The authors present a paper devoted to the 40^th anniversary of pediatric faculty of Vladivostok State Medical University. It comprises the facts concerning history of faculty organisation and evolution, gives a review of contemporary research, training and practical activities performed by the staff members of departments affiliated to the faculty. The authors place special emphasis on the role of university in establishing and improving the medical and disease-prevention service to children living in the Far Eastern Federal District of Russia. The studies substantiate the necessity of proceeding from traditional methods of pregraduation and graduate education to innovation approach to organisation of academic activities. The existing faculty's educational research school evaluates its future trends and provides a basis for increasing the faculty's role in educational, training and research activities of the university.

The paper provides researches of clinical and immunological features of HIV-infection associated with tuberculosis diagnosed in 40 patients at various stages of this disease with allowance for antiretroviral therapy. The control group was inclusive of 50 patients having HIV-infection without tuberculosis. The immune system state was evaluated in accordance with total number of T-lymphocytes and their subsets, content of tu-mour-a necrosis factor, interleukin-6 and their soluble receptors in blood serum. The findings give evidence of T-cell immune deficiency at all stages of HIV-infection. Hypercytokinemia was in correlation with the severity of persistent infection. Multidirectional dynamics in the level of cytokine soluble receptors in the presence of HIV-infection both associated with tuberculosis and without it in the conditions of antiretroviral therapy allow developing additional criteria for its prescription and efficiency evaluation.

The authors have conducted clinical evaluation of significance of gastrointestinal endoscopic examination in protocol of lactase deficiency diagnostics of nursing infants. 36 infants have undergone endoscopic examination of esophagus, stomach and jejunum combined with mucus membrane biopsy. The data analysis was performed using special programme Medical Vision. The results allow considering that development of pathogenetically reasonable therapy protocols for nursing infants' hypolactasia requires taking account of mucus membrane state of all gastrointestinal tract. The algorithm for standard diagnostic manoeuvres should be inclusive of endoscopic and histologic study of mucus membrane of esophagus, stomach, and jejunum. Special emphasis should be placed to infants who have lactase deficiency events associated with dermatopathy signs.

This paper describes efficiency of Pneumo-23 multiagent pneumococcal vaccine used for immunisation of 50 infants who have suffered from pneumonia, among them are 42 infants having atopic asthma. The studies show clinical parameters, levels of cytokines and immunoglobulins. It has been proved that vaccination does not cause the atopic process to have complications and facilitates prevention of respiratory diseases, bacterial complications and asthma exacerbations

The authors have monitored dynamics in local and system synthesis of cytokines, IgE immunoglobulin E and cytokine regulation in progression of allergic inflammation of 200 infants suffered from various forms of allergic diseases (bronchial asthma, atopic dermatitis, allergic rhinitis, combination of bronchial asthma with allergic rhinitis, other combinations). Progression of children's allergic diseases showed increase in production of interleukins 4 and 13 as well as IgE immunoglobulin E, which was growing by the age of 7-8 years old, coupled with decrease in interferon level. They detected correlation relationships of and changes in regulatory content numbers of IgE immunoglobulin E, interleukins 4 and 13 during bronchial asthma, allergic rhinitis, atopic dermatitis and at various combinations of such diseases. They draw an inference that dynamics in cytokine profile is a diagnostic and prognostic criterion for progression of allergic diseases at preschool age

The authors have observed 96 patients aged 1 month to 7 years who have perinatal contact with HIV-infection. Upon the attainment of the age of 18 months, 18 infants (18.8%) were diagnosed as having perinatal HIV-infection. Among significant factors defining the prognosis of progression and severity of infants' HIV-infection are burdened perinatal history (abuse of narcotics, abuse of alcohol, viral hepatitis), efficiency of prenatal prophylaxis, early antiretroviral treatment, recurrent severe respiratory infections and apparent dermatitis implications. Efficiency of highly active antiretroviral therapy in terms of standard and alternative regimens exceeded 80%. Structure of causes of HIV-infected infants' deaths based upon proprietary data gets in line with Russian statistics.

