37 research outputs found
Comparison of Certain Results of Simultaneous Measurements of Solar Wind Characteristics on Spacecrafts ''Venera-3'' and ''Pioneer-6''
Ion concentration, ion velocity, and other solar wind characteristics measured simultaneously aboard spacecraf
DIAGNOSTIC EFFICACY OF C-REACTIVE PROTEIN AND IL-6 AS MARKERS OF SYSTEMIC INFLAMMATION
Currently, despite widespread use of the terms βsystemic inflammationβ (SI) and βsystemic inflammatory responseβ (SIR), there are no generally accepted criteria for their verification. These processes are often identified (which is methodologically incorrect) and associated with an increase in pro-inflammatory mediators in the blood. However, SI is a complex process that requires integral criteria including assessment of SIR as reactivity level, and additional SI phenomena, such as microthrombosis, systemic alteration, and distress of the neuroendocrine system. At the same time, there is a need to assess individual CB indicators as a more affordable alternative for medical practice than the use of complex integral indicators. Our objective was to evaluate diagnostic efficacy of CRP and IL-6 levels as markers of acute and chronic systemic inflammation. The data of patients with acute critical conditions of infectious and non-infectious genesis were analyzed to study acute systemic inflammation (SI), data of patients with autoimmune diseases, chronic organ failure and other chronic destructive diseases were analyzed to study chronic systemic inflammation (ChrSI). SIR severity was evaluated by the calculation of an integral index β reactivity level (RL). Differentiation of the inflammatory process to either classical inflammation (CI), or systemic inflammation was carried out using the previously proposed scale of SI, verification of chronic systemic inflammation was performed by means of ChrSI scale. SI (or ChrSI) was revealed in all groups of patients, and the frequency of SI registration in patients with acute conditions increased with development of multi-organ failure. The frequency of SIR was higher in all groups, thus confirming inability to equate these disorders. ROC analysis showed that CRP level had poor diagnostic efficacy on the development of SI/ChrSI (AUC < 0.6), and IL-6 level had very good diagnostic value (AUC 0.8-0.9). The prognostic value of the markers for detecting the SIR was higher, with AUCIL-6 exceeding AUCCRP. Thus, IL-6 in many acute and chronic pathologies is sufficiently closer to integral indices than C-reactive protein with respect to diagnostic efficiency, and the dynamics of IL-6 in blood may be used to predict and evaluate complications associated with acute and chronic SI, as well as to prescribe and monitor the results of anticytokine therapy. Β© 2022, Π ΠΠΠ
Π§Π΅ΡΠ΅ΠΏΠ½ΠΎ-ΠΌΠΎΠ·Π³ΠΎΠ²Π°Ρ ΡΡΠ°Π²ΠΌΠ° ΠΈ Π½Π΅ΠΉΡΠΎΠ²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΠ΅: ΠΎΠ±Π·ΠΎΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ²
