patients with acute cholecystitis and concomitant diabetes, surgical treatment should be performed on the first day after the preoperative preparation during the first 12 hours, aimed at compensating for diabetes and improving microcirculation. The preference should be given to laparoscopic cholecystectomy, which reduces the number of postoperative complications by 5 times and mortality by 4.5 times.

Aim. The research was conducted for the study of the adhesion of samples of the domestic modern photopolymerizable base composite material in comparison with other materials for the manufacture of the denture bases.

Materials and methods. Five samples of the materials were tested to conduct a microbiological study on the subject of primary adhesion of microorganisms to the surface of the base materials. The adhesion of microorganisms to the samples of the base composite materials was assessed using the index method.

Results. As a result of a laboratory research, it can be concluded that the new photopolymerization material «Sample 1» used for the manufacture of the bases for the removable dentures has 1, 19 times lower adhesive activity to the colonyforming Prevotella intermedia microorganisms and Candida krusei mushrooms in comparison with the acrylic plastics and thermoplastic materials «Sample 2»; 1,14 times in comparison with the nylon material «Sample 3» and with the monomer material «Sample 4» with a statistically reliable variable number. It should be noted that the Axil-LC topcoat varnish supplied with the Sample 1 basic material kit increases microbial adhesion by 1.36 times.

Conclusion. The adhesion of microorganisms to the materials that are used in dental practice is due to the surface tension coefficient – the greater the surface tension coefficient, the higher the probability of adhesion of microorganisms on the surface of these materials. The investigated new photopolymerization material «Sample 1» without coating with a protective varnish showed low adhesion to all major pathogens. Covering with a protective lacquer design, which is a part of the set of the material, significantly increases the adhesion of microorganisms on the surface of the material. The established indexes of microorganisms adhesion to the material «Sample 1» allow us to recommend it for the manufacture of bases for temporary dentures and immediate dentures in the treatment at the stages of dental implantation.

Aim. The study was designed to establish the influence of transcranial electrostimulation on the stress tolerance of students by the method of T. Holmes and R. Rahe.

Materials and methods.The observations were made on 127 students aged 19-22. They were 50 boys and 77 girls. The students were divided into the main group (78 people) and the comparison group (49 people). Transcranial electrostimulation was carried out for the students of the main group: 2 sessions per week and 5 sessions per week. Stress resistance was assessed by the test of stress resistance and social adaptation of T. Holmes and R. Rahe before the course of transcranial electrostimulation and after it. The level of stress resistance was determined in the comparison group within the same time frame. Transcranial electrostimulation (TES) was performed by the “Transair-03” apparatus on the testees in the sitting position. The value of the pulse current of 3 mA, frequency 7.5 Hz was used. The exposure time was 30 minutes. The results of the study were processed with the help of the “Statistika 6.0” computer program.

Results. At the end of the school year, students had low, threshold and high levels of stress resistance. These levels of resistance to stress remained in those individuals who did not undergo transcranial electrostimulation, and also in students who had 2 transcranial electrostimulation sessions per week. After 5 sessions of transcranial electrostimulation per week, students had a threshold and high levels of stress resistance; there was no low level. After 5 sessions of transcranial electrostimulation the total number of points in students with a threshold level of stress resistance statistically decreased by 11,0% in comparison with the initial result. The total number of points after transcranial electrostimulation in students with a high level of stress resistance statistically decreased by 8,4%.

Conclusion. The results indicate an increase in the level of students' stress tolerance and the effectiveness of transcranial therapy for at least 5 sessions per week.

Aim. The study was designed for the evaluation of the effect of ointments with dry extracts of potentilla on the dynamics of the healing process of full-thickness skin wounds.

Materials and methods. The wound healing activity estimation of the proposed dosage form was conducted on white Wistar rats. The results of macroscopic studies (the area of the wound defect, the state of the scab, the presence of hemorrhage beneath it, the degree of inflammatory processes in the underlying tissues, including deeply located tissue structures, up to the muscle elements) and the results of histological examination were the criterion for evaluating the effectiveness of the wound healing agent. In the course of the experiment, the animals were divided into 4 groups: the main group (treatment with the ointment with a dry extract of potentilla), control group No. 1 (treatment with the ointment base), control group No. 2 (without treatment), and control group No. 3 (treatment with the «Chlorophyllipt» drug.