The paper provides studies of both clinical picture of Ixodid tick-borne borreliosis diagnosed in children living in Primorsky Krai and its correlation with Borrelia genotypes identified from patients' blood serum. Ixodid tick-borne borreliosis clinically manifests in primary affect at the place of tick sting, regional lymphadenitis, diseases of cardio-vascular system as well as high frequency of non-erythematous infection forms (up to 51.9%). Preliminary researches related to genetic typing of etiological agents showed more frequent detecting of Borellia garinii, but damages of central nervous system described in other regions of Russia were not representative of clinical picture of this disease.

The paper describes results of studies of system of cytokines and a1-acid glycoprotein carried out for 60 new-born children suffered from congenital pneumonia, within the first 3 days of their lives. It has been revealed that imbalance of immunologic mechanisms of new-born children having congenital pneumonia is accompanied by decrease in neutrophil inflammatory responses, manifests in low level of interleukin-8 and ineffectiveness of protective and adaptive cell functions. Applying of Viferon-1 as a part of complex therapy allowed the survival rate for new-born children having severe manifestations of disease to increase as well as the intensive care to be optimised, the periods of treatment to shorten and the detected immunologic imbalance to be resolved in due time.

Based upon surgical clinical pictures, the authors have analysed 41 observations of focal affections of livers and spleens diagnosed in children aged 1 month to 17 years old. Most often they registered calcified focuses and cysts (parasitogenic and nonparasitic). The result is that the pathology described is much more widespread than expected before. The authors suggest hospitalising all the children having a diagnosis named "focal affection of liver (spleen)" to department of surgery for examination and deciding what therapeutic approach to use.

The paper reports hygienic research results of how five meteorological and two heliogeophysical factors have an influence upon initial incidence of urinary organs among children living in Dalnegorsk. The facts obtained from 1995 to 2004 comprise 97.1% of children (about 15,000 persons). The level of weather and climate load on human thermal control system was calculated based on V.I. Risanov's method (1997). It has been established that among seasonal factors of children's glomerulonephritis risk are weather and climate load and atmosphere pressure. Risk of dysmetabolic nephropathy increases at electromagnetic solar radiation on a frequency of 3,000 MHz.

The experiments using Wistar line rats (110 animals), which have been ummunised with several antigens, show biological role of changes in stability of phagocyte lysosomal membranes in forming and regulating the magnitude of immune response. The findings substantiate a significance of state of phagocyte lysosomal membranes at early stages of immunogenesis that sets a final result of immune response and implies an opportunity of its focused correction.

The authors have examined 90 patients having Viral Hepatitis C and 205 patients with combined pathology - HIV-infection and Hepatitis C. Total RNA was being separated in polymerase chain reaction with reverse transcription and detection of products in real-time mode. The 1st genotype of Hepatitis Virus with prevalence of subtype b was the most frequent in both groups; the 2nd virus genotype was more often registered with patients having single-agent infection; and the 3rd virus genotype was diagnosed in patients with combined pathology.

The authors have studied hemodynamics and concentration of catecholamines in blood plasma taken from 56 pregnant women aged 21 to 28 years old at gestation periods from 31 to 36 weeks who suffer from heart failure. They performed abdominal delivery. It was found that the choice of anesthesia during such type of medical intervention for the parturient women having moderate heart failure was a balanced general multicomponent anesthesia with artificial pulmonary ventilation on the basis of epidural blocks using lower concentrations of Bupivacaine. Application of balanced epidural anesthesia with spontaneous respiration may become an alternative to transfer of pregnant women having heart failure to artificial pulmonary ventilation.

