ИНТЕРЬВЬЮ АКАДЕМИКА РАМН В. П. КАЗНАЧЕЕВА «НОВОСИБИРСКОМУ ОБОЗРЕВАТЕЛЮ» Влаиль Петрович Казначеев - выдающийся советский ученый-энциклопедист, крупный организатор здравоохранения, профессор, академик РАМН. Был ректором Новосибирского государственного медицинского университета, первым президентом Сибирского Филиала (затем Отделения) АМН СССР. По его инициативе был открыт Новосибирский Институт клинической и экспериментальной медицины СОАМН СССР, директором которого он являлся. Им разработан ряд научно-практических теорий - адаптации и адаптационного стресса, системы жизнеобеспечения, экологического баланса, которые легли в основу реализации ряда государственных медико-социальных программ сохранения и развития здоровья населения Сибири и Крайнего Севера. В. П. Казначеев - основатель крупной терапевтической школы, изучающей основные нозологические формы антропоэкопатологии. Выдвигаемые академиком Казначеевым теории и идеи поражают своей масштабностью и оригинальностью, а поднимаемые им вопросы актуальны и постоянно привлекают внимание широких кругов медицинской общественности. Редколлегия полагает, что публикация интервью академика Казначеева В. П., данного «Новосибирскому обозревателю», с его любезного согласия, будет полезна читателям нашего журнала.

In work the approach for an estimation of the importance of this or that criterion in formation of a mid-annual doze of an internal irradiation of inhabitants of the rural settlements located in territory of radioactive pollution is offered.

There was analyzed the status of thyroid system parameters and frequency of individual values prevalence of antibody - carriage at children’s born in May 1986 - February 1987 exposed to iodine radio nuclides in intra-uterine period of development from 4 regions of Gomel Oblast (Gomel, Loev, Rechitsa, Khoiniki). At comparison of prevalence frequency of antibody - carriage to microsomal antigen among young men and girls it is shown that the given parameter statistically significantly is defined more often in the basic group at comparison with the conditional control; also there was marked statistically significant difference in Gomel region among young men and girls. The parameters of thyroid system status (thyrotropic hormone, free thyroxin) at children’s exposed to irradiation during intra-uterine development are within physiological values.

In the review there are main radiobiological concepts analyzed, and some details of low radiation action on the organism discussed. The transfer of high-dose radiation mechanisms of action on the low-dose radiation is seemed to be incorrect. The ways of low-dose radiobiology problems are discussed.

The purpose of article is the review of principles of evidence based medicine and the meta-analysis. A prominent aspect of evidence based medicine is definition of degree of reliability of the information. Quantitative association of the given various clinical researches by means of the meta-analysis allows to receive results which cannot be received from separate clinical researches. Reading and studying of systematic reviews and results of the meta-analysis allows to be guided more effectively in a considerable quantity of published articles.

The structure, dynamics of development of an acute myocardial infarction depending on the sex, age, terms of receipt to hospital, gravity of injury of myocardium at a hospital stage of treatment were tracked.

HBO application to accompany the acute MI traditional pharmacotherapy proved to reduce MI recurrence within 2 years following in-patient discharge (19% decrease in reference group and 5.3% in test group, χ² = 5.0, р < 0.05), possible to raise the 2-year survival rate from 86.2 up to 94.7% (р = 0.047, when applying Fischer’s exact test).

Repressing the quantitative analysis results of connective fibrous tissue of 10 cases died due to acute myocardial infarction and 11cases died due to accident.

Interconnection of dyslipidemia and atherosclerosis was studied in 185' patients with arterial hypertension (AH). It has been revealed that dyslipidaemia produces different effects on atherosclerotic changes in the central, visceral, cerebral and peripheral vascular areas in patients with AH of the 1^st, 2^nd and 3^rd degrees. It has been marked that in patients with AH of the 1^st degree the most effect of hypercholesterinemia and hypertriglycerinemia is produced on the central, cerebral, peripheral atherosclerosis, hypo-alfa-cholesterinemia - on the peripheral atherosclerosis. In patients with durable AH of the 2^nd and 3^rd degrees the most effect of hypertriglycerinemia is registered on the cerebral and visceral atherosclerosis.

There was performed the analysis of local markers distribution (genomic DNA and antigen material) HSV, CMV, С.pneumoniae (СР) и M.pneumoniae (МР) in the endothelium of the abdominal aorta taking into account morphologic characteristics of the vascular wall. Vessels samples of 89 corpses (35,2 ± 9,8 years old) were included into the investigation. There was revealed a high index of atherosclerotic samples lesions of abdominal aorta for the studied Gomel region population at the age of 20-49 years old (94,4%). As the result of polymerase chain reaction (PCR) analysis of atherosclerotically changed vessels samples HSV genome was revealed in 59,5% of cases, CMV - 52,4%, CР - 45,2%, MР - 67,9%. Revelation indices of genomic DNA HSV, CMV, СР, МР for died of atherosclerosis manifestations (n = 25) and from accidental causes (n = 64) were approximately at the same level (P > 0,05). Antigen material of the studied pathogens was reliably more often revealed in the group of people died of atherosclerosis (P < 0,05). The received results correspond with infectious inflammatory conception of atherosclerosis.

