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THE MINISTRY OF PUBLIC HEALTH AND reventive and clinical medicine SOCIAL DEVELOPMENT (HERALD OF THE MECHNIKOV OF THE RUSSIAN SAINT-PETERSBURG STATE MEDICAL FEDERATION P ACADEMY) № 2 (35) 2010 4 issues a year SCIENTIFIC JOURNAL

The journal is in the list of issues Editor-in-chief recommended by the Higher Academician of RAMS, Honoured scientist of RF, M.D., Professor Certification Commission for the A.V.Shabrov publication of research papers reproducing contents of doctor EDITORIAL BOARD and candidate dissertations. Academician of RAMS, Honoured Scientist of RF, M.D., Professor V.G.ARTAMONOVA (Saint-Petersburg), M.D., Professor A.M.BOLSHAKOV All rights reserved. Using any (Moscow), A.A.BORISOV (Saint-Petersburg), Honoured Scientist of RF, M.D., material of the journal reference Professor V.A.DOTSENKO (Saint-Petersburg), M.D., Professor L.P.ZUEVA (Saint-Petersburg), M.D., Professor S.I.IVANOV (Moscow), M.D., Professor is obligatory. A.V.ISTOMIN (Moscow), M.D., Professor V.R.KUCHMA (Moscow), M.D., Professor B.V.LIMIN (Vologda), Honoured Scientist of RF, M.D., Professor Address of the editorial board: V.S.LUCHKEVICH (Saint-Petersburg), Honoured Scientist of RF, M.D., 195067, Saint-Petersburg, Professor V.G.MAIMULOV (vice-editor-in-chief, Saint-Petersburg), Piskarevsky prospect 47, Academician of RAMS, Honoured Scientist of RF, M.D., Professor I.I. Mechnikov Saint-Petersburg G.G.ONISCHENKO (Moscow), Academician of RAMS, Honoured Scientist of State Medical Academy, building RF, M.D., Professor Yu.Р.PIVOVAROV (Moscow), Academician of RAMS, 35, scientific department. Honoured Scientist of RF, M.D., Professor S.N.PUZIN (Moscow), Fax: 8 (812) 740-15-24, Academician of RAMS, Honoured Scientist of RF, M.D., Professor, Tel.: 8 (812) 543-59-18 Yu.A. RAKHMANIN (Moscow), M.D., Professor P.G.ROMASHOV (Saint- Petersburg), Academician of RAMS, Honoured Scientist of RF, M.D., Professor e-mail: [email protected] P.I.SIDOROV (Arkhangelsk), Academician of RAMS, Honoured Scientist of [email protected] RF, M.D., Professor G.A.SOFRONOV (Saint-Petersburg), Academician of [email protected]. RAMS, Honoured Scientist of RF, M.D., Professor V.I.STARODUBOV Web-сайт: http://www. (Moscow), M.D., Professor E.I.TKACHENKO (Saint-Petersburg), profclinmed.spb.ru Academician of RAMS, Honoured Scientist of RF, Professor V.A.TUTELIYAN (Moscow), Honoured Scientist of RF, M.D., Professor ЛР № 020496 V.P.CHASCHIN (Saint-Petersburg), M.D., Professor T.S.CHERNYAKINA Sent to the press: 25.12.2007. (executive secretary, Saint-Petersburg)

Format 60 х 84 ⅛. EDITORIAL COUNCIL Offset printing. Corresponding member of RAMS, M.D., Professor N.M.ANICHKOV (Saint- Conventional printer’s sheets 25. Petersburg), Candidate of Medicine A.I.VERESCHAGIN (Moscow), M.D., Educational printer’s sheets 20. Professor L.I.GLUSHKOVA (Syktyvkar), M.D., Professor S.A.GORBANEV Number of copies 1000. (Saint-Petersburg), M.D., Professor V.A.DADALI (Saint-Petersburg), M.D., Order № 1088 Professor G.I.DIYACHUK (Saint-Petersburg), Corresponding member of RAMS, M.D., Professor N.V.Zaitseva (Perm), M.D., Professor A.L.ZELDIN Computer make-up – «Articom (Saint-Petersburg), Doctor of Biology, Professor A.L.KOVALENKO (Saint- plus» Ltd. Printed in the Petersburg), Corresponding member of RAMS, Professor «Printing house ”Beresta”» Ltd., B.A.KURLYANDSKY (Moscow), M.D., Professor S.A.LINNIK (Saint- Petersburg), M.D., Professor A.V.MELTSER (Saint-Petersburg), M.D., Saint-Petersburg, Kolya Professor S.V.NAGORNY (Saint-Petersburg), M.D., Professor Tomchak str., 28 V.I.NIKOLAEV (Saint-Petersburg), M.D., Professor V.M.PETRENKO (Saint- Petersburg), M.D., Professor L.G.PODUNOVA (Moscow), Honoured Scientist ISSN 2074-9120 of RF, M.D., Professor I.V.POLYAKOV (Saint-Petersburg), Candidate of Preventive and clinical medicine Medicine I.A.RAKITIN (Saint-Petersburg), M.D., Professor (Herald of the Mechnikov Saint- V.G.RADCHENKO (Saint-Petersburg), M.D., Professor A.V.Skalny Petersburg state medical (Moskow), M.D., Professor E.G.TOPUZOV (Saint-Petersburg), M.D., academy). Professor S.A.KHOTIMCHENKO (Moscow), M.D., Professor A.G. SHIMAN 2010 № 1 (34), 201 pp. (Saint-Petersburg), Corresponding Member of RAMS, M.D., Professor Subscription index: 42363- A.P.SCHERBO (Saint-Petersburg), M.D., Professor I.Sh.YAKUBOVA (Saint- Petersburg) полугод, 42364-год

1 SAINT-PETERSBURG – 2010

CONTENTS

PUBLIC HEALTH AND PUBLIC HEALTH SERVICES Eremin G.B., Yakubova I.Sh., Maimulov V.G., Chernyakina T.S., Suvorova A.V., Blinova L.T., Petrashevich V.A. Problems of quality support in medical aid organization for children and adolescents in educational establishments Orel V.I., Keshishev I.A. Structural bases of disabled children complex rehabilitation Shestakov V.P., Svintsov A.A., Chernyakina T.S., Ovcharenko S.A., Chepik K.V. Analysis of dynamics of primary disability of the population of the Russian Federation due to craniocerebral injury Paskar N.A., Karuzin S.V., Polyakov I.V., Alborov A.H., Arbuzova Y.M., Kulikov V.D. The characteristic of morbidity and mortality rate of adult population of Saint-Petersburg because of illnesses of blood circulation system

MOTHER AND CHILDHOOD PROTECTION Degtyaryova Е.А., Romantsov M.G., Zhdanova O.I., Mikheeva А.А., Avakyan А.А. Cytoflavin as a means for the correction of posthypoxic myocardial lesions in newborn infants Abdurakhimova K.Sh. Integral evaluation of enterobiasis risk factors importance and risk group formation in preschool children

HYGIENE OF THE SURROUNDING AND INDUSTRIAL ENVIRONMENT Kovtunova M.E., Pozdeev N.M., Kashin K.P., Kunof V.K. Seasonal influence on the parameters of protein metabolism in donors of plasma for fractionation Nekhoroshev A.S., Danilova N.B., Morozova E.I. Methodological aspects of the use of training programs on hygiene of oral cavity physician-stomatologists practitioners

2 Navruzov E.B. Reproductive system hormones content in rats at the hossipole intoxication Usmanova Sh.F. Microenvironmental problems of medical nurses in clinical subdivisions

NEW TECHNOLOGIES, METHODS OF DIAGNOSTICS, TREATMENT AND PREVENTION IN PUBLIC HEALTH SERVICES Gontar I.P., Nenasheva N.V., Matasova N.A., Avetisova E.R., Kochneva L.I., Zborovskaya I.A. Clinical-diagnostic value of determination of antibodies to elastin and elastase in patients with rheumatic arthritis, systemic lupus erythematosus, systemic scleroderma Orlov A.Yu., Kokin G. S., Daminov R. G., Komkov D.Yu., Berishvili K.Sh. Methods of examination of patients with peripheral nerve tumors Grenkova Yu.M., Safronova M.M. Modern approaches to diagnostics of uterine cervix diseases in post menopause Ibragimov Sh.I., Abdullaev T.U. HLA-antigen association with climacteric keratoderma Nilova L.Yu., Orishak E.A., Boitsov A.G. Regarding the problem of probiotics usage for intestinal disbacteriosis therapy

CLINICAL AND EXPERIMENTAL STUDIES Belkov A.V., Russin A.S., Sadique M. I., Kolesnichenko M.G., Burbello A.T. Clinical prognostic value of metabolic treatment in patients with myocardial infarction Gorbacheva I.A., Sycheva Yu.A., Slepneva L.V., Alekseeva N.N., Malozemova V. A, Popov D.A. Antihypoxic therapy resources in ischemic heart treatment Livanov G.A, Amagyrov V.P., Batotsyrenov B.V., Lodyagin A.N., Batotsyrenova H.V. Metabolic distress correction in complicated forms of myocardial infarction

3 Frolova N.L.1 Features of autonomic regulation of heart rate in cardiac patients with psychosomatic profile Kozyrev A.G., Surkova E.A., Gichkin A.Yu., Perley V. E. Endotelin-1content in patients with bronchial asthma with concomitant hypertensive disease Goldzon M.A., Dolgikh V.T., Girsh A.O. Contractile rat myocardial function disorders at thermal trauma and ways of their correction Belova S.V. Simulation of experimental arthritis Tarasov A.N. Pancreas graft formation depending on conditions of its blood supply Komyakov B. K., Guliev B. G., Shibliev R. G., Alekseev M. Yu. Complications of percutaneous nephrolithotripsy Alexandrova L.A., Zhloba A.A., Blashko E.L., Chefu S.G. Kuzmenko N.V., Tsirlin V.A. Methabolism of aminothiols and antioxidant status in rats under experimental renal ischemia Belokrylov Н.М. Choice of optimum tactics for treatment of Legga-Kalve- Pertes disease Arsenev A.A., Dmitriev B. V., Makarov V. K. Immunoreactivity features in patients with benign prostate hyperplasia and prostate adenocarcinoma Seliverstov P.V., Teterina L.A., Radchenko V.G., Sitkin S.I., Suvorov A.N., Alekhina G.G. Aged changes in the gastrointestinal tract in patients with disbiosis of the large intestine on the background of liver chronic diseases Abdulaev M.A., Plotnikov Yu.V., Mukhanna A.M. Еarly results of treatment of patients with perforated gastroduodenal ulcers Chuprov I.N., Klyucharyova S.V. Romanova V.L Parenchymal basal membrane in various types of the skin basal cell carcinoma Slepnev M.V., Frolova N.Yu. Study of pharmacological activity of ointments, obtained on the basis of the gel – Arespol Komleva N.E, Spirin V.F, Grishina T.V, Novikova T.A, Medentsov V.A, Mikhailova N.A, Skvortsov V.O Influence dorsopatiya of agricultural workers on quality of life

4 EPIDEMIOLOGY, MICROBIOLOGY, INFECTIOUS AND PARASITIC DISEASES Kargaltseva N.M.,Burbello A.T., Kocherovets V.I., Fedorenko A.S. Clinical and microbiological features of blood flow infections Aleksandrova E.A., Lepilin A.V., Kazimirova N.E., Shuldyakov A.A. Cycloferon liniment efficiency study in the complex therapy of oral cavity inflammatory diseases in tuberculous patients Khalikova Sh.A., Daminova M.N. Amino acid spectrum and nitrogen oxide state in blood serum of children with chronic virus hepatitis C

RESTORATIVE MEDICINE Burmistrov D.A., Demin G.S., Khardikov O.I. Strong training by STEN method as a way to restore flexibility and reduce pain syndrome in patients with lumbosacral osteochondrosis in different ages Gzogyan M.N., Tarasov N.I., Isakov L.K., Krivonosov D.S., Kuznetsova T.V., Yarkovskaya A.P., Teplyakov A.T. The effectiveness of rehabilitation measures with long-standing physical training in outpatient recovery in patients after myocardial infarction

MEDICAL PSYCHOLOGY, PSYCHIATRY, PSYCHOTHERAPY

Belov V.G., Parfenov Yu.A., Dergunov A.A., Orlovsky M.S. Art therapy in treatment of non-psychotic affective distresses Vlasova O.L. Clinico-psychological features of patients with a various clinical versions of current of a metabolic syndrome

SCIENTIFIC REVIEWS Romantsov M. G., Goryacheva L.G., Kovalenko A.L. Pharmaco-therapeutic cycloferon efficacy in pediatric practice Petrova N.N. Medical products for pharmacological correction of sensorineural hearing loss 5 Sologub T.V., Romantsov M. G, Semenyako N.A., Kovalenko S.N., Kovalenko A.L., Sukhanov D.S. Modern approaches to HCV-infection treatment

TO AUTHORS ATTENTION

PUBLIC HEALTH AND PUBLIC HEALTH SERVICES

1256 Еремин+ UDC 613.955/.956:614.39 © G.B. Еremin, I.Sh. Yakubova, A.V. Suvorova, V.G. Maimulov, T.S. Chernyakina, L.T. Blinova, V.A. Petrashevich, 2010 Eremin G.B.1, Yakubova I.Sh.1, Suvorova A.V.1, Maimulov V.G.1, Chernyakina T.S.1, Blinova L.T.1, Petrashevich V.A.2 Problems of quality support in medical aid organization for children and adolescents in educational establishments // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1 State Educational Establishment of Higher Professional Training «Mechnikov Sankt-Petersburg State Medical Academy of the Federal Agency for Public Health and Social Development of the Russian Federation». Russia, 195067, Saint- Petersburg, K-67, Piskarevsky pr., 47. Tel.: 8(812)543-96-09, fax: 8(812)740-15-24, e-mail: [email protected]; www.mechnik.spb.ru 2 Municipal policlinic N 88, Russia, 198261, Saint-Petersburg, General Simonyak str., 6, tel.: 8(812)750-80-11, fax: 8(812)750-9246. S u m m a r y : The article deals with the problems of quality in medical help organization to children and adolescents in educational establishments. Components of medical aid are specified. Problems of development of medical standards aid to children and adolescents in educational establishments are set. K e y w o r d s : children, adolescents, medical aid, educational establishments I n f o r m a t i o n a b o u t t h e a u t h o r s :

6 Eremin Gennady Borisovich – Candidate of Medical Sciences, head of the branch of the FSI «Consultation-methodical center for licensing» of the Federal service on Public health and social development in Saint-Petersburg and Leningrad region», Russia, 191311, Saint-Petersburg, Smolny str. 3, let. А. Tel.: 8(812)576-79- 90. E-mail: [email protected] Yakubova Irek Shavkatovna - Doctor of Medicine, Professor of the department of Preventive Medicine and Health Protection of the Mechnikov Saint-Petersburg State Medical Academy, work tel./fax: 8(812)543-17-47, mobile phone: 8(921)965- 04-89. E-mail: [email protected] Suvorova Anna Vasilievna - Candidate of Medical Sciences, Assistant- Professor of the department of Preventive Medicine and Health Protection of the Mechnikov Saint-Petersburg State Medical Academy, work tel./fax: 8(812)543-17- 47, mobile phone: 8(911)755-7910. E-mail: [email protected] Maimulov Valery Georgievich – Honoured scientist, M.D., Professor, head of the department of Preventive Medicine and Health Protection of the faculty for Advanced Training of the state educational establishment for higher professional training “I.I.Mechnikov Saint-Petersburg State Medical Academy» of the Federal agency for Public Health and Social Development of the Russian Federation”, Russia, 195067, Saint-Petersburg, К-67, Piskarevsky prospect, 47 Tel. 8(812)543-96-09, fax: 8(812)140-15-24, e-mail: mechnik @gmail.com Chernyakina Tatiyana Sergeevna – M.D., Professor of the department of Preventive Medicine and Health Protection of the Faculty for Advanced Training of the SEE HPT «SPSMA named after I.I.Mechnikov of Roszdrav», tel.: (812)543-49- 41, fax: (812)543-93-18. E-mail: m а [email protected] Blinova Lyubov Timofeevna - Candidate of Medical Sciences, Assistant- Professor of the department of Preventive Medicine and Health Protection of the Mechnikov Saint-Petersburg State Medical Academy, work tel./fax: 8(812)543-17- 47, mobile phone: 8(911)119-90-71. E-mail: [email protected]

7 Petrashevich Vladimir Alekseevich – Candidate of Medical Sciences, chief physician of the municipal polyclinic № 88, Russia, 198261, Saint-Petersburg, General Simonyan str., 6. Yel.: 8(812)750-80-11, fax: 8(812)750-92-46. M a t e r i a l R e c e i v e d 28.11.2009 г.

8 1334 Орел+ UDC 34:616-036.868 © V.I. Orel, I.A. Keshishev, 2010 Orel V.I.¹, Keshishev I.A.² Structural bases of disabled children complex rehabilitation // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. ¹Saint-Petersburg State Pediatric Medical Academy, Russia, Saint-Petersburg, 194100, Litovskaya str., 2. Phone: 295-06-46, 542-39-83, fax: 295-40-85. E-mail: [email protected] ²Children Rehabilitation Center, Russia, Saint-Petersburg Federal State Institution the «Saint-Petersburg Scientific-Practical Center for Disabled Medical and Social Examination, Prosthetics and Rehabilitation named after G.A.Albrekht of the Federal Agency for Public Health and Public Health Services»: Russia, Saint- Petersburg, 195067, Bestuzhevskaya str., 50. Phone: 8(812)544-22-66, 544-13-26. E- mail: [email protected], Web-address: http: //reabin.sp.ru S u m m a r y : The article contains practical bases in complex rehabilitation of disabled children, including medical, professional, psychological-and-pedagogical, social rehabilitation. K e y w o r d s : disabled children; complex rehabilitation measures. I n f o r m a t i o n a b o u t t h e a u t h o r s : Orel V.I. – head of the department of «Social Pediatrics and Public Health Organization» of FAT and RT of the Saint-Petersburg State Pediatric Academy, Saint-Petersburg. Keshishev I.A. – doctor in children rehabilitation-restoration center of FSI «A.A. Albrekht Saint-Petersburg Scientific-Practical Center of Medical-Social Examination, Prosthetics and Rehabilitation of Disabled of the Federal Medical- Biological Agency of the Russian Federation». Tel.: 8(812)544-22-66, 544-13-26, E- mail: [email protected]. M a t e r i a l R e c e i v e d 10.06.2010 г.

9 1253 Шестаков+ UDC 614.1-056.266/.267:616.714-001:616.831-001 © V.P. Shestakov, A.A. Svintsov, T.S. Chernyakina, S.A. Ovcharenko, K.V. Chepik, 2010 Shestakov V. P, Svintsov A.A., Chernyakina T.S., Ovcharenko S.A., Chepik К.V. Analysis of primary physical inability dynamic parameters due to craniocerebral trauma // Preventive and Clinical Medicine. – 2010. - № 2 (35). – P. Federal state institution «G.A. Albrekht St.-Petersburg Scientific-Practical Centre for Medical-Social Examination, Prosthetics and Rehabilitation of Invalids of the Medical and Biologic Agency»: Russia, 195067, St.-Petersburg, Bestuzhevskayay str., 50. Tel.: +7(812) 544-22-66, 544-13-26. E-mail: [email protected]. S u m m a r y : Рurpose of the study – to define and estimate the dynamics of prevalence of primary physical inability of citizens due to craniocerebral trauma depending on a place of residence, age and physical inability group. Material: Results of the primary examination of citizens (Russian Federation) at the age of 18 and over because of consequences of head injuries (Class MKB-10 Т90) for the period of 2005-2008. Methods: Statistical analysis of primary physical inability parameters. Results: Figures for primary physical inability as a consequence of craniocerebral trauma were higher in countryside, than in urban settlements and than on the average across the Russian Federation. The maximum level was registered among middle aged persons, and minimum – in persons of advanced age. The highest figures were registered in II and III groups of physical inability. In Siberian and Far East Federal districts (FD) the parameter of primary physical inability of I group was above the mean parameter across the Russian Federation in all the analyzed years, II group - in Southern and Siberian FD, III group - only in Southern FD. The figures for primary physical inability of II and III groups considerably exceeding those across the Russian Federation were in the Chechen republic. For 4 years the level of primary physical inability both across the Russian Federation, and also in urban settlements and countryside, as well as in all federal districts, age groups and physical inability groups decreased. The obtained statistical data on physical inability of various groups 10 of the population due to craniocerebral trauma can serve a basis for the development of regional and nation-wide programs of rehabilitation, for planning of regularly- personnel structure and equipment of the establishments realizing individual programs of invalids rehabilitation. K e y w o r d s : craniocerebral trauma; primary physical inability dynamic prevalence; distribution due to a place of residence; age and physical inability groups. R e f e r e n c e s 1. Андреева О.С, Осадчих А.И., Пузин С.Н. Правовые, организационные и методические основы реабилитации инвалидов: Руководство, том 1. - М, 2005. - 456 с. 2. Гришина Л.П., Дымочка М.А., Василенко О.Ю., Люберицкая Л.П. Основные тенденции первичной инвалидности взрослого населения и ее гендерные особенности в Российской Федерации в 2003—2006 гг. // Медико- социальная экспертиза и реабилитация. – 2008. - № 1. - С. 4-6. 3. Гришина Л.П. Анализ инвалидности взрослого населения по обращаемости в бюро медико-социальной экспертизы Российской Федерации // Медико-социальная экспертиза и реабилитация. – 2008. - № 1. - С. 28-31. 4. Зверев К.В., Панков В.Е., Тананян Н.В. Структура и уровень первичной инвалидности взрослого населения по классам болезней в Российской Федерации в 2003—2006 гг. // Медико-социальная экспертиза и реабилитация. – 2008. - № 1. - С. 22-24. 5. Коновалов, А.Н. Основные итоги отраслевой научно-технической программы С.09 “Травма центральной нервной системы” (1986-1990 гг.) / А.Н. Коновалов, Л.Б. Лихтерман // Журн. вопросы нейрохирургии им. Н.Н. Бурденко. - 1992. - № 4/5. - С. 39. 6. Лихтерман Л.Б. Черепно-мозговая травма: итоги века // Медицинская газета. - 2000. - № 16 (3 марта 2000 г.). 7. Meдико-социальная экспертиза больных вследствие черепно- мозговой травмы: Методические рекомендации / Сост: Л.С. Гиткина, В.Б. Смычек, Т.Д.

11 Рябцева, И.Я. Чапко, Е.Ф. Святская. – Минск: Бел. НИИ экспертизы трудоспособности и организации труда инвалидов, 2001. - 26 с. 8. Орехова Г.Г., Бабенко А.И. Эпидемиология черепно-мозгового травматизма // Медицина в Кузбассе. – 2008. - № 2. – С. 10-14. 9. Пузин С.Н., Гришина Л.П., Кардаков Н.Л. Инвалидность в Российской Федерации. - М, 2006. - 224 с. 10. Пузин С.Н., Гришина Л.П., Лунёв В.П. Инвалидность трудоспособного населения в Российской Федерации. - М, 2007. - 208 с. 11. Пугиев Л.И. Динамика первичной инвалидности у лиц молодого возраста в Российской Федерации и ее субъектах // Медико-социальная экспертиза и реабилитация. – 2008. - № 1. - С. 24-27. 12. Святская Е.Ф. Медико-социальная экспертиза больных с последствиями черепно-мозговой травмы / Е.Ф. Святская // Медицинская панорама. - 2004. № 9. - С. 47-48 13. Смычек В.Б., Копыток А.В. Показатели первичной инвалидности и потребность в видах медико-социальной реабилитации вследствие внутричерепных травм // Комплексная реабилитация больных и инвалидов. – 2008. – № 2-3. – 66-77 с. 14. Basso, A. Advances in management of neurosurgical trauma in different continents / A. Basso, B. Previgliano, J.M. Ignacio et al. // World J. Surg. - 2001. - Vol. 25, № 9. - P. 1174-1178. I n f o r m a t i o n a b o u t t h e a u t h o r s : Shestakov Vladimir Petruvich – Doctor of Medical Sciences, Deputy-director of the Federal State Institution the «Saint-Petersburg Scientific-Practical Center for Disabled Medical and Social Examination, Prosthetics and Rehabilitation named after G.A.Albrekht of Roszdrav». FSI the “Saint-Petersburg Scientific-Practical Center for Medical-and-Social Examination, Prosthetics and Rehabilitation of Disabled named after G.A.Albrekht of Roszdrav. Рhone: +7 (812) 544-22-66, 544- 13-26. E-mail: [email protected].

12 Svintsov Alexander Anatolievich – Candidate of Medical Sciences, head of the department of the Federal State Institution the «Saint-Petersburg Scientific-Practical Center for Disabled Medical and Social Examination, Prosthetics and Rehabilitation named after G.A.Albrekht of Roszdrav». Tel.: +7 (812) 544-22-66, 544-13-26. E- mail: [email protected]. Chernyakina Tatiyana Sergeevna – Doctor of Medicine, Professor of the department of Preventive Medicine and Health Protection of the Faculty for Advanced Training of the SEE HPT «Mechnikov Saint-Petersburg State Medical Academy of Roszdrav», tel./fax: (812)543-49-41, tel. home: 8(812) 525-59-47, tel. mob.: 8-950-028-61-93. E-mail: m а [email protected] Ovcharenko Svetlana Alekseevna – Doctor of Medicine, Professor, head of the department «Theory and Practice of Social Work» Saint-Petersburg State University of service and economic. Tel. work.: 8(812) 252-18-97, tel. home: 8(813) 702-45-04, tel. mob.: 8-921-974-00-98. E-mail: [email protected] Chepic Kirill Vladimirovich – senior researcher of the Federal State Institution “Albrekht Saint-Petersburg Scientific-Practical Center of Medical-Social Examination, Prosthetics and Rehabilitation of the disabled of the Federal Madical- and-Biological Agency” Теl.: +7 (812) 544-22-66, 544-13-26. E-mail: reabin @ nkl .ru. M a t e r i a l R e c e i v e d 24.11.2009 г.

