As part of a current worldwide effort to understand  the physiology of human BAT (hBAT) and whether its thermogenic activity can be manipulated to treat obesity, the workshop ‘‘Exploring the Roles of Brown Fat in Humans’’ was convened at the National Institutes of Health on February 25–26, 2014. Presentations and discussion indicated that hBAT and its physiological roles are complex, and research is needed to understand  the health impact of hBAT beyond thermogenesis and body weight regulation, and to define its interactions with core physiological processes like glucose homeostasis, cachexia, physical activity, bone structure, sleep, circadian rhythms. Consensus points and guidelines for future experiments have been summarized in the article of Aaron M. Cypess, Carol R. HaftMaren, R. Laughlin, Houchun H. Hu. Brown Fat in Humans: Consensus Points and Experimental Guidelines (Cell Metabolism. 2014 Sep 2;20(3):408-15. DOI: 10.1016/j.cmet.2014.07.025), which more extensive referat is presented by authors of this paper.

The article shows data on the effect of different factor groups on the development of cerebral palsy in children, it also describes the pathogenetic features of its formation.

This article provides an analysis of the literature data devoted to research on the use of the proximal femoral nail antirotation (PFNA) with and without augmentation in patients in fractures of the osteoporotic femur. The authors used the descriptive and analytical methods. The search for relevant publications carried out in the databases: Google Scholar, e-Library Medline, and the Cochrane Consort library. To date, the evidence base for the benefits of using PFNA with augmentation in osteosynthesis of hip fractures accompanied by osteoporosis need to provide the randomized controlled trials, despite the obvious theoretical and experimental advantages of the method.

Purpose: to compare the depth of anesthesia and hemodynamic reactions during general anesthesia for caesarean section.

Materials and Methods: 45 pregnant women scheduled for caesarean section under general anesthesia were enrolled. All patients were divided into 3 groups (15 patients in each), depending on the general anesthetics. In the 1st group used sodium thiopental 5 mg / kg, in the 2nd sodium thiopental 5 mg / kg with sevoflurane (0.5 MAC), 3rd propofol 2.5 mg / kg. Mean arterial pressure (MAP) and index of AAI were estimated at six basic stages of the operation.

Results: the highest rates of mean arterial pressure and AAI index were observed in the first group.

Summary: the use of a mixture of thiopental sodium dose of 5 mg/kg with sevoflurane (0.5 MAC) or propofol dose of 2.5 mg / kg provide a sufficient surgical level of depth of anesthesia in the main stages of the operation; allow minimize hypertensive response for intubation and surgical trauma in comparison with the thiopental sodium dose of 5 mg/kg.

Purpose: to prove the relevance of the application of wound dressings with early surgical treatment of borderline burns on the extremities in children.

Materials and Methods: the core group patients with borderline burns on the extremities who were treated by early surgical treatment with the use of wound dressings, the comparison group patients with borderline burns on the legs, were treated with conservative method (ligation using wound coverings).

Results: the study showed the advantage of early surgical treatment of borderline burns on the extremities in children with the use of wound dressings to the local conservative treatment of burns data.

Summary: implementation of early surgical treatment with the use of wound dressings allows you to «cure the patient in a single operation», which significantly reduces the complexity of the treatment process, reduces the number of dressings, including reducing the amount of use of the wound surface and the dressing, reduces treatment time, improves the quality of life during treatment.

Purpose: to study the microbiota of postmenopausal vagina both in women with genital prolapse and healthy women.

Materials and methods: we examined 84 females (54 76 years old) including 20 healthy women (Group 1) and 64 patients with diagnosed genital prolapse requiring surgical correction (Group 2). Microscopic and bacteriological examinations of the microflora in posterior vaginal fornix were performed for all participants.

Results: in Group 1 lactobacilli were revealed in the vagina in 10,0% of cases, in the second group these microorganisms are not found. In Groups 1 and 2 coagulase-negative staphylococci (70,0% 93,7%) and Corynebacterium spp. (30,0% 68,7%) are dominant  among facultative anaerobic bacteria, with Eubacterium spp. prevailing (70,0% 84,4%) among nonclostridial anaerobes.

