Aim. Evaluation of the experience of treatment of patients with consequences of hematogenous osteomyelitis using the technique of intramedullary reinforcement.

Materials and methods. The data treatment of 25 patients aged 12 to 17 years with a shortening of the humerus after hematogenous osteomyelitis. Patients were divided into two groups: the first (n = 15) – to extend the shoulder technique was used bifocal distraction osteosynthesis; the second (n = 10) – to extend the shoulder technique used bifocal distraction osteosynthesis using intramedullary reinforcement (IMR).

Results. Applying the methodology IMR reduced the fixation index by an average of 4,6 days/cm (p <0,05). Long term recovery movement in the shoulder and elbow joints of patients in both groups after the treatment was not significantly different. In assessing the safety of the IMA revealed no differences in adverse events. Changes of biochemical parameters marked in patients with IMA group, were typical of patients undergoing limb lengthening by Ilizarov.

Conclusion. According to clinical data, as well as according to other research methods, contraindications in terms of the safety of the IMR with the humerus lengthening in patients with consequences of osteomyelitis is not revealed.

The purpose of the study is to develop an effective radiological symptom-complex of small-sized breast cancer affected by fibrocystic breast disease by using multivariate statistical methods.

Materials and methods. Radiological findings of small-sized breast cancer affected by fibrocystic mastopathy were analyzed in 100 patients with histologically verified diagnosis.

Results. It was revealed that the conventional approach to the analysis of mammograms based on the detection of the primary, secondary and indirect mammographic signs of small-sized breast cancer is not effective enough - the sensitivity of mammography is only 62%. Fibrocystic disease and moderate-to-severe sclerosing adenosis make small-sized breast cancer hard to visualize by mammography. The detailed analysis of mammograms allowed us to identify the additional manifestations of small-sized breast cancer affected by mastopathy. The computer program allowing us to evaluate the risk of small-size breast cancer and the diagnostic algorithm for detecting small size breast cancer with sensitivity of 92% were developed. 

The purpose of the study is to evaluate the effect of dynamic and static exercises on eNOS concentrations in the blood plasma of athletes who do cyclic and strength kind of sports, as well as in men, who are not involved in any sports.

Materials and methods. Determination of plasma concentrations of eNOS was performed by using enzyme immunoassay. Blood samples were collected from weightlifters and track and field athletes before and after static and dynamic exercises.

Results. It has been shown that regular exercises contribute to a significant increase in the background level of endothelial nitric oxide synthase (eNOS) in the plasma of athletes. It is necessary to note that eNOS is almost twice higher in the weightlifters than in the track and field athletes. eNOS concentrations significantly decrease in athletes after static exercises , but on the contrary, increase after dynamic exercises. eNOS level rise in untrained individuals occurs after all kinds of exercises, although the influence of dynamic exercises is much more pronounced. Plasma concentrations of eNOS in all groups returned to baseline during the recovery period.

These results suggest that the underlying mechanism that regulates the amount of eNOS in the plasma during exercises is associated with vascular factors, first and foremost, with the intensity of regional blood flow and its impact on the endothelium surface. Therefore, this protein cannot be positioned as a representative of a myokine group. 

Objective of the study is to determine the influence of mucoactive drugs of various groups on the activity of non-specific proteases and their inhibitors in the blood serum and sinonasal discharge during treatment of patients with acute purulent rhinosinusitis.

Materials and methods. 48 patients with acute purulent rhinosinusitis were treated; they were randomly assigned to four groups: N-acetylcysteine was used in Group 1 (n = 11), S-carboxymethylcysteine – in Group 2 (n = 14), phytoneering herbal drug (BNO-101) Sinupret – in Group 3 (n = 13). The control group consisted of patients (n = 10) who did not receive mucoactive agents during the treatment. Normal values were determined in 12 healthy volunteers. The material for the study included blood serum and sinonasal discharge of the patients. We studied elastase-like activity, trypsin-like activity, antitryptic activity and acid-stable inhibitors.