The revealing of HFE gene mutations C282Y and H63D in 31 patients with chronic hepatitis and liver cirrhosis of different etiology was studied. Mutations were associated more often with male sex (52.9%) vs. female (21.4%) and alcohol abusing (46.2%) vs. non-drinkers (33.3%). In persons with mutations response to interferon therapy was poorer and fibrosis predominated over inflammation in liver bioptates.

At an infectious-inflammatory pathology increase of activity free-radical processes is observed. Besides active forms of oxygen in oxidizing processes participate as well metabolites of oxide nitrogen which formation depends from перекисных processes. In work expressiveness free-radical processes is investigated at an infectious-inflammatory pathology and changes of some parameters of a homeostasis on a background of oxidizing stress. Research has shown presence of biochemical attributes of damage of cells of a liver, on a background infectious-inflammatory to a pathology which are directly not mentioning a liver.

The social and medical status of patients with HIV-associated tuberculosis are investigated, groups of risk of development of a double infection are allocated. They are single men 30-40, with the secondary education, living of a city, the drug addicts abusing alcohol, who were in prison, with a chronic hepatitis C virus infection.

Efficacy of adenotomy in two groups of patients (with hypertrophy of pharyngeal tonsil and chronic adenoiditis) was investigated. The investigation revealed that children with adenoiditis have shown better nasal breathing in distant period than children with adenoid hypertrophy without accompanying adenoiditis. We propose to consider chronic inflammation of pharyngeal tonsil as positive predictor for quality of nasal breathing after surgery. In children with pharyngeal hypertrophy without chronic adenoiditis partial adenotomy under endoscopic visual control is more preferable to preserve its immunological function.

Using questioning method there was studied the quality of life of patients with chronic cerebrovascular deficiency at liquidators and the Chernobyl-affected persons before and after surgical restoration of an adequate blood flow in a carotid extracranial section. There was used a questionnaire Medical Outcome Study Short Form-36 (SF-36) to estimate the quality of life.

The object of the research: residents of Gomel Oblast. The aim of the research - definition of comparative frequency of transitory ischemic attacks at liquidators and in other groups of population, studying of percentage of patients with disability caused by ischemic stroke.

Hospital mortality in patients with severe acute pancreatitis remains high. Some of these patients develop increased intra-abdominal pressure which may contribute to organ dysfunction. The aim is to study a role of an intra-abdominal hypertension at a severe acute pancreatitis. Sixty-five patients with severe acute pancreatitis who had been treated from 2005 to 2007 were studied. It is suggested that intra-abdominal pressure monitoring may be used as a marker of the severity and prognosis of severe acute pancreatitis.

Severe fibrous changes are established to appear more often in case of the persistence of herpetic infection in the liver; inflammatory infiltration of portal tracts without any difference in its structure is more manifested, as well as polymorphism of hepatocytes and their nuclei with more frequent combination of moderate cellular polymorphism and marked nuclear polymorphism in compare with chronical hepatitis B without the persistence of herpetic infection in the liver. At the same time poor and moderate polymorphism of hepatocytes and their nuclei develop more frequently in case of chronic hepatitis B without the persistence of herpetic infection in the liver. There are no established differences between men and women in two study groups according to all clinical and morphological characteristics. The persistence of herpetic infection in case of chronical hepatitis B is considered as a chronical slowly progressive infection with a flaccid course because of the absence of established differences in morphological and laboratory characteristics and of inflammatory activity between chronical hepatitis B with the persistence of herpetic infection in the liver and chronical hepatitis B without the persistence of herpetic infection in the liver, as well as the presence of intranuclear herpetic II type - inclusions and more frequent development of severe fibrous changes.

The analysis of a correlation of a degree traumatic stenosis of the backboned canal is fulfilled at damages the lower cervical column in the groups with the different degree of neurological compensation and the basic rates spinal injuries, which use in the standard classifications by force of correlation matrix construction.

The devised method of roentgenological estimation of spine sagital plane with scoliotic deformity is represented. Using the characteristic of normal sagital spine balance three forms of its lesion was determined: compensated, subcompensated, decompensated. These forms are expedient to serve as an objective criterion for pathology diagnosis, for estimation of its progress in dynamics and estimation of carried out corrective treatment effectiveness.

