In our article, we focus on molecular mechanisms of immediately early genes expression. We discuss extracellular signals that are transduced into the nucleus through a variety of signaling mechanisms to elicit changes in patterns of immediately early genes expression, chiefly focusing on c-fos. Immediate early genes are involved in many different normal and pathological processes including cell differentiation, cell proliferation, metabolism, inflammation,  oncogenic  transformation  and stress. The earliest known and best characterized include c-fos, c-myc and c-jun, genes that were found to be homologous to retroviral oncogenes. We highlight several signaling  pathways that induce genes expression such as mitogen-activated protein kinase (MAPK), protein kinase A, protein kinase C, JAK-STAT and calcium-dependent pathways. Each one plays important role in immediate early genes activation. Signal transduction eventually leads to the activation of transcription factors and epigenetic modifications. Immediate early gene products are on average mostly transcription factors. FOS and JUN are major components of the AP-1 transcription factor which is responsible for regulating late genes expression involved in multitude of different function such as cell proliferation and differentiation. Therefore, abnormally immediate early gene expression contributes to pathological processes.

Objective: to explore the possibility of diagnosis of hepatobiliary pathology at the medical examination  of employees. Materials and methods: inspection data, questionnaires, ultrasound of the hepatobiliary system 141 people including 93 women and 48 men, ranging in age from 22 to 74 years were analyzed. Esophagogastroduodenoscopy, identification of Helicobacter pylori, biochemical blood  analysis (glucose, cholesterol, total  bilirubine  its fractions,  alanine  aminotransferase,  aspartate aminotransferase, γ-glutamyl transpeptidase, fibrinogen), FibroTest, research of a feces on eggs of helminths, Giardia, fecal occult blood were performed when required. Results: the medical examination revealed: GIT (70.2%), hepatic steatosis (24.1%), periportal fibrosis was (17.7%), cholesterols gallbladder (9.2%), gallstones (7.8%), chronic cholecystitis (5.7%), liver cyst (4.9%), hemangioma of the liver (4.3%), gallbladder polyp (2.1%), and comorbidities of the pancreas, upper digestive tube. The pathology observed in individuals of working age. Conclusions: carrying out of additional prophylactic medical examinations improves diagnosis, quality of health interventions without interruption from work.

Objective: estimate of analgetic effect at extremely low temperature  in the conditions  of cryochamber for general air cryotherapy. Materials and methods: 335 patients (144 males and 191 females) in age from 20 to 72 years with pathology of locomotorium (deforming dorsopathies) took part in researches. Researches were conducted with the use of cryochamber for creation extremely low temperature. Results: the analysis of curves of probability of absence of analgetic effect showed that approximately 50,0% of patients had the lasting analgetic effect after 20±1,50 session of treatment. Conclusions: for achievement of maximal analgetic effect at 95% patients approximately 30 valuable sessions of general air cryotherapy in the cryochambe required. Influences of age, gender and seasons on efficiency of antinociceptive action at this contingent of patients statistically was not detected (р>0,05).

Objective: examine the possibility of introducing enhanced recovery protocol (ERP) in the surgical treatment of colon cancer. Materials and methods: the article on the model of treatment of 77 patients studied the possibility of introducing ERP after surgery for colon cancer. In the study group (35 patients) was used to adapt to the particular branch of option ERP. In 42 patients of the control group it was used traditional methods of perioperative management. Results: in the structure of postoperative complications in the study group was dominated by the system, then in the comparison group prevailed as severe intra-abdominal excesses and Extra-serious complications. In the study group had achieved a threefold reduction in the incidence of general complications (17% vs. 45%) and reduction in the duration of the postoperative period, from 13 to 9,1 days in case that the average frequency reproducibility ERP components was 83,7%. Conclusions: the introduction of a local ERP significantly reduces is a common frequency and severity of post-operative complications.

Objective: to assess the human  adaptive respiratory responses formed in during cyclic stay in artificial hypoxic gaseous environment with oxygen content in nitrogen of 17% (AHGE-17). Materials and methods: in 12 male, aged 25-52 in during cyclic stay in AHGE-17 (daily, for 2 hours, 15 sessions in total) was evaluated external respiratory function (ERF). Results: in response to stay in AHGE-17 the test subjects showed reduced activity of the respiratory system that manifested itself in reducing lung ventilation, gas exchange and respiratory efficiency. Further proceedings are accompanied by statistically significant reduction in the severity of these reactions; In addition, all surveyed also noted optimization of parameters of ERF in normal conditions. Conclusions: the identified human reactions of ERF in stay in AHGE-17 reflected the «transition» of cells and tissues to more economical mode of activity that allows the body to endure such hypoxic condition without express of oxygen transport mechanisms.

