Cardiovascular disease is the leading cause of death all over the world: for no other reason as many people die every year as from the cardiovascular disease. Taking into account the high medical and social significance of the problem of treating patients with coronary heart disease and acute myocardial infarction, the search for new effective methods of preventing or weakening ischemic myocardial damage and revealing the mechanisms of their implementation is an urgent task of modern experimental and clinical medicine.
The aim of the study was to experimentally test the cardioprotective efficiency of pharmacological postconditioning with lactic acid in myocardial ischemia-reperfusion in rats with transient hypercholesterolemia.
In the course of the study, it was found that remote ischemic postconditioning (RIPostC) during myocardial ischemia-reperfusion leads to an increase in the level of lactate in the blood and has an infarction-limiting effect in rats. It was revealed that lactate, after injection into the bloodstream of animals at a dose of 10 mg/kg 25 minutes after the start of reperfusion, like RIPostC, leads to a decrease in the necrosis area in the left ventricular of the myocardium. Pharmacological postconditioning with lactate is ineffective in the limiting necrosis area in the myocardium of the left ventricle of rats with transient hypercholesterolemia. The presence of such a risk factor for cardiovascular diseases as hypercholesterolemia can serve as a criterion for excluding the use of pharmacological postconditioning with lactate as a way to reduce ischemic and reperfusion damage to the myocardium in patients with acute myocardial infarction.

The aim of the study was to assess the distribution of polymorphic variants G681A of the CYP2C19 gene, H1/H2 of the P2RY12 gene, and T1565C of the ITGB3 gene and to study their effect on the platelet activity and clopidogrel efficacy in patients with stable stenocardia living in the Grodno region. The study included 92 patients with stable stenocardia, 89 of them underwent elective percutaneous coronary intervention (PCI), and 93 practically healthy people. The survey data (general clinical, aggregometry, general blood count and platelet indices, and polymerase chain reaction genotyping) were analyzed using the STATISTICA 10.0 software.
A high prevalence of carriage of genotypes associated with possible variability in response to clopidogrel therapy was revealed both among patients with stable stenocardia and among practically healthy individuals in the Grodno region. The frequency of occurrence of studying genotypes among patients with stable stanocardia was 23.9 % for the CYP2C19 gene (polymorphic locus G681A), 40.2 % for the P2RY12 gene (polymorphic locus H1/H2), and 31.5 % for the gene ITGB3 (polymorphic locus T1565C). For the group of practically healthy individuals, the distribution of these genotypes was 18.3; 46.2; 37.6 %, respectively. Associations were revealed between the carriage of the 681A allele of the CYP2C19 gene and the H2 haplotype of the P2RY12 gene with high residual platelet reactivity during clopidogrel therapy in patients with stable stenocardia. An association was found between the carriage of the H2 haplotype of the H1/H2 polymorphism of the P2RY12 gene with high platelet MPV values and a higher frequency of large platelets (P-LCR) in patients with stable stenocardia.

The objective of the study was to determine the causes of postoperative anterior knee pain after total knee arthroplasty for preventing its occurrence and improving the surgery results.
The treatment results of 77 (112 cases) patients with cruciate-retaining total knee arthroplasty without patellar replacement were analyzed. The study involved 62 (80.5 %) women and 15 (19.5 %) men. The average age (Me (25‒75 %)) of the patients was 65 (60‒70) years. There were 97 cases (87 %) with varus deformity of the knee joint, 15 cases with valgus deformity (13 %). The average angle of varus deformity was 11.22 ± 3.81°, the average angle of valgus deformity was 11 ± 4.27°. After the anterior pain appeared, patients were examined in 2‒3, 4‒5 and 6‒7 months after surgery using clinical, X-ray (anterior-posterior, lateral and axial projections, topogram of lower extremities), and EMG methods.
The causes of anterior postoperative knee pain were: implant components misplacement, patellar microcirculation disorders (chondrolysis, avascular necrosis due to circular patella denervation), patellofemoral joint imbalance, and functional causes. Pain manifested itself at active leg loading and knee motion because of implant components misplacement within 2‒3 months in 34 cases (94 %), 4‒5 months ‒ in 2 cases (6 %). Patellar microcirculation disorders within 4‒5 months ‒ in 5 cases (21 %), 6‒7 months ‒ in 19 (79 %) cases. Imbalance in the patellofemoral joint within 2‒3 months ‒ in 29 cases (69 %), 4‒5 months ‒ in 13 cases (31 %). Functional causes of pain appeared within 2‒3 months ‒ in 7 cases (70 %), 4‒5 months ‒ in 3 cases (30 %).
The causes of postoperative anterior pain in total knee arthroplasty can be incorrect surgical technique, changes in patellar blood supply or in the biomechanics of the patellofemoral joint due to the imbalance of the thigh muscles.

