On the basis of the analysis of the results of radiological research of the cervical spine of 152 patients with osteochondro-sis, the objective criteria of macro- and microstructural deformations in vertebrae and the degree of their mineralization are established, which allows one to diagnose the degenerative dystrophic process and to resolve the questions of treatment and medical rehabilitation.

The аim of the study was to develop a method of repeated and delayed esophageal reconstruction after incomplete esophageal replacement for patients with esophageal and gastroesophageal carcinomas. From 2010 to 2015 at the N.N. Alexandrov National Cancer Centre of Belarus 41 patients underwent repeated (n = 29) and delayed (n = 12) esophageal replacement by colon interposition after radical surgery for esophageal and gastroesophageal carcinomas after incomplete esophagoplasty. To evaluate the technology effectiveness, all patients were divided into two groups – control (n = 21) and main (n = 20) ones. In the control group esophageal reconstruction was performed by the previously used procedure, in the main group – by the developed method with vascular augmentation of the graft by the vascular anastomosis formation between colonic and internal thoracic vessels. The use of a new method of esophageal reconstruction has reduced the overall incidence of postoperative complications (from 57.1 to 15.0 %, p = 0.006) mainly due to decreasing the incidence of ischemic complications (from 33.3 to 5.0 %, p = 0.024). The method of reconstruction has allowed one to increase the overall survival: 1-year – with 43.2 ± 11.4 to 66.7 ± 11.4 %, and 3-year – with 21.6 ± 10.5 to 34.3 ± 13.2 % (p_log-rank = 0.350). At the same time, the median survival increased from 6.0 ± 1.0 months to 16.0 ± 1.5 months. Additional blood supply to the graft has reduced the incidence of esophageal anastomotic scar stricture from 28.6 to 5.0 % (p = 0.048). The new method of esophageal reconstruction can improve the immediate and long-term results of plastic in patients suffering from esophageal and gastroesophageal carcinomas after surgery with incomplete esophagoplasty without affecting the frequency and structure of postoperative complications, in-hospital and 30-day mortality.

A long-term (10 days) use of probiotics in the diet leads to a shortened re-polarization period, an increase in the electrical diastole of the heart (“Dialakt”), the intensification of excitation processes in the myocardium of the atria and ventricles (“Bifidumbacterin”). At the same time, the indicators of heart rate variability point to the weakening of the effects of choline and the simultaneous strengthening – adrenergic effects on the heart. However, the fixed functional alterations were not accompanied by changes in myocardial histology. The study of the microbial profile of the colon revealed a general increase in the titer of the probiotic flora, which was associated with the elimination of opportunistic representatives. The smears of the descending colon were consistent with the morphological criteria of standards in the same conditions.

Hyperaldosteronism plays a crucial role in the pathogenesis of resistant arterial hypertension. Increased aldosterone concentration often follows obesity. Mineralocorticoid receptor antagonists are expected to reduce the blood pressure (BP) in hypertensive patients, but the correlation between their efficiency and the body mass of patients has not been yet found. The efficiency of mineralocorticoid receptor antagonists in the complex therapy of resistant arterial hypertension in patients with normal body mass, overweight and obesity was compared in this study. The study included 54 non-black patients (21 men, 33 women, the mean age 54.5 ± 7.1 years) with resistant arterial hypertension defined as the baseline office BP of more than 140/90 mm Hg despite an intensive treatment with at least three antihypertensive agents, one of which was a diuretic. The main exclusion criteria were the secondary hypertension and the primary hyperaldosteronism. All patients were divided into 2 groups: 1st group (n = 24) included patients with the body mass index (BMI) < 25 kg/m2, 2nd one (n = 30) consisted of people with the increased BMI (≥ 25 kg/m²). Mineralocorticoid receptor antagonist spironolactone (25–50 mg/d) was additionally prescribed to all patients. On the baseline and after 6 month of treatment all patients underwent office BP measurements and 24-hour BP measurements with the mean systolic and diastolic BP assessment.  There were no significant differences in the level of the mean 24-hour BP (141.2 ± 3.6/84.7 ± 2.4 mm Hg in the 1st group and 141.2 ± 3.9/84.2 ± 1.8 mm Hg in the 2nd group) and antihypertensive therapy between the groups on the baseline (p > 0.05). After 6 month the mean 24-hour systolic and diastolic BP significantly reduced in the both groups (р < 0.05) with the greatest decrease (р = 0.02) in the 2nd group (mean 11.7 ± 0.5/5.8 ± 1.4 mm Hg) in comparison to the 1st group (mean 8.9 ± 0.7/3.9 ± 1.5 mm Hg). The target BP level was achieved in 12 (50 %) patients of the 1st group and in 24 (80 %) patients of the 2nd one (χ² = 4.13, p = 0.04).  Addition of mineralocorticoid receptor antagonists to the complex therapy of resistant arterial hypertension leads to a BP decrease, especially in patients with overweight and obesity.

The article presents a new method of transpedicular fixation of unstable injuries of the lumbar spine. Presented are the results of treatment of 146 patients using a new method of transpedicular fixation and the results of the classical method of transpedicular fixation in the treatment of 200 patients operated at two neurosurgical departments of the Republican Scientific and Practical Centre for Traumatology and Orthopedics (in Minsk, Belarus).