Summary: we revealed vaginal flora patterns typical of postmenopausal women (healthy and patients with genital prolapse), which should be considered during correction of dysbiotic changes in the given biotope.

Purpose: 39 patients were conducted 156 measurements of bioelectric potential of the oral mucosa.

Materials and Methods: all examined patients have different metallic inclusions. The control group consisted of 20 patients (aged 41-67 years old) with diseases of hard dental tissues (caries and its complications).

Results: the patients with galvanism were received oral cavity sanation which included the removal of dissimilar metals from oral cavity and the antiinflammatory treatment of paradentium.

Summary: the elimination of local factors doesn’t reduce the values of bioelectric potential (BP) up to the physiological norm. After the completion of treatment the values of BP have decreased on average by 20%.

Purpose: to investigate the effect of mineralocorticoid receptor antagonists on atrial electrophysiological parameters and frequency of AF episodes in recurrence AF and left ventricular diastolic dysfunction.

Material and methods: prospective cohort study included 89 patients with recurrence non-valvular AF and left ventricular diastolic dysfunction who had sinus rhythm at baseline. All patients received ACE inhibitors, β-blockers, statins, antithrombotic and  antiarrhythmic  drugs  and  were randomly  assigned to  either  standard  therapy  only (Control  group,  46 patients)  or mineralocorticoid receptor antagonists spironolactone 25 mg titrated to 50 mg (SPRL group, 43 patients) added to standard treatment.  At baseline and after 6 months of treatment P-wave duration and dispersion of standard electrocardiogram (ECG), P-wave signal-averaged ECG parameters (total filtered P-wave duration (FiP) and a root-mean-squared voltage of the terminal 20 ms (RMS-20) and atrial late potentials (ALP) were evaluated. The primary endpoint of the study was AF recurrence.

Results: at baseline there were no significant differences between groups. After 6 months of treatment significant reduction in P-wave dispersion were found in SPRL group. FiP improved significantly in both groups, but more in the SPRL group, RMS-20 increased only in the SPRL group. At baseline ALP was detected in 38 (82.6%) patients in Control group and in 36 (83.7%) of SPRL group (χ2 = 0.02, p = 0.887). After 6 months the ALP rate was significantly decreased in SPRL group (56.1%, χ2 = 6.4, p = 0.011 compared to baseline) but remained high in Control (76.0%, χ2 = 0.27, p = 0.6). AF recurrences were documented in 33 (71.7%, 95% CI 57.6-84.0%) patients in Control group and in 21 (48.8%, 95% CI 33.7-64.0%) in SPRL group (χ2 = 3.97, p = 0.046). Additional spironolactone intake was associated with 22.9% (95% CI 2.6-40.8%, p = 0,048) risk reduction of AF recurrence.

Summary: application of spironolactone for 6 months additionally to standard therapy in patients with recurrent AF and left ventricular diastolic dysfunction leads to significant improvement in the atrial electrophysiological parameters and decrease in AF recurrence.

Purpose: to develop the methodology for risk-assessment of the potential hazard of the Rostov region’s territory due to anthrax based on the spatial analysis, independent of the administrative division.

Materials and Methods: for development the risk-based assessment of potential hazards of territory due to anthrax the registration data of cases for 132 years have been used. The construction of risk cartograms were carried out on the basis of biweight distribution of stationary unfavorable places due to anthrax.

Results: the average value of the epizootic index and density of stationary unfavorable places due to anthrax are calculated for 413 administrative units of the Rostov region.

Summary: the identification of «risk areas» by using risk-based methodology would provide the more accurate results than the zoning due to administrative territories.

Purpose: to assess the dynamics of the level of anti-inflammatory cytokines (IL-4, IL-10) in the process of the standard treatment and the use of TES-therapy in patients with stable angina II-III functional class.

Materials and Methods: the study investigated the level of anti-inflammatory cytokines (IL-4, IL-10) in 60 patients with angina pectoris II-III FC on the background of standard treatment and when carrying out TES-therapy.

