The analysis of demographic indicators (population size, sex, age composition of the population, number of births and deaths, natural increase (decrease) in the population, migration growth of the population) in Perm and Perm Region (PR) for the period 1990 - 2016 Department of Population Censuses and Demographic Statistics of the Territorial Body of the Federal Service of State Statistics for PR (PERMSTAT).
In the Perm Region in 2013, and in Perm in 2012, an increase in the population was recorded, which indicates the end of the depopulation period that has been observed since the 1990s. XX century. The analyzed period in Perm and the PR is characterized by an increase in the birth rate and a decrease in mortality. However, the natural increase in the population remains insignificant.
The article gives a detailed description of the gender and age structure of the female population, which makes it possible to assess the reproductive potential of the region.
The revealed regularities and trends allow defining strategic directions for improving the medical and demographic situation in the Perm Region.

Aim. To carry out the qualitative analysis of metal implant, inserted into the bone, determine tactics for treatment of inflammatory process in the postoperative period of metallosteosynthesis.

Materials and methods. The treatment of 1325 patients with the developing posttraumatic osteomyelitis of the upper and lower extremities in the Department of Complicated Traumatology of City Clinical Hospital № 6 and traumatology departments of Perm for 10 years (2004–2014) was analyzed.

Results. Metallosis was observed in 227 (17.2 %) persons. Matallosis was manifested by suppuration and fistula formation in the region of screw 2–3 months after operative treatment of fracture in 177 (76.3 %) patients, and in 50 (27.7 %) patients – by acute purulent inflammatory process immediately after the surgery. In 34 (15 %) patients, computed tomography and MRI demonstrated metal bone impregnations. All these 227 (17.2 %) patients underwent elimination of metal constructions. The postoperative wounds after elimination of metal constructions healed primarily in 152 (66 %) patients. Secondary healing of the postoperative wounds was noted in 75 (44 %) persons. The long-term results were studied during 3 years in 189 (83 %) patients. The development of the postoperative osteomyelitic process, connected with late removal of metal construction, was registered in 8 (4.4 %) persons. False joint was formed in 1 (0.5 %) patient with tibial fracture. Positive long-term result was reached in 180 (95.2 %) persons.

Conclusions. Timely diagnosis, correctly chosen technique of treatment permit to provide full restoration of the structure and function, and obtain positive medical and social rehabilitation in this category of patients.

Aim. To estimate the opportunities of proton density-weighed magnetic resonance tomograms in diagnosis of microstructural changes of articular cartilage (AC) in osteoarthritis (OA) on the basis of proton density (PD) variability analyzed.

Materials and methods. Sixty two patients with OA and 8 volunteers without OA were examined. All the patients underwent MRI of the knee joints, using tomograph with magnetic field intensity equal to 1.5 tesla. To assess MR images, semiquantitative measurements of articular tissues on the basis of WORMS protocols were used. To estimate the proton density, manual segmentation of PDFS-weighed images of the knee joint medial condyle was implemented. The proton density was estimated, applying 3-D histogram (0–255).

Results. At stage I of osteoarthritis, fall in density H⁺ in the peripheral zone of AC was observed, but it was preserved in the contact part, exposed to maximum statodynamic loadings. At stage II, significant progressing decrease in H⁺ density peaks in the AC regions, subjected to lesser loads, with preservation of high spectral peaks in the region of elevated friction was stated. Stage III of gonarthrosis was characterized by decrease in H⁺-spectra as a whole, especially in the loading regions of AC. At stage IV of OA, global reduction in PD intensity was observed along the whole cartilaginous plate surface.

Conclusions. The detected patterns of changes in proton density spectra reflect the known degenerative process in AC with osteoarthritis. This property of proton-weight MR-images can be used for assessment of microstructural changes in the articular cartilage with OA.

Aim. To assess the influence of changes, observed in men and women with type 1and 2 diabetes mellitus (DM1, DM2) on the state of bone metabolism markers; to determine the directions of changes in bone remodeling serum markers among patients of both genders, suffering from this disease.

Materials and methods. The cross-sectional study of patients, diagnosed DM1 (n = 98) and DM2 (n = 137) was conducted; the control group included 82 persons. In all patients, calciotropic hormones, the serum markers of bone remodeling, were studied.

