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This article presents a review of the current literature on the problem of omission and prolapse of the internal genitalia in women. Patients diagnosed with pelvic organ prolapse need pelvic floor plastic surgery. Currently, in spite of the extensive experience in managing this category of patients, there is still no single and unambiguous approach to the choice of surgical treatment tactics. This review describes the latest information on the etiopathogenesis of pelvic floor supporting apparatus lesions, namely, systemic connective tissue dysplasia as the main development factor. Prospective development of genetic and immunohistochemical marker diagnosis is the key to individual selection of treatment options for this multidisciplinary problem. The results of interventions are characterized by extreme variability in terms of both effectiveness and the frequency of intra- and postoperative complications. The treatment of rare forms of prolapse after surgery for rectal cancer also raises many questions. The current multitude of types of surgical interventions for genital prolapse and variants of pelvic floor defect closure is constantly being modified. To date, there is no universal treatment option, and all available techniques have both advantages and disadvantages, as well as limited application due to the risk of somatic complications, high recurrence rate, and the need for expensive equipment and a highly qualified surgeon. New research is needed, taking into account the current knowledge about the cellular and molecular mechanism of the lesion of the pelvic floor supporting apparatus. All of this will improve the methods of correction of pelvic organ prolapse in both typical and rare forms caused by iatrogenic factors. As a result, this may lead to an improvement in the quality of life of such patients.

Despite the lack of information in the medical literature on endometrioid disease complicated by infectious and inflammatory diseases, past community-acquired pneumonia caused by the new coronavirus infection may cause purulent-septic complications of endometriosis. The effect of the virus on endometrioid cysts was hematogenous in this clinical case. The information presented in this report can help clinicians in conducting differential diagnostics in patients with a history of endometriosis and previous SARS-CoV-2, establishing a diagnosis, as well as determining the tactics of examination and treatment. © Eco-Vector, 2021

AIM: The aim of this study was to investigate the morphometric features of tissues after exposure to bipolar energy of various electrosurgical generators and surgical hemostatic instruments used in vaginal hysterectomy. MATERIALS AND METHODS: The study included 48 individuals who underwent a vaginal hysterectomy. The patients were divided in three groups based on the instrument used for sealing blood vessels: a BiClamp ® was applied in Group 1 ( n = 16), a TissueSeal PLUS COMFORT ® in Group 2 ( n = 16), and a Thunderbeat ® in Group 3 ( n = 16). The maximum temperature of tissue measured using a Fluke FLK TIS 40 9HZ thermal imaging infrared camera was compared within the groups. RESULTS: The maximum tissue temperature between the branches on electroligation, the minimum tissue temperature, and the tissue temperature at the coagulation boundary were significantly lower when using a TissueSeal PLUS COMFORT ® clamp than when using BiClamp ® and Thunderbeat ® clamps (H value = 41.8, p ≤ 0.01). Morphometric parameters (prevalence, coagulation depth and area) were the smallest with a TissueSeal PLUS COMFORT ® clamp compared to other clamps. CONCLUSIONS: Using a TissueSeal PLUS COMFORT ® clamp during vaginal hysterectomy is effective and safe and has the best thermometric and morphometric characteristics when applied to the tissue, thereby reducing the risk of lateral thermal damage. The possibility of perifocal heat transfer varies with the type of tool and with the temperature at the coagulation boundary.

In recent studies, it has been established that extralevator abdominoperineal extirpation (ELAPE) of the rectum can improve the oncological results of treatment of distal rectal cancer compared to standard abdominoperineal extirpation. As a result of extralevator dissection, a large defect of the perineum is formed, which requires plastic closure. While performing ELAPE, the structures that form the pelvic diaphragm are affected. This increases the risk of pelvic organ prolapse in women and significantly affects the quality of life of these patients, which requires subsequent surgical treatment. Despite the fact that pelvic organ prolapse develops as a consequence of previous surgical treatment by an oncologist, they do not consider it as a complication in the long-term postoperative period. Such patients are not referred to the operating gynecologist. Currently, this problem is poorly understood and there are no standardized approaches to the surgical treatment of pelvic prolapse in this category of patients.

