Perinatal mental health of the mother occupies a central position in healthcare, the same as caring for a newborn baby. Maternal depression is the lead pathology of postpartum period. Despite the high prevalence and importance to the overall development of children, most cases of depression are unappreciated, unrecognized and untreated. Inattention to issues which are related to physical and mental health of women, leads to severe negative social and economic consequences for society. Statistical comparison of the total number of pregnant women, the number of births in the United States in 2007, excluding cases of fetal loss, including still-births and miscarriages with similar Russian data allowed to calculate the approximate prevalence of postpartum depression in the same period. Presumable probability of postpartum depression is 15% in
different regions of the world, and the diagnostic criteria of DSM-IV for postpartum depression are representative for comparison. Considering these assumptions, according to 2007 each year about 260,000 out of 1 mln. 600,000 of Russian women in childbirth may suffer from post-natal depression. The results have a probabilistic character. For the mothers the consequences of unrecognized and untreated depression after childbirth are the most frequent. It should be seen as a depressive episode or recurrent depressive disorder which has a singular coloring due to the appearance in the peak period of reproductive age of women. Postpartum depression may increase the possibility of occurrence of relapse of a depressive disorder as well as the transition to a state of chronic depression. Alcoholism or drug use is a common complication of depression; the risk of suicide increases, especially during the time of reducing the severity of the most severe symptoms of depression, though it is below the prevalence of suicide among the population. Particular
attention should be paid to such symptoms as instability in mood and irritability as during the postpartum depression and in its residual period. They can cause child abuse. This paper also presents current data on the epidemiology, etiology, risk factors for postpartum depression, its clinical manifestations, the influence of untreated maternal depression on child development, therapy and educational modules to spread multidisciplinary and inter-agency approach in perinatal mental health problems.

With gistostereometry study the structure of the anal canal and anal sphincter dogs in norm and after proctectomy with bringing down the colon, forming neoanus and neosphinkter. The artificial sphincter is
the inevitable process of smooth muscle atrophy can save at least half the volume of smooth muscle, similar to the number in the internal sphincter needed to restore function after holding involuntary proctectomy. Neoanus of mucous and submucosal colon relegated acquired typical smooth relief with the advent of the vertical pleats on the type of anal columns of Morgagni and with the perianal skin was closely associated with the subcutaneous portion of the external sphincter smooth muscle and an artificial sphincter. Thus, the experimental model of the internal sphincter and neoanus created by bringing down the mucous and the formation of smooth cuffs, very similar in quantitative and qualitative terms, the structure of the anal canal and anal sphincter dogs and can be used in clinical practice.

Tuberculosis (TB) is a common disease caused by infection of Mycobacterium tuberculosis and influenced by host hereditary and environmental factors. Accumulated genomic data obtained through the use of new methodological approaches, including analysis of associative networks, contribute to the understanding of the hereditary basis of the disease. In the current study, we carried out the reconstruction and analysis of associative network representing
molecular genetic links between proteins/genes involved in the development of TB. In the associative network, well studied proteins and genes with a decisive importance in the efficiency of the human immune response against a pathogen predominated. However, this approach identified 12 new genes encoding for the respective proteins in the associative network polymorphismsof which has not been studied regarding the development of TB.

Objective. To study the physical growth and development of adolescents (aged 13–16 years) living in the Tomsk region. 

Material and Methods. This study is a framework (№299 from 18.07.2011) of the Department of Health Care of Tomsk region, we analyzed the results of medical examinations of adolescents (n = 7120, average age 13.98 ± 0.04, 49.87% – boys). Measurements of height and weight, the circumference of the chest and head (data rounded to 0.1 kg and 0.1 cm, respectively) are taken. The body mass index (BMI) is calculated as the ratio of weight (kg) / height2 (m2). Statistical analysis was performed using the software package Statistica for Windows 10.0 and the software StatCalc 6.0.

