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Inflammatory process is at the heart of artificial (artificial) purulent-inflammatory diseases of soft tissues (APDST), which may lead to the development of phlegmon and abscesses at the site of invasion within a three-day period. The study of the cytokine status of rats with APDST allows us to evaluate the dynamics of inflammation markers and assess the peculiarities of the pathological course in artificial model of inflammation. The experiment was carried out on 126 white Wistar rats divided into 3 groups: (1) the main group (n = 57), where the laboratory model of APDST was used; (2) a comparison group (n = 58), in which the rats were injected with a mixture of opportunistic bacterial strains isolated from pure cultures of human oral fluid, i.e., S. epidermidis, S. mitis, S. salivarius at the titer of 9lg (CFU) per 1 ml injected together with a mixture of 2.5% hydrocortisone acetate emulsion (20 mg per 100 g of animal body weight), and dexamethasone solution at the dose of 0.5 mg; (3) control group (n = 11), where the animals were injected with 0.9% sodium chloride solution in a volume of 0.3 ml, together with a mixture of 2.5% hydrocortisone acetate emulsion at the rate of 20 mg per 100 g of body weight, and dexamethasone solution at the dose of 0.5 mg. Blood cells were studied using the Mindray DC-2800 Vet Auto Hematology Analyzer automated rat blood test system. The dynamics of pro-inflammatory cytokines: tumor necrosis factor (TNF), interleukin-1β (IL-1β), interleukin-6 (IL-6), antiinflammatory cytokines: interleukin-4 (IL-4), interleukin-10 (IL-10) was assessed by enzyme immunoassay. To predict the course of inflammation towards complications, or resolution of the inflammatory process, the ratio of pro-inflammatory to anti-inflammatory cytokines was used, with normal ratio considered an estimated average of the cytokine ratio for the control group. When analyzing results of this experimental study, the nature of cellular inflammatory response was assessed in dynamics, and its relationship with inflammation markers was determined. All animals of the main group developed soft tissue phlegmon within 3 to 7 days from the beginning of the experiment, and their mortality rate was 100%. In comparison group, the abscesses developed in 82.8% of cases on the day 12 to 15 from the start of the experiment, without any deaths observed. The ratio of pro- and anti-inflammatory cytokines in the main group increased 8-fold already by the end of the 1st day, the comparison group was characterized by the absence of significant differences from the control group. The highest levels of pro-inflammatory cytokines were recorded in the main experimental group on the days 12 to 15.

The aim of the research was to study plasmids 2.3 MDa (3609 bp) and their distribution in Salmonella Enteritidis strains isolated from various environmental sources at different times on the territory of the Russian Federation. Material and methods. A PCR typing of 33 S. Enteritidis strains, isolated for the period from 1995 to 2017, containing plasmid 2.3 MDa described earlier in microbe strains has been carried out. Results and discussion. The plasmid was firstly sequenced by us. Its relatedness to plasmid in GenBank from the strain of S. Typhimurium CFSAN001921 described in the United States has been revealed. It has been established that plasmid p2.3 presents within 23 years in S. Enteritidis strains isolated from patients and food at administrative territories of majority of the Russian Federation subjects. In addition, it has been shown that plasmid p2.3 can be heterogeneous in nucleotide composition. Conclusion. Considering the fact that plasmid p2.3 was isolated from patients in the USA, and strains we investigated were from patients and food in Russia, it can be assumed that the distribution area of the plasmid has a transcontinental nature.

Since the mid-20th century, dissociative identity disorder (DID) has been one of the most exciting subject-matters in American popular fiction. Sh. Jackson’ The Bird’s Nest (1954) and C. Thigpen & H. Cleckley’s The Three Faces of Eve (1957) marked the first peak of popularity of ‘multiple personality’ texts. However, it was only after R. Bloch’s Psycho (1959), that split personality became firmly connected to child sexual abuse. Split Consciousness Novel became formulaic after F. Schreiber’s Sybil (1973), where the protagonist’s ego-states further multiplied. Its publication in 1973 marked the second peak of the popularity of the genre. Moreover, it triggered the public imagination bringing about the DID epidemics, possibly hysterical, and heated discussions concerning the validity of this diagnosis. Split Consciousness Novel highlights the paradoxes of psychotherapy and communication at large. The authors of the essay deconstruct The Minds of Billy Milligan in detail since it problematizes psychic disease as ethical paradox.