This article presents a comparative analysis of the effectiveness of endoscopic transpapillary management in patients with choledocholithiasis. The minimal complications are achieved using classical endoscopic papillosphincterotomy. However, in some cases, cannulation can be extremely difficult (stenosis, tumor of the major duodenal papilla, the anatomical features of the major duodenal papilla) or even impossible (wedged stone), and the introduction of a guidewire into the pancreatic duct significantly increases the risk of developing postoperative pancreatitis. The desire to increase the success when performing endoscopic papillosphincterotomy with diagnostic purpose (to perform endoscopic retrograde cholangiopancreatography after failure of traditional cannulation) and for the purpose of performing transpapillary operations has naturally led to the development of new non-standard methods of endoscopic papillotomy, the introduction of new instruments – wire guides and guided cannulas. Further increase in the frequency of successful endoscopic papillotomy can be facilitated by using atypical methods of surgery. Some authors show that classical papillosphincterotomy is comparable to the method of endoscopic papillosphincterotomy with balloon dilatation in effectiveness of extracting stones from the common bile duct. However, balloon dilatation in the extraction of choledocholithiasis is preferable due to fewer postoperative complications.The authors of this article note that endoscopic management do not always solve the problem of choledocholithiasis, but still have undeniable advantages compared with the laparotomy, in which choledocholithotomy sometimes has to be expanded, and duodenotomy with transduodenal papillosphincterotomy is conducted. Literature shows that main mortality causes after endoscopic interventions in patients with choledocholithiasis were progression of purulent cholangitis, biliary sepsis, acute postoperative pancreatitis, “discharge” syndrome.

The authors described the case of replantation of the right hand in the men of 28 years after a traumatic amputation. This injury was accompanied by damage to the main vessels, which could lead to acute blood loss, hemorrhagic shock and death. The complication after surgery in the form of suppuration of the wound and its effective treatment was shown. This clinical example demonstrated the possibility of limb replantation in traumatic amputations not only in specialized clinics, but also in General surgical hospitals. The basis of the success of the results of the operation was the phasing in the treatment, active monitoring of the replanted limb in order to early identifying possible complications in the postoperative period.

This paper contained data from different literature about problem of minimally invasive treatment of patients with choledocholithiasis. The clinical example justified the use of partial papillosphincterotomy with balloon dilatation in the case of large choledocholithiasis. It was shown that the use of this operation did not increase the risk of intra and postoperative complications during the lithoextraction of large stones from the biliary tract.

Background. In recent years, various methods of combined anesthesia during abdominal surgery have been introduced into clinical practice.Aim. To demonstrate the possibilities of a combination of high prolonged spinal anesthesia and endotracheal anesthesia during abdominal surgery.Materials and methods. A clinical case of combined use of high prolonged spinal anesthesia and endotracheal anesthesia in a 48-year-old patient with a tumor in the right half of the ascending part of the right half of the colon is presented.Results. The patient received a puncture of the spinal space at a standard point and was installed a spinal catheter in the cranial direction for 3 cm. An isobaric solution of marcaine in the initial dose of 20 mg was injected into the catheter. The regulation of the development of the block was regulated by the inclination of the head end of the table by 60°. After that endotracheal anesthesia was performed on the basis of fentanyl and propofol. This combination allowed to expand the scope of surgical intervention, provided adequate pain relief intraoperatively and in the postoperative period, without the use of narcotic analgesics. With the appearance of signs of recovery of pain sensitivity, intraoperatively or in the postoperative period, re-introduction of the anesthetic into the spinal catheter was performed in half of the initial dose with liquor barbotage. In the early postoperative period, the patient was on strict bed rest with a head end of the bed raised at 30–45°. The method provides complete segmental blockade and muscle relaxation in the area of operation, stability of central hemodynamics during surgery and in the postoperative period.Conclusion. This type of anesthesia is more easily tolerated by patients, accompanied by early awakening and extubation, characterized by stability of central hemodynamics, reduced risk of complications, the possibility of prolonging anesthesia with lower doses of narcotic analgesics in the intraoperative period, providing high-quality anesthesia in the postoperative period without resorting to the use of narcotic analgesics.

