INTRODUCTION

Growth of number of the chronic diseases demanding «a constant intervention throughout years or decades», is one of the most actual problems of modern medicine [83, 160, 298, 333]. The special attention turns steady growth at children and teenagers of chronic diseases of organs of urinary system, first of all a pyelonephritis (PN), a glomerulonephritis (GN) and tubulointerstitsialnogo a nephritis (OOZES) [64, 65, 74, 80, 118, 136, 137, 218, 227, 254, 286].

In clinical practice the pediatrist quite often faces difficult diagnostic cases of diseases of organs of the urinary system, demanding carrying out of difficult differentsialno-diagnostic search [212]. Late diagnostics and wrong tactics of conducting such patients lead to development in them of complications in the form of chronic renal insufficiency. In researches of last years the augmentation of quantity of children with chronic renal insufficiency [16, 74, 76, 77, 79, 80, 161] becomes perceptible.

To the XX-th century extremity it has been established, that mechanisms of advance various on an aetiology and a pathogenesis of diseases of organs of urinary system are identical, and measures of their preventive maintenance consist in retardation of advance of renal insufficiency [75, 76, 77, 79, 195, 227, 260, 261, 270, 286, 287]. In this connection the concept «Chronic illness of kidneys» (HBP) which reflects uniform approaches to improvement of quality of treatment and improvement of outcomes at patients with diseases of organs of urinary system [74, 75, 76, 77, 79, 102, 143, 260, 261, 270, 287] is framed.

Connecting tissue (DST) [1, 5, 36, 37, 46, 62, 63, 66, 67, 68, 85, 89, 91, 103, 106, 108, 120, 127, 129, 149, 173, 174, 188, 214, 218, 220, 241]. Syndrome DST at children with diseases of organs of urinary system is observed with frequency of 68,3 % [173].

The pathology of an organ of sight is extremely widespread phenomenon at DST [15, 47, 106, 140, 141, 173, 187, 215, 220]. Progressing short-sightedness at children often assotsiirovana with DST, being its significant marker [47, 91, 140, 141, 159, 181, 187, 220]. Prevalence of the short-sightedness combined with syndrome DST, at children of school age, according to various authors, is in limits from 39,0 % to 79,2 % [140, 141, 181].

Despite high frequency of a pathology of organs of urinary system and a sight organ at DST, the given diseases in a combination are studied till now insufficiently. Questions of tactics of pathogenetic treatment of patients with DST are opened, the uniform conventional approaches to conducting such patients are not present [66, 89, 91, 106, 149, 173].

As a perspective method of treatment sochetannyh diseases, assotsiirovannyh with undifferentiated DST it is possible to survey use of an impulsive low-frequency electromagnetic field (INEMP), generated by the apparatus of INFITA TH, in connection with poliorgannostju actions of the given physical factor [15, 47, 59, 169].

For studying of efficiency of methods of treatment sochetannyh diseases probably use of experimental models. However, experimental researches, behind few exceptions, are spent on healthy experimental animals without modelling of a pathological condition that complicates an estimation of true efficiency of medical methods.

All these circumstances testify to an urgency of a problem and demand the further working out of new complex methods of treatment sochetannyh diseases, assotsiirovannyh with DST from children.

Research objective: a clinico-experimental substantiation of application of the complex approach to treatment of children at sochetannyh diseases (HBP and progressing short-sightedness), united undifferentiated DST.

For object in view achievement following problems are defined:

1. To study frequency and structure of a pathology of organs of the urinary system combined with short-sightedness, at children of younger and senior school age.

2. To investigate external and internal fenotipicheskie signs DST at children with HBP, combined with short-sightedness.

3. To estimate in the conditions of experimentally induced renal pathology of feature of changes of an organ of sight.

4. To investigate the immune status and to define influence of course INEMP on immunologic indicators of animals with modelirovannym chronic OOZES.

5. To estimate an electrogenesis of a retina and conductivity on an optic nerve at children after a course of influence INEMP.

6. To study efficiency of application of complex technology of treatment of children with sochetannymi diseases (HBP and progressing short-sightedness), united undifferentiated DST.

Scientific novelty of work

1. At children of younger and senior school age prevalence of the nephrological pathology combined with short-sightedness is defined.

2. Are taped external and internal fenotipicheskie signs DST at children with HBP, combined with short-sightedness.

3. Changes of a vascular tract and a retina of eyes of animals in the conditions of the induced renal pathology are defined.

