Vol 23, No 7 (2016)

We present structural specification of shock-producing trauma in 140 patients admitted to I level injury care center (Arkhangelsk Regional Hospital) in 2008-2013 and in 104 patients with shock-producing trauma, treated in Arkhangelsk Medical Preventive Institution (MPI) in 2002. Study is observational, cohort, longitudinal, retrospective. Statistic analysis was made by using programmes EpiInfo (TM) 3.4.1. and SPSS 19.0 for Windows. Among 140 patients I degree traumatic shock (TS) was identified in 36 (25,7 %; 95 % CI: 18,5-32,9), II degree - in 72 (51,4 %; 95 % CI: 43,2-59,7), III degree in 30 (21,4 %; 95 % CI: 14,6-28,2) and IV degree in 2 (1,5 %; 95 % CI: 0,5-3,4) patients. As can be seen from the above among patients with shock-producing trauma more than half have TS II degree and its occurrence exceeds 2 times - TS I degree, 2,4 times - TS III degree and 36 times - TS IV degree. Changes are observed in structure of polytrauma and traumatic shock in patients treated in Arkhangelsk Regional Hospital till (2002) and later when the hospital got the status of I level injury care center (2013). Patients' density with TS I degree increased 2,6 times, with с TS II degree - 5,6 times and with TS III degree - 2,4 times. These structural changes are due to routing of injured in pedestrian accidents and patients with catatrauma to I level injury care center. We have found out statistically significant decrease of patients density with pelvis injury - 1,7 times, 2 times with spinal cord injury and 1,6 times with intra-abdominal injury. However, significant increase of patients density with chest injury in 1,6 times is registered.

Parameters of central hemodynamics in young men and women - junior students of the medical faculty of Khanty-Mansiysk State Medical Academy have been studied. As a result of daily monitoring, the average daily indicators of heart rate (HR), systolic (SBP) and diastolic (DBP), mean arterial pressure (MAP), pulse (PP) blood pressure, vegetative index Kerdo (VIK) were detected. The values of HR, SBP, DBP, VIK, SBP time index, DBP time index, SBP variability, DBP variability were obtained in day and night periods. Thus the girls had significantly higher values of daily average HR, day and night HR compared to boys. The boys showed higher SBP values. According to DBP indicators vascular tone in the groups of boys and girls did not differ significantly. Thus, intersexual differences between girls and boys were observed in minute blood volume mechanisms related to heart work. As it turned out, male students had high parasympaticus tonus, especially at night, which corresponds to strengthening of parasympathetic activity. The activity of sympathetic nervous system in young women was significantly higher than in boys in all measurement periods. High pressure (SBP time index) effect on target organs was significantly higher in boys than in young women. BP variability in boys and girls was comparable to the normal values, but at night variability indices of SBP were higher in group of boys.

By means of enzymoiimmunoassay and flow cytofluorometry the effect of carbon monoxide and ultraviolet (UV)-light on the expression level of the receptor complex molecules (CD95 and CD8 markers) on the membranes of human blood lymphocytes has been studied. It was stated that the carbon monoxide causes decrease of CD95 receptors on the surface immune cells during (60 ^ 90 min). However, strengthening of this effect was registered in 24 hours. It is shown that UV-light in 453 and 755 J/m2 doses provides the pro-apoptotic effect as related to the expression level of CD95 receptors of analyzed cells. After daily thermostating of modified lymphocytes, different receptiveness of CD8 molecules to carbon monoxide was revealed. Thus, in patients with initially higher levels of CD8 markers - decrease is registered, and in individuals with initially low - increase in this marker levels. The obtained data of blood lymphocytes receptor profile changes in the presence of low molecular ligand (CO) must be taken into account in the Ultraviolet Blood Irradiation-therapy in patients with different etiologies.

The authors presents a propensity score matching (PSM) technique - an effective method to control the effect of confounding factors in observational studies. PSM has been shown to be as efficient as linear regression analysis, but can be performed using smaller samples. This article presents the basic principles of PSM and its practical application using STATA 13 software for the studies with continuous dependent variable.