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Using the method of high-frequency ion-plasma sputtering (magnetron high-frequency deposition under conditions of ion-plasma assisted using a gas (argon) plasma generator «PINK») on the surface of a high-entropy CoFeCrMnNi alloy of non-equiatomic composition. Boron-containing coatings of the elemental composition Al – Mg – B and Mg – Ti – B with a thickness of 3 μm are formed. Using transmission electron diffraction microscopy, it was found that the coatings are amorphous-crystalline, i.e. contain nanosized 1.5-2 nm islands of the crystalline phase located in an amorphous matrix. It is shown that the coating deposition is accompanied by the formation in the substrate layer (high-entropy alloy) adjacent to the coating of a nanocrystalline structure with a crystallite size of 25-40 nm. At the boundaries of the crystallites, particles of iron boride of the FeB and Fe3B compositions are revealed, which indicate the penetration of boron into the substrate. The particle size of iron boride is 5-8 nm.

The surface alloying was carried out by single-cycle and multi-cycle (5 cycles «sputtering-irradiation», in each cycle the thickness of the titanium film 0,5 µm), i.e. high-speed melting of the system «film (Ti)/(steel AISI 310S) substrate» by pulsed electron beam. Nitriding (793 K; for 1, 3 and 5 hours) was carried out under conditions of realization of the elion (electron and ion) treatment mode. The isothermal cross sections of the ternary systems of the state diagram of the Cr – Fe – Ni – Ti – N alloy formed at different stages of the complex treatment of steel are considered. It is shown that (1) irradiation of steel by a pulsed electron beam is accompanied by the formation of a structure of high-speed cellular crystallization of solid solution based on γ–Fe; (2) nitriding of steel in the initial state is accompanied by formation of nitrides of iron Fe4N and chrome CrN with a total content of 79,8 wt.%; (3) pulsed electron-beam pre-irradiation of steel leads to a decrease in the rate of nitride formation during subsequent nitriding; the total nitride content of 53 wt.%; (4) regardless of the number of alloying cycles (titanium concentration in the surface layer) after five hours of nitriding in the samples formed a surface layer of nitrides of chromium and iron (1 cycle of doping) or nitrides of chromium and titanium (5 cycles of doping).

The objective of the study: to obtain a live attenuated strain and investigate its properties by multiple cultures of the virulent strain of Mycobacterium tuberculosis H37Rv.Subjects and Methods. The original virulent strain H37Rv was subcultured 70 times in 7H9 liquid medium. Genetic properties of the new strain, degree of avirulence, and vaccine properties were studied.Results. Mycobacteria of the new strain MtbBN lost their virulence to inbred mice. Eight mutations were identified by whole genome sequencing: single nucleotide insertions and deletions (in/del) distinguishing the MtbBN and H37Rv strains. The MtbBN strain demonstrated vaccine potential at the BCG level. Additionally, in some genetic models, the attenuated strain was highly effective in protecting inbred mice when infected with Mtb H37Rv as opposed to BCG.

For many years, cardiovascular diseases have been a major cause of morbidity and mortality worldwide. In modern society these have become one of the most pressing medical and social problems. To date, progression of coronary heart disease (CHD) and its complications is strongly associated with increased homocysteine (HC) level and hypovitaminosis D. However, medical literature does not sufficiently cover the issues of drug treatment of patients with metabolic disorders after coronary artery bypass grafting, therefore, more detailed study of this problem is required. The aim. To develop a differentiated approach to the medical treatment of CHD patients before and after direct myocardial revascularization. Materials and methods. The study analyzed the data of 133 patients, 117 (87.96%) men and 16 (12.03%) women, diagnosed with CHD. In these patients, the levels of homocysteine and vitamin D were evaluated. Depending on the levels of hyperhomocysteinemia and vitamin D, the patients were divided into 3 groups. Results. About 70% of the patients examined had elevated blood homocysteine levels greater than 15 ¤mol/L. Based on selective CAG (MSCT CA) findings and complete examination, myocardial revascularization was indicated in 133 patients, as recommended by the 2018 ESC/EACTS Guidelines on myocardial revascularization. In 95% of cases (126 patients), direct myocardial revascularization was performed. All the patients received standard therapy preoperatively, and after getting results of HC and vitamin D tests, metabolic therapy, including folic acid, vitamins B6, B12 and D, depending on HC and vitamin D levels, was prescribed. Conclusions. Hyperhomocysteinemia and hypovitaminosis D provoke impaired endothelial vasomotor function and activate neointimal hyperplasia. Patients with hyperhomocysteinemia and vitamin D deficiency should receive metabolic therapy based on folic acid, vitamins B 6 and B12, and vitamin D, both preoperatively and postoperatively. The first control of HC and vitamin D levels is carried out within 3 months after the treatment initiation.