Results. Conducted treatment course resulted in improved clinical symptoms and decreased proteolytic activity in the blood serum and sinonasal discharge of the patients with acute purulent rhinosinusitis as compared to the patients’ parameters before treatment. Against this background, the state of proteinase inhibitors did not significantly change. This is primarily caused by the fact that antitryptic activity in acute purulent rhinosinusitis remained practically unchanged as compared to the parameter at the beginning of treatment. However, there is a tendency towards an increase in the inhibitory potential during treatment with mucoactive drugs. The highest level of this increase was observed when patients were taking BNO-101. On Day 10 of the study it resulted in the significant increase in antitryptic activity(ATA) as compared to the group prior to the treatment. The level of acid-stable inhibitors (ASI) in patients with purulent rhinosinusitis significantly decreased in the settings of acute purulent inflammation, and the activity of ASI increased during the treatment.

Conclusion. The study of non-specific proteases and antiprotease potential of sinonasal discharge demonstrates that the decrease in protease activity and normalization of their inhibitors level depends on the mucoactive agent chosen. The most effective treatment option reduces the aggressive effect of non-specific proteases on mucosa and connective tissue structures. The mucoactive drugs’ effect of improved drainage increases antiprotease potential by restoring the structure and functional activity of the mucosa. Restoration of mucosa increases synthesis and secretion of acid-stable protease inhibitors which are the key component of local antiprotease protection. 

Materials and methods. 18 native humic acids (HAs) were received from nine representative types of peat of the Tomsk region. Two extraction methods were used: sodium hydroxide and sodium pyrophosphate. Molecular structure parameters were investigated by IR-spectroscopy. The assessement of qualitative and quantitative features of the IR-spectra of 18 different humic acids was made. When HAs with mouse macrophages were cultured their ability to influence the NO-stimulation was determined. Thus, the biological activity of HAs and its dependence on the parameters of the molecular structure were studied.

Results. The results of infrared spectroscopy showed that the HAs of upland types of peat contain more carbonyl, carboxyl, and ester groups, and HAs of lowland types of peat contain more aromatic carbon, phenolic and alcoholic hydroxyl, ether and carbohydrate fragments. The results of biological activity showed that HAs from upland types of peat induce the formation of nitrogen oxide, wherein the cell activation decreases with HAs obtained by alkali. All types of HAs from lowland types of peat contain an admixture of endotoxin. Some HAs obtained by sodium pyrophosphate have higher immunotropic activity; the HAs can cause antigen-specific stimulation of cells. The activity of HAs does not depend on endotoxin admixture. The results of molecular spectroscopy showed that the most biologically active HAs have higher aromaticity and higher concentration of oxygen-containing functional groups. This result can be used as a marker factor in the standardization of HAs. 

The purpose of the article is to study the effect of air and water-immersion cooling media on the hemostatic system in the pre-active period of cold trauma.

Material and methods. The study was performed on 43 laboratory Wistar rats. Single air hypothermia was modeled by placing animals in individual cells into a cooling chamber at a temperature –25 °С. The animals were in the chamber until the rectal temperature reached 30 °C, which corresponded to a moderate degree of hypothermia in rats. Water immersion hypothermia was modeled by placing animals in individual cells into water with a temperature 5 °C and air 7 °C. The criterion for cessation of exposure was a rectal temperature of 27–30 °C, which also corresponded to a moderate degree of hypothermia. We assessed the state of vascularplatelet and plasma hemostasis, as well as the physiological state of anticoagulant and fibrinolytic systems. The study was performed by using routine techniques and an integral method - thromboelastography.