Liver is an exceptional organ due to unique anatomical and physiological features, as well as advanced regenerative ability. Discovery of molecular mechanisms governing liver regeneration allowed researchers to use them to enhance liver regeneration. However, significant progress in this area was achieved through the introduction of gene therapy. In this manuscript, the authors consider stem cells for cell therapy and tissue engineering, as well as an alternative to liver transplantation.Печень является исключительным органом из-за своих уникальных анатомических и физиологических характеристик, а также из-за неограниченной регенерационной способности. Открытие молекулярных механизмов, управляющих регенерацией печени, позволило исследователям использовать их для усиления регенерации печени. Однако значительный прогресс в этой области достигнут благодаря внедрению генной терапии. В обзоре особое внимание уделяется стволовым клеткам не только как потенциальному материалу для клеточной терапии и тканевой инженерии, но и как альтернативе трансплантации печени.

Urinary tract infections are one of the common diseases that are frequent in clinical practice of different physicians. The main agents that are plated from urine at the urinary tract infections are E. coli, Proteus mirabilis, Klebsiella spp., Pseudomonas spp., Staphylococcus aureus, Morganella morganii, Citrobacter freundii. Effective treatment of UTI is only possible with the restoration of normal urodynamics and the correction of complicating factors and concomitant diseases. The aim of the study was to evaluate pharmacotherapeutic efficacy and safety of the medication "Uroprofit" in complex treatment of UTl. At the treatment of persistent bacterial infection of the lower urinary tract which is one of the challenges in urological practice, "Uroprofit" is an effective and safe medication. It has antibacterial, anti-inflammatory, antispasmodic, immunomodulatory properties.

It is known that liver is able to restore own dimensions and functional properties in response to various injuries. Despite extensive injuries, liver can preserve functional activity. Analysis of liver regeneration mechanisms allowed us to obtain significant results in the treatment of hepatitis, cirrhosis and liver failure. Liver regeneration processes substantiate the development of hepatocellular cancer following cirrhosis. Modern experimental and clinical data on liver regeneration, as well as current methods of stimulating this process are summarized in the manuscript. Despite significant advances in this issue, there are still many questions in scientific understanding of liver regeneration.Печень — это уникальный орган, способный восстанавливать свои размеры и свойства в ответ на различного рода повреждения. При этом, даже несмотря на обширные травмы, она способна выполнять сложные функции. Исследование механизмов регенерации печени позволило получить значительные результаты в лечении гепатита различной этиологии, цирроза, печеночной недостаточности. Понимание процессов регенерации печени дает возможность обосновать развитие гепатоцеллюлярного рака при циррозе печени. В статье обобщены современные экспериментальные и клинические данные по регенерации печени и методам стимуляции данного процесса. Несмотря на существенные достижения в данном вопросе, в научном понимании регенерации печени остается еще много пробелов.

The article presents the review of modern Russian and foreign literature devoted to a problem of treatment of chronic endometritis. It was shown that treatment of this pathology should be conducted in two stages. The basis of the first stage is antibacterial therapy, the basis of the second stage is complex treatment with application of vascular preparations, vitamin therapy, endocrinotherapy, physiotherapy. In addition the article brings up several debatable questions of treatment of chronic endometritis and expediency of application of hormones, probiotic, immunomodulators in particular. Also the article presents the estimation of various methods of medical products introduction. The positive effect is received from local application of medical products. It was noticed that the search of new medical products is proceeding.

