The anniversary article devoted to the 50th anniversary of the Sakhalin regional hospital. The data on origin and start of the Hospital are resulted. The path from a small clinic up to modern versatile hospital, capable to render highly specialized medical and preventive help is shown. The data on departments and diagnostic centers, interaction of regional hospital with the medical institutions of region are resulted. The long‑term plans of development connected to expansion of the medical services and introduction in practice of new medical technologies are shown.

The history of start and development of medical help to the population of the Sakhalin area, the organization and activity of regional hospital is shown. The legal and organizational documents regulating work of medical service are resulted. The special attention is given to the questions of quality of medical help at the present stage, to its perfection and the control.

On the basis of own experience of the 64 tracheostomies, 24 by the percutaneous method, authors suggest the indications and contra‑indications to various ways of this manipulation. The preference is given to the Grizg method of the tracheostomy. The brief review of the literature is resulted. The conclusion about the preferable use of the percutaneous dilatation tracheostomy versus traditional interventions is shown.

The second part of the review of the literature (see. PMJ, 2007, № 2, p. 23–27), devoted to surgical tactics at aorta aneurism. Authors analyze various ways of operative interventions, their merits and demerits. The certain attention is given to postoperative death rate and the long‑term follow‑up.

This paper presents a literature review related to features of immunopatogenesis of the tick‑borne encephalitis (TBE). The data about virus‑induced changes of lymphocytes at different forms TBE is evidence of the depression of T‑cellular immunity, continuance of which correlates with heaviness of clinical flow of disease. The facts, relating to features of an apoptosis of blood cells and them cytokine‑mediated abilities at different forms TBE, are not numerous and requires the further studying. Along with intensive studying of a protective role virus‑neutralizing antibodies at TBE, research as well mechanisms of evasion of virus TBE from eliminating actions of these antibodies is necessary. The drugs applied to treatment TBE, not always possess reliable therapeutic effect. In this connection search and application of the most effective drugs is rather actual, that in turn requires more a profound knowledge immunopatogenesis of TBE.

On the basis of examination and treatment of group of 22 patients with psychogenic cardialgias it is concluded the efficiency of acupuncture in the complex therapy of this condition (the positive effect is received in 21 cases). In the conclusion the importance of differential diagnostics of the psychogenic cardialgias and somatic heart diseases is emphasized.

Experience of the plasmapheresis use in a combination with extracorporeal processing of the erythrocytes by the glucocorticoids in complex treatment of 48 patients with hormone‑dependent bronchial asthma. In all supervisions the positive effect has been received. System steroids are cancelled in 13 cases of 21, the reduction of the doze was achieved in 8 cases. Duration of remission at severe bronchial asthma has prolonged till 6–9 months and at the mild asthma ‑ till 9–12 months. The control of an arterial hypertension and diabetes has improved. At all patients night symptoms have disappeared, the number of attacks in the day time has decreased. The reference to the physician occurred not more often than once in a quarter. Re‑hospitalization within one year was required 7 of 19 patients with a severe bronchial asthma.

The results of treatment of 59 patients with spine trauma are investigated. For diagnostics we used not only X‑Rays but CT and MRT. Recording of traumas was conducted according to classification by Magerl et al. (1994). The method of a choice at the inferior cervical spine trauma was anterior access with the spondilodesis by the auto‑bone and fixing by the mono‑cortical plates. At chest and lumbar spine fractures the transpedicular fixing was used. Splintered chest spine fractures needed the decompression of the channel with the anterior spondilodesis. The necessity of active surgical treatment with use of modern systems of stabilization is suggested at fractures of spinal column.

Modern diagnostics and treatment of the diaphragmatic ruptures is one of the most difficult problems of modern surgery of polytrauma. Since 1989 till 2006 in the Department of Faculty surgery of the VSMU 36 cases with the diaphragmatic ruptures were observed. On the basis of the analysis of case records the principal causes of difficulties in diagnostics of this pathology are suuggested, the list of necessary diagnostic procedures and rational surgical tactics that has allowed achieving favorable result in 72% of cases is determined.

1050 men of 18–70 years old with various urogenital infections, in 1998–2005 are surveyed. Besides physical exam, the blood, sperm, and urogenital cultures are investigated. The etiology of the infertility was researched, including antisperm antibodies. It is shown, that urogenital infections render not only direct toxic and inflammatory action, but also by the mutagen action cause indirect immune related answer in sperm cells and organs – producers. The elimination of infectious and mutagen effects is possible only at purposeful complex etiologic therapy consistently withdrawing or inhibiting the factors of different action.