Results. The obtained results, regarding assessment of bone metabolism markers content in blood of DM1 and DM2 patients compared to the control, indicated the presence of pathological changes in bone remodeling processes in the form of decrease in osteogenesis marker PINP for patients with DM1 by 16 %, DM 2 – by 12 %, compared with the control group, and increase in bone resorption marker b-CTx in 32 % of patients with DM1 and 25 % with DM2; inconsistency of changes in bone remodeling processes in DM1 patients, with preferential alterations of bone resorption indices, was determined in 28 % of cases. Patients with DM2 had lower PINP and b-CTx levels that reflects the lower bone tissue metabolism, compared to DM1 patients, irrespective of age and duration of disease.

Conclusions. The bone mass loss in the majority of the examined patients with diabetes is connected with suppression of osteogenesis and to a significantly lesser extent – with bone tissue resorption. Bone remodeling marker values in patients with DM2 are lower than with DM1. Such factors as glycemic profile compensation, duration of diabetes and presence of diabetic nephropathy are able to influence bone metabolism.

Aim. To study the biomechanical peculiarities of orthopedic disorders in patients after cerebral stroke and estimate possibilities for their correction.

Materials and methods. One hundred and thirty two persons in the late rehabilitation period after the cerebral stroke were examined. The state of loco-motor system biomechanics was assessed, using the rehabilitation complexes “TRUST-M” and “ST-150”.

Results. The late rehabilitation period of stroke was characterized by decrease in walking rate and time, rise in step cycle. Speed of movement was disturbed. Combined pain, spasticity, contracture and functional asymmetry of the extremities length determined the formation of individual variant of patient’s pathological locomotor stereotype. When implementing correlation analysis, marked correlation between the severity of orthopedic disorders and the asymmetry of pelvis and extremities length was detected. To correct biomechanical disorders, it was recommended to use complex orthopedic treatment by means of prosthetic-orthopedic devices, which permitted to move and provided stable holding of extremity segments in the desired position.

Conclusion. 1. Biomechanical indices characterize the severity of orthopedic pathology in the late rehabilitation period following cerebral stroke. 2. Biomechanical disorders are connected with decreased walking rate and time, raised step cycle, impaired speed of movement. 3. Timely biomechanical orthopedic diagnosis and adequacy of applying prosthetic-orthopedic devices guarantee efficiency of rehabilitation measures in patients after cerebral stroke.

Aim. To estimate the statistical indices of informative value of clinical McIsaac scale at the example of scarlatina in children.

Materials and methods. Retrospective cliniсostatistical analysis was carried out on the basis of 30 medical cards of children, hospitalized to children’s unit of Perm Regional Clinical Infectious Hospital in 2017 with diagnosis of scarlatina. The control group consisted of 25 children with moderately severe tonsillopharyngitis.

Results. Clinical peculiar features of scarlatina were studied in 30 children, hospitalized to children’s infectious unit in 2017. Nowadays, scarlatina was revealed to have a typical course with characteristic clinical symptoms, including punctate rash, intoxication with increased temperature up to 38–39, acute tonsillitis, absence of cough in the acute period, moderate regional lymphadenitis. At the hospital stage, there predominate moderately severe forms of this disease. Bacteriological verification of Streptococcus pyogenes (at admittance to the hospital) in the investigated group was 74 %. Typical punctate rash remains the basic clinical symptom of scarlatina. Informative value of McIsaac scale for diagnosis of BHSA-tonsillitis with scarlatina infection was assessed. Specificity of assessment was 92 %.

Conclusions. Clinicodiagnostic McIsaac scale is highly informative for diagnosis of BHSA-tonsillitis among children.

Aim. To study the dynamics of lung cancer (LC) morbidity among the population of five cities of the Republic of Bashkortostan over the period from 2010 to 2016 and the structure of industrial emissions for grounding of adequate integral index, connected with LC morbidity and development of preventive measures to decrease malignant neoplasms.

Materials and methods. The structure of gross emissions of industrial enterprises and ecologohygienic assessment of atmospheric air was conducted according to the materials of the Department of Rospotrebnadzor in Bashkortostan for 2010–2016. Lung cancer morbidity in the above mentioned territories was studied by the materials of Republican Clinical Oncological Dispensary. To estimate the influence of gross emissions on LC morbidity, modeling technique, adequate to panel analysis of spatially dynamic structural data, was applied.

Results. The assessment of carcinogenic risk of atmospheric air emissions, taking into account not separate carcinogens, but their combined effect as substances with similarly directed impact, detected accurate correlation of dependence of high LC morbidity on the resultant carcinogens action.