Authors of given article conducted an estimation of pharmacotherapeutic efficiency of gel Kvotlan in the treatment of long-to-heal trophic ulcers of venous ethiology. 32 patients with venous trophic ulcers were included in the analysis of case records. There were 12 (37,5%) men and 20 (62,5%) women among them. The age of patients varied from 32 to 69 years. A preparation applied in the form of gel in a combination with gauze wad once a day, putting on ulcer wound interface. Treatment took 21 day. Application of Kvotlan on wound interface stimulated macrophagal reaction, strengthened proliferation of fibroblasts and epithelial, reduced degree of bacterial contamination of trophic ulcer. Clarification of ulcers from fibrin presence was reached by 15,2 days from an start of treatment. Along with clarification of wound interface there was a considerable decrease in a painful syndrome and also reduction of degree of discomfort. Kvotlan has expressed antibacterial and antioxidant effects. Besides, gel has expressed recycling and wound healing properties in comparison with comparison preparations. High percent of recovery of patients after one course of treatment and low level of relapses allow to recommend gel application of Kvotlan in complex therapy of trophic ulcers in case of chronic venous insufficiency diseases.

This work is about outcomes of surgical treatment aortic arch obstruction in children performed with the use of selective cerebral perfusion and moderate hypothermia. The study included 97 patients with aortic coarctation, recoarctation and hypoplastic aortic arch. The patients were divided into 3 groups. 75 patients with isolated coarctation and recoarctation or with concomitant atrial septal defects, patentforamen ovale and patent ductus arterious were assigned to the 1st group. The 2nd group included 13 patients with aortic arch obstruction and ventricular septal defects. The 3rd group consisted of 9 patients with coarctation, recoarctation and complex intracardiac anomalies. All patients underwent reconstruction of the aortic arch with selective cerebral perfusion and moderate hypothermia. Overall mortality rate was 4%. Postoperative complications took place in 7% of the cases: 1% - postoperative bleeding, 1% - paresis of the diaphragm, 2% - pneumothorax, 2% - chylothorax, and 1% of the cases - vocal cords paresis. Respiratory postoperative complications were registered in 5% of cases. In 6% of the cases patients had neurological postoperative complications. After the operation there was no gradientfound between the pressures on upper and lower extremities. We consider that antegrade selective cerebral perfusion and moderate hypothermia during aortic arch reconstruction are effective methods of brain and visceral organs protection.

Authors of article make an assessment of pharmacotherapeutic activity of Ventrophyt and Polyphytochol at chronic duodenal ileus. Using large number of clinical observations (218 patients) authors analyze the effect of these plant agents on a disease pattern, indicators of intraduodenal pressure, motor evacuation function of various departments of a gastroenteric path. Researches showed that the agents favorably influence on motor evacuation activity of a gastroenteric path. Ventrophyt have expressed impact on bioelectric activity of both stomach and duodenum with increase of rhythmicity factor. Polyphytochol in complex therapy has the impact on activity of duodenum with increase rhythmicity factor and without significant influencing bioelectric activity of a stomach. Besides, the agents reduce intraduodenal pressure, normalize biochemical indicators of gastric juice, improve the quality of life of patients both in acute and in the remote period. In the remote period it is established more expressed pharmacotherapeutic efficiency of Ventrophyt in comparison with Polyphytochol. The researched plant agents can be widely recommended in clinical practice.