Introduction A scientifically-based knowledge on the incidence, dynamics of detection and structure of congenital malformations of the musculoskeletal system (CMMS) has both practical and scientific significance. For many years, the Turner Institute has close scientific and practical ties with the state public health institution "Diagnostic Medical and Genetic Center" of St. Petersburg which carries out a regional monitoring of congenital disorders in St.Petersburg. Our objective was to present regional statistical data on the CMMS detection and structure in newborns and children of the first and second years of life, morbidity and disability in children aged 0-17 years in connection with congenital malformations of the musculoskeletal system, to study the proportion of CMMS patients in the orthopedic clinic and their need for surgical, including high-tech, treatment, and dispensary follow-ups in outpatient orthopaedic settings. Material and methods Regional statistics of St. Petersburg on prevalence, dynamics and structure of congenital malformations of the musculoskeletal system in children born in St. Petersburg in 2001–2015 were analyzed. The statistical data on the prevalence of congenital malformations of the musculoskeletal system in children aged 0–17 years in St. Petersburg were studied. Based on the studies conducted at the Turner Institute in 2014–2016, the proportion of patients treated for congenital malformations of the musculoskeletal system was revealed as well as their need for surgical treatment. Peculiarities of dispensary follow-ups of CMMS patients at orthopedic consultations of children's clinics of St. Petersburg were analyzed. Results and discussion The prevalence and structure of congenital malformations of the musculoskeletal system in 783,000 children born in St. Petersburg in the period of 2001–2015 are presented in accordance with blocks Q65–Q79 of ICD-10. Diagnostic results of congenital malformations of the musculoskeletal system in newborns (2.70 ‰) and in children of the same group until they reached three years of age (4.21 ‰) were studied in dynamics. Infacnts and children up to 17 years old with congenital malformations of the musculoskeletal system are under regular supervision of orthopedic surgeons. Disability due to congenital anomalies and malformations takes the third place among all the diseases detected in patients aged 0-17 years, established by pediatric medical and social expert boards of St. Petersburg. At the clinic of the Turner Institute, the proportion of patients with CMMS among all admitted patients was 38.6 %. Among them, 78 % of patients with CMMS received surgical treatment, of which 80 % of operations were performed using high technologies. Conclusions Statistics on congenital malformations of the musculoskeletal system in newborns and children under 3 years old and a high level of their disability shows the need in a specialized care for these children, including high-tech surgical treatment.

The article presents the data of international registries and cohort studies of systemic lupus erythematosus (SLE). It justifies the purpose and objectives of the international registry of SLE patients, a Eurasian cohort (RENAISSANCE), which was launched in 2012 and amalgamated the leading rheumatology centers of the Russian Federation (V.A. Nasonova Research Institute of Rheumatology; Department of Rheumatology, Pacific State Medical University), Kazakhstan (Department of Rheumatology, S.D. Asfendiyarov Kazakh National Medical University), and Kyrgyzstan (Academician M. Mirrakhimov National Center for Cardiology and Therapy), which mainly concentrate patients with the acute course of this disease. The first data of the registry are given.

Objective: to reveal irreversible organ damages and to establish factors that influence their development in a RENAISSANCE cohort of patients with systemic lupus erythematosus (SLE) admitted to the clinic of the V.A. Nasonova Research Institute of Rheumatology in the period 2012 to 2014.Subjects and methods. The investigation enrolled 231 young (mean age, 34.91±11.10 years) patients (209 women and 22 men) with a mean SLE duration of 107.65±97.36 months. On admission of the patients, the investigators collected history data (disease duration, the number of exacerbations and hospitalizations during the follow-up period), assessed current disease activity by SLEDAI-2K, irreversible organ damages by SLICC damage index (DI), and the therapy performed.Results and discussion. Irreversible organ damages were absent in 95 (41%) patients; one or more damages associated with both disease itself and the therapy were observed in the other (59%) patients. There were low (1), mean (2–4), and high (>4) SLICC DI values in 64 (28%), 62 (27%), and 11 (5%) patients, respectively. Ocular lesions were most common (35%); a significant proportion of patients were found to have damages to the cardiovascular (22%), musculoskeletal (19%), and nervous (10%) systems. Lung disease, diabetes mellitus, and cancer were less prevalent (6.0, 3.4, and 1.3%, respectively). The patients with damages were significantly older (p = 0.02), had a longer disease duration (p = 0.0005) and more frequent SLE exacerbations and hospitalizations (p = 0.0003 and p = 0.001, respectively). The patients with DI ≥1 received glucocorticoids (GCs) longer (p = 0.001). At the onset of SLE they had significantly higher doses of GCs (mean 44.06±18.97 mg) than those without damages (35.91±20.12 mg; р = 0.002). DI correlated with GC doses at the onset of the disease, duration of GC use, number of hospitalizations and exacerbations. There was also a statistically significant correlation of overall SLICC DI with the duration of disease (r = 0.23) and the total dose of cyclophosphamide (CP) (r = 0.19).Conclusion. Irreversible organ damages are present in 59 patients in the RENAISSANCE cohort. Older individuals develop a larger number of damages, with higher frequency of exacerbations and hospitalizations, longer use of GCs, and higher cumulative dose of CP. DI correlates with the dose of GC and does not depend on the activity and clinical manifestations of SLE at its onset.

