Differential diagnostic technique for keratolytic processes of oral mucosa classified among white manifestations

FIELD: medicine.

SUBSTANCE: clinical assessment of the oral mucosa state is ensured by examining non-stimulated oral fluid or swabs. That involves determining five parameters: content of yeast-like fungi Candida in the yeast or mycelia form (1), concentration of secretory immunoglobulin A (SIgA) (2) and lysozyme (3), emission light sum (S) 5 minutes before chemoluminescent examination (4); the Wood-beam beam luminescent examination covers marginal portions of the gum and apexes of interdental papillas, buccal mucosa within dental occlusion, dorsal surface of the tongue within the thread-like processes, and performing morphological examination of the multilayer squamous epithelium of the buccal mucosa along the dental occlusion line (5). The derived results enable diagnosing the absence of pathogenic microflora and oral mucosa pathology, Candida carriage or chronic oral candidiasis in the mycelia or yeast form in the form of hyperkeratosis or leukokeratosis.

EFFECT: using the invention enables increasing the differential diagnostic accuracy for keratolytic processes in the form of white manifestations.

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The invention relates to medicine, namely to dentistry, laboratory diagnosis, and can be used for differential diagnostics of processes increased keratinization of the epithelium - keratosis, manifested in the form of "white margins by type of violation: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis, due to identified kandidonositelstvo and candidiasis, the imbalance of the main factors of nonspecific resistance and status of oxidative stress in the oral cavity, and further to optimize and improve the effectiveness of their treatment on the basis of differentiated criteria and the clinical condition of the mucous membrane, the elimination of candidior (yeast or mycelial form), the correction of oxidative protection (free - radical oxidation) and nonspecific factors of protection of the oral cavity in people living in the region with adverse environmental factors in age from 15 to 45 years.

Diseases of the oral mucosa (SOR) are currently the major issue dentistry, as early diagnosis and further treatment is significant difficulties with the accuracy of clinical diagnosis only in 30-35% of cases.

Over the last decade has increased lesion of the oral mucosa, the training is a result of yeast fungi of the genus Candida. This is due to the fact that fungal infection refers to the opportunistic and under certain conditions in the oral cavity, due to chronic inflammation, imbalance of local immunity, oxidative stress can be activated and appear on the mucous membrane in the form of the following States: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis.

The difficulties in the diagnosis of pathology of the oral mucosa is also due to the diversity and similarity of the clinical picture, dynamic change under the effect as total adverse factors (external environment) and local (mucosal injury, microbial contamination).

Inspection SOR has important diagnostic value in a number of pathological conditions: diseases of periodontal tissues, mucous membranes, infectious diseases, diseases of internal organs.

In diseases of the mucous membrane related to "white acts", change the color and overall appearance of the mucous self diagnostic values are not, however, in combination with other symptoms may support the clinical diagnosis. Hyperemia, pastos, swelling, raids, hypertrophy or smoothness of the papillae of the tongue, keratoticheskie changes in the oral mucosa, frothy, thick saliva (oral fluid), bad breath, dry mucous - all these and the changes characteristic of many diseases of the oral mucosa.

Disease SOR occur with the decline of local resistance, impaired differentiation and keratinization of epithelial cells, as well as changes in the microflora of the mucosa. In this regard, there is a need to identify violations increased keratinization in the lining for the differential diagnosis of the following type: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis, due to the pathogenic effect of yeast-like fungi of the genus Candida (yeast or mycelial form) with the identified kandidonositelstvo or candidiasis SOR.

The oral cavity of a person is a complex ecological system in which external factors (biological, bacterial) interact with internal (periodontal bacterial community, the local immune system of the mucosa, epithelium, saliva (not stimulated oral fluid), the oxidative system. Pathogenetic link of diseases of the oral cavity, including the mucosa, is oxidative stress, which is caused by an imbalance between antioxidant and prooxidant systems. The main role in this process is played by reactive oxygen species (ROS), thereby initiated reactions of free-radical oxidation (CPO), including the peroxide oxidation of lipids (POL), leading to x the chemical modification and destruction of biomolecules, disruption of tissue respiration in the inner membrane of mitochondria and processes hydroxylation in the microsomes. Excessive production of ROS and / or disruption of the normal functioning of the antioxidant defense systems cause increased oxidative damage of biomolecules, leading to the development of dysfunction of cells and tissues of the body (oxidative stress). The result is that cells with phagocytic activity, also produce oxygen radicals, which enable them to microbiocides. In pathological processes associated with chronic inflammation in the mucous, increases the number of free radicals, is the depolymerization of hyaluronic acid and the formation of the active factor of chemotaxis, migration of neutrophils to the site of inflammation, increased capillary permeability, initiates the process of lipid peroxidation, violated tissue respiration in the mitochondria and processes hydroxylation in the microsomes with the release of lysosomal enzymes and oxidative tissue damage. Of particular interest in this process is enhanced by inhibition of desquamation of the epithelium, stabilization of mast cells, ensuring cytotoxic and cytostatic effect of macrophages, neutrophils to pathogenic microorganisms. Synthesis of ROS is directly related to diseases is alasti mouth, based on chronic inflammation. The identified imbalance SRO diseases SOR requires correct medication with the inclusion of drugs with antioxidant or prooxidant action.

Diskeratoz (keratosis) SORA is a disease associated with impaired keratinization of the epithelium, morphologically diskeratoz manifests itself in the form of hyperkeratosis, parakeratosis or acanthosis. Morphologically there is discretization and degeneration of the cells of the spinous layer cells fall out of common regard; the disruption observed in the other layers. Diskeratoz may be limited and common and is manifested by excessive expansion of the cover of the mucous membrane, or has the appearance of a defect. More likely to occur simultaneous manifestation of productive and destructive (mixed form) processes. There are two types of dyskeratosis: benign and malignant. Benign diskeratoz clinically manifested by the appearance of plots, fine-flaked peeling. When parakeratosis violation of the process of keratinization is associated with loss of epithelial cells ability to produce keratohyalin. Parakeratosis is a normal condition of most areas of the epithelium; as a pathological process parakeratosis is considered only in areas where there is a normal full keratinization [Ivanochko So on, Ha the Moscow L. C., Kovalchuk L. C., and others a Comprehensive study of the mechanisms of chronic inflammation in periodontitis // Dentistry. - 2000. No. 4. - S. 13-16]; [Vladimirov, Y. A. Free radicals in biological systems / Y. A. Vladimirov // Soros educational journal. - 2000. No. 12. - S. 13-19].

Hyperkeratosis is a significant increase in the stratum corneum compared to its thickness when the keratosis. When this process in parallel with the increase in the number of layers of the stratum corneum is the development grainy. In the literature there is a term "lejkokeratoz" used to designate the area of hyperkeratosis white color. Acanthosis histological term describing the thickening of the epithelium due to enhanced proliferation of basal and subulate layer. The process is accompanied by elongation magsasagawa outgrowths of epithelial and more pronounced growth in connective tissue.

Candidiasis (candidosis) is a disease which is caused by yeast-like fungi of the genus Candida. On the mucous membrane of the oral cavity is inhabited by various species of yeast-like fungi as saprophytes. Pathological changes often cause Candida albicans, Candida tropicalis, Candida pseudotropicalis, Candida krusei, Candida guilliermondi, however, often pathological changes cause Candida albicans.

The oral cavity is considered the primary reservoir of yeast-like fungi of the genus Candida, the same species of fungi in the oral cavity are detected in the biofilm, the gingival epithelium, mucosa of the cheeks, the dorsal surface of the tongue.

According to the literature, the average number of fungi of the genus Candida, inhabiting the oral cavity, is 102-103CFU/ml or CFU/swab. Candida albicans is a representative of the resident microflora of the mouth of a person and is found in small quantities, and an inactive state in 50-70% of patients with no clinical signs of candidiasis, stands out from the gingival sulcus in 10-90% of cases, 10% of patients in the form pseudomycelium, germinating in the epithelium, in 70% of subjects found kandidonositelstvo.

Localization of yeast-like fungi of the genus Candida in the oral cavity diverse: different parts of the mucous membrane (mucosa of the cheeks, the gums, the dorsal surface of the tongue), cavities, root canals. Yeast-like fungi of the genus Candida love an acidic environment (pH of 5.8 to 6.5), multiply rapidly, thereby disrupting the protective properties of saliva. Growth of pathogenic microorganisms at lower immune resistance also increases the number of yeast-like fungi of the genus Candida and thereby contribute to their invasion of the mucous membrane of the mouth. Cells of the surface layer of the epithelium of the oral cavity is always covered by numerous microorganisms, including fungi of the genus Candida, which, penetrating into the cells of the epithelium, sometimes to the basal what about the layer, multiply them with increased virulence.