The retrospective analysis of efficiency of treatment of acute leukemia in the Hematological center of the Sakhalin regional hospital in 2001–2005 is done. Of 27 cases of disease 20 were non‑lymphoblast and 7 – lymphoblast leukemia. The peak of the disease was 2004 (8 new cases). Among non‑lymphoblast the maximum was in the age group from 41 till 50 years. Among acute lymphoblast – in the age from 16 till 30 years more often. In 23 cases the polychemotherapy under the protocols was carried out. In 3 cases it has been contra‑indicated because of the severe somatic status, a hemorrhage syndrome and life‑threatening bleedings, and 1 patient has refused polychemotherapy. As a result of an induction course in 23 patients remission is achieved at 14, among them 7 are in remission and are off the register. These parameters of efficiency of treatment of the acute leukemia are the same to the average rate in the Russian Federation.

153 in term newborns underwent the analysis on immune parameters of the umbilical blood and questioning of mothers about the allergic anamnesis. The results of research show the stimulation of immune system of the child by infectious factors in the intra‑uterine period. These facts correlate to the “hygienic hypothesis” about a protective role of mild infectious diseases in the atopic illnesses through the stimulation of the Th1 of immunity and high production of the γ‑interferon.

On the basis of the treatment of two groups of patients with deep veins thromboses of the legs the schemes of the anti‑coagulant therapy are discussed. It is shown, that simultaneous use of direct and indirect anticoagulants allows to reduce the duration of hospitalization. The use of low initial dozes of indirect anticoagulants (warfarin – 5 mg and less) is not justified owing to prolonged required level of the hypocoagulation.

Despite of the certain progress in antibacterial therapy of the heavy hospital infections caused by P. aeruginosa, the frequency of failures remains to the highest. Distinctions in intensity of formation and circulation of P. aeruginosa resistant to antibiotics are connected to distinctions in a policy of application of antibiotics in various hospitals. The received data testify to necessity of correction of reports empirical antibiotic therapy of intrahospital pneumonias in departments of intensive therapy. Results of molecule genetic typing have shown the low efficiency of disk‑diffusions method and prove the necessity of studying of sensitivity of microorganisms to antibiotics with method of serial delutions.

By the method of biomicroscopy authors studied the reaction of the micro‑vessels of dura and pia mater, gut mesenteries, a wide ligament of the uterus, and skin to the irradiation of the the helium ‑ neon laser. The diameter of vessels and blood velocity, sensitivity influence and duration of response was studied with the help of the automated system of the analysis of images AllegroMC. The expressed organ features of the micro‑vessels are found. The most sensitive were the precapillaries of the pia mater. They quickly reacted to an irradiation, but also quickly came back to an initial level of blood velocity and diameter. The least reactive were the vessels of a wide ligament of the uterus; however they needed also a lot of time for the restoration of initial parameters.

The typical features of diagnostics, differential diagnostics and principles of treatment of the Bechet disease on a material of own 7 supervisions are described. The brief review of the literature devoted to the etiology and epidemiology of this disease is given. The necessity of correct diagnostics and adequate therapy of the disease that provides 100% 5‑years survival rate of patients is emphasized.

In experiment on 18 male rats authors modeled sharp and chronic cold stress (–20°С on 20 min) in 4 groups of animals. Studied the changes of a testosterone level in plasma by radioimmune analysis and changes of activity of NADPHdiaphorase of the testicles and cavernous bodies by the histochemical method by Hope, Vincеnt (1989). The activity of enzyme was estimated cytophotometrically. The wide representation of the structures with active NADPHdiaphorase in the testicles and cavernous bodies is established. As a result of sharp cold stress the reduction in a testosterone level and increase of NADPHdiaphorase activity of the testicles and cavernous bodies on 4^th, 7^th and 14^th day of the stress reaction was observed. The revealed changes can be the part of the pathogenesis of the sexual dysfunctions at stress‑reaction.

Epidemiological parameters of tuberculosis in Primorsky Krai since 1994 till 2005 are investigated. The growth of tuberculosis morbidity of teenagers in 2005 as 76.5 on 100 thousand population is revealed, exceeding average Russian morbidity in 2.3 times. 17‑year teenagers were involved more often. The tuberculosis at teenagers was found at routine exam ‑ from 58.5 up to 77.5% of all for the first time revealed cases. The clinical structure of disease was characterized by prevalence of the infiltrative form of an infection. Since 2003 the teenagers allocating resistant micobacteria have appeared. A high density of tuberculosis in a contagious phase of disintegration was marked. The received materials allow thinking the restriction of distribution of tuberculosis in this age group a priority problem.

The morbidity from measles, parotitis, diphtheria and whooping‑cough in autonomous region of Taimyr among small nationalities since 1970 till 2004 is investigated. The post‑vaccinal immunity to the above‑named infections at 2765 person is studied. Small nationalities comparing to Caucasian population have higher parameters of morbidity by controlled infections. From different ethnic groups of the Taimyr region the lowest parameters of immunity and accordingly higher morbidity are registered at nganasan nationality. Authors recommend treating aboriginal population as the risk group of measles, parotitis, diphtheria and whooping‑cough.

Results of research have revealed the greatest decrease quality of a lives at patients paranoid schizophrenia and schyzotypal disorders. Patients with schizoaffective psychoses during long time kept peculiar to them before disease a level of social adaptation. The ideational component in a greater degree has been lowered at patients with schyzotypal disorders, it has appeared inadequate at patients paranoid schizophrenia and was positively painted at patients with schizoaffective frustration.