The long-term Mycobacterium tuberculosis drug resistance monitoring data were obtained in St. Petersburg Research Institute Phthisiopulmonology for four periods of observation (I — 1984–1988 years, start period; II — 1996–2000 years, the period of acute epidemic situation and the sharp rise in drug resistance; III — 2007–2011 years, the period of relative stabilization; IV — 2012–2014 years, the final period). Totally 2267 strains from patients with pulmonary tuberculosis, treated previously and with chronic process, and 691 strains from patients with extrapulmonary tuberculosis were studied. Researches of drug resistance were made by indirect method of absolute concentrations in the medium Lowenstein–Jensen and in the automated system ВАСТЕС™ MGIT™ 960 (Becton Dickinson, USA). It shows a steady increase of the overall drug resistance, which has reached in the last three years 90.1% in pulmonary tuberculosis. At the same time there was a sharp worsening of the structure of drug resistance due to the growth of multidrug (MDR) and extensively drug-resistant (XDR), which by 2014 accounted for 81.9 vs 28.5% in 1984–1988. In extrapulmonary tuberculosis the growth of drug resistance of Mycobacterium tuberculosis continues to outpace: overall drug resistance increased from 39.4% (1984–1988) to 80.2% (2012–2014), reaching figures that are comparable to those of pulmonary tuberculosis. At the same time there was an even more rapid change for the worse of its structure due to the increase of MDR/XDR strains: from 10.5% in the first period to 69.5% in the fourth. This is due to the more frequency of existing in locus of extrapulmonary tuberculosis of highly adaptive multiresistant strains of genotype Beijing: in tuberculous spondylitis, which is the most severe and frequent form of osteoarticular tuberculosis, 70 of the 78 (89.7%) Mycobacterium tuberculosis isolates with MDR/XDR belong to this genotype. In pulmonary tuberculosis the XDR growth rate exceed those in extrapulmonary tuberculosis: from 26.8% (III period) to 39.5% (IV period) and, accordingly, from 8.0 to 8.6%. The situation with drug resistance in all localizations of the disease may be characterized as extremely tense, which can lead to unpredictable consequences, if promptly one not take appropriate measures.

The paper presents a literature review demonstrating the importance of using the damage index (DI) for the comprehensive evaluation of the degree of irreversible organ changes in patients with systemic lupus erythematosus (SLE). The need and prerequisites for creating this reliable tool developed by the Systemic Lupus International Collaborating Clinics (SLICC) Group in 1996 have been substantiated. The emergence of DI is emphasized to be associated with higher survivals in patients with SLE in the past decades and with an increase of their irreversible organ damages that were a consequence of both disease activity and performed therapy. Particular attention is given to the explanation for a possibility of using DI not only to estimate the degree of irreversible organ damages in a specific patient, but also to choose more adequate therapy. According to the guidelines of the US Food and Drug Administration (FDA) and the European League Against Rheumatism (EULAR), DI along with activity indices (SLEDAI, BILAG) is indicated to be included in the comprehensive assessment of performed therapy in patients with SLE.

The clinical and radiographic manifestations of maturity-onset tuberculous spondylitis were analyzed in 107 patients. If Mycobacterium tuberculosis (MBT) is drug resistant, the extent and degree of spinal bone destruction, the extent of abscess formation, and the rate of neurological disorders are greater than those in the MBT drug sensitivity group; however, the significant difference concerns only the involvement of vertebral arches in destruction. The pattern and activity of a tuberculous process in the lung and the proportion of bacteria-excreting persons with drug resistance in MBT significantly exceed those with drug sensitivity. All the patients were operated on; the diagnosis was histologically verified in 100% of cases; the postoperative specimens exhibited MBT culture in 72.9%; the polymerase chain reaction was positive n 98.9%. Bacteriological and molecular genetic studies established multiple drug resistance in 73.4%, polyresistance in 17.3%, and monoresistance in 9.3%.

Thirty-five case histories were analyzed in patients with tuberculous spondylitis (TS) in the presence of HIV infection. The peculiarity of TS in HIV-infected patients is a preponderance of the disseminated and multiple forms of spinal lesion. The patients of this category versus those without HIV infection also tended to have a higher rate of significant neurological disorders (types A-C by the ASIA scale, 1992). With drastically suppressed immunity, the patients with TS and HIV infection (blood CD4+ levels of less than 200 cells/µl of blood) had the disseminated forms significantly more frequently (χ2 = 1.480; p = 0.089) and cases of multiple locations (χ2 = 4.174; p = 0.124) in the vertebral column.

Colloid-chemical properties of surface active substances of different nature on the boundary of styrene/water, isoprene/water, mixture of styrene and isoprene/water are discussed. It was shown that the mechanism of creation polymer-monomer particles are depending from composition of emulsion

The properties of butadiene-styrene latexes, stabylized by the mixes of surface-active substances included silicon SAS, practically unsolved in water, were investigated. It was shown that they are characterized by low foaming, practically unswollen in water and stable in the solutions of electrolites

Mixing an alcoholic extract of propolis with distilled water or aqueous solution, which model seawater composition, give rise to aqueous dispersions with or without emulsifier. High dispersion stability is attained at hydrophylic-lipophylic balance equaled 13.9 using sorbitan oleate and polyoxyethylene sorbitan monooleate (Polysorbate-80) as a binary emulsifier. The initial particle size of dispersions is almost identical regardless of the presence of the emulsifier or water salinity. However, in the latter case a dispersion with essentially narrow size distribution is formed and, as a result, the dispersion is more resistant to coagulation and phase separation. Apparently, the main contribution to the stability of the aqueous propolis dispersion is made by the structural-mechanical barrier, which is formed by a thick adsorption layer of the hydrated nonionic surfactant.