The microstructure of the SOR has morphological features on topographic zones, visual inspection and determines its clinical criteria in the standard. SOR, like all the digestive tract, covered by stratified squamous epithelium. Mucous cheeks mostly covered with stratified squamous not roguebasin epithelium, rich in glycogen, in the field of clamping teeth epithelium rogowiec in response to pathological effects. Gingival mucosa (marginal gingival and the tops of the interdental papillae gums) in the norm covered with flat roguebasin epithelium, which in response to microbial factor has increased keratinization, mucous dorsal surface of the tongue in the norm covered by stratified squamous epithelium, in the field of filiform papillae in response to microbial colonization and coated bloom is also increased keratinization.

In this category of persons residing in the region with adverse environmental factors, regardless of age, condition of the mucous membrane of the cheek in the area of closing the teeth, the marginal portion of the gums and the tops of the gingival papillae, dorsal surface of the tongue in the area of filiform papillae (taste bulblets) in response to microbial colonization of yeast fungi of the genus Candida or identified Candida is a carrier acquires catarrhal and keratoticheskie type of chronic inflammation with heightened keratinization type: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis.

Morphological changes of the LITTER depends on the time and nature of the impact of pathogenic factors, the level of the ecosystem state, local immunity, oxidative system. This determines the severity keratoticheskie mucosal lesions in this category of persons, manifested both subjectively and clinically.

The color of the mucous membrane is also one of the main clinical signs characteristic of its individual sections. Under pathological conditions the LITTER caused by kandidonositelstvo or candidiasis in people living in the region with adverse environmental factors, the color of the mucosa due to the influence of local and General factors and gains on the background of unmodified mucosal lesions hyperemia, pastoznost, and puffiness.

The pathogenesis of candidal infection is complex and depends on the pathogenic properties of fungi of the genus Candida on the state of local immunity factors and other antimicrobial factors in the oral cavity and correlates with the severity of clinical manifestations and indicators index for rating GAMES, KPI, the CPU. It is the level of functional systems of the mouth depending on age, health state and other factors characterizes the ecosystem as a whole. Kandidonositelstvo, manifested as atypical or CTE is Tay form of candidiasis, depends on the condition of the whole body and occurs according to the literature up to 88% of cases.

There is a method of assessing the status of SRO in oral fluid in inflammatory periodontal diseases, namely, that in the oral fluid, record levels of chemiluminescence, the maximum flash from 0.8 to 5 conventional units and setosum from 1.5 to 37 conventional units assessed as low activity of free-radical oxidation, and in the complex treatment administered prooxidants, maximum flash from 6,55 to 45 and setosum from 612 to 497 conventional units assessed as high activity of free-radical oxidation in the complex treatment administered antioxidants [patent RU 2140633, 1999 ]. However, this diagnostic method takes into account only gross violations of free-radical oxidation in HICP.

Oral fluid that bathes the tissues of the oral cavity, consists of mixed saliva, Kumanovo epithelium, food debris, microorganisms and their metabolic products. Currently, in vitro studies are widely used study of oral fluid collected after pre-rinsing the mouth with 200 ml of saline for 10-15 minutes.

However, this method of collecting material for research not possible to assess the extent of gross violations of homeostasis, taktak after rinsing from the mouth is removed more cells Kumanovo epithelium, changing the concentration factors of local immunity, which were achieved in the oral cavity within the last 8-10 hours.

The prototype of the present invention is a method of determining the state of the COP and periodontal tissues, including taking scrapings of the epithelial cells from the inner surface of the cheeks, washing, fixing, painting and counting the average number of adhered bacterial cells on the same epitheliocyte, and the index definition colonization buccal epithelium (ICBA) taking into account the intensity of caries (CPU) and hygiene index (GI) of the oral cavity. When IKBA from 0 to 9 the condition of the oral cavity assign 0 points and evaluate how the predisposition to inflammatory disease RESISTANCE, when IKBA from 10 to 59 - 1-2 points - the state estimate, as normal, CPU=0, GI=1-1,4 points, IKBA from 60 to 89 - 3 points - risk group, with IKBA from 90 to 119 - 4 points - the state estimate as offset, CPU - 1-4. When IKBA from 120 to 159 - 5 points - as subcompensated, CPU - 5-7 points, IKBA from 160 and above - 6 - 10 points - as decompensated condition of the oral cavity, the CPU 8 points [patent RU 2158426, 2000 ].

However, the known method does not allow differential diagnosis keratoticheskie processes SOR in the form of "white acts", which is manifested by increased keratinization type parakeratosis, keratosis, is hyperkeratosis, "lejkokeratoz" and acanthosis due kandidonositelstvo and candidiasis in people living in the region with adverse environmental factors, because it does not detect the presence of oxidative stress, the imbalance of the main factors of nonspecific resistance, contamination of the oral cavity yeast fungi of the genus Candida, processes of differentiation and keratinization of epithelial cells.

The objective of the invention is to develop a method of differential diagnosis of high degree of keratinization of the epithelium - keratoticheskie process in the form of "white acts" type: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz" and acanthosis, due to the pronounced clinical and morphological changes multilayer flat orogovevshih epithelium detected by kandidonositelstvo or candidiasis, the imbalance of the main factors of nonspecific resistance and oxidative stress.

Technical result achieved - improving the accuracy of differential diagnosis keratoticheskie processes in the form of "white manifestations."

The proposed method of differential diagnosis keratoticheskie processes as follows. In non-stimulated saliva (mixed saliva), collection of which is conducted on an empty stomach for 15 minutes without pre-rinsing Palast the mouth, determine the state of the main factors of nonspecific resistance of oral fluid (concentration of secretory immunoglobulin a and lysozyme), are chemiluminescence and determine sutasoma radiation for 5 minutes study for the detection of oxidative stress, as well as determine kandidonositelstvo or candidiasis by bacteriological seeding oral fluid and smears from the mucous membrane of the gums, cheeks along the lines of closing the teeth, the dorsal surface of the tongue. Spend luminescent study in beams of wood mucous marginal portion of the gingiva and gingival papillae, the mucous membrane of the cheek in the area of closing the teeth, the dorsal surface of the tongue in the area of filiform papillae (taste bulblets), clinical (visual inspection) and morphological investigation of multilayer orogovevshih squamous epithelium of the mucous membrane of the cheeks, along the lines of closing the teeth, the marginal portion of the gingiva and gingival papilla and the dorsal surface of the tongue in the area of filiform papillae.

The resulting sample is not stimulated oral fluid centrifuged at 1500 rpm for 20 minutes the Supernatant part are used to determine the factors of local immunity - lysozyme and secretory immunoglobulin A (SIgA). For the quantitative determination of SIgA in oral fluid using solid-phase immunoassay method and commercially the set of "SIgA-ELISA-BEST-strip" (JSC "Vector-best", , Novosibirsk). The results of the analysis recorded photometrically at a wavelength of 450 nm. The density measurement is carried out in one step all used the wells in immunoassay analyzer. The SIgA concentration in samples is determined by a calibration curve. The material is subjected to statistical analysis using student's criterion.

Lysozyme activity of mixed saliva studied spectrophotometrically by the method of O. C. Bukharin (1975) with live culture. Used daily culture of Micrococcus lysodeyticus, which is washed with a saturated solution of phosphate buffer and adjusted to fotoelektrokalorimetry before reading the optical density of 0.66 (cuvette with a diameter of 3.0 cm; quality control - saline). The inactivate serum for 30 minutes at a temperature of 56°C. Then, the sample with the culture for 30 minutes, placed in a thermostat at 37°C. the Optical density measured on fotoelektrokalorimetry with protective light filter in a ditch with a diameter of 3.0 cm, as take control saline.

The chemiluminescence of oral fluid is measured in the unit of CHL-003 [Farkhutdinov P. P. a Device for recording chemiluminescence (Chemiluminometer - holdem-003). / P. P. Farkhutdinov, C. A. Lihovsky // Methods of evaluation of antioxidant activity of biologically active substances therapeutic and prophylactic N. the values M., 2005, 155-172].

As the most informative indicator of CHL determine sutasoma radiation S for 5 minutes research. The entire measurement process PI and the results are analyzed in the automatic mode, which allows to increase the accuracy and objectivity of the information received.