To date, it has been established that in the progression of coronary artery disease (CAD) and its complications, an increase in the level of homocysteine and hypovitaminosis D are essential. However, medical publications do not adequately cover the study of the effects of hyperhomocysteinemia and vitamin D deficiency on the course of atherosclerosis and the functional state of the myocardium, and requires more detailed research of this problem. Objective. To study the functional state of the myocardium depending on the degree of hyperhomocysteinemia and hypovitaminosis D in patients with CAD. Materials and methods. The study analyzed data from 69 diagnosed with CAD. Depending on the degree of hyperhomocysteinemia and the level of vitamin D, patients were divided into 3 groups. Results. In all patients, speckle-tracking echocardiography revealed a decrease in longitudinal and circular myocardial deformation. Patients with hyperhomocysteinemia and vitamin D deficiency had significantly lower myocardial deformity. Comparing the data of echocardiography, it was found that in patients of all three groups – no significant difference in hemodynamic parameters was found, despite the difference in the level of HC and vitamin D. Conclusions. Hyperhomocysteinemia and hypovitaminosis D are risk factors for the development of CAD. It was revealed that the higher level of homocysteine and the pronounced deficiency of vitamin D, are associated with more pronounced changes in the functional state of the myocardium.

The article is aimed at researching the tax regulation of investment activity of banks of Ukraine in the current conditions of development of the national economy; identifying the tax stimuli and deterrent factors of investment activity of banking institutions in the formation of investment portfolio. Tax regulation of the banking system directly influences the development of not only the monetary system, but also the national economy in general. Tax instruments for stimulating investment activity of banks are proposed to be grouped depending on the mechanism of influence, goals and types of investments. The dynamics of investments and their share in the assets of Ukrainian banks over the past five years are analyzed. The annual advance in the share of investments in the assets of Ukrainian banks shows an increase in the interest of banks in placing funds into investment objects. The assessment of the change in the composition and structure of the investment portfolio of Ukrainian banks for 2015–2019 was carried out, identifying that domestic banks focused on improving the liquidity of investments, i. e., financial instruments that can be sold at any time at favorable prices. The dynamics of the composition and structure of the portfolio of securities of domestic banks in recent years was researched, determining that the largest share for 2015–2016 made the securities for sale (more than 86%), while the securities before maturity amounted to more than 10%. When considering the structure of the portfolio of securities of banks during 2017-2019, it is specified that the most important is the proportion of investments in securities, which are accounted for at fair value through other comprehensive income, namely, more than 70%. Having examined the problems of domestic banking investment, we believe that stimulation in this direction should be carried out in terms of creating a favorable stable regulatory framework and an effective taxation regime.

The objective: to study the quantity and variability of bacterial microbiota in lower gut, the prevalence of microorganisms resistant to antibacterial drugs among microorganisms isolated from the bronchi of pulmonary tuberculosis patients receiving chemotherapy.Subjects and methods. Microorganisms of the bacterial microbiota from lower gastrointestinal tract isolated from respiratory tuberculosis patients were studied. 178 patients were examined retrospectively and 53 patients were examined prospectively. Diagnostic specimens obtained from the bronchi/lungs (sputum, bronchoalveolar lavage fluid, aspirate, etc.) of respiratory tuberculosis patients were tested. Bacteriological tests complying with current regulatory documents were used.Results. It was found out that gut microbiota varied in tuberculosis patients of various age groups at different stages of treatment and in addition to that, the microbiota was characterized by certain pronounced manifestations of dysbiosis. In cases when clinically significant microorganisms were isolated from bronchi of respiratory tuberculosis patients, a relatively high prevalence of microorganisms resistant to the most important antibacterial drugs was detected.

An actual problem in surgical practice is paresis of the gastrointestinal tract, the main manifestation of which is constipation after surgical treatment. Treatment of postoperative gastrointestinal paresis, which is manifested primarily by constipation, should be comprehensive and, if necessary, patients are shown taking laxatives to stimulate bowel function.Sodium picosulfate is one of the most commonly used and effective drugs, belongs to the group of synthetic stimulant laxatives. The above review noted the safety and effectiveness of sodium picosulfate for atonic constipation, for regulating stool (hemorrhoids, proctitis, anus cracks), for preparing for surgical operations, instrumental and radiological examinations.The presence of picosulfate in the clinic and hospital surgeon’s arsenal makes it possible to optimize the drug therapy in surgical patients with constipation syndrome at the hospital and outpatient treatment stage.

For experimental modeling of tuberculosis, animals of various species are used, each of which has its own advantages and disadvantages. Specific characteristics of animal genetics and immunology during the development of tuberculosis in the experiment were studied in sufficient detail. In addition, mice, guinea pigs, and primates are widely used to test new vaccines and candidate drugs. Modeling of tuberculosis of reproductive organs of females has been developed much worse, since artificial approaches to reproducing genital tuberculosis which do not correspond to the real development of pathology in humans, are more often used. The review describes aspects of modeling tuberculosis as systemic and local infectious process including the study of disorders in the reproductive system of female animals during the development of pulmonary tuberculosis.

