The article presents the results of molecular genetic study based on typing of class II HLA genes (DRB1, DQA1, DQB1) in patients in age from 8 months to 18 years with a referral diagnosis of celiac disease or with suspected celiac disease. The study of the gene HLA class II with three-locus haplotypes DRB1-DQA1-DQB1 revealed carriers of the haplotypes associated with celiac disease. The researchers found a high frequency of carriers of the haplotypes DRB1*04 - DQA1*03:01 - DQB1*03:02 (DQ8 type) in the Yakuts compared to the Russians.

The article reports a prospective study of women with uterine fibroids. The patients went to the clinic for conservative myomectomy and uterine artery embolization. Endovascular UAE has proved to be the most effective method of UF treatment, having fibroid nodes in the size up to 10 cm with a good vascularization, as well as submucous nodes localization. Thus, UAE among patients with UF provides little traumatic intervention with good clinical effect and reduction in the size of the uterus, as well as preserves the uterus, which is especially important for women with unrealized reproductive function, having contraindications to surgery and categorical rejection of it. In this way, the optimal outcome of organ‐saving UF treatment is achieved not only due to the skill of the surgeon, the adequacy of the selected surgical approach, providing minimization of operational risks, but also due to a whole complex of measures, including diagnosing disorders in various links of reproductive system and rational management of pre‐ and post‐operative stages in accordance with complex rehabilitation.

The objective of our study is to clarify the distribution of immunohistochemical marker expression of MMP‐1, MMP‐2 and TIMP‐1 in the sacrouterine and round ligaments of the uterus among women with genital prolapse.

The research was performed on the material of biopsies of sacrouterine and round ligaments of the uterus on both sides taken during vaginal hysterectomy from 15 women with genital prolapse aged 42 to 65 years old. It was found that the decrease in the accumulation of TIMP‐1 on the background of high expression of metalloproteinases in the POP contrasts with a moderate level of expression of MMP‐2, low MMP‐1 and moderate TIMP‐1 in the control group, which affects the density of the VCR. Connective tissue loosening, reducing of its elasticity and tensile strength was accompanied by degradation of fibers and increased degradation of collagen, defining pathobiochemical disorders in the pelvic dysfunction.

It has been shown that for an objective appraisal of the impact of active influence of chronic pyelonephritis on the feto‐placental complex is possible in determining the constituents of pro‐ and anti‐inflammatory cytokines. The results of this research on cytokine status give an evidence of the unstabilized nature of the immune system in women with CP. In spite of the complete clinical and laboratory remission of the disease, contributions to the development of gestational complications were due to the lack of pregravidal training and early prevention of placental insufficiency. It has been established that, despite the absence of specific features in the placenta of women with chronic pyelonephritis that highlighted to the compensatory and sub‐compensatory changes against the backdrop of dystrophic, microcirculatory and other disorders, reflecting not only the provision of the required conditions for the existence of the fetus, but as well as the degree of destructive lesions and severe shift in immunological equilibrium.

The results of the analysis of patients with increased body weight examination and state of their biliary system are presented. It is shown that a significant part of the observed patients are in risk group for the biliary tract diseases. Regardless of the degree of obesity these patients have disorders of fat metabolism: atherogenic dyslipidemia, impaired hormonal function. Significant amounts of the examined have pathology of the biliary system – non‐alcoholic amyloid liver disease, the presence of bile heterogeneity (sludge) and the gallstones. It is revealed that the increased weight, together with serious cardiovascular system pathology and endocrine disorders affect the overall metabolism and, in particular, functional disorders of the biliary system

The adaptive capacity of the circulatory system of the NEFU named after M.K. Ammosov 1 st year she‐students in terms of adaptation to training in high school was studied.

In the girls somatometric data (height, weight) and hemodynamic parameters (heart rate, blood pressure) by conventional techniques, as well as indicators of circulatory system adaptive capacity (AP) and double product (DP), or Robinson index were determined.

DP analysis showed that the functional reserves of the cardiovascular system has been stretched and depleted in 55.5% of cases. AP in 98.5% of cases was unsatisfactory.

Indicators of reserves of the cardiovascular system of the 1st year students were worse than in the control group, indicating the emergency power of stress or of its long duration.