Comprehensive microbiological examination includes: bacteriological sowing of mixed saliva (oral fluid) and smears from the oral cavity (mouth, tongue, gums). This study includes the allocation of present yeast-like fungi of the genus Candida spp., the determination of their number, gives you the opportunity to judge the severity of the violation microbiocenosis in the presence or absence of identified Candida fungus, and the existing character of the inflammatory process.

Oral fluid centrifuged at 1500 rpm for 10 minutes. Then about precipitation (disposable plastic loop) is placed on a selective chromogenic medium HiCrome Candida Agar ("Himedia, India). Crops incubated at 30°C for 24 h On the second day, take into account the results of cultivation. In the absence of growth give a negative answer about the presence of Candida in the material, in the presence of growth indicate total microbial number, which is expressed by the number colonialisme units (CFU) per unit volume of material, and conduct rapid identification, the th species of the genus Candida on the colour of the colonies.

In addition, prepare smears on slides from a material with the dorsal surface of the tongue in the area of filiform papillae, the mucous membrane of the cheeks along the line of closure of the teeth and gums paint them on a Gram-for further microscopic examination and determination of the number and kinds of white blood cells, flora. In smears stained by Gram determine their morphological and tinctorial properties, as well as conduct a quantitative assessment (Menshikov centuries 2003). The study material from the oral cavity microflora do with the observance of Sanitary rules SP 1.2.731-99.

The method of fluorescent diagnostics beams of wood mucous membranes of the mouth based on the ability of tissues and their cellular elements under the action of ultraviolet rays to change their natural color. The method is non-invasive and can be used in the diagnosis of white manifestations in the form keratoticheskie processes in the oral cavity, has a high degree of reliability. In the rays of the wood healthy oral mucosa has a bluish-purple glow, the language of a healthy person's fluorescent in shades from orange to red. When keratoticheskie processes: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis oral mucosa has accordingly bluish-purple glow, dull yellow, bluish-purple Sweden is e, gray-yellow glow.

The advantages of the proposed method are the possibility of using mass inspections, accessibility and reproducibility with a high degree of relevance and the reliability of the results. At the same time, the proposed method of differential diagnosis keratoticheskie processes, manifested in the form of "white manifestations of mucosal-type: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz" and acanthosis, is one of the reliable early markers of increased keratinization and the possibility of malignancy in individuals living in the region with adverse environmental factors in age from 15 to 45 years.

The invention is illustrated by the following figures, which presents histograms (stained with hematoxilin and eosin): Fig. 1 - parakeratosis: cellular desquamation of the Horny layer of the stratified squamous epithelium; Fig. 2 - parakeratosis: swelling of cells in the granular and spinous layers of Fig. 3 - keratosis: enhanced cellular desquamation of the superficial layer of the stratified squamous epithelium; Fig. 4 - hyperkeratosis: enhanced cellular desquamation of the Horny layer of the epithelium, swelling of the cells in the granular and spinous layers of Fig. 5 - "lejkokeratoz": the expansion of the granular and stratum corneum; Fig. 6 - "lejkokeratoz": in the cytoplasm of cells of the granular layer of the increase in the number of keratohyaline; in Fig. 7 - "lejkokeratoz": infiltration stormy cell lympho-macrophage fibroelastosis cells; Fig. 8 - "lejkokeratoz": pronounced hyperkeratosis with increased basal layer and the presence of the granular layer, and Fig. 9 - "lejkokeratoz": marked acanthosis, and Fig. 10 - "lejkokeratoz": infiltration own plate of mucosal macrophages, lymphocytes, plasma cells, fibroblasts.

We have investigated 68 bioplanta soft gum tissue, obtained by extraction of teeth for orthodontic reasons, 57 bioplanta mucosa of the cheeks, along the lines of closing the teeth, with signs of lejkokeratoz" on the basis of informed consent, persons aged 15 to 45 years living in the region with adverse environmental factors.

On the mucous membrane of the mouth in response to exposure to pathogenic microflora dominated yeast-like fungi of the genus Candida (yeast or mycelial form) appear pockets slight hyperemia, pastoznost, swelling, chronic catarrhal and keratoticheskie inflammation, lesions keratoticheskie manifestations in stratified squamous orogovevshi epithelium marginal part of the gums, and vertices of gingival papillae, dorsal surface of the tongue in the area of filiform papillae (taste of onions) and the mucous membrane of the cheeks on line clamping teeth.

Different the processes of increased keratinization different characteristic clinical signs.

When parakeratosis - whitish grey filmy strands are spot on slightly hyperemic mucosa, do not rise above the level of the mucous membrane, can be easily removed by poskablivanii.

When keratosis - whitish-grey filmy strands, slightly protrude above the level of damaged or swollen pale pink mucous, not tightly fused with a tissue.

When hyperkeratosis site of increased keratinization has a cloudy white-gray in color, rises above the level of the healthy mucous membrane.

When lejkokeratoz" without signs of malignancy mucous membrane of the cheeks along the line joining the teeth with uneven film blurred gray-white in color, in the form of spots of clear outlines, not rising above the level of the thick mucous that is not removed by poskablivanii.

When lejkokeratoz" with possible clinical signs of malignancy plot of the film haze gray-white in color, thick consistency, rises above the level of the healthy mucosa, is not removed by poskablivanii.

Differential-diagnostically identified keratoticheskie processes, disorders of keratinization of the epithelium, manifested in the form of "white margins determine the appropriate status in stratified squamous orogovevshi epithelium-type: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", aka the TOZ.

Most of the violations of the process of keratinization chronic diffuse catarrhal and keratoticheskie inflammation of the mucous membrane of the cheeks, along the lines of closing the teeth, the dorsal surface of the tongue, marginal part of the gums, the tops of the gingival papillae, correspond to the state of disturbance of the normal process of keratinization type - parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis.

These processes caused the identified kandidonositelstvo or candidiasis, imbalance nonspecific factors of local immunity and oxidative stress in the oral cavity, and also require optimization and increase of efficiency of treatment on the basis of differentiated criteria condition of the mucous membrane, the elimination of candidior (yeast or mycelial form), the correction of oxidative protection (free - radical oxidation) and nonspecific factors of protection of the oral cavity in persons aged 15 to 45 years.

The ecosystem of the oral cavity in young people (15-24 years) with identified kandidonositelstvo (102-103CFU/ml CFU/swab) characterizes the process type parakeratosis, which is more pronounced in multi-layer flat orogovevshi epithelium marginal part of the gums and the tops of the gingival papillae, with candidiasis (104-107CFU/ml CFU/swab) characterizes the process is with the type of keratosis, hyperkeratosis, "lejkokeratoz", acanthosis, which is more pronounced in multi-layer flat orogovevshi epithelium of the mucous membrane of the cheeks, along the lines of closing the teeth, the marginal portion of the gums and the tops of the gingival papillae, dorsal surface of the tongue in the area of filiform papillae (taste bulblets).

Among young people (15-24 years) if contamination of the mouth yeast fungi of the genus Candida 102-103CFU/ml or CFU/swab, the yeast form, fluorescent diagnostics in the rays of the wood - bluish-purple glow, morphologically on the mucous membrane marginal portion of the gums and the tops of the gingival papillae revealed marked changes that differ from the healthy tissues violation enhanced desquamation of cells of the corneal layer of the epithelium, the cells of the granular layer are signs of swelling and hydropic degeneration, swelling of the cells of the spinous layer data characteristics determine kandidonositelstvo in the yeast form, a violation of the process of keratinization of the mucous type parakeratosis (figure 1, 2). Clinically this is manifested viscous, frothy saliva, with swelling of the mucous membrane of the gums, whitish strands of turbidity are spot on edematous, hyperemic mucous marginal part of the gums and the tops of the gingival papillae, are easily removed by poskablivanii, gingival papillae bleeding during probing.

In persons of young people who CSOs age (15-24 years) when contamination of the oral cavity 10 4-105(CFU/ml CFU/swab) in the mucosa of the cheeks, along the lines of closing the teeth, the marginal portion of the gums and the tops of the gingival papillae morphological changes occur by enhancing the desquamation of the Horny and perinuclear swelling of the granular layer, thickening of the epithelial layer due to the proliferation of cells of the basal and spinous layers, the signs of hydropic degeneration of the epithelial layer of the epithelium, with flattening of the layers of the multilayer planar orogovevshih epithelium (figure 3). Clinically it is manifested by increased viscosity of saliva and its (swelling, swelling of the mucous membrane, the presence of keratoticheskie whitish-gray filmy cords, not tightly soldered with tissues, easily removable by poskablivanii, resembling a kind of "velvet paper, slightly protrude above the level of damaged or swollen pale pink mucous, fluorescent diagnostics in the rays of the wood - dull yellow tint - these characteristics determine the violation of the process of keratinization type of keratosis epithelium, chronic oral thrush (yeast or mycelial form).