1336 Паскарь + UDC 614.1:616.1 (470.23) © N.A. Paskar, S.V. Karuzin, I.V. Polyakov, A.H. Alborov, Y.M. Arbuzova, V.D. Kulikov, 2010 Paskar N.A.1, Karuzin S.V.1,2 Polyakov I.V.2, Alborov A.H.3, Arbuzova Y.M.3, Kulikov V.D.3 The characteristic of morbidity and mortality rate of adult population of Saint-Petersburg because of illnesses of blood circulation system // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1Federal State Establishment «Federal Centre of Heart, Blood and Endocrinology of V.A. Almazov, Rosmedtehnology». Russia, 197341, Saint- 13 Petersburg, Accuratova str., 2. Tel/fax: 8(812)702-37-00. E-mail: director@hbe- centre.ru; www.almazovcentre.ru 2State Educational Establishment of Higher Professional Training «Mechnikov Sankt-Petersburg State Medical Academy of the Federal Agency for Public Health and Social Development of the Russian Federation». Russia, 195067, Saint- Petersburg, K-67, Piskarevsky pr., 47. Tel.: 8(812)543-96-09, fax: 8(812)740-15-24, e-mail: [email protected]; www.mechnik.spb.ru 3Saint-Petersburg State Medical Establishment «Medical information-analytical centre». Russia, 198095, St.-Petersburg, Shkapina str., 30. Tel.: 8(812)576-22-22, fax: 8(812)576-22-23 E-mail: [email protected] S u m m a r y : From the beginning of 1990th years illnesses of blood circulation system continue remain leaders in morbidity and mortality structure. The basic damage put cerebrovascular diseases, diseases characterised by the raised blood pressure and an ischemic heart trouble to health of the Russian population. K e y w o r d s : illnesses of blood circulation system; morbidity; mortality; quality of a life. R e f e r e n c e s 1. Демографический ежегодник России. - М., 2008. - С. 306-312. 2. Регионы России. Социально-экономические показатели. - М., 2008. - С. 60-62, 316-317. 3. Регионы Северо-Западного Федерального округа. Социально- экономические показатели, 2007 год. Статистический сборник. – Сыктывкар: Комистат, 2007. - 182 с. 4. Российский статистический ежегодник. - М., 2008. - С. 112-116. 5. Социально-значимые заболевания населения России в 2006 году. Статистические материалы. - М., 2007. - 67 с. I n f o r m a t i o n a b o u t t h e a u t h o r s : Paskar Nadezhda Andreevna - candidate of medical sciences, head of Department of rendering hi-tech medical aid with group of an estimation quality of

14 hi-tec medical aid Federal State Establishment «Federal Centre of Heart, Blood and Endocrinology of V.A. Almazov, Rosmedtehnology». Work tel.: 8(812)702-55-82. Karuzin Sergey Vyacheslavovich - the internal post-graduate student of the Course of Management and Economy of Public Health Services of Department Socially-Humanities Science, Economy and Low of Saint-Petersburg State Medical Academy named after I.I. Mechnikov. The initial scientific employee of Department of rendering hi-tech medical aid with group of an estimation quality of hi-tec medical aid Federal State Establishment «Federal Centre of Heart, Blood and Endocrinology of V.A. Almazov, Rosmedtehnology». Work tel.: 8(812)543-02-64. Polyakov Igor Vasilevich - doctor of medicine, professor, head of the Course of Management and Economy of Public Health Services of Department Socially- Humanities Science, Economy and Low of Saint-Petersburg State Medical Academy named after I.I. Mechnikov. Work tel.: 8(812)543-02-64. Alborov Alan Hsarbegovich – director of St.-Petersburg State Medical Establishment «Medical information-analytical centre». Ph. 8(812)576-22-22, a fax: 8(812)576-22-23. Arbuzova Yulia Mikhaylovna – engineer of department of analysis and forecasting of St.-Petersburg State Medical Establishment «Medical information- analytical centre». Ph. 8(812)576-22-37, a fax: 8(812)576-22-23. Kulikov Valery Dmitrievich – candidate of medical sciences, manager of department of analysis and forecasting of St.-Petersburg State Medical Establishment «Medical information-analytical centre». Ph. 8(812)576-22-75, a fax: 8(812)576-22- 23. M a t e r i a l R e c e i v e d 23.06.2010 г.

MOTHER AND CHILDHOOD PROTECTION 1327 Дегтярева+ UDC 616.12-053.31:615.27 © Е.А. Degtyaryova, M.G. Romantsov, O.I. Zhdanova, А.А. Mikheeva, А.А. Avakyan, 2010

15 Degtyaryova Е.А.1, Romantsov M.G.2, Zhdanova O.I.1, Mikheeva А.А.3, Avakyan А.А.3 Cytoflavin as a means for the correction of posthypoxic myocardial lesions in newborn infants // Preventive and clinical medicine. – 2010. - № 2 (35). – P 1 Russian University of People Friendship (RUDN), Russia, 117198, Moscow, Miklukho-Maklay str. 6. 2 Scientific-Technological Pharmaceutical Firm «POLYSAN», Russia, 191119, Saint-Petersburg, Ligovsky prospect, 112, tel.: 8(812)110-82-25,112-13-79, е-mail: [email protected], STPF “POLYSAN” www.polysan.ru 3State educational institution of the higher professional training Roszdrav Russian State Medical University (SEE RSMU ), Russia, 117997, Moscow, Ostrovetyanova str., tel.: 8 (495) 434-03-29, e-mail: [email protected] S u m m a r y : A multicenter trial of 30 infants with post-hypoxic myocardial lesions associated with I-II degree cerebral ischemia has revealed that the inclusion of Cytoflavin infusions into the complex standard treatment leads, besides the improvement of general clinical status, to significantly more rapid, as compared to the control group, positive dynamics of pump and contractile myocardial functions, elimination of hyperfermentemia, hypoxia and electrical instability of the myocardium, energetic deficit, repolarization changes within the first 5 days of in- hospital therapy as well as during the follow-up from 1 to 6 months of life. K e y w o r d s : cytoflavin; ischemia-hypoxia; newborn infants; myocardium. R e f e r e n c e s 1. Афанасьев В.В. Цитофлавин в интенсивной терапии / В.В. Афанасьев // Пособие для врачей. – СПб., 2005. – 36 с. 2. Визир В.А. Метаболические кардиомиопротекторы: фармакологические свойства и применение в клинической практике / В.А. Визир, И.Н. Волошина, Н.А. Волошин // Методические рекомендации. – Запорожье, 2006. – 34 с. 3. Ланкин В.З. Свободнорадикальные процессы в норме и при патологических состояниях / В.З. Ланкин, А.К. Тихазе, Ю.Н. Беленков //

16 Пособие для врачей. Издание второе, исправленное и дополненное. М.: Медицина, 2001. – 78 с. 4. Прахов А.В. Функциональное состояние сердца у новорожденных детей с различными вариантами сочетанной перинатальной патологии / А.В. Прахов, Ж.В. Альбицкая, Ю.Д. Гиршович // Детские болезни сердца и сосудов. – 2004. - № 3. – С. 60-63. 5. Симонова Л.В. Постгипоксический синдром дезадаптации сердечно- сосудистой системы у новорожденных и детей раннего возраста / Л.В. Симонова, Н.П. Котлукова, М.Е. Ерофеева // Педиатрия. – 2000. - № 3. - С. 17-21. 6. Таболин В.А. Актуальные проблемы перинатальной кардиологии / В.А. Таболин, Н.П. Котлукова, Л.П. Симонова // Педиатрия. - 2000. - № 5. - С. 13-22. 7. Costa S. Serum troponin T usefull of myocacardial damage in newborn infants with perinatal asphexia / S. Costa, E. Zecca //Acta Paediatrica. – 2007. – Vol. 96. – Р. 181-185. 8. Clark S.G. Concentration of cardiac troponin T in neonates with and without respiratory distress / S.G. Clark, Р. Newland, C.W. Yoxall // Arch Dis Child Fetal Neonatal Ed. – 2004. - Vol. 89. – Р. 348-352. 9. Eques J. Myocardial infarction in relation to perinatal hypoxia // J. Eques, V. Flores, M. Mendivil // AN Esp. Pediatr. – 1983. – Vol. 19, №4. – P. 263-267. 10. Muller J.C. Value of myocardial hypoxia markers (CK and its MB-fraction, troponin T, Q-T interval) and serum creatinine for the retrospective diagnosis of perinatal asphyxia / J.C. Muller, В. Thielsen // Biology neonate. – 1998. - Vol. 73. – Р. 367-374. 11. Rowe R.D. Transient myocardial ischemia of the newborn infant-form of severe cardiorespiratory distress in full term infants / R.D. Rowe, T. Hoffman // J. Pediatr. – 1972. - Vol. 81. – Р. 234-250.

17 12. Sharma R. The role of inflammatory mediators in chronic heart failure: cytokines, nitric oxide, and endothelin-1 / R. Sharma, A.J. Coats, S.D. Anker // Int. J. Cardiology. – 2000. – Vol. 72, № 2. – P. 175-186. 13. Tiernan C.F. The role of tumor necrosis factor alpha in the pathophysiology of congestive heart failure / C.F. Tiernan, A.M. Feldman // Curr. Cardiol. Rep. – 2000. – Vol. 2, № 3. – P. 189-197. I n f o r m a t i o n a b o u t t h e a u t h o r s : Degtyareva E.A. - Doctor of Medicine, Professor of the department of Children Diseases of RUDN, chief physician of children infectious clinical hospital №6, Moscow, Vice-President of the Association of Children Cardiologists of Russia. Romantsov Mikhail Grigorievich – Doctor of Medicine, Professor of the department of Infectious Diseases of SEEHPT «Saint-Petersburg State Medical Academy named after I.I.Mechnikov of Roszdrav», chief adviser for scientific work of the Open Company NTFF «POLYSAN». Тel.: 8-812-710-82-25. E-mail: [email protected] Zhdanova Olga Ivanovna - Candidate of Medical Sciences, Assistant of the department of Children Diseases of RUDN. Mikheeva Anna Anatolievna - Candidate of Medical Sciences, Assistant of the department of children diseases №3 of RSMU, deputy-head physician for medical work CICH №6. Tel.: 8(495) 456-34-71. Avakyan Alexander Armenovich – Assistant of the department of children Disease of the Medical faculty of RSMU, deputy-head physician for medical work CICH №6. Tel.: 8(495) 456-34-71.

M a t e r i a l R e c e i v e d 01.06.2010 г.

1308 Абдурахимова+ UDC 616.995.1:616-02-053.4 © K.Sh. Abdurakhimova, 2010 Abdurakhimova K.Sh. Integral evaluation of enterobiasis risk factors importance and risk group formation in preschool children // Preventive and clinical medicine. – 2010. - № 2 (35). – Р.

18 Tаshkent Medical Aсademy, Ministry of Health of the Republic of Uzbekistan, 100109, Uzbekistan, Tаshkent, Faroby str., 2, Tel: +998 (71) 1507825, 2148311; Fax: +998 (71) 2185948, E-mail: [email protected]; [email protected] S u m m a r y : It has been calculated prognostic risk tables that can be used in practical purposes to determine the chance of enterobiasis occurrence at the age of 3 until 7 years old. Proposed tables can be used in realization of preventive and sanitary measures to eliminate and reduce the effect of revealed unfavourable factors. K e y w o r d s : children with enterobiasis; risk factor; risk group. R e f e r e n c e s 1. Маркин А.В. Формирование групп риска среди детей дошкольного возраста при энтеробиозе / А.В. Маркин // Гиг.и сан. - 1991. -№ 2. – С. 64-67. 2. Пономарева Л.А. Прогнозирование показателей здоровья населения на основе интегрированной оценки значимости факторов среды обитания человека (методические рекомендации) / Л.А. Пономарева, Б.М. Маматкулов, Ю.Ю. Ассесорова // Ташкент, 2009. - 16 с. 3. Шиган Е.Н. Методы прогнозирования и модемирования в социально- гигиенических исследованиях / Е.Н. Шиган. – М.: Медицина, 1986. – 207 с. I n f o r m a t i o n a b o u t t h e a u t h o r : Abdurakhimova Kamola Shahobutdinovna - рost-graduate at the department of children, teenagers and nutrition hygiene in the Tаshkent Medical Aсademy. Tel.: +998 (71) 214-84-11. M a t e r i a l R e c e i v e d 31.03.2010 г.

HYGIENE OF THE SURROUNDING AND INDUSTRIAL ENVIRONMENT

1306 Ковтунова+ UDC 615.38:611.018.54:612.015.348-07«32» © M.E. Kovtunova, N.M. Pozdeev, K.P. Kashin, V.K. Kunof, 2010

19 Kovtunova M. E., Pozdeev N.M., Kashin K.P., Kunof V.K. Seasonal influence on the parameters of protein metabolism in donors of plasma for fractionation // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Federal State Institution «Kirov Research Institute of Hematology and Blood Transfusion of the Federal Medical Biological Agency of Russia». Russia, 610027, Kirov, Krasnoarmeyskaya str., 72. Теl.: 8(8332) 54-97-31, Fax: 8(8332) 54-97-31. E- mail: [email protected] S u m m a r y : To estimate the influence of a seasonal factor on the content of the total protein and protein fractions in plasma donors for fractioning we analyzed their dynamics among 341 persons (male and female) aged from 18 to 65. Based on the results of one-factor disperse analysis we established seasonal changes of the following figures of protein metabolism: albumin, the sum of globulins, β1-globulins and β2-globulins – among male and female, as well as γ-globulins among female. The influence of a seasonal factor was mostly observed in globulin-components, especially among female donors. K e y w o r d s : seasonality indices of protein metabolism; donation of plasma for fractionation.

A serious shortage of medical preparations is seen at the present time in Russia. The lag of blood service production complexes behind the international experience, on the one hand, the lack of sufficient resources for medical prophylactic establishments, on the other hand, are responsible for that (1,2). In new category of donors designed for fractionation has been introduced according to the Russian ministry of Health and Social development order in № 175n of 16.07.2008. It is a specialized donation of plasma intended exclusively for production purposes. Blood plasma plays an important part in the maintenance of homeostasis in the human organism, it ensures a constant volume of liquid in the blood vessels, transportation of different substances arriving in the blood, neutralization and removing of metabolites. The protein composition of the plasma for manufacturing preparations must correspond to the appropriate requirements. Production of

20 preparation out of donor blood and its components is a major problem facing modern transfusiology. Blood preparations are most important for treating patient with severe diseases accompanied by loss of protein. It is well known that a person consumes more meat foods in the winter and early spring and more vegetables and fruit in the summer and early autumn/ Investigation of indices for protein metabolism in the donors of plasma for transaction and depending on the season was of scientific and practical interest. The purpose of investigation was evaluation of the general protein level and its fractions during different seasons. M a t e r i a l s a n d m e t h o d s o f t h e i n v e s t i g a t i o n . 341 donors of plasma for fractionation, i.e. 199 males and 142 females aged 18 through 65 years were examined. Laboratory studies were carried out in accordance with the Russian ministry of Public Health Order № 364 “On ratification of procedure for medical examination of donors of blood and its components” in the wording of the Russian ministry of Public Health and Social Development Order from 16.04.2008, the number 175n. The studies included determination of the general protein levels and its fractions: albumin, aggregate globulins, 1- globulins, 1- globulins, 2- globulins and – globulin. Statistical processing of the results was performed using regressive and single-factor dispersion analysis. R e s u l t s o f t h e i n v e s t i g a t i o n a n d d i s c u s s i o n . Statistical analysis of indicates for the four seasons (winter, spring, summer, autumn) was made in separate male and female groups. The registered levels of albumin, aggregate globulins, 1- globulins, 1- globulins, 2- globulins and – globulins were in all donors within the range of normal indices. A comparative avaluation of the seasonal factor effect on the protein composition of the plasma in males and females revealed certain regularities. The following table shows the results obtained in the investigation of the protein metabolism in the donors of plasma for fractionation depending on the season. Table Indices for protein metabolism in the donors of plasma for fractionation Season Males Females

21 n M m s V n M m s V General proteins Winter 22 65,93 1,26 6,91 10,5% 21 69,1 1,89 8,66 12,5% Spring 45 66,98 0,87 5,85 8,7% 40 67,65 1,19 7,53 11,1% Summer 60 67,45 0,81 6,25 9,3% 31 69,42 1,14 6,37 9,2% Autumn 72 68,97 0,82 6,99 10,1% 56 69,45 0,99 7,44 10,7% Albumin Winter 22 59,61 0,41 2,22 3,7% 21 57,3 1,4 6,4 11,2% Spring 45 60,41 0,26 1,76 2,9% 40 58,69 0,44 2,77 4,7% Summer 60 58,95 0,34 2,67 4,5% 31 56,33 0,57 3,17 5,6% Autumn 72 59,25 0,31 2,59 4,4% 56 58,26 0,41 3,05 5,2% Aggregate globulins Winter 22 40,39 0,41 2,22 5,5% 21 42,66 1,02 4,66 10,9% Spring 45 39,61 0,26 1,74 4,4% 40 41,02 0,39 2,5 6,1% Summer 60 41,05 0,34 2,67 6,5% 31 43,67 0,57 3,17 7,3% Autumn 72 40,68 0,31 2,58 6,3% 56 41,71 0,4 2,97 7,1% α1- globulins Winter 22 3,6 0,08 0,44 12,2% 21 3,58 0,13 0,57 15,9% Spring 45 3,6 0,06 0,4 11,1% 40 3,61 0,06 0,39 10,8% Summer 60 3,67 0,07 0,5 13,6% 31 3,62 0,11 0,62 17,1% Autumn 72 3,6 0,07 0,6 16,7% 56 3,69 0,05 0,39 10,6% α2- globulins Winter 22 9,03 0,26 1,42 15,7% 21 9,29 0,25 1,16 12,5% Spring 45 9,01 0,17 1,11 12,3% 40 8,91 0,14 0,9 10,1% Summer 60 8,97 0,19 1,44 16,1% 31 8,61 0,18 1,01 11,7% Autumn 72 8,79 0,14 1,16 13,2% 56 8,96 0,15 1,11 10,6% β1- globulins Winter 22 5,61 0,13 0,7 12,5% 21 5,77 0,14 0,65 11,3% Spring 45 5,76 0,09 0,59 10,2% 40 5,88 0,09 0,54 9,2% Summer 60 5,54 0,07 0,53 9,6% 31 6,18 0,15 0,84 13,6% Autumn 72 5,96 0,08 0,72 12,1% 56 6,26 0,07 0,54 8,6% β2- globulins 22 Winter 22 9,27 0,22 1,18 12,7% 21 9,59 0,34 1,57 16,4% Spring 45 8,9 0,17 1,15 12,9% 40 9,09 0,18 1,15 12,7% Summer 60 9,91 0,12 0,96 9,7% 31 10,1 0,22 1,24 12,3% Autumn 72 9,77 0,16 1,34 13,7% 56 9,71 0,14 1,05 10,8% γ - globulins Winter 22 12,88 0,38 2,06 16,0% 21 14,43 0,65 2,98 20,7% Spring 45 12,36 0,21 1,38 11,2% 40 13,68 0,33 2,09 15,3% Summer 60 12,95 0,27 2,09 16,1% 31 15,16 0,36 1,98 13,1% Autumn 72 12,64 0,25 2,15 17,0% 56 13,12 0,24 1,83 13,9%

Note. Variation coefficient of V < 33% for all indices. The coefficient of variation in the statistical analysis was less than 33% for all investigation indices depending on the season which is testimony to homogeneity of the data totality. Single – factor dispersion analysis of the seasonal influence on the protein indices for donors of plasma for fractionation showed their variability according to the following criteria: albumin, aggregate globulins, 1- globulins and 2- globulins in males and females, as well as – globulins in females. But the degree of this influence was not considerably significant as a whole. The greatest degree of this influence depending on the seasonal factor was established for 2- globulins and – globulins in females: = 0,58 and = 0,12, accordingly. Expressed in percentage, the index for the degree of the seasonal factor influence on 2- globulins was 58%, on – globulins 12%, on 1- globulins 9% in females. The greatest degree of the seasonal factor influence was 10% for 2- globulins and 7% for 1- globulins in males. The data tabulated in the table show that the content of general protein in females was lowest in the spring, highest in the summer and autumn. The level of albumin both in females and males was highest in spring and lower in summer. A pronounced seasonal effect was seen in the total values for globulins: the concentration was high in summer and low in spring. It should be marked in this case that the seasonal redistribution of the globulin fractions is somewhat different: high

23 values of 1- globulins, substantiated by a dispersion analysis, were registered in the donors of both sexes in the autumn, 2- globulins in the summer and autumn and low values were in winter, – globulins in the winter, in the summer and in the spring accordingly. C o n c l u s i o n . Consequently, the results of the single-factor dispersion analysis of the seasonal influence on the protein composition of the blood plasma from the donors of this component designed for the subsequent making out of them medical preparations revealed certain regularities. So, the content of general proteins and its fractions was within the range of normal values. Seasonal changes were demonstrated in following indices for the protein metabolism: albumin, total albumins, 1- globulins and 2- globulins both in males and females, as well as – globulins in females. The influence of seasonal factor was greater on globulin components, especially in female donors. The reason for a change of the indices for proteins may be connected with peculiarities of nourishment in different seasons as well as with the fact that women are more prone to using diet. R e f e r e n c e s 1. Russanov V.M., Levin I. Medical blood preparations.-M.: ID Medpractica, 2004-P.284. 2. Levin I, Russanov V.M. Blood service. (International analytical revue).-M.: Medpractica, M. 2007-P.316. 3. Russian ministry of Public Health Order in № 364 of 14.09.2001 «On ratification of procedure for medical examination of donors of blood and its components » in the wording of the Russian ministry of Public Health and Social Development Order from 16.04.2008, the number 175n. I n f o r m a t i o n a b o u t t h e a u t h o r s : Kovtunova Marina Evgenievna - candidate of medical science, scientific secretary of the FSI «Kirov Research Institute of Hematology and Blood Transfusion of the FMBA of Russia», work tel.: 8(8332) 54-96-76. E-mail: [email protected]

24 Pozdeev Nikolai Markovich - doctor of medicine, Deputy Director of the FSI «Kirov Research Institute of Hematology and Blood Transfusion of the FMBA of Russia», work tel.: 8(8332) 37-68-95. E-mail: [email protected] Kashin Konstantin Pavlovich - part-time postgraduate FSI «Kirov Research Institute of Hematology and Blood Transfusion of the FMBA of Russia», transfusiologists, phone: 8(961)568-17-61. E-mail: [email protected] Kunof Viktor Konstantinovich - medical director of blood transfusion centre, work tel.: 8(833) 54-25-27. M a t e r i a l R e c e i v e d 22.03.2010 г.

1285 Нехорошев+ UDC 613.6:616.31 © A.S. Nekhoroshev, N.B. Danilova, E.I. Morozova, 2010 Nekhoroshev A.S.1, Danilova, N.B.2, Morozova E.I.2 Methodological aspects of the use of training programs on hygiene of oral cavity physician-stomatologists practitioners // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1 Saint-Petersburg state medical academy named after I.I. Mechnicov, Russia, 195067, Saint-Petersburg, Piskariovskiy av., 47. Tel.: 8(812)545-13-39, fax: 8(812)545-13-39. E-mail: [email protected] 2 State Educational Establishment for Additional Professional Training «Saint- Petersburg Medical Academy for Post-Diploma Training of the Federal Agency for Public Health and Social Development of the Russian Federation», Russia, 191015, Kirochnaya str., 41, tel.:8(812) 272-52-06, fax: 8(812)273-00-39, e-mail: [email protected] S u m m a r y : Improvement of a condition of stomatologic health of children and adults is impossible without medical education, training and development of skills and the manipulations connected with personal hygiene of an oral cavity. It once again underlines importance of introduction of programs of training to hygiene of an oral cavity in various treatment-and-prophylactic establishments of a stomatologic profile of our country for all age groups of the population.

25 K e y w o r d s : doctor the stomatologist; oral cavity; training programs; medical education.

R e f e r e n c e s 1. Багдасарова О.А. Выбор рациональной системы профилактики кариеса зубов у детей школьного возраста / О.А. Багдасарова // Автореф…дис. канд. мед. наук. – Самара, 2009. – 22 с. 2. Киселева Е.Г. Взаимоотношения врачей и пациентов на детском стоматологическом приеме и пути их улучшения / Е.Г. Киселева, Д.А. Кузьмина. – СПб.: ООО «МЕДИ издательство», 2006. – 48 с. 3. Кобиясова И.В. Практика и теория грамотного общения с пациентом / И.В. Кобиясова, М.А. Соболева // Профилактика сегодня. – 2009.- № 9. – С. 14- 20. 4. Приказ Министерства здравоохранения и социального развития РФ от 14 апреля 2006 г. № 289 «О мерах по дальнейшему совершенствованию стоматологической помощи детям в Российской Федерации». Приложение №8 «Рекомендуемые штатные нормативы медицинского и другого персонала детской стоматологической поликлиники». 5. СанПиН 1.2.676-97 «Гигиенические требования к производству, качеству и безопасности средств гигиены полости рта». Утвержденные Постановлением (с изм., внесенными постановлениями Главного государственного врача РФ от 20.10.1997 №24) (с изм. от 10.12.2002) (вместе с «Руководством по косметической продукции, утвержденной ЕЭС» (инструкция 76/768/ЕЭС)). 6. Улитовский С.Б. Практическая гигиена полости рта / С.Б. Улитовский. – М., 2002. – С. 328. I n f o r m a t i o n a b o u t t h e a u t h o r s : Nekhoroshev A.S. - doctor of medicine, professor, department of preventive medicine Saint-Petersburg state medical academy named after I.I. Mechnicov. Tel.: 8(812)545-13-39, fax: 8(812)545-13-39, e-mail: [email protected]

26 Danilova Natalia Borisovna the candidate of medical sciences, first category physician the doctor of the first category, the assistant to chair of therapeutic stomatology of. Saint-Petersburg Medical Academy for Post-Diploma Training of the Federal Agency for Public Health and Social Development of the Russian Federation. Russia, 191015, St.-Petersburg, Kirochnaya str., 41. Тel.: 8(812)532-08-80. E-mail: [email protected] Morozova Elena Ivanovna - the doctor of the first category physician, assistant professor of therapeutic stomatology department of Sankt. The Petersburg medical academy for Post-Diploma Training of the Federal Agency for Public Health and Social Development of the Russian Federation. Russia, 191015, St.-Petersburg, Kirochnaya str., 41. Тel.: 8(812)532-08-80. E-mail: [email protected] M a t e r i a l R e c e i v e d 09.02.2010 г.

1324 Наврузов+ UDC 591.1+612.669+631.17+614.7 © E.B. Navruzov, 2010 Navruzov E.B. Reproductive system hormones content in rats at the hossipole intoxication // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Tаshkent Medical Aсademy, Ministry of Health of the Republic of Uzbekistan, 100109, Uzbekistan, Tаshkent, Faroby str., 2, Tel: +998 (71) 1507825, 2148311; Fax: +998 (71) 2185948, E-mail: [email protected]; [email protected] S u m m a r y : The variability of honadotrope and sex hormones under the influence of acute intoxication by hossipole revealed the presence of dose-effect dependence in the experimental groups of male and female white vats. The disturbances of honadotrope hormons secretion appear secondary in the response to sharp change of hormonal function, which allows to consider the affection of honads leading on the hossipole intoxication. K e y w o r d s : hossipole; reproductive function; steroidic and honadotropic hormones. R e f e r e n c e s

27 1. Байкулов А.А. Токсикологичская оценка хлопкового масла / А.А. Байкулов, А.С. Худайберганов // Токсикологический вестник. – 2001. - № 2. - С. 21-23. 2. Байкулов А.А. Медико-биологическое обоснование гигиенических критериев пищевой, биологической ценности и безопасности хлопкового масла, получаемого при различных технологических режимах / А.А. Байкулов // Автореф…дис. канд. мед. наук. – Ташкент, 2003. – 20 с. 3. Вильям М.Кэттайл Патфизиология эндокринной системы / М.Кэттайл Вильям, А.Арки. Рональд. - СПб., 2001. – 336 с. 4. Гистология, цитология, эмбриология. Атлас: Учебное пособие / О.В. Волкова [и др.] – М.: Медицина, 1996. – С. 398-453. 5. Душкин В.А. Лабораторное животноводство / В.А. Душкин. – М., 1980. – 48 с. 6. Карпенко Н.А. Влияние тестостерона и его метаболита дегидротестстерона на уровень некоторых гормонов у гипотиреоидных крыс / Н.А. Карпенко // Проблемы эндокринологии. - 1991.- Т. 31., № 6. - С. 40-43. 7. Меньшикова В.В. Лабораторные методы исследования в клинике. Справочник / В.В. Меньшикова.- М.: Медицина, 1987. – 368 с. 8. Майкл Т. Мак Дермотт. Секреты эндокринологии / Мак Дермотт Майкл Т. пер. с англ. - М.- СПб.: Издательство Бином – невский диалект., 2001. - С. 309-379. 9. Серов В.П. Практическое руководство по гинекологической эндокринологии / В.П. Серов, В.Н. Прилепская, Т.Я. Пшеничникова. - М., 1995. – 286 с. 10. Соатов Т.С. Изменения в содержании гормонов и липидных комплексов в крови у мужчин с нарушениями половой и тиереидной функций / Т.С. Соатов, М.К. Мансурова, Д. Алиева // Журнал теоретической и клинической медицины. - 1999. - № 1. - С. 89-91. I n f o r m a t i o n a b o u t t h e a u t h o r :

28 Navruzov Ernazar Botirovich – jr. scientific assistant of the scientific research sector of Tashkent Medical Academy, work phone: 8(833)150-78-24. M a t e r i a l R e c e i v e d 21.05.2010 г.