Results. Average height of adolescents is (163.10 ± 0.09) cm. On Average boys are taller than girls ((165.34 ± 0.15) cm and (160.87 ± 0.11) cm, p < 0.001). The body weight is (53.99 ± 0.13) kg (boys – (55.28 ± 0.20) kg, girls – (52.72 ± 0.17) kg, p < 0.001). Boys chest circumference is (79.26 ± 0.30) cm, girls is (79.99 ± 0.13) cm, head circumference are (55.43 ± 0.07) cm and (54.77 ± 0.04) cm, respectively (p < 0.01). The results show difference between Tomsk boys and rest of the Russia Federation. The average BMI is (20.20 ± 0.04) kg/m2 (girls – (20.32 ± 0.07), boys – (20.08 ± 0.06) kg/m2). The urban lifestyle in Tomsk Region leads to boys obesity.

Conclusion. The study revealed the regional physical growth and development characteristics. Anthropometric data in Tomsk region adolescents are higher than the same data in RF.

Due to the high incidence of tuberculosis of women of reproductive age research at 270 patients was conducted. The group of research included women with infertility and genital tuberculosis, pregnant women with active tuberculosis of lungs, pregnant women with clinically cured tuberculosis of respiratory organs. Pregnant women with tuberculosis of lungs were more often from sociopathic families, had venereal diseases, HIV infection, hepatitises.

Objective. Todetermine the diagnostic value of neopterin as a marker of dysfunction of peritoneal immune factors for estimating the severity of external genital endometriosis (EGE).

Material and methods. The concentration of neopterin in the peritoneal fluid (PF) and venous blood of 16 patients with EGE and 10 patients with benign ovarian cysts were evaluated.

Results. There wasn’t significant relationship between the concentration of the neopterin in the venous blood and clinical data. There weren't significant relationship between the concentration of the neopterin in the venous blood and clinical data. There were the significant correlation between the concentration of neopterin in the PF of patients with EGE and pain by the B'n'B scale (r = 0.545, p = 0.044) and pain by NRC scale of (r = 0.362 p = 0.203). There were correlation between the concentration of neopterin in the PF of patients with EGE and the severity of endometriosis by rAFS scale (r = 0.598, p = 0.051), and between the neopterin concentration in PF and adhesions (r = 0.487, p = 0.128).

Conclusion. Thus, it is possible to use the the neopterin concentrations in the PF of patients with EGE as a marker of disease severity and as a predictor of recurrence endometriosis.

The formation of oxidative stress lies at the heart of many frequent and socially-important diseases. Blood lymphocytes are the cells which provide immunological control of our organism. As a result of
their function implementation blood lymphocytes contact with different endogenic and exogenic factors, which can lead to active oxygen species production activation, macromolecules oxidative modification and to cell survival alteration. At the present time it is essential to expand and deepen the fundamental knowledge of blood lymphocytes apoptosis regulation peculiarities. The research objective was to establish the interaction among alterations of glutathione system condition, carbonylation level, protein glutathionylation and caspase-3 activity in blood lymphocytes during
oxidative stress in vitro.

Material and Methods. The material for research was blood lymphocytes cultivated with addition of hydrogen peroxide in final concentration of 0,5 mmol and/or protein SH-group inhibitor N-
ethylmaleimide – 5 mmol, protector – 5 mmol – 1,4-dithioerythritol.
Reduced, oxidized and protein-bound glutathione concentration was measured by method of spectropho-tometry, additionally, the ratio size of reduced to oxidized thiol fraction was estimated. With help of
enzymoimmunoassay the level of protein carbonyl derivatives was evaluated; caspase-3 activity was registered by spectrofluorometric method.

Results. Protein SH-group blocking in blood lymphocytes during oxidative stress in vitro was accompanied by protein-bound glutathione concentration rapid decrease in connection with increase of protein carbonyl derivatives content and caspase-3 activity. Protein SH-group protection in blood lymphocytes during oxidative stress in vitro was accompanied by concentration increase of protein-bound glutathione and protein carbonyl derivatives under comparable values of enzyme activity under study.