Now, so important to consider the business as a financial and profitability structure, that is interested in competitiveness, efficient activity and economic development. The achievement of the defined indicators of successful business is possible of the presence of professional, experienced and conscientious employees, so is the important to form such a system of personnel management, which is in order to promote the competence of the employees. In addition to making business investments in training and developing competencies of the employees, an important prerequisite is the meaningful and purposeful willingness of the personality to foster the development of herself professional competence in the context of the actual volatile and unpredictable VUCA-world. To that, in the article describe the conceptual foundations of professional personal self-development in the context of the VUCA-world and presented of the basic VUCA-competencies as the competitive advantages of the modern business environment. According to the provisions of the VUCA-world, important competencies of the employees there are: prognostic vision in the context of prospect of business development; understanding of the actual needs and purpose of the business activity; creativity, as the ability to the put forward alternative solutions of the business problems, and agility, as the ability and the internally determined conviction to act in the interests of the business. The explained of importance of social and area organization as main conditions for the professional self-development, personal awareness and competitiveness of the employees. In the context of the activity approach, the revealed of the importance of the professional environment for the development of the leading competencies of the employe. So, in the article is express of the priority of the psycho-sociology need for the formation of such the model of the development of the competencies of the employee, that would be answer of the needs of actual unpredictable VUCA-world.

Introduction. In today’s knowledge society, the amount of scientific-applied information, which university graduates have to acquire, continues to increase continuously. There is a concurrent reduction in the number of study hours to undertake educational programmes in order to increase the hours for students’ independent work. Against this background, higher school is required to increase future experts’ competencies. Therefore, the content of fundamental and special disciplines of entire period of training and independent work of students should be thoroughly coordinated by increasing students’ motivation to self-education and self-development. Classroom-based and independent learning of disciplines and sections of fundamental academic courses, especially chemistry, is impossible without formation of students’ scientific thinking. Today, it is difficult to consider the activity of most professionals without the ability to think scientifically: active expansion of science into professional sphere has a strong tendency to be increased.The aim of the present research is to show the possibilities of formation and development of scientific thinking in the students of natural-scientific and technical directions of education using the example of studying of one of the elements of programmes in chemistry (the method of nuclear magnetic resonance (NMR) analysis).Methodology and research methods. The research was carried out on the basis of competency-based, systematic and interdisciplinary approaches. The methods of analysis, synthesis, integration, differentiation and compactification of fundamental knowledge and training material were used.Results and scientific novelty. The high potential of chemical education for formation of scientific thinking, subject content (chemical), natural-scientific and holistic scientific thinking is emphasised. However, chemistry education in higher education institution is complicated by the absence of the unified structure of fundamental preparation, the preservation of extensive approach to the content of chemical disciplines, the irrational organisation of students’ independent work, which now is accounted for a half of instructional time. Overcoming these problems lies in the dialectic unity of fundamental and practice-oriented knowledge, which is provided by the compliance with the principles of continuity and interdisciplinarity. It is necessary to provide deductive structurisation of training material in order to give integrity and systemacity to the content of education, without which it is impossible to create a comprehensive natural-scientific picture of the world in students. The key initial element of vocational training stimulating the formation of reflexive skills and scientific thinking of future experts is mastering by students of a categorical-conceptual framework of science, which is consistently and comprehensively revealed throughout a high school stage of education. The authors designated phases of development of scientific thinking (formal-logical, reflexive-theoretical, hypothetico-deductive thinking), which are not clearly differentiated due to interpenetration and entanglement of their components and identity of thought processes in terms of their speed and quality. However, the allocation of these stages allows to structure and to correct the content of educational material taking into account the characteristics and the level of students’ readiness.From these standpoints, the expediency of more detailed examination of the NMR method is proved within the disciplines such as “Chemistry”, “General Chemistry”, “Inorganic Chemistry” and “Analytical Chemistry” (a part of material about the NMR method can be worked out by students independently). This method, based on one phenomenon, includes hundreds of various types of the experiments, which are intended for receiving particular information. The NMR method is widely used both in scientific research, including master’s thesis, and in the most various manufacturing spheres. Today, the spectroscopy of NMR is recognised as the most powerful informative and perspective method of structural analysis of substance. The fundamental nature, interdisciplinarity and universality of the method provide students with basic professional knowledge on physics, chemistry, medicine, biology, technology and ecology. The authors of the present research propose the option of configuration of educational information on NMR. According to the suggested version, the principle of work is the following: firstly, bachelors study the system of key concepts and terms, moving gradually from formal-logical to substantial generalisations; then, students learn to explain the phenomena scientifically and to make forecasts, and, as a result, they become the “owners” of hypothetico-deductive thinking. The acquired competencies are the key to professional literacy, which is improved in master’s degree programme, when the previously compactified scientific knowledge in a contracted form is developed in the form suitable for an optimal solution of a particular research or practical aim. The similar scheme of vocational training makes it possible to overcome traditional orientation of high school programmes of the natural-science block (i.e. retention of permanently growing amount of factual material).Practical significance. The research materials can be useful for methodologists of the higher school, for experts engaged in methodological development and the organisation of educational process, for high school teachers of chemistry and related disciplines, for post-graduate students and master’s students of chemical and chemico-technological specialties as well.