Results. The results of the macroscopic and histological studies made it possible to conclude that the wound healing process in the treatment with the ointment with a dry extract of potentilla had a number of features. The proposed dosage form enhanced the regeneration of the multilayered squamous epithelium, accelerated the maturation of the granulation tissue, and eliminated the inflammation and infiltration in the first days of treatment, which led to a significant reduction in the healing time when it was applied (15-18 days). In the animals of the control groups No. 1 and No. 2, the described processes occurred much more slowly, and inflammatory infiltration persisted almost throughout the entire experiment. The wound surface was healed on the 27-30th day. A lot of common features were noted in the mechanism and timing of wound healing in the treatment with the ointment with a dry extract of potentilla and a reference preparation – «Сhlorophyllipt».

Conclusion. The ointment with a dry extract of potentilla significantly speeds up the healing process of full-thickness skin wounds.

Aim. The research was conducted to study the processes occurring in soft tissues in the surgical treatment of widespread purulent-inflammatory processes of the maxillofacial area and to confirm the effectiveness of the developed optimal surgical technology.

Materials and methods. A surgical treatment of 20 patients with the widespread purulent-inflammatory processes of maxillofacial area was carried out according to the developed surgical technology. In all cases, the tissue was taken from the area of the pathological focus for the pathomorphological examination at all stages of treatment.

Results. The morphological study of the drugs obtained during a primary surgery on the purulent-inflammatory focus showed a picture of the serous-purulent inflammation with a severe leukocyte infiltration. Necrobiosis and tissue necrosis prevailed in the center of the purulent-inflammatory focus. After 3 days, the wound began to grow young granulation tissue with a large number of capillary kidneys, a marked decrease in the level of leukocyte infiltration, the appearance of fibroblasts and lymph-histiocytic elements, the formation of fibrous connective tissue.

Conclusion. The morphological assessment of the wound process showed a positive dynamics and the effectiveness of the proposed treatment of the patients with purulent-inflammatory processes of the maxillofacial area.

Aim. The study was conducted for the characteristics of the morphoimmunohistochemical status of the implant from polylactic acid (PLA) located in the dermis.

Materials and methods. The study was performed on rats (30 individuals) with subdermal administration of the drug in a volume of 0,05 ml. The results were evaluated after two weeks, 1 and 2 months after the injection. The sections were stained with hematoxylin and eosin, according to Van Gieson, with the help of Mallory and Masson reaction. Collagen fibers were studied after the staining with picrosirius red under polarized light. Monoclonal antibodies of CD 68 and antibodies to vimentin were used to determine the expression of immunohistochemical markers.

Results. It is shown that the rate of collagen synthesis varies in different parts of the dermis. There is a sharp increase in the volume of the fibrous component around the implant, and there is only a tendency to increase in the synthesis in the implant itself. In this case, the increase in the volume of the extracellular matrix is associated with type I and III collagen.

Conclusion. The detected activation of collagen synthesis by fibroblasts can be used as a regulator of the volume of the matrix, which is very important for the modern regenerative medicine.

Aim. The research was conducted for the assessment of the impact of chronic salpingoophoritis on the ovarian reserve of women in various phases of reproductive age.

Materials and methods. A prospective, controlled and open cohort study was performed in 2013-2018 (n=202). The main group consisted of women with chronic salpingoophoritis (ChrSO) who applied for preconception consultation (n=138). In accordance with the reproductive age phase, the main group was divided into subgroups: the early reproductive age period (ERP, n=44), the peak reproductive age period (PRP, n=56), the late reproductive period (LRP, n=38). The control group consisted of conditionally healthy women of reproductive age (n=64). The ovarian reserve (OR) was estimated on the basis of the serum level of antimullerian hormone (AMH), inhibin B, estradiol, follicle stimulating hormone (FSH), an ultrasoundbased assessment of the number of antral follicles (AF), and the ovarian volume.