The objective of the study was to develop the problem of complex treatment of surgical infections of the skin and soft tissues (SISST).
The studies were carried out in 201 patients with SISST who were treated at the Department of Purulent Surgery of the Hospital Surgery Clinic of the EE “Vitebsk State Medical University” in 2017–2020. As a result, it was developed: a protocol for a rational use of antibiotics in the patients with SISST, an effective regimen for use of antiseptic drugs, a method for treating purulent wounds with autologous bone marrow aspirates.
For 13 years, there have been significant changes in the etiological structure of gram-negative problematic pathogens in patients with purulent wounds. The share of K.pneumoniae increased approximately 8 times (by 12.25 %; p < 0.05), and A.baumannii ‒ 9 times (by 14.69 %; p < 0.05). The share of MRSA remained virtually unchanged. The resistance of problem microorganisms to almost all antibacterial drugs significantly increased. For MRSA-induced SISST, glycopeptides (vancomycin) should be recommended as a drug of choice, and oxazolidinones (linezolid) and glycylcyclines (tigecycline) should be recommended as a reserve; K. pneumoniae ‒ colistat and tigecycline; P. aeruginosа ‒ carbapenems (doripenem) and colistat; A. baumannii ‒ penicillins or cephalosporins with sulbactam (ampicillin + sulbactam) and colistat.
It was found that septomyrin and 0.02 % chlorhexidine bigluconate have the greatest activity against the leading representatives of the microflora of purulent wounds. With a combined use of septomirin and chlorhexidine, the bacterial contamination of wounds decreased below the critical level already on the 2nd day after surgical treatment (p < 0.01).
To stimulate wound healing, sternocentesis is performed and automyeloaspirate is taken. The curettage of the wound and the aspirate introduction into the wound edges and the application to the wound surface are performed. It has been established that, along with the pelvic bones, the sternum can be an alternative source of red bone marrow. The myeloaspirate volume obtained by sternal puncture varied from 10 to 140 ml. The developed method allows us to reliably reduce the duration of the 2 phase of the wound process by 7 days (р < 0.01).

Dysregulation of innate and adaptive immunity is a central mechanism in the pathogenesis of inflammatory bowel diseases (IBD) that include Crohn’s disease (CD) and ulcerative colitis (UC). Given the immunomodulatory properties of multipotent mesenchymal stromal cells (MMSCs), developing new pathogenetic approaches to the IBD treatment using cell therapy seems to be promising.
In this article, the effect of intra-arterial and intravenous MMSCs on in vitro monocytes/macrophages cytokine-producing function and splenocytes proliferative activity in laboratory animals with experimental IBD under the conditions of nonspecific and specific stimulation (mannan – cell wall component of Saccharomyces cerevisiae yeast) was studied.
MMSC cultures have been shown to possess an immunomodulatory effect against the background of improved clinical, morphometric parameters, and the pathomorphological picture of experimental IBD damage. Intra-arterial and intravenous administration of cell cultures decreased the mannan-induced TNF-α production by CD68+ cells and mitogen/mannan-stimulated splenocyte proliferation that confirms the immunosuppressive effect of MMSC cultures on autoreactive splenocyte clones in experimental IBD. The obtained results testify to the anti-inflammatory effect of cell therapy in the experimental modeling of IBD and justified a combined administration of MMSC cultures.