Conclusions. High LC morbidity in the cities of Bashkortostan is connected with high gross emission of carcinogens into the atmospheric air. Information on gross emissions of carcinogens and their structure can serve as an integral criterion of atmospheric pollution impact on lung cancer morbidity.

Aim. To estimate the dynamics of the main demographic indices (population, gender and age composition of population, number of born and dead, natural population increase (loss), migration growth of population) in Perm and Perm Krai (PK) over the period of 1990–2016.

Materials and methods. The data, presented by the department of population census and demographic statistics of Territorial Board of the Federal Service for State Statistics in PK (Permstat) were analyzed.

Results. In Perm Krai – in 2013 and in Perm – in 2012, there was registered increase in the population, confirming the end of depopulation period, observed since the nineties of the XX century. The analyzed period is characterized by growth in birth rate and fall in death rate in Perm and Perm Krai. However, the natural population increase remains insignificant. The detailed characteristic of gender and age structure is presented in the paper; it permits to assess the reproductive potential of the region.

Conclusions. The detected tendencies make it possible to determine the strategic directions for improvement of medicodemographic situation in Perm Krai.

Aim. To determine the structure of functional disorders and their dynamic changes in children with congenital cleft lip and palate from the position of International Classification of Functioning.

Materials and methods. The indices, included into International Classification of Functioning, were assessed in 77 children (age range 1 to 6 years) with congenital cleft lip and palate, who received a complex five-stage therapy.

Results. Direct correlation between the type of cleft and the value of disorders in classification constituents “function” and “structure” was revealed. Thus, in patients with bilateral cleft lip and palate, disorders of functions reached 82 %, in children with one-sided cleft lip and palate – 45 %. In children of group I, more marked structural disorders were observed, forming from 24 to 96 %, in children of groups 2 and 3 – from 5 to 49 %. In children with bilateral cleft lip and palate, there were observed more marked abnormalities in the category “activity and participation” (25–95 %) compared to children of groups 2 and 3 (0–24 %).

Conclusions. Application of International Classification of Functioning for children with congenital cleft lip and palate shows a wide range of the assessed functional disorders and the possibility of using it for dynamic analysis of efficiency and treatment.

Aim. To establish the structural changes in the prostate of reproductive experimental animals in conditions of long immunosuppression.

Materials and methods. Sixty white rats of reproductive age were studied. The state of immunosuppression was modeled with intramuscular introduction of cyclophosphamide in the dose of 1.5 mg/kg of the body mass during 10 days. Linear sizes and volume of the organ were determined. At the microscopic level, height and width of epithelial cells, their volume as well as large and small diameters and cell nuclei volumes were determined.

Results. In response to long immunosuppressive impact, organometric indices of the prostate both in the early (on days 7, 15) and late (on day 30) observation periods decreased owing to indirect cytotoxic impact of cyclophosphamide on the glandular and stromal components of the organ.

Conclusions. The decreased values of linear-volumetric micromorphometric indices within the same observation periods confirm the dynamics of organometric parameters of the gland and prove intensive response of the organ at micro-and-submicroscopic level.

The paper presents the clinical case of a 28-year-old patient, diagnosed noncompact myocardium of the left ventricle. The disease debuted from heart rate disturbance; Lown’s grade 4B ventricular premature beats were revealed according to the results of durable electrocardiogram monitoring. In echocardiography, significant decrease in the left ventricular ejection fraction was stated. After magnetic resonance imaging of the heart, the presence of two layers of myocardium, compact and noncompact with the latter exceeding the compact layer more than twofold was diagnosed. The patient underwent slow titration of the dose of angiotensin-converting enzyme inhibitors up to the maximum under the arterial pressure control. The following recommendations were given: anticoagulants for primary prevention of thromboembolic complications, planned implantation of a two-chamber artificial cardioaverter-defibrillator for primary prevention of sudden heart death.

Monocytic chemotactic protein-1-cytokin, attributed to the group of chemokins, is the most powerful factor of monocyte chemotaxis in the body of mammalians as well as memory T-cells and dendrite cells to inflammatory foci and is produced upon tissue damages or infection introduced. MCP-1 is mainly secreted by monocytes, macrophages and dendrite cells. Clinical significance of MCP-1 consists in participation of some diseases in pathogenesis: psoriasis, rheumatoid arthritis, atherosclerosis. MCP-1 is involved into the processes of developing central nervous system diseases, which are characterized by neuronal degeneration. Besides, this cytokine plays a significant role in vascular complications of type 2 diabetes mellitus and formation of obesity insulin resistance.