Results. The age of women ranged from 18 to 40 years. Based on the discriminant analysis, it was found that the main indicators determining the specificity of the OR in ChrSO, depending on the phase of reproductive age, are the number of antral follicles, estradiol level and AMH (Wilks’ lambda = 0.35503, p<0.0001). The specificity of the OR of women with ChrSO (difference from the control group), regardless of the phase of reproductive age, initially and when evaluated after 6 months, is determined by the number of AF and the level of estradiol and AMH; the number of AF and AMH is determined with a similar estimate after 12 months. The specificity of the OR in ChrSO, which is dependent on the reproductive age phase, has been proved through the analysis with the neural networks training(the proportion of correct answers is more than 80%). The linear relationships were established between the values of each OR parameter in women with ChrSO. Initially, when estimating after 6 and 12 months, linear regression equations were calculated, allowing the values of individual OR parameters to be calculated over 6 and 12 months.

Conclusion. Chronic salpingoophoritis (ChrSO) is associated with a decrease in ovarian reserve in women of reproductive age. The effect of ChrSO on some parameters of the ovarian reserve depends on the age phase of the reproductive period, which increases with time (after 6, 12 months). The presence of ChrSO in women planning future pregnancies requires preventive and therapeutic measures aimed at preserving the ovarian reserve and the preferred implementation of fertility in early reproductive age before the ovarian reserve starts to decline.

Aim. The study was conducted to assess the level of awareness of surgeons about the principles of safe perioperative pharmacotherapy.

Materials and methods. The survey of surgeons was conducted in 2018 on the basis of a questionnaire made by the authors, consisting of 60 questions and tasks, divided into 6 thematic blocks. The respondents had to demonstrate their knowledge both in the field of general principles of safe pharmacotherapy and private issues of using analgesics, anticoagulants, antibiotics in the perioperative period. The results of the survey were assessed as a percentage (proportion of correct answers) individually for each respondent and in total.

Results. The results of the survey showed a lack of a deep understanding of the principles of safe pharmacotherapy in most clinical cases. Despite the fact that a number of answers completely correlated with the positions of evidence-based medicine, in general, there was a lack of systemic knowledge. The survey made it possible to identify those important points that should be first highlighted in the preparation of the training program.

Conclusion. Every doctor should strive to minimize the preventable medical errors associated with pharmacotherapy. This is feasible only in the process of continuous daily learning. Practitioners' interest in the efficacy and safety of pharmacotherapy and mastering the basic decision-making algorithms for prescribing, controlling safety and cancelling drugs will improve the quality of medical care.

Aim. The study was designed to perform a complex examination of the dynamics of the activity of protease inhibitor system along with the morphological study of cell and tissue components of the skin regeneration in the modelling of the 2nd degree thermal burn in rats.

Materials and methods. The studies were conducted on 40 mature male Wistar rats. We determined the trypsin-like, elastase-like, antitrypsin activity and acid-stable inhibitors of proteinases in supernatants of homogenates of the skin of rats after the modelling of a burn injury by the enzymatic methods. The wound healing process was evaluated based on the macroscopic, histological examination with the general staining by hematoxylin and eosin, van Gieson’s picrofuchsin, and transmission electron microscopy.

Results. The complex analysis of the skin regeneration revealed the role of the enzymatic reactions and the inflammatory microenvironment in the development of pathogenetic and morphological tissue changes in the dynamics of wound healing. The homeostasis of proteinase-inhibitory system was accompanied by both local and systemic disorders. The nonspecific proteinases occupied the key positions among the mediators of the biochemical alteration. The dynamics of changes was characterized by a powerful proteolysis with a progressive depletion of the inhibitory potential, which caused the development of a secondary-alterative process. The launch of the cascade of the inflammatory responses led to the disruption of the microcirculation and the damage of the blood-tissue barriers, the proteolytic destruction of the connective fibers, the formation of an edema and the disruption of the regenerative capacity of a damaged tissue. Morphological destructive changes in the skin remained up to 7-14 days, a decreased regenerative ability of the skin was manifested by a violation of the proliferation and differentiation of the epidermis. According to the electron microscopy, the phenomenon of tissue and intracellular edema, lesions of the microcirculatory bed, leukocyte-macrophage infiltration persisted up to 14 days of the experiment. The disruptions of the structure of the intercellular contacts between epidermocytes, macrophages in the dermis and many newly formed collagen fibers were still noticeable by the 14th day.

Conclusion. The results of the study showed the progressive development of the destructive reactions after the modelling of 2nd degree thermal burn. There was an increase in the level of proteolytic activity on the background of depletion of the inhibitory potential. There was the persistence of the alterative changes in the skin up to 7-14 days and the complication of the reparative processes with suppuration, impaired proliferation and differentiation of the epidermis. The performed investigation is important for the determination of further ways of pathogenetic correction.

