This review summarizes information on the protective inhibition of human behavior in extreme conditions. It has been shown that cortical cells have a limit of working capacity, upon reaching which protective inhibition develops, which protects the body from excessive exhaustion. The basis of the protective inhibition is the activity of corticospinal neuronal mechanisms. Emotional arousal affects the speed of development of the protective inhibition. The neural networks of the cortex, subcortical formations (basal nuclei, limbic system), and the structures of the brain stem are the anatomical substrate for the formation of transcendental states. One of the neuromodulators providing the transcendental mental states is dopamine. Cortexin and Mildronate increase brain efficiency in extreme conditions. Stimulation of the central nervous system reduces central fatigue and, consequently, increases working capacity. Hypoxia of the brain, on the contrary, reduces the effectiveness of physical exercises in extreme activities. In the disadaptive state, the inhibitory processes prevail in the central nervous system and the fatigue and the protective inhibition occur more quickly.

Striving to achieve the goals of the training process with the irrational use of physical activity can lead to a decrease in the adaptive and reserve capabilities of the athlete. The development of changes in the endocrine, cardiovascular and central nervous systems may result in the development of overtraining syndrome. There is no unified approach to the definition, diagnosis, treatment and prevention of overtraining syndrome in the literature up to the present day. The endocrine aspects of the development of the overtraining syndrome are not sufficiently studied. In particular, there is no clear understanding of the degree of involvement of various hormonal mechanisms in its pathogenesis and ideas about the possibilities of using hormone levels to diagnose this condition. The purpose of this publication is to summarize and systematize the available concepts regarding the endocrine aspects of the overtraining syndrome.

Objective: the aim of this study was to evaluate the dynamics of the enzyme creatine phospokinase (CPK) in professional soccer players during the competitive period and to develop criteria and standards for the short and long-term adaptation of the athlete's body to physical exertion. Materials and methods: clinical and laboratory monitoring. During two seasons of the national championship 26 soccer players of high sports qualification (age: 26.7±3.1 years, height: 181.5±5.8 cm, fat content in the body: 9.9±1.7%) were examined. All athletes met the following criteria for inclusion in the study: participation in the pre-season, competition period; measurement of CPK level before the start of the season and at all time points after three games during the season; participation time - at least 75 minutes of the match (75-90 min/match); absence of muscle damage and complaints from the muscular system. Results: a twofold increase in the level of CPK was registered on the day after the match; a uniform decrease in the concentration of the enzyme was detected 60-72 hours after the match with the return of indicators to the pre-game level (p <0.05). The relation between athlete’s complaints for general muscular fatigue and high CPK values was established. There was a multiple increase in the concentration of CPK in cases of recorded muscle damage. Conclusions: determination of the CPK level in professional soccer players allows to monitor and evaluate the dynamics of the recovery process, to identify cases of hidden muscle damage. Digital criteria for urgent and long-term normal adaptation of athletes to physical loads based on the content of CPK were obtained.

Objective: the evaluation of the micronutrient content in highly skilled hockey players during the competition period to reveal the influence of physical loads on the vitamin-mineral saturation of human organism. Materials and methods: contents of some micronutrients, cortisol and testosterone were analyzed in the blood samples of 33 sportsmen of continental league hockey team (average 26,4±0,8 years) during the competition period. Results: a high level of cortisol and a high anabolism index was revealed during the entire competitive period. The content of macroelements in the blood of the hockey players corresponded to the reference values, but the concentration of cuprum and chromium was reduced. Low values of the vitamins B2 and E were also detected in the blood of the athletes. Conclusion: the sportsmen became overtrained during the competition period. The high saturation of micronutrients corresponding to the physical loads was not observed; instead, a pronounced deficiency of some micronutrients was revealed. The physical loads in overtrained sportsmen caused a decrease of the micronutrient content in the sportsmen’s organisms. Therefore, sportsmen need the optimization of nutrition by the use of natural food products rich in micronutrients. The intake of biologically active supplements (chosen individually) should be a secondary measure only.