Thus, the adaptive reserves of an organism of students are characterized as unsatisfactory. The observed decrease in the adaptive capacity of the organism, even in the absence of the manifested disease testifies a lower level of health and increases the risk of disease.

In experimental conditions the possibility to correct free radical lipid oxidation of rats’ organism membranes was studied with the introduction of the succinate containing drug called remaxol. The animals were divided into 4 groups and each of them had 30 rats: intact animals which were held in standard conditions of vivarium; the control group in which rats were exposed to cold during three hours daily; the experimental group in which before cooling animals had a daily intake of the remaxol in a dose of 50 mg/kg; the experimental group in which before cooling animals had a daily intake of the remaxol in a dose of 100 mg/kg. It was found out that in the blood of experimental animals a daily cold exposure during three hours contributes to the increase of lipid hydroperoxides level (by 25 – 41%), of diene conjugate (by 38 – 54%), and of malonic dialdehyde (by 27 – 74%) against the decrease of antioxidant system activity in the blood of intact animals.

The purpose of the study. To study the incidence of exogenous factors and ulcerogenic topical features of newly diagnosed gastric ulcers in the KhMAO‐Yugra residents.

Materials and methods. A total of 32 residents of Yugra Khanty‐Mansi Autonomous with newly diagnosed stomach ulcers were under study. All patients in the examination of stomach ulcers are diagnosed based on the EFGDS results.

Results. There was revealed a predominant localization of ulcer bleeding from newly diagnosed gastric ulcers ‐ the body of the stomach. It was noted the high frequency of alcohol‐related new cases of stomach ulcers, complicated with bleeding. Perforations of new cases of stomach ulcers are not exceeding the rate of exogenous factors of ulcerogenesis compared with bleeding and uncomplicated new cases of stomach ulcers.

Conclusion. It is noted the high frequency of alcohol associated newly diagnosed gastric ulcers complicated by bleeding. Mixed Hp‐invasion and NSAIDs for bleeding ulcers of new cases are less common than in patients with uncomplicated disease.

This work is based on the analysis of complex treatment of patients with pancreatic necrosis treated at the surgical department of the Republican Hospital №2 – Emergency Center of the Sakha (Yakutia) Republic in the period from 2010 to 2015. The study allowed to adapt and improve a duplex immunocorrection in pancreatic necrosis in a multidisciplinary surgical hospital that along with the other constituents of intensive therapy has allowed in a whole to reduce the amount of intra– and extra abdominal complications and lethal outcomes in a sterile pancreatic necrosis phase and in the phase of infectious complications.

A new method for correction of congenital clubfoot without surgery in the infants, developed and used in the practice of Department of orthopedics and Traumatology, Pediatric Center RH №1 ‐ NCM Yakutsk in 2012i is presented in the article.

The technique is based on the anatomical features of nerve pathways in children of the first months of life and constant multiplanar foot traction by new device with a functional effect on certain muscle groups. This method eliminates the main drawback of conservative treatment of congenital clubfoot such as possible necrosis of the skin and soft tissues due to the lack of control over soft tissue located under the circular plaster cast.

The proposed method and device can be widely used in outpatient service.

The prevalence and intensity of parodontium diseases among children of school age and also teenagers of educational institutions of Yakutsk have been studied. Their high level of frequency in these examined groups where mostly chronic catarrhal gingivitis and rarer localised chronic periodontitis of mild case were defined. On the other hand, the unsatisfactory oral cavity hygiene was revealed in these groups of children that accordingly characterized insufficient level of sanitary culture of children and their parents. We’ve chosen preparation "Yagel" for the research. It is made of native vegetative raw materials of frond lichens extract of Cladina family. It has a high maintenance of usnicand other lichen derivative acids in clathrate shape with lichen β ‐ oligosaccharides and possesses the antimicrobial action which hasn’t been studied earlier in clinical dentistry. Taking it into account we’vestudied antibiotic action of "Yagel" to conditional‐ pathogenic microflora incase of gingivitis. The microbiologicassessment of this medication has revealed certain features of minimum inhibiting concentration and minimum bactericidal concentration. So, the use of "Yagel" affected on quantitative and quality indicators of gram‐ positive, gram‐negative microorganisms and also Candidainfection. The revealed inhibiting and bactericidal concentration of "Yagel" allowed to assert that it could promote reverse development of inflammatory process of gum tissues in the clinical plan and accordingly, reduce period of treatment and help treatment‐and‐prophylactic efficacy. In this connection this preparation could be applied in complex gingivitis therapy as alternative medication. Thus "Yagel" is produced in Yakutsk that defines its low cost price and availability for a wide range of the population. There is a necessity of further researches of clinical efficacy of "Yagel" in pathological processes of parodontium tissues of inflammatory‐destructive character.