HIV-positive patients and patients having HIV-infection associated with tuberculosis. The authors have studied dependency of detection probability for tuberculosis diagnosed in HIV-positive patients from initial levels of immunological profile at various stages of disease using stratification analysis. They also have performed logistic regression analysis with backward selection of predictors and detecting of tuberculosis contagion as dependent variable. Tuberculosis risk was dependent to a considerable extent on HIV RNA level, number of lymphocytes and length of tuberculosis preventive treatment. They have suggested a diagnostic search algorithm for early detection of tuberculosis in HIV-positive patients, which implies monitoring of ummunological markers (tumour-a necrosis factor, interleukin-10 and soluble receptor of interleukin-6) and their detection in certain intervals.

The paper provides an experience in carrying out chemical prophylaxis of HIV vertical transmission in Primorsky Krai. Over 1997-2008, 553 infants born of HIV-positive women were under medical supervision. Diagnosis "perinatal HIV-infection" was proved in 61 cases, while follow-up for 341 patients was cancelled upon the attainment of the age of 18 months. The three-stage chemical prophylaxis, including prescription of antiretroviral drugs, prior to or on the 28th week of pregnancy considerably mitigates the risk of HIV transmission from mother to child rather than the immediate two-stage prophylaxis.

Experiments with 100 males Wistar-Kyoto aged 4 days to 24 months (11 age groups) allowed studying nucleus tractus solitarius of medulla oblongata. Over the whole period of postnatal ontogenesis some intense quantitative and qualitative transmutations of nitroxide-positive neurons were registered. The enzyme activity being low during the first days of life has reached its maximum values by 1-3 months, following which it was decreasing step by step. Before reaching the 3-month age, there was an increase in sizes and numbers of nitroxidergic neurons with a reduction of their relative density values. It is the authors' opinion that the changes described in this paper may have an influence upon efficiency of central regulation of vascular tone and may become one of the mechanisms for senile arterial hypertension

The paper describes systolic and pulse pressures in aorta, their relationship with peripheral arterial tension and basic characteristics of aorta rigidity, which have been observed in 60 patients suffered from chronic obstructive lung disease coupled with chronic coronary heart disease. The result of treatment is 30 healthy patients. The authors have applied a method of noninvasive arteriography and evidenced an increase in aortal systolic and pulse pressure and decrease in compliance of great blood vessels during the 1st and 2nd stages of chronic obstructive lung disease. The findings substantiate a correlation between increase of central and peripheral arterial tension and basic characteristics of aorta rigidity. The 3^rd stage of chronic obstructive lung disease included "paradoxical" decrease in central and peripheral arterial and aortal pulse pressures. Among the more sensitive elastance indices of great blood vessels and myocardium are augmentation index, difference and affinity index of central and peripheral systolic pressure, relationship between indices of cardiac cycle area, and interval of left ventricle ejection period. The markers specified above may be used to evaluate the degree of cardiovascular risk in case of combined cardiorespiratory pathology.

Comorbidity analysis of children and adolescents suffering from duodenal ulcer disease allowed identifying the group of clinical entities, which are several times frequent than in cases of non-ulcer affects of gastrointestinal tract and are in connection with deficiency in fat-soluble vitamins A and E. This group comprises anemia, skin diseases, eye diseases, vegetative disfunctions, thyroid function abnormalities, diseases of the musculoskeletal system, diseases of hepatobiliary system and ENT-organs, and protein-energy malnutrition. Deficiency of fat-soluble vitamins was of multiple-factor nature: deterioration of blotting capacity, intake of drugs, formation of free-radical compounds related to contamination with Helicobacter pylori, etc.

The paper describes characteristics of immunological changes observed in 106 children suffering from combined forms of Yersiniosis and Virus Hepatitis A. In all cases, the authors have manifested a significant imbalance of pro- and anti-inflammatory cytokines in the blood serum and evaluated the changes in levels of interleukins 2, 4 and 8 and у-interferon secondary to immunocorrective therapy of 60 patients. According to the authors' opinion, if there are originally high concentrations of interleukin-8 and у-interferon, the complex treatment should involve applying interferon-inducing factors. But low concentrations of those cytokines should imply recombinant interferon.