Traumatic brain injury is one of the main causes of both acute and long-term morbidity that concern that affects individuals in all demographics. The processes that occur during traumatic brain injury and neuroinflammation cannot be fully explained in most clinical and preclinical researches. Neuroinflammation is a very complex interaction between the cells of the innate and adaptive immune systems. The development of reactions of the innate immune system occurs under the influence of various signals that are released from damaged cells and tissues. This leads to the activation of neutrophils, microglia and astrocytes, the release of complement, as well as the release of histamine by mast cells. Subsequently, activation of an adaptive immune response leads to the development of later effects of neuroinflammation. The topic of biomarkers in traumatic brain injury is extensive and rapidly developing. We presented an overview of the most common and well-studied biomarkers in the literature regarding head injury in humans and their role in predicting the outcome in traumatic brain injury. Among the presented biomarkers, the most specific for traumatic brain injury are interleukins-6, -8, -10 and matrix metalloproteinases. We can use interleukin-6 to predict the outcome and risk of complications of traumatic brain injury. The concentration of interleukin-8 shows the relationship of the biomarker with mortality. We can use interleukin-10 to confirm the results of computed tomography in traumatic brain injury. Matrix metalloproteinases present the degree of violation of the blood-brain barrier and brain dysfunction. Other indicators need a more complete study to clarify their role in this pathology. Of course, for a more reliable conclusion about the patient's condition, it is preferable to use the data of several biomarkers at the same time. Β© 2012 Scientific Centre for Family Health and Human Reproduction Problems. All Rights Reserved
ΠΠΎΠ²ΡΠ΅ ΡΠΎΡΠΌΡ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Π²ΡΠ΅Π·Π΄Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΆΠΈΡΠ΅Π»ΡΠΌ ΡΠ΅Π²Π΅ΡΠ½ΡΡ ΡΠ°ΠΉΠΎΠ½ΠΎΠ² Π‘ΠΈΠ±ΠΈΡΠΈ
Alongside with economic problems of development of North the important place is borrowed by a problem of guarding of health of the population. The population of Boreal districts of Siberia is subject to effect of a lot of the unfavorable factors both connatural (climatic conditions), and anthropogenic (ecological trouble) character. A corollary it is the high level of a case rate, violation on the part of cardiovascular, nervous and other systems of an organism. The inhabitants of boreal districts, workers of oil-extracting branch are bunch of the boosted risk on creation of a pathology of organs of a circulation and endocrine system. The data quota needs a regular control of a state of health and opportune rendering of a medical care in amplate volume. The optimal form of organization of a medical care to the population of Boreal districts is the direction of exit medical crews in items of their residing. Such form of work is economically favourable and at the least expenditures allows to reach appreciable social and medico-sanitary effect.ΠΠ°ΡΡΠ΄Ρ Ρ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π‘Π΅Π²Π΅ΡΠ° Π²Π°ΠΆΠ½ΠΎΠ΅ ΠΌΠ΅ΡΡΠΎ Π·Π°Π½ΠΈΠΌΠ°Π΅Ρ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ° ΠΎΡ
ΡΠ°Π½Ρ Π·Π΄ΠΎΡΠΎΠ²ΡΡ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ. ΠΠ°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ ΡΠ΅Π²Π΅ΡΠ½ΡΡ
