Vol 22, No 4 (2017)

Introduction. HCV is the cause not only of cirrhosis, hepatocellular carcinoma, but also extrahepatic manifestations. Currently, HCV is considered as an independent risk factor for thyroid pathology. In recent years, the level of pathology of the thyroid gland in the Altai Territory has increased by 16.4 times, which determined the purpose of this study: to study the features of the thyroid status in patients with chronic hepatitis C (CHC) in the Altai Territory. Materials and methods. There was executed a prospective, dynamic clinical, laboratory and instrumental examination of 240 CHC patients (47,5% of men and 52,5% of women aged of from 18 to 50 years), 120 of whom had HCV (49,1% of men and 50,9% of women, aged of from 18 to 50 years, mean age: 41,1±9,91 years) who did not receive antiviral therapy (HTV), the pathology of the thyroid gland in them was established for the first time. The study included the assessment of the level of TSH, total and free T3, T4, antibodies to thyreperoxidase (APPO), ultrasound examination of the thyroid gland. The diagnosis of CHC is based on HCV RNA, anti-HCV (core, NS3-5), blood biochemistry, fibrosis level score according to Metavir (elastometry, PBP). Results of the study. In HCV patients there were revealed autoimmune thyroiditis (AIT) (5%), AIT with hypothyroidism (10%), AIT with latent hypothyroidism (8,3%), latent hypothyroidism (10%), hypothyroidism (16,6%), euthyroidism (49,1%) and thyrotoxicosis in only 1 patient. Variants of thyroid dysfunction were presented in the form of euthyroidism (60%), hypothyroidism (20%), hyperthyroidism (10%) and autoimmune thyroiditis (10%). The relationship between the development of the thyroid dysfunction (TD) and the history of the history of HCV infection has been established. Discussion and conclusions. CHC patients were more likely to have a history of euthyroidism and hypothyroidism. The relationship between TD and the duration of HCV infection can be regarded as its extrahepatic manifestation, and not as comorbid conditions. Thorough examination of the thyroid status it makes possible to identify TD people, which can be reflected in the choice of antiviral therapy and will determine the prognosis of the development of side effects.

The aim of the study is the improvement of the efficiency of IVF on the basis of the determination of immunological and infectious risk factors for miscarriage. The materials and methods. The object of research were 21 female infertility patients included in the program of ancillary reproductive technologies (ART) for the period of 2014-2016, who had in a history from one to four ineffective IVF response. The average age of studied women was 33.5±0.9 years, the number of years with infertility amounted to 7,3±1,0. In the preparation for IVF women received a complete course of general clinical examination to identify the causes of infertility. The study of the immune status was carried out with the use of one - and two-parameter phenotyping, the results included data obtained with the flow-through cytofluorometer BECKMAN COULTER EPICS XL-II (USA), treated according to standard protocols. The control group consisted of 30 fertile women. The results of the study. Infertility women planning IVF, were found to be characterized by presenting a combination of persistent opportunistic infections of herpes group: HSV and CMV. In the 90,5% of women there were identified various immunodeficiency states from both cellular and humoral immunity: the characteristic increase in the content of HLA-DR, a reduction in CD19+ cells. In primary infertility states changes in cellular immunity were more pronounced, additionally there was the decline in immunoregulatory index (IRI), the increase in the content of CD8+, CD25+, IgM. An imbalance of the immune system in women with persistence of several opportunistic infections was both more pronounced, than in cases with monoinfection and manifested by such abnormalities of cellular immunity as the gain in the content of CD8+, NK cells CD16+, CD56+, CD25+, a decline in IRI. The conclusion. In the course of the preparation for IVF in an examination mode of women with the primary infertility and the presence of markers of several opportunistic infections, it is advisable to include an evaluation of the immune status. The identification of secondary immune deficiency is an indication for inclusion of immunocorrective therapy in the comprehensive treatment.

The aim of this work was to genotype Vibrio cholerae strains, based on 9 INDEL-markers. We identified 26 genotypes in 223 strains studied. Based on the cluster analysis, all genotypes were grouped into 8 clusters. A geographic attachment to specific regions was characteristic for some of the clusters. Toxigenic strains formed a separate cluster and have genotypes different from atoxigenic strains. All strains V cholerae O1 Eltor, isolated from 1929 to 2014, had an identical genotype, different from the genotypes of V. cholerae O1 classical and V. cholerae O139. A loss of cholera toxin gene was shown to fail to give rise in the alteration of INDEL-genotype. This allows us recommend this genotyping method for the identification strains that had a cholera toxin gene in the past. Under annual isolation of strains of V. cholerae from environmental objects, their population was established to be particular due to a high level of genetic diversity. This makes it possible to propose the use of the diversity index as one of the criteria for the assessment of epidemiological risk.

This paper presents the authors’ opinion concerning such understudied issue of epizootology as the cause of the stability of the functioning of the natural focus of infection. The diversity of the biocenotic complex including main, secondary and casual carriers; numerous, small in number and rare vectors; strains with high virulence, low virulence and altered strains of the causative agent of infection, as well as population nonuniformity of biocenosis constituents contribute to the stability of the functioning of the natural focus in certain landscape-geographic conditions. The heterogeneity during the achievement of the abundance peak by various carrier and vector species also promotes to the stability. Universality of the principle of the proposition offered here for three- and two-component constituents of a natural focus of infection, as well as for infections caused by sapronotic pathogens, allows consider it as a biological law of the stable functioning of a natural focus of infection.

Diagnosis of Ixodes tick borreliosis (SDS) at an early stage of the disease is not perfect that creates problems in a timely diagnosis. This paper presents the results of a comparative analysis of the incidence rate of Ixodes tick borreliosis (CBI) in the Ulyanovsk region for the period 2002-2013; there is considered the pattern of mite species and the results of their research on Borrelia species (2011-2013).