An overview of Russian and foreign literature data with an analysis of the epidemiology of primary hyperparathyroidism (PGPT) was made. It wasnoted, that previously PHPTwas considered a severe disabling disease with the development of complications such as nephrolithiasis and osteoporosis. However,recently, the data of population-screening studies of blood calcium in several countries in Europe and North America opened the «invisible part of the iceberg» - a large number of mild (olygosymptomatic and asymptomatic) forms of the disease.According to different authors, the prevalence of PHPT is 0.5 to 34 cases per 1000 population, i.e.about 1%, and among people over 55 years – about 2%. NormocalciemicPHPT – a newly detected form nowadays is of particular interest. To date, analysis of blood calcium in Russia is not a routine biochemical test, and patients with PHPToften receive specialized care at the stage of irreversible complications. Therefore, it is necessary to increasethe awareness of physicians about the epidemiology and clinical presentation of the disease, to identify risk groups of PHPTand implement the diagnostic algorithms in the daily doctor’s practice.

The literature review analyzed the modern concept of successful rehabilitation of functional motor impairments after stroke, in particular the need for correction of spasticity as a significant component of the disability of patients. Submitted the epidemiology, occurrence, phenomenology and diagnostics of poststroke spasticity. Reflected the general principles of treatment and selection of individual treatment strategies based on modern methods of evidence-based medicine. Discussed the possibility of using botulinum toxin A in acute stroke in the development of spasticity. There is the reasonable necessity of a system approach to the implementation of Botulinum toxin therapy in routine clinical practice of primary vascular branches the implementation of educational programs.

Рurpose: to demonstrate the ability to assess the state regulation system in patients with severe burns, using the tetrad of Gale and scale of pain. Materials and methods: we assessed the functional regulation of the system of 150 patients. All patients were treated in the clinic of thermal injuries from 2005 to 2012. Patients were divided into three groups, depending on the severity of burn shock. We assessed the execution of the tetrad Gale and the level of pain on a 10-point scale. The tetrad of Gale was scored on a scale from 0 to 5 units. This assessment was performed on admission, one day, two days. Results: meaning of the tetrad of Gale varies depending on the disturbance of consciousness. The correct interpretation allows to evaluate the functioning of the system of the regulation. 34% of patients with burn disease were able to perform elements of the tetrad of Gale. Others have a abnormalities associated with various events of pre-hospital care and the patient’s condition. Pain reaction were assessed in different periods after burn injury. Also pain responses in different degrees of burn shock were evaluated. We have found that the most severe pain from admission decreases to the time elimination of burn shock. Summary: determination dysregulation system allows purposefully to influence the pathogenesis in a particular situation.

Purpose: the features of the innate and adaptive immunity of patients with multiple sclerosis was investigated. Materials and methods: the results of flow cytometry, reaction of blast transformation of lymphocytes,immunosorbent assay and other parameters of innate immunity of 85 patients with multiple sclerosis was investigated. Results: It is determined that the factors of innate immunity play a significant role in the pathogenesis of multiple sclerosis. We can see the evaluation of suchimmunogenesis stages as recognition, activation, proliferation, differentiation of immune cells. Summary: all stages of the immune response were disturbed during exacerbation of multiple sclerosis. The antigen recognition processes are restored with the remission of this disease. The stages of the activation, proliferation and differentiation of immune cells were without changes.

Purpose: to evaluate the impact of a comprehensive rehabilitation therapy on the results of organ-preserving UF treatment technology being based on the study of adaptation reactions nature and cytokine profile. Materials and methods: the study involved 265 women with uterine fibroids after laparoscopic myomectomy, laparotomic myomectomy and UAE (with and without complex rehabilitation after surgery). Adaptation reactions after different treatment technologies and cytokine profile after UAE (TNF-α, IL-1β, IL-2, IL-6, IL-4, IFN-γ, Fas-L) were under thorough study. Results: myoma growth relapses during the observation period were distinguished among 12 patients after LSM, 16 – after LTM, 11 – after UAE. Molecular mechanisms of disease recurrence were clarified, especially in the absence of rehabilitation: long-term proinflammatory shift characteristic of an early postoperative period, destructive processes aggravation in the injured myometrial tissue with the increase in the dynamics of anti-apoptotic activity (Fas-L lack), Th1-cell factors depletion and immunosuppression development. Summary: the profile of adaptation reactions is shown to be not only the predictor of disease recurrence but also the criterion of a full-course rehabilitation. Cytokine profile study after UAE contributes to the prediction of treatment technology ineffectiveness.