Secondary hyperparathyroidism (SHPT) is one of the most clinically significant complications of chronic kidney disease (CKD) due to associated mineral, bone disorders, and metastatic calcification. The indicators of mineral and bone metabolism of 635 patients with different CKD stages and 50 persons of the control group were analyzed using a neural network algorithm and the mathematical technology BootStrаp, which allowed determining the target PTH intervals for each stage in patients with CKD, corresponding to the optimal indicators of mineral density and metabolism bone tissue, in order to improve the survival of this category of patients. It was found that the upper limit of the reference interval of the PTH level in patients with CKD and GFR > 35 ml/min coincides with the general population, in patients with CKD and GFR 15‒35 ml/min it is 185 pg/ml, which is 3 times higher than in the general population, and in patients with CKD and GFR < 15 ml/min it is 500 pg/ml (7.5 times higher than in the general population). In dialysis patients with the PTH level of 500‒1500 pg/ml, it is possible to maintain satisfactory parameters of bone metabolism, and the PTH level of >1500 pg/ml determines the extreme risk of developing severe SHPT complications.

Currently, the advanced studies have been justified and implemented in the Republic of Belarus that enable the production and a practical use of a domestic rapid test and allow dentists to apply microbiological diagnosis methods.
The objective of the study was to develop a domestic rapid test for periodontology, indicating the procedure for preparatory clinical and laboratory measures using PCR and trypsin-like activity of periopathogenic microflora (Treponema denticola, Porphyromonas gingivalis, Bacteroides forsythus)
Dental examination was performed in 60 patients with clinical signs of generalized periodontitis and a 5‒6 mm deep pathological dentogingival pocket (PDGP), aged 35–44 (the main group), and 140 patients without signs of periodontal diseases, aged 20–24 (the control group). These patients were selected among the visitors of Chair No. 3 of the Belarusian State Medical University. The laboratory diagnosis was made using PCR and evaluating the trypsin-like activity of periopathogenic microflora.
The algorithm of preparatory clinical and laboratory measures was suggested for diagnosis of periodontal diseases, including material sampling and identification of periopathogenic microorganisms in the sample using a biochemical method; sampling, preservation and storage of material for quantitative PRC testing; and the identification of the genetic material of periopathogenic microorganisms by means of a real-time quantitative PRC method.
The basic principles of microbiological diagnosis in periodontology enable making a true diagnosis, planning treatment and assessing the treatment results.
We examined the content of the gingival sulcus and/or the periodontal pocket in patients who have periodontal diseases. It was noted that the most rational tools for removing the periodontal pocket content in patients with periodontal diseases was a paper pin.
The development of a domestic express test in periodontology demonstrated the need of preparatory clinical and laboratory activities using PCR and trypsin-like activity of periopathogenic microflora (Treponema denticola, Porphyromonas gingivalis, Bacteroides forsythus).

Using the stopped flow method and based on the study of the intensity of light scattering, the effect of pharmacological preparations used in the clinic on the water exchange of human erythrocytes, catalyzed by aquaporin AQP1, was studied. Pharmacological preparations used in therapeutic concentrations have a variable inhibitory effect on water permeability of the erythrocyte membrane. The obtained results broaden our understanding of the molecular action mechanism of the investigated drugs. In view of the wide distribution of AQP1 in various human tissues, these data should be taken into account when carrying out therapeutic measures aimed at normalizing the water exchange of organs and tissues.