The tribological characteristics of a model «cartilage-cartilage» pair friction at presence of various lubricating medium has been investigated. A computerized pendular tribometer for an estimation of the friction processes in the joints of living organisms has been proposed. It is shown an effectiveness of a made precise pendular device by the example of investigation of lubricating behaviour of natural synovial fluid and it substitute on the base of blood serum.

In article results of an experimental research of laboratory animals in a condition of a traumatic shock are stated, and also morphological characteristics of shock changes in various bodies are presented. The comparative analysis of morphological changes of various groups of laboratory animals depending on a kind of medical tactics is lead.

The results of rats myocardium morphometric analyses with different terms of hypokinesia are given. Big structural and functional changes on organ, tissue and cell levels have been discovered. Though these infringements are partially compensated in case of lasting hypokinesia they may cause heart pathology development.

Surgical methods of modelling of cysts of the pancreas are generalized, the critical estimation is given. The original way of reproduction of pseudocysts of pancreas of a white rat, where the basis is the local cold influence on the pancreas with cryosurgical complex KCH 3A/B is offered. The work was done with the observance of the rules stipulated by the European Commission on supervision of carrying out laboratory and other experiments with participation of experimental animals of different kinds. Cooling was carried out intraoperatively, by the direct contact of the cryosurgical tip with the tissue of the pancreas. It is established that after the cryoinfluence from -60 C to -180 C for 40 and more seconds, pseudocyst of the pancreas, containing necrosative tissue, inflammatory эксудат and pancreatic juice is formed. The presented way is simple in its execution and allows to get the necessary result in 100% cases. The offered model of the pseudocyst of the pancreas gives an opportunity to study mechanisms of the origin of the pathology and to approve the ways of the treatment.

The analysis of the data pancreatic application of Volume Ultrasaund Imaging at 25 patients is carried out. Efficiency of рancreatic application of Volume Ultrasaund Imaging for definition of mutual relation of volumetric formations of a pancreas with adjacent anatomic formations is shown. It is offered additional of Volume Ultrasaund Imaging an attribute tumoral formations of a pancreas, suitable for use as diagnostic criterion at tumoral and опухолеподобных formations.

The dynamics of psychic-emotional condition and functional readiness of skilled sportsmen was analyzed using «Omega S» methodic. At the beginning of the winter period of the preparation the level of the energetic supplementation and psychic-emotional condition were below then norm. After 3,5 training months the parameters are within the norm. There is opposite correlation between the level of psychic-emotional condition and the neurotism data of Aizenk test.

The present article represents the analysis of scientific-methodical approaches available for estimation of natural resources potential and recreational suitability of water reservoirs. It has been defined that no uniform approach for such estimation exists at present. The problem of recreational suitability estimation of water reservoirs should be approached in a complex way: with the use of medico-biological, psychologic-aesthetic, ecological, technological and other aspects.

The changing of atmosphere conditions and climate changing in Gomel city were investigated during the winter time. It is revealed gradually but true increasing of the air temperature in January for the past years. The atmosphere index of January was defined. For this researching period the decreasing of Earth magnetic disturbance was observed.

In present work we focused on comparative analysis trends of mortality due to pancreatitis and fatal alcohol poisoning in Russia in 1965-2005. ARIMA time series analysis suggests a positive association between pancreatitis mortality rate and fatal alcohol poisoning rate for male (r = 0,74; SE = 0,14), and female (r = 0,50; SE = 0,14) at zero lag. According to outcomes of present study the intoxication-oriented pattern of alcohol consumption is a risk factor for mortality due to pancreatitis for male, as well as for female.

The population peptic ulcer (PU) heaviness is influenced by various factors: social, economic and demographic features of a society, efficiency of medical actions, chronobiological factors, etc. In recent years in Belarus and the CIS countries the decrease in quantity of complicated forms PU is marked. It is due to positive social and economic changes, the improvement of conservative treatment. Meanwhile, the decrease in frequency of perforated ulcers as an objective parameter of the population PU heaviness took place only after 2006. It is impossible to explain this by only medical or social achievements. The correlation dependence of initial incidence of PU disease and frequencies of perforated ulcer with eleventh annual cycles of solar activity (SА) is stated.

Physical rehabilitation is a drug-free, natural biological method, a part of a medical rehabilitation. The aim and the problems are defined by a doctor and a tutor depending on indications and counter-indications to the medical physical training.

In article the case of combined infections is described: mononucleosis infectiosa + chicken pox which has developed at the patient hospitalized in the Gomel regional infectious clinical hospital. The following case meets seldom and represents difficulties in treatment.

The clinical case of rarely meeting (in literature we succeeded find out information only about a 51 case) leiomyosarcom of omentum, complicated the interapeitonial bleeding is presented. Tumour about 13cm in a diameter remote during an urgent operation, at the term of supervision more than 2 years , patient is healthy, without the signs of reccurence disease.