The article presents an analysis of the rivaraksoban application after replacement of large joints held in the Republican Hospital №2, Yakutsk from January 2012 to December 2013. Studies have shown that rivoraksoban intake reduces the number of complications and increases the level of commitment to the anticoagulant therapy in these patients

The analysis of statistical data on morbidity and surgical treatment of acquired heart defects in Russia and the Far Eastern Federal District for the 2004-2013 to assess the dynamics and the potential development of this type of care was done. From 2004 to 2009 there was a trend decrease in the etiology of rheumatic valvular heart disease in the Far East and Russia, and from 2012 patients from this group for the first time accounted for less than half of the all operated with valvular heart disease. The growth rate of the number of prosthetics and renovations increased significantly in 10 years, as well as the number of simultaneous use of prosthetic valves and reconstruction, combined with coronary bypass surgery. The growth of operational activity in the Far East has not led to significant changes in its position among the regions of the Russian Federation. The revealed ambiguity of postoperative mortality indicators points to the contradictions in the principles of evaluation in various institutions of the country.

The purpose of creation of any system of compensation is the motivation of workers on improvement of quality of the made production or service, in a case with health care this service is medical care, besides is solved, and a problem of attraction of new qualified personnel. In this article we tried to consider one of methods of optimization and growth of workers of health care, namely the conclusion of the labor effective contract. For this purpose we offer not only new functions, but also criteria of overall performance of the medical personnel, thus are surely considered also social guarantees of the worker. As a result of this work the data which allowed speaking about recommendations about effective use of a manpower and formation of an average salary above than in region economy were obtained.

Providing quality of medical care is the main objective of the health system. While in Russia the priority interests of the patient are fixed at the legislative level. In 2004 the World Health Assembly defined the main task of modern medicine to radically increase the safety and quality of treatment. Criteria of safe medical care were defined. The article attempts to determine the medical and expert criteria for qualifying an emergency trauma care on the basis of the analysis of a large number of medical records, the sociological poll, both of doctors and patients, assessment of regulatory initiative on the legal legislative documents. We defined algorithm for estimating the quality of medical care for the injured with the musculoskeletal system lesion.

The analysis of the dynamics of the supply of the Sakha (Yakutia) Republic population by physicians of all specialties, doctors-pediatricians, taking into account the pediatric surgeons, pediatric endocrinologists, pediatric oncologists for the 1995-2013 was done. In general in the Sakha Republic (Yakutia) during the analyzed period the increase of the children’s population by doctors staffing of the pediatric profile was marked. This increase happened, both in Russia and in the Republic Sakha (Yakutia), mainly due to the reduction of the child population and, to a lesser extent, increasing the number of doctors themselves. The study has revealed the growth of doctors - pediatricians just in densely populated areas and the preservation of the unavailability of pediatric care in areas with low population density of the Sakha (Yakutia) Republic.

The article presents the results of medical examination with questioning of workers of a water transport of Yakutia. This document provides information about age, nationality, sex. Moreover, the social characteristics (work experience, position, marital status), the attitude to health, attitude to unhealthy habits are analyzed. Harmful production factors of respondents are considered precisely and its relationship with nosological structure of diseases.

This paper presents social and clinical data on newly identified patients with pulmonary infiltrative multidrug-resistant tuberculosis in the Sakha Republic (Yakutia) treated at the Therapy Department for Pulmonary Tuberculosis no.3, the Research&Practice Center for Tuberculosis. The majority of the patients were unemployed individuals of active working age, with the history of close family exposure to sputum-positive case. Most often, tuberculosis was detected on presentation to a doctor, and the detected cases were mostly cases with extensive destructive disease and high bacterial loads of multidrug-resistant M.tuberculosis.