Results: in the group of patients with angina pectoris II-III functional class on the 8 days of standard therapy were observed significant changes in the content of major anti-inflammatory cytokines IL-4 and IL-10. When added to standard treatment with TES-therapy level of the main anti-inflammatory cytokines (IL-4, IL-10) for 8 days significantly decreased.

Summary: the results suggest that TES-therapy allows to reduce the degree of activity of systemic inflammatory response in significantly more strokes than the standard treatment. It is therefore advisable for the inclusion of TES-therapy in the standard treatment of patients stable angina II-III functional class.

Purpose: comparative evaluation of surgical methods of treatment of decompensated cicatricial-ulcerative stenosis of the duodenum and rationale for the choice of optimal tactics in complex treatment of these patients.

Materials and Methods: summarizes the experience of complex treatment of 112 patients with decompensated cicatricialulcerative stenosis of the duodenum. 82 patients underwent radical duodenoplasty, aimed at restoring the motor-evacuation and secretory functions of the stomach, selective proximal vagotomy. 30 patients underwent resection of 2/3 of the stomach in various modifications.

Results: The highest number  of complications in the main group account for those patients who were simultaneously performed duodenoplasty and SPV. With the transition to a two-step method of surgical treatment postoperative complications almost never met. Almost all the pathological conditions in the long-term period after surgery is more pronounced in patients who underwent resection of the stomach.

Summary: adical duodenoplasty allows to demonstrate the possibility of full recovery of gastric function after radical removal of pathological substrate and the preservation of the pylorus.

Purpose: in order to assess the adaptive hemodynamic responses formed in humans during cyclic stay (daily, for 2 hours, 15 sessions in total) in normobaric hypoxic gaseous environment with oxygen content in nitrogen of 15% (NHGE-15).

Materials and methods: a study has been conducted with participation of 12 male test subjects aged 25-52. In course of cyclic stay in NHGE-15, systemic and cerebral blood flow parameters were evaluated in the test subjects.

Results: in response to stay in NHGE, at the initial stage of the testing procedure, the test subjects showed hyperkinetic systematic circulation reactions: cardiac acceleration, increase in systemic blood pressure and cardiac output, with decrease in peripheral vascular resistance. At the same time, an increase in blood flow to cerebral vessels and hypersthenia in major cerebral vessels were revealed. Further stay in NHGE-15 was accompanied by a statistically significant reduction in severity of the above responses reflecting a gradual decrease in «stressfulness» of hypoxic effect due to formation in the body of primary adaptational structural and functional alterations in oxygen transport  systems, regulatory and plastic processes. The fact of systemic and regional hemodynamics parameter optimizing was also revealed, recorded under normal conditions of gaseous environment, in course of the cyclic hypoxic impact.

Summary: hypoxic exposure on the human body leads to centralization of the circulatory system, aimed at the maintenance of oxygen supply of vital organs. The result of hypoxic training is to reduce the severity of the reaction by increasing the reliability of functioning of the system of hemodynamics and its regulatory mechanisms.

Purpose: to explore the results of application of minimally invasive technologies in treatment of colorectal cancer with liver metastases.

Materials and methods: results of treatment of 55 patients with colorectal cancer with liver metastases (T2-3N0-1M1) were analyzed. 25 patients, who underwent laparoscopic procedures on the colon with atypical liver resection or radiofrequency thermal ablation of liver metastases with interstitial chemotherapy and laparoscopic catheterization umbilical vein, formed the study group. 30 patients, who underwent open surgery, formed the control group. Chemotherapy was performed for both groups of patients (drugs was injected through the umbilical vein in the study group and through a peripheral vein in the control group).

Results: laparoscopic approach led to reliable decrease of postoperative complications and  improvement in the life quality of patients during the postoperative period (p<0,05).

Summary: minimally invasive combination treatment reduced the rate of progression by 32% and increase the time to disease progression for 7 months (p <0,05) in the study group.

Purpose: the dynamics of natural death for hepatocytes was examined with light optical and electron microscopic methods.