Conclusion. The carried out research shows that caspase-3 and protein-bound glutathione are the molecular targets of selective control over programmed cell death. The received indices of caspase-3 activity change and protein-bound glutathione concentration alteration in blood lymphocytes during oxidative stress in vitro can be used when elaborating target therapy approaches to diseases accompanied by apoptosis disregulation.

The research objective is to determine the state of endothelium-dependent and endothelium-independent vasodilatation in patients with coronary heart disease (CHD) associated with chronic obstructive pulmonary disease (COPD).

Material and methods. In the cross-sectional study included 122 patients with CHD associated with COPD: 68 people of them are patients with stable angina without acute coronary events in history and 54 patients with acute ST segment elevation myocardial infarction (STEMI). Comparison group comprised 53 patients with stable angina and 51 patients after STEMI without concomitant COPD. Patients were included if they met the following inclusion criteria: male, age <60 years, verified forms of CHD (stable angina, STEMI), documented with COPD without exacerbation and forced expiratory volume in 1 second > 30% in the groups with CHD and COPD. Arterial endothelial function was tested with high-resolution ultrasonography: brachial artery diameter was measured at rest, after flow increase (which causes endothelium-dependent dilatation), and after administration of sublingual nitroglycerin (an endothelium-independent dilator).

Results. We found that endothelial dysfunction in patients with acute and chronic forms of CHD in combination with COPD are more pronounced than in isolated CHD.

Conclusion. Expressed depression functional vascular reserve in patients with CHD associated with COPD, should be taken into account when conducting individualized therapy of these patients.

Objective. Investigation of hypolipidemic effect of sesquiterpene γ-lactone Arglabin in hepatoma tissue culture (HTC).

Materials and methods. In this study we’ve evaluated the effect of sesquiterpene γ-lactone Arglabin and gemfibrozil (reference drug) on the lipid content in the hepatoma tissue culture (HTC) which were incubated with a fat emulsion “Lipofundin” by fluorescent method with vital dye Nile Red. The cell viability was investigated using the MTT-test and staining by Trypan blue.

Results. Cultivation of cell cultures of rat’s hepatoma cell line HTC with Arglabin and gemfibrozil in concentrations from 10 to 50 μmol and from 0.25 to 0.5 mmol, respectively, had no cytotoxic effect.
HTC cell viability did not change compared with the corresponding rate in the control culture. Experimental hyperlipidemia in hepatoma culture was induced by the addition in the incubation medium
of fat emulsion “Lipofundin” in a final concentration of 0.05 %. The fluorescence intensity of Nile Red in the cells was increased 4-fold (p < 0.05), which indicates a significant accumulation of lipids in the cytosol of cells. In these steady-state Arglabin and gemfibrozil at concentrations 75–100 μM and 0.25–1.0 mM, respectively, reduced the content of lipid in cells. 

Conclusion. In the model of hyperlipidemia induced by lipofundin, sesquiterpene γ-lactone Arglabin prevents the accumulation of lipids in the HTC cell line, as evidenced by a decrease in Nile Red fluorescence. However hypolipidemic effect of Arglabin is associated with cytotoxic effects, which is typical for anticancer drugs.