The article presents the results of a retrospective epidemiological analysis of the rotavirus incidence in the Russian Federation, Saint Petersburg, Novgorod Oblast and the Sakha Republic (Yakutia) in 2000-2013. It identifies regional variations in the epidemic process intensity in the prevaccination period, age groups of risk, and the role of the water factor in the infection transmission. The age group most susceptible to the disease is children under two years of age.

The WHO‐100 questionnaire helps on researching the quality of life the of hepatitis and cirrhosis patients.

Research objective: to assess the quality of life (QoL) of chronic viral hepatitis (CHV) and cirrhosis (C) patients.

Due to the questionnaire there were examined 15 patients with CHV and C.

It is stated that chronic viral hepatitis reduces the quality of life on spiritual sphere, and the quality of life of cirrhosis patients were lower on all spheres (physical, mental, social and spiritual).

Therefore, rehabilitation activities must be not only medical, but also of psychological and sociocultural orientation. The “WHOQoL‐100” questionnaire can be used as additional tool for estimating severity and also effectiveness of carried out medical and rehabilitation activities.

This article presents the results about influence of motor transport on accumulation of heavy metals (HM) of lead, zinc, copper and cadmium in the soil and in fodder plants of pasturable grounds of the Khangalassky region. Results of our researches testify that the pasture of cattle in close proximity to a highway can be the prerequisite of impurity of animal husbandry products by heavy metals. As a result of analyses of samples of the soils selected in the Khangalassky region showed that concentration of Pb, Cd, Cu, Zn in a soil cover of pasturable grounds of the village of Tekhtyur and village Nemyugyu don't exceed the established sanitary and hygienic standards. It is revealed that the maintenance of Pb, Cd, Zn, Cu in fodder herbs of pastures of the village of Tekhtyur and village Nemyugyu depended on their concentration in the soil. Thus the level of cadmium and lead in plants isn't exceeded by maximum concentration limit, and concentration of zinc and copper in 5 m of a highway exceeded maximum concentration limit.

There are some problems in maintaining the demographic safety in the Republic of Sakha (Yakutia). Such integral indicators as life expectancy, depopulation index and total fertility rate can be applied as indicators of demographic safety. In aggregated form they characterize reproduction of the population, the basic concept that lies in demographic safety entity.

The Arctic is a region of prospective industrial development of natural resources. It is important to have demographic potential with the necessary quantitative and qualitative parameters.

Mortality processes are the most important in terms of demographic safety for the Arctic and Northern regions of the Republic. Current state of population mortality is estimated as representing a certain threat to the demographic security. There were positive signs for the 2009‐ 2014 years: the number of deaths and the overall death rate were decreased. However, mortality rates are significantly higher than the average for the Republic.

The infant mortality rate, which is estimated in the world community as an indicator of social welfare society, has extremely uneven dynamics that due to the presence of demographically small aggregates. Over the years, the infant mortality rate is higher than the average for the Republic.

High mortality due to external causes of death remains the essential point in the characterization of mortality in the Arctic regions of Yakutia. In most of the Arctic and Northern regions of the Republic, the absolute number of deaths from external causes was decreased. However, stable high indicators compared with average coefficients for the Republic are marked there. For example, in the Allaihovskiy district in 2012 year mortality from suicide was above the national average of 7.75 times and in 2014 year in Anabarskiy district –7.8 times.

Elevated levels of population losses as a result of external causes of death requires special measures to preserve the demographic potential of Arctic regions, having a special geopolitical importance and representing the main resettlement area of the small‐numbered indigenous peoples of the North.

The article presents results of studies of physical capacity and lipid peroxidation in the highly skilled sportsmen - single combat wrestlers in the Far North. It was shown that the level of physical capacity of sportsmen – single combat wrestlers was depended on the cardiorespiratory system indices, which was manifested in a significant predominance of the effects of the parasympathetic system on the cardiovascular system and the greater lability of regulatory mechanisms. The intensity of lipid peroxidation and antioxidant system state affect the physical capacity of the sportsmen - single combat wrestlers

The article presents the materials of the leading researchers on the issue of the traditional food of indigenous residents of Yakutia in the extreme conditions of the North.