Results. It was established that during water immersion cooling, experimental animals developed thrombocytosis and activated their aggregation function. Laboratory indicators characterizing the initial stages of plasma hemostasis, and external and internal ways of activation did not change at this intensity of hypothermic exposure. At the same time, at the final stage of coagulation, pronounced thrombinemia was recorded, which was confirmed by a significant increase in the concentration of soluble fibrin-monomer complexes and a decrease in the time of their self-assembly. In addition, inhibition of fibrinolytic activity of plasma associated with a decrease in the concentration of antithrombin III was observed. In this case, single air hypothermia, accompanied by the rise in a rectal temperature up to 30 ° C, also caused significant changes in the hemostatic system. Vascular-platelet hemostasis responded to a significant decrease in aggregation activity of platelets. In plasma hemostasis, the final stage of coagulation was involved the most, which was manifested in hypocoagulant shifts. Along with this, pronounced inhibition of fibrinolytic activity of blood plasma was recorded. Thus, the described hemostasiological pictures indicate a pronounced influence of the environment causing supercooling on the response of an organism with hypothermia. In case of immersion hypothermia an increase in a rectal temperature up to 30 ºС is accompanied by a pronounced activation of the coagulation processes and the thrombotic state of readiness. When supercooling with air after reaching a rectal temperature of 30 ° C, secondary hypocoagulation shifts are recorded. 

The purpose of the paper is to study qualitative composition and quantitative content of primary exchange compounds in duckweed (Lemna minor L.), trisulki duckweed (Lemna trisulca L.) and spirodela (Spirodella polyrrhiza (L.) Schleid).

Materials and methods. The subject of the study was air-dried samples of grass collected during their 2010- 2011 growing season in low-flow and stagnant water bodies of Kozhevnikovsky and Tomsk districts of the Tomsk region. The concentration of free monosaccharides was determined by direct-phase high-performance liquid chromatography. The concentration of the bound sugars was determined by capillary electrophoresis using Applied Biosystem 273T (Thermophischer Ltd., USA). To obtain data on the qualitative composition and quantitative content of amino acids, the amino acid analyzer Hitachi 835 (Japan) was used.

Results. It was found out that the least amount of amino acids contained in the water extract from duckweed trifoliate – 96,14 mg, which is 2 times less than in extracts of Lemna minor and Lemna multirooted (205,65 and 208,38 mg, respectively). In duckweed the minimum content of free and bound monosaccharides was determined to be 10,54%, while in the Lemna trifoliate and Lemna multirooted their content was 14,30% and 15,35%, respectively. This study showed the qualitative and quantitative differences of free and bound monosaccharide and amino acid composition between previously mentioned species. 

Aim. The aim of our study is to explore the mechanisms of neuroprotective effects of p-tyrosol in acute global cerebral ischemia-reperfusion in rats.

Material and methods. The study was performed on 30 male rats stock Wistar (250–300 g).Animals were divided into 3 groups of 10 rats. In the control and experimental groups we performed the new 3VO model of cerebral ischemia-reperfusion, and the sham-operated animals underwent the same surgical procedures, but without the ligature imposition. Animals in the experimental group received p-tyrosol for 5 days intravenously at a daily dose of 20 mg/kg in a 2% solution. The sham-operated rats and control animals received a isotonic solution of NaCl at the same scheme. We measured rheological blood parameters and the content of products of lipid peroxidation in the brain tissue on the 5th day after cerebral ischemia-reperfusion.

Results. Acute ischemia-reperfusion of the brain in rats from the control group caused the significant hemorheological abnormalities, including the increased whole blood viscosity and plasma viscosity, decreased the erythrocyte aggregation half-time and decreased red blood cell deformability index. The increase blood viscosity caused the decrease of the oxygen delivery to the tissues. The content of diene and triene conjugates, fluorescent products and the lipid oxidation index increased in the brain tissue of the control group. These abnormalities induced the death of 50% animals from the control group. Given intravenously to animals of the experimental group, p-tyrosol reduced the whole blood viscosity by 19–31%, the plasma viscosity by 6% and increased the erythrocyte deformability by 31–40%, that led to the increase of oxygen availability for tissues by 21–31% in comparison with the control group. The contents of diene and p-triene conjugates and fluorescent products in the brain tissue under course administration of p-tyrosol decreased respectively by 37%, 49 and 45%, that reflected in the decreasing of lipids oxidation index by 38% in comparison with the control group. The number of survived animals in the experimental group was 1,4 times bigger than in the control group.