Objective: to study associations between VDR gene 283 A>G (BsmI) polymorphism and osteoporotic changes in various sites of skeleton in postmenopausal women. Materials and methods: 525 postmenopausal women were examined. The densitometry was carried out by dual energy X-ray absorptiometry. VDR gene 283 A>G (BsmI) polymorphism was investigated by the realtime PCR method. Results: this investigation determined correlation (P<0,05) between mineral density of lumbar vertebrae L1-L4, left and right proximal femoral neck and total hip, distal forearm of not dominant arm and women body weight (rs from 0,36 to 0,54), body mass index (rs from 0,28 to 0,42), postmenopausal period duration (rs from -0,13 to -0,51). The osteoporosis at L1-L4 lumbar vertebrae had associations with GG genotype (Р=0,009) and G allele (Р=0,016) of VDR gene 283 A>G (BsmI) polymorphism. Correlation between 283 A>G (BsmI) polymorphism and osteoporotic changes in proximal femoral neck and total hip, distal forearm was not established (P>0,05). Conclusions: the obtained data can be used for detection of predisposition to osteoporosis development in postmenopausal women and treatment-and-prophylactic  actions efficiency risings.

Objective: rate the importance of the factors affecting the level of mortality in polytrauma victims in the early posttraumatic period hospitalized in the regional multidisciplinary hospital. Material and methods: in this work is the analysis of treatment results of 3873 patients with polytrauma (NISS≥17), treated in Research Institute Regional clinical hospital №1 named after prof. C. V. Ochapovskiy in Krasnodar in the period from 2003 to 2014. During this time period the upgrading of the versatile hospital, reorganization scheme of assistance to victims with polytrauma within the hospital and development of a regional system of hospitalization. Results: the mortality among patients with polytrauma was decreased from 39.8% in 2003 to 8.1% in 2014. Conclusion: there are identified and evaluated eight factors that influenced the decline of mortality in patients with polytrauma.

Objective: substantiation  for the use of various schemes for chemoprevention  of tuberculosis in HIV-infected patients.

Materials and methods: for the study used data from the Cabinet of the early detection of tuberculosis outpatient card (form №025), journals of chemoprevention appointments, results of chemoprevention held at the 1211 HIV-infected patients in 2014 and 2015. Results: the most appropriate scheme is the combination of two anti-tuberculosis medicines within three months, instead of receiving the medicines for six months. Such schemes are due not only to the reduction of the duration of the course of treatment, but also better tolerated chemotherapy patients. Conclusions: chemoprevention of tuberculosis to HIV-infected persons should be carried out according to certain indications with the obligatory account contraindications. Apply standard regimens consisting of one or two anti-TB medicines or fixed-dose chemoprevention for the successful treatment of patients.

Objective: identify the most acceptable options of anesthesia at urgent operative interventions concerning thoracoabdominal injuries depending on hemodynamic variables. Materials and methods: a retrospective analysis of medical cards of 203 patients treated in a specialized departament  about thoracoabdominal injuries. The severity of injuries according to ISS was 21.2±7.0 points. We estimated the impact of different anesthesia methods on such hemodynamic parameters as mean arterial pressure, heart rate, Кerdo index, Allgower index. For statistical data processing we used the program Microsoft Office Excel 2007, as well as automatic calculators site www.medcalc.org. Results: in patients with thoracoabdominal injuries commonly used inhalation anesthesia. The choice of method of anesthesia is based on anesthesiology-operation risk and indicators of hemodynamics in the preoperative period. The most commonly observed unstable hemodynamics during anesthesia with ketamine and nitrous oxide, the least – during anesthesia with propofol and sevoflurane. At high values of Kerdo index is more likely to occur when stable hemodynamics using propofol and sevoflurane, at low values – when using nitrous oxide and ketamine. In terms of total intravenous anesthesia ketamine patients often required the use of drugs with inotropic effects. Conclusions: If thoracoabdominal trauma patients with a predominance of the sympathetic tone of the nervous system, treatment of choice is anesthetic management total intravenous anesthesia using ketamine. In patients with a predominance of activity of the parasympathetic nervous system is possible to use inhalation anaesthesia.