Using the model of ulceration according to the method of H. Shay, 34 rats showed severe antiulcer action of Calcium Pectate, which may be comparable to Maalox action. The results from biochemical analysis of gastral secretion describing the stomach secretory and protective function allow making a conclusion that such polysaccharide is of complex gastroprotective effect. In the authors' opinion, mechanism of protective effect is implemented in the following response chain: moderate stimulation of secretion of proteolytic enzymes and hydrochloric acid - activation of mucosa chemoreceptors - induction of glycoproteins synthesis and regeneration of accessory cells - enhancement of mucosa protective properties.

The paper provides analysis of laboratory tests used to identify activity of Cytomegalovirus infection in groups of HIV-positive patients with veneral and percutaneous channels of infection. It has been revealed that in more frequent cases the leukocytic suspension obtained from HIV-positive injecting drug users was indicative of Cytomegalovirus DNA or antigens, which levels correlated to Cytomegalovirus manifestation. The low efficiency of serologic tests was proved for diagnostics and prediction of the disease progress. The authors suggested using the following serologic markers as basic laboratory criteria: IgM Immunoglobulin M and, especially, IgA Immunoglobulin A originated from Cytomegalovirus as well as DNA and antigens ("early" proteins) detected in the leukocytic suspension during immunofluorescence reaction and polymerase chain reaction.

Application of standards by medical personnel working in educational institutions facilitates improving the quality of students' preventive care and decreasing their incidence rate. This paper shows why it is so significant to specify, particularise and economically ensure the work of doctor and trained nurse for the purpose to improve preventive examinations and increase effectiveness of recommendations for optimising physical and neuropsychic growth as well as social adaptation. The paper interprets an algorithm for actions to be taken by medical personnel of the educational institution with a view to control health situation and organisation of academic activity, physical education, rehabilitation of children suffering from chronic diseases, immunologic prophylaxis, and hygienic education of students, parents and teachers. This will allow substantiating in an unbiased manner the load of doctor and trained nurse, specifying the criteria of quality of their work as well as differentiating the remuneration of labour taking account of its quality

The paper discusses the basic activities of maternity and child welfare service of the Department of Health, Primorsky Krai, among which the most important is the preventive one - preservation of mother and child health. It places a special emphasis on top-priority national project "Health" and purpose-oriented programmes "Safe Maternity", "Planned Parenthood", "Healthy Child", "Healthy Generation" in resolving the service's tasks.

The paper describes organisation of medical care for HIV-positive patients in Primorsky Krai. It places a special emphasis on authorised specialists working in the Regional Clinical Centre of Prevention and Fight against AIDS. It is shown that timely periodic health examination of HIV-positive patients is one of the basic conditions for increasing the lifetime and improving the quality of their lives. The authors investigate a variety of aspects related to implementation of top-priority national project "Health" and pilot project oriented to treatment and preventive care of parenteral Hepatitis in HIV-positive patients in Primorsky Krai.

The paper shows organisation chart of medical care to patients with combined pathology - HIV infection and chronic Virus Hepatitis B and C - in Primorsky Krai and experience in applying combined antiviral therapy (interferons and Ribavirin) for the purposes of top-priority national project "Health" during
2007-2008. In 2007 and 2008, two hundred HIV-positive patients were subject to antiviral treatment with regard to Hepatitis B and C. By the end of 2008, 168 patients were under antiviral treatment. The course of antiviral therapy for HIV-positive patients was equal to 48 weeks. By the end of January 2009, 52 patients completed the treatment of parenteral Hepatitis, among them 42 patients passed a full course, 10 patients stopped their treatment for various reasons.

Epidemic of HIV infection in Privolzhsky federal district is instantiated by a growth of total number of HIV-positive people, involvement of rural areas, and increase in the share of patients with late stages of disease. The paper analyses the work performed by AIDS regional centres in the federal district to carry out preventive medical examination of HIV-positive patients in 2008. The authors have evaluated dynamics in distribution of HIV-positive patients by stages of disease, disclosed the most frequent secondary and associated diseases, described the deceased patients in accordance with clinical stages of disease, and analysed how HIV-positive patients of various age groups were being covered by laboratory examination, antiretroviral therapy and hospital treatment.