Among young people (15-24 years) when contamination of the oral cavity 104-107(CFU/ml CFU/swab) (filamentous or yeast form), morphologically identified increased desquamation of the stratum corneum, swelling of the granular and spinous layers (figure ). Fluorescent diagnostics of the mucous membrane of the cheeks on line clamping teeth and the dorsal surface of the tongue in the area of filiform papillae in the rays of the wood gives a bluish-Fioletovo glow. Clinically it is manifested by increased viscosity of saliva and its (swelling, swelling of the mucous membrane, the plot of turbidity mucous whitish-gray color, rises above the level of the healthy mucosa. The fibres are tightly fused with the mucous membranes, difficult to remove - these characteristics determine the violation of the process of keratinization of the mucous membrane of the cheeks on line clamping teeth and the dorsal surface of the tongue in the area of filiform papillae on the type of hyperkeratosis, chronic candidiasis of the oral cavity (filamentous or yeast form).

Among persons aged 35-45 years when contamination of the oral cavity 104-107(CFU/ml CFU/swab) objectively mucous membrane of the cheeks along the line of closure of the teeth with the plot of the film haze of gray-white color, with tuberous plaques, thick consistency, above the level of the healthy mucosa, rough, not removed by poskablivanii. Clinically it is manifested by increased viscosity of saliva and its (swelling, swelling of the mucous membrane, dryness and roughness, increasing the size and thickness be accompanied filmy cords.

Fluorescent diagnostics in the rays of the wood - grey-yellow glow. Morpho is logicheskie identified the strengthening of the process of hyperkeratosis with severe overgrowth of the Horny and granular layers of the epithelium, in the cytoplasm of cells of the granular layer of the increase in the number of keratohyaline, in the connective tissue stroma of the lesion diffuse chronic inflammation with infiltration of lymphocytes and plasma cells (figure 5, 6, 7) is determined a violation of the process of keratinization type "lejkokeratoz" with clinical signs of possible malignancy, chronic candidiasis (filamentous or yeast form).

Among persons aged 20 to 45 years old when contamination of the oral cavity 104-107(CFU/ml CFU/swab) objectively on the mucous membrane of the cheeks along the line joining the teeth of the identified film clouding in the form of spots with sharp edges, gray-white in color, not rising above the level of healthy mucosa, is not removed by poskablivanii. Fluorescent diagnostics in the rays of the wood - bluish-purple with patches of bluish-purple glow. Morphologically identified an impairment of physiological proliferation of epithelial cells, deep ingrowth of epithelium into the connective tissue stroma of the cheeks, in the epithelial layer, there has been a violation epithelization with the phenomenon of the process of lejkokeratoz" (figure 8), increased basal layer, the presence of the granular layer and marked acanthosis (figure 9), private plate infiltrated by macrophages, lymphocytes, plasma cells, fibroblasts (figure 10) Yes the nom case is defined as an increased process of keratinization with signs of physiological proliferation of epithelial cells, and marked acanthosis in the epithelial layer, revealed deep ingrowth of epithelium into the connective tissue stroma cheeks - which indicates the course of hypersensitivity reactions of the delayed type in the tissues and the development of chronic inflammation, this ratio determines the violation of the process of keratinization type "lejkokeratoz" without clinical signs of future malignancy.

A clinical examination 660 of young people aged 15 to 24 years and 100 persons in the age from 25 to 45 years living in the region with adverse environmental factors, which determined the content of the nonspecific factors of local immunity of the oral cavity - SIgA and lysozyme, an indicator of free-radical oxidation (oxidative stress) in oral fluid, the microflora of the oral cavity for the presence of yeast-like fungi of the genus Candida (yeast or michelena form).

According to the results of a comprehensive clinical and laboratory studies of young people aged yeast-like fungi of the genus Candida identified as candicemichelle at 4.3 percent and 95.6% of cases of chronic candidiasis. Among persons aged 35-45 years 100% of cases of chronic candidiasis.

As a result, the five clinical groups:

1. Clinical group (aged 15 to 24 years) clinical and morphologically identified the mucous membranes of the marginal is part of the gums and peaks of the gingival papillae corresponds to the process of keratinization by type - parakeratosis, kandidonositelstvo (yeast form 102-103CFU/ml CFU/swab).

2. Clinical group (aged 15 to 24 years) clinical and morphologically identified the state of the mucosa of the marginal part of the gums, and vertices of gingival papillae, the mucous membrane of the cheeks along the line of closure of the teeth corresponds to the violation of the process of keratinization type - keratosis, chronic oral thrush (yeast and mycelial forms 104-105CFU/ml CFU/there.).

3. Clinical group (aged aged 15 to 24 years) clinical and morphologically identified the condition of the dorsal surface of the tongue in the area of filiform papillae (taste onions) and the mucous membrane of the cheeks along the line of closure of the teeth corresponds to the violation of the process of keratinization type - hyperkeratosis, chronic oral thrush (yeast and mycelial forms 104-107CFU/ml CFU/there.).

4. Clinical group (aged 35 to 45 years) clinical and morphologically identified the state of the mucosa of the cheeks, along the line of closure of the teeth corresponds to the violation of the process of keratinization type "lejkokeratoz" with possible further signs of malignancy, chronic oral thrush (yeast and mycelial forms 105-107CFU/ml CFU/there.).

5. Clinical group (ages 20 to 45 years) clinical and morphol the cally identified the state of the mucosa of the cheeks, along the line of closure of the teeth corresponds to the violation of the process of keratinization type "lejkokeratoz" without signs of malignancy, chronic oral thrush (yeast and mycelial forms 104-107CFU/ml CFU/there.).

Further analysis of these data SIgA, lysozyme and chemiluminescence oral fluid depending on group membership. Set the following:

In persons aged 15 to 24 years at secondary quantitative and qualitative values of the concentration of yeast-like fungi of the genus Candida in yeast form - 102-103CFU/ml CFU/swab, averages SIgA concentration of 0.43±0,017 g/l lysozyme and 3.7±1,95 mg/ml, sutasoma S - 0,64±0,07.E. diagnose kandidonositelstvo and violation of the process of keratinization of the mucous marginal part of the gums and peaks of the gingival papillae type - parakeratosis, fluorescent diagnostics gives a bluish-purple glow and confirm the status of parakeratosis mucous marginal part of the gums, and vertices of gingival papilla (p<0,05).

In persons aged 15 to 24 years at secondary quantitative and qualitative values of the concentration of yeast-like fungi of the genus Candida (in mycelial and yeast forms) - 104-105(CFU/ml CFU/swab), average values SIgA 0,7±0,02 g/l lysozyme 7,01±0,84 mg/ml, S - 0,75±0,09.E. diagnose chronic candidiasis of the oral cavity and the violation of the process of keratinization type keratosis mucous marginal part of the gums, the tops of the gingival papillae, mucous is blocki cheeks along the lines of closing the teeth, confirmed fluorescent diagnostics - dull yellow tint (p<0,05).

In persons aged 15 to 24 years at secondary quantitative and qualitative values of the concentration of yeast-like fungi of the genus Candida (in mycelial and yeast forms) 104-107(CFU/ml CFU/swab), SIgA 0,97±0.08 g/l lysozyme and 12.4±0,29 mg/ml, S - 0,93±0,05.E. diagnose an increased process of keratinization type - hyperkeratosis of the mucous membrane of the cheeks, along the lines of closing the teeth, the dorsal surface of the tongue in the area of filiform papillae (taste bulblets), confirmed fluorescent diagnostics, a bluish - purple glow (p<0,05).

Among persons aged 35 to 45 years of age with secondary quantitative and qualitative values of the concentration of yeast-like fungi of the genus Candida (in mycelial and yeast forms) 104-107(CFU/ml CFU/swab), SIgA 0,97±0.08 g/l lysozyme and 12.4±0,29 mg/ml, S - 0,93±0,05.E. diagnose an increased process of keratinization type "lejkokeratoz" mucous membrane of the cheeks, along the lines of closing the teeth with signs of possible malignancy confirmed fluorescent diagnosis - grey-yellow glow and morphologically (p<0,05).