The aim of the research was to study localization of wandering focus and effectiveness of extensive endocardectomy at left ventricular reconstruction in patients with ischemic heart disease (IHD) with postinfarction left ventricular aneurysm (LVA) in combination with ventricular tachycardia (VT). Examined patients besides diagnostic routines had intracardiac electrophysiological examination (EPE) with use of 3D-navigation system CARTOTX (Biosense Webster). During EPE abnormal zones of delayed navigating and zones of double potential with main localization in the area of cacuminal and middle septate segments were found. All patients were divided into two groups: patients of the first group had aortocoronary bypass (ACB) in combination with left ventricular reconstruction completed with extended resection of endocardium with pinch of all cacuminal and middle septate segments; 2 patients of the second group had isolated ACB, 2 patients had ACB with mitral annuloplasty with rim and de Vega plasty of tricuspid valve, 1 patient had percutaneous transluminal coronary angioplasty, 10 patients hadACB in combination with LVA plasty without extended endocardium resection. As the result of the treatment in the first group there were no VT episodes after resection of aneurysm with extended endocardium resection; 33 % of patients in the second group had implantable cardioverter defibrillator, 7 % of the patients had radio frequency ablation of VT nidus, 7 % of the patients had anti-arrhythmic therapy. Taking into consideration that main localization of ectopic nidus in patients with IHD with postinfarction LVA and VT is in the area of cacuminal and middle septate segments, left ventricular reconstruction in these patients needs to be conducted with extended resection of endocardium of these segments.

To evaluate the efficacy of the most common endoscopic transpapillary interventions for choledocholithiasis in randomized controlled trial.There were 90 patients with choledocholithiasis who were randomized into 3 groups: main, clinical comparison 1, clinical comparison 2. In the main group A (n=30), patients underwent endoscopic partial papillosphincterotomy combined with balloon dilatation, in the group of clinical comparison 1 (n=30) - endoscopic papillosphincterotomy, in the group of clinical comparison 2 (n=30) - endoscopic papillosphincterotomy with mechanical lithotripsy.The greatest number of complications (38%) was observed in the group of clinical comparison 2. Less morbidity was noted in the group of clinical comparison 1 (19%). Minimum number of complications was observed in the main group (6%). Acute pancreatitis was diagnosed in groups of clinical comparison 1 and 2 as a rule, whereas only 3% of patients had this complication in the main group. Cholangitis was predominantly observed in the group of clinical comparison 2, in other groups this complication occurred in 3% of patients. Bleeding was observed only in the groups of clinical comparison 1 and 2 (10 and 13%, respectively). Loss of the lithotripter rope (3%) was detected only in the group of clinical comparison 2.Endoscopic partial papillosphincterotomy with balloon dilatation is advisable for choledocholithiasis due to minimal risk of intra- and postoperative complications.Цель исследования - оценить эффективность наиболее часто используемых эндоскопических транспапиллярных вмешательств по поводу крупного холедохолитиаза. Материал и методы. Исследование выполнено среди 90 больных с крупным холедохолитиазом, случайным образом рандомизированных на три группы по 30 человек: основная, клинического сравнения 1 и клинического сравнения 2. В основной группе пациентам проводили эндоскопическую парциальную папиллосфинктеротомию в сочетании с баллонной дилатацией, в группе клинического сравнения 1 - эндоскопическую папиллосфинктеротомию, в группе клинического сравнения 2 - эндоскопическую папиллосфинктеротомию с механической литотрипсией. Результаты. Наибольшее количество осложнений - 38% отмечено в группе клинического сравнения 2. Несколько реже осложнения наблюдали в группе клинического сравнения 1 - 24%. Минимальное количество осложнений было в основной группе - 6%. Острый панкреатит чаще всего регистрировали в группах клинического сравнения 1 и 2, тогда как в основной группе - лишь в 3% случаев. Холангит чаще всего отмечали в группе клинического сравнения 2, кровотечение - только в группах клинического сравнения 1 и 2 - соответственно 12 и 14%. Повреждение корзины Дормиа наблюдали только в группе клинического сравнения 2 -7%. Выводы. При выборе лечебной тактики по поводу крупного холедохолитиаза целесообразно использовать эндоскопическую парциальную папиллосфинктеротомию, при которой риск интра- и послеоперационных осложнений минимальный.