1325 Усманова+ UDC 614.2.07:614.211:616.31-022:616.327.2-022:616.5-022 © Sh.F. Usmanova, 2010 Usmanova Sh.F. Microenvironmental problems of medical nurses in clinical subdivisions // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Тashkent Medical Academy, Ministry of Health of the Republic of Uzbekistan, Republic of Uzbekistan, Tashkent, 100109, Faroby str., 2, Tеl.: +998(71)150-78-25, 214-83-11, 150-78-01 Fax: +998(71)150-78-28. Web: www. tma.uz E-mail: info@ tma.uz; [email protected]; [email protected] S u m m a r y : An expressed dysbiosis of microflora which characteristic feature is reduction of anaerobic group and growth of facultative flora was established on skin, nasopharynx, oral cavity of medical nurses in the aging groups from 29 to 39 engaging in different clinical subdivisions. Microflora dysbiosis requires correction. K e y w o r d s : Medical nurses; microflora of skin, nasopharynx, oral cavity; microflora dysbiosis. R e f e r e n c e s 1. Венцел Р.П. Внутрибольничные инфекции / Р.П. Венцел. - М.: «Медицина», 1990. – 656 с. 2. Грачева Н.М. Дисбактериозы кишечника: причины возникновения, диагностика, применение бактериальных биологических препаратов / Н.М. Грачева, Н.Д. Ющук, Р.П. Чупрынина. - М., 1999. – 41 с. 3. Смолянская А.З. Современные аспекты дисбактериоза кишечника и его бактериологическая диагностика / А.З. Смолянская, Г.И. Гончарова, Н.Н. Лизко // Лабораторное дело. – 1994. - № 3. - С. 167-170. I n f o r m a t i o n a b o u t t h e a u t h o r :

29 Usmanova Shahnoza Faruhtdinovna – aspirant of department of Social Health & Organization and Management of Health Science of the Tashkent Medical Academy; office phone: +998(71)150-78-04; E-mail: valentinа[email protected] M a t e r i a l R e c e i v e d 24.05.2010 г.

NEW TECHNOLOGIES, METHODS OF DIAGNOSTICS, TREATMENT AND PREVENTION IN PUBLIC HEALTH SERVICES 1213 Гонтарь+ UDC 616.72-002.77-08+616.5-004.1-08+616.5-002.252.2-08 © I.P. Gontar, N.V. Nenasheva, N.A. Matasova, E.R. Avetisova, L.I. Kochneva, I.A. Zborovskaya, 2010 Gontar I.P., Nenasheva N.V., Matasova N.A., Avetisova E.R., Kochneva L.I., Zborovskaya I.A. Clinical-diagnostic value of determination of antibodies to elastin and elastase in patients with rheumatic arthritis, systemic lupus erythematosus, systemic scleroderma // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State Institution Research Institute for Clinical and Experimental Rheumatology of the Russian Academy of Medical Sciences, 400138, Volgograd, Zemlyachki str., 76, tel.: 8-8442-35-56-48, fax: 8-8442-93-42-11, e-mail: [email protected] S u m m a r y : Article describes the building of anti-elastin and anti-elastase antibodies by patients with connective tissue diseases, demonstrates a correlation between their level and development of illness. K e y w o r d s : rheumatoid arthritis, systemic lupus erythematosus, scleroderma, elastin and elastase antibodies, diagnostic importance. R e f e r e n c e s 1. Гонтарь И.П. Иммобилизированные гранулированные антигенные препараты с магнитными свойствами в диагностике и лечении ревматоидного артрита, системной красной волчанки и системной склеродермии (клинико-

30 экспериментальное исследование) // Автореф. дисс….док.м.н. – Волгоград. – 2006. – 34 с. 2. Colburn K.K. Serum anti-tropo:anti-elastin antibody ratio assessing elastin tumover in scleroderma / K.K. Colburn, G.T. Kelly, M.C. Malto // Clin Rheumatol. – 1992. - Vol. 11. - № 2. – Р. 206-210. 3. Colburn K.K. Abnormalities of serum antielastin antibodies in connective tissue diseases / K.K. Colburn, E. Langga-Shariffi, G.T. Kelly // J Investig Med. – 2003. - Vol. 51. - № 2. – Р. 104-109. 4. Dunphy J. Antineutrophil cytoplasmic antibodies and HLA class II alleles in minocycline-induced lupus-like syndrome / J. Dunphy, M. Oliver, A.L. Rands // Br. J. Dermatol. – 2000. - Vol. 142. - № 3. – Р. 461-467. 5. Gminski J. Anti-elastin antibodies in systemic lupus erythematosus / J. Gminski, W. Poborski, A. Kasprzak // Pol Tyg Lek. – 1990. - Vol. 45. - № 25-26. – Р. 513-515. I n f o r m a t i o n a b o u t t h e a u t h o r s : M a t e r i a l R e c e i v e d 12.10.2009 г.

1311 Орлов+ UDC 616.833-006-07 © A.Yu. Orlov, G.S. Kokin, R.G. Daminov, D.Yu. Komkov, K.Sh. Berishvili, 2010 Orlov A.Yu., Kokin G. S., Daminov R. G., Komkov D.Yu., Berishvili K.Sh. Methods of examination of patients with peripheral nerve tumors // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Russian Polenov Neurosurgial Institute. Russia, 191014, St-Petersburg, Mayakovsky str., 12, tel./fax: 8 (812) 275-56-03, e-mail: [email protected] S u m m a r y : This work was made in Russian Polenov Neurosurgial Institute. It’s based on inspection and treatment of 284 patients with tumours of peripheral nervous system. During this work, the complex of research of that pations has been developed. It included clinical inspection? Electrophysiological, ultrasonic,

31 MRT. There were shown positire and negative sides and expediency of carryng out of these researches at pations with tumours of peripheral nervous system before the operative treatment. K e y w o r d s : tumor of a peripheral nerve; nerve; inspection of patients.

According to the literature, only 50% patients with tumors of peripheral nerve trunks of extremities had correct preoperative diagnosis. In this connection correct and full diagnostics of this pathology is very important for clinical physicians. In the literature, despite of variety of diagnostics methods, the complex of examination for patients with peripheral nerve tumors (PNT) of extremities is not so clear. R e s e a r c h o b j e c t i v e : to analyze advantages and disadvantages of various methods used for examination of patients with peripheral nerve tumors and to offer an optimum complex of examination of patients with this pathology. M a t e r i a l s a n d m e t h o d s : The complex of examination of patients with this pathology offered by RNHI named after professor A.L.Polenov, is based on comprehensive examination and treatment of 284 patients with PNT of extremities and includes: clinical-neurological, electrophysiological examination (electric diagnostics, electromyography), ultrasonic examination (USE), magnetic resonant imaging (MRI). R e s e a r c h r e s u l t s a n d d i s c u s s i o n : The clinical-neurologic examination included careful history taking, paying attention to the fact of occurrence of pain symptoms, moment of origin of the space-occupying process feeling (palpation), difference which occurred between these two facts. Visual examination and palpation of patients in order to identify this localized pain, sense of new growth, its mobility, displaceability to the poles and palpatory determination of the limits of the tumor and its consistence, Tinel’s sign [2,3,7]. In order to determine a degree of disorder of conductivity of nerve trunks affected by the tumor, we have used: classic electric diagnostics, study of "intensity- duration" curve, electromyography, stimulation electromyography, diaphoresis

32 assessment, in order to determine the local blood flow, wee have determined skin temperature, tachooscilography and reactive hyperemia. Nowadays the following methods - diaphoresis assessment, local blood flow assessment, determination of skin temperature, tachooscilography, reactive hyperemia are not in use at the branch due to significant labor input, out-of-date equipment, insufficient informativity and ambiguous interpretation of the results. The methods of classical electric diagnostics used before an advent of electromyography and radiodiagnostics methods, was aimed at identification of changes of nerve conductivity threshold – both quantitative changes or (partial, full) reaction of muscles regeneration. Determination of muscles denervation is based on determination of axon excitability, i.e. the minimal degree of muscle activation at impulse current supply. The control of minimal muscle activation was carried out visually, the current was supplied to the motor point of the muscle. The minimum current intensity at maximum duration (300 msec). Now an estimation of "current intensity -duration" is carried out less often for some reasons [1,2,9]: 1. The method is based on subjective criterion of muscle activation (visual); 2. Significant labor input of the research; 3. Ambiguous interpretation of the results, because at partial preservation of not affected nervous fibers in the nerve the "current intense-duration" curve will be a sum of excitability of affected and not-affected fibers; 4. Sufficient persistence of changes of the curve at an estimation of reinnervation in comparison with needle EMG; 5. There are no modern devices for carrying out of the examination. Previously used device UEI-1 is thoroughly off-market and obsolescent, the process of its manufacturing was stopped more than 15 years ago; 6. Classical electric diagnostics helps to estimate an excitability of only low- threshold, low-myelinated fibers. In view of the fact, that axons of the highly myelinated fibers are affected at loss of connection with neuron body earlier than axons of non-myelinated (low-threshold) fibers [3], we can say, that the method of estimation of M-response parameters is more sensitive, than classical electric

33 diagnostics. Electroneuromyography (ENMG) is a method of registration and examination of bioelectric activity of a muscle at rest and at self-produced tension. In the broad sense of the word, the term electromyography includes all kinds of myography techniques (global ENMG, needle ENMG and stimulation techniques). ENMG together with clinical data helps to solve many diagnostic problems: 1. Detection of the defect 2. Determination of degree of affection of the disturbed functions (full or partial conductivity trouble) 3. Determination of stages and nature of pathological process (denervation, reinnervation) Superficial (global, epicutaneous or total EMG) is a method of registration and study of biopotentials of muscles at rest and at self-produced tension by detection of bioelectric activity with the help of superficial electrodes from skin surface above the motor point. This method is non-invasive and painless, it helps to estimate electric activity of muscles globally, i.e. totally. Needle (or local EMG) is a method of registration and studying of bioelectric activity of motor fibers and motor muscle units by needle electrodes at rest and at self- produced tension. This method is invasive and painful, but it helps to identify the mechanisms of work of the nervous and muscular system, which can be not identified correctly by superficial EMG. EMG stimulation is a method of registration and studying of bioelectric activity of the muscles caused by activation of a nerve at any place or by activation of the receptors of neurons by electric or mechanical stimulus. Registration of evoked (by stimulation) activity of the muscle is carried out either by epicutaneous or needle electrodes depending on the research problem, muscle depth and on the necessities to exclude an activity of induction from adjacent muscles [5]. An important disadvantage of the electrophysiological diagnostics methods (electric diagnostics and ENMG) - there is no opportunity to characterize and visualize relative positions of space occupying lesion, nerve trunk and surrounding tissues that is

34 important for making a decision about surgical treatment. Using ultrasonic examination (USE) and magnetic resonance imaging (MRI) we can visualize the tumor, and to establish relative positions with nerve trunk and surrounding tissues. Ultrasonic examination is widespread method of diagnostics, it helps to visualize a space occupying lesion and to study the topographic anatomy relations of the tumor and surrounding tissues. Use of modern ultrasonic scanners with high-frequency sensors with frequency 7- 17 MHz helps to get an image of nerve trunks and tumors quickly without any invasion. During the scanning process it is necessary to estimate an anatomic integrity of the nerve trunk, its structure, clearness of the contours of the tumor, nerve and condition of surrounding tissues [4,12]. An ultrasonic image of nerve trunk tumor is typically anechoic mass with not always homogeneous echogenicity. Taking into account the features of tumor anatomy and its location inside of the nerve trunk, the tumor will have round or oval shape with even contours and clear borders. Sometimes it is possible to see spindle shape with distribution of the along the nerve trunk. Use of color duplex mapping mode helps to identify the presence of own tumor vessels and to determine relative positions of the affected nerve with adjacent main vessels. If echoscopy results show unclear borders of the tumor, an invasive relative position to surrounding tissues and vessels, we can say that it is malignant tumor [4,12]. Except for simplicity of use, cheapness and availability the ultrasonic method of diagnostics has one more very important advantage - an opportunity of its use during the operation. So, in case of rather small dimensions of the tumor and rather poor differentiation along the nerve we can carry out contact ultrasonic examination. As a result, the surgeon can identify the borders of the tumor along the nerve more precisely. We have used the intraoperation ultrasonic navigation method many times. Disadvantages of the method are: visualization of not affected nerve trunks is complicated, i.e. it is hard to identify the nerve in the muscular tissues of the healthy extremity. For its more precise visualization it is necessary to use sensors with higher

35 frequency of radiation. However, proceeding from the physics of the method, the higher is the radiation frequency, the lower is the penetrating ability of the ultrasonic beam into the tissues.

Thus, the high-quality image can be obtained only for superficial objects or for quite large objects. Magnetic resonance imaging (MRI) has many advantages compared to other examination methods, such as an opportunity of multiplane research, absence of ionizing radiation, absence of artifacts from bone structures. With the help of modern MRI devices and special software it is possible to get information not only about the tissues surrounding the tumor, but also about nerve structures. MRI [6] helps to estimate anatomic and topographic ratios of nerve trunks, large vessels and surrounding tissues, to solve the problems of differential diagnostics, including, detection of space occupying lesion and to offer histological structure of the tumor. Using MRI we can determine a location of the mass, its influence on a nerve trunk, its extent, to compare the pathologically changed sites with opposite intact sites. In practice it is very convenient to use software with fat signal suppression in order to improve the quality of visualization [8,10,11]. MRI of peripheral nerves alongside with the results of clinical-neurological and electrophysiological methods of examination helps to make the diagnosis more specific, to find indications and contra-indications for surgical treatment, to select the optimum access and volume of surgical intervention. C o n c l u s i o n : In order to make a right diagnosis and define the indications, treatment tactics in patients with peripheral nerve tumors at preoperation stage, it is necessary to carry out the flowing actions: 1. Clinical and neurological examination. 2. Electroneuromyography 3. Ultrasonic examination. 4. Magnetic resonance tomography.

36 R e f e r e n c e s 1. Bersnev V.P. Classic electric diagnostics and determination of "intensity - duration" curve at nerve injuries // Guidelines. - L., 1974. - 23 pages. 2. Grigorovich K. A. About diagnostics and surgical treatment of spinal nerves neurinomas // Surgery theory and practice. - Proceedings of LSGMI. - Т. 57. - L., I960. Pages 308-319. 3. Grigorovich К.А. Surgical nerve injuries. - L., "Medicine". - 1981. – 302 pages. 4. Eskin N.A., Golubev V.G., Bogdashevskij D.R. et al. Echography of nerves, tendons and ligaments // SonoAce International. 2005. Issue 13. Pages 82-94. 5. Komantsev V.N., Zabolotnykh V.A. Methodical bases of clinical electroneuromyography – doctor’s manual / Komantsev V.N., Zabolotnykh V.A.- Saint Petersburg, 2001. _ 349 pages. 6. Konovalov A.N. Magnetic resonance tomography in neurosurgery / A.N.Konovalov, V.N, Kornienko, I.N. Pronin. - M.: Vidar, 1997. - 472 pages. 7. Popeljanskij J. J. Diseases of peripheral nervous system. / J.J. Popeljanskij. - M.: Medicine, 1989.-275 pages. 8. Abernathy CD, Onofrio BM, Scheithauer BW, Pairolero PC, Shives TC. Surgical management of giant sacral schwannomas. J Neurosurg 1986; 65:286-95. 9. Altenburger К. Electrodiagnostik // Bumke О., Foerster О. Handbuch der neurologie. 1937.-747. 10. Elston DM, Bergfeld WF, Biscotti CV, McMahon JT.Schwannoma with sweat duct differentiation. J Cutan Pathol 1993; 20:254-8. 11. Peer S., Bodner G. High-Resolution Sonography of the Peripheral Nervous System // 2003. Springer. 140 p. I n f o r m a t i o n a b o u t t h e a u t h o r s : Orlov A.J. - candidat of medical sciences Russian Polenov Neurosurgial Institute, tel.: 8(921)910-40-06, e-mail: [email protected] Kokin G.S. - candidat of medical sciences, post-graduate student Russian Polenov Neurosurgial Institute, tel.: 8(812)272-26-03.

37 Daminov R.G- physician-neurologist, post-graduate student Russian Polenov Neurosurgial Institute. tel.: 8(812)272-26-03. Komkov D.J. - candidat of medical sciences, post-graduate student Russian Polenov Neurosurgial Institute, tel.: 272-26-03. Berishvili K.S. - physician-neurologist, post-graduate student Russian Polenov Neurosurgial Institute. tel.: 8(812)272-26-03. M a t e r i a l R e c e i v e d 13.04.2010 г.

1278 Гренкова+ UDC 618.146/.17-07 © Yu.M. Grenkova, M.M. Safronova, 2010 Grenkova Yu.M., Safronova M.M. Modern approaches to diagnostics of uterine cervix diseases in post menopause // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State Educational Establishment for Additional Professional Training «Saint- Petersburg Medical Academy for Post-Diploma Training of the Federal Agency for Public Health and Social Development of the Russian Federation», Russia, 191015, Kirochnaya str.,41, tel.:8(812) 272-52-06, fax: 8(812)273-00-39, e-mail: [email protected] S u m m a r y : This study was dew to ultrasonic examination cervix uteri in postmenopausal women. Our data indicated different types of ultrasonic images of cervix due to duration of post menopause. The study involved 91 postmenopausal women, among them 59,3% of cases diagnosed endocervicitis. Were identified ultrasound signs endocervicitis in postmenopausal women. K e y w o r d s : endocervicitis; postmenopausal; ultrasonography; ultrasound examination. In recent years in Russia, a steady increase in number of infectious- inflammatory diseases of the vagina and the cervix of the uterus has occurred, 73,2 % of them involving endocervicitis [1]. Within 10 years following cessation of menstruations, the “postmenopause atrophic vaginitis” occurs in 75% of the women

38 [2]. In the postmenopause, no tendency towards any decrease in the cervix of the uterus (CU) inflammatory diseases can be observed in spite of reduction in the sex activity which might be due to presence of inflammatory diseases in the past, to the process becoming chronic, to errors in the diagnostics and therapy [3]. The clinical picture of inflammatory diseases of the genitals lower segments in the postmenopause women reveals a number of specific features due to age-specific changes in the genitals’ mucous membrane. In association with the ovaries function fall-out, the blood supply becomes rather worse, elasticity of the sex organs’ mucous membrane becomes reduced, the rhythm of epithelium desquamation disappears, production of mucus sharply drops due to metaplasia and changes in the cylindrical epithelium structure, the vaginal microbiocenosis becomes disturbed, and the physiological protection of the vaginal epithelium and endocervix becomes much lower. These factors provide for appearance of favourable conditions for exogenous opportunistic pathogenic bacteria and for activation of the endogenous those. The reduction of the protection factors in the postmenopause prompts the persistence of infection. Diagnostics of the cervix of the uterus chronic inflammatory diseases, particularly of the cervical canal, is quite complicated. In fact, the existing endocervicitis is due to penetration of microorganisms to the intercellular space of the mucous membrane crypts against the background of occurring metaplasia which makes the infectious factor less accessible for diagnostics and sanitation [3]. The main techniques of assessment of the cervix of the uterus condition involve visual examination with the aid of gynaecological mirror and colposcope, as well as microbiological and oncocytological study of the material obtained from ecto- and endocervix. Also assessment of junction of different types of the epithelium, revealing of the background pathological condition (inflammation, dyskeratosis), and diagnostics of cervical intraepithelial dysplasia are important. A screening technique for revealing CU cancer involves oncocytological study. To verify the pathogenic agent in inflammation, bacterioscopic, bacteriological and molecular-biological techniques are used.

39 The cervical canal relates to the so called “mute” zone of diagnostics because of practical inaccessibility for its study in its upper 2/3. The assessment of the cervical canal condition is made more difficult by obliterating processes associated with some past inflammation, or diathermic-surgical methods of treatment, or age- specific changes. Diagnostic curettage of the cervical canal relates to invasive method often quite difficult to perform and insufficiently informative by many positions. A highly informative and non-invasive method involves ultrasonic study of the small pelvis organs that is included in the algorithm of gynaecological examination of the patients. In this connection, the improvement of the radial diagnostics of the uterus is quite promising for revealing pathological conditions of the CU and, particularly, the endocervix. O b j e c t i v e o f t h e w o r k . More precise definition of diagnostic capacities of the echography for assessing the condition of the cervix of the uterus in patients with cervicitis in postmenopause. M a t e r i a l s a n d m e t h o d s o f t h e s t u d y . 91 women aged 45 to 79 were studied, the women having had the menopause for the last 1 to 25 years. The patients presented complaints of discomfort in the genitals area: itching, burning, pain in the vagina, unpleasant sensations in urination, smearing sanguinolent discharges from the reproductive tracts, dyspareunia. We related the patients to the endocervicitis verification risk group if their examination with the aid of gynaecological mirror and colposcope revealed signs as follows: hyperaemia around the external orifice of the cervix of the uterus, contact haemophilic manifestations from the cervix of the uterus, mucin-purulent discharges from the cervical canal, the picture of “diffuse” and/or “focal” colpitis in colposcopy. In bacteriological study, the amount of polymorphous-nuclear leucocytes over 10 was taken into consideration at magnification х 1000 and examining of at least 5 fields of vision, as well as finding of trichomonades, gonococcus. In bacteriological study – discharge of pathogenic microorganisms; opportunistic pathogenic microorganisms in amount of the titre >10х4CFU/ml. In molecular-biological techniques – revealing of absolute pathogenic microorganisms (Mycoplasma genitalium, C. trachomatis,

40 T.vaginalis, N.gonorrhoeae) [4]. In cytological study of the smears taken from the cervix of the uterus in endocervicitis, “mixed” or “atrophic” type of the smear can be seen (often in the postmenopause duration over 5 years) against the background of large number of leucocytes [5]. In the course of the laboratory studies, in 54 (59,34%) of the 91 patients, clinical-laboratory manifestations of endocervicitis were found. Past history of 82,14% women revealed past inflammatory diseases of the genitals lower segments which suggested chronic proceeding of the infection due to low-quality diagnostics and therapy in the past (p<0,01). In the past, the trichomonade infection was mostly diagnosed: 35,29% (p<0,01), which is indirectly corroborated by persistent complaints of dysuria (19,61%) and repeated treatment of the so called “cystitis” in previous years. All the patients were subjected to a complex gynaecological examination with the aid of common techniques at the base of the State Healthcare Institution “The Municipal Outpatient Clinic № 83”, at the base of the L.O.Ott Research Institute of Obstetrics and Gynaecology of the Russian Acad. Med. Sci. The echography was performed with the apparatus of the expert class ALOKA-5500 (Japan). Transvaginal ultrasonic study of the cervix of the uterus was used in its standard technique and then complemented with the EDC. R e s u l t s o f t h e s t u d y a n d t h e i r d i s c u s s i o n . Specific features of the genitals lower segment’s mucous membrane in postmenopause include gradually thinning multilayer pavement epithelium the surface of which becomes smooth, bright and vulnerable (in traumatisation, small haemorrhages may occur). In endocervicitis in postmenopause, the discharges in all the patients are scarce serous-purulent those. In 54,9% of cases, contact bleeding due to obvious vulnerability of the epithelium occurred against the background of infection (p<0,01). In 70,59%, signs of light “diffuse” and/or “focal” colpitis were observed against the background of the epithelium age-specific changes of various grades. In study of microbiocenosis, in 82,35% of cases a considerable increase in the number of neutrophile granulocytes occurred against the background of absence of

41 the lactobacilli and a large amount of cocco-bacillary flora. In bacteriological study, in 33,33% of cases an ample growth of E.coli was found in the titre amount over 10х4CFU/ml. In cytological study, in the smears, the cells of the “lower” intermediate and parabasal rows with no atypia prevailed; in 64,7% of cases, an “inflammatory” type of the smear had been found that was often accompanied by reactive changes of the parabasal cells which demanded application of differential diagnostics with a dysplastic process with the aid of the “proliferative test” with ovestine. Use of the transvaginal US study enabled one to investigate into the endocervix condition, its thickness, echo-structure, surrounding stroma of the cervical canal, and to visualize contours of the CU vaginal segment in its whole extent. The cervix of the uterus with no pathological changes during the US study in the postmenopause patients has the shape of cylinder, even external contours, the same thickness of anterior and posterior walls, homogeneous structure comparable by its echogenicity with the echogenicity of the uterus body myometrium. The CU M- echo occupies central position and is an imaging of the cervical canal and surrounding subepithelial segments of the cervix of the uterus that are isoechogenic to the surrounding stroma. In the EDC of the tissues adjacent to the endocervix, singular loci of blood flow may be observed. We have determined various types of the endocervix visualization depending on the postmenopause duration under normal conditions. In 73,7% of the patients with the postmenopause duration under five years, the CU M-echo was visualized in the form of a hyperechogenic strip of thickness up to 1-2 mm, with homogeneous structure that was a reflection of the anterior and posterior walls of the cervical canal mucous membrane. In the patients with the postmenopause duration over five years, in 66% of cases, the CU structure was homogeneous, the imaging of the M-echo was absent. In endocervicitis, irrespective of the postmenopause duration, the echography in 100% revealed extension of the M-echo width for over 4.5 mm on account of enlargement of the cervical canal for over 2 mm with accumulation of liquid content

42 in it, as well as inflammatory infiltration of the cervical canal epithelium and the adjacent structures (р<0,01). In 47,1% of cases in endocervicitis, thickening of the cervical canal wall was visualized in the form of a hyperechogenic strip of a 2-3-mm width around the enlarged cervical canal of inhomogeneous structure that can be traced in fragment. In 32,4% of cases, the hypoechogenic area of 3 to 10 mm width around the cervical canal enlarged on account of inflammatory infiltration around the unevenly thickened wall of the cervical canal, was visualised. When assessing the data obtained, the ultrasonic study capacity in diagnostics of endocervicitis amounted up to 82,4%, its specifics amounting up to 87%. C o n c l u s i o n . Complex diagnostics of the cervix of the uterus condition including modern capacities of the echography improves the diagnostics on account of assessment of the endocervix structure thus revealing the changes specific for an inflammatory process in the postmenopause women. R e f e r e n c e s 1. Балан В.Е. Принципы заместительной гормонотерапии урогенитальных расстройств / В.Е. Балан // Гинекология. – 2000. - № 2(5). – С. 140-142. 2. Прилепская В.Н. Заболевания шейки матки, влагалища и вульвы / В.Н. Прилепская. - М.: МЕДпресс, 1999 .- С. 201-213. 3. Сметник В.П. Руководство по климактерию / В.П. Сметник, В.И. Кулаков. - М.: МИА, 2001. - С. 40-52. 4. Современные технологии в лечении больных с хроническими цервицитами / Т.А. Федорова [и др.] // Российский Конгресс «Генитальные инфекции и патология шейки матки»: тезисы. – М., 2004. – 83 с. 5. Хмельницкий О.К. Цитологическая и гистологическая диагностика заболеваний шейки матки и тела матки / О.К. Хмельницкий. – СПб.: Сотис, 2000. - 332 с. I n f o r m a t i o n a b o u t t h e a u t h o r s : Grenkova Yulia Michaylovna– post graduated student of Department of Women's Reproductive Health, SPB MAPS, work tel.: 8(812)272-21-07, e-mail: [email protected]

43 Safronova Margarita Michaylovna – doctor of medicine, professor, Head of the Department of Women's Reproductive Health, SPB MAPS, work tel.: 8(812)272-21- 07. M a t e r i a l R e c e i v e d 22.12.2009 г.