Purpose: to study the pathological aspects of the wound bed in combustiology depending on the surgical treatment methods. Materials and Methods: the histomorphological drugs early after early necrectomy under tow non-perforated grafts at 3, 5 and 7 days after surgery; studied the wound fibrous layer to the plastics granulation by full-thickness transplant. Results: the study examined the dynamics of pathological soft tissue changes in the process of engraftment in the upper and lower extremities, including the use of primary techniques for plastic harness. Studied and described pathological changes in the edges and bottom of the burn wound granulation face to plasticity free skin graft. Summary: histomorphological study engraftment autografts after early treatment, and study of the fibrous layer of granulation is relevant in combustiology, as it allows to predict the quality of engraftment, depending on the localization of the burn wound, healing techniques used, as well as the quality of debridement in the transplant skin graft.

Purpose: the study of dental morbidity of Rostov state medical University staff according to the appealability. Materials and methods: the study of dental morbidity was carried out according to the appealability of Rostov state medical University staff to the dental Department of the clinic during 2014. Results: the most frequent cause of carious pathology was uncomplicated caries - 81, 9%, the incidence of complicated dental caries was 18.1% (pulpitis of 10.2%, periodontitis 7.9 %). Summary: the prevalence of carious destruction among the Rostov state medical university staff was 100 %. The incidence of tooth decay depends on age and sex.

Purpose: improvement of epidemiological surveillance of anthrax in the Rostov region with the use of a geoinformational system (GIS). Materials and methods: for GIS development soil maps of «The Unified State Register of Soil Resources of Russia» are used; information on incidence of anthrax provided by experts of «The Center of Hygiene and Epidemiology in the Rostov Region» from 1990 to 2014; computer Quantum GIS 2.2 program. Results: GIS allows carrying out the multiple-factor analysis, to reveal patterns of anthrax spread among people and animals, to carry out the comparative historical analysis of data, to monitor dynamics and a trend of incidence. Summary: GIS information will form a basis for the analysis, planning and implementation of epidemiological and veterinary surveillance in the Rostov region.

Purpose: to improve the results of treatment in patients with recto-vaginal fistulas by individual justification of selection the method and formation of differential diagnostic and treatment algorithm. Materials and methods: results of surgical treatment 15 patients with rectovaginal fistulas have been evaluated. Applied two categories of surgical procedures: 8 patients underwent excision of the fistula, followed by stratified suturing wound tight without of components sfinkterolevatoroplasty. 7 patients supplemented operation performing segmental proctoplasty, plastic vaginal wall mobilized mucous and submucosal graft after anterior sfinkterolevatoroplasty. Results: two cases of recurrence were registered in the first group occurring. In the second group was not registered any recurrences. Summary: the use of radical excision techniques of rectovaginal fistula, supplemented anterior sfinkterolevatoroplasty is the most promising way to significantly reduce the number of postoperative complications and recurrence of the disease by restoring the layered structure of the rectovaginal septum.

Purpose: to identify the relationship between the development of atrophic changes of gastric mucosa and the presence of Helicobacter pylori pathogenicity factors in children with CGD. Materials and Methods: the study involved 96 children (8-14 years). All children were held esophagogastroduodenoscopy with biopsy mucosa antrum, histological examination of biopsy samples, diagnose H. pylori, genotyping of H. pylori. Results: in the group with atrophic changes characterized by a significantly higher percentage of H. pylori-positive patients, I serotype of H. pylori (CagA + and VacA +) and prevailed subtype VacAm1 (χ2: p <0,005), and in patients without atrophic changes in the coolant significantly more often determined VacAm2. Availability dupA gene is associated with a lower chance of atrophy. Summary: the relationships between the formation of atrophic changes of gastric mucosa and the presence of vacA, cagA, dupA Helicobacter pylori in children with chronic gastroduodenitis.

Purpose: the paper is devoted to the study of sternal angle in preschool children. Materials and methods: ultrasonography was used to detect the sternal angle value in 27 children (12 boys and 15 girls) at the age from four to six years, subdivided into 3 groups according to age. Each age-based group included subgroups of boys and girls. Results: it has been established that the sternal angle in preschool children is 189,74 ± 1,29°. Its value for the preschool boys was 189,54 ±1,8°, in girls of the same age group the sternal angle reached 190 ± 1,76°. Summary: performed study has revealed that the sternal angle value in preschool children is sufficiently stable and independent from the child’s age and sex. At the same time, preschool children exhibit individual reclination (up to 25°) of the manubrium relatively to the body of sternum, which should be considered during surgery.