The results of factorial analysis of the available data of morphological research of the brain in patients with chronic hepatitis C (HCV) infection are presented in this article. Three most appreciable morphogenetic factors (encephalitic, angiopatho-logical and inflammatory-dystrophic), which influence the development of brain alterations observed during HCV-infection, were found. These findings can be used to select perspective directions of further morphogenetic studies.

The prediction of disease progression in patients with high-risk transitional-cell non-muscle invasive bladder cancer (NMIBC) can help in the decision-making for patients eligible to early cystectomy. In this study we evaluated the association of different immunohistochemical tissue markers in patients with NMIBC at a high risk of disease progression. 179 patients with NMIBC that underwent complete TUR ± intravesical therapy between 2004 and 2007 and available follow-up were selected. Microscopic slides were reviewed: tumour stage, grade (WHO 1973 and 2004), the presence of carcinoma in situ and lymphovascular invasion was determined. Additionally, the expression of Ki67, р53, р63, CK 20, СK 18, CK 10/13 and CK 5/6 was determined after immunohistochemical staining of paraffin embedded tissue samples. The pathology results were correlated with the progression-free survival (PFS defined as the development of the muscle invasive disease, metastases or the death from cancer). 5-year PFS in patients with positive nuclear staining (≥50 %) with р53 antibodies and/or positive cytoplasm staining with CK 5/6 (≥50 %) was 55 % (95 % CI 39–70) compared to 84 % (95 % CI 77–90) in patients without the expression of these markers (HR 4.0, 95 % CI 2.2–7.0 (p < 0.001).

In the current investigation the relative and absolute count of minor leukocyte subsets was assayed: CD1c⁺ and CD141⁺ myeloid dendritic cells, CD14⁺/CD16⁺ blood monocytes, monocytic and granulocytic (CD15⁺ and CD33⁺) myeloid-derived suppressor cells in 33 patients with infectious mononucleosis compared with healthy controls. In patients with infectious mononucleosis the statistically significant myeloid dendritic cell subset redistribution was determined with the increase of CD141⁺ cells, indicative of its role in the immunopathogenesis of the disease. The decrease of the plasmacytoid dendritic cell count in patients with mononucleosis was observed, suggesting the migration to the lymphoid tissue or the selective depletion. The CD15⁺ myeloid suppressor cells count was increased, which decreased the antiviral immunity and at the same time, possibly prevented an excessive T-cell proliferation. The monocytic myeloid-derived suppressor cell count was reduced, explaining the EBV-induced immune system hyperstimulation. Thus it was established that patients with infectious mononucleosis exhibited diverse changes in the content of the minor leukocyte subsets, thus indicating a marked imbalance between pro- and anti-inflammatory immunity factors.

The aim of this study was to evaluate the effect of parenteral administration of streptokinase during the organ explantation from a cadaveric donor, in combination with the optimization of temperature and time factors of the explantation procedure on the initial function of renal graft. As the result of the clinical trial, in the recipient group, where the streptokinase was administered, the organ perfusion time reduced, the afferent perfusion highway was cooled, and the reduction of kidney transplant dysfunctions was achieved. Streptokinase contributed to a better release of the microvasculature from the blood cells, as evidenced by the histological examination of the distal ureter of kidney graft.

The aim of the work was to evaluate the effectiveness of differential treatment for patients with chronic cerebral ischemia (CCI) of the 1st stage. The survey was attended by 51 patients divided into a control group that underwent basic therapy, and 2 major groups (Group 1 – basic therapy + electrophoresis of mildronat + neyramin; 2nd – basic therapy + intravenous laser irradiation of blood (ILIB) + neyramin. On the basis of the dynamics of biochemical parameters and vascular reactivity parameters and with regard to the violation of the skin microhemodynamics (MHD) and metabolic changes it is expedient to prescribe a complex treatment, including medications and physical factors, to patients with differentiated CCI.

The research is devoted to studying the changes in energy metabolism and the aggregation activity of preserved platelets during storage and the influence of suspending environment of different composition on them. It is established that during 3 days the exchange of adenine nucleotides occurs with the energy-dependent processes dominant in cells when energy indicators are conversed. The deficit of ATP, the transition to anaerobic glycolysis and the reduction in the aggregation activity of platelets are marked by the end of the conservation term. The modification of suspending environment by amino acids improves the platelet quality.

It is found that the administration of UDCA to females with obstructive cholestasis, which has been modeled on the 17th day of gestation, does not change significantly the course of genetically determined processes associated with childbirth, but has a protective effect on the vascular link of the placenta changed during cholestasis and on cytochemical disturbances of its cellular elements.

The therapeutic potential of human embryonic stem cells was justified for their using in regenerative medicine. The philosophical and methodological, and bioethical problems of clinic application of human embryonic stem cells were analyzed and the possible ways of their solving were suggested.

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system leading to severe neurological deficits. Current MS treatment consists in using immunomodulatory agents aimed to reduce a rate of relapses. However, these agents are usually insufficient to treat the chronic neurological disability. The haematopoietic stem cell transplantation (HSCT) is a perspective method of MS treatment. Our review of the literature presents the information on the clinical trials of MS HSCT.

New data on structural and functional protective mechanisms of blood supply to the brain to prevent the transient ischemic attack (TIA) occurrence are presented. Data on the prognostic diagnosis of TIA etiopathogenic subtypes are also presented. The following statistical parameters are: sensitivity – 73 %, specificity – 89, accuracy – 78 %.