ΡΠ°ΠΉΠΎΠ½ΠΎΠ² Π‘ΠΈΠ±ΠΈΡΠΈ ΠΏΠΎΠ΄Π²Π΅ΡΠΆΠ΅Π½ΠΎ Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΡ ΡΠ΅Π»ΠΎΠ³ΠΎ ΡΡΠ΄Π° Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΊΠ°ΠΊ ΠΏΡΠΈΡΠΎΠ΄Π½ΠΎΠ³ΠΎ (ΠΊΠ»ΠΈΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΠ»ΠΎΠ²ΠΈΡ), ΡΠ°ΠΊ ΠΈ Π°Π½ΡΡΠΎΠΏΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ (ΡΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΠΎΠ»ΡΡΠΈΠ΅) Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ°. Π‘Π»Π΅Π΄ΡΡΠ²ΠΈΠ΅ΠΌ ΡΡΠΎΠ³ΠΎ ΡΠ²Π»ΡΠ΅ΡΡΡ Π²ΡΡΠΎΠΊΠΈΠΉ ΡΡΠΎΠ²Π΅Π½Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ, Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΡΠΎ ΡΡΠΎΡΠΎΠ½Ρ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ, Π½Π΅ΡΠ²Π½ΠΎΠΉ ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΡΠΈΡΡΠ΅ΠΌ ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ°. ΠΠΈΡΠ΅Π»ΠΈ ΡΠ΅Π²Π΅ΡΠ½ΡΡ
ΡΠ°ΠΉΠΎΠ½ΠΎΠ², ΡΠ°Π±ΠΎΡΠ½ΠΈΠΊΠΈ Π½Π΅ΡΡΠ΅Π΄ΠΎΠ±ΡΠ²Π°ΡΡΠ΅ΠΉ ΠΎΡΡΠ°ΡΠ»ΠΈ ΡΠ²Π»ΡΡΡΡΡ Π³ΡΡΠΏΠΏΠΎΠΉ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° ΠΏΠΎ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΎΡΠ³Π°Π½ΠΎΠ² ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ. ΠΠ°Π½Π½ΡΠΉ ΠΊΠΎΠ½ΡΠΈΠ½Π³Π΅Π½Ρ Π½ΡΠΆΠ΄Π°Π΅ΡΡΡ Π² ΡΠ΅Π³ΡΠ»ΡΡΠ½ΠΎΠΌ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π·Π΄ΠΎΡΠΎΠ²ΡΡ (ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠΌΠΎΡΡΠ°Ρ
) ΠΈ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌ ΠΎΠΊΠ°Π·Π°Π½ΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π² ΡΠ°ΡΡΠΈΡΠ΅Π½Π½ΠΎΠΌ ΠΎΠ±ΡΠ΅ΠΌΠ΅. ΠΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΎΡΠΌΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΡΠ΅Π²Π΅ΡΠ½ΡΡ
ΡΠ°ΠΉΠΎΠ½ΠΎΠ² ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ Π²ΡΠ΅Π·Π΄Π½ΡΡ
Π²ΡΠ°ΡΠ΅Π±Π½ΡΡ
Π±ΡΠΈΠ³Π°Π΄ Π² ΠΏΡΠ½ΠΊΡΡ ΠΏΡΠΎΠΆΠΈΠ²Π°Π½ΠΈΡ. Π’Π°ΠΊΠ°Ρ ΡΠΎΡΠΌΠ° ΡΠ°Π±ΠΎΡΡ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈ Π²ΡΠ³ΠΎΠ΄Π½Π° ΠΈ ΠΏΡΠΈ Π½Π°ΠΈΠΌΠ΅Π½ΡΡΠΈΡ
Π·Π°ΡΡΠ°ΡΠ°Ρ
ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π΄ΠΎΡΡΠΈΡΡ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠ°Π½ΠΈΡΠ°ΡΠ½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΠΊΡΠ°
Clinical observation of application of power kinesitherapy method in treating pain syndromes of the lumbar spine
The most vulnerable to develop diseases and back pain, congestion intervertebral disc is the lumbar spine. Low back pain is the most common complaint. Thus at 10 - 20% of patients in the acute pain chronic transformed. Chronic low back pain is an important public health problem with a significant social and economic impact involving substantial direct and indirect costs. The use of methods of physical rehabilitation - one of the main directions of pathogenetic treatment of this disease. The effectiveness of the method of power kinesitherapy treatment of pain of the lumbar spine.ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΠ·Π²ΠΈΠΌΡΠΌ ΠΏΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΈ Π±ΠΎΠ»Π΅ΠΉ Π² ΡΠΏΠΈΠ½Π΅, Ρ ΠΏΠ΅ΡΠ΅Π³ΡΡΠ·ΠΊΠ°ΠΌΠΈ ΠΌΠ΅ΠΆΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ²ΡΡ
Π΄ΠΈΡΠΊΠΎΠ² ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΠΉ ΠΎΡΠ΄Π΅Π» ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ°. ΠΠΎΠ»Ρ Π² ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠΌ ΠΎΡΠ΄Π΅Π»Π΅ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΠΉ ΠΆΠ°Π»ΠΎΠ±ΠΎΠΉ. ΠΡΠΈ ΡΡΠΎΠΌ Ρ 10 - 20 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΡΡΡΠ°Ρ Π±ΠΎΠ»Ρ ΡΡΠ°Π½ΡΡΠΎΡΠΌΠΈΡΡΠ΅ΡΡΡ Π² Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΡΡ. Π₯ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»Ρ Π² ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠΌ ΠΎΡΠ΄Π΅Π»Π΅ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΡΠ²Π»ΡΠ΅ΡΡΡ Π²Π°ΠΆΠ½ΠΎΠΉ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠΎΠΉ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΡΠΎ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΡΠ°ΡΡ