Conclusion. Course administration of p-tyrosol to rats with acute cerebral ischemia-reperfusion reduces the blood viscosity and the intensity of oxidative stress in the brain tissue. The results of these effects are the reduction of negative outcomes of ischemia-reperfusion of the brain and the increasing of animal surviving, that confirms the neuroprotective action of p-tyrosol in these conditions. 

Aim of the study. Rate dapagliflozin effective in the prevention and treatment of experimental urate nephropathy.

Мaterials and methods. The study was conducted on 30 male rats Wistar stock weighing 220–310 g. For the formation of urate nephropathy in rats using reproduced earlier classic model inhibiting uricase, causing the development of hyperuricemia in rodents. The animal was determined daily urine content MC, total proteins, creatinine, and enzyme activity of renal dysfunction markers LDH, gamma-glutamyl and N-acetyl-β-D-glucosaminidase. After the experiment the rat blood obtained after decapitation determined content MC, creatinine, catalase, glutathione peroxidase, superoxide dismutase, reduced glutathione, thiobarbiturate-reactive products, total antioxidant activity and a common pro-oxidant activity. In the kidneys of rats was determined by the same parameters of free radical oxidation.

Results. It was found that prolonged use of dapagliflozin in the prophylactic and therapeutic regimes, despite a decline in urinary pH, significantly improves the condition of animals with experimental urate nephrolithiasis, as evidenced by a significant decrease in the level of uric acid in blood plasma and urine of rats, a decrease in LDH activity in urine and inhibition process is free -radical oxidation.

Сonclusion. Prolonged use of dapagliflozin in the prophylactic and therapeutic regimes, despite a decline urine pH, improved the urate nephrolithiasis, as evidenced by a significant decrease in the level of uric acid in blood plasma and urine of rats, decreased activity of LDH in urine and inhibition of the process of free-radical oxidation. 

The purpose of the paper is to study the prevalence of structural scoliosis among 6–18 year-old school children from Novosibirsk using the computed optical topography (COMOT) data.

Materials and methods. A program of annual examination of the posture (using special developed COMOT) among school children of decreed ages, which was started in 2010 in all schools of the city, enabled data collection of more than 190,000 school children aged 6 to 18, including 49,0% girls and 51,0% foys COMOT provides reconstruction of a 3D-model of the dorsal surface of the body, assessment of the posture state, identification of structural scoliosis at an early stage, and precise determination of the scoliosis degree by angle of lateral asymmetry (LA) which is a topographic analogue of the Cobb angle.

Results. As the LA increases from 5−9º to ≥ 40º, the percentage of structural scoliosis rapidly falls from 31,1% to 0,04% in girls (G) and from 26,4% to 0,01% in boys (B), and the girls to boys ratio increases from 1,18 to 6,92. By the age of 17 years, skeletal growth in boys is generally completed; the G/B ratio for scoliosis ≥10º becomes 1,62; the rate of scolioses amounts to 5,3% (G) and 3,3% (B). The rate of scolioses ≥40º (with allowance for operated patients) has amounted to 0,24% (G) and 0,022% (B). Similar data may be expected in the adult population.

Conclusion. COMOT enabled a reliable estimation of the scoliosis severity and made it possible, unlike other screening schemes, to establish a modern system of prophylaxis of severe scoliosis forms in Novosibirsk. This biennially screening is sufficient for timely detection, follow-up and referral of a risk group to clinics. 

Purpose: to evaluate the interrelationships of proinflammatory cytokines serum levels with the development of acute myocardial infarction (MI) complications.