Recently, there have been more and more indications of alcoholic pathology burdened by drug use and vice versa. It is evident that the dopamine system plays an important role in the development of addiction when using drugs and alcohol. Experimentally, the long-term combined effect of psychoactive substances on neuromendatory changes in the dopaminergic system in the brain is poorly understood and requires more detailed consideration.
The aim of the study was to examine the changes in the dopaminergic system in the hypothalamus and midbrain of rats during chronic alcohol intoxication, as well as a complex administration of morphine and ethanol.
The experiments were carried out on white outbred male rats. Using the HPLC method, the levels of dopamine and its metabolites were determined in the regions of the brain during chronic alcohol intoxication, as well as with a combined administration of morphine and ethanol with various durations (7, 14 and 21 days).
Chronic alcohol intoxication led to the signs of acceleration of the dopamine turnover only in the hypothalamus on the 7th and 14th days and its accumulation during three weeks of alcoholization. In the midbrain, a decrease in the concentration of the neurotransmitter was revealed when ethanol was injected for 7 days. Co-administration of surfactants was accompanied by slightly different changes: complex 7- and 21-day alcohol-morphine intoxication is accompanied by the dopamine accumulation in the hypothalamus and the decrease in the neurotransmitter turnover in the midbrain on the 14th and 21st days.

The anti-inflammatory properties of the combination of meloxicam and atypical NSAID N-acetyl-L-proline (Groceprol®) after intragastric administration in a model of carrageenan paw edema in mice were studied. The average effective dose of N-acetyl-L-proline calculated by the regression analysis method in this model was 414 mg/kg, and the average effective dose of meloxicam was 2.85 mg/kg. In the combination in a ratio of 40:1, the activity of the compounds increases significantly, the ED50 of meloxicam decreases to 1 mg/kg, a similar value of N-acetyl-L-proline becomes 43 mg/kg. The same trend was also observed with another mass ratio of components of 20:1. The analysis of the pharmacodynamics of the combination of drugs according to the T. Chou method showed an additive type of interaction, typical for compounds with different mechanisms of primary action. It was established that a combination of N-acetyl-L-proline and meloxicam in the weight ratios of 40:1 and 20:1 demonstrate synergism, allowing to reduce the dose of the components in 2.7–9.6 times as compared with the effect of the drugs individually.
The results of the study are the experimental justification for the use of anti-inflammatory synergistic combination of N-acetyl-L-proline and meloxicam.

The aim of the study was to create a prognostic model for determining the probability of developing congenital pneumonia in preterm infants with low body weight.
108 preterm infants with low body weight who were in the department of anesthesiology and resuscitation (with wards for newborns) and the pediatric department for preterm infants were examined.
A comparative analysis of 214 life history data, outcomes of previous pregnancies, complications of present pregnancy in mothers, clinical and laboratory methods of study in newborns in the first three days of life was carried out. Later, the most important factors associated with the development of congenital pneumonia in premature infants with low body weight were identified: from the obstetric and gynecological history of the mother’s life – undeveloped pregnancy (RR = 13.46 (10.11‒17.91)) and spontaneous miscarriage (RR = 3.79 (2.69‒5.35)); the complications of this pregnancy, chronic fetoplacental insufficiency (RR = 3.47 (2.48‒4.87)); the results of histological placenta examination – the changes in the inflammatory placenta (RR = 11.98 (8.84‒16.23)); according to the clinical data of the infant in the first three days of life – the presence of severe respiratory failure (RR = 21.25 (15.69‒28.77)).
Using the prognostic model, threshold values were calculated: for non-developing pregnancy – 0.727, spontaneous miscarriage – 0.445, chronic fetoplacental insufficiency – 0.418, changes in the inflammatory placenta – 0.688, severe respiratory failure – 0.690, which, with threshold values of ≥0.45, allows us to identify a high-risk group for the development of congenital pneumonia among premature infants with low body weight.