The dynamics of antibodies of A, M, G classes at 30 patients with different clinical forms of the Ixodae tick borreliosis during the early period of illness is investigated. It is shown, that patients with non‑erythemic form of disease have e later increase of concentration of antibodies of all classes in comparison with the erythemic form. It is the result of low borreliemia and an opportunity of an endocellular location of the microorganism. Authentic increase of IgA, IgM at erythemic patients on the 1^st week of illness with their subsequent increase confirms the Th2‑immune answer.

30 patients with chronic obstructive pulmonary disease (COPD), hypertonic disease and combined left and right heart hypertrophy were examined. The comparative (control) groups included 32 COPD patients with right heart hypertrophy as well as 35 ones with hypertonic disease. The results of combined heart hypertrophy diagnosis in COPD patients by means of the standard electrocardiogram and computer electrocardiotopography method showed the higher efficiency of the latter.

The clinical and immunologic influence of use of the “Pneumo‑23” vaccine (France) at 42 children with bronchial asthma after pneumonias is done. Statistically authentic increase in specific antibodies (IgМ and IgG) as to the poly‑saccharide complex of the vaccine, and also to Т3, В6, 9N‑serotypes of the S.  pneumoniae is revealed, that testifies the specific post‑vaccinal immunity. Decrease in local level of the interleukin‑8 and respiratory inflammation severity is found. Safety and immune efficiency of vaccination of children with the respiratory diseases is shown.

The experience of treatment of 37 patients with the strictures and obliterations of urethra in urological Department of the Sakhalin regional hospital is submitted. Indications and contra‑indications, and also efficiency of open and endoscopic interventions on urethra are shown. It is concluded, that endourethral intervention is a method of the first and final stages at correction of the strictures and obliterations of male urethra. The extension of the urethra strictures for endoscopic manipulations should not exceed 2 cm; otherwise the relapse frequency is about 50%. The endoscopic treatment of the obliteration of the anterior part of urethra is unpromising.

In the article the brief review of the electromyography opportunities is resulted, as well as the methods of its use and practical examples of diagnostics of various diseases. The author concludes, that wide introduction of this method of research into the clinical practice will improve the diagnostics of the neuromuscular diseases.

The review of a clinical material – 494 cases of the benign prostate tumors. One third of patients (32.9%) are treated operatively: transbladder adenomectomy (95 interventions) and transurethral prostate resections (68 cases). In the postoperative period the severe complications were marked in the first group of patients more often. The conclusion about indications to the transurethral resections is shown, also because the long‑term results testify the greater efficiency of open surgery.

The results of treatment of 32 patients with brain trauma with the focal brain lesions are analyzed. Among the death risk factors are the deep loose of consciousness, the expressed disposition of brain structures and old age. The conclusion about the necessity of round‑the‑clock CT service is done, as well as about the necessity of internal decompression and radical removal of the lesions at special conditions.

Case from practice. In the child with the mental retardation and epileptic seizures cariotyping showed the deletionof the long shoulder of the 11^th chromosome. Parents and close relatives are healthy. The case differs from the classical description of similar anomalies by the absence of congenital organ anomalies and so‑called small signs.

Supervision from practice of a case of the osteopoikilia at the woman born in 1955. In the world it is described no more than 100 cases of this disease presenting by round or oval homogenous sclerotic lesions in many bones. The diagnosis has been found by screening X‑ray exam. It is emphasized, that in this case the congenital pathology of bones was combined with the dermatitis.

The article is devoted to the organization of work of the consultant polyclinic of the Sakhalin regional hospital. At scheduled capacity of 270 visits the polyclinic annually provides more than 70 thousand visits to the inhabitants of the Sakhalin area. The polyclinic has a sanatorium on 28 beds. Consultations are provided on 26 specialties. Eight rooms are the part of the specialized centers created on the basis of hospital that allows to solve the schedule questions, improves the continuity between the polyclinic and the hospital. In a final part of the article the ways of improvement of material base, increase of availability and quality of specialized medical help in the region are shown.

The analysis of the architecture decisions of medical institutions of Vladivostok is done. The majority are in the adapted buildings, rooms, only 29.2% of them are constructed on a standard project. Only 20.3% of the institutions are located in a residential suburb with the distance not less than 500 m. Only 40.7% of medical institutions provide allowable hygienic and anti‑epidemic modes and conditions of stay of patients, work and rest of the personnel. Such situation can render adverse influence on working conditions of the medical personnel and raise the risk of occupational diseases.

The historical material devoted to start and development of ophthalmologic service of the Sakhalin area. Stages of development from the first ophthalmologic beds in the Yuzhno‑Sakhalinsk city hospital (1957) up to now are shown. Today the ophthalmologic microsurgical center works on the basis of regional hospital where the modern operative interventions are provided, and preventive, educational and scientific work is conducted.