[The expertise evaluation of organization of rendering of acute, emergency and urgent medical care in rural regions of Novosibirsk oblast'].

The most problematic spheres in the resource support of emergency medical care to rural residents are the completeness of staff of physicians in rural medical surgeries, community hospitals and departments of emergency medical care in central district hospitals. The provision of feldsher obstetrics posts with sanitary motor transport and medical equipment is yet another problematic sphere. The main troubles during provision of emergency medical care at feldsher obstetrics posts are related to surgery treatment. The organization of emergency and urgent medical care suffers of many unresolved problems related to informational program support at feldsher obstetrics posts, polyclinics of central district hospitals.

[Effect of alendronate on bone tissue status of senescence-accelerated OXYS rats].

The purpose of this research was to study the effect of Alendronate on bone mineral density (BMD) and markers of bone turnover in male and female Wistar rats and senescence-accelerated OXYS rats with early development of osteoporosis. The animals were treated with Alendronate (0.84 mg/kg) during 2 months from the age of 8 months. The effect of the drug depended on genotype and sex of animals. Alendronate increased the BMD and bone formation markers osteocalcin levels in the blood of female rats OXYS with low their initial level. In Wistar rats the drug increased bone mineral density only in males, while females reduced the level of osteocalcin. The level of serum calcium did not change, but its urinary excretion in Wistar male rats and in female rats of both strains was increased. The ability to influence on the development of disease by standard treatment shows that OXYS rats are suitable models to study the pathogenesis and design of new therapeutic targets of osteoporosis.

[Development of osteoporosis in prematurely aging OXYS rats].

The early osteoporosis in OXYS rats is the presentation of accelerated senescence and earlier positioned as senile. The present study shows the changes in metabolism detected in OXYS rats in the postnatal period. They lead to the development of osteoporosis in future and may underlie the formation of reduced peak bone mass. 90 males OXYS rats used in this study aged from 10 days to 24 months and the control group consisted of 90 male Wistar rats of the matched ages. No differences in BMD in OXYS and Wistar rats at the age of 10 days and 3 months was revealed. At the age of 10 days the OXYS rats showed the higher by 40% activity of ALH--the marker of osteoblast activity--than Wistar rats; but at the age of 3 months ALH activity in OXYS was lower than in Wistar rats. The peak bone mass and BMD in Wistar rats is formed by the age of 12 months, in OXYS rats already by 6, but it did not reach the level of Wistar. The content of Ca in the blood and bone tissue changes similarly: no difference in young age, but reduces in OXYS rats after 6 months to the background of enhanced Ca excretion in urine. However, changing the mineral composition of bone in OXYS rats did not affect the mechanical strength: the absolute strength of the long bones in OXYS at 12 months was lower than that of Wistar, but at the expense of decrease by 1,7 times the cross-sectional area. We suppose that genetically determined hypoplasia of the bone tissue in OXYS rats is the starts of pathogenetic mechanisms of idiopathic osteoporosis.

[Cathepsin K and matrix metalloproteases activity in the bone tissue of OXYS rats with developing osteoporosis].

The comparative study of activity of cysteine protease cathepsin K and matrix metalloproteases (MMPs) in bone tissue of accelerated senescent OXYS rats with early ageing comparatively to Wistar rats of the same age was performed. Early development osteoporosis is a typical feature of OXYS rats. In bone tissue of 3 month old OXYS rats, before appearance of osteoporosis manifestation cathepsin K activity was higher, whereas MMPs activity was lower than in Wistar rats. In Wistar rats (3 and 14 months old) cathepsin K activity of spine was shown to increase, and MMPs activity to decrease. In OXYS rats age-related change of cathepsin K and MMPs activity in bone tissue had the opposite direction. As a result of this there were no differences between Wistar and OXYS rats 14 months old despite the marked osteoporosis in OXYS rats as revealed our early researches. Serum Q2-macroglobulin activity was higher in 14 months old OXYS rats. The role of activation of cathepsin K in bone resorption in the development of osteoporosis in early ageing OXYS rats is discussed.

[Bone matrix glycosaminoglycans and osteoporosis development in early aging OXYS rats].

Proteoglycans play a crucial role in bone tissue formation promoting consolidation of collagen fibers and bonds between them and mineral crystals. The composition of extracellular matrix proteoglycans was analyzed in early aging OXYS rats with signs of early osteoporosis versus Wistar rats at the age of 2, 4, 6, and 8 months. It was found that bone mineral density in two month OXYS rats was lower than in age-matched Wistar rats. It increased only till 6 month of age in OXYS rats, and during the whole observation period in Wistar rats. Formation of peak bone mass in Wistar rats was accompanied by change in composition of proteoglycan pools in bone tissue matrix: accumulation of macromolecular keratan sulfate-containing proteoglycans, and decrease of uronic acid and sulfated glycosaminoglycan content. OXYS rats were noted for accumulation of micro- and macromolecular proteoglycans: uronic acids and sulfated glycosaminoglycans. Chondroitin sulfate AC and dermatan sulfate were accumulated in OXYS rat bone tissue with the increase in mineral density difference. Keratin sulfate was completely absent here, in contrast to Wistar rats.