4. It is experimentally proved immunomodulirujushchee action INEMP at OOZES.

5. Given influences INEMP on an electrogenesis of a retina and conductivity on an optic nerve at children are specified.

6. Efficiency of application of a complex method of treatment sochetannyh diseases (HBP and progressing short-sightedness), united undifferentiated DST is shown.

The practical importance

1. The frequent combination of a pathology of organs of urinary system to short-sightedness specifies in expediency of complex inspection of the given contingent of patients at interdisciplinary level, including the pediatrist, the ophthalmologist, the nephrologist, the cardiologist, the gastroenterologist.

2. The new technology of complex treatment at children sochetannyh diseases (HBP and progressing short-sightedness), united undifferentiated DST is developed.

3. Model chronic OOZES probably to use as an original technique of reception of a toksiko-allergic uveitis in experiment and for immunologic researches at a chronic inflammatory nephrological pathology

4. Methodical references are developed for practical public health services on application of complex treatment at sochetannyh the diseases united undifferentiated DST.

The substantive provisions of the dissertation which are taken out on protection

1. Development sochetannoj pathologies of organs of urinary system and an organ of the sight, united DST, is caused by burdeness of the family anamnesis, deviations at a stage of pre-natal development, an adverse current perinatalnogo the period, a frequent case rate in postnatalnom the development period.

2. INEMP, generated by the apparatus INFITA TH, in the conditions of the induced renal pathology renders antiinflammatory and immunomodulirujushchee actions.

3. A complex method of treatment at children sochetannyh diseases (HBP and progressing short-sightedness) allows to lower frequency of exacerbations HBP and to reduce a year gradient of advance of short-sightedness.

Introduction of results of research in practice

Results of work are introduced in practice of children's ophthalmologic office FGBU «the Out-patient department № 4» Administrative offices of the President of the Russian Federation, polyclinic unit of the Children's city hospital №13 of N.F.Filatova.

Materials of the spent researches are included in the program of lectures for students, clinical interns, post-graduate students and used at carrying out of a practical training with doctors on chairs of hospital pediatrics №1 (managing chair - professor P.V.Shumilov), ophthalmologies of pediatric faculty (managing chair - the Member - of a correspondent of the Russian Academy of Medical Science, professor E.I.Sidorenko) GBOU VPO RNIMU of N.I.Pirogova of Ministry of Health of Russia, and also at carrying out of lectures for doctors of pediatric case FGBU «the Out-patient department № 4» Administrative offices of the President of the Russian Federation (the head physician - E.JU.Zhuravlyov).

Work approbation

Substantive provisions of dissertational work are reported and discussed at scientifically-practical conference with the international participation «an eye Bodily machinery» in MNII eye illnesses it. Gelmgoltsa Rosmedtehnology, Moscow, 2009; 9th Congress of ophthalmologists of Russia, Moscow, 2010; Anniversary scientific conference «the Neva horizons», St.-Petersburg, 2010; I th All-Russia conference «Pediatric aspects of a dysplasia of a connecting tissue. Achievements and prospects», Moscow, 2010; II th All-Russia conference «Pediatric aspects of a dysplasia of a connecting tissue. Achievements and prospects» Moscow, 2011; VII International conference on reabilitologii, Moscow, 2011; scientific conference of ophthalmologists «the Neva horizons», Sankt - Petersburg, 2012; scientifically-practical conference «Actual problems of pediatrics», Moscow, 2013; scientific conference of ophthalmologists «the Neva horizons», St.-Petersburg, 2014.

Dissertation approbation is spent at joint scientifically-practical conference of collective of employees of chair of hospital pediatrics №1 pediatric faculties (managing chair - professor P.V.Shumilov) and chairs of ophthalmology of pediatric faculty (managing chair - a member-correspondent of the Russian Academy of Medical Science, professor E.I.Sidorenko) GBOU VPO RNIMU of N.I.Pirogova of Ministry of Health of Russia from 30.01.2014

Publications

On a dissertation theme 29 scientific works are published. From them 13 works in magazines and the editions entering into the list of leading reviewed scientific magazines and editions, defined by the Higher certifying commission. 2 patents of the Russian Federation for inventions are received: № 2371146 from 27.10.2009 and № 2373970 from 27.11.2009 the demand for the invention Is submitted
(Registration number 2013152177 from 25.11.2013) in FGBU «Federal institute of the industrial property».

Structure and dissertation volume

The dissertation is stated on 153 pages of the typewritten text and consists of introduction, the review of the literature, the description of materials and methods of research, own data (4 heads), the conclusion, conclusions, practical references and the literature list. The illustrative material is presented by 14 tables and 35 drawings.

The bibliographic index includes 339 sources, including 226 domestic and 113 foreign.