Materials and methods. Eighty two patients with AMI were studied. Prospective short-term study included, patients with uncomplicated non-Q wave MI (n = 27), patients with Q-wave MI complicated by acute left ventricular insufficiency Killip class I–II (n = 30), patients with Q-wave MI complicated by acute left ventricular insufficiency Killip class III–IV (n = 17), non-survivors due to development of cardiogenic shock (n = 8) and age and gender matched healthy controls (n = 12). Serum levels of IL-1β, IL-6 and TNF-α had been evaluated by means of ELISA method. Blood samples had been drawn on admission to the hospital within 18–28 hours from the onset of symptoms, at 3d and 14th days of MI. Risk stratification was assessed on admission according to the GUSTO Score.

Results. All cytokines levels were significantly elevated in MI patients in comparison to controls. Mean concentrations of IL-6 at baseline were higher among patients with MI complicated by cardiogenic shock than in group with uncomplicated MI (27,45 vs 16,04 pg/mL; р < 0,001). The same was revealed in concentration of TNF-α (24,74 vs 19,58 pg/mL; р < 0,01), while mean concentration of IL-1β did not differ significantly between these two groups. Non-survivors also showed significantly higher levels of IL-6, TNF-α than all groups of survived patients.

Conclusions. Increased levels of IL-6 and TNF-α at 1-st day of MI are associated with the development of acute left ventricular insufficiency and unfavorable prognosis. 

Purpose of the study. Experimental approbation of a new domestic ultrasound contrast agent (UCA) based on sulfur hexafluoride in the diagnosis of focal liver lesions of inflammatory genesis.

Materials and methods. The investigated ultrasound contrast agent (UCA) was a heterogeneous gas-liquid system consisting of micro bubbles of a sparingly soluble gas of sulfur hexafluoride (SF6) surrounded by a flexible mobile membrane of surfactants. Experimental work was carried out on rabbits. The study group included rabbits of males and females with focal liver lesion of inflammatory genesis (n = 12) weighing 1500- 1700 g. UCA was administered to animals in the ear vein. Focal lesions of the liver in animals were created in the experimental laboratory conditions. 14 days after the operation, all animals were subjected to ultrasound examination of the surgical intervention zones by using the Toshiba Aplio 400 scanners (Japan) with a 3,5–8 MHz convection sensor. In a natural study, the size, structure and echogenicity of the focus were assessed, the degree of vascularization, the evenness and clarity of the contours were determined. When performing post contrast ultrasound, the time of the onset of contrast enhancement, the total duration of contrast, the changes in the contrast enhancement of the focus in different phases of the study were measured, the dimensions of the focus were measured, and the evenness and acuity of contours were measured. For histological examination, liver fragments and lungs were used. 

In this review questions of development of endothelial dysfunction and its influence on progressing of a disease at an obliterating atherosclerosis of vessels of the lower extremities are considered. The role of selektin in adhesion of leukocytes on the endothelial cells leading to inflammatory reaction of a vascular wall is defined. In researches influence of the infectious agent on risk of development of a disease is noted. Decrease in dilatiruyushchy function of an endothelium happens due to deficiency of synthesis of nitrogen oxide. Development of an oxidizing stress and development of the fissile forms of oxygen exerts negative impact on an endothelium. The indicators associated with an atherosclerosis are inflammation mediators, markers of endothelial dysfunction and an angiogenesis, a lipide profile and factors of coagulation.

This article analyzes the current state of the problem of the correction of anophthalmic syndrome. Evaluated various methods of formation of the locomotor stump after removal of the eyeball, gave a detailed description of different types of materials for the fabrication of orbital implant, as well as reflect the basic principles of prevention of complications.