Pulmonary embolism (PE) is a major life-threatening illness which remains one of the main causes of sudden death throughout the world. The analysis of diagnosis and treatment of 472 patients with acute pulmonary embolism for a period of 10 years was performed. High efficiency of diagnosis using multispiral computer angiopulmonography (MSCT APG) has been established, thus this method completely supersedes the traditional selective angiopulmonography. Seventeen (3.6 %) patients died due to PE recurrence, another 8 (1.7 %) patients died due to the bleeding after using fibrinolytics and anticoagulants, and 14 (2.9 %) died due to progression of organs failure. This emphasizes the need to improve measures aimed to prevent PE recurrence and identify sources of possible bleeding and refrain from aggressive fibrinolytic therapy. The use of differentiated approach to the treatment with thrombolytic therapy and anticoagulants enabled to achieve recovery in 433 (91.7 %) patients who were discharged for outpatient treatment. New oral anticoagulants were prescribed to 94 (21.7 %) patients after discharge.

The possibilities of the automated information-analytical system for monitoring the highest qualification scientific personnel training are presented. It is shown that the application of the above system allows to get information about the state of the highest qualification scientific personnel training in the Republic of Belarus, to perform the analysis of the dynamics of the postgraduate education development on a wide range of quantitative and qualitative indicators.

Introduction. In Federal State Standards of the Higher Education (FSS HE) of the natural-science and technical specialties and also in a number of the corresponding professional standards, the competence in the field of analytical chemistry is specified as one of the main qualification characteristics of an expert/university graduate. It is caused by interdisciplinarity of analytical chemistry and a wide range of application of analysis methods which are used today not only directly on chemical production, but also in power engineering, construction engineering, metallurgy, materials science, standardization, certification, and many other spheres. At the current time, however, there is a big gap between achievements of chemical science and content of high school discipline that reduces quality of staff training demanded in labour market. This discrepancy is caused both by preservation of traditional methodology of teaching chemistry and the reasons of the methodical plan. The aim of the publication is to search for more effective and productive ways of mastering the educational material that is relevant for acquiring the qualifications required from the university graduate. Methodology and research methods. Methodological framework of the article involves the concepts of chemical and natural-science education at the higher school; the principles of the system-based, cognitive, practice-focused and competence-based training. Results and scientific novelty. On the basis of the review and generalization of scientific and methodological resources on the theory and practice of application of the analysis methods of substances from didactic positions, a number of these methods have been singled out and compared; their role and features in determination of a molecule structure and other characteristics of an individual substance and its solutions have been shown. Despite the fact that the work is carried out using known methods of analysis, such a generalization makes it possible to more clearly understand the principles of the choice of a method and the method importance according to the purposes and specifics of the studied object that is essential for formation of research skills during training, as well as for formation of scientific thinking and the required qualification acquisition by graduates of the natural-science and technical specialties. In order to update the acquired knowledge, the examples illustrating applied use of various analysis methods in modern research and production practice have been collected. Tables have been made for a faster perception of the material by methods of analysis for the purpose of an informed choice of the method. Reliance on the principle of tabular collection of material makes it easier to understand the individuality of the method; allows teachers to reduce their workload; and on the part of students, to shorten the time and simplify the procedure of choosing the method of chemical, physicochemical and/or physical analysis. Practical significance. The work is compiled in accordance with the State General Educational Standards of Higher Professional Education, and can be recommended to practising and beginning teachers of higher education institutions, as well as graduate students of chemical specialties. The materials presented in the article can assist in designing the curricula of chemical disciplines or modules of educational programs.

The appearance of blood in the bowel movement is one of the most disturbing and serious symptoms of diseases of the gastrointestinal tract (GIT), especially its lower divisions whistleblower intestinal vascular integrity and mucous membranes. Invaluable in the diagnosis of bleeding from the lower GIT endoscopy is the colon, allowing to establish the source of bleeding in more than 90% of patients. The key to accurate diagnosis and successful treatment in the future is the optimal preparation of the patient for endoscopy. A number of foreign and domestic studies demonstrated high efficacy and safety of use in preparation for endoscopy / X-ray examination of the colon and for surgery on the colon preparation Fleet® Phospho-soda.

Aim. Acute pulmonary embolism (PE) is a common and often fatal disease with the level of mortality in the acute phase from 7 to 11%. In order to develop indications to thrombolytic therapy the short-term results of treatment with the use of combination therapy were studied. This treatment included: thrombolysis and /or anticoagulant therapy, with the usage of new oral anticoagulants and treatment of acute pulmonary hypertension. 231 patients with pulmonary embolism were examined. Methods and results. Angiography, echocardiography, multidetector computed tomography of the chest were used to evaluate the results of treatment. Among those groups prevailed elderly and senile patients with concomitant chronic disorders of the cardiovascular and respiratory systems. This for certain significantly worsens pulmonary embolism. Therefore, thrombolysis was used in cases of massive and submassive pulmonary embolism and as well as prostaglandin E1 drugs were used for the treatment of acute pulmonary hypertension and new oral anticoagulants. It was found that this treatment regimen resulted to a significant clinical improvement, restoration of adequate pulmonary blood flow and pulmonary hypertension rate decrease.