ΠΎΠ΄Π°ΠΌΠΈ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΡΠΈΠ·ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΈ - ΠΎΠ΄Π½ΠΎ ΠΈΠ· Π³Π»Π°Π²Π½ΡΡ
Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΉ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄Π°Π½Π½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. ΠΠΎΠΊΠ°Π·Π°Π½Π° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΌΠ΅ΡΠΎΠ΄Π° ΡΠΈΠ»ΠΎΠ²ΠΎΠΉ ΠΊΠΈΠ½Π΅Π·ΠΈΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»Π΅Π²ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ°
The opportunities of early drug resistanceβs establishment of M.tuberculosis clinical isolate by immunology blood reactionsβ assessment of infected patient
Background: It is an indisputable fact of the need of rapid determination of drug resistance pulmonary tuberculosis pathogen at diagnosis. The aim of the study was the realization of the possibility of establishing M.tuberculosis drug resistance by identifying immunological reactions infected patient blood for the presence of the pathogen. Materials and methods: 90 persons were examined: 29 patients with infiltrative pulmonary tuberculosis (at 12 patients the disease is caused by drug-sensitive M.tuberculosis, at 17 β multidrug-resistant M.tuberculosis), 25 blood donors and 36 (test sample for testing statistical hypotheses). Spectrum of laboratory tests is executed, the operation of the main reflecting subpopulations of immune cells, micro- and maΡrophages, regulatory proteines. Results: A consequence of the study a significant amount of data obtained in the study was the use of multiple regression analysis to assess the significance of laboratory parameters and establish the relationship defining the sensitivity of tuberculosis variant pathogen. Conclusions: It was proven for the first time that the expression of HLA-DR on T-lymphocytes and phagocytic activity of blood granulocytes infiltrative pulmonary tuberculosis patients represent drug resistance of clinical isolates M.tuberculosis.ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠ΅ΠΎΡΠΏΠΎΡΠΈΠΌΡΠΌ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ°ΠΊΡ Π½Π°Π»ΠΈΡΠΈΡ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΠΈ Π±ΡΡΡΡΠΎΠ³ΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Ρ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π° Π»Π΅Π³ΠΊΠΈΡ
ΠΏΡΠΈ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°. Π¦Π΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ°Π»Π° ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ M.tuberculosis ΠΏΡΡΠ΅ΠΌ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ ΠΊΡΠΎΠ²ΠΈ ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π½Π° ΠΏΡΠΈΡΡΡΡΡΠ²ΠΈΠ΅ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Ρ. ΠΠ΅ΡΠΎΠ΄Ρ. ΠΡΠ»ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΎ 90 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ, ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