Femoral hernia strangulation is usually observed in middle-aged women. There are few case reports of appendix strangulation in the femoral hernia. Acute appendicitis in a strangulated femoral hernia is relatively rare (0.4% of cases). Clinical case of acute destructive appendicitis within a strangulated femoral hernia in an elderly woman is reported in the article. If there is doubt about the urgency of surgical intervention, surgeon needs to take a proactive stance and lean toward emergency surgery. Surgeon should be aware of possible strangulation-associated destructive appendicitis due to injury of the appendix.Ущемление бедренной грыжи - осложнение, которое преимущественно наблюдается у женщин среднего возраста. В литературе имеются единичные описания случаев ущемления червеобразного отростка в бедренной грыже. Аппендицит в ущемленной бедренной грыже выявляется в 0,4% случаев. В статье приводится клинический случай острого деструктивного аппендицита в ущемленной бедренной грыже у пожилой женщины. При наличии сомнений в неотложности выполнения хирургического вмешательства хирургу необходимо занять активную позицию и склониться к экстренной операции. Хирург должен знать о возможности развития деструктивного аппендицита при ущемлении из-за травматизации червеобразного отростка.

Authors of the given work develop a technique of high spinal anaesthesia in the operations on the upper part of abdominal cavity, and also conduct the assessment of its efficiency and safety at the operations. Experience of performance of 112 operations is presented. The given way of one-stage high spinal anaesthesia allows to achieve the high neuromuscular block to level of the 1-2nd thoracic vertebras. Time introductions anaesthetics in volume to 5 -10 ml. makes (on the average) 1 - 2 minutes that allows to create high degree of turbulence of an entered solution and as promotes distribution of vortical streams in cranial a direction liqour spaces for the purpose of distribution anaesthetics further from an injection place. In the early postoperative period anaesthesia was not required from patients narcotic analgetics. Complications in a kind: headaches, a nausea, vomiting, temperature it has not been noted. Complications from operative intervention it was not marked. In article it is shown that high spinal anaesthesia has considerable advantages before other kinds of anaesthesia, in particular before endotrachea a narcosis. It is easier transferred by the patient, does not cause terrible complications.

In given article the results of the research of application of cytoflavin in patients with a syndrome of diabetic foot complicated by trophic ulcers of the 1-2 degree according to Wagner classification are described. The main place is taken by the interpretation of clinical and laboratory and instrumental marks, such as stimulation of reparative processes and reduction middle time of restoration of skin at the ulcer defects areas of the foot of 1-2 degree, significantly expressed reduction middle marks of glycemic profile at the stages of the research, normalization of indices of lipid peroxidation (malondialdehyde and catalase) and redress the imbalance of patients' prooxidant-antioxidant system in the blood serum, improvement clinical and instrumental marks of blood flow, such as Doppler ultrasound of the arteries of the lower limbs, average linear velocity of blood flow (Vaver), peripheral resistance index (Ri), systolic-diastolic ratio (1SD) right after the taken therapy. The dynamics of the changes of ankle-brachial index illustrating the clinical example is also given.

The purpose of the given work is specification adverse prognostical criteria of outcomes of treatment of acute nonspecific empiema pleurae. Work is based on the results of complex treatment of 123 patients with empiema pleurae of not traumatic character. The acute abscess and a lung gangrene (37,9 %) was a principal cause of development of empiema. It is established that the most authentic factors of failures of treatment of empiema were overdue diagnostics acute empiema pleurae; defects and errors in treatment; insufficient preoperative preparation of the patient; an insufficient skill level of the surgeon; late reference for medical aid. Preventive maintenance of the specified defects of rendering of medical aid for the patient with acute empiema pleurae will allow to improve results of treatment of patients with the given pathology.