Among persons aged 20 to 45 years of age with secondary quantitative and qualitative values of the concentration of yeast-like fungi of the genus Candida (in mycelial and yeast forms) 104-107(CFU/ml, the OE/pad), SIgA 0,97±0.08 g/l lysozyme and 12.4±0,29 mg/ml, S - 0,93±0,05.E. diagnose an increased process of keratinization of the mucous membrane of the cheeks, along the lines of closing the teeth with the phenomenon of hyperkeratosis and acanthosis in the type - "lejkokeratoz", with no signs of malignancy confirmed fluorescent diagnostics, bluish - purple with patches of bluish-purple glow and morphologically (p<0,05).

The advantages of the proposed diagnostic method is reproducible with a high degree of relevance and the reliability of the results.

In the available scientific and medical and patent literature is not found identical with the method of differential diagnosis of disorders of the process of keratinization, corresponding to the state of parakeratosis, keratosis, hyperkeratosis of the mucous membrane marginal portion of the gums and peaks of the gingival papillae, dorsal surface of the tongue in the area of filiform papillae, the increased process of keratinization of the mucous membrane of the cheek in the area of closing the teeth, the type of "lejkokeratoz" with signs of possible malignancy and lejkokeratoz" with hyperkeratosis and acanthosis with no signs of malignancy, the mucous membrane of the cheeks, along the lines of closing the teeth, by morphological differentiation state of multi-layer flat orogovevshih epithelium, fluorescent diagnostics in beams of wood, definition Kahn is economicallv and candidiasis (yeast or mycelial form) the contents of the local factors of nonspecific resistance of oral fluid (SIgA and lysozyme) and indicator of oxidative stress in persons residing in the region with adverse environmental factors depending on age. Thus, the claimed invention meets the criterion of "novelty".

The research of the authors was first established and proven that the proposed quantitative and qualitative values of the number of yeast-like fungi of the genus Candida in yeast or mycelial and yeast forms (kandidonositelstvo or chronic candidiasis), the imbalance factors of nonspecific resistance of oral fluid (SIgA and lysozyme) and indicator of oxidative stress, as well as changing the color of the mucous in the rays of the wood and morphological changes of stratified squamous orogovevshih epithelium depending on age are informative and reliable criteria for the differential diagnosis of "white manifestations depending on the status of violations of the process of keratinization type - parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis. Thus, the claimed invention meets the criterion of "inventive step".

The proposed method is illustrated by the following clinical examples.

Example 1

Patient B., 15 years old. Preventive dental inspection is God: the state of the oral mucous membrane marginal portion of the gingiva and gingival papillae moderately moist, edematous, hyperemic, when the sensing spontaneous bleeding, a small number of dental plaque. Whitish strands of plaque are spot on mucous marginal part of the gums, and vertices of gingival papillae, are easily removed during scraping. Oral fluid is foamy, viscous, high viscosity.

Research samples are not stimulated oral fluid and smears from the oral cavity, the following data:

SIgA-0,413±0,017 g/l,

Lysozyme - 5,657±1,95 mg/ml,

S - 0,57±0,07.E.

Fluorescent diagnostics - gingival mucosa gives a bluish-purple glow.

Morphologically in stratified squamous orogovevshi epithelium was observed violation of the granular layer, the signs of swelling and hydropic degeneration, swelling of the cells of the spinous layer.

Qualitative and quantitative composition of microflora of the oral cavity (oral fluid, smear with gum): yeast-like fungi of the genus Candida in yeast form - 102103CFU/ml CFU/swab.

Final diagnosis: Kandidonositelstvo, violation of the process of keratinization of the mucous membrane marginal portion of the gingiva and gingival papillae type parakeratosis. Assigned to the correction of local immunity, dysbiotic shift in candicemichelle, oxidative stress drugs with prooxidant effect, and adaptogens, LAZ is rnie technology (photodynamic therapy), autoregeneration using enriched platelet autoplasma injection.

Example 2

Patient A., 18 years. Preventive dental check-UPS: the state of the oral mucosa marginal part of the gums, and vertices of gingival papilla swollen, hyperemic, when probing bleeding, there is an insignificant amount of dental plaque, the mucous membrane of the cheeks on line clamping teeth swollen. Determined thickened whitish-grey keratoticheskie filmy strands, not tightly fused with a tissue, when the sections are easily removed.

Oral fluid enhanced viscosity, foaming, bad breath.

Research samples are not stimulated oral fluid obtained the following data:

SIgA is 0.72±0.02 g/l,

Lysozyme is 7.85±0,84 mg/ml,

S - 0,66±0,09.E.

The colonization of the oral cavity (the strokes gums and cheek, oral fluid)

- mushrooms of the genus Candida (yeast and mycelial form) of 104-105CFU/ml CFU/swab.

Fluorescent diagnostics - mucous papillary part of the gums, mucosa of the cheek in the area of closing the teeth is provided in the beams of wood dull yellow color.

Morphologically identified increased desquamation of the stratum corneum and perinuclear swelling of the granular layer. Thickening of the epithelial layer due to the proliferation of cells of the basal and spinous layers, the signs of atopicheskogo degeneration of epithelial layer of the epithelium with thickening of the layers of the multilayer planar orogovevshih epithelium.

Final diagnosis: chronic oral thrush (yeast or mycelial form), violation of the process of keratinization of the mucous membrane marginal portion of the gingiva, gingival papillae and cheeks on line clamping teeth by type of keratosis.

Treatment of candidiasis drugs that are yeast-like fungi, correction of local immunity immunomodulatory drugs, oxidative stress drugs with prooxidant effect, adaptogens, laser technology (photodynamic therapy), autoregeneration using enriched platelet autoplasma injection.

Example 3

Patient S., 23 years. Preventive dental check-UPS: the state of the oral mucosa of the cheeks, along the lines of closing the teeth swollen. Be accompanied filmy strands turbid whitish-gray color, with a ring of hyperemia, rise above the level of healthy mucous membrane.

On the dorsal surface of the tongue defined areas of hyperkeratosis filiform papillae, coated tinged whitish-gray color. Areas of hyperkeratosis tightly soldered to the mucous membrane, difficult to remove.

Oral fluid is thick, viscous, frothy. Bad breath (halitosis). Research samples are not stimulated oral fluid obtained the following data:

SIgA - 0,89±0.08 g/l,

Lysozyme - 12,11±0,29 mg/ml,

S - 0,88±0,05.E.

The colonization of the oral cavity (oral fluid swabs - cheek and the dorsal surface of the tongue) is a yeast-like fungi of the genus Candida (in mycelial and yeast forms) - 104-107CFU/ml CFU/swab.

When Troubleshooting in the rays of the wood - bluish-purple glow of the mucous membrane of the cheeks on line clamping teeth and the dorsal surface of the tongue in the area of filiform papillae.

Morphologically identified the strengthening of the process of keratinization of the corneal layer, swelling of the granular and spinous layers.

Final diagnosis: chronic oral thrush (yeast form), violation of the process of keratinization buccal mucosa along the line of clamping teeth and the dorsal surface of the tongue in the area of filiform papillae on the type of hyperkeratosis.

Treatment of candidiasis drugs that are yeast-like fungi, correction of local immunity - immunomodulatory drugs, oxidative stress drugs with prooxidant effect, keratoplasty, adaptogens, laser technology (photodynamic therapy), autoregeneration using enriched platelet autoplasma injection.

Example 4

Patient M., aged 40. Preventive dental check-UPS: the state of the oral mucosa of the cheek in the area of closing the teeth of a film haze of gray-white color, with BU is rotimi plaques thick consistency, rises above the level of the healthy mucosa. Areas of hyperkeratosis increased size and thickness tightly soldered to the mucous membrane, are not removed by poskablivanii, dryness, roughness mucous.

Oral fluid enhanced viscosity and (swelling. Bad breath (halitosis).

Research samples are not stimulated oral fluid obtained the following data:

SIgA - 1,05±0.08 g/l,

Lysozyme - 12,69±0,29 mg/ml,

S - 0,98±0,05.E.

The colonization of the oral cavity (oral fluid and swab from the cheek) is a yeast-like fungi of the genus Candida (in mycelial and yeast forms) - 104-107CFU/ml CFU/swab.

When Troubleshooting in the rays of the wood - grey-yellow glow of the mucous membrane of the cheeks along the line of closure.

Morphologically identified the strengthening of the process of hyperkeratosis with severe overgrowth of the Horny and granular layers of the epithelium, in the cytoplasm of cells of the granular layer of the increase in the number of keratohyaline, the presence of connective tissue stroma of the lesion diffuse chronic inflammation with infiltration of lymphocytes and plasma cells, determines that a violation of the process of keratinization of the mucous membrane of the cheeks on line clamping teeth.