Aim. The research was designed to study the possibilities of ultrasound examination with Color Doppler imaging (CDI) and three-dimensional volumetric reconstruction (3D) in the diagnostics of adenomyosis of minimal prevalence in patients with unspecified infertility and reproductive losses at the early stages of gestation.

Materials and methods. 40 patients with unspecified infertility and early pregnancy loss (the main group) and 35 healthy patients (the control group) were examined in the course of the study. All patients underwent small pelvic ultrasound in В / CDI / 3D-modes with an assessment of the junctional zone (JZ) on days 5-7 and 18-22 of the menstrual cycle (MC).

Results. In the main group, there was a discrepancy between the structure of the endometrium and the phase of the cycle at 5-7 days of the MC, a decrease in vascularization of the JZ at 18-22 days of the MC, a local increase in blood flow in the endometrium in phases 1 and 2 of the MC; the fuzziness of the junctional zone, an increase in min and max thickness of the junctional zone, the difference between them, as well as the ratio of max thickness of the junctional zone to the thickness of the uterus wall regardless of the phase of the MC (p = 0.005; 0.0001; 0.005; 0.03; 0.0004; 0, 0001; 0.0001; 0.0001; 0.0001 respectively).

Conclusion. Ultrasonography with the CDI and 3D reconstruction allows us to identify a high-risk group by the presence of a minimal prevalence of adenomyosis in the patients with unspecified infertility and reproductive losses at the early stages of gestation.

Aim. The study was designed for the evaluation of the quality of life of children with retinal detachment during vitrectomy.

Materials and methods. 23 children with retinal detachment aged from 10 to 17 years were treated. Surgical treatment consisted of a three-port vitrectomy and a laser endocoagulation of the retina. 3 groups were formed with the help of a random sampling. During the surgical treatment of group I (n=8), only balanced non-oxidant solutions of salts (Balsed Salt Solution − BSS) were used. Tablets of antioxidant preparations were not assigned. Saline solutions with antioxidants (BSS plus) were used to carry out surgery for group II (n=8). Group III (n=7) was additionally taking antioxidant preparations peros for 3 months in the postoperative period . The quality of life was studied using the abridged Russian version of the VFQ-25 questionnaire. 10 children of the same age with no indications of surgical treatment of retinal detachment were selected for the control group. Statistical analysis of the obtained data was carried out using a set of programs for applied statistical analysis Analyst Soft, Bio Stat 2007.

Results. A week after the surgical treatment, no increase in visometric data was observed. Six months later, a significant increase in visual acuity was revealed. The highest visometric data were observed in group II due to the minimal progression of lens opacities. Group I patients had the lowest values of this index.

Conclusion. The positive effect of the surgical treatment of retinal detachment positively influenced the patients’ quality of life in the early and late postoperative period.

Aim. The study was designed for conducting a molecular genetic analysis of DNA of the tooth pulp and establishing the genetic relationship of the child and the parent.

Materials and methods. The tooth number 16 of the claimed father was provided for the DNA extraction. Saliva samples and DNA preparations of the prospective daughter were obtained for the study. In the course of the research, the M-sorbbone reagent kit was used to isolate DNA from the bone powder.

Results. The conducted studies have shown that the DNA preparations isolated from a tooth and the N sample of saliva have the following genotypic allelic combinations. It was established that for each of the studied STP systems in the genome of the claimed father an allele is found, which formally coincides with the allele of conditionally paternal (nonmaternal) origin in the child’s genome.

Conclusion. As shown by the results of the study, the only carrier of DNA in a forensic medical molecular genetic examination, in this case, was a tooth, namely, pulp, which was protected by the durable tissues – dentin and enamel. The uniqueness of this case lies in the fact that it is the pulp that is the only tissue that retains the genetic information making it possible to state the high probability of the claimed relationship of the father and the child.

Aim. The study was conducted to estimate the clinical and pharmacoeconomic efficiency of proton pump inhibitors (PPIs) omeprazole and esomeprazole when GERD patients undergo a course of medical treatment.

Materials and methods. 25 GERD patients with a history of the disease for more than 5 years were under observation in Krasnodar regional clinical hospital № 2 from 2017 till 2018. All the patients have been thoroughly examined. Conservative therapy included the «gold standard» of proton pump inhibitors. Evaluation of the efficiency included the number of disease relapses in the period of dynamic observation and the calculation of the cost-effectiveness ratio.