The aim of this article to discuss about modern vascular prostheses which used in reconstructive surgery. The treatment of patients with peripheral arterial disease is one of the most relevant sections of vascular surgery. Up to 65% of all cases, affected femoropopliteal segment. Surgical revascularization plays a center role in the treatment of peripheral artery disease. This article provides a classification of vascular grafts, analyzed their shortcomings and advantages, describes the prospects for their development. Unfortunately, despite the technical advances, has not yet developed an ideal vascular prosthesis. Thus there is a need of search for new materials and modifications of available materials, with the goal of creating a prosthesis for properties close to ideal.

The review is dedicated to the diagnostics of hypochromic microcytic anemia among pregnant women with carbohydrate metabolism disorders by means of existing laboratory algorithm of examination. We give some data on the anemic syndrome in women with diabetes mellitus type 1. These data demonstrate an equal occurrence of anemia of chronic disorder and iron-deficiency anemia in this group of patients. Special attention is paid to the role of hepcidin in iron metabolism as well as to the mechanisms of regulation of hepcidin production under normal and pathological conditions. The review cites researches, which demonstrate the effectiveness of hepcidin measurement for differential diagnostics of anemic syndrome. We also touch upon the problem concerning treatment of anemia of chronic disorder.

Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.

This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.

According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federation 

In the mechanisms of chronic heart failure (CHF) the key role traditionally given to a violation of intracardiac haemocirculation. Thus, in the guidelines for the evaluation and management of chronic heart failure in the adult, experts of the American College of Cardiology and the American Heart Association (2001-2013) define CHF as «a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood». Usually rightly believe that than the expression of inotropic and/or lusitropic failure of the appropriate ventricle in patients with CHF, the generally lower of him quality of life and a worse prognosis. However, the severity of the clinical manifestations of heart failure, on the one hand, and reducing the level of satisfaction with life - on the other, is not always depends only on the state of intracardiac hemodynamics. The authors of the review have analyzed papers published on the problem of the pathology of the peripheral circulation in CHF. Consistently examines the role of peripheral vascular remodeling and increased arterial stiffness, endothelial dysfunction of major and resistance arteries, as well as pathology of microcirculation. It has been shown that the development and progression of heart failure is accompanied by a deterioration in the peripheral circulation due to the remodeling of arteries muscular-elastic type and veins with a reduction in vascular dilatation reserve, increase of regional vascular resistance and venous tone, disturbances of tissue transcapillary exchange of oxygen and activate of procoagulant properties of blood. The significance of the effects of vasoconstrictor neurohormonal systems and inflammation in mechanisms of disorders of peripheral circulation in patients with CHF, particularly associated with the metabolic syndrome, have discussed.

Progressive subcortical vascular leukoencephalopathy caused by chronic hypertension was singled out as a separate disease by Alois Alzheimer and named “Binswanger’s Disease”(BD). Before the introduction of neuroimaging techniques in clinical practice BD was considered as a rare disease and in most cases it was diagnosed during autopsy. More than 80% of BD’s debuts occur on the sixth or seventh decade of life and are characterized by a mild but inexorably progressive course with episodes of exacerbation. At the last stage of the disease, clinical picture is presented by dementia, disorders of the self-service and the pelvic organs functions. The article presents a 42 years-old patient with the terminal stage of the BD’s type vascular dementia verified by postmortem histological examination. It is known that age is an unmodified risk factor for cardiovascular disease. However, in recent decades there has been “vascular risk rejuvenation” of the world, which calls for the development and improvement of approaches to screening and clinical examination of these contingents. The presented case report demonstrates the difficulty in the diagnosis of this pathology of the brain and demonstrates the need for inclusion of the BD in a number of differential diagnostic in patients with cerebrovascular diseases. In addition, we believe that dementia screening should include medical and psychological counseling of patients at risk.

The biography of doctor of medical sciences, Professor of the Pathophysiology Department of Siberian State Medical University, Corresponding Member of Russian Academy of Sciences, has been prezented. The main directions of scientific educational and public activity of the scientist are shown.