Final diagnosis: chronic oral thrush (yeast form), the violation process increased keratinization of the mucous membrane of y is to the line joining the teeth of the type "lejkokeratoz", with signs of a possible malignancy.

Treatment of candidiasis drugs that are yeast-like fungi, correction of local immunity - immunomodulatory drugs, oxidative stress drugs with prooxidant effect, keratoplasty, adaptogens, laser technology (photodynamic therapy), autoregeneration using enriched platelet autoplasma application.

Example 5

Patient S., aged 22. Preventive dental check-UPS: the condition of the oral cavity: on the mucous membrane of the cheek in the area of clamping teeth stain with irregular clouding epithelium with sharp edges, reminiscent of the film the gray-white color, not rising above the level of healthy mucosa, is not removed by poskablivanii.

Oral fluid enhanced viscosity and (swelling. Bad breath (halitosis). Research samples are not stimulated oral fluid obtained the following data:

SIgA - 0,89±0.08 g/l,

Lysozyme - 12,11±0,29 mg/ml,

S - 0,97±0,05.E.

The colonization of the oral cavity (oral fluid and swab from the cheek) is a yeast-like fungi of the genus Candida (in mycelial and yeast forms) - 104-107KGE/ml, CFU/swab.

When Troubleshooting in the rays of the wood - bluish-purple with patches of bluish-purple glow of the mucous membrane of the cheeks along the line of closure.

Morphologically you who go the violation of physiological proliferation of epithelial cells, deep ingrowth of epithelium into the connective tissue stroma of the cheeks, your own plate infiltrated by macrophages, lymphocytes, plasma cells, fibroblasts, impaired epithelialization with the phenomenon of the process of increased keratinization - parakeratosis, hyperkeratosis, expressed acanthosis, there has been a violation of normal keratinization - "lejkokeratoz". Thus, there is a process of increased keratinization with signs of physiological proliferation of epithelial cells and the severity of acanthosis in the epithelial layer, deep rastani epithelium into the connective tissue stroma cheeks, infiltration own plates macrophages, lymphocytes, plasma cells, fibroblasts, indicating for reactions of delayed-type hypersensitivity and the development of chronic inflammation. Final diagnosis: chronic candidiasis of the oral cavity (mycelial and yeast forms), "lejkokeratoz" mucous membrane of the cheeks on line clamping teeth without signs of malignancy.

Treatment of candidiasis drugs that are yeast-like fungi, correction of local immunity - immunomodulatory drugs, oxidative stress drugs with prooxidant effect, keratoplasty, adaptogens, laser technology (photodynamic therapy), autoregeneration using enriched Tr is Molteni autoplasma injection.

Thus, persons living in the region with adverse environmental factors in age from 15 to 45 years, revealed the characteristic morphological changes of stratified squamous orogovevshih epithelium by type - parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", apoptosis, and immune deficiency in the form of imbalance nonspecific factors of local immunity, kandidonositelstvo, yeast and mycelial forms of chronic candidiasis, an imbalance of oxidative stress, requiring treatment and preventive measures with the purpose of the funds, eliminating the fungi of the genus Candida, stimulating local immunity, oxidative stress, and destination of the funds, stimulating the reparative process of the mucous.

The application of the proposed method allows to reduce time and improve accuracy of diagnosis processes increased keratinization of the epithelium in this category of persons - keratosis, manifested in the form of "white margins by type of violation: parakeratosis, keratosis, hyperkeratosis, "lejkokeratoz", acanthosis. The proposed method is easily reproducible in the clinical laboratory and achieved the specified technical result. Thus, the claimed invention meets the criterion of "industrial applicability".

Way differentia Inoi diagnosis keratoticheskie processes of oral mucosa in persons, living in a region with adverse environmental factors in age from 15 to 45 years, due to kandidonositelstvo and candidiasis of the oral cavity, by clinical definition of the condition of the mucous membranes of the oral cavity, characterized in that in non-stimulated oral fluid and smears determine the content of yeast-like fungi of the genus Candida in yeast or filamentous form, the concentration of secretory immunoglobulin A (SIgA) and lysozyme, are chemiluminescence oral fluid and determine sutasoma radiation (S) within 5 minutes of the study, carried out fluorescence study in beams of wood mucous marginal part of the gums, and vertices of gingival papilla the mucous membrane of the cheek in the area of closing the teeth, the dorsal surface of the tongue in the area of filiform papillae, the morphological study of stratified squamous orogovevshih epithelium of the mucous membrane of the cheeks, along the lines of closing the teeth, the marginal portion of the gums and peaks of the gingival papillae, dorsal surface of the tongue in the area of filiform papillae, when the content of fungi of the genus Candida 102-103CFU/ml or CFU/swab, the concentration of SIgA 0,248±0,024 g/l, the concentration of lysozyme 0,24±being 0.036 µg/ml, the value of S 0,43±0,07.E., bluish-purple glow in the rays of the wood without clinical and morphological changes of the stratified squamous epithelium of diagnosticaindustrie pathogenic microflora and pathology of mucous membrane in the form of increased keratinization in persons aged 15-45 years; in persons aged 15 to 24 years when the content of fungi of the genus Candida in yeast form 102-103CFU/ml or CFU/swab, SIgA concentration of 0.43±0,017 g/l lysozyme and 3.7±1,95 mg/ml, the value S of 0.45±0,07.E., bluish-purple glow in the rays of the wood mucous marginal part of the gums, and vertices of gingival papillae, the existence of a clinically-defined whitish cords opacities, which are spot on hyperemic edematous mucosa, easily removed by poskablivanii, morphologically defined violations desquamation of cells of the corneal layer of the epithelium with the presence in cells of the granular layer swelling and hydropic degeneration, swelling of the cells of the spinous layer diagnose kandidonositelstvo in the yeast form, a violation of the process of keratinization of the mucous membrane marginal portion of the gums and peaks of the gingival papillae type parakeratosis; among persons aged 15 to 24 years when the content of fungi of the genus Candida 104-105CFU/ml or CFU/swab in yeast and mycelial form, the concentration of SIgA 0,7±0,02 g/l lysozyme 7,01±0,84 mg/ml, S 0,75±0,09.E., dull yellow glow in the rays of the wood mucous marginal part of the gums, and vertices of gingival papillae, the mucous membrane of the cheeks, along the lines of closing the teeth, the presence of clinically-defined whitish-gray filmy cords, easily removable by poskablivanii, amid damaged or domestic is Oh pale pink mucous, morphologically defined enhanced desquamation of the stratum corneum and perinuclear swelling of the granular layer, thickening of the epithelial layer due to the proliferation of cells of the basal and spinous layers, hydropic degeneration of the epithelial layer of the epithelium diagnose chronic candidiasis of the oral cavity in mycelial or yeast form, a violation of the process of keratinization of the mucous membrane marginal portion of the gums, the tops of the gingival papillae, cheeks along the line joining the teeth by type of keratosis; among persons aged 15 to 24 years when the content of fungi of the genus Candida 104-107CFU/ml or CFU/swab, SIgA concentration of 0.97±0.08 g/l lysozyme and 12.4±0,29 mg/ml, the value of S 0,93±0,05.E., bluish-purple glow in the rays of the wood of the mucous membrane of the cheeks on line clamping teeth and the dorsal surface of the tongue in the area of filiform papillae, the presence of clinically defined plot of turbidity mucous whitish-gray color, above the level of the healthy mucous membrane, removable hard when poskablivanii, morphologically defined gain desquamation of the stratum corneum, swelling granular and spinous layers diagnose chronic candidiasis of the oral cavity in mycelial or yeast form, a violation of the process of keratinization buccal mucosa along the line of clamping teeth and the dorsal surface of the tongue in the area of naevi the different papillae on the type of hyperkeratosis; among persons aged 35 to 45 years old when the content of fungi of the genus Candida 104-107CFU/ml or CFU/swab, SIgA concentration of 0.97±0.08 g/l lysozyme and 12.4±0,29 mg/ml, the value of S 0,93±0,05.E., gray-yellow glow in the rays of the wood of the mucous membrane of the cheeks, along the lines of closing the teeth, the presence of clinically-defined film haze of gray-white color, with tuberous plaques, thick consistency, above the level of the healthy mucosa, do not disappear when poskablivanii, morphologically defined process hyperkeratosis with severe overgrowth of the Horny and granular layers of the epithelium, increasing the number of keratohyaline in the cytoplasm of cells of the granular layer, the presence of connective tissue stroma of the lesion diffuse chronic inflammation with infiltration of lymphocytes and plasma cells diagnosed chronic candidiasis of the oral cavity in mycelial or yeast form, violation of the process of keratinization buccal mucosa along the lines of closing the teeth, the type of "lejkokeratoz" with possible signs of malignancy; in persons aged 20 to 45 years old when the content of fungi of the genus Candida 104-107CFU/ml or CFU/swab, SIgA concentration of 0.97±0.08 g/l lysozyme and 12.4±0,29 mg/ml, the value of S 0,93±0,05.E., bluish-purple glow with patches of bluish-purple glow in the rays of the wood of the mucous membrane o the to line of closing the teeth, the presence of clinically detectable lesion film opacities in the form of spots with sharp edges, gray-white in color, not rising above the level of the healthy mucosa, not removable by poskablivanii, morphologically defined physiological disorders of proliferation of epithelial cells, deep rastani epithelium into the connective tissue stroma cheeks, violations epithelization with the phenomenon of the process of hyperkeratosis in the epithelial layer, increasing the basal layer, the presence of the granular layer and the severity of acanthosis, infiltration own plates macrophages, lymphocytes, plasma cells, fibroblasts diagnose candidiasis of the oral cavity in mycelial or yeast form, violation of the process of keratinization buccal mucosa along the lines of closing the teeth, the type of "lejkokeratoz" without clinical signs of future malignancy.