Currently, the Armed Forces are facing the problem of the death of personnel who committed suicide, which makes it important to look for the reasons of suicidal behavior.
The study involved 169 men, divided into two groups: the first group consisted of persons of military age, in the amount of 115 people and the second group included 54 people who committed parasuicide using highly lethal methods of self-harm (GLIVS). During the study, socio-demographic characteristics (age, marital status, living conditions, professional status, characteristics and conditions of upbringing) and individual psychological personality traits (type of temperament, introversion-extraversion, neuroticism, ostentatiousness, fixedness, formalism, excitability, hyperthymia, dysthymia, anxiety, exaltation, affectability, cyclothymia) were assessed. The calculations were performed using the statistical package IBM SPSS Statistics 22.
Statistically significant differences between the study groups were due to the presence of differences between persons brought up in two-parent families. These groups differed in the phlegmatic type of temperament (predominant in GLIVS), the character traits of excitability, dysthymia, and hyperthymia. For GLIVS brought up in two-parent families, in addition to the phlegmatic type of temperament, it was characterized by the presence of punishments in childhood, a lower level of education (secondary education prevailed), a lower level of neuroticism, excitability, dysthymia and anxiety, an average level of hyperthymicity.
Statistically significant differences between the study groups were revealed in terms of the type of temperament, excitability, dysthymism, and hypotensiveness and were due to the presence of differences between persons brought up in full families.
Individuals from full families of GLIVS are characterized by the presence of more frequent punishments in childhood, a phlegmatic type of temperament, a lower level of education, a lower level of neuroticism, excitability, dysthymia, anxiety.

Changes in the fractionation scheme of the radiotherapy course have an impact on the results of treatment of cancer patients. If changes in the fractionation scheme are not taken into account, this leads to under-irradiation of tumor cells and a possible occurrence of subsequent relapses. There are radiobiological models in order to take into account the errors in the radiation dose delivered to the tumor. They allow predicting the tumor control, as well as the toxicity level in normal tissues after traditional RT.
The objective of the work is to assess the effectiveness of the absorbed dose in the event, if the fractionation scheme in the RT course changes, and to develop an algorithm that takes into account breaks between treatment sessions.
In the study, the effectiveness of the radiation dose delivered to the tumor due to a change in the total treatment time is assessed analytically, a graphical dependence of the radiation dose efficiency on the duration of the unplanned interruption in the treatment of patients is built for the most common oncological localizations, an algorithm for radiotherapy procedures taking into account deviations from the standard radiation treatment pattern is developed.

Lymphadenopathy is one of the leading manifestations of an overt or latent infectious process in viral diseases, and in their differential diagnosis of diseases it is considered as one of the leading markers.
Objective ‒ to determine the importance of lymphadenopathy in the differential diagnosis of the primary form of the Epstein-Barr viral infection, recurrent respiratory diseases and adenovirus infection in children and adolescents.
336 children and adolescents aged 7 to 17 years inclusive with viral infections and lymphadenopathy were examined: 93 patients with the primary form of Epstein-Barr viral infection (EBVI), 167 patients with recurrent respiratory diseases (RRD), 76 patients with tonsillar adenoviral infections (ADVI), which underwent ultrasound examination of the submandibular, anterior and posterior cervical, inguinal and mesenteric lymph nodes.
Lymphadenopathy of various localization was detected in all patients with the primary form of EBVI, RRD and ADVI. A detailed analysis of the topographic features of lymphadenopathy in the context of the timing of its regression showed that in children and adolescents with the primary form of EBVI, the disease began with a simultaneous enlargement of the lymph nodes of all groups, and the increase in the posterior cervical and submandibular lymph nodes did not correspond to the objective state of the oropharyngeal lesion. In RRD, lymphadenopathy of the cervical region was most often observed, and in ADVI, moderate generalized lymphadenopathy was observed.
Lymphadenopathy in EBVI is generally characterized by a large diameter (2.7 ± 0.06 cm) of the lymph nodes; whereas in RRD and ADVI, lymph nodes of small (0.5 ± 0.03 cm) and medium (0.6 ± 0.1 cm) diameters prevailed. Morphological changes in the lymph nodes in lymphadenopathy in the primary form of Epstein-Barr viral infection, recurrent respiratory diseases and adenovirus infection are manifested by a heterogeneous structure and different echogenicity of the stroma, which can be taken into account as a marker at the stages of early and differential diagnosis of the listed viral infections.