Material and Methods: material was the liver of mature rabbits (n=12) and white rats (n=15), that, after common morphological treatment was analyzed under light N 4800 M (x100 immersion) and electron microscope JEM-100S.

Results: there were two kinds of apoptosis in the liver of experimental animals. At the first type of apoptosis the large vacuoles occurs in hepatocytes’, cytoplasm at rats, that are changed with small foamy structures (stormy cytoplasm), observing in both animals. At the second type of apoptosis the hepatocyte’ nucleus is decomposed into large fragments, the karyorrhexis (nuclear catastrophe) occurs.

Purpose: analysis of fatty acids composition of the vaginal tissue and determining of a possibility of vitamins and antioxidants correcting influence on expressiveness of atrophic changes in women with atrophic colpitis.

Materials and Methods: vaginal tissue of 35 women (age 51 ± 2.8 years) having objective signs of a moderate atrophy was investigated. Group of comparison 35 women (age 48 ± 3.6 years) without pathologic urogenital symptoms. Fatty acids composition of vaginal tissue was investigated by method of a gas-liquid chromatography.

Results: fatty acids composition of vaginal tissue had the statistical difference in relation to such fatty acids as myristic, myristooleic, pentadecanoic, palmitic, heptadecanoic, heptadecaenic, linoleic, linolenic and arachic.

Purpose: to reveal a correlation between the symptoms and heart rhythm as well as to evaluate the incidence of symptomatic and asymptomatic paroxysmal atrial fibrillation (AF) in patients with paroxysmal AF after catheter ablation and antiarrhythmic drug therapy (AAD) through long-term observation based on data from implantable cardiac heart monitors (ICM).

Materials and Methods: 92 patients with paroxysmal AF were randomly broken into two groups: 1) AF catheter ablation + ICM (Group I; n=46); 2) AAD + ICM (Group II; n=46). The data recorded by the device were matched against the symptoms diaries kept by the patients.

Results: through the follow-up period (24 months), 17 (40%) patients of the catheter ablation Group and another 33 (71.8%) patients belonging to the AAD Group had AF relapse, whereas in 4 (23.5%) patients of the catheter ablation group and in 1 (3%) patients of the AAD group the paroxysms were asymptomatic. Only 30% of episodes recorded by the ICM in the AF catheter ablation + ICM Group and 78% of episodes in patients receiving AAD + ICM were found to be true AF paroxysms.

Summary: the rhythm status did not match the patients’ symptoms in terms of AF, which was observed in 70% of the cases after catheter ablation and in 22% of cases in the AAD group. Asymptomatic AF was more common among the patients belonging to the catheter ablation group (23.5%) if compared to those who underwent AAD (3%). The subjective evaluation of the symptoms done by the patients regarding their arrhythmia did not reflect the true state of things related to the heart rhythm, which makes such evaluation not reliable if employed to judge the treatment efficiency.

Purpose: improve the immediate results of treatment of patients with acute colonic obstruction of tumor genesis through the use of a new method of colon decompression.

Materials and methods: the study included 35 patients who were divided into 2 groups. The control group consisted of 9 patients who were formed from a double-barreled colostomy minimal access without removing the contents of the large intestine and the rehabilitation of its lumen.The main group consisted of 26 patients,which after the application of double-barreled loop ileostomy through minimal access for the removal of intestinal contents was used a new method of colon decompression.

Results: in the main group was noted more rapid normalization  of basic clinical and laboratory parameters, as well as indicators of abdominal pressure. Complications were found in the main group in 1 (3.8%) patient, in the control group in 3 (33.3%) patients.

Summary: а new method reduces the number of complications and deaths compared with conventional double-barreled ileostomy,due to forced removal of colon content and readjustment of its lumen, leading to a more rapid normalization of the major clinical and laboratory parameters as well as parameters of intraabdominal pressure.

Purpose: to expand the conception of molecular and biochemical changes in genital prolapse (GP) based on the study of morphological and immunohistochemical features in connective tissue structures of the ligamentous apparatus of the pelvic floor and their dependence on genetic polymorphisms MMP / TIMP.