Objective: the examine variants of quantity of intercostal nerves in the area of the lateral edge rectus sheath around umbilical region, depending on the shape of the anterior abdominal wall. Materials and methods: There were studied 88 floating corpses of both sexes without pathology of the anterior abdominal wall. Among them there were 45% male corpses (mean age – 53,8±11,9 years) and 55% – female corpses (51,9±13,2 years). We measured linea bicostalis, linea bispinalis and linea xiphoidopubica, determined quantity of the intercostal nerves in the umbilical region of the anterior abdominal wall. Results: At the study of anthropometric parameters of the anterior abdominal wall were found that linea bicostalis averaged 29,2±0,3 cm, linea bispinalis – 28,2±0,2 cm, linea xiphoidopubica – 30,4±0,5 cm. Using method of cluster analysis of the new data were obtained the main shapes of anterior abdominal wall: male, oval, female. It was found that persons with a female shape of the anterior abdominal wall was observed significantly more often 2 pairs of intercostal nerves (74%). In turn, at persons with oval shape were often observed 3 pairs of intercostal nerves (60%). In the cases of the male shape of the anterior abdominal wall 1 pair of intercostal nerves were observed in 38%, and 2 pairs of nerves – in 50% of cases. Conclusions: The quantity of intercostal nerves in the area of the lateral edge rectus sheath around umbilical region depends on the shape of the anterior abdominal wall.

Objective: to study electrophysiological parameters and clinical results of direct constant His bundle pacing (HBP). Materials and methods: we examined 36 patients, divided into 2 equal groups (of 18 patients) according to the type of pacing. Group 1 included patients with atrial lead delivery and group 2with ventricle lead delivery. Within 12 months after implantation of the pacemaker were evaluated pacing options, ECG data, changes in heart cavities sizes, quality of life assessments with the MOS SF-36. Results: it turned out that in group 1 QRS duration was 111±13 ms, whereas QRS duration in group 2 was 134±19 ms. So QRS duration and morphology corresponded to physiological and excluded uprising of ventricle dyssynchrony, LV diastolic dysfunction and chronic heart insufficiency, quality of life were higher for group 1 paients : 71±8,5 whereas 63±9,9 in group 2. Conclusions: implantation atrial lead in His-bundle provides more reliable fixation, less early dislocation risk in early postoperative period and facilitates lead extraction. Clinical implementation of this method will contribute Russian industry, which is especially important in import substitution conditions, to the creation of special lead, delivery system and DDDR pacemaker with a backup ventricle channel.

Objective: to present a brief overview of the current drug abuse situation and to examine a medical case of intravenous administration  of methylenedioxypyrovalerone (MDVP). Materials and methods: clinical follow-up study and analysis of the clinical issues. Results: this article presents a review of MDVP prevalence, causes of toxic manifestations, physical and psychological dependence on MDPV and the development of the phenomenon  of parenteral administration. Conclusions: the article may be of interest for specialists in the sphere of chemical analysis of narcotic drugs, experts in psychiatry and narcology, managers and organizers of anti-drug services.

The article considers problems of assessment of the quality of human resource capacity of health organizations. The analysis of existing methods of an estimation of personnel potential. Describes the main components of the system of personnel policy of the medical organization. Developed graphical representation of personnel potential of the employee.

Te scientific thematics of all the Anti-Plague institutes, fulfilled within the framework of activity of Commission for the problem “Cholera and human pathogenic vibrios” of the Coordination Scientific Council on sanitary-epidemiological protection of the territory of the Russian Federation, has been adjusted with the aim to enhance effectiveness and practical significance as well as to optimize the time frames and comprehensiveness of research works. In the result, to exclude topic duplication, a decision has been taken about integrated interinstitute development of the most currently actual priority directions of investigations on the problem “Cholera and human pathogenic vibrios”.

Objectve: establishment of evaluation criteria used in the framework of internal quality control in newborns with intestinal atresia. Materials and methods: for the realization of the goal studied regulations governing the relevant aspects of health care. Results: the study was formed lists criteria for evaluation. Conclusions: the use of these criteria aimed at optimizing organizational models activity pediatric surgery, allowing you to eventually may become one of the components of actions aimed at reducing infant mortality in Rostov Region.