1276 Ибрагимов+ UDC 616.5+616.97 © Sh.I. Ibragimov, T.U. Abdullaev, 2010 Ibragimov Sh.I., Abdullaev T.U. HLA-antigen association with climacteric keratoderma // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Scientific Research Institute of Dermatology and Venerology of Health Ministry of the Republic of Uzbekistan. Tashkent, Uzbekistan, Faroby str., 3, tel.: 8(371) 150-71-05, fax: 8(371) 214-50-68. E-mail: www. niidiv.uz S u m m a r y : Last years great interest is marked to problem of keratoderma, particularly to climacteric keratoderma (CK) as one more often occuring in women of climacteric period. The aim of our study was research of antigens HLA his to compatibility in patients with climacteric keratoderma. The results of taken researches have shown, that be genotyping of alleles HLA-В17 in women with CK, revealed markers of predisposition and resistance to CK. K e y w o r d s : climacteric keratoderma; HLA; genotype. R e f e r e n c e s 1. Каламкарян А.А. Синдром Хакстхаузена климактерическая ладонно- подошвенная кератодермия / А.А. Каламкарян, Е.Г.Федорова, Е.В. Бухарина // Вестн. Дерматол. и венерологии. - 1984. - № 9. - С. 4-6. 2. Рахимова Д.А. Распределение HLA-антигенов в узбекской популяции Ташкентской области / Д.А. Рахимова, А.Т. Исхаков, Р.М. Рузыбакиев // Актуальные вопросы иммунологии и аллергологии. – Ташкент, 1996. - Т.8. - С.149-155.

44 3. Хаитов Р.М. Иммуногенетика и иммунология: резистентность к инфекциям / Р.М. Хаитов, В.М. Манько, Л.П. Алексеев. – Ташкент: Ибн-Сино, 1991. - 454 с. 4. Luca Gavalli-Sforza L. The history and geography of human genes / L. Luca Gavalli-Sforza, P. Menozzi, A. Piazza. - USA. - 1996. – 356 р. I n f o r m a t i o n a b o u t t h e a u t h o r s : Ibragimov Sharof Ismailovitch - doctor of medicine, head of the Scientific Research Institute of Dermatology and Venerology of Health Ministry of the Republic of Uzbekistan. Оffice phone: 8(371) 150-71-05, mob.ph: (+99890) 370-95- 08, E-mail: www. niidiv.uz Abdullaev Temurbek Ulugbekovitch – post graduate of Scientific Research Institute of Dermatology and Venerology of Health Ministry of the Republic of Uzbekistan. Оffice phone: 8(371) 150-71-05, mob.ph: (+9897) 101-88-77. M a t e r i a l R e c e i v e d 16.12.2009 г.

1341 Нилова+ UDC 616.34-008.87-07:579.864 © L.Yu. Nilova, E.A. Orishak, A.G. Boitsov, 2010 Nilova L.Yu., Orishak E.A., Boitsov A.G. Regarding the problem of probiotics usage for intestinal disbacteriosis therapy // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State Educational Establishment of Higher Professional Training «Mechnikov Sankt-Petersburg State Medical Academy of the Federal Agency for Public Health and Social Development of the Russian Federation». Russia, 195067, Saint- Petersburg, K-67, Piskarevsky pr., 47. Tel.: 8(812)543-96-09, fax: 8(812)740-15-24, tel./fax: 8(812)543-01-26. Е-mail: [email protected] S u m m a r y : The purpose of the research is to develop the procedure of the individual choice of different trademarks probiotics containing lactobacteria for therapy in intestinal disbacteriosis. The tasks of the research are to examine adhesiveness of probiotics lactobacteria, to compare their adhesive activity to the different epithelia type. 45 Samples and methods. Cells of intestinal and buccal epithelium are taken for the adhesion. The results are registered in average quantity of bacteria number attached to one epithelia cell. The intensity of the adhesive activity is measured in the scale 1-5. The results of the research state the possibility to use probiotics lactobacteria rate of adhesion to buccal epithelial cells for understanding their rate of adhesion to intestinal epithelium of a certain patient. The adhesion intensity depends on receptor complementarity of lactobacteria and patient’s epithelial cells, i.e. patient-specific choice of different trademarks preparations for therapy in intestinal disbacteriosis is founded. K e y w o r d s : disbacteriosis; probiotics; adhesion; adhesiveness of probiotics strains; Lactobacillus. R e f e r e n c e s 1. Адгезия лактобактерий к клеткам вагинального и буккального эпителия / А.Г. Бойцов, С.В. Рищук, Ю.Ю. Ильясов, Т.А. Гречанинова // Вестник СПбГМА им. И.И. Мечникова. - 2004. - № 4(5). - С. 191-193. 2. Адгезивные и гемагглютинирующие свойства лактобацилл / В.И. Брилис, Т.А. Брилене, Х.П. Ленцнер, А.А. Ленцнер // Журнал микробиологии, эпидемиологии и иммунологии. - 1982. - № 9. - С. 75-78. 3. Стандартизация реакции прямой гемагглютинации, вызываемой бактериями рода Lactobacillus / Е.Д. Бершадская, Н.Г. Фиш, П.П. Шевьев, В.И. Огарков / Журнал микробиологии, эпидемиологии и иммунологии. - 1986. - № 8. - С. 69-71. 4. Киселев С.А. Пробиотики: новый подход к механизму терапевтического действия при лечении дисбактериоза кишечника / С.А. Киселев, Д.С. Чичерин // Клиническое питание. - 2007. - № 1-2. С. 44. 5. Микроэкология кишечника у детей и её нарушения / П.Л. Щербаков [и др.] // Фарматека. - 2007. - № 14 (148). - С. 28-34.

46 6. Savage D.C. Microorganisms associated with epithelial surfaces and stability of the indigenous gastrointestinal microflora / D.C. Savage // Nahrung. – 1987. – Vol. 31, № 5-6. – P. 383-95. 7. Schillinger U. In vitro adherence and other properties of lactobacilli used in probiotic yoghurt-like products / U. Schillinge, C. Guigas, W.H. Heinrich // International Dairy Journal. – 2005. – Vol. 15, № 12. – P. 1289-1297. I n f o r m a t i o n a b o u t t h e a u t h o r s : Nilova Ludmila Yurievna – Candidate of Medical Sciences, ass. professor of the department of microbiology, virology and immunology of the SPbGMA named after I.I. Mechnikov, tel./fax: 8(812)543-01-95, e-mail: [email protected] Orishak Elena Alexandrovna - Candidate of Medical Sciences, docent of the department of microbiology, virology and immunology of the SPbGMA named after I.I. Mechnikov, tel./fax: 8(812)543-01-95, e-mail: [email protected] Boitsov Alexey Gennadievich - doctor of medicine, professor, head of the department of microbiology, virology and immunology of the SPbGMA named after I.I. Mechnikov, tel./fax: 8(812)543-01-95, e-mail: [email protected] M a t e r i a l R e c e i v e d 29.06.2010 г.

CLINICAL AND EXPERIMENTAL STUDIES

1343 Бельков+ UDC 616.12-005.8:615.27 © A.V. Belkov, A.S. Russin, M.I. Sadique, M.G. Kolesnichenko, A.T. Burbello, 2010 Belkov A.V., Russin A.S., Sadique M.I., Kolesnichenko M.G., Burbello A.T. Clinical prognostic value of metabolic treatment in patients with myocardial infarction // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State Educational Institution of Higher Professional Training «Saint-Petersburg State Medical Academy named after I.I. Mechnicov» under Roszdrav, Russia,

47 195067, St. Petersburg, Piskarevsky pr., 47, tel./fax: 8(812)543-01-26, e-mail: [email protected] S u m m a r y : 62 patients have been observed aged till 70 years which have recieved an acute myocardial infarction, receiving in addition to the basic therapy of polyene and trimetazidine , in comparison with control group, the positive value of metabolic therapy on balance of vegetative nervous system and electric activity of a myocardium has been revealed. K e y w o r d s : a myocardial infarction; trimetazidine; polyene; sudden death. R e f e r e n c e s 1. Мазур Н.А. Внезапная смерть // В кн. Болезни сердца и сосудов. Под ред. Е.И.Чазова. - М.: Медицина, 1992, - С. 133-146. 2. Camm A.J. Mortality in patients after a recent myocardial infarction: a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification / A.J. Camm, C.M. Pratt, P.J. Schwartz // Circulation. - 2004. - Vol. 109. - P. 990-996. 3. Casolo G.C. Heart rate variability during the acute phase of myocardial infarction / G.C. Casolo, P. Stroder, C. Signorini // Circulation. - 1992. - Vol. 85. - P. 2073-2079. 4. Farrell T.G. Risk stratification for arrhythmic events in postinfarction patients based on heart rhythm variability, ambulatory electrocardiographic variables and the signal-averaged electrocardiogram / T.G. Farrell, Y. Bashir, T. Cripps // J. Am. Coll. Cardiol. – 1991. – Vol. 18. - № 5. – P. 687–697. 5. Podrid P.J. Epidemiology and Stratification of Risk for Sudden Cardiac Death / P.J. Podrid, R.J. Myerburg // Clin. Cardiol. - 2005. - Vol. 28 (Suppl. I). - P. 3- 11. 6. Turitto G. Sudden cardiac death prediction: the signal averaged electrocardiogram / G. Turitto, N. El-Sherif // Europace. – 2002. - Vol. (A). - P.137. I n f o r m a t i o n a b o u t t h e a u t h o r s :

48 Burbello Alexandra Timofeevna – Doctor of medicine, professor, head of the department of hospital therapy with course of clinical pharmacology. Saint- Petersburg State Medical Academy, named after I.I.Mechnikov, phone: 8(812)543- 94-34. Belkov Alexey Viktorovich – Fellowship at the department of Hospital therapy Saint-Petersburg State Medical Academy, named after I.I.Mechnikov, mobile phone 8(921)945-77-21, е-mail:[email protected] Russin Alexander Sergeevich – Fellowship at the department of faculty therapy Saint-Petersburg State Medical Academy, named after I.I.Mechnikov, ph. 8(812)543- 17-17. Kolesnichenko M G - Fellowship at the department of faculty therapy Saint- Petersburg State Medical Academy, named after I.I.Mechnikov, ph. 8(812)543-15- 72. Sadique Mohammad Imran- Fellowship at the department of faculty therapy Saint-Petersburg State Medical Academy, named after I.I.Mechnikov, ph. 8(812)543- 15-72. M a t e r i a l R e c e i v e d 29.06.2010 г.

1298 Горбачева+ UDC 616.12-005.4:615.27 © I.A.Gorbacheva, Yu.A.Sycheva, L.V.Slepneva, N.N.Alekseeva, V.A. Malozemova, D.A. Popov, 2010

Gorbacheva I.A.1, Sycheva Yu.A.1, Slepneva L.V.2, Alexeeva N.N.2, Malozemova V.A. 1, Popov D.A. 1 Antihypoxic therapy resources in ischemic heart treatment // Preventive and clinical medicine. - 2010. - № 2 (35). – Р. 1State educational institution of higher professional education «Saint- Petersburg Pavlov State Medical University of the Federal Agency for Health Care and Social Development of the Russian Federation ». Russia, 197022, St.-Petersburg, L. Tolstoy str., 6/8. Tel.: 8(812)238-71-53, fax: 8(812)234-01-25. Е-mail: [email protected] 49 2 Federal State Institution «Russian Research Institute of Hematology and Transfusiology of the Federal Agency for Advanced Technology Medical Aid». Russia, 191024, St.-Petersburg, 2-th Sovetskaya str., 16. Tel.: 8(812)274-56-50, fax: 8(812)717-25-50. S u m m a r y : Noticeable interest in usage of antihypoxants with cytoprotective and antioxidative effects for augmentation of oxygen utilization by myocardial tissue is seen in the last time. A new medicinal form of an antioxidant natrium fumarate, medication «Confumine», is perspective. This study medication has demonstrated antiarrythmic effect and positive inotropic effect in the experiment with post hemorrhagic ischemia and coronary heart infarction. All this determines necessity of Confumine usage investigation in the patients with chronic forms of ischemic heart disease. K e y w o r d s : antihypoxants; medication Confumine; chronic forms of ischemic heart disease. I n f o r m a t i o n a b o u t t h e a u t h o r s : Gorbacheva I. A. - doctor of medicine, head of the stomatologycal department of internal diseases Saint-Petersburg Pavlov State Medical University, tel. 8(911)334- 38-99. Sycheva Yu. A. - candidate of medical science, assistant at the stomatologycal department of internal diseases Saint-Petersburg Pavlov State Medical University, tel. 8(921)647-62-16. Slepneva L V. - candidate of medical science, the leading scientific employee, Russian Research Institute of Hematology and Transfusiology, tel. 8(812)717-10-80. Alekseeva N N. - candidate of biological science, the leading scientific employee, Russian Research Institute of Hematology and Transfusiology, tel. 8(812)717-10-80. Malozemova V.A. - assistant at the stomatologycal department of internal diseases Saint-Petersburg Pavlov State Medical University, tel. 8(911)220-24-95. Popov D.A. - the clinical intern of the stomatologycal department of internal diseases Saint-Petersburg Pavlov State Medical University, tel. 8(950)014-24-54.

50 M a t e r i a l R e c e i v e d 15.03.2010 г. 1299 Ливанов+ UDC 616.12-005.8:616-008.9 © G.A. Livanov, V.P. Amagyrov, B.V. Batotsyrenov, A.N. Lodyagin, H.V. Batotsyrenova., 2010 Livanov G.A., Amagyrov V.P., Batotsyrenov B.V., Lodyagin A.N., Batotsyrenova H.V. Metabolic distress correction in complicated forms of myocardial infarction // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1I.I. Dzanilidze First Aid Research Institute, Russia, 192242, St.-Petersburg, Budapeshtskaya str., 3. 2 Municipal health care institution «The State clinical first medical aid hospital named after Agapov V.V.», Russia, 670042, Republic of Buryatiya, Ulan-Ude, Stroiteley prospect, 1. S u m m a r y : It has been resulted the evaluation of clinical finding in 36 patients with acute myocardial infarction, complicated by acute heart failure (AHF) II-IV difficulty classes by Killip Т., Kimball J. (1967). Cytoflavin and perftoran promoted a decrease of patient’s critical situation length, patient’s day number and lethality. It was established that using of these drugs decreased tissues hypoxia depth, lipid peroxidation and restored antioxidant system activity and oxygen utilization. K e y w o r d s : acute myocardial infarction; acute heart failure; perftoran; cytoflavin; antioxidant system; oxygen utilization. R e f e r e n c e s 1. Бойцов С.А. Клиническое изучение противоишемического препарата Мексикор у больных с неосложненными формами инфаркта миокарда с зубцом Q / С.А. Бойцов, А.А. Фролов, В.Ю. Полумисков // Клин. исследования лекарственных средств в России. - 2004. – № 2. – С. 28-32. 2. Метаболическая десинхронизация при критических состояниях / Г.А. Ливанов [и др.] // Общая реаниматология. - 2006. – № 1. – С. 42-46.

51 3. Руда М.Я. О системе лечения больных с острым коронарным синдромом / М.Я. Руда // Кардиологический вестник. - 2006. – Т. 1, № 2. – С. 3- 6. 4. Рябов Г.А. Гипоксия критических состояний / Г.А. Рябов. – М.: Медицина, 1988. – 287 с. 5. Семиголовский Н.Ю. Применение антигипоксантов в остром периоде инфаркта миокарда / Н.Ю. Семиголовский // Анестезиология и реаниматология. - 1998. – № 2. - С. 56-59. 6. Сравнительная динамика маркеров воспаления и NT-proBNP при различных вариантах лечения больных с острым коронарным синдромом / Шрейдер Е.В. [и др.] // Кардиология. - 2008. - № 8. – С. 20-27. 7. Abbate A. C-reactive protein and other inflammatory biomarkers as predictors of outcome following acute coronary syndromes / A. Abbate, G.G. Biondi- Zoccai, S. Brugaletta // Semin Vasc Med. – 2003. - № 3. – Р. 375-384. 8. Antman E.M. ACC/AHA guidelines for the management of patients with ST- elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction) / E.M. Antman // 2004 – www.acc.org/ clinical/guidelines/stemi/index. 9. Biasucci L.M. Inflammation, atherosclerosis and acute coronary syndromes / L.M. Biasucci, M. Santamaria, G. Liuzzo // Minerva Cardioangiol. – 2002. – Vol. 50, № 5. – Р. 475-486. 10. Mold C. Complement activation by apoptotic endothelial cells following hypoxia/reoxygenation / C. Mold, C.A. Morris // Immunology. - 2001. – Vol. 102, № 3. – Р. 359-364. I n f o r m a t i o n a b o u t t h e a u t h o r s : M a t e r i a l R e c e i v e d 09.03.2010 г.

1339 Фролова+ UDC 612.821 52 © N.L. Frolova, 2010 Frolova N.L. Features of autonomic regulation of heart rate in cardiac patients with psychosomatic profile // Preventive and clinical medicine. – 2010. - № 2 (35). – P. Federal government agency «Military Medical Academy» (FGA MMA). Russia, 194044, St.-Petersburg, Academician Lebedev str., 6. Tel.: 8(812)542-20-91. E-mail: http://www.vmeda.spb.ru S u m m a r y : The aim of this study was to detect сardiovascular neuroregulation and rhythms of the autonomic nervous system by cardiovascular disease. Short-term recordings of heart rate variability distinguish two main spectral components: a high-frequency (HF) component (ranging between 0.15-0.40 Hz), a low-frequency (LF) component (ranging between 0.04-0.15 Hz), and LF/HF ratio respectively considered markers of parasympathetic, sympathetic control and sympatovagal balance. The changes in HF and LF powers and LF/HF ratio observed by the free breathing, the 6 min breathing and the coordinating components of respiration and heart rate variability series. K e y w o r d s : heart rate variability; breathing rhythm; cardiovascular disease. R e f e r e n c e s 1. Вариабельность ритма сердца: представления о механизмах / С.А. Котельников, А.Д. Ноздрачев, М.М. Одинак, Е.Б. Шустов, И.Ю. Коваленко, В.Ю. Давыденко // Физиология человека.– 2002. – Том 28. – № 1. – С. 130 – 141. 2. Использование кардиореспираторного биоуправления в диагностике и коррекции регуляторных нарушений при нейроциркуляторной астении / Н.Л. Фролова, А.С. Свистов, А.Е. Филиппов, Н.Б. Суворов // Вестник Российской Военно-медицинской академии. – 2005. – № 2 (13). – С. 243-247. 3. Heart Rate Variability. Standards of measurements, physiological interpretation, and clinical use / Task Fors of the European Sosiery of Cardiology and

53 the North American Sosiery of Pacing and Electrophysiology // Circulation. – 1996. – Vol. 95. – P. 1043. 4. Melcher A. Carotid baroreflex heart rate control during the active and the assisted breathing cycle in man / A. Melcher // Acta Physiol. Scand. – 1980. – Vol.108. – № 2. - P. 165. 5. Power spectrum analysis of heart rate fluctuation: A quantitative probe of beat-to-beat cardiovascular control / S.D. Akselrod [et al.] // Science. – 1981. – Vol. 213. – № 4503. – Р. 220. 6. Richter D.W. Cardiorespiratory control / D.W. Richter, K.M. Spyer // Central regulation of automomic fluctuations. – N.Y.: Oxford Univ. – Press, 1990. – P. 189. I n f o r m a t i o n a b o u t t h e a u t h o r : Frolova Natalia Lvovna - PhD, Cathedral Assistant of Naval and Hospital Therapy Department. Mob.: 8(911)195-08-09. E-mail: [email protected].

M a t e r i a l R e c e i v e d 24.06.2010 г.

1294 Козырев+ UDC 616.248+616-009.12]:577.112 ©A.G. Kozyrev, E.A. Surkova, A.Yu. Gichkin, V.E. Perley, 2010 Kozyrev A.G., Surkova E.A., Gichkin A.Yu., Perley V.E. Endotelin-1 content in patients with bronchial asthma with concomitant hypertensive disease // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State Educational Establishment for Higher Professional Training «Saint- Petersburg State I.P. Pavlov Medical University of the Federal Agency for Public Health and Social Development of the Russian Federation». Russia, 197022, St.- Petersburg, Lev Tolstoy str. 6/8. Tel. 8(812)4997153, fax 8(812)2340897. S u m m a r y : Serum levels of endothelin-1 were investigated in 80 asthmatic subjects. Serum level of endothelin-1 after the treatment of asthma exacerbation was higher in patients with concomitant essential hypertension, stage I, than in patients with optimal and normal blood pressure. K e y w o r d s : bronchial asthma, essential hypertension, endothelin-1 54 Endothelin 1 (ET-1) represents a polypeptide that has many biological effects, and can act as an autocrine/paracrine mediator. Apart from having vasoconstrictive function ET-1 can also be characterized with pro-inflammatory and proliferative activity, can stimulate production of free radicals, and may activate platelets. ET-1 is considered as one of the major components that results in endothelial dysfunction and cardiovascular disorders [1]. It is known [9] that ET-1 has a profound effect in pathogenesis of lung diseases, including bronchial asthma (BA). Lungs represent tissue site where ET-1 undergoes metabolic turnover. A i m o f s t u d y – to evaluate serum concentration of ET-1 in patients with bronchial asthma and concomitant essential hypertension (EH). M a t e r i a l s a n d M e t h o d s . In our study we included 80 BA patients who visited a pulmonologist due to exacerbation of disease. This group of patients was composed of 21 male and 59 females, average age 54.0 ± 1.0 years old. In 5 patients mild persistent BA (mBA) was diagnosed, in 56 – moderate BA (moBA), in 19 – severe BA (sBA). 33 BA patients (Group I) had optimal or normal values of blood pressure (BP). In 10 patients (Group II) high normal BP was recorded. In 37 cases patients with BA were diagnosed to have EH, including EH stage I in 19 cases (Group III), EH stage II – in 18 cases (Group IV). The most part of patients from Group III and IV had EH grade 1. In control group we included 10 healthy persons (3 males and 7 females, average age 57.1 ± 1.7 years old). Prior to starting these examinations all patients signed Informed Consent. In our study we included outpatients who had no overt clinical signs of present or previous complications after cardiovascular diseases (coronary heart disease, stroke) or renal diseases; non-smokers, with normal fasting plasma glucose level. During the first visit nine patients with BA and concomitant EH were found to take their hypotensive medicines regularly, including angiotensin converting enzyme inhibitor (enalapril) – 3 cases, diuretic drug (indapamide) – 2 cases, angiotensin II receptor antagonist (losartan) – 1 case, calcium channel antagonist (nifedipine) – 1 case, a selective β1 receptor blocker (metoprolol tartrate) – 1 case, and combined

55 drug (enalapril / hydrochlorothiazide) – 1 case. 2-5 days prior to the study hypotensive therapy was cancelled. In case patients should have to continue taking medicines they were not included. All patients were examined before and after medical treatment of BA exacerbation (time period between the first and next examination was 1.5-2 months). Fasting blood sampling was performed before noon (845-900 am). Six hours before blood sampling patients were not inhaling short-acting β2-agonists, and within 24 hours – prolonged β2-agonists. ET-1 levels in patients’ plasma were estimated by using Enzyme Immunoassay test-kit for the quantitative determination of endothelin (Biomedica Gruppe, Austria). Optical density of samples was measured by using photometer “ELM-3000” (DRG, USA), at 450 nm wavelength and comparison wavelength 620 nm. Respiratory function tests were performed by using Erich Jager apparatus (Germany). Hemodynamic parameters were measured by using premier cardiovascular ultrasound system GE VIVID7 Dimension (General Electric, USA). Therapeutic regimen for BA patients included inhaled glucocorticosteroids and β2-agonists (short-acting and prolonged); no systemic glucocorticosteroids were applied. In case hypotensive therapy was necessary patients were given lisinopril (10 mg a day) and/or amlodipine (5 mg a day) or by using them as combination drug – 10 mg lisinopril plus 5 mg amlodipine, daily (35 patients, including 17 patients with BA and concomitant EH stage I, and 18 patients with BA and concomitant EH stage II). Statistical analysis was performed according to the general routine methods by using software STATISTICA 6.0. All data are shown as mean value (М) ± SE (m). Statistical significance between groups was calculated with a Student’s t-test. To measure relationship between studied parameters we calculated correlation coefficient (r). R e s u l t s a n d D i s c u s s i o n . In Table 1 we show a distribution of examined patients according to BA severity as well as the presence of concomitant EH. There was found that BA severity was associated with higher probability of concomitant EH.

56 Table 1 Distribution of examined patients according to BA severity level and concomitant EH Groups of I II III IV Total patients mBA 3 (66.6 %) 2 (33.3 %) 0 0 5 (100 %) moBA 26 (46.4 %) 6 (10.0 %) 12 (21.4 %) 12 (21.4 %) 56 (100 %) sBA 4 (21.1 %) 2 (10.6 %) 7 (36.8 %) 6 (31.6 %) 19 (100 %)

During the treatment a positive dynamics of both airway flow index as well as BP values was documented. In particular, we saw that during the second examination prior to blood sampling patients with EH had systolic BP that decreased by 6.2±1.8 mmHg (4.7±2.8 mmHg in Group III and 7.5±2.5 mmHg in Group IV), whereas diastolic BP decreased by 4.7±1.7 mmHg (3.1±2.8 mmHg in Group III and 6.1±2.1 mmHg in Group IV). All examined patients did not show signs of severely increased pulmonary artery systolic pressure (PASP) that was equal to 30.0±0.4 mmHg. No significant differences were found in PASP values among groups with patients having mild, moderate, or severe BA. PASP in Group I (28.1±0.7 mmHg) was slightly lower as compared with patients from Group II (31.2±0.9 mmHg, p<0.05), Group III (31.1±0.8 mmHg, p<0.01), Group IV (31.2±0.8 mmHg, p<0.01). After treatment was completed no significant decrease in PASP was found. When we measured serum ET-1 levels we did not reveal significant differences between whole group of patients with BA (first and second examination) and control group (Table 2). Table 2 ET-1 serum level in examined patients, fmol/ml Groups of patients Before treatment After treatment BA, n=80 0.232±0.022 0.242±0.020 Control group, n=10 0.208±0.025

ET-1 serum level was not significantly different among patients with mild, moderate or severe BA (Table 3). Table 3

57 ET-1 serum level in examined patients according to the BA severity level, fmol/ml Groups of patients Before treatment After treatment mBA, n=5 0.177±0.034 0.216±0.037 moBA, n=56 0.247±0.031 0.252±0.025 sBA, n=19 0.202±0.019 0.223±0.047 Control group, n=10 0.208±0.025

We found out that ET-1 serum level was significantly affected with associated cardiovascular pathology (Table 4). After treatment there was shown that patients from Group III and Group I had significant differences in ET-1 serum levels (0.315±0.053 vs. 0.207±0.027 fmol/ml, respectively, p<0.05). After treatment patients in Group III had higher ET-1 level in serum than before treatment (0.315±0.053 vs. 0.196±0.022 fmol/ml, respectively, p<0.05). Table 4 ET-1 serum level in BA patients according to concomitant EH, fmol/ml Groups of patients Before treatment After treatment I, n=33 0.224±0.038 0.207±0.027* II, n=10 0.225±0.054 0.257±0.043 III, n=19 0.196±0.022§ 0.315±0.053*§ IV, n=18 0.290±0.060 0.224±0.043 Control group, n=10 0.208±0.025 Comments. * – statistically significant differences between groups, p<0.05. § – statistically significant differences are found before and after treatment, p<0.05.