: 29 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠ²Π½ΡΠΌ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·ΠΎΠΌ Π»Π΅Π³ΠΊΠΈΡ
(Ρ 12 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΠ½ Π±ΡΠ» Π²ΡΠ·Π²Π°Π½ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΠΈΠ·ΠΎΠ»ΡΡΠ°ΠΌΠΈ M.tuberculΠΎsis, Ρ 17 β ΠΈΠ·ΠΎΠ»ΡΡΠ°ΠΌΠΈ Ρ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΡΡ), 25 Π΄ΠΎΠ½ΠΎΡΠΎΠ² ΠΊΡΠΎΠ²ΠΈ ΠΈ 36 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ β ΡΠ΅ΡΡΠΎΠ²Π°Ρ Π²ΡΠ±ΠΎΡΠΊΠ° Π΄Π»Ρ ΠΏΡΠΎΠ²Π΅ΡΠΊΠΈ ΡΠ°Π·ΡΠ°Π±Π°ΡΡΠ²Π°Π΅ΠΌΠΎΠΉ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π³ΠΈΠΏΠΎΡΠ΅Π·Ρ. ΠΡΠΏΠΎΠ»Π½Π΅Π½ ΡΠΈΡΠΎΠΊΠΈΠΉ ΡΠΏΠ΅ΠΊΡΡ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΠΎΡΡΠ°ΠΆΠ°ΡΡΠΈΠΉ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΡΡΠ±ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΠΊΠΎΠΌΠΏΠ΅ΡΠ΅Π½ΡΠ½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ, ΠΌΠΈΠΊΡΠΎ- ΠΈ ΠΌΠ°ΠΊΡΠΎΡΠ°Π³ΠΎΡΠΈΡΠΎΠ², ΡΠ΅Π³ΡΠ»ΡΡΠΎΡΠ½ΡΡ
ΠΏΠ΅ΠΏΡΠΈΠ΄ΠΎΠ². ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘Π»Π΅Π΄ΡΡΠ²ΠΈΠ΅ΠΌ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π΄Π°Π½Π½ΡΡ
ΡΡΠ°Π»ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΠΈ Π΄Π΅ΡΠ΅ΠΊΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΈ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠ΅ΠΉ Π²Π°ΡΠΈΠ°Π½Ρ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Ρ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π° Π»Π΅Π³ΠΊΠΈΡ
. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΏΠ΅ΡΠ²ΡΠ΅ Π΄ΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡ HLA-DR Π½Π° Ρ-Π»ΠΈΠΌΡΠΎΡΠΈΡΠ°Ρ
ΠΈ ΡΠ°Π³ΠΎΡΠΈΡΠ°ΡΠ½Π°Ρ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π³ΡΠ°Π½ΡΠ»ΠΎΡΠΈΡΠΎΠ² ΠΊΡΠΎΠ²ΠΈ Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠ²Π½ΡΠΌ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·ΠΎΠΌ Π»Π΅Π³ΠΊΠΈΡ
ΠΎΡΡΠ°ΠΆΠ°ΡΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ·ΠΎΠ»ΡΡΠ° M.tuberculosis
Development of laboratory diagnostic criteria of pulmonary tuberculosis on the study of immunological reactions of blood the patient
Background: Diagnosis of pulmonary tuberculosis, especially in the early stages of the disease, is an urgent problem that caused widespread pathogen in a population. Changes in laboratory parameters, presenting the state of the main parts of the immune system may be a "mirror" of infection development. The aim of the study is the establishment of the laboratory criteria for the diagnosis of pulmonary tuberculosis based on detection of changes in immunological reactions of patient's peripheral blood. Materials and methods: Immunological parameters of blood of 160 people were studied: 25 blood donors, 99 patients with pulmonary tuberculosis (31 patients with tuberculoma, 44 patients - with infiltrative pulmonary tuberculosis, 24 patients β with fibro-cavernous pulmonary tuberculosis), and an additional group of 36 patients included in the study for statistical evaluation of the hypotheses. Results: It is found that the presence of lung tuberculoma accompanied by a decrease in phagocytic and functional metabolic activity of monocytes, increased number of T, Ξ³Ξ³-T cells. Development infiltrative tuberculosis associated with increasing the population of monocytes expressing HLA-DR, as well as the concentration of IL-4, decreased number of T-helper and T-cytotoxic lymphocytes. The formation of fibrous-cavernous tuberculosis is consistent with increased expression of CD11b and CD11c on monocytes, increasing the population of B lymphocytes. Conclusions: Laboratory tests evaluating the patient's immune system were, allowing to establish the existence of different clinical forms of tuberculous lung. Diagnostic sensitivity and specificity of diagnostic tests proposed in the range of 80,3% to 97,6%.ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅. Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π° Π»Π΅Π³ΠΊΠΈΡ
, ΠΏΡΠ΅ΠΆΠ΄Π΅ Π²ΡΠ΅Π³ΠΎ Π½Π° ΡΠ°Π½Π½ΠΈΡ
ΡΡΠ°Π΄ΠΈΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΎΡΡΠ°Π΅ΡΡΡ Π²Π΅ΡΡΠΌΠ° Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π·Π°Π΄Π°ΡΠ΅ΠΉ, ΡΡΠΎ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½ΠΎ ΡΠΈΡΠΎΠΊΠΈΠΌ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π° Π² ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ. ΠΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ, ΠΎΡΡΠ°ΠΆΠ°ΡΡΠΈΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
Π·Π²Π΅Π½ΡΠ΅Π² ΠΈΠΌΠΌΡΠ½Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, ΠΌΠΎΠΆΠ΅Ρ ΡΠ²Π»ΡΡΡΡΡ Β«Π·Π΅ΡΠΊΠ°Π»ΠΎΠΌΒ» ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΠ΅ΠΉΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ. Π¦Π΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ°Π»ΠΎ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π° Π»Π΅Π³ΠΊΠΈΡ
, Π±Π°Π·ΠΈΡΡΡΡΠΈΡ
ΡΡ Π½Π° Π΄Π΅ΡΠ΅ΠΊΡΠΈΠΈ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°. ΠΠ΅ΡΠΎΠ΄Ρ. ΠΠ·ΡΡΠ΅Π½Ρ ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΠΊΡΠΎΠ²ΠΈ 160 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ: 25 Π΄ΠΎΠ½ΠΎΡΠΎΠ² ΠΊΡΠΎΠ²ΠΈ, 99 Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·ΠΎΠΌ Π»Π΅Π³ΠΊΠΈΡ
(31 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅ΠΌΠ°ΠΌΠΈ, 44 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠ²Π½ΡΠΌ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·ΠΎΠΌ Π»Π΅Π³ΠΊΠΈΡ
, 24 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠΈΠ±ΡΠΎΠ·Π½ΠΎ-ΠΊΠ°Π²Π΅ΡΠ½ΠΎΠ·Π½ΡΠΌ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·ΠΎΠΌ Π»Π΅Π³ΠΊΠΈΡ
) ΠΈ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΈΠ· 36 Π±ΠΎΠ»ΡΠ½ΡΡ
, Π²ΠΊΠ»ΡΡΠ΅Π½Π½ΠΎΠΉ Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π»Ρ ΠΏΡΠΎΠ²Π΅ΡΠΊΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π³ΠΈΠΏΠΎΡΠ΅Π·. ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π½Π°Π»ΠΈΡΠΈΠ΅ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅ΠΌ Π»Π΅Π³ΠΊΠΈΡ
ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ°Π³ΠΎΡΠΈΡΠ°ΡΠ½ΠΎΠΉ ΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎ-ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΌΠΎΠ½ΠΎΡΠΈΡΠΎΠ², ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠ»Π° Ρ-,Ξ³Ξ΄-Ρ-ΠΊΠ»Π΅ΡΠΎΠΊ. ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π° ΡΠ²ΡΠ·Π°Π½ΠΎ Ρ ΡΠΎΡΡΠΎΠΌ ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ ΠΌΠΎΠ½ΠΎΡΠΈΡΠΎΠ², ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡΡΡΡΠΈΡ
HLA-DR, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ IL-4, ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° Ρ-Ρ
Π΅Π»ΠΏΠ΅ΡΠΎΠ² ΠΈ Ρ-ΡΠΈΡΠΎΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠ². Π€ΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΈΠ±ΡΠΎΠ·Π½ΠΎ-ΠΊΠ°Π²Π΅ΡΠ½ΠΎΠ·Π½ΠΎΠ³ΠΎ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π° ΡΠΎΠ³Π»Π°ΡΡΠ΅ΡΡΡ Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ CD11b ΠΈ CD11c Π½Π° ΠΌΠΎΠ½ΠΎΡΠΈΡΠ°Ρ
