The literature review presents the modern data on the pelvic adhesions’ etiology and pathogenesis at women of reproductive age. Pelvic adhesion is a dynamic differentiated cell vascularized structure. Development of an active inflammatory process, which involving cells and proinflammatory mediators may be into a stage of tissue remodeling, collagen formation, that is the initial symptoms of adhesions. A vicious circle and a cascade of mutually supporting changes leads to adhesive disease and patients’ disability.

This review summarizes the current evidence on the role of cytokines in the pathogenesis of ischemic myocardial damage. It described the important role of inflammation in the development of coronary heart disease. The role of individual cytokines in the pathogenesis of coronary artery disease and the most frequent forms of it - angina. It is shown that in patients with coronary heart disease progression of the disease is due to an imbalance in cytokine system, elevated pro-inflammatory cytokines (TNF, IL-1β, IL-6). Anti-inflammatory cytokines (IL-4, IL-10) inhibit the secretion of proinflammatory cytokines by limiting excessive intensity of the immune response. Revealed increasing levels of TGF-β1 as a key cytokine that promotes the development of fibrosis in the wall of the heart and blood vessels. The interrelation between improving markers of inflammation and the development of coronary heart disease, the predictive value of these markers of inflammation in patients with stable coronary heart disease: angina of effort of different functional classes.

The concept of personalization apply to pharmaceuticals, which is considered a universal means of treatment of specific diseases. But over time, it becomes clear that the response of the patients with the same disease at the same drug differs depending on genotype of the patient and other factors, so that there may be considerable variation in the efficacy and safety of the drug used to treat certain diseases. This is due to various factors, but chief among them are the peculiarities of the cytochrome P450 system, which plays an important role in maintaining the homeostasis of the chemical under physiological and pathological conditions of the internal environment.

Despite the advances in the diagnosis and treatment of cardiovascular diseases, the cardiac mortality takes a leading position among the causes of general mortality. It was also noted that depressive disorders are widespread among the cardiovascular patients. They induce the impairment of cardiac prognosis both in patients with cardiovascular disease and in patients without cardiac disease. The article outlines the basic pathophysiological mechanisms of interaction between depressive symptoms and cardiovascular disease. In addition, the article focuses on the diagnosis of depressive symptoms as a factor determining cardiac prognosis.

Exponential data quantity growth in the field of molecular genetics and genetic terminology growing list can easily confuse the doctor who doesn’t have special preparation. In this regard the article purpose was the attempt to fill missing knowledge of molecular genetics at practical doctors and also to show genetic testing achievements and practical importance in woman health assessment. The basic molecular genetics concepts (heredity and variability, genotype and phenotype, dominant and recessive genes, homozygote and heterozygote, monogenic and polygenic illnesses, etc.) are specified in the work. Genetic factors and their role in pathogenesis of such diseases as obesity, diabetes mellitus, oncologic diseases including actual for women breast and ovaries cancer, thrombophilia that have key value at pregnancy pathology, and osteoporosis which is especially dangerous for post-menopausal period women are presented. Introduction of molecular genetics methods in clinical practice opens new opportunities for medical services quality improvement and doctor effectiveness increase.

Purpose: assessment of the circumstances and the severity of injuries in victims in the accident , registered in the Arctic zone of the Arkhangelsk region.

Materials and methods: we analyzed the medical histories of 327 victims of road traffic accidents in 2012-2014 in Severodvinsk and adjoiningroads of Arkhangelsk region (12-km section of the federal road M-8 «Kholmogory» and a range of regional roads connecting the city with other municipalities).

Results: the circumstances of the accidents and severity of victims’ injuries were estimated using a scale of ISS (Injury severity score), the prevalence of injuries of drivers and passengers on the regional roads and injuries of pedestrians — on the roads of Severodvinskwasrevealed.

Summary: pedestrians had the most severe injuries on the regional roadsamong other victims, motorcyclists- in urban area. The prevalence of severe concomitant injuries was registered in males.

Purpose: to determine the functional state of the biliary system at Gastroesophageal reflux disease (GERD) depending on the degree of esophageal mucosal lesions.

Material and methods: 115 patients with GERD were studied. Functional state of the biliary system was performed by dynamic ultrasound-based diagnostic medical imaging technique with using standard stimulus of gallbladder. Morphological study of the esophageal mucosa was done in all patients with GERD. The degree of inflammation was graduated according to the histological classification of reflux esophagitis F.Ismail-Beigi in the modification KLHeilmann

Results: different violations motor-evacuation function of the biliary system were detected in 89 (77.4%) patients with GERD: reduction of LP, as well as its prolongation, deferred primary reaction, gallbladder dyskinesia. Ultrasound signs of dysfunction the sphincter of Oddi were detected in 85 (73.9%) patients with GERD.