Previously there was shown that ET-1 levels may be increased in patients with BA. In some cases ET-1 levels were tend to normalize while airway narrowing is getting improved [3]. In our study we found that serum ET-1 level in BA patients was comparable with that one from subjects of control group. At the same time, during the first examination moderate significant correlation between ET-1 level and relative increase of forced expiratory volume in 1 second (as compared with basic value) was shown. For the whole group correlation coefficient was 0.29, р=0.011. Magnitude of correlation was going up in parallel with BA severity level. In particular, correlation was insignificant in patients with mild BA, whereas in case of moderate BA

58 correlation coefficient was reaching 0.32, р=0.019, and in patients with severe BA it was reaching up to 0.46, р=0.049. During the last 20 years a role of ET-1 in development and progression of arterial hypertension has been widely debated. It is known that despite its vasopressor capacity ET-1 was increased only in few patients with arterial hypertension [2], including patients with pheochromocytoma [8], patients with arterial hypertension associated with obesity [6]. Course of arterial hypertension may be ameliorated by using angiotensin converting enzyme inhibitors, that can be accompanied with decrease of ET-1 levels [4]. In our study we have found that ET-1 concentration after treatment in BA patients with concomitant EH stage I was higher than in subjects who had optimal or normal BP values. However, it is worth mentioning that the serum ET-1 level in BA patients with concomitant EH stage I was slightly increasing as BP value (and airway narrowing) was becoming normalized. It might be due to the fact that duration of treatment course was short. Consequently, there was not enough time spent between two examination points (before and after treatment). Moreover, it is known [7] that in human ET-1 mediates its bronchoconstrictive effect via B-type receptors (ЕТв). When ET-1 acts on ЕTв receptors it mainly induces vasorelaxation rather than vasoconstriction as compared with signaling via ЕTа receptors [10]. Previously there was shown that in experimental conditions chronic hypoxia is characterized with enhanced ET-1-mediated signaling via ЕTв receptors that leads not only to bronchoconstriction but vasorelaxation as well [5]. It is possible that patients with combined pathology might have increased ET-1 level at some stages that could be accompanied with vasorelaxation. It is supported by the evidence that BA patients with concomitant EH (Group III + IV) were found to have an inverse correlation between ET-1 level after treatment and BP values, in particular, systolic (r=-0.38, p=0.036) as well as diastolic (r=-0.38, p=0.037). C o n c l u s i o n . We have found that in BA patients ET-1 level in blood serum was dependent not only on the course of the respiratory disease, but also it was affected by accompanying cardiovascular pathology. After treatment of BA

59 exacerbation patients with concomitant EH stage I were shown to have a higher serum level of endothelin-1 as compared with patients who had normal or optimal BP values.

References: 1. Böhm F., Pernow J. The importance of endothelin-1 for vascular dysfunction in cardiovascular disease // Cardiovasc Res. – 2007. – V. 76. № 1. - P. 8-18. 2. Dhaun N., Goddard J., Kohan D.E., Pollock D.M., Schiffrin E.L., Webb D.J. Role of endothelin-1 in clinical hypertension: 20 years on // Hypertension. – 2008. – V. 52. - № 3. - P. 452-459. 3. Fagan K.A., McMurtry I.F., Rodman D.M. Role of endothelin-1 in lung disease // Respir. Res. – 2001. - V. 2. - № 2. – Р. 90–101. 4. Hlubocká Z., Umnerová V., Heller S., Peleska J., Jindra A., Jáchymová M., Kvasnicka J., Aschermann M., Horký K. Is mild essential hypertension without obvious organ complications and risk factors associated with increased levels of circulating markers of endothelial dysfunction? Effect of ACE inhibitor therapy // Vnitr. Lek. – 2002. – V. 48. - № 8. – Р. 718-723. 5. Lal H., Yu Q., Williams K.I., Woodward B. Hypoxia augments conversion of big- endothelin-1 and endothelin ET(B) receptor-mediated actions in rat lungs //Eur J Pharmacol. – 2000. – V. 402. - № 1-2. Р. 101-110. 6. Letizia C., Celi M., Cerci S., Scuro L., Delfini E., Subioli S., Caliumi C., D'Erasmo E. High circulating levels of adrenomedullin and endothelin-1 in obesity associated with arterial hypertension // Ital. Heart J. Suppl. – 2001. - V. 2. - № 9. - Р 1011-1015 7. Naline E., Bertrand C., Biyah K., Fujitani Y., Okada T., Bisson A., Advenier C. Modulation of ET-1-induced contraction of human bronchi by airway epithelium- dependent nitric oxide release via ETA receptor activation // Br. J. Pharmacol. - 1999 - V. 126. - № 2. – Р. 529–535. 8. Oishi S., Sasaki M., Sato T. Elevated immunoreactive endothelin levels in patients with phaeochromocytoma // Am J Hypertens. – 1994. – V. 7. - № 8. – P. 717–722.

60 9. Polikepahad S., Moore R.M., Venugopal C.S. Endothelins and airways - a short review // Res. Commun. Mol. Pathol. Pharmacol. – 2006. – V. 119. - № 1-6. – Р. 3- 51. 10. Rich S., McLaughlin V.V. Endothelin receptor blockers in cardiovascular disease // Circulation. – 2003. – V. 108. - № 18. – P. 2184-2190. State Educational Establishment for Higher Professional Training «Saint- Petersburg State I.P. Pavlov Medical University of the Federal Agency for Public Health and Social Development of the Russian Federation». Russia, 197022, St.- Petersburg, Lev Tolstoy str. 6/8. Tel. 8(812)499-71-53, fax 8(812)234-08-97. S u m m a r y : Serum levels of endothelin-1 were investigated in 80 asthmatic subjects. Serum level of endothelin-1 after the treatment of asthma exacerbation was higher in patients with concomitant essential hypertension, stage I, than in patients with optimal and normal blood pressure. K e y w o r d s : bronchial asthma; essential hypertension; endothelin-1. R e f e r e n c e s 1. Böhm F. The importance of endothelin-1 for vascular dysfunction in cardiovascular disease / F. Böhm, J. Pernow // Cardiovasc Res. – 2007. – Vol. 76. - № 1. - P. 8-18. 2. Dhaun N. Role of endothelin-1 in clinical hypertension: 20 years on / N. Dhaun, J. Goddard, D.E. Kohan // Hypertension. – 2008. – Vol. 52. - № 3. - P. 452-459. 3. Fagan K.A. Role of endothelin-1 in lung disease / K.A. Fagan, I.F. McMurtry, D.M. Rodman // Respir. Res. – 2001. - Vol. 2. - № 2. – Р. 90–101. 4. Hlubocká Z. Is mild essential hypertension without obvious organ complications and risk factors associated with increased levels of circulating markers of endothelial dysfunction? Effect of ACE inhibitor therapy / Z. Hlubocká, V. Umnerová, S. Heller // Vnitr. Lek. – 2002. – Vol. 48. - № 8. – Р. 718-723. 5. Lal H. Hypoxia augments conversion of big-endothelin-1 and endothelin ET(B) receptor-mediated actions in rat lungs / H. Lal, Q. Yu, K.I. Williams, B. Woodward // Eur. J. Pharmacol. – 2000. – Vol. 402. - № 1-2. Р. 101-110.

61 6. Letizia C. High circulating levels of adrenomedullin and endothelin-1 in obesity associated with arterial hypertension / C. Letizia, M. Celi, S. Cerci // Ital. Heart J. Suppl. – 2001. - Vol. 2. - № 9. – Р. 1011-1015. 7. Naline E. Modulation of ET-1-induced contraction of human bronchi by airway epithelium-dependent nitric oxide release via ETA receptor activation / E. Naline, C. Bertrand, K. Biyah // Br. J. Pharmacol. - 1999 - Vol. 126. - № 2. – Р. 529–535. 8. Oishi S. Elevated immunoreactive endothelin levels in patients with phaeochromocytoma / S. Oishi, M. Sasaki, T. Sato // Am. J. Hypertens. – 1994. – Vol. 7. - № 8. – P. 717–722. 9. Polikepahad S. Endothelins and airways - a short review / S. Polikepahad, R.M. Moore, C.S. Venugopal // Res. Commun. Mol. Pathol. Pharmacol. – 2006. – Vol. 119. - № 1-6. – Р. 3-51. 10. Rich S. Endothelin receptor blockers in cardiovascular disease / S. Rich, V.V. McLaughlin // Circulation. – 2003. – Vol. 108. - № 18. – P. 2184-2190. I n f o r m a t i o n a b o u t t h e a u t h o r s : Kozyrev Andrey Gennadievich - candidate of medical sciences, senior research officer, Scientific Research Institute of Pulmonology, Saint-Petersburg State I.P. Pavlov Medical University, work tel. 8(812)499-68-89, e-mail: [email protected] Surkova Elena Arkadievna - candidate of medical sciences, senior research officer, Center of Molecular Medicine, Saint-Petersburg State I.P. Pavlov Medical University, work tel. 8(812)499-71-94, e-mail: [email protected] Gichkin Alexey Yurievich - candidate of medical sciences, senior research officer, Scientific Research Institute of Pulmonology, Saint-Petersburg State I.P. Pavlov Medical University, work tel. 8(812)499-68-65, e-mail: [email protected] Perley Vitaliy Evgenievich - doctor of medicine, principal research officer, Scientific Research Institute of Pulmonology, Saint-Petersburg State I.P. Pavlov Medical University, work tel. 8(812)499-68-65, e-mail: [email protected] M a t e r i a l R e c e i v e d 19.02.2010 г.

62 1286 Гольдзон+ UDC 616.127 – 001.17 – 085 – 092.9 © M.A. Goldzon, V.T. Dolgikh, A.O. Girsh, 2010 Goldzon M.A., Dolgikh V.T., Girsh A.O. Contractile rat myocardial function disorders at thermal trauma and ways of their correction // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State Educational Establishment of Higher Professional Training «Omsk State Medical academy of the Federal Agency for Public Health and Social Development of the Russian Federation», Russia, 644099, г. Omsk, Lenina str., 12, tel.: 8(381)223- 32-89. S u m m а r y : Studied indicators of work of the isolated heart of the burnt rats and their change at carrying out infusion therapies. Infringements of the contraction functions of a myocardium at the burnt animals and their improvement are revealed at combined infusion therapies. K e y w o r d s : a thermal trauma; infusion therapy; the isolated heart. R e f e r e n c e s 1. Адмакин А.Л. Осложнения ожоговой болезни, их причины и коррекция / А.Л. Адмакин, С.А. Петрачков // II съезд комбустиологов России. Сборник научных трудов. – М., 2008. - С. 97-98. 2. Вазина И.Р. Термическая травма: летальность, причины смерти, диагностические ошибки и ятрогенные осложнения / И.Р. Вазина, С.Н. Бугров, С.А. Бухвалов // II съезд комбустиологов России. Сборник научных трудов. – М., 2008. - С. 11-13. 3. Зильбер А.П. Этюды критической медицины / А.П. Зильбер. – М.: МЕДпресс-информ, 2006. – 568 с. 4. Николаев С.Б. Иммунометаболические эффекты агонистов опиоидных рецепторов при экспериментальной ожоговой травме / С.Б. Николаев, Н.А. Быстрова, Ю.Д. Ляшев // Курский научно-практический вестник «Человек и его здоровье». – 2005. - № 3. – С. 16-23.

63 5. Fallen E.T. Apparatus for study of ventricular function and metabolism in the isolated rat / E.T. Fallen, W.G. Elliott, R. Gorlin // J. Appl. Physiol. – 1967. – Vol. 22. - № 4. - Р. 836-839. I n f o r m a t i o n a b o u t a u t o r s : Dolgikh Vladimir Terentevich - doctor of medicine, professor head of the Department of Pathologic Physiology with course of clinical pathophysiology of Omsk state medical academy, tel.: 8(3812)23-03-78, e-mail: [email protected] Girsh Andrey Ottovich - doctor of medicine, professor of chair of anesthesiology, resuscitation and intensive therapy of Omsk state medical academy, tel.: 8(3812)23-03-78, e-mail: [email protected] Goldzon Marina Alexandrovna - intern of chair of hospital therapy of Omsk state medical academy, tel.: 8(904)329-46-50; e-mail: [email protected] M a t e r i a l R e c e i v e d 09.02.2010 г.

1322 Белова+ UDC 616.72-002:616-092.9 © S.V. Belova, 2010 Belova S.V. Simulation of experimental arthritis // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Federal government agency «Saratov Research Institute of Traumatology and Orthopedics», Russia, 410002, Saratov, Chernyshevsky str., 148. Tel.: 8(845)223-04- 13. e-mail: [email protected] S u m m a r y : The possibility to model an experimental rheumatoid arthritis by means of a new method (Patent RU 2351021) is demonstrated. A good comparativeness of histological manifestations, hematological, cytological, biochemical and histomorphologic alterations by experimental animals and patients with rheumatoid arthritis as well as reliability and rapidity of an adequate reproduction of this pathology permits to recommend this new model for studying of pathogenesis, improving of diagnostic,s methods and approving of various schemes (with and without medicaments) of therapy of rheumatoid arthritis.

64 K e y w o r d s : rheumatoid arthritis; pathogenesis; diagnostics and treatment. R e f e r e n c e s 1. Гриневич Ю.А. Определение иммунных комплексов в крови онкологических больных / Ю.А. Гриневич, А.И. Алферов // Лаб. дело. - 1984. - № 8. – С. 493-496. 2. Карякина Е.В. Клиническое значение определения гликозаминогликанов сыворотки крови и синовиальной жидкости при ревматоидном артрите / Е.В. Карякина // Вопр. ревматологии. - 1982. - № 4. – С. 31-34. 3. Насонова В.А. Ревматические болезни. Руководство для врачей / В.А. Насонова, Н.В. Бунчук. - М.: Медицина, 1997. – 35 с. 4. Пат. № 2351021 РФ Способ моделирования экспериментального ревматоидного артрита / С.В. Белова, Е.В. Карякина, Е.А. Кистнер; заявитель и патентообладатель Саратовский Научно-исследовательский институт травматологии и ортопедии; опубл. 27.03.2009г., Бюл. № 9. – 5 с. 5. Шехтер А.Б. Оценка морфологических проявлений синовита у больных ревматоидным артритом: Методические рекомендации / А.Б. Шехтер, А.А. Крель, З.П. Ращупкин. - М., 1985. – 30 с. 6. Pettipher E.R. Leucocyte infiltration and cartilage proteoglycan loss in immune arthritis in the rabbit / E.R. Pettipher, B. Henderson, S. Moncada, // Br. J. Pharmacol. – 1988. – Vol. 95. - P. 169-176. I n f o r m a t i o n a b o u t t h e a u t h o r : Belova Svetlana Vyacheslavovna - Senior researcher, assistant of the department of Laboratory and Functional Diagnostics of the Saratov Research Institute of Traumatology and Orthopedics, tel.: 8(845)223-46-68, e-mail: [email protected] M a t e r i a l R e c e i v e d 18.05.2010 г.

1295 Тарасов+ UDC 616.37-089.819843 65 © A.N. Tarasov, 2010 Tarasov A.N. Pancreas graft formation depending on conditions of its blood supply // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State educational institution of higher professional education «Kemerovo State medical academy» Intermediate level surgery department, Russia, 650016, Kemerovo, Oktyabrsky av., 22, tel: 8(384)239-63-96, 8(384)239-65-63. E-mail: [email protected] S u m m a r y : The literature and the results of own studies, which were devoted to the segment transplant forming opportunities and the method’s choice of pancreas crossing were presented in the experimental work. In connection with the aim the features of organ angioarchitecture were studied in dependence on age and body type. The materials and the methods of this survey are in line with strictly determined protocols, out of which the results about pancreas angioarchitecture direct dependence on age and donor body type were done, which can be used in clinics of pancreas disease in future. K e y w o r d s : experiment; pancreas; angioarchitecture; transplantation. R e f e r e n c e s 1. Данилов М.В. Хирургия поджелудочной железы / М.В. Данилов, В.Д. Федоров. - М.: Медицина, 1995. - 512с. 2. Кокс Д. Прикладная статистика. Принципы и примеры / Д. Кокс, Э. Снелл. - М.: Мир, 1984. - 200с. 3. Эндоскопическая ультрасонография в диагностике хирургических заболеваний поджелудочной железы / Ю.Г. Старков [и др.] // Хирургия. - 2008. - №1. - С.47-52. 4. Ariyama J. Endoscopic ultrasound and intraductal ultrasound in the diagnosis of small pancreatic tumors / J. Ariyama, M. Suyama, K. Satoh // Abdom Imaging. – 1998. – Vol. 23. – Р. 380-386. 5. Penman I.D. Endoscopic ultrasound / I.D. Penman // Endoscopy. – 2001. - Vol. 33. – Р. 940-948.

66 6. Saftoiu A. Endoscopic ultrasound elastography – a new imaging technique for the visualization of tissue elasticity distribution / A. Saftoiu, P. Vilman // J. Gasroinestin liver dis. – 2006. - Vol. 15. - №2. – Р. 161-165. I n f o r m a t i o n a b o u t t h e a u t h o r : Tarasov Andrey Nikolaevich the post-graduate student of chair of faculty surgery of the «Kemerovo state medical academy», work tel.: 8(3842)39-65-63, e- mail: [email protected] M a t e r i a l R e c e i v e d 26.02.2010 г.

1246 Комяков+ UDC 613.6:677 © B.K. Komyakov, B.G. Guliev, R.G. Shibliev, M.Yu. Alekseev, 2010 Komyakov B.K., Guliev B.G., Shibliev R.G., Alekseev M.Yu. Complications of percutaneous nephrolithotripsy // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State educational institution of higher professional education «St. Petersburg State Medical Academy named after I.I. Mechnikov». Russia, 195067, St. Petersburg, Piskarevsky pr., 47, tel./fax: 8(812)543-01-26, e-mail: [email protected] S u m m a r y : Results of percutaneous treatment of 458 patients with renal stones. From them open surgical interventions are made 157 (68,3%), endoscopic treatment - 52 (22,6%) and nephroectomy - 21 (9,1%) to the patient. The good long- term results plastic interventions on ureteropelvic junction have been received at 114 (82,6%), after endoscopic interventions only at 39 (75,0%) patients. Percutaneous interventions are shown at secondary strictures of ureteropelvic junction, when performance of open surgical interventions are technically inconvenient, and at patients with a unique kidney are very dangerous. K e y w o r d s : renal stones; percutaneous treatment; complication. С п и с о к л и т е р а т у р ы

67 1. Мартов А.Г. Рентген-эндоскопические методы диагностики и лечения заболеваний почек и верхних мочевых путей (суправезикальная эндоурология). Автореф. дисс. … д-ра мед. наук. – М., 1993. – 76 с. 2. Cortellini P. Major complications of percutaneous nephrolithotripsy (PCNL). Analysis of our cases / P. Cortellini, A. Frattini, S. Ferretti // Minerva Urol Nefrol. – 1997. –Vol. 49. - № 4. – P. 203–236. 3. Gremmo E. Hemorrhagic complications during percutaneous nephrolithotomy. Retrospective studies of 772 cases / E. Gremmo, P. Ballanger, B. Dore // Prog Urol. – 1999. – Vol. 3. – P. 460–463. 4. Kondas J. Splenic injury: a rare complication of percutaneuos nephrolithotomy / J. Kondas, E. Szentgyorgyi, L. Vaczi // Int. Urol. Nephrol. – 1994. – Vol. 26. - № 4. – P. 399–404. 5. Konishi T. Renal pseudoaneurysm successfully treated by superselective embolization as a complication of percutaneous nephrolithotomy: report of a case / T. Konishi, M. Kokuho, M. Narita // Hinyokika Kiyo. – 1991. – Vol. 37. - № 10. – P. 1299–1302. 6. Looser C. The catheter embolization of acute hematuria after percutaneous nephrostomy and nephrolitholapaxy / C. Looser, J. Triller, D. Ackermann // Rofo. – 1992. – Vol. 157. - № 5. – P. 490–494. 7. Nakata F. Septic attack during percutaneous nephrolithotripsy under epidural anesthesia / F. Nakata, H. Yamamoto, M. Okada // Masui. – 1993. –Vol. 42. - № 6. – P.931–932. 8. Narasimham D.L. Percutaneous nephrolithotomy through an intercostal approach / D.L. Narasimham, B. Jacobsson, P. Vijayan // Acta Radiol. – 1991. – Vol. 32. - № 2. – P. 162–165. 9. Patel A. Air travel and thromboembolic complications after percutaneous nephrolithotomy for staghorn stone / A. Patel, G.J. Fuchs // J. Endourol. –1998. – Vol. 12. - № 1. – P. 51–53.

68 10. Radecka E. Complications associated with percutaneous nephrolithotripsy: supra – versus subcostal access. A retrospective study / E. Radecka, M. Brehmer, K. Holmgren // Acta Radiol. – 2003. – Vol. 44. - № 4. – P. 447–451. 11. Ugras M. Severe renal bleeding caused by a ruptured renal sheath: case report of a rare complication of percutaneous nephrolithotomy / M. Ugras, A. Gunes, C. Baydinc // BMC Urol. – 2002. – Vol. 18. - № 1-2. – P. 10. 12. Wang J.H. Pyeloduodenal fistula: report of 2 cases / J.H. Wang, J.H. Chiang, T. Chang // J. Formos. Med. Assoc. – 1990. – Vol. 89. - № 12. – P. 1111-1114. 13. Wolf J.S. Management of intraoperatively diagnosed colonic injury during percutaneous nephrolithotomy / J.S. Wolf // Tech Urol. – 1998. – Vol. 4. - № 3. – P. 160–164. I n f o r m a t i o n a b o u t t h e a u t h o r s : Komyakov Boris Kirillovich - doctor of medicine, professor of the Department of Urology St. Petersburg State Medical Academy named after I.I. Mechnikov, work tel.: 8(812)510-94-33, E-mail: [email protected] Guliev Bakhman Gidayatovich – doctor of medical sciences, docent of the Department of Urology St. Petersburg State Medical Academy named after I.I. Mechnikov, work tel.: 8(921)945-34-80. Shibliev Rustam Gudbiddinivich - the post-graduate student of the Department of Urology St. Petersburg State Medical Academy named after I.I. Mechnikov, Tel.: 8(950)011-64-24, E-mail.: shibliyev@mail. ru Alexeev Michail Yurevich - the post-graduate student of the Department of Urology St. Petersburg State Medical Academy named after I.I. Mechnikov, Tel.: 8(921)950-37-27. M a t e r i a l R e c e i v e d 17.11.2009 г.

1326 Александрова+ UDC 616 – 005.4:59.086

69 © L.A. Alexandrova, A.A. Zhloba, E.L. Blashko, S.G. Chefu, N.V. Kuzmenko, V.A. Tsirlin, 2010 Alexandrova L.A.1,2, Zhloba A.A.1,2, Blashko E.L.1,2, Chefu S.G.,1,2 Kuzmenko N.V.2, Tsirlin V.A.1,2 Methabolism of aminothiols and antioxidant status in rats under experimental renal ischemia // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1 State educational institution of higher professional education «Saint- Petersburg Pavlov State Medical University, Ministry of Health Care and Social Development». Russia, 197022, St.-Petersburg, Lev Tolstoy str., 6/8, tel.: 8(812)499- 71-53, fax: 8(812)234-01-25, e-mail: [email protected] 2 Almazov Federal Heart, Blood and Endocrinology Centre, Akkuratova str., 2, Saint-Petersburg, Russia, 194341, Phone: 8(812)702-37-00, e-mail: info@hbe- centre.ru S u m m a r y : The present study examined the relationship between aminothiol metabolism and antioxidant status in plasma and kidney after one-sided ischemia of rat kidney. The experimental date showed stable intermediate hyperhomocysteinemia, which positive correlated with malonyl dialdehyde concentration and negative correlated with SH-groups concentration in the ischemic kidney. The increased gamma-glutamyl transferase activity and superoxide dismutase activity negatively correlated in ischemic kidney. K e y w o r d s : hyperhomocysteinemia; antioxidant status; ischemia; kidneys. R e f e r e n c e s 1. Александрова Л.А. Оценка антиоксидантной эффективности фитотерапии больных дисциркуляторной энцефалопатией / Л.А. Александрова, М.Л. Поспелова, О.Д. Барнаулов // Ученые записки СПбГМУ им. И.П.Павлова. – 2000. – Т. 7, № 4. – С. 73-77. 2. Королев Д.В. Программный комплекс для исследования зависимости артериального, перфузионного давления и сигнала ЭКГ от различных воздействий / Д.В. Королев, И.В. Александров, Д.Л. Сонин, М.М. Галагудза // В

70 сб. «Математические методы в технике и технологиях ММТТ – XV». – Тамбов: Тамбовский государственный технический университет – 2002. – Т. 7. – С. 155- 156. 3. Чиж А.С. Нефрология в терапевтической практике / А.С. Чиж. – М.: Высшая школа, 1998. – 557 с. 4. Dominici S. Prooxidant reactions promoted by soluble and cell-bound gamma-glutamyltransferase activity / S. Dominici, A. Paolicchi, A. Corti, E. Maellaro // Methods enzymol. – 2005. – Vol. 401. – P. 484-501. 5. Hell F. Angiotesin II-induced calcium signaling in the afferent arteriole from rats with two-kidney, one-clip hypertension / F. Hell, Q.B. Vagnes, B.M. Iversen // Am. J. Physiol. Renal. Physiol. – 2006. – Vol. 291. – № 1. – P. 140-147. 6. Graham M. Plasma homocysteine as a risk factor for vascular disease: the European concerted action project / M. Graham, L. Daly, H. Refsum // JAMA. – 1997. – Vol. 277. – № 22. – P. 1775-1781. 7. Lee D.H. Is serum gamma glutamyltransferase a marker of oxidative stress? / D.H. Lee, B. Rune, D. Jacobs // Free Radical Research – 2004. – Vol. 38. – № 6 – P. 535–539. 8. Perna A.F. Homocysteine and oxidative stress / A.F. Perna, D. Ingrosso, N.G. De Santo // Amino Acids. – 2003. – Vol. 25. – P. 409-417. 9. Pompella A. The significance of serum gamma-glutamyltransferase in cardiovascular diseases / A. Pompella, M. Emdin, C. Passino, A. Paolicchi // Clin. Chem. Lab. Med. – 2004. – Vol. 42. – № 10. – P. 1085-1091. 10. Zhloba A.A. Liquid chromatographic determination of total homocysteine in blood plasma with photometric detection / A.A. Zhloba, E.L. Blashko // J. Chromatogr. B. Analyt. Technol. Biomed. Life Sci. – 2004. – Vol. 800. – № 1. – P. 275-280. I n f o r m a t i o n a b o u t t h e a u t h o r s : Alexandrova Ludmila Alexandrovna – candidate of biological sciences, senior research scientist of the Biochemistry department of Scientific Research Center St.- Petersburg Pavlov State Medical University and Group of proteomics Institute of

71 Molecular Biology and Genetics, work tel.: 8(812)499-71-08, e-mail: [email protected] Zhloba Alexandr Anatolievich – doctor of medicine, professor, head of the Biochemistry Department of Scientific Research Center St.-Petersburg Pavlov State Medical University, and Group of proteomics Institute of Molecular Biology and Genetics, work tel.: 8(812)499-71-08, e-mail: [email protected] Blashko Eduard Lvovich – candidate of biological sciences, senior research scientist of the Biochemistry department of Scientific Research Center St.-Petersburg Pavlov State Medical University and Group of proteomics Institute of Molecular Biology and Genetics, work tel.: 8(812)499-71-08, e-mail: [email protected] Chefu Svetlana Grigorievna – candidate of biological sciences, head of the Laser Medicine Center St.-Petersburg Pavlov State Medical University, and senior research scientist of The Scientific Research Laboratory of microcirculation Almazov Federal Heart, Blood and Endocrinology Centre, work tel.: 8(812)499-70-35, e-mail: [email protected] Kuzmenko Natalia Vladimirovna – candidate of biological sciences, senior research scientist of Scientific Research Division of experimental physiology and pharmacology Institute of Experimental Medicine, Almazov Federal Heart, Blood and Endocrinology Centre tel.: 8(812)550-07-00. Tsirlin V.A. – doctor of medicine, professor, head of Scientific Research Division of experimental physiology and pharmacology Institute of Experimental Medicine Almazov Federal Heart, Blood and Endocrinology Centre, tel.: 8(812)550- 07-00. M a t e r i a l R e c e i v e d 01.06.2010 г.