Urgency of the research was determined by insufficiency of information in modern literature about microbiological structure antibiotic sensitivity of main pathogens of urinary tract infection among capable people in conditions of hospital. The aim. of the research was to increase effectiveness of antibiotic therapy of stationary infections of urinary tract in conditions of north. The results of stationary examination of 1109 capable patients (males and. females) with infections of urinary tract from 1998 to 2009 years were studied. Data of microbiological examination is based on 700 bacteriological urine analyses. Antibiotic sensitivity of uropathogens was determined by disc-diffuse method. Structure of stationary infections of urinary tract in groups of patients of one sex was quite equal, but at the same time there are significant differences between groups of males and. females. Lately infections of urinary tract caused by intrahospital pathogens that are non-sensitive to common antibiotics (Proteus, KIebsieIIa and. Pseudomonas родов) started to be revealed, in patients arriving from other hospitals. It demands using reserve antibiotics. This underscores urgency of monitoring of uropathogens spectrum, and. their antibiotic-sensitivity for each hospital that has respective possibiIities. It was reveaIed. that chronic pyelonephritis with concomitant urolithiasis is the main nosoform in capable peopIe in conditions of north, in the structure of stationary infections of urinary tract. Acute and uncomplicated chronic pyeIonephritis and. aIso acute and. chronic cystitis more than twice prevaiI among femaIes in comparison, with males. The most important pathogens of stationary infections of urinary tract are: S. epidermidis, S. saprophyticus S. aureus for men; E. coIi, S. еpidermidis S. saprophyticus and. S. aureus for women at uncompIicated infections of urinary tract and. E. coli, S. saprophyticus, S. epidermidis for women at compIicated infections of urinary tract. Main uropathogens in researched, contingent had. higher sensitivity in vitro for gentamycin ofIoxacin, and Iower sensitivity — for cefotaxime, ceftriaxone and. ciprofloxacin. The most of resistant cuItures for antibacterial preparations that are the most frequently used for the treatment of infections of urinary tract is among E. coli, the Ieast part — among S. aureus.

For the purpose of increasing of the efficiency of antibioticotherapy of urinary tract infections (UTI) among people of giving age in the conditions of High North were analyzed results of permanent checkup and treatment of 1109 patients. Chronic pyelonephritis combined with concomitant urolithiasis prevail among these people in the structure of permanent UTI. Acute and uncomplicated chronic pyelonephritis, acute and chronic cystitis among female prevail more than 2 times. Main agents of permanent UTI among men are S. epidermidis , S. saprophyticus , S. aureus ; main agents with women in uncomplicated UTI are E. coli , S. epidermidis , S. saprophyticus and S. aureus ; main agents of complicated UTI are E. coli , S. saprophyticus , S. epidermidis . Main uropathogens in vitro are more sensitive to gentamicin, ofloxacin, they are less sensitive to cefotaxime, ceftriaxone and ciprofloxacin. The largest share of resistant strains was indentified in vitro to traditionally used antibiotics for treatment of UTI among E. coli , the smallest share was indentified with S. aureus .

The results of permanent checkup and treatment of 419 female were studied for optimization of prophylaxis and treatment of urinary tract infections (UTI) with women of giving age in the conditions of the North. It was established that uncomplicated aсute pyelonephritis and aсute cystitis prevail with young women, in the half of cases these diseases are associated with inflamed gynaecological pathology. Chronic pyelonephritis combining with concomitant urolithiasis and chronic cystitis, associating with deficit of estrogens, prevail among female of old age. Factors of military service contribute to development aсute UTI and appearing of chronic UTI in earlier age.

In this paper the authors summarized the literature data on diagnostics of diabetic foot syndrome. The review noted that the diagnosis should be based on an objective examination of the patient, as well as important special methods of investigation of the vascular system, including both invasive and noninvasive.

The article presents the results of complex treatment of empyema pleuras in 66 patients. In all cases pleural empyema of non-traumatic character was observed. Positive results are marked in patients underwent complex treatment which included intrapleural introduction of preparation «Baliz».

Acute hepatic failure is a cause of a significant amount of liver diseases. In a basis of pathogenesis of acute hepatic failure lie necrotic processes, apoptosis and necroapoptosis of hepatocytes. In this review modern information on a question of acute hepatic failure is analysed and generalized, and. therefore problem questions on pathogenesis, diagnostics and. treatment of this severe complication are revealed. In the world there are plenty prognostic tests of acute hepatic failure outcomes, however they not always can predict current of disease and. have the limited value.