 

Same patents:

FIELD: medicine.

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EFFECT: ensuring the prognostic diagnosis of misadaptation disorders as shown by the individual's immune status.

2 ex

FIELD: medicine.

SUBSTANCE: foetal gender is pre-specified by two-dimensional ultrasonic scanning. D-dimer is then measured in pregnant woman's venous blood by immunoturbidimetry. If the measured value in the pregnant women carrying the male foetuses is 350 ng/ml and more, while the correspondent value in the pregnant women carrying the female foetuses is 520 ng/ml and more, coagulation failure are diagnosed.

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6 ex

FIELD: biotechnologies.

SUBSTANCE: invention refers to test systems for content determination for mycopolysaccharides and derivatives including sections similar to synthetic linear nona-β-(1→3)-D-glucoside in environment, in room dust as well, and can be applied for ambient object pyrogenicity assessment during ecological monitoring and residential and production facilities for determination of ambient pyrogenic dust load by inhibition immunoenzyme analysis in solid phase. Test system includes a tray with synthetic linear nona-β-(1→3)-D-glucoside conjugate with bull serum albumin, immobilized on the internal surface of craters, calibrators containing synthetic linear nona-β-(1→3)-D-glucoside solution; lyophilized specific polyclonal rabbit antiserum; anti-species antibody conjugate against IgG(H+L) of rabbit with horse radish peroxidase; 25-fold concentrate of 0.1M phosphate salt buffer solution with 0.05% Tween-20 (PSB-T) pH 7.2-7.4; solution for polyclonal antiserum dilution; solution for dilution of anti-species antibody conjugate against IgG(H+L) of rabbit with horse radish peroxidase; chromogene; stop reagent.

EFFECT: convenient and efficient system for ecological research.

2 tbl, 6 ex

FIELD: biotechnologies.

SUBSTANCE: invention offers method of printing biological ligands in the form of oligosaccharides and/or polysaccharides, and/or peptides, and/or glycopeptides, and/or biotin. A layer of hydrophobic non-volatile fluid not mixing with biological ligand solvent and having lower specific weight than biological ligand solution is applied in advance onto a substrate. Then biological ligands are printed by contact-free method. Vaseline, mineral oil or higher saturated hydrocarbons or mix thereof are used as hydrophobic non-volatile fluid. Preferable thickness of hydrophobic nonvolatile fluid layer is 50-200 mcm.

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3 cl, 2 dwg, 3 ex

FIELD: electricity.

SUBSTANCE: electrochemical method for determination of gram-negative pathogenic bacteria in analysed medium suggests using as signal tag of electroactive magnet nanocomposite particles, which are produced before conjugation stage by creation of transition metals or their compounds for electroactive polymer coating on the surface of magnet nanoparticles. Concentration of pathogenic microorganisms is defined by electrochemical response registered directly in result of conversion of electroactive polymer coating.

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7 dwg, 6 ex

FIELD: medicine.

SUBSTANCE: CD16+CD25+ and IL-6 are measured in blood of the newborn children born by mothers with persistent herpes virus infection on the 7-10 day. If the CD16+CD25+ values are 3.5% and less, while the IL-6 value is 32.6 pg/ml and more, the progression of severe infection caused by herpes simplex type 1 and 2 is diagnosed in the newborn children. The method enables reducing the time of analysis and increasing the accuracy of individual prognosis.

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3 ex

FIELD: medicine.

SUBSTANCE: sRAGE is measured in the peripheral venous blood of a pregnant woman with threatening premature delivery in the time of 22-27 weeks. If the measured value is 659.5 pg/l or less, the perinatal hypoxic central nervous system lesions are predicted in the newborn children.

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1 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: risk factors are established by determining polymorphisms of cytokine genes and H. pylory genotype. The risk factors are graded (A1-A2) and assigned values. That is followed by determining the prognostic coefficients P1, P2 by formulas: P1=-1.54+0.57*A1+0.53*A2 and P2=0.21+1.77*A1+1.70*A2, wherein A1 is a genotype of C+3953T IL-1β polymorphism: TT=0.44, TC=0.51, CC=2.63; A2 is a genotype of IL-1Ra VNTR polymorphism: R2R2=1.74, R2R3=8.08, R2R4=1.33, R3R3=1.59, R3R4=0.30, R4R4=0.51. If P1>P2, a low risk is predicted, while P1<P2 enables predicting a high risk of duodenal ulcer. The technique possesses a quite high sensitivity (100%), specificity (50%) and accuracy (75%) in evaluating the risk of duodenal ulcer.

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2 ex

FIELD: medicine.

SUBSTANCE: patient's blood cell characteristics are measured by determining their glass adhesiveness. That is combined with measuring their aggregation ability and following the location and constituents of the interacting cells. Further, the cells are divided into mononuclear and polynuclear ones, quantitatively calibrated and incubated together in an optimum environment. The method can be used for the cytological cell characterisation in oncologic and autoimmune diseases.

EFFECT: invention provides higher reliability and effectiveness of the known method for the agglomerated leukocyte count.

3 ex

FIELD: medicine.

SUBSTANCE: Tetrahymena pyriformis cell suspension, RD reagent representing a pool of at least 10 factor D-free healthy donor's serums with the other complement components and factors being active as follows from chromatographic sorption of factor D in a column with SM-Sephadex C-50, and a test sample containing factor D to be analysed are introduced into measuring cells of an automated live infusorium counter, and live cells are determined every minute. If the dynamic time pattern of the live cell counts is the same for the test sample and reference representing the pool of 10 healthy donor's serums, the complement factor D activities in both samples are supposed to be equal.

EFFECT: effective method for evaluating the functional activity of the complement applicable in diagnosing a number of diseases.

2 cl, 1 dwg, 1 ex

FIELD: chemistry.

SUBSTANCE: method includes selection, and crushing of biomaterial, two-stage extraction of pesticides with n-hexane, purification of biomaterial from coextractive substances with concentrated sulphuric acid, formation of concentrate of n-hexane extract of pesticides, drying, sample formation by dissolution in 0.5-1 ml of n-hexane and carrying out gaschromatographic identification.

EFFECT: invention is characterised by higher effectiveness and accuracy of research and can be used in biology, ecology, medicine for gaschromatographic identification of organochlorine pesticides, namely α-HCCH, β-HCCH, γ-HCCH, DDT, DDD, DDE, in various biomaterials, such as lipids of internal organs and tissues, blood, milk, bird feathers.

2 cl, 1 dwg

FIELD: medicine.

SUBSTANCE: invention represents a method for preclinical study of cardiotropic antiarrhythmic drugs, involving determining the bioelectric parameters in isolated multicellular perfused preparations and measuring an action potential duration, differing by the fact that the isolated multicellular perfused preparations are presented by rat's pulmonary vein myocardium; the parameters are measured in three operation modes of the multicellular preparations; a resting potential is additionally measured; varying APD 90%, related APD 50%/APD 90%, a spontaneous shear velocity of the resting potential, the most positive membrane potential in the resting preparation, a spontaneous activity train repetition rate, spontaneous action potential train repetition and variability frequency, post-depolarisation number and intensity, as well as a shear membrane potential corresponding to the beginning of train activity are used to evaluate the signs of antiarrhythmic and arrhythmogenic action.