1304 Белокрылов+ UDC 616.718.41-002.4-089 © N.M. Belokrylov, O.V. Gonina, N.V. Polyakova, N.A. Pekk, 2010

72 Belokrylov N.M., Gonina O.V., Polyakova N.V., Pekk N.A. Choice of optimum tactics for treatment of Legg-Kalve-Perthes disease // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Public health services municipal hospital №9 named after M.A. Tverye. Russia, 614990, Perm, Brothers Ignatov str., 2, tel.: 8(342)221-75-20. S u m m a r y : A 20-year experience of treatment of 282 children with Legg-Kalve-Perthes’ disease is presented. 180 patients were conservatively treated, 102 (36%) were operated on. Residual anatomic defects were found in 46% of cases with a 2nd and 3rd stages of the disease. Early conservative treatment and correction of deformations at the 4th and 5th stages of the disease were preferred. Тhe positive outcomes after surgical treatment were noted 95%. K e y w o r d s : coxofemoral joint; Legg-Kalve-Perthes disease; femur head osteochondropathy; pelvic osteotomy; femur osteotomy. R e f e r e n c e s 1. Барсуков Д.Б. Ортопедохирургическое лечение детей с болезнью Легга- Кальве-Пертеса / Д.Б. Барсуков: Дисс…. канд. мед. наук. – СПб., 2003. - 245 с. 2. Барсуков Д.Б. Ошибки в выборе тактики и метода лечения детей с болезнью Пертеса / Д.Б. Барсуков, А.И. Краснов // Оптимальные технологии диагностики и лечения в детской травматологии и ортопедии, ошибки и осложнения: Материалы симпозиума детских травматологов-ортопедов России (Волгоград). – СПб., 2003. - С. 234-236. 3. Белецкий А.В. Остеотомии бедра при лечении болезни Пертеса у детей / А.В. Белецкий, М.Н. Корень // Материалы итоговой научно-практической конференции. - Минск, 1995. - С. 55-56. 4. Овчинников Г.И. Медицинская реабилитация больных асептическим некрозом головки бедренной кости / Г.И. Овчинников: Автореф. дисс…. докт. мед. наук. – Киев, 1991. – 34 с. 5. Тимофеева М.И. Функциональное обоснование новых методов оперативного лечения болезни Пертеса у детей / М.И. Тимофеева: Автореф. дисс…. докт. мед. наук. - Пермь, 1991. – 39 с.

73 6. Цыкунов М.Б. Методика клинической оценки функционального состояния тазобедренного сустава у детей и подростков / М.Б. Цыкунов, М.А. Еремушкин, В.Д. Шарпарь // Вестник травматологии и ортопедии имени Н.Н. Приорова. – 2001. - № 3. – С. 13-18. 7. Mose K. Methods of measuring in Legg-Calve-Perthes diasease with special regard to the prognosis / K. Mose // Clin. Orthop. – 1980. – № 150. – P. 103-109. I n f o r m a t i o n a b o u t t h e a u t h o r s : Belokrylov Nikolay Mihajlovich - doctor of medicine managing department of children's orthopedy and traumatology of Public health services municipal hospital № 9 named after M.A. Tverye, main children's traumatologist-orthopedist of the Ministry of Health of the Perm region, office number: 8(342)221-82-80, e-mail: [email protected] Gonina Olga Valerevna - the candidate of medical sciences, the doctor, the traumatologist-orthopedist of department of children's orthopedy and traumatology of Public health services municipal hospital № 9 of M.A. Tverye № 9 named after M.A. Tverуe, office number: 8(342)221-65-90. Polyakova Natalia Vladimirovna - the candidate of medical sciences, the doctor, the traumatologist-orthopedist of department of children's orthopedy and traumatology of Public health services municipal hospital № 9 named after M.A. Tverуe, office number: 8(342)221-65-90. Pekk Natalya Aleksandrovna - the doctor, the traumatologist-orthopedist of department of children's orthopedy and traumatology of Public health services municipal hospital № 9 named after M.A. Tverуe, office number: 8(342)221-65-90. M a t e r i a l R e c e i v e d 16.03.2010 г.

1235 Арсеньев+ UDC 616.65-006-07+616.65-007.61-07 © A.A. Arsenev, B.V. Dmitriev, V.K. Makarov, 2010

74 Arsenev A.A., Dmitriev B.V., Makarov V.K. Immunoreactivity features in patients with benign prostate hyperplasia and prostate adenocarcinoma // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. State educational institution of higher professional education «Tver State Medical Academy». Russia, 170100, Tver, Sovetskaya str., 4. Тel.: 8(4822)32-17-79, fax: 8(4822)34-43-09. Е-mail: [email protected] S u m m a r y : Clinical blood analysis of patients with prostate cancer showed significant leucocyte decrease. Features of immunoreactivity in patients with benign prostate hyperplasia include immune lack of CD8 and CD19 cells. While in patients with prostate cancer there was more marked decrease of CD3, CD4, CD8 and CD19 lymphocytes. K e y w o r d s : benign prostate hyperplasia; prostate cancer; immune reactivity. R e f e r e n c e s 1. Клиническая онкоурология / под ред. Б.П. Матвеева. – М.:Вердана, 2003. - 457с. 2. Лимфоциты / под ред. Дж. Клауса. – М.: Мир, 1990. – 95 с. 3. Урология / под ред. Н.А. Лопаткина. - М.: ГЕОТАР-МЕДИА, 2007. – 265 с. 4. Guess H.A. Epidemiology and natural history of benign prostatic hyperplasia / H.A. Guess // Urol. Clin. North. Am. - 1995. - Vol. 22. - P. 247-261. 5. Quinn M. Patterns and trends in prostata cancer incidence, survival, prevalence and mortality / M. Quinn, P. Babb // International comparisons BJU. Int. - 2002. - Vol. 90. - № 2. - Р. 162-173. С в е д е н и я о б а в т о р а х : I n f o r m a t i o n a b o u t t h e a u t h o r s : M a t e r i a l R e c e i v e d 31.10.2009 г.

1328 Селиверстов+ UDC 616.34-008.87-07:616.36-002.2

75 © P.V. Seliverstov, L.A. Teterina, V.G. Radchenko, S.I. Sitkin, A.N. Suvorov, G.G. Alekhina, 2010 Seliverstov P. V., Teterina L.A., Radchenko V. G., Sitkin S.I., Suvorov A.N., Alekhina G.G. Aged changes in the gastrointestinal tract in patients with disbiosis of the large intestine on the background of liver chronic diseases // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1 Federal Agency for Public Health and Social Development State Educational Establishment for Higher Professional Training «Mechnikov’s Saint-Petersburg State Medical Academy» (SEE YPT SPSMA named after Mechnikov Rosgoszdrav). Russia, 195067, Saint-Petersburg, Piskarevsky pr., 47. Tel.: 8(812)543-96-09, fax: 8(812)740-15-24. Е-mail: [email protected] 2 Institute of Experimental Medicine of the NorthWest Branch of the Russian Academy of Medical Sciences ( IEM NWB RAMS). Russia, 197376, St.Petersburg, akad.Pavlov str.,12. Phone: 8(812)234-68-68, fax: 8(812)234-94-89. Е-mail: [email protected], [email protected] 3 Limited company «Avena», Russia, 194100, St.Petersburg, Kamennoostrovsky prospect, 71. Phone: 8(812)234-68-65. Е-mail: [email protected] S u m m a r y : In the process of vital activity every human organism undergoes a number of changes leading to its aging. The serious changes in all internal organs, including the gastrointestinal tract occur. Nowadays, the effectiveness of «Laminolakt» appears to be sufficiently high for the correction of disbiosis against the background of the chronic diseases of the liver, in patients over 60 y.o. (years of age). «Laminolakt» has both local and general systemic antipyretic effect. K e y w o r d s : Laminolakt; aging; disbiosis; the liver. R e f e r e n c e s 1. Барановский А.Ю. Основы питания россиян / А.Ю. Барановский, Л.И. Назаренко. – СПб.: Питер, 2007. – 528 с.

76 2. Барановский А.Ю. Болезни обмена веществ / А.Ю. Барановский. – СПб.: СпецЛит, 2002. – 235 с. 3. Барановский А.Ю. Болезни пожилых / А.Ю. Барановский – М.: ЗАО «Центрполиграф», 2002. – 633 с. 4. Барановский А.Ю. Клиническое питание / А.Ю. Барановский, К.Л. Райхельсон. - М.: ЗАО «Центрполиграф», 2008. – 21 с. 5. Барановский А.Ю. Диетология: Руководство. 3-е изд. / А.Ю. Барановский. – СПб.: Питер-Юг, 2008. – 960 с. 6. Валенкевич Л.Н. Гастроэнтерология в гериатрии / Л.Н. Валенкевич. – Л.: Медицина, 1987. – 240 с. 7. Воробьев В.И. Организация оздоровительного и лечебного питания / В.И.Воробьев. – М.: Медицина, 2002. – 15 с. 8. Дворецкий Л.И. Справочник по диагностике и лечению заболеваний у пожилых / Л.И. Дворецкий, Л.Б. Лазебник. – М.: ООО "Издательство Новая Волна", 2000. – 543 с. 9. Коркушко О.В. Гериатрия в терапевтической практике / О.В. Коркушко, Д.Ф. Чеботарев, Е.Г. Калиновская. – Киев: Здоров′я, 1993. – 840 с. 10. Лисовский В.А. Экология и питание / В.А. Лисовский, З.Я. Зандукели, И.М. Мухин . – СПб.: Лениздат, 1998. – 254 с. 11. Покровский А.А. Беседы о питании / А.А. Покровский. – М.: Медицина, 1968. – 188 c. 12. Смолянский Б.Л. Диетология. Новейший справочник для врачей / Б.Л. Смолянский, В.Г. Лифляндский. – СПб.: Сова; М.: Издательство Эксмо, 2003. – 816 с. I n f o r m a t i o n a b o u t t h e a u t h o r s : Seliverstov Pavel Vasilievich – assistant of the department of Internal Diseases with the course of Therapy and Nephrology of the faculty for Advanced Training of the SPSMA named after I.I. Mechnikov. Work tel.: 8(812)543-05-86, e-mail: [email protected]

77 Teterina Ludmila Anatolievna– aspirant of the department of Internal Diseases with the course of Therapy and Nephrology of the faculty for Advanced Training of the SPSMA named after I.I. Mechnikov. Work tel.: 8(812)543-05-86, e-mail: [email protected] Sitkin Stanislav Igorevich – candidate of Medical Sciences, docent of the department of Propedeutics with the course of Gastroenterology and Internal Diseases of the SPSMA named after I.I. Mechnikov. Work tel.: 8(812)543-04-60, e- mail: [email protected] Radchenko Valerii Grygorievich – professor of the department of Internal Diseases with the course of Therapy and Nephrology of the faculty for Advanced Training of the SPSMA named after I.I. Mechnikov. Work tel.: 8(812)543-05-86, e- mail: [email protected] Suvorov Alexander Nikolaevitch – head of the lab of molecular microbiology of pathogenic microbes, doctor of medical sciences, professor of microbiology. Institute of Experimental Medicine. Work tel.: 8(812)234-93-19, e-mail: [email protected] Alechina Galina Gennadievna – LLC Avena. Director of the company, MD, PhD. Work tel.:8(812)234-68-65, e-mail: [email protected] M a t e r i a l R e c e i v e d 01.06.2010 г.

1329 Абдулаев+ UDC 616.33-002.45-08+616.342-002.45-08 © M.A. Abdulaev, Yu.V. Plotnikov, A.M. Mukhanna, 2010 Abdulaev M.A.2, Plotnikov Yu.V.1, Mukhanna A.M.1 Еarly results of treatment of patients with perforated gastroduodenal ulcers // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1State Educational institution of higher education «Saint-Petersburg State Medical Academy named after I.I.Mechnikov of the Federal Agency for Public Health and Social Development». Russia, 195067, St.-Petersburg, Piskarevckу pr., 47. Теl.: 8(812)543-94-20, fax: 8(812)545-47-53. Е-mail: [email protected]

78 2 The State Alexander Hospital, Russia, 191015, St.-Petersburg, Solidarnosti av., 4. Теl.: 8(812)589-16-30, fax: 8(812)589-11-41. E-mail: [email protected] S u m m a r y : Monitoring analyzed 290 patients with perforated gastroduodenal ulcers. 64% of the patients underwent laparoscopic suture perforation holes, 28% - traditional laparotomic access. The frequency of postoperative complications of laparoscopic surgery was significantly lower (χ2 = 43,6; P <0,001), and also significantly reduced mortality in the postoperative period (χ2 = 20,4; P <0,001). K e y w o r d s : perforative ulcer; laparoscopic suture; traditional access. R e f e r e n c e s 1. Бачев И.И. Хирургическая тактика при кровоточащих язвах желудка и двенадцатиперстной кишки / И.И. Бачев // Хирургия. – 1991. - № 9. – С. 137- 143. 2. Борисов А.Е. Лапароскопическое ушивание перфоративных гастродуоденальных язв. 3-й Всероссийский съезд по эндоскопической хирургии: Тезисы докладов. / А.Е. Борисов, С.Е. Митин, С.И. Пешехонов // Эндоскоп. хир. – 2000. - № 2. – С. 12-13. 3. Григорьев П.Я. Краткое формулярное руководство по гастроэнтерологии и гепатологии / П.Я. Григорьев, Э.П. Яковенко. - М., 2003. - 112 с. 4. Ефименко Н.А. Перфоративные гастродуоденальные язвы: Патогенез осложнений, их профилактика и лечение / Н.А. Ефименко, Ю.М. Стойко, А.А. Курыгин. - М., СПб., 2001. – 192 с. 5. Исаков В.А. Предложения по использованию рекомендаций второго Маастрихтского соглашения по эрадикации Helicobacter pylori / В.А. Исаков, П.Л. Щербаков // Клинические перспективы гастроэнтерологии, гепатологии. - 2002. - № 4. - С. 31-34. 6. Опыт применения малоинвазивных вмешательств с использованием лапароскопической техники при осложнениях язвенной болезни

79 двенадцатиперстной кишки / Ю.М. Панцырев [и др.] // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2000. - № 6. – С. 65-68. 7. Панцырев Ю.М. Хирургическое лечение прободных и кровоточащих гастродуоденальных язв / Ю.М. Панцырев, А.И. Михалев, Е.Д. Федоров // Хирургия им Н.И. Пирогова. – 2003. –№ 3. - С. 43-49. I n f o r m a t i o n a b o u t t h e a u t h o r s : Magomed Abdulayev Abdulaevich - doctor of Medical Sciences, professor of surgical disease with a course of pediatric surgery. Head first to the surgical department of St. Petersburg Alexander City hospital. Tel.: 8(921)908-16-16, E-mail: [email protected] Plotnikov Yuri Vladimirovitch - doctor of Medical Sciences, professor of surgical disease with a course of pediatric surgery. Tel.: 8(953)3466342 E-mail: [email protected] Mukhanna Abdulla Mohammad - post-graduate department of surgical disease with a course of pediatric surgery. Tel.: 8(906)275-42-23 E-mail: [email protected] M a t e r i a l R e c e i v e d 01.06.2010 г.

1332 Чупров+ UDC 616.5-006.6-018 © I.N. Chuprov, S.V. Klyucharyova, V.L. Romanova, 2010 Chuprov I.N.1, Klyucharyova S.V.2, Romanova V.L.2 Parenchymal basal membrane in various types of the skin basal cell carcinoma // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1 State Educational Establishment for Additional Professional Training «Saint- Petersburg Medical Academy for Post-Diploma Training of the Federal Agency for Public Health and Social Development of the Russian Federation», Russia, 191015, Kirochnaya str.,41, tel.:8(812) 272-52-06, fax: 8(812)273-00-39, e-mail: [email protected] 2 Federal Agency for Public Health and Social Development State Educational Establishment for Higher Professional Training «Mechnikov Saint-Petersburg State 80 Medical Academy» (SEE YPT SPSMA named after Mechnikov Rosgoszdrav). Russia, 195067, Saint-Petersburg, Piskarevsky pr., 47. Tel.: 8(812)543-96-09, fax: 8(812)740-15-24, e-mail: [email protected] S u m m a r y : The immunohistochemical study of the main components of the parenchymal basal membrane - collagen IV and E-cadherin in different types of the skin basal cell carcinoma was carried out. Most prominent basement membrane`s disruptions was dominated in aggressive infiltrative BCC (p=0,008). K e y w o r d s : skin; basal cell carcinoma; basal membrane; immunohistochemistry. R e f e r e n c e s 1. Аничков Н.М. Биология опухолевого роста (молекулярно-медицинские аспекты) / Н.М. Аничков, И.М. Кветной, С.С. Коновалов. – СПб.: Прайм- ЕВРОЗНАК, 2004. – 224 с. 2. Дерматоонкология / под ред. Г.А. Галил-Оглы, В.А. Молочкова, Ю.В. Сергеева. − М.: Медицина для всех, 2005. − 872 с. 3. Дубенский В.В. Современные аспекты эпидемиологии, патогенеза, клиники и лечения базально-клеточного рака кожи / В.В. Дубенский, А.А. Гармонов // Вестник дерматологии и венерологии. − 2004. − № 6. − С. 7−12. 4. Особенности инвазии базально-клеточного рака / Н.Г. Дойкова [и др.] // Архив патологии. − 2000. − № 3. − С. 29−33. 5. Снарская Е.С. Базалиома / Е.С. Снарская, В.А. Молочков. − М.: Медицина, 2003. − 324 с. 6. Хлебникова А.Н. Клинико-морфологические и иммуногистохимические особенности различных форм базальноклеточного рака кожи и комплексный метод его лечения : автореф. дис. …д-ра мед. наук : 14.00.11, 14.00.15 / А.Н. Хлебникова. – М., 2007. – 37 с. 7. Bedeutung der Basalmembran fur das Wachstum von Tumoren – Immunhistochemische Aspekte unter besonderer Berucksichtigung von Tumoren des Kopf / A. Nerlich [et al.] // Laryngorhinootologie. − 1994. − № 12. − P. 631−636.

81 8. Evaluation of basement membrane status in aggressive skin carcinomas with skull base invasion: a case-control study / C.R. Cernea [et al.] // Ann Diagn Pathol. − 2005. − № 3. − P. 130−133. 9. Expression of beta-catenin in basal cell carcinoma / M. El-Bahrawy [et al.] // Br J Dermatol. − 2003. − № 5. − P. 964−970. 10. Expression of desmoglein I and plakoglobin in skin carcinomas / H. Tada [et al.] // J Cutan Pathol. − 2000. − № 1. − P. 24−29. 11. Kirihara Y. Clinicopathological and immunohistochemical study of basal cell carcinoma with reference to the features of basement membrane / Y. Kirihara, J. Haratake, A. Horie // J Dermatol. − 1992. − № 3. − P. 161−169. 12. Panuncio A. Immunohistochemical study of nerve fibres in basal cell carcinoma / A. Panuncio, R. Vignale, G. Lopez // Eur J Dermatol. − 2003. − № 3. − P. 250−253. 13. Quatresooz P. Differential expression of alpha1 (IV) and alpha-5 (IV) collagen chains in basal-cell carcinoma / P. Quatresooz, O. Martalo, G.E. Pierard // J Cutan Pathol. − 2003. − № 9. − P. 548−552. 14. Takeuchi T. Downregulation of expression of a novel cadherin molecule, T- cadherin, in basal cell carcinoma of the skin / T. Takeuchi, S.B. Liang, Y. Ohtsuki // Mol Carcinog. − 2002. − № 4. − P. 173−179. 15. The expression of nectin-1alpha in normal human skin and various skin tumours / H. Matsushima [et al.] // Br J Dermatol. − 2003. − № 4. − P . 755−762. I n f o r m a t i o n a b o u t a u t h o r s : Chuprov Igor Nikolaevich - Candidate of Medical Sciences, Assistant- Professor, Saint-Petersburg Medical Academy for Post-Diploma Training, tel.: 8(921)387-03-78, 8(904)619-74-21, e-mail: [email protected] Klyuchareva Svetlana Victorovna - Doctor of Medicine, Professor of the department of Dermatovenerology of the I.I.Mechnikov Saint-Petersburg State Medical Academy. Tel.: 8(92)-747-30-85. E-mail: [email protected]

82 Romanova Victoriya Leonidovna – post-graduate student of the department of Dermatovenerology of the I.I.Mechnikov Saint-Petersburg State Medical Academy. Tel.: 8(921)747-30-85. E-mail: [email protected] M a t e r i a l R e c e i v e d 10.06.2010 г.

1337 Слепнев+ UDC 613.014.24+615.07:615.454.12 © M.V. Slepnev, N.Yu. Frolova, 2010 Slepnev M.V., Frolova N.Yu. Study of pharmacological activity of ointments, obtained on the basis of the gel Arespol // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Federal Agency of Health Care and Social Development State Educational Institution of Higher Professional Educational «Saint-Petersburg State Chemical Pharmaceutical Academy», Russia, 197376, St.-Petersburg, Popov str., 14, tel.: 8(812)234-57-29, fax: 8(812)234-60-44, е-mail: [email protected] S u m m a r y : Characteristic anti-allergic and anti-inflammatory action of the developed gels with 5% tannin; 5% zink oxide and 1% dimedrol; 5% zink oxide and 2% novocaine was established on the experimental model of allergic contagious dermatitis, which denotes the possibility of gel Arespol use in the compounding the above formulations instead of traditionally employed vaseline. K e y w o r d s : acrylic polymers; Arespola gel, extemporal ointments, dermatitis R e f e r e n c e s 1. Алексеев К.В. Опыт использования редкосшитых акриловых полимеров в составе новых дерматологических препаратов / К.В. Алексеев // Матер. науч.- практ. конф. «Актуальные вопросы косметологии». – СПб., 2000. – 80 с. 2. Алексеев К.В. Редкосшитые акриловые полимеры в фармации / К.В. Алексеев, В.Н. Ли, В.Н. Демишев // Фармация. - 1987. - № 5. - С. 15–18. 3. Залкан П.М. Влияние синтетических моющих средств на реактивность кожи морских свинок / П.М. Залкан, Е.А. Иевлева // Актуальные вопросы профессиональной дерматологии. – М.: Медицина, 1965. – 112 с. 83 4. Изучение возможности получения олеогелей с местными анестетиками на основе редкосшитых акриловых полимеров / Б.Л. Молдавер [и др.]  Х Российский национальный конгресс «Человек и лекарство»: тез. докл. – М., 2003. - С. 636. 5. Тенцова А.И. Современные аспекты исследования и производства мазей / А.И. Тенцова, В.М. Грецкий. – М.: Медицина, 1980. – 192 с. 6. Formulating Topical Products // The proven polymers in pharmaceuticals. Bulletin 14. – B.F. Goodrich, 1994. 7. Polymers for Pharmaceutical Applications // The proven polymers in pharmaceuticals. Bulletin 1. – B.F. Goodrich, 1994. I n f o r m a t i o n a b o u t t h e a u t h o r s : Slepnev Michail Vladimirivich - candidate of pharmaceutical sciences, assistant-professor of the Department of Technology of Medicinal Forms, Saint- Petersburg State Chemical Pharmaceutical Academy, work tel.: 8(812)234-49-31, e- mail: [email protected] Frolova Natalia Yuryevna - candidate of biological sciences, senior research worker of the Laboratory of Pharmacological Studies, Saint-Petersburg State Chemical Pharmaceutical Academy, work tel.: 8(812)234-90-34, e-mail: [email protected] M a t e r i a l R e c e i v e d 24.06.2010 г.

1344 Комлева UDC 616.741:616.711:613.60 © N.E. Komleva, V.F. Spirin, T.V. Grishina, T.A. Novikova, V.A. Medentsov, N.A. Mikhailova, V.O. Skvortsov, 2010 Komleva N.E, Spirin V.F, Grishina T.V, Novikova T.A, Medentsov V.A, Mikhailova N.A, Skvortsov V.O Influence dorsopatiya of agricultural workers on quality of life // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Federal State Institution of Science Saratov Research Institute of Rural Hygiene of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare (FSIS Saratov Research Institute of Rural Hygiene 84 Rospotrebnadzor). Russia, 410022, Saratov, str. Zarechnyа, 1a. Tel.: 8 (8452) 92-78- 90. E-mail: [email protected] S u m m a r y : Quality of life of agricultural workers with a diagnosis dorsopatiya statistically significantly lower compared to urban residents. Most likely, such social components, as working conditions and peculiarities of life in rural areas are important factors in the analysis of quality of life.

K e y w o r d s : dorsopatiya, quality of life, agricultural workers. С п и с о к л и т е р а т у р ы 1. Болевые синдромы в неврологической практике / А.М. Вейн [и др.]; под ред. А.М. Вейна. - М.: Медпресс, 1999. – 372 с. 2. Григорьева В.Н. Психосоматические аспекты нейрореабилитации. Хронические боли / В.Н. Григорьева – Нижний Новгород: Изд-во Нижегородской гос. Медицинской академии, 2004. – 420 с. 3. Новик А.А. Руководство по исследованию качества жизни в медицине / А.А. Новик, Т.И. Ионова. - СПб.: Издательский дом «Нева», 2002. - 320 с. 4. Bullinger M. Health has connected quality of life and subjective health. The brief review of the status of a research for new criterions of an evaluation in medicine / M. Bullinger // Psychother.-Psychosom. Med. - 1997. - Vol. 47. - P. 76-91. 5. Meers C. Quality, connected by health, of life in clinical practice / C. Meers // J. GANNT. – 1996. - Vol. 6. - P. 29-31. 6. Meier D. Evaluation of quality of life / D. Meier // Ther. Umsch. - 1997. - Vol. 54. - P. 321-325. 7. Musschenga A.W. The relation between the concepts «Quality of life», health and good luck / A.W. Musschenga // J. Med. Philos. - 1997. - Vol. 22. - P. 11- 28. 8. Osoba D., Brada M. Health-related quality of life in pacients treated with temozolomide vs. procarbazine for recurrent glioblastoma miltiforme / D. Osoba, M. Brada // J. Clin. Oncol. - 2000. - V. 18. - № 7. - Р. 481-491. 9. Pincus T., Griffit J. Prevalence of the self-informed depression in the patients with rheumatoid arthritis / T. Pincus, J. Griffit // Br. J. Reumatol. - 1996. -

85 Vol. 35. - P. 879-883. 10. Staguet M.J. Quality of life assessment in clinical trials / M.J. Staguet. - Oxford university Press: Oxford. New York, Tokyo. - 1998. - 360 p. I n f o r m a t i o n a b o u t t h e a u t h o r s : Komleva Natalia E. - PhD, Head of the Clinical Division FSIS Saratov Institute of Rural Hygiene Rospotrebnadzor, work tel.: 8 (8452) 92-78-90, home tel.: 8 (8452) 23-05-86, mobile tel.: 8 - 917-217-07-67. E-mail: [email protected] Spirin Vladimir F. - MD, professor, director of FSIS Saratov Institute of Rural Hygiene Rospotrebnadzor, work tel.: 8 (8452) 92-78-90. Grishina Tatiana V. - PhD, Senior Fellow of the clinical department FSIS Saratov Institute of Rural Hygiene Rospotrebnadzor, work tel.: 8 (8452) 92-78-90. Novikova Tamara A. - PhD, Head of the Department occupational medicine FSIS Saratov Institute of Rural Hygiene Rospotrebnadzor. Medentsov Vyacheslav A. - Junior Researcher of the clinical department FSIS Saratov Institute of Rural Hygiene Rospotrebnadzor, work tel.: 8 (8452) 92-78-90. Mikhailova Natalia A. - PhD, senior researcher at the Department of Occupational Medicine FSIS Saratov Institute of Rural Hygiene Rospotrebnadzor, work tel.: 8 (8452) 92-78-90. Skvortsov, Vyacheslav O. - the clinic of occupational diseases FSIS Saratov Institute of Rural Hygiene Rospotrebnadzor, work tel.: 8 (8452) 92-78-90. M a t e r i a l R e c e i v e d 30.06.2010 г.