The purpose of this study is to examine the regional characteristics of the working‐age population mortality in the Republic of Sakha (Yakutia). With the use of the continuous statistical method and the method of mathematical analysis, there was done a retrospective analysis of the official data from mortality reports by the Territorial Office of the Federal State Statistics Service (FSSS) and demographic yearbooks of the Republic of Sakha (Yakutia) for the period of 1990‐ 2014. It was found out that the distinguishing feature of the mortality in the republic is a high level of human losses in the younger age groups from preventable causes. As of 2013 data, the mortality rate of the working‐age population exceeded the Russian Federation average by 5%, in particular, cardiovascular diseases – by 10.3%, external causes – by 26.7%. At the same time, Yakutia demonstrates a decreasing trend of the working ‐ age population mortality from all the major classes of the causes, which determined the 2014 decrease in crude mortality rate in this age group by 5.1% (down to 5.7 per 1,000 population of the corresponding age). In the structure of causes of death in working‐age population of the Russian Federation as a whole, the ranking places were successively occupied by cardiovascular diseases (170.3 per 100 thousand people of working age), external causes (158.3), and neoplasms (81.9). In Yakutia, the leading position went to external causes (216.1), followed by cardiovascular diseases (189.9), and neoplasms (67.1).

The study of the level, structure and trends of the working‐age population mortality in the republic in the context of different health‐economic groups of regions (Arctic, industrial, rural) reveals significant intra‐regional variations in the data. In the period 1990‐2014, all the groups of regions showed significant increase in the working‐age population mortality rate. It should be noted that the rural group rate was remaining relatively stable, as there was no increase in the mortality of working‐age women; still, it was higher than the average republic’s indicator by 7.0%. Since 2000, the Arctic regions showed the highest mortality rates in the working‐age group in the republic, with the excess being observed in both men and women. Over the entire study period, the group of industrial regions demonstrated a relatively prosperous situation, despite a growing trend.

Differences were also identified in the structure of the main causes of mortality of the working‐age people in different groups of regions. The Arctic group experienced the highest numbers of deaths from cardiovascular diseases (345.7 per 100 thousand people of working age), digestive diseases (56.4), external causes (404.5), whereas the industrial group – from infectious diseases (20.0) and neoplasms (75.0). The rural group, with the average numbers for all the major causes, showed an upward trend in mortality from cardiovascular diseases and external causes.

Premature mortality of working‐age people in the republic results in economic cost for the society, which annually makes the average of 0.4% of the gross regional product.

This article is devoted to the study of the immune status in children with pathology of the pancreas. At the analysis of changes of immune status in children with chronic pancreatitis we revealed the greatest decline in T-cell level and components of complement, a decrease level of immunoglobulin A, IFN-γ, FNO-ά.

Clinical records of 21 patients aged 27‐57 years who were on hospital treatment after liver transplantation in Therapy Department of the “No.1 Republican Hospital ‐ National Centre of Medicine” State‐Financed Institution of the Republic of Sakha (Yakutia) in 2004‐2015 are analyzed. Transplantation is carried out in stages of decompensation of cirrhosis of non‐viral and viral etiology. Early performed surgery increases life time of patients and improves the quality of their life.

We studied the cytokine profile in children with various forms of juvenile arthritis aged from 0 till 16 years old. The average values of the levels of proinflammatory cytokines (TNF-α, IFN-γ and IL-6) in ten times exceed the upper limit of the normal range. High levels of the proinflammatory cytokine IL-1β significantly correlates with family history of patients, and high levels of anti-inflammatory cytokine IL-10 is observed in patients with juvenile ancylosing spondylitis (JAS).

The review analyzed the manifestations of connective tissue dysplasia (CTD) in the form of disorders in the cardiovascular system, the musculoskeletal system, internal organs, eyes and maxillofacial area and organs, the tissues of the oral cavity. In this regard, assessment of individual risk of children with different degrees of CTD severity will contribute to the search for new tools and methods, which to some extent will prevent the development of dental diseases and characterize the forecast of children’s health protection. It is important, that the organs and tissues of the mouth cavity, as well as other organs, body systems have desmogenous origin where their constituent components determine the level of protective processes in various diseases. A common manifestation of phenotypic traits of CTD in the oral cavity are the anomalies of dentition, vestibular inclination of the front teeth of the upper jaw, deep incisal overlap, distal occlusion, high gothic sky, dystopia and crowding of the teeth, as well as a deviated septum. Herewith CDT multi-organ failure may affect the frequency of the dysfunction of the temporomandibular joint, caries and non-carious lesions, periodontal diseases, disorders in the development of teeth, chewing muscles parafunctions.