At present time, the death rate from cardiovascular disease occupies leading position in the structure of total mortality worldwide. The opportunity to conduct non-invasive studies of the coronary arteries has appeared through the development and implementation of multislice computed tomography (MSCT) into medical practice, which carry 64 or more sections. Aim. The purpose of this research is the identification of diagnostic capabilities of 64-slice MSCT in the verification of the severity of coronary artery lesions in patients with proven coronary artery disease. Methods and results. The study has been conducted on a 64-slice CT scanner Optima 660 (GE, USA). The degree of stenosis and calcification of the coronary arteries and also central hemodynamics have been studied. The analysis of survey results of 65 patients with coronary heart disease (30.8% of patients had a history of myocardial infarction) has been carried out. The average age of patients in observation group was 60.2 ± 10.56 years. Male patients were dominated (75.4%). According to the 64-slice MSCT it has been found that coronary artery stenosis occurs ≥ 50% in 90.0% of patients with myocardial infarction, and in 32.5% of patients with symptomatic coronary artery disease. Conclusion. Therefore, MSCT has sufficient specificity in the diagnosis of occlusive and stenotic lesions of the coronary arteries, and can be used for screening patients with suspected coronary artery disease.

The aim of the investigation is to show the possibility of updating of the training program of the discipline «Chemistry» intended for training of engineers of chemical specialties of higher educational institutions on the basis of results of the last researches in the field of nanochemistry. The article is addressed to the scientists and teachers developing the specific fields of science, to students and graduate students who have decided to devote themselves to new perspective science of the 21st century.Methods. The analysis of the works concerning the combinational scattering method (Raman spectroscopy) is made. Exposure to the combinational scattering method and the method of infrared spectroscopy is necessary for the undergraduates who are engaged in synthesis of new nanomaterials on the basis of carbon while deciding of the obtained experimental data. The physical and chemical analysis was used in the research to study the properties and structure of shungite of the Zazhoginsky field – the unique natural mineral containing nanoparticles and the effective sorbent applied to purification of drinking water (emission spectral analysis with inductively coupled plasma, Raman spectroscopy and Infrared spectroscopy).Results and scientific novelty. When processing shungite with toluene, ochroleucous resinous substance was educed; this is an organic substance according to data of IR-spectroscopy. On the basis of the analysis of data of Ramanspectroscopy, the line about 2700 cm–1 is offered to consider as the indicator of crystallinity. A variety of physical and chemical and structural properties in connection on the basis of shungite allows us to speak about chemistry of fullerenes and nanochemistry as the new perspective direction of chemistry.Practical significance. Described data on Raman-spectroscopy will help undergraduates, young scientists and researchers to identify various modifications of carbon in the nanomaterials synthesized by them on the basis of carbon. The data received during the research can be used for laboratory work «Determination of shungit nanocomponents through modern physical and chemical methods», having included it in the subject «Carbon» of the program of discipline «Chemistry». The materials of the article can also serve as a starting point for creation of a special short-term course on studying of materials of group of carbon in the system of advanced training for employees of the entities who are engaged in shungite processing.

Abstract. The aim of the investigation is to select how the thermal decomposition of crystallohydrate magnesium nitrates to capture the nitrogen compounds that are harmful to the environment; for the return of nitric acid to the initial stage of the process. Methods. The methods involve physical and chemical analysis (IR spectroscopy, rentgennofazovy analysis), thermolysis and thermal hydrolysis of magnesium nitrate. Results. Magnitudes of thermal effects are determined; mechanisms of thermal decomposition of magnesium nitrate in air and overheated water vapor are posed. Thermohydrolysis renders possible to produce undiluted magnesium oxide and regenerate nitric acid. Scientific novelty. Undiluted magnesium oxide was produced by the method that requires less energy consumption. Practical significance. The research results on regeneration of nitric acid and its reuse in the raw material processing containing magnesium open new prospects for production and can be applied as course materials for a practical training in organic chemistry in postgraduate study on chemical specialties.

The 11th Banff Conference of solid organs allografts pathology was held in a suburb of Paris from June 6 to 10. Papers were presented by created at the previous conference working groups on the following areas: isolated v-lesion, fibrosis scoring, glomerular lesions, molecular pathology, polyomavirus nephropathy and quality assurance of immunohis-tochemical procedures. The main topics of discussion were antibody-mediated rejection, management of sensitized patients, the approach to the diagnosis of transplant rejection by the methods of genomics and proteomics, and the role of protocol biopsies. There were suggestions to reconsider how to assess polyomavirus nephropathy, glomerulitis, transplant glomerulopathy. Term «epithelial-mesenchymal transition» was considered inappropriate and need to be replaced.