, ΡΠΎΡΡΠΎΠΌ ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ Π-Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠ². ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Ρ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΠ΅ ΡΠ΅ΡΡΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΈΠΌΠΌΡΠ½Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡΠΈΠ΅ ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡ Π½Π°Π»ΠΈΡΠΈΠ΅ ΡΠ°Π·Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΡΠΌ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π½Π° Π»Π΅Π³ΠΊΠΈΡ
. Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ ΠΏΡΠ΅Π΄Π»Π°Π³Π°Π΅ΠΌΡΡ
ΡΠ΅ΡΡΠΎΠ² Π²Π°ΡΡΠΈΡΡΠ΅Ρ Π² Π΄ΠΈΠ°ΠΏΠ°Π·ΠΎΠ½Π΅ ΠΎΡ 80,3% Π΄ΠΎ 97,6%
ΠΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ Π²ΡΠ΅Π·Π΄Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΡΠ΅Π²Π΅ΡΠ½ΡΡ ΡΠ°ΠΉΠΎΠ½ΠΎΠ² Π’ΠΎΠΌΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ
Field medical aid is most effective in providing the population of northern areas of Tomsk region with qualitative and accessible medical services. Development of such organization form is the most perspective way of health protection system perfection in the region. The most results will be achieved while providing the interaction and coordination of the activity of territorial treatment-and-diagnostic institutions and field medical teams. The field forms of aid should complete the activity of regional hospitals, provide the accessibility of medical services in remote areas and equalize the quality of medical aid in areas particularly regarding high-tech treatment-and-diagnostic procedures.ΠΡΠ΅Π·Π΄Π½Π°Ρ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ°Ρ ΠΏΠΎΠΌΠΎΡΡ ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ Π² ΠΏΠ»Π°Π½Π΅ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΡΠ΅Π²Π΅ΡΠ½ΡΡ
ΡΠ°ΠΉΠΎΠ½ΠΎΠ² Π’ΠΎΠΌΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠΌΠΈ ΡΡΠ»ΡΠ³Π°ΠΌΠΈ. Π Π°Π·Π²ΠΈΡΠΈΠ΅ ΡΠ°ΠΊΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠΎΡΠΌΡ ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΠΏΡΡΠ΅ΠΌ ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ Π² ΡΠ΅Π³ΠΈΠΎΠ½Π΅. ΠΠ°ΠΈΠ±ΠΎΠ»ΡΡΠΈΠΉ ΡΡΡΠ΅ΠΊΡ Π±ΡΠ΄Π΅Ρ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡ ΠΏΡΠΈ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΠΈ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΈ ΠΊΠΎΠΎΡΠ΄ΠΈΠ½Π°ΡΠΈΠΈ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΠ°Π»ΡΠ½ΡΡ
Π»Π΅ΡΠ΅Π±Π½ΠΎ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ ΠΈ Π²ΡΠ΅Π·Π΄Π½ΡΡ
ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
Π±ΡΠΈΠ³Π°Π΄. ΠΡΠ΅Π·Π΄Π½ΡΠ΅ ΡΠΎΡΠΌΡ ΠΏΠΎΠΌΠΎΡΠΈ Π΄ΠΎΠ»ΠΆΠ½Ρ Π΄ΠΎΠΏΠΎΠ»Π½ΡΡΡ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΡΠ°ΠΉΠΎΠ½Π½ΡΡ
Π±ΠΎΠ»ΡΠ½ΠΈΡ, ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°ΡΡ Π΄ΠΎΡΡΡΠΏΠ½ΠΎΡΡΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΡΠ»ΡΠ³ Π² ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
ΡΠ°ΠΉΠΎΠ½Π°Ρ
, Π²ΡΡΠ°Π²Π½ΠΈΠ²Π°ΡΡ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΏΠΎ ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΡΠΌ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ Π²ΡΡΠΎΠΊΠΎΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΡΡ
Π»Π΅ΡΠ΅Π±Π½ΠΎ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ΅Π΄ΡΡ