Pharmacoepidemiological and pharmacoeconomical analysis of endometrit drug therapy at special treatment-and-prophylactic institutions of the city of Tomsk. Estimate the intensity of the appointment of antibacterial drugs endometrit therapy using the methodology of the WHO ATC/DDD, calculated indicators of the intensity of the consumption of drugs in the course of treatment per patient. It was shown that 70% of the established daily dose had to beta-lactam antibiotics and macrolide. For the most common options for antibiotic therapy established nosology of the indicators of clinical efficacy. The calculation of the cost of the schemes of antibiotic therapy, which showed that the cost of treatment is maximal during therapy with ceftriaxone + clarithromycin (4902 RUR); further descending follow: amoxicillin / clavulanic acid + roxithromycin (4658 RUR); benzylpenicillin and gentamicin (4231 RUR). Economic efficiency of antibacterial treatments endometritis a
“cost – effectiveness”. The cost of the patient, achieved remission, made during therapy with amoxicillin/clavulanic acid and roxithromycin (5416 RUR), During therapy with ceftriaxone and clarithromycin (6052 RUR), the treatment of benzylpenicillin and gentamicin (14420 RUR). Pharmacoeconomic evaluation results showed that the least acceptable scheme of antibacterial therapy
of endometrit in the hospital is the combination of benzyl penicillin and gentamicin. Тhe antibiotic therapy for endometrit may be recommended by a combination of amoxicillin / clavulanic acid and
roxithromycin and clarithromycin and ceftriaxone, for which there was no statistically significant differences in clinical efficacy and cost of antibiotic therapy.

The aim of the study was to investigate the expression of insulin-like growth factor binding protein 6 (IGFBP-6) in cancer tissues in relation with clinical and morphological parameters, IGF-IR expression, serum adiponectin level and its receptors (AdipoR1, AdipoR2) in patients with colorectal cancer.

Material and Methods. The study included 31 patients with colorectal cancer (T2–4N0–2M0). Serum adiponectin level, AdipoR1 and AdipoR2 expression were evaluated with ELISA. IGF-IR expression was evaluated in tumor tissue by flow cytometry. IGFBP-6 expression was evaluated with Western blotting.

Results. The dependence of IGFBP-6 expression, AdipoR1, AdipoR2 on tumor invasion and lymph nodes status were revealed. There is no association IGFBP-6 expression, AdipoR1 and AdipoR2 expression and serum adiponectin level with metabolic syndrome. The revealed positive relationships between IGFBP-6 expression and AdipoR1 expression, between IGFBP-6 expression and AdipoR2 expression, between IGF-IR and AdipoR1 expression show cross-talk between IGF-IR and adiponectin/AdipoR1 pathways in colorectal carcinomas.

This review focuses at the problem of the genetic basis of comorbidity. We discuss the concepts and terms relating to combinations of diseases. The guidelines of the study of comorbidity using modern high throughput methods and approaches of genetics, molecular biology and bioinformatics are designated. In this review we present results of studies showing genetic specificity for the combined phenotypes dif-ferent from the isolated disease, we considergene-gene and gene-environment interactions in comorbidity. We also discuss the role of single nucleotide polymorphisms and structural genome variations in the
development of comorbidity. Own results of researching shared genes of inversely comorbid diseases like as bronchial asthma and
tuberculosis are presented.

An analysis of literature data was conducted to characterize the main current stage of development and formation of diagnosis and treatment of shoulder instability. The purpose of this review was to determine the main directions in the treatment of recurrent shoulder instability and problematic issues that require further scientific research. The main results of patients monitoring that were undergone different types of arthroscopic treatment were presented. The present level of diagnostics allows to accurately define the indications for surgical treatment. A method of glenoid bone defect reconstruction is presented that based on careful preoperative planning. Determination of possible risk factors and every possible pathogenesis link and individual preoperative planning are the main tasks in the prevention of the shoulder instability recurrences.

We present a rare case of Stark–Kaeser type scapuloperoneal syndrome type with mild weakness and hypotrophy in proximal limb, with rough paresis of feet, walking dysfunction and slowly-progressive course. The article briefly describes current views on the etiology and pathogenesis of this disease. The case is of interest to physicians of various specialties for the differential diagnosis of inherited neuromuscular disorders.

The history of formation and development of the Department of traumatology and orthopedics, military surgery of Siberian State Medical University for 50 years has been presented. Information about the scientists who have made contributions to the theory and practice of traumatology and orthopedics, the training of medical staff are given. The main directions of scientific and practical activities are shown.