Results. When patients were taking esomeprazole, the relapses of the GERD disease were rare. The cost-effectiveness ratio was lower.

Conclusion. The use of esomeprazole during the treatment of GERD patients has lower economic expenditures. The relapses of the disease are also less frequent.

Aim. The study was conducted to analyze the sources of literature on the etiology and pathogenesis of the temporomandibular joint dysfunction (TMJD) with the reflection of the most urgent and unresolved problems.

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

Results. It was revealed that the issue of the etiology and pathogenesis of the TMJD remains open. There are different points of view on the etiology and pathogenesis of this pathology which allow many researchers to not only study the various causes of this pathology known to date but also to work towards finding new etiological factors. The polyetiology of the TMJD explains not only complexity but also requires complex diagnosis and treatment of this pathology.

Conclusion. Despite the diversity of views on the etiology and pathogenesis of the TMJ, a number of issues remain that require detailed study. Obviously, it is necessary not only to improve the available methods of diagnosis and treatment but also to develop new methods based on the available various modern views on the problem of the etiology and pathogenesis of the TMJD.

Aim. The main aim of this research is to overview some main methods of anxiety assessment of animals by the behavioral tests based on the unconditional models. Animal models of anxiety disorders are actively used for studying their etiology and pathogenesis and for their treatment and prevention. This review describes some basic unconditional methods of anxiety disorders assessment in laboratory animals: open field test, light-dark box test / light-dark exploration box, elevated plus-maze and Suok test. The principles of conducting this test, regulated parameters and their link with anxiety-level are described.

Conclusion. A modern researcher possesses different methods of modeling anxiety disorders in rodents. The tendency to an in-depth assessment of the behavioral reactions is noted. The use of the described models allows us to reveal and analyze the anxiolytic activity of new pharmacological drugs and non-pharmacological methods of pathological anxiety management. The most important aspect of performing this research is the correct matching of received data and normal and pathological human physiology features. 

Delirium is an acute change in mental status in the form of disorientation in time and space, loss of attention and disruption of sleep/wake patterns. From the psychopathological point of view, delirium is a qualitative disorder of consciousness with concomitant disorders of perception (illusions and hallucinations). Postoperative delirium (POD) is one of the postoperative complications that occur in patients of any age, including children. As a rule, POD develops within 5-7 days after the surgery. The frequency of its occurrence varies in different age groups. Nowadays more than 230 million surgeries are performed annually in the world, and the frequency of POD depends on the type of surgical operations, age of a patient and a number of risk factors. The effects of POD include cognitive disorders, prolonged hospitalization, increased mortality, leading to a significant increase in healthcare costs. The implementation of the protocol on the diagnosis and therapy of delirium, based on modern recommendations, can improve the clinical outcome.

Aim. The study was designed to review the Russian and foreign literature of recent years on modern methods of diagnosis and management of children with pulmonary hypertension.

Materials and methods. The analysis of Russian and foreign literature was conducted in RSCI, Scopus, Web of Science, Pubmed databases.

Results. Pulmonary hypertension (LH) is a rare, severe and progressive pathology with an unfavorable prognosis. For the first time, the clinical case of LH was described in the early XXth century, and only in recent decades, there were new drugs that could improve patients’ survival. The problem of LH is relevant in the clinical practice of a pediatrician. This pathology is often a complication of many cardiovascular and bronchopulmonary diseases in children. More than half of congenital heart defects in children are accompanied by LH. Bronchopulmonary dysplasia and interstitial lung lesions are also the leading causes of LH in the pediatric population. The evolution of drug therapy is associated with new ideas about the pathogenesis of the disease. If previously LH was associated with vascular tone disorders, recently, the pathogenesis is considered as a vascular remodeling, accompanied by a pathomorphological cascade of cell proliferation, hypertrophy, apoptosis, production and degradation of the intercellular matrix. However, despite the obvious breakthrough in the treatment of LH, the disease remains incurable and life-threatening.

Conclusion. The problem of perfect diagnosis and effective treatment of LH is not completely solved nowadays. However, the progress made in pathogenetic therapy in the last decade allows us to hope for the emergence of new drugs that can significantly improve the prognosis and prolong the life of the patient.