Objective: to study the attitude towards doping among students in Russian sport. Materials and methods: sociological quantitative on-line research using river-sampling was conducted among students of secondary and high school education engaged in physical culture on a regular basis and also among students choosing a specialization in the sphere of physical culture and sport including supplementary education programs of secondary specialized education. Study included 450 secondary school students (Group#l) and 450 secondary specialized education students in the sphere of physical culture and sport (Group#2). Results: the research carried out that the students’ attitude towards doping was similar. Negative assessment of misuse of prohibited substances was consistent alongside with support of anti-doping educational programs and activities. Low level of awareness about the issue of doping in sport was detected. Conclusions: creating and implementing robust anti-doping educational program aimed at different target audiences (taking into account sport specific and awareness level) are the main ways to the effective fight against doping in sport.

The analysis of literature data on modern methods of gonarthrosis treatment based on a decrease in the body weight of patients was conducted. The pathogenetic relationship between obesity and osteoarthritis, in particular, the role of adipokines, was considered. It was shown that a decrease in body weight contributed to a positive dynamics of the functional state of joints affected by osteoarthritis. At the same time, there was a complex system of physical, personal, psychological and social barriers and incentives to keep these patients at the proper level of physical activity. It was indicated that one of the ways to improve the effectiveness of treatment should be the use of methods that activate patients with osteoarthritis. The need to develop and approbate methods based on programs to increase the level of physical activity of patients, including the use of methods of therapeutic physical training was noted.

Objective: presentation of various women wrestlers' body constitution indicators in the form of basic factors and creation of estimated centile scales. Materials and methods: the material for this study was the results of the morphological surveys of the strongest wrestlers - freestyle women athletes, members of the Russian national teams, that participate in major international competitions (n = 162). Longitudinal, transverse and circumference body sizes as well as skinfold thickness was measured and body composition was analyzed by bioimpedance method in all women athletes. Based on received data the following calculated indicators were determined: proportions of the body, body composition, somatotype etc. Generally, the survey program included 142 different indicators characterizing the body constitution of women athletes. Results: the factor analysis of women wrestlers' body constitution identified 7 factors that explained 90,43% of generalized variance. Lean body mass (kg), skeletal muscle mass (%), forearm length (cm)/arm length (cm) index, pelvis-and-crest diameter (cm)/acromial diameter (cm) index, fat mass (%) (according to Mateiko), femur circumference (cm)/tibia length (cm) and foot height (cm) index, phase angle (deg.)were considered as valid indicators. Furthermore, valid indicators represented a maximal variability and dispersion of studied indicators in this sports specialization. It gives the basis to use them for development of estimated centile scales. Conclusions: analysis factor structure of elite women wrestlers' body constitution indicated that it can be described by 7 factors with high significant reliability (90,43%).

Objective: to develop the methodology to assess the adaptive reserve of the vascular system of the abdominal cavity in children based on the determination of hemodynamic parameters in abdominal arteries and veins in the dynamics of the functional tests. Materials and methods: the study included 48 healthy children and 33 children with a mixed form of cystic fibrosis from 4 to 17 years old. Doppler method determined the parameters of blood circulation in the abdominal vessels (abdominal segment of the aorta, celiac trunk, superior mesenteric, common hepatic, the splenic artery, the lower hollow, portal, and splenic vein). Adaptive reserve of the vascular system was assessed using postprandial and respiratory testes. Results: eating and breath holding in healthy children caused a dilatation of the abdominal vessels and a significant increase in volumetric blood flow velocity. In the presence of liver damage, a decrease of adaptive reserve of regional hemodynamics of the abdominal cavity was registered. The main changing was a decrease in the degree of physiological dilation of the abdominal vessels and the lack of adequate growth of the values of volumetric blood flow velocity after performing the functional tests. Conclusions: reduction of adaptive reserve of the vascular system of the abdomen is an early sign of liver injury in cystic fibrosis and precedes the appearance of structural defects of the body.