The retrospective analysis of the influence of histological changes in donor kidneys on the KAG function during first year was conducted in 75 recipients of a cadaveric kidney. The state of tubuli, glomeruli, interstitium, vessels was assessed semiquantitatively in the material of «0»-biopsies. The endpoints were serum creatinine and glomerular filtration rate at 3, 6 and 12 months. KAG function in the first year is programmed by histological changes in all compartments of donor kidney. Influence of histological changes is time-dependent: the effect of ischemic damage shows up quickly, but disappeared after 6 months; the effect of arteriolohyalinosis and arteriosclerosis begins to show up later – since 6 months; changes in glomeruli have influence on a KAG function in 3 months and 1 year; interstitial fibrosis in cortex and medulla negatively influences KAG function on the extent of all first year. Our data argue for the necessity of «0»-biopsies examination for the prediction of KAG subsequent function.

The aim of this study was morphological characteristics of peculiar properties of acute T-cells- (ATMR) and antibody-mediated kidney allograft rejection (AAMR). Histological slices of kidney allograft biopsies were examined after coloration by routine methods and immunohistochemical proceeding for C4d, CD45R0 T-lymphocytes antigen and CD68 macrophages antigen. We’ve determined that the key features of ATMR are: increasing of T-lymphocytes interstitial infi ltration with the same level of macrophages infi ltration comparing with implantation biopsies, mild mononuclear glomerulitis and capillaritis; tubulitis. Morphological traits of AAMR are neutrophilic and T-lymphocytes glomerulitis, diffuse capillaritis, capillaries dilatation and margination of mononuclear cells with admixture of neutrophils, macrophagal interstitial infi ltration under semiquantitative evaluation, as well as, more pronounced, than in ATMR, T-lymphoctes and macrophages interstitial infi ltration under quantitative evaluation.

Abstract Entry. Mechanical jaundice is frequent complication of gallstone disease both in urgent and in planned surgery. In the last few years the increase of amount of patients with mechanical jaundice, especially persons of elderly and senile age, is marked and the results of their treatment don’t satisfy surgeons fully. A similar situation cannot remain regardless and requires the search of new ways of decision of this problem. Research aim. Determination of the most optimal methods of diagnostics and treatment of patients with the gallstone disease complicated by mechanical jaundice and estimation of efficiency of their application. Materials and research methods. The results of laparoscopic cholecystectomy in 3054 patients with gallstone disease and its complications are analyzed. Experience of surgical treatment of 297 (9,7%) patients with gallstone disease complicated by mechanical jaundice is presented. The most frequent complications were: choledocholithiasis, mechanical jaundice - in 290 (9,5%) patients, combination of choledocholithiasis with stenosis of large duodenal papilla - in 218 (7,1%), stricture of choledoch - in 7 (0,2%). Endoscopic papillosphincterotomy and laparoscopic cholecystectomy was performed for 263 (8,6%) patients with mechanical jaundice. Research results. On the I stage of treatment of mechanical jaundice in 263 (8,6%) patients with choledocholithiasis and combination of choledocholithiasis with stenosis of large duodenal papilla endoscopic papillosphincterotomy was performed. On the II stage of treatment of patients laparoscopic cholecystectomy was conducted. It was performed on the 2-7 days after endoscopic papillosphincterotomy and verification of the absence of stones in choledoch. The new method of implementation of laparoscopic cholecystectomy the key moment of which is subserosal coagulation of branches of cystic artery is described. The curatively-diagnostic algorithm of treatment of patients with gallstone disease complicated by mechanical jaundice is offered. Conclusions. The most informative method in diagnostics of choledocholithiasis, complicated by mechanical jaundice, is endoscopic retrograde cholangiopancreatography (85,4% - 95%). Endoscopic papillosphincterotomy is the most effective for patients with the diameter of stones in choledoch less than 10 mm. At a diameter more than 10 mm endoscopic papillosphincterotomy in most cases is ineffective. Such patients must undergo the operative intervention by an open method. Usage of two stage of treatment of the gallstone disease complicated by mechanical jaundice must be priority. We consider the first stage must include combination of endoscopic retrograde cholangiopancreatography and endoscopic papillosphincterotomy, the second stage – laparoscopic cholecystectomy. The method of gall-bladder devascularisation at laparoscopic cholecystectomy with the use of subserosal coagulation of small branches of cystic artery without selection and ligation of her main branch is the effective method of extrahepatic bilious ducts and main (cystic and hepatic) arteries damage prophylaxis.

Art as a social phenomenon has always been one of the most important elements of the official public life sphere, which implements a number of specific and non–specific social functions. The article addresses the problem of relations between society and art, analyzes subsystem of culture functioning and reveales sociological components of art and society interaction.