Summary: the positive relationship between reduced tone the sphincter of Oddi, which leads to erratic and excessive bile outflow in the duodenum, and the severity of GERD was revealed. Such relationship might be because of dysmotoric duodenum and duodeno-gastro-esophageal reflux, wherein alkaline contents of the reflux damage esophagus much more than gastric acidic contents.

Purpose: estimation of morbidity and prevalence of disease of child’s population is studied in the settlements of the Lugansk region with a different ecological situation.

Materials and methods: studied in Luhansk region of Ukraine the morbidity and prevalence of diseases in children for the period of 2000-2013 years and adolescents for the 1997-2013 years in the industrial cities with a high technological load and rural area with the less significant technological load is performed based on statistical data analysis yearbooks prepared of Lugansk Regional Focal Point for Health and the Focal Point of the Lugansk Regional Children’s Hospital.

Results: in the industrial cities of Luhansk region with a high technological load than in rural settlements is mark more considerable level incidence and prevalence of diseases in children and adolescents. Among the different classes of diseases, the morbidity of which prevails both among children and adolescents in the industrial cities than in rural settlements, revealed the following: I (infectious and parasitic diseases), VIII (diseases of the ear and mastoid process), XIII (diseases of the musculoskeletal system and connective tissue), XIV (diseases of the genitourinary system), XVII (anomaly of congenital) and XIX (injuries, poisoning and certain other consequences of external causes). As well as the prevalence of established dominance – I, VII (diseases of eyes and supplementary аpparatus), VIII, XIII, XIV, XVII and XIX classes of diseases.

Summary: the morbidity and prevalence of disease of child’s population are determined by population density, the average annually emissions of pollutants and the amount of industrial waste per 1 km2. Prophylactic recommendations are developed.

Purpose: to study the effect of socio-economic factors on the incidence, prevalence and mortality from TB in the Kaluga region.

Materials and methods: a statistical analysis of the impact of socio-economic situation in the Kaluga region on the epidemiologic situation on tuberculosis.

Results: the identified socio-economic indicators, significantly influence the incidence, prevalence and mortality of tuberculosis.

Summary: the dependence confirms the socio-economic conditionality of the tuberculosis problem.

Purpose: to compare between the ultrasound investigation data and cytokines level, lipids in blood, histologic pattern in the atherosclerotic plaques of different types in injury of inner carotid arthery.

Materials and methods: this work is grounded on study results and treatment of 130 patients, which were divided into two groups: with stable plaques (73 patients) and unstable plaques (57 patients).

Results: by comparing the ultrasound imaging results and clinical pattern it was established that the most significant are atherosclerotic plaques near 3 mm and more and plaques with ulceration as well. Atherosclerotic plaque destruction is accompanied by the higher levels of anti-inflammatory cytokines, such as TNF, IL-6, CRP and anti-inflammatory cytokine IL-10. All the patients experienced an index increase of total cholesterol, HDLP, LDLP, VLDLP and triglycerides.

Summary: atherosclerotic plaque destabilization is accompanied by TNF concentration increase 15,9±1,91 pg/ml, IL-6 16,3±1,8 pg/ml, IL-10 4,92±0,82 pg/ml and CRP 8,42±1,21 pg/ml. It was established a strong correlation connection between the confirmed presence of unstable atherosclerotic plaque in patient, ultrasound imaging data as well as histologic investigation.

Purpose: to study the activity of local and systemic inflammation in fertile and infertile patients with chronic prostatitis (CP) depending on the presence of sexually transmitted infections (STIs).

Materials and Methods: we have studied the levels of interleukin-8 and lactoferrin in spermoplasma, C-reactive protein level in the serum at 140 fertile and 140 infertile patients with chronic prostatitis on the background of STIs.

Results: the severity of local and systemic inflammatory response in infertile patients with CP was higher than in fertile patients. This indicates an active role of chronic inflammation in the development of infertility in patients with CP, which was confirmed by the presence of correlated interrelations between the presence of infertility and the level of lactoferrin in spermoplasma (r=0,84; p<0,001), level of interleukin-8 in spermoplasma (r=0,49; p<0,001), C-reactive protein level in serum (r=0,6; p<0,001).

Summary: traced the role of STI in supporting local and systemic inflammation, as in the group of fertile and infertile group of patients with CP. The severity of local inflammation in the group of infertile patients with CP and STIs was highest.

Purpose: too analyse a set of parameters of fatty acid composition of vaginal tissue as well as vitamin D, calcium and phosphorus content in blood of women with atrophic colpitis in the post-reproductive period.

Materials and methods: we have examined vaginal tissue and blood of 35 women (age 51 ± 2.8 years), having objective signs of moderate atrophy. Control group included 35 women (age 48 ± 3.6 years) lacking any pathological urogenital symptomatics. The fatty acid composition of vaginal tissue, and also the levels of vitamin D, calcium and phosphorus in blood have been analysed.