The paper provides official information on prevalence rate of HIV-infection in Primorsky Krai. The monitoring implied using materials of official state registration and results of epidemical studies of HIV infection areas. It is shown that the previous years are marked by stabilisation in incidence rate and even its slight decrease. The leading channel of infection is still parenteral one. In addition to that there is an increase in number of HIV-positive women and children born of HIV-positive mothers. Epidemical process is concentrated in vulnerable groups so far, but in the last few years it increasingly involves various strata of society and the epidemic includes young people of active working age.

In the article was examined medicinal-organizational technologies that are applied to the children of early age with the separate of the perinatal period. It is proved the necessity of the long and dynamical observational for the children the holding the complex of the postnatal diagnostic, of restoration of treatment and rehabilitation on main classes of diseases: neurological, Orthopedic, cardiological, ophthalmologic, immunoallergylogical and so on, as the continuation of antenatal clinicolaboratorian and instrumental complex in system of "mother and child".

The paper studies normal ultrasound anatomy of inguinal region, its abnormalities in inguinal hernias of various types and in related pathology. The authors have developed an algorithm of ultrasound screening of patients suffering from hernial bulge in inguinal region, which is specific up to 100% and allows verifying the type of inguinal hernia accurate within 93%.

The paper shows analysis of HIV-infection incidence rate diagnosed during admission to Regional Clinical Hospital #2 (Vladivostok) in 2006-2008 in the amount of 101 observations, among which 25% of primary HIV-infection incidents have been diagnosed in the infectious disease ward. It is noted that a number of patients having late stages of disease described by severe secondary diseases has increased.

The paper presents clinical observations of Kaposi's sarcoma diagnosed in 25 years old patient having HIV-infection and atypical localisation of primary lesion -skin of feet - with further dissemination on skin of body and upper extremities.

The paper provides analysis of post mortem examinations of HIV-positive patients deceased in the Regional Clinical Centre of Prevention and Fight against AIDS in 2000-2008. It shows tissue reactions during tuberculosis depending upon HIV-infection stage and degree of immunosuppression.

The paper presents analysis of 592 out-patient medical records of those HIV-positive patients who have been exposed to highly-active anti-retroviral therapy from 2006 to 2008. As noted, there was a significant reduction of HIV-positive patients' lethality in comparison with patients without having the causal treatment administered.

The author shows materials obtained after examination of 15 HIV-positive patients having chronic Hepatitis C who have been exposed to antiviral therapy in the conditions of infectious in-patient department. Steady virological response and biochemical remission were reached for 75% of patients.

The author has carried out epidemiologic analysis of 127 accidents involving biologic fluids taken from HIV-positive patients of medical and preventive treatment facilities in Primorsky Krai. As noted, such accidents became more frequent from 2007 to 2008. Among the participants of accidents are most often nurses (51.9%), doctors (24.4%) and medical assistants (11.8%). Most of medical workers had the HIV infection postexposure antiretroviral prophylaxis done (in 29 cases such prophylaxis was not performed due to the late visit of injured persons). Over the whole period of observations, no occupational contagion was registered. In this paper, the author also discusses measures for optimisation and 100% postexposure prophylaxis of HIV infection among the personnel of medical and preventive treatment facilities in Primorsky Krai.

In 2002-2008, 96 abandoned children were treated in the regional department for children born of HIV-infected mothers. Social and medical portrait of HIV-positive mothers who have abandoned their new-born children seems to be extremely negative. These are, for the most part, socially disadapted women having somatic and gynaecological pathology, infectious diseases with parenteral transmission (abuse of narcotics), and sexually transmitted diseases. The findings give evidence of social aspect of this problem, which requires resolving from the state authorities.