Until recently for patients with chronic lower limbs ischemia (CLI) there were several ways of treatment. In 50–90% of patients, whose treatment was ineffective, major amputation was done on thigh level. The alternative method of lower limbs revascularization is a stem cell therapy. Preliminary researches data proved safety and efficiency autologous stem cells use in patients with CLI. The positive results of randomized clinical researches will allow to introduce stem cell therapy in practice and do it one of the methods for treatment of patients with CLI.

This paper addresses spatial aspects of reactive astrogliosis in the substantia nigra pars compacta (SNc) of the rat brain observed 40 and 70 days after the intracerebral 12 µg rotenone infusion. The infusion was shown to cause a marked increase in astrocyte density at both analyzed time points. Minimal spanning tree (MST) analysis was applied to analyze spatial patterns formed by nigral astrocytes. Spatial clusters of these cells, identified as disjoint MST subgraphs, were more numerous in the infused SNc tissue as compared with the control one. Size and density of clusters were significantly different between the infused and control areas 40 and 70 days after the infusion. In conclusion, the data suggests that rotenone-related astrogliosis in the substantia nigra includes changes in spatial patterns of astrocytes as well as transient spatial clustering of these cells. [ABSTRACT FROM AUTHOR]

The study was organized to provide additional characteristic of chronic dysfunction of renal allo-transplant using such biomarkers of serum and urine as enzymes (alanine aminotransferase), aspartate aminotransferase, gamma- glutamiltransferase, alkaline phosphatase, N-acetyl-β-D-glucosaminidase, interleukins (IL-2, IL-8, IL-10), beta-2- microglobulin. The chronic dysfunction of renal allo-transplant is characterized by increasing of concentration of IL-10 and beta-2-microglobulin in serum and increasing of concentration of beta-2-microglobulin, IL-2, IL-8 in urine and increasing of activity of N-acetyl-β-D-glucosaminidase, alkaline phosphatase, aspartate aminotransferase, gamma-glutamiltransferase as compared with patients with satisfactory function of renal allo-transplant. The multivariant logistic regression analysis established that only activity of N-acetyl-β-D-glucosaminidase in urine was reliably independently related to chronic dysfunction of renal allo-transplant. It is assumed that increasing of concentration of beta-2-microglobulin in serum testifies glomerular dysfunction and in urine--tubular dysfunction of renal allo-transplant. The enzymeuria indicates continuing damage of epithelium of proximal tubules of nephron. The classification of patients with satisfactory function and chronic dysfunction of renal allo-transplant established that the highest indicators of square under ROC-curves had concentration of beta-2-microglobulin in serum (0.858 ± 0.061) and urine (0.733 ± 0.079) and activity of N-acetyl-β-D-glucosaminidase in urine (0.701 ± 0.061). To specify diagnosis of chronic dysfunction of renal allo-transplant the most useful (ratio of likelihood of positive result 10 and 11 correspondingly) are tests of beta-2- microglobulin in serum (more than 8.55 mkg/ml) and N-acetyl-β-D-glucosaminidase/creatinine in urine (more than 34 nmol/(sl)/ mmol/l). These discoveries require further validation and confirmation by implementation of morphological analysis of bioptat of renal allo-transplant.

In a structure of the cardio-vascular system diseases in Ukraine the part of chronical ischemia of the lower extremities tissues constitutes more than 20%. Due to diffuse affection of the distal parts of arterial bed it is impossible to succeed in performance of a direct" revascularization in 40% of patients. In 60-87% of such patients a severe ischemia of the lower extremities tissues occurs, causing the necessity of their high amputation performance on the hip level. The results of surgical treatment of 36 patients, suffering inoperable types of the peripheral arteries occlusion were analyzed. In 18 patients the algorithm of intraoperative ultrasound duplex scanning was applied, surgical interventions were performed using optimized procedures. As a second stage the PRP-therapy was conducted, since the second post-operative day all the patients have had performed the elaborated complex of physical exercises, directed on the shin and hip muscles strengthening. Optimization of the lower extremities indirect revascularization methods have permitted to increase the rate of the treatment positive results from 55.6 to 88.9%, to reduce the unsatisfactory results rate--from 44.4 to 11.1%. The PRP-therapy and complex of regular physical exercises conduction have promoted the VEGF content enhancement in the blood serum by 15.6%. malleolar-brachial index--by 28.9% in the patients, suffering occlusion of femoro-popliteo-tibial segment. PRP-concentrate constitutes a potent cell biological activator of the VEGF, improves metabolism and microcirculation in muscles and cells of the skin.

On the basis of their experience with 530 kidney transplantations and literature data the authors argue the necessity of careful assessment of the kidney allograft state at all stages of its life. An accent is thus done on the necessity of the complex diagnostics with using noninvasive and invasive methods that will facilitate the kidney allograft dysfunction prediction and prevention, and longer time of the kidney allograft survival.

The peroxidal oxidation of lipids (POL) and antioxidant defense (AOD) system state in the patients blood before renal transplantation performing and on the fourth day after it were studied, depending on kind of familial or potential agonal with beating (DBH) or nonbeating (DNBH) heart donor applied and the presence of complications--delayed renal autotransplant (RAT) function and acute reaction of rejection (ARR). In chronic renal insufficiency, RAT transplantation from cadaver, DNBH and ARR the POL processes intensification and AOD system activity lowering were noted.