Objective: to study dynamics of parameters of system immunity of athletes during the recovery period against the background of the combined reception of antler bathtubs and extract of larvae of a wax moth. Materials and methods: dynamics of parameters of the immune system of 28 athletes (skiers) had been studied during the recovery period. The main group of athletes (14 people) received antler bathtubs in combination with intake of extract of larvae of a wax moth, and group of comparison - only antler bathtubs. Results: the analysis of the results of the survey showed that the combined reception of the extract of the larvae of the wax moth and antler baths by athletes has a pronounced effect on the dynamics of the studied parameters. The significant augmentation of initially lowered subpopulations of lymphocytes became perceptible (CD3+, CD4+, CD8+). There was an essential depression of concentration of pro-inflammatory cytokines of TNF-a and IL-6 in blood serum and depression of spontaneous production of pro-inflammatory cytokines of TNF-a (p =0,010), IL-6 and IL lß by blood cells. Conclusions: the obtained data confirm the expressed immunomodulatory effect of extract of larvae of a wax moth in athletes during the recovery period.

Objective: to evaluatethe preventive immunotherapy's (PIT) influence on indicators of cellular immunity of highly qualified combat athletes, depending on the level of sporting achievements. Materials and methods: research included 79 sportsmen with average age of 25,2 years, average weight 76,9 kg, sports experience no less than 10 years and sports rank no less than master of sports. Participants were stratified by the level of achievements in sports. The group 1 with highest level of achievements consisted of 31 sportsmen, each of who earned victory or a prize place on biggest international competitions (such as championships of Europe, World and Olympic Games). Remaining 48 participants didn't have such achievements, but theywere a part of national team (Group 2). PIT included probiotic - Fervital, a complex preparation of omega 3-6-9 fatty acids, vitamin-mineral complex - the Alphabet-biorhythm; antioxidant complex - Ubigold Q10 (coenzyme Q + vitamin E); antihypoxant - Hypoxen; sedative - Novo-Passit; adaptogenic drug - Gerimax Ginseng; polyenzyme complex - Wobenzym. Results: there was a great balance of cellular immunity in the group 1 before the PIT due to the higher content of CD4⁺ and CD19⁺ cells. A statistically significant increase in the relative content of CD3⁺ and CD8⁺ cells and a decrease in the relative and absolute content of CD16⁺ cells was detected against the background of PIT in the group l. But the group 2, on the contrary, showed an increase in the relative and absolute content of CD16⁺ cells. Conclusions: the obtained results showed a different reaction in the both groups to the conducted preventive immunotherapy, which, apparently, was due to the initial difference in the biochemical, genetic, psychological potential of athletes of these two groups.

Objective: subcutaneous rupture of the distal biceps tendon is the most common tendon injury of the elbow. Recently with the best understanding of the anatomy and the advent of new fixations many surgeons took up the use of single incision surgery, as an alternative to replace the tendon. Materials and methods: 40 male patients (average age 45,2) operated from 2006 to 2016. Results: only 3 cases had post-surgery complications: 1. a transient neurapraxia of the posterior interosseous nerve, 2. a radio-ulnar synostosis with stiffness in pronation and supination, and 3. a stiffness of the elbow in extension of approximately 5° degrees. Conclusions: the reinsertion of the distal biceps tendon with bone tunnel in anatomical site is a safe, reproducible technique that offers excellent clinical results. Patients achieve a complete recovery of the elbow range of motion, strength and endurance, with minimal risk of complications

Objective: to study the genetic selection of the EPAS1 gene (G/А, rsl867785) in a group of athletes involved in Greco-Roman wrestling with different levels of sportsmanship. Materials and methods: the genetic examination of 79 male athletes (from 7 to 25 years old) involved in Greco-Roman wrestling and 92 controls (from 7 to 30 years old) was performed. Results: the frequency of A-allele associated with better adaptation to hypoxic conditions was higher in the group of wrestlers (EPAS1*GG - 27.8% EPAS1*AG - 67.1% and EPAS1*AA - 5.1% against EPAS1*GG - 56.5% EPAS1*AG - 35.9% and EPAS1 *AA - 7.6 %. x² = 16.7 p = 0.0002). The frequency of A-allele carriers increased with increasing level of sportsmanship of studied athletes. The increase in the frequency of minor A-allele in the subgroup of Greco-Roman wrestlers testifies to their advantage in comparison with the carriers of G-allele. Conclusions: G/A-polymorphism of the EPAS1 gene can be used in the selection and prediction of sports success in Greco-Roman wrestling.