EPIDEMIOLOGY, DIAGNOSTICS, CLINIC AND PREVENTION OF INFECTIOUS AND PARASITIC DISEASES 1346 Каргальцева+ UDC 616.1-07:616.9 © N.M. Kargaltseva, A.T. Burbello, V.I. Kocherovets, A.S. Fedorenko, 2010 Kargaltseva N.M.1, Burbello A.T.1, Kocherovets V.I.2, Fedorenko A.S.1 Clinical and microbiological features of blood flow infections // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 86 1 State Educational Establishment for Higher Professional Training «Saint- Petersburg State Medical Academy named after I.I. Mechnikov of the Federal Agency for Public Health and Social Development of the Russian Federation», Russia, 195067, St. Petersburg, Piskarevsky pr., 47, tel./fax: 8(812)543-01-26, e- mail: [email protected] 2 The I.M.Sechenov Moscow Medical Academy the State Education Institution of Higher Professional Training of the Federal Agency of Health Care and Social Development of the Russian Federation. Russia, 119991, Moscow, Trubetskaya street, 8-2. Теl.: 8(495)248-05-53, e-mail: http://www.mma.ru S u m m a r y : Bloodstream infection (BI) is connected with the presence of both the microorganisms in blood and the clinical symptoms in patients. It is known that high temperature is a leading clinical symptom of infectious disease. Obtained hemoculture confirms the presence of microorganisms in blood. The authors compared the clinical symptoms of bloodstream infection with the results of microbiological blood tests. There were 204 patients interviewed according to a special questionnaire. All patients, blood was analysed by microscopic and cultivation tests. The leading clinical symptoms of patients with BI were: high temperature and chill (63,2%), skin abscesses (72,1%), diseases of upper respiratory tract (63,7%) and unstable stool (diarrhea or constipation) (53,9%). Blood was collected in anticoagulant to have buffy-coat layer which was used for the blood smears and blood culture. The blood smears for microscopic examination were painted using Gram method. Blood cultures were kept in aerobic and anaerobic conditions. The microorganisms were discovered in 97,8% of the blood smears as monomorphologies (17,4%) and associations of morphological forms (82,6%). The microorganisms were isolated in 55,2% of blood samples as monomorphologies (64,3%) and associations of morphological forms (35,7%). It was revealed logical connection between certain clinical manifestations of bloodstream infection and the presence of various microorganisms in blood by

87 detecting the clinically important symptoms of bloodstream infection along with discovering and isolating blood microorganisms by rapid and express methods. K e y w o r d s : clinical symptoms; blood smear; hemoculture; buffy coat. R e f e r e n c e s 1. Дисбактериозы – актуальная проблема медицины / А.А. Воробьев, Н.А. Абрамов, В.М. Бондаренко, Б.А. Шендеров // Вестн. РАМН. - 1997. - № 3. - С. 4-7. 2. Пат. 2098486 РФ. Способ диагностики бактериемии / Н.М. Каргальцева; заявитель и патентообладатель Санкт-Петербургская государственная медицинская академия им. И.И. Мечникова. - № 95\10928\13 от 21.06.95, Бюл. № 34. – 5 с. 3. Принципы бактериологического исследования крови больных инфекционным эндокардитом. Методические рекомендации / В.И. Кочеровец, Н.М. Каргальцева, В.С. Гуревич, Б.Б. Бондаренко. - Ленинград, 1990. – 23 с. 4. Beekmann S.E. Determining the clinical significance of coagulase-negative Staphylococci isolated from blood cultures / S.E. Beekmann, D.J. Diekema, G.V. Doern // Infect. Control. Hosp. Epidemiol. - 2005. - Vol. 26. № 6. - P. 559-566. 5. Fever in liver transplant recipient: changing spectrum of etiologic agents / F.Y. Chang, N. Singh, T. Gayowski, M.M. Wagener, J.R. Marino // Cl. Inf. Dis. - 1998. - Vol. 26. - P. 59-65. 6. Nosocomial bacteremia: clinical significance of a single bloodculture positive for coagulase-negative staphylococci / B. Favre, S. Hugonnet, L. Correa, H. Sax, P. Rohner, D. Pittet // Infect. Control. Hosp. Epidemiol. - 2005. - Vol. 26.- № 8. - P. 697-702. I n f o r m a t i o n a b o u t t h e a u t h o r s : Kargaltseva Nataliya Mikhailovna c- Candidate of Medical Sciences, teacher at the course of clinical laboratory diagnostics of the Mechnikov Saint-Petersburg State Medical Academy. Work tel.; 8(812)292-32-25, e-mail: [email protected] Burbello Aleksandra Timofeevna – Doctor of Medicine, Professor of the department of Hospital Therapy with the course of Clinical Pharmacology, Family

88 Medicine and Clinical Laboratory Diagnostics; head of the course of Clinical Pharmacology of the Mechnikov Saint-Petersburg State Medical Academy. Work tel.: 8(812)543-94-34, e-mail: [email protected] Kocherovets Vladimir Ivanovich – Doctor of Medicine, Professor of the department of Pharmacological Chemistry and Pharmacognostics of the faculty for Post-Diploma Professional Training (FPDPT) of the Sechenov Moscow Medical Academy. Work tel.; 8(495)656-25-75 Fedorenko Anastasiya Mikhailovna – post-graduate student of the department of Hospital Therapy with the course of Clinical Pharmacology and Clinical Laboratory Diagnostics of the Mechnikov Saint-Petersburg State Medical Academy M a t e r i a l R e c e i v e d 06.07.2010 г.

1312 Александрова+ UDC [616.314.17.18-008.1-06:616-002.5]:085.37(045) © E.A. Aleksandrova, A.V. Lepilin, N.E. Kazimirova, A.A. Shuldyakov, 2010 Aleksandrova E.A., Lepilin A.V., Kazimirova N.E., Shuldyakov A.A. Cycloferon liniment efficiency study in the complex therapy of oral cavity inflammatory diseases in tuberculous patients // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Saratov State Medical University named after V.I. Razumovsky, Russia, 410012, Saratov, Bolshaya Kazachya str., 112, tel.: 8(452)27-33-70, 8(452)51-15-32 fax: 8(452)51-15-34, 8(452)51-16-17, Е-mail: [email protected], http://www.sgmu.ru S u m m a r y : For the purpose to determine the clinic-pathogenetic efficacy of Cycloferon liniment in the combined therapy of periodontitis of patients with focal tuberculosis medical examination and treatment of 40 patients is carried out. It is established, that use of liniment Cycloferon in the combined treatment of patients with focal tuberculosis allows to accelerate process of normalization of parameters lipid peroxidation and antioxidant potential of blood, to decrease infection load (herpes symplex virus I, candida albicans, staphylococcus aureus) in parodontal recess and evidence of local inflammation with reduction of activity of the factor

89 tumours necrosis and interleukin 1b, what provides acceleration of recuperation processes, lowering of frequency of parodontitis backsets. K e y w o r d s : periodontitis; tuberculosis; Cycloferon. R e f e r e n c e s 1. Васильева Л.С. Клинические варианты течения туберкулеза легких как проявление адаптационных реакций организма в условиях различных эпидемиологических периодов / Л.С. Васильева, Т.П. Филиппова // Сибирский медицинский журнал. - 2006. - № 6. – С. 35-41. 2. Данилевский Н.Ф. Заболевания пародонта / Н.Ф. Данилевский, А.В. Борисенко. - Киев: Здоровье, 2000. - 464 с. 3. Зайцева Е.М. Клинико-микробиологические параллели и цитокиновый профиль у больных пародонтитом на фоне коплексного лечения с использованием линимента циклоферона / Е.М. Зайцева // Автореф. дис. … канд. мед. наук. – Волгоград, 2007. – 25 с. 4. Использование циклоферона и интерферона человеческого гамма - препарата ингарон в комплексном лечении больных туберкулезом легких и ВИЧ-инфекций / И. Йола [и др.] // Вестник СПбГМА им. И.И. Мечникова. -2006. - № 3. - С. 150-154. 5. Курякина Н.В. Заболевания пародонта / Н.В. Курякина, Т.Ф. Кутепова. - Н.Новгород, 2000. – 158 с. 6. Романцов М.Г. Иммунодефицитные состояния: коррекция циклофероном / М.Г. Романцов, Ф.И. Ершов, А.Л. Коваленко. – СПб. – 1998. – 35 с. 7. Соболева Л.А. Оптимизация терапии больных пародонтитом / Л.А. Соболева, А.В. Лепилин, А.А. Шульдяков // Вестник Санкт-Петербургской государственной медицинской академии им. И.И. Мечникова. – 2004. - № 1. - С. 130-133. 8. Шилова М.В. Туберкулез в России / М.В. Шилова. - Воронеж: ВГПУ, 2007. – 150 с. I n f o r m a t i o n a b o u t t h e a u t h o r s :

90 Aleksandrova Helen Aleksandrovna - the stomatologist of the therapeutic department of № 1 consultative stomatological polyclinic on the profit and loss accounting basis of clinical hospital n.a. S.R. Mirotvortseva, e-mail: [email protected] Lepilin Alexander Victorovich - doctor of medicine, professor, head of department of surgical stomatology, Saratov State Medical University n.a. V.I. Razumovsky, tel.: 8(8452)28-88-30. Kazimirova Natalia Evgenyevna - doctor of medicine, professor, head of department of Phtisiopneumology Saratov State Medical University n.a. V.I. Razumovsky, phone: 8(8452)46-12-11; e-mail: [email protected] Shuldyakov Andrey Anatolyevich - doctor of medicine, professor, head of department of infectious disease, Saratov State Medical University n.a. V.I. Razumovsky, phone: 8(8452)58-06-49, e-mail: [email protected] M a t e r i a l R e c e i v e d 14.04.2010 г.

1284 Халикова+ UDC 616.36-002.14+546.172.6.31+612.11 © Sh.A. Khalikova, M.N. Daminova, 2010 Khalikova Sh.A., Daminova M.N. Amino acid spectrum and nitrogen oxide state in blood serum of children with chronic virus hepatitis C // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Tashkent Pediatric Medical Institute of the Ministry of Health of the Republic of Uzbekistan, Tashkent, Bagishomol str., 223. Tel.: 8(371)260-31-26, fax: 8(371)262-33-14, E-mail: [email protected] S u m m a r y : Studies have shown that patients with HCV amino acid spectrum and the end products of nitric oxide (NO) in serum differ significantly depending on the severity of the disease. So reliable elevation of argenin and NO content in blood serum of patients may have a great importance in pathogenesis and severity course of acute and chronic viral hepatitis C. K e y w o r d s : hepatitis C, the spectrum of amino acids, nitric oxide.

91 R e f e r e n c e s 1. Абдукадырова М.А. Прогностические маркеры хронизации вирусного гепатита С / М.А. Абдукадырова // Иммунология. – 2002. – Т. 234.- № 1 – С. 47- 50. 2. Виноградов Н.А. Изменение синтеза оксида азота, содержания адренокортикотропного гормона и кортизола в крови при вирусном гепатите В / Н.А. Виноградов // Клиническая медицина. – 2001. – № 11. – С. 47-51. 3. Ивашкин В.Т. Оксид азота в регуляции функциональной активности физиологических систем / В.Т. Ивашкин, О.М. Дранкина // Российский журнал гастроэнтерологии, гепатологии, колопроктологии. – 2000. – № 4. – С. 16-21. 4. Рома М.Я. Модификация экспресс-метода определения нитритов / М.Я. Рома, Е.С. Яковлева, Я. Лутсо // Вопросы онкологии. – 1991. – Т. 37. – № 4. – С. 71-72. 5. Cooper C. Nitric oxide and iron proteins / C. Cooper // Biochim. Biophys. Acta. – 1999. - Vol. 1411. – P. 290-309. 6. Debier C. Vitamins A and E: metabolism, roles and transfer to off spring / C. Debier, Y. Larondelle // Br. J.Nutr. – 2005. – Vol. 93, № 2. – P. 153-174. 7. Stеven A. Amino Acid Analysis Utilizing. Fhenylisotiocyanata Derivatives / A. Stеven, J. Cohen Daviel // Analyt. Biohem. – 1998. – Vol. 17, № 1. – P. 1-16. I n f o r m a t i o n a b o u t t h e a u t h o r s : Khalikova Shakhista Abdurakhmanbekovna - assistant of childhood infections of the Tashkent Pediatric Medical Institute, Ministry of Health of the Republic of Uzbekistan, Tashkent, Tel.: 8(371)245-38-08, fax: 8(371)262-33-14, E-mail: [email protected] Daminova Malikа Nasirovna - MD, assistant professor of pediatric infections of the Tashkent Pediatric Medical Institute, Ministry of Health of the Republic of Uzbekistan, Tashkent, Tel.: 8(371)248-06-61, fax: 8(371)262-33-14, E-mail: [email protected] M a t e r i a l R e c e i v e d 14.01.2010 г.

92 RESTORATIVE MEDICINE 1330 Бурмистров+ UDC 616.711.6-003.974:615.82 © D.A. Burmistrov, G.S. Demin, O.I. Khardikov, 2010 Burmistrov D.A.1, Demin G.S.2, Khardikov O.I.3 Strong training by STEN method as a way to restore flexibility and reduce pain syndrome in patients with lumbosacral osteochondrosis in different ages // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1 St. Petersburg Institute of Bioregulation and Gerontology of the North- Western Branch of the Russian Academy of Medical Sciences Federal State. Russia, 197110, St. Petersburg, Dinamo str., 3. Тel.: 8(812)274-56-50, fax: 8(812)717-25-50, 8(812)274-92-27. E-mail: [email protected] 2 «GENE», Ltd. Russia, 190020, St.-Petersburg, Tsiolkovsky str., 11. Тel.: 8(812)575-18-67, fax: 8(812)600-77-54. Е-mail: [email protected] 3 St. Petersburg State Medical Academy named after I.I. Mechnikov. Russia, 195067, St. Petersburg, Piskarevsky pr., 47, tel./fax: 8(812)543-01-26, e-mail: [email protected] S u m m a r y : The program STAN promotes an increase of strength qualities, recovery of flexibility, elimination of pain syndrome and increase of physical capacity. Using this program allows the person to carry out whole amount of different activities, improving quality of life. K e y w o r d s : spinal osteochondrosis; pain syndrome; power training; flexibility; quality of life. R e f e r e n c e s 1. Бубновский С.М. Руководство по кинезитерапии дорсопатий и грыж позвоночника / С.М. Бубновский. – М.: «МАКС Пресс», 2002. – 100 с. 2. Бурмистров Д.А. Силовая тренировка при болевом синдроме в спине: Учебно-методическое пособие / Д.А. Бурмистров, В.С. Степанов. – СПб.: СПбГАФК им. П.Ф. Лесгафта, 2003. – 63 с.

93 3. Гупта М.К. 69 уникальных лечебных поз и упражнений от болей в позвоночнике, спине и шее: Естественный путь к здоровью / М.К. Гупта. – М.: АСТ: Астрель, 2007. – 127 с. 4. Ингерлейб М.Б. Анатомия Физических упражнений / М.Б. Ингерлейб. – Ростов н/Д: Феникс, 2009. – 187 с. 5. Милюкова И.В. Оздоровительная гимнастика для позвоночника / И.В. Милюкова, Т.А. Евдокимова. – М.: АСТ; СПб.: Сова, 2007. – 156 с. 6. Попелянский А.Я. Клиническая пропедевтика мануальной медицины / А.Я. Попелянский. – М.: МЕДпресс-информ, 2003. – 136 с. 7. Laliberte R. The men's health guide to peak conditioning / R. Laliberte, S.C. George. – USA: Rodale Inc, 1997. – 384 p. 8. Sandler D. Weight training fundamentals / D. Sandler. – USA: Human Kinetics Publishers, 2003. – 152 p. 9. SF-36 Health Survey: Manual and interpretation guide / J.E. Ware, K.K. Snow, M. Kosinski, B. Gandek. – Boston: The Health Institute, New England Medical Center, Mass, 1993. – 126 p. 10. Vella M. Anatomy for strength and fitness training / M. Vella. – London: New Holland Publishers (UK) Ltd, 2006. – 144 p. I n f o r m a t i o n a b o u t t h e a u t h o r s : Burmistrov Dmitrii A. - Ph.D., Senior Researcher, Laboratory of Clinical Pathology age of the St. Petersburg Institute of Bioregulation and Gerontology of the North-Western Branch of the Russian Academy of Medical Sciences, Saint Petersburg, Russia, tel.: 8(812)274-92-27. E-mail: [email protected] Demin G.S - Ph.D., director of development NIKOR, Gene Ltd, Saint Petersburg, Russia. E-mail: [email protected] Khardikov Oleg I. – clinical ordinator of the Department of Neurology, Neurosurgery and Medical Genetics of St. Petersburg State Medical Academy named after I.I. Mechnikov. Work tel.: 8(812)543-01-26, e-mail: [email protected] M a t e r i a l R e c e i v e d 08.06.2010 г.

94 1335 Гзогян+ UDC 616.127-005.8-08-039.34:615.825  M.N. Gzogyan, N.I. Tarasov, L.K. Isakov, D.S. Krivonosov, T.V. Kuznetsova, A.P. Yarkovskaya, A.T. Teplyakov, 2010 Gzogyan M.N.1, Tarasov N.I.1, Isakov L.K.1, Krivonosov D.S.1, Kuznetsova T.V.1, Yarkovskaya A.P.1, Teplyakov A.T.2 The effectiveness of rehabilitation measures with long-standing physical training in outpatient recovery in patients after myocardial infarction // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1State educational institution of higher professional education «Kemerovo State Medical Academy», Federal Agency for Health and Social Development, Faculty of postgraduate training. Russia, 650029, Kemerovo, Voroshilova str., 22-a. Тel: 8(3842)73-48-56, e-mail: [email protected] 2State institution Scientific-Research Institute of Cardiology of the Tomsk scientific center of Siberia filial of the Russian Academy of Medical Sciences (SI SRIC TSCSF RAMS), Russia, 634012, Tomsk, Kievskaya str., 111-a, tel.: 8(3822)55-54-04, fax: 8(3822)55-50-57, e-mail: [email protected] S u m m a r y : In the outpatient rehabilitation of patients, MI constant controlled physical training run on the background of the supporting base ischemic therapy are highly effective and safe: significantly reduced the frequency weight, angina and FC; increase exercise tolerance and quality of life. K e y w o r d s : rehabilitation; myocardial infarction; controlled physical training; outpatient. R e f e r e n c e s 1. Аронов Д.М. Постстационарный этап реабилитации больных ишемической болезнью сердца / Д.М. Аронов, М.Г. Бубнова, Г.В. Погосова // Сердце. – Т. 4, № 2. - С. 103-107. 2. Гасилин В.С. Поликлинический этап реабилитации больных инфарктом миокарда / В.С. Гасилин, Н.М. Куликова. - М.: Медицина, 1984. – 176 с.

95 3. Николаева Л.Ф. Реабилитация больных ишемической болезнью сердца / Л.Ф. Николаева, Д.М. Аронов. - М.: Медицина, 1988. – 288 с. 4. Статико–динамические тренировки в стационарной реабилитации больных с острой коронарной патологией / А.Н. Сумин [и др.] // Кардиология. – 2000. - № 3. – С. 16–21. 5. Тарасов Н.И. Значение ранних нагрузочных тестов для прогноза и сроков госпитализации больных инфарктом миокарда / Н.И. Тарасов, О.Л. Барбараш, В.Н. Каретникова // Российский кардиологический журнал. – 1998. - № 1. – С. 3 – 10. 6. Чернявская Т.К. Изучение эффективности и безопасности применения дозированных физических тренировок в комплексной терапии пациентов с ХСН III-IV ФК / Т.К. Чернявская, О.Н. Волгина // Журнал Сердечная недостаточность. – Т. 5, № 5. - С. 244-248. 7. Aronow W.S. Effect of beta blockers alone, of angiotensin - converting enzyme inhibitors alone, and of beta blockers plus angiotensin - converting enzyme inhibitors on new coronary events and on congestive heart failure in older persons with healed myocardial infarcts and asymptomatic left ventricular systolic dysfunction / W.S. Aronow, C. Ahn, I. Kronzon // Am J Cardiol. - 2001.- Vol. 88, Issue 11. - P. 1298-1300. 8. Effects of short-term exercise training and activity restriction on functional capacity in patients with severe chronic congestive heart failure / K. Meyer [et al.] // Am. J. Cardiol. – 1996. - Vol. 78. - P. 1017-1022. 9. Prognostic significance of myocardial ischemia detected by ambulatory electrocardiography, exercise treadmill testing, and electrocardiogram at rest to predict cardiac events by one year (The Asymptomatic Cardiac Ischemia Pilot [ACIP] Study / P.H. Stone [et al.] // Am. J. Cardiol. - 1997. - Vol. 80. - P. 1395-1401. 10. Combination neurohormonal blocade with ACE inhibitors, angiotensin 2 antagonists and beta-blockers in patients with heart failure / R. Tsuyuki [et al.] // Can J Cardiol. - 1997. - Vol. 13. - P. 1166-1174. I n f o r m a t i o n a b o u t t h e a u t h o r s :

96 Gzogyan Margarita Nikolaevna - PhD, Assistant Professor Department of doctors in primary care and SMP GOU VPO KemGMA Federal Agency for Health and Social Development, a phone: 8(3842)32-72-86, e-mail: [email protected] Tarasov Nikolai Ivanovich - Doctor of Medical Sciences, Professor, Head of the Department of doctors in primary care and SMP GOU VPO KemGMA Federal Agency for Health and Social Development, the phone: 8(3842)64-45-98, e-mail: [email protected] Isakov Leonid Konstantinovich - PhD, Assistant Department of doctors primary health care and SMP GOU VPO KemGMA Federal Agency for Health and Social Development, the phone: 8(3842)32-72-86, e-mail: isakovy @ inbox.ru Krivonosov Denis Sergeevich - PhD, Assistant Department of doctors in primary care and SMP GOU VPO KemGMA Federal Agency for Health and Social Development, a phone: 8(3842)32-72-86, e-mail: [email protected] Kuznetsova Tatyana Vasilevna - graduate student education of doctors in primary care and SMP GOU VPO KemGMA Federal Agency Health and Social Development, phone: 8(3842)32-72-86, e-mail: [email protected] Yarkovskaya Alena Pavlovna - graduate student education of doctors in primary care and SMP GOU VPO KemGMA Federal Agency Health and Social Development, рhone: 8(3842)32-72-86, e-mail: [email protected] Teplyakov Alexander Trofimovich - Doctor of Medical Sciences, professor, head of cardiac insufficiency GU NIIK TNC RAMN, phone: 8(3822)55-54-04, e- mail: [email protected] M a t e r i a l R e c e i v e d 11.06.2010 г.

MEDICAL PSYCHOLOGY, PSYCHIATRY, PSYCHOTHERAPY 1277 Белов+ UDC 616.895.6 © V.G. Belov, Yu.A. Parfеonov, A.V. Dergunov, M.S. Orlovsky, 2010

97 Belov V.G., Parfenov Yu.A., Dergunov A.A., Orlovsky M.S. Art therapy in treatment of non-psychotic affective distresses // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Federal State Institution «Military Medical Academy named after S.M.Kirov of the Ministry of Defense of the Russian Federation», Russia, 194044, St.-Petersburg, Aс. Lebedev str., 41. Тel.: 8 (812) 292-32-23, fax: 8 (812) 745-65-19. Е-mail: my- [email protected] S u m m a r y : Presented data on examination to evaluate psychotherapeutic effectiveness of the art-therapy method for patients with depressive conditions of non-psychotic range, coupled with somatic pathology of a different degree and psychopathologic structure. K e y w o r d s : art-therapy; affective disorder; psychotherapy; somatic depression. At the present time long-period somatical (latent depressive) depressions, being so-called “challenge for psychiatry and psychology” remain the object for continuous discussions, and their treatment remains one of the most important problems for the domestic and foreign psychiatry [1–4]. The great interest of the researchers to this problem appears not only due to vast distributions of these depressive conditions (up to 30% – 35%) [5] and high level of psychosocial disorders in patients with chronic somatical depressions but also preconditioned by difficulty and unclear status of numerous doubtful questions on their correction and prophylactics. Despite the presence of multiple elaborated plans for farmacotherapy there is no univocal opinion for the action of biological therapy on clinical appearances of different symptoms at somatical depressions [5,6]. That’s why there is obvious the necessity of extension of the therapeutic means for correction the somatical depressions by non-biologic therapy - the psychotherapy. In this presented examination, the means of correction the affective pathology is used the method of art-therapy, which combines the medical and humanitarian knowledge and helps forward increased effectiveness of therapy.

98 T h e p u r p o s e o f t h i s w o r k . To investigate the dynamics of somatical affective disorders in patients, who underwent art-therapy at exacerbation and remission periods. M a t e r i a l a n d m e t o d s . At the methodical point of view this investigation was planned as an opened application of art-therapy for treatment of somatical depression. There were selected the next criteria for inclusion of patients into the trial: 1. Male and female patients aged from 18 to 65 years old. 2. The accordance with diagnostic criteria of International Classification of Diseases (10-th edition) for various types of somatical depressions. 3. Rating of depression on the Hamilton’s scale (HDRS) [7]. The examination was performed as the monopsychotherapy method. There was provided the wash-out period at which all the psychotropic drugs were avoided for patients not less than 48 hours prior the basal psychiatric and neurological evaluation of the patient’s status. In a case of acute excitement or severe insomnia there was allowed the application of benzodiazepine drugs. Psychotherapy course for all the patients was 12 weeks. The choice of topics and techniques of art-therapy is defined on the estimation of the necessities of the group and general tasks for correction and prophylactics of affective prepsychotic disorders. The process of the group art-therapy included three main stages: (1) the stage of basal diagnostics and formation of therapeutic and group relations; (2) main stage, directed to reconstruction of personality and harmonization of the patient’s system of relations; (3) Final stage (Table 1) [8]. Table 1 Characteristics of the group art-therapy for correction of affective disorders in examined sample group Stages Purposes of the stage Preliminary interview and preparation of patients for taking part in the group work, evaluation of anamnesis and concomitant diseases, formation of intent for atr- 1 Stage therapeutic treatment; beginning of work with the group, acquaintance of the group members. 2 Stage Psychological self-revelation of the members of the group (individual needs, feelings and problems) in creative activity and discussions; processing of internal personal conflicts, changes of self-overview in patients about themselves and others, getting of a 99 new experience and new skills by patients. Summarizing the results of the group work, fixation of the acquired experience and 3 Stage skills and also planning by the group members the exact steps on application the acquired experience in their every day’s life

For objectifications of the clinical data there was provided the secondary application of the psychometric scale HDRS. The evaluation was performed on different stages of treatment: before the course of art-therapy there was estimated the basal condition of patient (first control point), in 4 weeks from the beginning of therapy there was registered the primary effect (second control point); and the final estimation was performed after 12 weeks at the end of investigation (third control point). The criteria of the good therapeutic effect was considered the reduced rating on the HDRS scale more than 30%. These patients were the group of responders. Other patients were the group of non-responders. In our investigation there were included 29 patients (15 women and 14 men), who underwent the treatment in a day-time hospital of the psycho-neurological dispensary №6, St.Petersburg. All the patients were appropriate to criteria of the International Classification of Diseases (10-th edition) for the part of somatoformical disorders (somatical depressions) (Table 2). The mean age was 31,4±6,8 years old. The anamnesis of the disease was from 5 months to 16 years, mean length of the disease was 3.9 years. The mean value on the Hamilton’s scale on the moment of inclusion for investigation was 17,2±1,9 what indicates a moderate level of depression in examined patients. Table 2 Psychical disorders in a sample group Amount of cases Exact disease 6 cases Vegetative depression [1] 2 cases Apatical depression 10 cases somatic depressive (somatical) dystimia 11 cases Vital cyclotimic depression

A n a l y s i s o f e f f e c t i v e n e s s . All 28 patients had finished investigation and were included to analysis of the effectiveness. There were no cases

100 of refuse from psychotherapy and impossibility to perform art-therapy due to cancellation of biological therapy or other reasons. When we used the sign of reduction for summary rating Hamilton’s scale, at the end of course of therapy in all the group of patients, who underwent art-therapu there were subdivided two groups: 16 (55%) patients were included in group №1 - responders and 13 (45%) patients in group №2 - non-responders. Reduce of rating on the HDRS scale during the process of therapy prevealed in responders group with presence of anxious-depressive symptoms in the structure of the actual exacerbation. This parameter at the final testing in the group №1 was 2.8 (Pic. 2) In a clinical pattern in non-responders group there prevailed such symptoms as a bad mood with feelings of a vital angst, anhedonical complaints, loss of ability to work, insomnia with early wakening, feelings of internal exertion and unclear anxiety. The same as in responders group, these patients already on the first week demonstrated the significant reduce of anxiety, but it’s basal level in this group was a bit lower - 3,56±1,3, but after the anxiety symptoms increased and at the end of investigation were 3.2±1,1 (Pic. 1).