Results: in atrophic colpitis the content of higher unsaturated fatty acids increases in vaginal tissue. At the same time the stable level of phosphorus and calcium metabolism is maintained in the blood.

Summary: in atrophic colpitis a pathogenic chain forms associated with the changes in direction of different metabolic pathways, the disruption of cell transport systems functioning. This leads to different systemic alterations on the cellular level, which can be related not only to steroidogenesis decrease, but also to the disruption of hormone-receptor transmission in differential signaling systems.

Purpose: to study the effect of application of intraluminal coronary bypass grafts on the intra- and early postoperative periods in patients with coronary artery disease, who underwent a direct myocardial revascularization under conditions of a parallel cardiopulmonary bypass.

Material and methods: the study included patients with multiple lesions of coronary arteries with an ejection fraction 51,2% ± 5,3. The patients were randomised into 2 groups: in the first group (n = 41) the cardiopulmonary bypass operation was accompanied by using intraluminal coronary grafts; in the second group (n = 52) - without this procedure. The superior effectiveness of the graft procedure was assessed by lesser changes in ST-segment of ECG during and after the operation, fluctuations in cardiac index, the value of the plasma fraction of cardiac creatine phosphokinase, and a number of complications during the intra-and postoperative periods.

Summary: based on these data it was concluded the advantage of application of intraluminal coronary bypass grafts with direct revascularization in parallel artificial circulation.

Purpose: to optimize surgical tactics and improve the results of treatment of rectocele.

Materials and methods: clinical group included 87 women suffering rectocele 2-3 degrees. Depending on the surgical treatment, the patients were divided into two groups. In Group 1 (n = 38) in the surgical treatment of transvaginal access comply with levatoroplastic and colporrhaphia. In Group 2 (n = 49) plastic rectocele was carried out from the combined transvaginal and transrectal access and was fixing domes sacrospinal vagina, colporrhaphia, augmented transrectal «time 11» mucopexy to a height of 5 cm above the dentate line.

Results: sonoelastometric study of stiffness of the muscles of the perineum, tonometric study of vaginal pressure gradient of rest and stress are important diagnostic criteria of pelvic floor functional insufficiency and severity of rectocele. Surgery in 2 patients was more physiological as, accompanied by fewer recurrences of development, higher quality of life and recommended that patients with 3 degrees of rectocele.

Summary: the severity of functional insufficiency of muscles of the perineum is the basis of choosing the tactics of surgical treatment of prolapse.

Purpose: to evaluate the effect of the degree of severity of obesity on metabolic profile, the LAP index, leptin levels and C-reactive protein (CRP) in men with type 2 diabetes c.

Materials and methods: 120 male patients aged 40-65 years with obesity and Type 2 diabetes (mean age 54.3 ± 5.3 years). To assess the influence of the degree of severity of obesity on metabolic parameters was undertaken a comparative analysis of the data, depending on the body mass index (BMI). The metabolic profile was evaluated in terms of lipid profile, fasting glucose, of HbA1c, insulin resistance index HOMA. The study of leptin and CRP concentrations produced using laboratory kits for ELISA eBioscience (Austria). We used a new indicator for the integrated assessment of metabolic and cardio-vascular risks — LAP index.

Results: analysis revealed no significant differences in fasting glucose, HbA1c and total cholesterol (TC) between the groups. In all groups, the study revealed an increase HOMA index from the first to the fourth group, which indicates an increase in the severity of insulin resistance.

Summary: the increase in body mass index is a factor that by enhancing insulin resistance and adipokines production, leading to aggravation of metabolic disorders and the rise of cardiovascular risk in men with obesity and type 2 diabetes. LAP index is a more accurate marker of metabolic disorders than conventional carbohydrate and lipid metabolism.

Purpose: evaluation of the effectiveness of the Tubosan and Thiotriazoline combined pathogenic treatment of patients with infiltrative pulmonary tuberculosis with exudative type of inflammatory tissue reaction.

Materials and methods: the study included 60 patients, statistical analysis of the data was performed on a PC using the software Statistica 6.0 under Windows XP.

Results: the use of a combination of drugs Tubosan and Thiotriazoline as part of an integrated treatment of infiltrative tuberculosis contributes to a significant improvement in clinical and radiological symptoms, indicators of cytokine and immune status, free radical oxidation and antioxidant protection. There are statistically significant differences depending on the surveyed group. The antioxidant and immunomodulatory effect of Tubosan and Thiotriazoline is proved.

Summary: the use of these drugs is accompanied by a pronounced positive clinical and laboratory dynamics and normalization of free radical oxidation and antioxidant protection, immune and cytokine status and is reasonable and appropriate.

Presents an overview of regulations on circulation of narcotic and psychotropic substances, which entered into force in 2015. The analysis of each instrument and particularly deployed, explained the fundamental differences from previous editions. A significant simplification of the rules of circulation of narcotic drugs and psychotropic drugs, as well as the paperwork associated with prescribing this group of drugs and logging.