The author reports his search for scientific papers in the open databases Pubmed, Europa Pubmed Central, eLIBRARY using the search terms «gallstones and pathogenesis», as well as Russian equivalents for “cholelithiasis”. For the analysis articles on the cholelithiasis pathogenesis with a high citation level were selected.

So far, the mechanisms of formation of stable nuclei of crystallization of cholesterol stones are not fully elucidated. Recently, there are many facts proving essential Galkin ‐ Chechulin effect in the formation of cholesterol stones crystal nuclei and the role of the bacteria and inflammation.

Thus, in the pathogenesis of gallstone disease, the Galkin‐Chechulin effect plays a significant role in the formation of stable crystallization nuclei (embryos). Such bilirubin containing microlites do not spontaneously dissolve and there may be no symptoms for decades, and in the event of the conditions, described by W.H. Admirand and D.M. Small they become nuclei of crystallization of cholesterol stones of macroscopic dimensions.

The literature review is based on the analysis of sources, covering histogenesis and organogenesis of the reproductive system of the fetus at the mother’s chronic urogenital infection. Topical issues were highlighted for further study of this problem.

Background and purpose. This review examines the evidence of epidemiological, pathophysiological and genetic studies on the search for risk factors of non‐traumatic cerebral aneurysms and subarachnoid hemorrhage.

Summary of the review. The epidemiological studies indicate significant differences in the incidence of subarachnoid hemorrhage in different populations. No one of the established risk factors can explain this phenomenon, and thus, likely there are other risk factors affecting the development of the disease. Mechanisms of aneurysm's development and rupture are not sufficiently clear currently. It was established the influence of genetic factors on the development of the cerebral aneurysms in many studies.

Conclusions. The data of recent studies suggest that the development and rupture of cerebral aneurysms are due to a complex interaction of modifiable factors and genetic predisposition. The discovery of new risk factors of the disease, including genetic ones, contributes to the understanding of mechanisms of cerebral aneurysms, and could be the basis for the prevention of subarachnoid hemorrhage.

The article presents the results of a pilot study of the relationship of quality of life (QOL) and clarity of self-concept among small in number people of the North. Low subjective evaluation of respondents’ of general health, vitality, characterizing the physical component of health was revealed. The study of psychological characteristics set average, close to the high, clarity of self-concept (58.8). Analysis of the relationship of quality of life and perceptions of respondents about themselves showed the presence of correlation between self-esteem and quality of life of clarity of self-concept. Respondents who had a high self-concept clarity had higher rates of physical, social functioning, evaluation of physical and psychological components of quality of life. The findings suggest the importance of considering QoL along with the psychological characteristics of small peoples of the North.

We report a patient with chronic inflammatory demyelinating polyneuropathy (CIDP) developed against hereditary motor‐sensory polyneuropathy (Charcot‐Marie‐Tooth disease type 1A). It is shown that the presence of chronic persistent herpes infection, stratifying on the mutation in the gene PMP22 (peripheral myelin protein), may lead to the development of autoimmune process, manifested demyelinating lesions of the peripheral nerves of the limbs and cranial nerves. CIDP – an autoimmune disease characterized by lesions of the myelin sheath of peripheral nerves, it accounts for about 20‐50% of undiagnosed polyneuropathy. The literature discusses the contribution of viruses of the family Herpes Viridae to the development of CIDP. Charcot‐Marie‐Tooth disease (CMT) – a large group of hereditary diseases of the nervous system characterized by chronic progressive weakness and atrophy of distal limb muscles, reduced tendon reflexes, foot deformities and hands, changes in gait and sensory impairments.

The authors have shown a clinical case of empyema with bronchopleural fistula. The successful implementation of collapse surgical intervention on the thorax to eliminate empyema cavity and further improvement of the patient at the ineffectiveness of classic minimally invasive surgical treatments is demonstrated.

The paper deals with the problem of forming healthy lifestyle. Thыe aim of the development and introduction of organizational and educational programs in activity of children’s medical organizations is a culture of healthy lifestyle. The purpose of the study is an analysis of the educational activity of consulting centre specialists of the polyclinic "Children’s city hospital"