Materials and Methods: the study involved 178 women aged 35 to 65, 134 of them with GP relapses (after hysterectomy by vaginal access because of a total and partial uterus and vaginal walls prolapse). Patients were randomized into the following groups: I – with manifestations of undifferentiated connective tissue dysplasia (CTD) (11.7 points on average) (n = 86); II – with no CTD signs (n = 48). Control group lll consisted of healthy women without any GP signs (among 15 patients abdominal hysterectomy was performed in connection with uterus hyperplastic processes) (n = 44). Used: morphological method of studies, immunohistochemical  (to assess tissue biopsies of sacrum-uterine  and round  uterine  ligaments), the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs), genotyping by polymerase chain reaction of MMP / TIMP polymorphisms.

Results: the morphological study of women’s ligamentous apparatus in cases with GP revealed significant fibrosis, coarser collagen septa among bundles of smooth muscle fibers and degenerative changes in individual smooth muscle cells. The group with GP and CTD features showed diffuse atrophy, hyaline or mucinous degeneration of smooth muscle tissue and evident edema of extracellular matrix in 65% of samples. Pathobiochemical disorders in cases of pelvic descencia were determined by an imbalance in collagen type I and III content, with the predominance of the latter, less durable; a decrease in elastin levels and its considerable fragmentation. The greatest expression of tissue degradation was observed among women with GP and CTD manifestations on account of increased MMP-1 and -2 levels; TIMP-1 content was lowest in the group. Associations with GP development have been established among women with CTD signs for genetic polymorphisms: rs3918242 СT gene MMP9 (0,54) (p = 0,007; OR = 3,2; 95% CI 1,3-7,6), rs17576 AG gene MMP9 (0.62 vs. 0,32, p = 0,01; OR = 2,9; 95% CI 1,2-7,0); rs3025058 5A6A gene MMP3 (0.52 vs. 0.45, p = 0.009; OR = 3.7; 95% CI 1,3-10,1); rs2285053 (rs2285052) CT gene MMP2 (0.44 vs. 0.27, p = 0,007; OR = 3,2; 95% CI 1,3-7,5). Statistical significance for the groups was preserved after the correction for multiple comparisons.

Purpose: to improve the results of portosystemic shunting surgical interventions using of procedures of adapting portal decompression during preoperation period.

Materials and Methods: the results of transjugular intrahepatic portosystemic shunt (TIPS procedure) in 113 patients were analyzed. In 60 cases the procedure of adapting portal decompression during a period 3-5 weeks using selective vasoconstrictor octreotide in complex with non-selective beta-blockers.

Results: during the follow-up postoperative period in group of patients who were undergone for adapting portal decompression the restitution of clinical and laboratory data was noticed and does not increase occurrence of hepatic insufficiency in comparison with control group.

Purpose: improving efficiency of treatment patients with multi-resistant tuberculosis.

Materials and methods: the results of treatment of 91 patients with multi-drug resistance tuberculosis  have been analyzed. Support of artificial pneumothorax with gaseous mix inclusive ozone was used in 30 cases.

Results: the strict keeping of procedure allows to have expressed local and systemic activity with absence of side effects.

Summary:  application of ozonated  solutions is effective and  economic method  of treatment  patients  with multi-drug resistance tuberculosis without strong fibrosis alterations in lungs. So, ozone therapy can be recommended in medical care of such contingent of patients.

A case of face myofascial pain syndrome of female patient 54 years old is discussed. The diagnostics criteria, including clinical and neurological examination, computerized  tomography  of brain, facial bones and temporomandibular  joints, diagnostic blockade are described. Treatment issues are discussed.

The article presents the results of analysis of the four-level’s system of internal quality’s control in Rostov State Medical University. There is a unified electronic database of quality’s control in the University’s clinic. Analysis of the results of quality’s control allows us to made the elimination and prevention of irregularities. During the reporting periods the electronic system calculates a mark of the medical help for each patient, a mark of the work of each doctor, a mark of the work of all departments. The marks of the electronic system seems to us as possibility to improve measures of personal responsibility of staff and to achieve collective results of work.