6

g 5,5

n 5 i

t 4,5

a 4

r 3,5 3 S 2,5 R 2 Group 1 D H 1-st control 2-тв control 3-rd control point point point Group 2

Picture 1. Dynamics of the anxiety rating on HDRS scale during art-therapy in responders group There was markable that at initial investigation the expression of psychopathological symptomatics in first group was a little bit more than in a second group, but there were no statistical difference between them (р>0,05). So, the general

101 expression of psychopathologic signs was not determinative in sensitivity to art- therapy. Already after 4 weeks there was marked the trend to more effective art-therapy in a group of patients with depressive symptoms. On the first stage of therapy the statistically obvious differences were registered by subscales, characterizing the anxiety-depression and somatical disorders (Pic. 2). After reducing of the anxiety rating other symptoms of depression also reduced smoothly, quite quickly (up to 2-nd – 3-rd week of treatment) disappeared insomnia and patients became more active physically, their mood had evened, but their complaints on anhedonia remained as well as reduced ability to work, problems with mental concentration, general somatical disbalance, disorders of the sexual mood and the weight loss. These symptoms appeared to be more resistant to conducted therapy and reduced only at the 4-6-th week of therapy – the patients started making real plans for future and more optimistically estimated their perspectives and started taking part in the everyday’s life and family activity. The indexes of positive dynamics in reduction of rating in Hamilton’s scale demonstrate the statistically reliable (p<0,001) reduce of depressive expressions (Table 3).

102 Suicide tends Guilt feelings Bad mood Disorders of sexual mood General somatical disorders Gastrointestinal disorders Somatic angst Excitation Group 2 Restraint Work and activity Group 1 Early waking Insomnia Difficult dormition Suicide tends Guilt feelings Bad mood

0 0,5 1 1,5 2 2,5 3 Pictu re 2. Reduce of rating during 4 weeks of art-therapy on HDRS subscales On the basis of presented data there is possible to make a proposition that so quick reduction of somatical symptoms is due to registration mostly secondary symptoms (conditioned by anxiety) which depend on expression of depressive disorders. Reduction of depressive symptoms in non-responders group appeared to be slower, although their initial rating on Hamilton’s scale was higher than in responders - 18,1±1,9. To the end of investigation the reduction of depressive symptoms in this group was 62,4% from initial level and the mean range on Hamilton;s scale was 11,3±1,5 (Table 3). Table 3 Results of indexes on HDRS method in longitude 1 group 2 group Control point № р m±n m±n 1 17,8±2,9 18,1±1,9 >0,05 2 12,3±1,2 14,2±1,4 >0,05 3 7,5±0.8 11,3±1.5 <0,05

103 The results of mathematical analysis, calculation of mean numbers, standard deviation and standard fallibility of mean number using Student’s t-criteria, the reliable differences in groups were achieved in the third control point. R e s u l t s 1. The main direction of the therapeutic method is anxiolytical activity, what is proved by a high level of anxiety reduction in responders and non-responders group. 2. Art-therapy has significant therapeutic ability for moderate depressive disorders, especially those, where main component of depressive syndrome is an anxiety combined with somatical appearances. 3. There is important to notice that among patients with recurrent affective disorders there were included to responders group mostly patients with a light degree of affective disorders, whereas in non-responders group there were mostly those with moderate degree of depressive disorder. There was insufficient effectiveness of the method for vital signs of depression at sufficient anxyolitic effect in these patients, what makes a task of combination the art-therapeutic method and anxyolitic means. 4. The results of the present investigation allow to make the conclusion on effectiveness of art-therapy for treatment a moderate deprerssive symptomatics, combined with psychosomatic reactions and vegetative disfunctions as the non- psychotic depressive disorders. R e f e r e n c e s 1. Авруцкий Г.Я. Лечение психически больных / Г.Я. Авруцкий, А.А. Недува. – М.: Медицина, 2008. – 528 с. 2. Вовин Р.Я. Социальная и клин. психиатр. / Р.Я. Вовин, М.В. Иванов. – СПб.: Гиппократ, 1995. – 180 с. 3. Горьков В.А. Психиатр. и психофармакотер / В.А. Горьков, В.А. Раюшкин. – Воронеж.: Медстар, 2005. – 315 с. 4. Копытин А.И. Руководство по групповой арт-терапии / А.И. Копытин. – СПб.: Речь, 2003. – 354 с. 5. Копытин А.И. Техники аналитической арт-терапии: исцеляющие путешествия / А.И. Копытин, Б.В. Корт. – СПб.: ВМедА, 2007. – 213 с.

104 6. Морозова М.А. Психиатр. и психофармакотер / М.А. Морозова, А.Г. Бениашвили, Н.Б. Жаркова // Вестн. ВМедА им. С.М. Кирова. – 2008. – № 1. – С. 74–75. 7. Морозова М.И. Британская модель оказания арт-терапевтической помощи» / М.И. Морозова, А.И. Кобиясов, В.Б. Жарикова // Вестн. ВМедА им. С.М. Кирова. – 2008. – № 1. – С. 74–75. 8. Рудестам К. Групповая психотерапия / К. Рудестам. – СПб.: Питер Ком, 1998. – 153 с. I n f o r m a t i o n a b o u t t h e a u t h o r s : Belov Vasiliy Georgievich - Doctor of medical science, professor of the sub- faculty of health psychology of Saint-Petersburg State Institute of Psychology and Social Work, 13-a, 12th line B.I., Saint-Petersburg,199178, tel.: 8(921) 400-16-47. Parfеonov Yuriy Alexandrovich - Candidate of medical science, scientific associate of the research laboratory of clinical pathophysiology of the sub-faculty of pathological physiology of the Military Medical Academy named after S.M.Kirov, tel.: 8(921)400-16-43. Dergunov Andreiy Anatolievich - Candidate of medical science, scientific associate of the research laboratory of clinical pathophysiology of the sub-faculty of pathological physiology of the Military Medical Academy named after S.M.Kirov, tel.: 8(921)400-16-43. Orlovsky Mikchail Sergeevich - psychiatrist of psychoneurologic dispencary No.6 of Kolpinskiy district, Saint-Petersburg. 1/5, Lenina prospect, Kolpino, Saint- Petersburg, 196563, tel.: 8(952)204-89-03. M a t e r i a l R e c e i v e d 22.12.2009 г.

1282 Власова + UDC 616. 12—008.331. 1:615.851. 13 © O.L. Vlasova, 2010

105 Vlasova O.L. Clinico-psychological features of patients with a various clinical versions of current of a metabolic syndrome // Preventive and clinical medicine. – 2010. – № 1 (35). – Р. Smolensk State Medical Academy, Russia, Smolensk, 214000, Krupskay str., 28, tel.: 8(4812)61-08-47; e-mail: sgma.info.ru S u m m a r y : Dynamic inspection of 60 patients with arterial hypertension within the limits of metabolic syndrome in the age of from 35 till 65 years (middle age 47,8±1,1 years) by which besides clinical, laboratory-tool inspection it was spent psychosommatic testing for a background of reception combined antihypertensive therapies is lead: candesartan and hydrochlorothiazide. It is shown, that as a result of treatment at patients it was observed proof hypothensive effect, there was a tendency to improvement of parameters lipidograme, has raised complaens to treatment, and the main thing, parameters of jet and personal uneasiness have authentically decreased, parameters of a physical, mental condition and, as a whole, the general quality of a life of patients have improved. K e y w o r d s : аrterial hypertension and metabolic syndrome; psychosommatic testing; candesartan and hydrochlorothiazide; lipidograme; quality of a life. R e f e r e n c e s 1. Баженова М.И. Приоритетные направления психологической работы с хроническими соматическими больными. Сб. Будущее клинической психологии. - Пермь, 2007. – С. 8-11. 2. Оганов Р.Г. Болезни сердца // Руководство для врачей. - М.: Литтерра, 2006. – 376 с. 3. Смулевич А.Б., Сыркин А.Л., Дробижев М.Ю. Психокардиология. - М., 2006. – Том 6. - № 5. – С. 271-276. 4. Смулевич А.Б. Депрессии в общей медицине. - М.: ООО «Медицинское информационное агентство», 2005. – 784 с.

106 5. Сыркин Ф.Л., Копылов Ф.Ю., Дробижев М.Ю. и др. Клинические и психосоматические особенности течения гипертонической болезни в условиях хронического стресса // Клиническая медицина. – 2008. - № 2. – С. 6-23. 6. Терра-энциклопедия психологических тестов-1. - М.: Терра-книжный клуб, 2000. – 259 с. 7. Чазов Е.И., Оганов Р.Г., Погосова Г.В. и др. Клинико- эпидемиологическая программа изучения депрессии в кардиологической практике: у больных артериальной гипертонией и ишемической болезнью сердца (КООРДИНАТА): первые результаты многоцентрового исследования // Кардиология. - 2005. - № 11. - С. 4-11. 8. Barnes V.A., Treiber F.A., Davis H. Impact of Transcendental Meditation on cardiovascular function at rest and during acute stress in adolescents with high normal blood pressure // J. Psychosom. Res. - 2001. - Vol.51. - JVM. - P.597-605. 9. Bloomgarden Z.T. Developments in diabetes and insulin resistance // Diabetes Care. – 2006. - №29. - P 161-167. 10. International Diabetes Federation: The IDF Consensus worldwide definition of the metabolic syndrome [article online]. A vailable from http: // www.idf.org / Accessed 2 June — 2005. I n f o r m a t i o n a b o u t t h e a u t h o r : Vlasova Oksana Leonidovna - Department of Pediatrics, therapy and dental schools Smolensk State Medical Academy, tel.: 8(4812)32-20-53. E-mail: [email protected] M a t e r i a l R e c e i v e d 29.12.2009 г.

SCIENTIFIC REVIEWS 1290 Романцов + UDC 615.28-053.2/.6 © M.G. Romantsov, L.G.Goryacheva, A.L.Kovalenko, 2010

107 Romantsov M.G.1, Goryacheva L.G.2, Kovalenko A.L.3 Pharmaco-therapeutic cycloferon efficacy in pediatric practice // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1Saint-Petersburg state medical academy named after I. I. Mechnikov, Saint- Petersburg, Russia, 195067, Saint-Petersburg, Piskariovsky pr. 47, Tel.: 8(812)545- 13-39, fax: 8(812)545-13-39. E-mail: [email protected] 2Federal State Institution “Research Institute for Children Infections” of the Federal medical-and-biological agency (FSI RICI FMBA Russia). Russia, 197022, Saint-Petersburg, Professor Popov str., 9. Tel.: 8(812)234-96-61. E-mail: [email protected] 3 Scientific-Technological Pharmaceutical Firm «POLYSAN», Russia, 191119, Saint-Petersburg, Ligovsky prospect, 112, tel.: 8(812)110-82-25,112-13-79. E-mail: [email protected], STPF «POLYSAN», www.polysan.ru S u m m a r y : The article presents the authors and literary data on cycloferon pharmacotherapeutic efficiency – the drug belonging to the group of interferon inductors, immunomodulators. Cycloferon effect in treatment of different socially important children diseases, including acute respiratory viral infections, bronchial asthma, allergic states, accompanied by the disorders of anti-infectious protection, mycoplasmic infection, broncho-pulmonary complications in acute respiratory viral infections with the low degree of radical oxidation intensity is described. Autoimmune process suppression, which is the cause of postvaccinal complications in often ill children, by cycloferon on the background of planned vaccination is shown. Results of cycloferon use in treatment of gastrointestinal tract disorders, intestinal infections both of viral and bacterial genesis are presented. Cycloferon is suggested for intestinal disbiosis correction. In 95% of children microflora restoration to the normal level was noted. The drug use for surgical pathology, particularly for appendicular peritonitis, with the aim to decrease postoperative complications and also for the correction of immune disorders in children with chronic viral hepatitis A and B, treated by complex therapy, is described. Cycloferon safety and efficiency is confirmed by the postmarketing randomized studies.

108 K e y w o r d s : cycloferon; acute respiratory viral infections; often ill children; chronic viral hepatitis C and B; intestinal disbiosis. R e f e r e n c e s 1. Агаева С.Г. Клинико-лабораторная характеристика хронического гепатита В на фоне лямблиоза у детей в условиях Дагестана // Автореф. дисс. …..к.м.н. - СПб. - 2009. – 21 с. 2. Белякова А.В. Нарушения иммунитета и их коррекция у детей с распространенным апендикулярным перитонитом // Автореф. дисс. ….к.м.н. -Челябинск. - 2006. – 21 с. 3. Балаболкин И.И. Терапевтическая эффективность индукторов синтеза интерферона при бронхиальной астме у детей, страдающих частыми острыми респираторными вирусными инфекциями / И.И. Балаболкин, И.В. Рылеева, В.А. Булгакова // Материалы IV конгресса педиатров-инфекционистов России «Актуальные вопросы инфекционной патологии у детей (диагностика и лечение)». - Москва, 2005. - С. 28. 4. Ботвиньев О.К. Циклоферон в терапии детей, больных пиелонефритом, ассоциированным с герпесвирусами / О.К. Ботвиньев, С.Б. Орехова, М.Г. Романцов //Антибиотики и химиотерапия. - 2009. - № 5-6. - С. 48-54. 5. Вершинина Е.Н. Терапевтическая коррекция иммунных расстройств при респираторных заболеваниях у детей с герпесвирусным инфицированием / Е.Н. Вершинина, В.В. Иванова, Л.В. Говорова // Информационно-методическое письмо для врачей. – СПб., 2007. – 26 с. 6. Влияние циклоферона на биологические свойства бактериальных внутриклеточных патогенов / О.В. Бухарин, Д.А. Кириллов, Н.В. Шеенков, В.А. Кириллов // Журн. микробиол., эпидемиол., иммунобиологии. – 2005. - № 3. – С. 8-10. 7. Гаращенко М.В. Новые технологии в медикаментозной профилактике острых респираторных заболеваний у детей школьного возраста в условиях мегаполиса // Автореф. дисс. …к.м.н. - М., 2007. – 21 с.

109 8. Горячева Л.Г. Терапия вирусных гепатитов у детей раннего возраста / Л.Г. Горячева // Врач. - 2006. - № 8. – С. 46-48. 9. Горячева Л.Г. Терапия вирусных гепатитов у детей с использованием препаратов различного механизма действия / Л.Г. Горячева // Вестник Санкт- Петербургской государственной медицинской академии им. И.И. Мечникова. - 2006. - № 4. – С. 115-119. 10. Григорян С.С. Индукторы интерферона: итоги и перспективы / С.С. Григорян // Интерферону – 50 лет. Материалы конференции. - М., 2007. -С. 66-72. 11. Дерюшева А.В. Влияние инфекции, вызванной вирусами простого герпеса на соматическую патологию у детей школьного возраста / А.В. Дерюшева, И.И. Львова. - СПб., 2008. – 24 с. 12. Железникова Г.Ф. Варианты иммунопатогенеза острых инфекций у детей / Г.Ф. Железникова, В.В. Иванова, Н.Е. Монахова. - СПб., 2007. – 80 с. 13. Ершов Ф.И. Антивирусные средства в педиатрии / Ф.И. Ершов, М.Г. Романцов. - М., 2005. – 132 с. 14. Ершов Ф.И. Интерфероны и их индукторы (от молекул до лекарств) / Ф.И. Ершов, О.И. Киселев. - М., 2005. – 211 с. 15. Иммуномодуляторы с противовирусной активностью. Учебное пособие // Под ред. М.Г. Романцова. - М., 2005. – 74 с. 16. Кетлинский С.А. Цитокины / С.А. Кетлинский, А.С. Симбирцев. - СПб., 2008. – 46 с. 17. Кондратьева Е.И. Экстренная неспецифическая профилактика ОРВИ и гриппа препаратом циклоферон у детей в эпидемический период / Е.И. Кондратьева // Вестник Санкт-Петербургской государственной медицинской академии им. И.И. Мечникова. - 2005. - № 1. - С. 72-76. 18. Краснова Е.И. Особенности иммунного ответа при инфекционном мононуклеозе и подходы к иммуномодулирующей терапии / Е.И. Краснова // Вестник Санкт-Петербургской государственной медицинской академии им. И.И. Мечникова. - 2005. - № 1. - С. 76-82.

110 19. Краснов В.В. Эффективность применения циклоферона у часто болеющих детей, имеющих маркеры активности герпетических инфекций / В.В. Краснов // Вестник Санкт-петербургской государственной медицинской академии им. И.И. Мечникова. - 2009. - № 1. - С. 148-153. 20. Королева Е.Г. Терапия респираторной микоплазменной инфекции у детей с отягощенным преморбидным фоном / Е.Г. Королева. - СПб., 2007. – 14 c. 21. Минаева Н.В. Особенности аллергической патологии у детей с синдромом нарушения противоинфекционной защиты // Автореф. дисс. … д.м.н. - Пермь. - 2006. – 44 с. 22. Михайлова Е.В. Применение препарата циклоферон в комплексной терапии кишечных инфекций ротавирусной этиологии у детей / Е.В. Михайлова, Д.Ю. Левин // Мат. III конгр. педиатров-инфекционистов «Актуальные вопросы инфекционной патологии у детей». - 2004. - С. 154-156. 23. Москалева Е.В. Циклоферон при ВИЧ-инфекции у детей с перинатальным инфицированием / Е.В. Москалева, С.В. Смирнова, А.Г. Петрова. - СПб. - 2008. – 24 с. 24. Назарочкина О.В, Вирусные менингиты у детей. Коррекция циклофероном нарушений в системе иммунитета / О.В. Назарочкина, Г.А. Харченко // Информационно-методическое письмо для врачей. - СПб. - 2008. – 22 с. 25. Ошева Т.М. Воспалительные заболевания верхних отделов пищеварительного тракта у детей / Т.М. Ошева // Информационно- методическое письмо для врачей. - СПб. - 2007. – 24 с. 26. Применение циклоферона для экстренной профилактики ОРВИ в организованных детских и подростковых коллективах. Методические рекомендации №23 Департамента здравоохранения Москвы / под ред. Е.А. Дегтяревой. - М., 2008. – 24 с. 27. Противовирусная терапия инфекционных болезней детского возраста. Сборник научных статей. - М., 2006. – 79 с.

111 28. Применение циклоферона в педиатрической практике. Сборник научных статей. - СПб., 2005. – 96 с. 29. Романцов М.Г. Практика педиатра. Циклоферон / М.Г. Романцов, В.В. Ботвиньева. - СПб., 2005. – 14 с. 30. Романцов М.Г. Рациональная фармакотерапия часто болеющих детей / М.Г. Романцов, В.В. Ботвиньева, О.Г. Шульдякова. - СПб., 2006. – 115 с. 31. Романцов М.Г. Часто болеющие дети. Современная фармакотерапия / М.Г. Романцов, Ф.И. Ершов. - М.: «ГЭОТАР-Медиа», 2009. – 349 с. 32. Романцов М.Г. Экстренная неспецифическая профилактика и лечение гриппа и ОРВИ. Лекция для врачей / М.Г. Романцов, Т.В. Сологуб. - СПб., 2008. – 42 с. 33. Романцов М.Г. Противовирусные и иммунотропные препараты в детской практике / М.Г. Романцов, Л.Г. Горячева, А.Л. Коваленко. - СПб., 2008. – 120 с. 34. Романцов М.Г. Грипп А/H1N1-типичная эмерджентная инфекця. Вопросы терапии и экстренной профилактики / М.Г. Романцов, В.В. Зарубаев, А.Л. Коваленко // Вестник Санкт-Петербургской государственной медицинской академии им. И.И. Мечникова. - 2009. - № 2. - С. 168-172. 35. Селькова Е.П. Профилактика респираторных заболеваний в период эпидемического подъема / Е.П. Селькова. - М., 2003. – 30 с. 36. Серозные менингиты у детей. Сборник статей. - СПб., 2007. – 30 с. 37. Тихомирова О.В. Ротавирусная инфекция. Особенности клинического течения и тактика терапии. Учебное пособие / О.В. Тихомирова. - СПб., 2005. – 80 с. 38. Эффективность циклоферона при проведении экстренной профилактики ОРВИ в организованных коллективах. Методические рекомендации для врачей / А.А. Шульдяков, С.В. Петленко, М.Г. Романцов, Т.В. Сологуб. - СПб., 2007. – 16 с. I n f o r m a t i o n a b o u t t h e a u t h o r s :

112 Romantsov Mikhail Grigorievich – Doctor of Medicine, Professor of the department of Infectious Diseases of SEEHPT «Saint-Petersburg State Medical Academy named after I.I.Mechnikov of Roszdrav». Тel.: 8-812-710-82-25. E-mail: [email protected] Goryacheva Larissa Georgievna – Doctor of Medicine, Head of the department of Viral Hepatitis and Liver Diseases of the Research Institute of Children Infections. Kovalenko Alexsandr Leonidovith - Scientific-Technological Pharmaceutical Firm «POLYSAN», Russia, 191119, Saint-Petersburg, Ligovsky prospect, 112, tel.: 8(812)110-82-25,112-13-79, е-mail: [email protected], STPF «POLYSAN» www.polysan.ru M a t e r i a l R e c e i v e d 10.02.2010 г.

1323 Петрова+ UDC: 616.28-008.14:616.8:615.2 © N.N. Petrova, 2010 Petrova N.N. Medical products for pharmacological correction of sensorineural hearing loss // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. Saint-Petersburg state medical academy named after I.I. Mechnicov, Russia, 195067, Saint-Petersburg, Piskariovsky pr., 47. Tel.: 8(812)545-13-39, fax: 8(812)545-13-39. E-mail: [email protected] S u m m a r y : In this work is represent review of literature from last 15 years about problem of pharmacological correction of sensorineural hearing loss with the main links of pathogenesis. There are facts about modern perspective medicines which used for pharmacological correction hearing loss such as antihypoxants, antioxidants etc. There are positive and negative sides of this medicines. The mast attention is for pharmacological effects. This effects are in protective action with acoustic analyzer in protective action with acoustic analyzer. K e y w o r d s : sensorineural hearing loss; hearing; treatment; antihypoxants; antioxidants. R e f e r e n c e s

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125 55. Younossi Z. The effects of HCV management on healt-related quality of life / Z. Younossi, Х. Kallman, J. Kincaid // Hepatology. - 2007. - Vol. 45. - № 3. - P. 806-816. 56. Wang Т. Immunomodulatory activities of IFN-gammalb in the treatment of chronic HCV infections / Т. Wang, S. Seiwert // J. Interferon Cytokine Res. - 2006. -Vol. 26. - № 7. - P. 473-483. I n f o r m a t i o n a b o u t t h e a u t h o r s : Sologub Tamara Vasilievna – Doctor of Medicine, Professor, head of the department of Infectious Diseases of the Saint-Petersburg State Medical Academy named after I.I.Mechnikov of Roszdrav, tel./fax: 8-812-717-27-07, e-mail: [email protected] Romantsov Mikhail Grigorievich – Doctor of Medicine, Professor of the department of Infectious Diseases of SEEHPT «Saint-Petersburg State Medical Academy named after I.I.Mechnikov of Roszdrav». Тel.: 8-812-710-82-25. E-mail: [email protected] Semenyako Nadezhda Aleksandrovna – Candidate of Medical Sciences, Assistant of the department of Infectious Diseases of the I.I.Mechnikov St.- Petersburg State Medical Academy. Tel.: 8(812)274-97-54. Kovalenko Svetlana Nikolaevna – senior teacher of the Saint-Petersburg branch of the Modern Humanitarian Academy. Kovalenko Alexsandr Leonidovith - Scientific-Technological Pharmaceutical Firm «POLYSAN», Russia, 191119, Saint-Petersburg, Ligovsky prospect, 112, tel.: 8(812)110-82-25,112-13-79, е-mail: [email protected], STPF «POLYSAN» www.polysan.ru Sukhanov Dmitry Sergeevich - Candidate of Medical Sciences, Assistant of the department of Phthysiopulmonology of the I.I.Mechnikov St.-Petersburg State Medical Academy. M a t e r i a l R e c e i v e d 10.02.2010 г.

126 TO AUTHORS’ ATTENTION

127 Пример оформления статьи на английском языке UDC 613.6:677 © V.M. Shmeleva, V.A. Kobilyanskaya, N.V. Aganezova, L.P. Papayan, 2010 Influence of haemocystein on plasma sensitivity to the activated C protein V.M. Shmeleva1, V.A. Kobilyanskaya1, N.V. Aganezova1, 2, L.P. Papayan1 1Russian Research Institute of Hematology and Transfusiology, Saint- Petersburg, Russia 2Saint-Petersburg Medical Academy for Post-Diploma Training, Saint- Petersburg, Russia Shmeleva V.M.1, Kobilyanskaya V.A.1, Aganezova N.V.2, Papayan L.P.1 Influence of haemocystein on plasma sensitivity to the activated C protein // Preventive and clinical medicine. – 2010. - № 2 (35). – Р. 1Federal State Institution «Russian Research Institute of Hematology and Transfusiology of the Federal Agency for Advanced Technology Medical Aid». Russia, 191024, St.-Petersburg, 2 Sovetskaya str., 16. Тel.: 8(812)274-56-50, fax: 8(812)717-25-50. E-mail: [email protected] 2State Educational Establishment for Additional Professional Training «Saint- Petersburg Medical Academy for Post-Diploma Training of the Federal Agency for Public Health and Social Development of the Russian Federation». Russia, 191015, St.-Petersburg, Kirochnaya str., 41. Тel.: 8(812)272-52-06, fax: 8(812)273-00-39. Е- mail: [email protected] A b s t r a c t : subject, theme, purpose of the study, method or methodology of the study, results of the study, field of results application, conclusions, additional information K e y w o r d s : через точку с запятой Текст статьи с абзаца, включающий: I n t r o d u c t i o n (краткое введение), далее с новых строк. T h e p u r p o s e o f t h e s t u d y . (Шрифт подзаголовка Times New Roman разреженный 4 пт.) Текст статьи – Шрифт Times New Roman, 14 пт., межстрочный интервал 1,5, выравнивание по ширине

128 M a t e r i a l a n d m e t h o d s o f t h e s t u d y . Текст - выравнивание по ширине T h e r e s u l t s o f t h e s t u d y . Текст - выравнивание по ширине D i s c u s s i o n o f s t u d y r e s u l t s . Текст - выравнивание по ширине. C o n c l u s i o n . Текст (по ширине) или S t u d y F i n d i n g s (по центру) выводы 1, 2, 3 и т.д. (с абзаца). Текст выводов - выравнивание по ширине (поля те же, что и для всего текста). R e f e r e n c e s (по центру). Текст списка - выравнивание по ширине (поля те же, что и для всего текста). Составляется по алфавиту, сначала отечественные авторы, а затем зарубежные в оригинальной транскрипции. Соблюдение правил библиографического описания и пунктуации в соответствии с ГОСТ 7.05-2008 (Введен в действие 01.01.2009 г.) – обязательно. I n f o r m a t i o n a b o u t t h e a u t h o r ( s ) : Sukharev Alexander Evgenievich - doctor of medicine, head of the Astrakhan Scientific Regional Public Institution of Humanitarian Problems «GRANT», work tel.: (8-3912) 22-16-32, home tel.: (8-3912) 23-88-15. Е-mail: [email protected] Afanasieva Galina Alexandrovna – candidate of medical sciences, assistant- professor of the Department of Pathologic Physiology of Saratov State Medical University, work tel.: (8-845-2) 66-97-91, home tel.: 8(845-2) 51-15-87, mobile phone 8-903-384-00-97. Е-mail: gafanaseva @ yandex .ru

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