EFFECT: more reliable prediction of the antiarrhythmic action of the potential pharmacological agents and reduction of experimental phase time.

3 dwg

FIELD: measurement equipment.

SUBSTANCE: invention comprises a method of determination of nano trace contaminants, supposing the use of emulsion from liquid crystal drops, dispersed in water and capable to change a configuration of liquid crystal drops in presence in the emulsion composition of foreign admixtures, measurement of change of intensity of light scattered by the emulsion, according to which it is possible to evaluate the content and density of required admixtures differing by that for a liquid crystal the compounds capable to trans-cis-transition under the effect of actinic light are selected and before measurement of change of light intensity the emulsion is illuminated additionally by actinic light, thus ensuring change of configuration in liquid crystal drops due to trans-cis-transition in liquid crystal molecules.

EFFECT: increase of sensitivity of method of determination of nano-trace contaminants.

FIELD: biotechnology.

SUBSTANCE: invention refers to a method for identifying living and dead mesozooplankton in seawater samples, which involves taking samples, staining the organisms with suitable colouring material, giving a visual estimation of the colour intensity of the units under the microscope, which is combined with microphotographying the units with an adjustable camera without changing the settings keeping throughout a photographic session of at least one sample; thereafter colour and brightness specifications average for each unit are measured in the formed images with using a painting program, e.g. Adobe Photoshop package, and the units are referred to living or dead by a discriminative analysis of the varied digital values.

EFFECT: improving the method.

FIELD: biotechnologies.

SUBSTANCE: identification method of blue pus bacillus Pseudomonas aeruginosa involves inoculation of the test material on a hard substrate, incubation of the inoculum under anaerobic conditions at the temperature of 37°C during 16-18 hours. The obtained bacterial mass in the amount of one bacteriological loop is placed in 300 mcl of a physiological solution and warmed-up at the temperature of 98-99°C during 20-30 minutes and centrifuged at 12000 revolutions per minute during 30 seconds. To a supernatant there added is colouring material for electrophoretic detection in the quantity of 0.5 mcl and 20 mcl is added to a well with a size of 4×1 mm 1.2% agarose gel on TAE-buffer with 10 mcl of 1% ethidium bromide. Besides, the amount of 3 mcl of the solution of standard DNA-marker 1 kb containing DNA fragments in the range of 250-10000 bp is added to the test well. Horizontal electrophoresis is performed during 15-20 minutes, and at detection on the obtained electrophoregramme of the test bacterial mass of three strips radiating in ultraviolet light, one of which corresponds to fragments of standard DNA-marker with the size of 10000 bp, the second one corresponds to fragments of standard DNA-marker with the size of 6000-8000 bp and the third strip at the end of the track in the form of a whisk, which corresponds to fragments of standard DNA-marker with the size of less than 750 bp, there identified is Pseudomonas aeruginosa in the test bacterial mass.

EFFECT: method allows quick and complete identification of pigment-shaping and non-pigment strains Pseudomonas aeruginosa in a test bacterial mass.

5 dwg, 2 ex

FIELD: agriculture.

SUBSTANCE: for analysis of removal with meadow grass of biochemicals the yield fluctuations are accounted depending on the structure of phytocenosis in the form of a ground cover. Conducting statistical data processing of testing the samples of grass from the test plots on the meander, central and terrace near flood plains, and also on the meadows with uneven and tiling location of grass species. And prior to establishment of sample plots the terrain reconnaissance is carried out with the grass cover selected for the measurements, an outline map of location of the components of the grass cover is made, then on each component of the grass cover in the form of a plot at least one temporary test plot is established, the wet and air-dry weight of the sample is determined by weighing on the cut grass sample. At that the tests on biochemical analysis are additionally carried out on the dried samples of grass to determine the concentration of at least three chemical nutrients in the form of mobile nitrogen, potassium and phosphorus oxides, and then by summing the concentrations of these three substances the total summarised removal of substances from the aerial part of grass on all test sites is calculated.

EFFECT: invention enables to determine the productivity of meadows.

9 cl, 12 dwg, 4 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: for the purpose of the confirmation of a patient's death caused by ventricular fibrillation accompanying myocardial infarction in the patients died from myocardial infarction in the course of autopsy on the basis of a macroscopic pattern, the pathological process age is determined. This enables selecting examination areas in the heart at the level of necrosis. Absolute values (AV) of the following cell populations are counted in the x600-magnified visual field with using haematoxylin and eosin: necrosis-borderline lymphocytes (Lfb) in myocardial infarction of the age of 1-2 days, necrosis neutrophilic granulocytes (NGn) and fibroblasts (Fbn) in myocardial infarction of the age of 3-5 days. The derived absolute values are compared to threshold values (TV) with the threshold values of Lfb=2, NGn=38, Fbn=1. Each visual field is assigned with a diagnostic coefficient (DC), which is equal to 1.9 at the age of myocardial infarction of 1-2 days, if the absolute values Lfb<2 or -3.9, Lfb>2; if the age of myocardial infarction is 3-5 days, the diagnostic coefficient is -2.1, if AFbn<1, or the diagnostic coefficient is 7.2, if the absolute value of Fbn>1; the diagnostic value of 1.36 is shown by the absolute value of NGn<38; the diagnostic value is -11, if the absolute value is NGn>38. The total value (ΣDC) is calculated by moving between the visual fields within the examined area, and if ΣDC>12.78, the patient's death is stated to have come from ventricular fibrillation; if ΣDC<-12.78, the death is stated to be caused otherwise.

EFFECT: information value and reliability of the examination accompanying forensic medical examination.

1 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to laboratory diagnostics and can be used for testing biological samples for pathogenic microorganisms. The device for microbiological analysis of the body fluid samples comprises a compartment for incubating sample containers, an analyser for studying the internal atmosphere of the above containers and a sorting system for classifying the above containers in accordance with the carbon dioxide content detected by the above analyser. The sorting system classifies the containers delivered from the above incubation compartment to divide the above containers into the positive containers to be analysed for identifying microorganisms found in the respective samples, and the negative containers wherein the analysis is not required for identifying the microorganisms, and also the unspecified containers to be incubated once again.

EFFECT: invention provides simplifying and accelerating the analysis of the biological samples for the pathogenic microorganisms.

10 cl, 8 dwg

FIELD: medicine.

SUBSTANCE: method involves a post-therapeutic cytological examination of smears sampled from septic wounds, a cell composition analysis, including neutrophilic granulocytes and tissue elements - fibroblasts and fibrocytes; the material sampled from the septic wound on the 3rd day from the beginning of therapy is used for the cytological examination to determine accessory signs of therapeutic pathomorphism, namely the morphology of neutrophilic granulocytes, fibroblasts and fibrocytes and the presence of oxyphilic ground substance; observing the nuclear fragmentation and cytoplasm vacuolation in the neutrophilic granulocytes, multinuclearity, nuclear lobulation, karyonuclei in nuclei, basophilia, cytoplasm grain and vacuolation in fibroblasts and fibrocytes, as well as the presence of the oxyphilic ground substance, the treatment is stated to be effective.

EFFECT: invention provides objective clinical findings of the wound process even on the third post-therapeutic day and can be used for the reliable determination of the clinical effectiveness in septic wounds.

1 ex, 5 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine. Substance of the early diagnostic technique for chronic renal disease consists in using a dosage range of dopamine of 1 to 3 mcg/kg of body weight and a standard water load of 200 ml. No glomerular filtration rate increase testifies to the presence of early signs of chronic renal disease.

EFFECT: using the declared technique enables standardising the examination as high as possible by precise dosage measurement of the preparation.

2 tbl, 2 ex

FIELD: chemistry.

SUBSTANCE: chemosensor film-type composite material for determining copper (II) cations is a film obtained by depositing a composition containing PVC, a crown-containing styryl dye 2-{2-[4-(1,4-dioxa-7,13-dithia-10-azacyclopentadecan-10-yl)phenyl]vinyl}-9-methyl-1,10-phenanthroline, solvent - tetrahydrofuran or acetonitrile, plasticiser - dioctyl ester sebacic acid and sodium tetraphenylborate, on an inert optically transparent substrate, followed by removal of the solvent and treatment of the obtained film with an aqueous solution of sodium acetate and acetic acid with pH=6.8 for 2-5 minutes. The invention enables to quantitatively determine copper (II) cations at the maximum allowable concentration level in aqueous media, as well as in the presence of tenfold excess of cations of other metals (K+, Na+, Ca+2, Mg+2).

EFFECT: high accuracy of determination.

2 cl, 1 dwg, 3 ex

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