Purpose: to examine the effectiveness of the TB control system in the Kaluga region in the modernization and optimization of health. Materials and methods: the medical records of the analysis of new TB cases. Results: the article shows that timely detection of tuberculosis in the Kaluga region at a low level. It was established nonhomogeneous quarterly detection of TB patients. The analysis of the effectiveness of the TB system in the Kaluga region. Summary: the results show weaknesses in the organization of detection and treatment of tuberculosis in the region.

Purpose: to establish a reference interval of protrombin time, activated partial tromboplastin time and fibrinogen at adult population of the Astrakhan region. Materials and methods: the reference group was formed of 120 men and 120 women of healthy residents of Astrakhan and the Astrakhan region in age from 21 tol 60 years (middle age 37,59 ± 0,88 years). The study of hemostasis in the blood plasma was performed using automatic coagulometer «Sta Compact» («Stago Diagnostica», France). Results: statistically significant difference in the mean values of studied parameter in men and women have been identified. The reference interval at adult population of the Astrakhan region on an automatic coagulometr of «Sta Compact» («Stago Diagnostica», France) made: protrombin time – 12,3 – 15,07 seconds, activated partial tromboplastin time – 26,9 – 35,75 seconds, fibrinogen – 2,13 – 4,23 g/l. Summary: the average values and intervals of protrombin time, activated partial tromboplastin time and fibrinogen established by us can be used as reference in cliniko-diagnostic laboratory Federal state budgetary establishment «Federal center cardiovascular surgery» (Astrakhan), in laboratories of the Astrakhan region during the work on similar analytical systems (on an automatic coagulometr «Sta Compact» («Stago Diagnostica», France)).

Purpose: the determination of quantitative and functional parameters of T, B lymphocytes and natural killer cells in patients in the dynamics of HIV infection. Materials and methods: the immunophenotyping, reaction of blast transformation of lymphocytes, enzyme immunoassay were used in 50 HIV-infected patients. Clinical stage was determined in accordance with the classification of the CDC (1993). Results: the progression of HIV infection connected with impaired function of regulatory T-lymphocytes. B cells lost their ability to produce high-affinity antibodies in the dynamics of HIV infection. Summary: the innate immune cells retain their functional capacity at the same time.

Purpose: to study the effect of pentoxifylline on coagulation system in trauma patients. Materials and methods: conducted a retrospective analysis of 81 medical card of the inpatient with thoracoabdominal trauma. In 26 patients the treatment regimen was included pentoxifylline, 55 patients the drug is not administered. All patients were assessed changes in indicators of the coagulation system. Results: the levels of platelets and APTT in the dynamics decreased, and fibrinogen and PTT increased by the fifth day of treatment. More pronounced these changes were in the group of patients that pentoxifylline was not appointed. The hemoglobin level was more stable in those patients who were administered pentoxifylline. Summary: the inclusion of pentoxifylline in the treatment of patients with thoracoabdominal injuries do not lead to violations of the blood coagulation system.

We want to present a case of the hereditary epidermolysis bullosain a newborn child. The peculiarity of this case is the complicated clinical course of this syndrome in a newborn child generated by congenital herpes infectionsand hypoxic affections of the central nervous system. Today there are no ethiopathogenetic treatment methods for treating hereditary epidermolysis bullosa. All available treatment methods are symptomatic and are mainly aimed at patient care.

Purpose: assessment of the free radical oxidation system and antioxidant protection, immune and cytokine status in patients with pulmonary infiltrative tuberculosis, depending on the type of inflammatory tissue reaction. Materials and Methods: the study included 60 patients with infiltrative pulmonary tuberculosis with exudative and productive type of inflammation.Statistical analysis of the data was performed using the program Statistica 6.0. Results: the patients with productive type of inflammation are mainly characterized by a limited process with poor bacterioexcretion, moderate disturbances in the free-radical oxidationsystem, antioxidant protection, immune and cytokine status. In patients with exudative type widespread destructive process with massive excretion of Mycobacterium tuberculosisprevails, as well as severe disturbances in the free-radical oxidationsystem, antioxidant protection, immune and cytokine status. Summary: the clinical and laboratory characteristics of infiltrative tuberculosis with different types of inflammatory tissue reaction should be considered duringprescription of pathogenetic treatment and prediction of the course and of the outcome of tuberculosis process.