There were examined 825 patients, in whom affection of extracranial arteries was revealed, including 340 (41.2%) men and 485 (58.8%) women, 27 to 73 years old. Atherosclerotic stenosis and occlusion of extracranial arteries was diagnosed in 305 (40.0%), pathologic kinking of vessels on atherosclerosis and hypertonic disease background--in 196 (23.8%), pathological kinking, caused by aortoarteriitis and fibrose--muscular displasia--in 197 (23.9%), hypoplasia of arteries--in 54 (6.5%), aortoarteriitis--in 73 (8.8%) patients. Stages I-IV ischemia together with proven affection of extracranial arteries served as indication for surgical treatment of chronic cerebro-vascular insufficiency. Depending on character of the arteries affection 11 kinds of operative interventions were conducted, using complex intraoperative program of the brain defense. Total number of reconstructive operations performed was 967. In 752 (91.2%) patients immediate good and satisfactory results were noted. In the late period 450 patients were examined: good results were achieved in 64.9%, satisfactory--in 22%, in 30 (6.7%) improvement did not occur and 28 (6.2%) died. Introduction of the proposed complex examination and surgical treatment program have permitted to improve the results of treatment of the patients, suffering chronic brain ischemia.

Surgical complications were studied, which occurred in 55 (20.37%) of 244 patients, to whom 270 renal allotransplantation (RAT) operations were performed. In 19 (34.6%) of recipients the urological complications were noted, in 20 (34.4%)--spontaneous rupture of the transplant, in 11 (20%)--lymphocele, in 5 (9.1%)--arrosive hemorrhage from the renal transplant artery. The methods of surgical correction of the RAT complications were optimized. Urological complications and spontaneous rupture of the renal allotransplant were revealed most frequently. An acute rejection reaction constitutes the most frequent cause of spontaneous rupture of the renal allotransplant. While the RAT surgical complications occurrence an active surgical tactics is adopted.

The results of 92 elective operative interventions, performed in 71 patients with chronic renal insufficiency (CRI) in terminal stage, were studied. Performance of elective operative interventions in patients with CRI in terminal stage, to whom the treatment, using chronic hemodialysis, was conducted, allows to increase quality of their medical and social rehabilitation considerably and the efficacy of kidney transplantation (KT). They constitute effective and safety method of treatment in complex surgical program of patients preparation to KT performance.

The causes of the renal allotransplant (RAT) removal during first year after the kidney transplantation performance were studied. Of 270 renal allotransplantations performed in 56 (20.5%) of recipients the transplant was removed during first year after the operation. In 36 (64.3%) of patients transplantnephrectomy was performed for immune conflict presented, in 12 (21.4%) of observations purulent-septic complications have become the cause of RAT removal and in 8 (14.3%)--the vascular causes (thrombosis of RAT artery, vein).

The methods of surgical treatment of spontaneous rupture of renal allotransplant (RAT) were studied up in 21 patients. In 17 (80.9%) of patients the RAT rupture was caused by an acute reaction of rejection (ARR), in 14.3% of observations--by an acute necrosis of tubules, in 2 (9.5%)--by renal vein thrombosis and in 2 (9.5%)--by an ischemic damage of the transplant. Surgical treatment of the RAT spontaneous rupture (except the cases with rupture due to renal vein thrombosis) must be managed by the hemorrhage stoppage, the RAT tissues strain reduction (decapsulation and the cross-like capsulotomy), conduction of its intraoperative anticrisis and antiischemic defense with subsequent complex therapy for ARR and the transplant dysfunction. Application of such a tactics of treatment have permitted to secure the RAT and its functions in spontaneous rupture in 82.4% of observations. The transplant survival was registered in terms up to one year in 64.7% of observations.

Results of treatment of 28 patients with polycystic kidney were presented. In 12 (42.9%) patients with terminal stage of chronic renal insufficiency transplantation of kidney (TK) was performed without preliminary nephrectomy or nephrectomy was done simultaneously with TK. In 16(57.1%) patients nephrectomy was performed in stage of preparation to allotransplantation. Were established advantages of preliminary performance of nephrectomy in patients with polycystosis on stage of preparation to TK: in one-year follow-up the settle down of renal allotransplant was noted in all patients.

There were analyzed the results of treatment of 1514 patients, to whom different reconstructive operations on vessels were performed. In 88 (5.8%) of them infectious-inflammatory complications occurred. Three groups of complications were assigned: superficial (in 43.2% observations), deep (in 44.3%) and common infectious (in 12.5%). To all the patients treatment was conducted, in 93.2% of observations positive result was noted, mortality had constituted 2.3%, amputation of lower extremity was performed in 4.5% of patients. There were assigned predisposing factors for the infectious complications occurrence. Complex of curative and prophylactic measures for application in reconstructive vascular surgery was elaborated.