Aim of the research: to explore the model of esophagus and stomach chemical burn with modern chemical agents in the experiment on animals. The article presents the results of experimental research of chemical burn of the esophagus in Vistar rats. The burn of esophagus was conducted by modern chemical agents. As the result of the research the substances with «low» and «high» degree of aggressiveness were determined.

The article presents our own experience of treatment of Hirschsprung disease in adults.

In the article the results of complex treatment of acute pleural empyema in 123 patients are presented. In all cases we observed pleural empyema of nontraumatic character. Positive results of treatment of patients with this pathology are marked in patients whose complex of treatment included laser therapy.

Immediate and long-term results of parenteral and oral administration of cytoflavin to patients with diabetic foot complicated by grade I and II trophic ulcers (Wagner classification) are considered with special reference to the assessment of reparative processes, normalization of the serum pro oxidant-antioxidant system, and improvement of clinical and instrumental bloodflow characteristics.

We summarize the literature data on diagnostics of diabetic foot syndrome including clinical examination and special invasive and non-invasive studies of the vascular system. The main methods are ultrasound dopplerography, X-ray contrast angiography, and ultrasound duplex scanning. Special attention is given to instrumental diagnostics of diabetic neuropathies. The golden standard for the evaluation of the function of the peripheral nervous system is electroneuromyography. Methods for the study of diabetic foot complications, such as osteoarthropathy and trophic ulcers, are discussed.

In present review different methods of hysterectomy. The technique of laparoscopic hysterectomy resulted in decreasing of complications and extended the number of indications. Summarizing everything mentioned above we can draw the conclusion that laparoscopic hysterectomy has the following advantages: minimal traumatization, cosmetic effect, shot postoperative and rehabilitation period, absence of complications in the late postoperative period, decrease of the risk of intraoperative complications. The experience accumulated proves the LH technique to be reasonable and efficient.

The report describes experience of treatment of diabetic foot syndrome over the period of 2009-2011. It demonstrates statistic analysis of lesions of arteries of lower extremities, and also frequency of surgical correction of purulent-necrotic lesions of extremities.

In our clinic we have been using laparoscopic- assisted vaginal hysterectomy since 1996. Our experience of LAVH amounts to 103 operations. The investigations we carried out confirmed undoubted advantages of laparoscopic-assisted vaginal hysterectomy over other methods in question. The technique used by us resulted in decreasing of complications and extended the number of indications. Summarizing everything mentioned above we can draw the conclusion that laparoscopic-assisted vaginal hysterectomy has the following advantages: minimal traumatization, favorable cosmetic effect, shot postoperative and rehabilitation period, absence of complications in the late postoperative period, decrease of the risk of intraoperative complications and absence of absolute contraindications. The experience accumulated proves the LAVH technique to be reasonable and efficient.

We have studied the three quark systems in an Effective Hamiltonian approach in QCD. With only two parameters: the string tension sigma and the strong coupling constant alpha_s we obtain a good description of the ground state light and heavy baryons. The prediction of masses of the doubly heavy baryons not discovered yet are also given. In particular, a mass of 3620 MeV for the lightest (ccu) baryon is found by employing the hyperspherical formalism to the three quark confining potential with the string junction., 8 pages, LaTex

А rare clinical case of trihobezoar of ileum, in the child of 6 years was characterized. The operation included, laparotomy, partial resection of intestine with, anastomosis. The child, was discharged, from the hospital after recover.

For the purpose of optimization of antibacterial treatment of urinary tract infection in 700young patients under the condition of North it was examined the responsivity of urinary tract pathogens to antibiotics in 1998-2009. The most effective group of antibiotics is revealed. The most frequent types of urinary tract pathogens are: in men - S. epidermidis, S. saprophyticus, S. aureus; in women with non-complicated UTI - E. coli, S. epidermidis, S. saprophyticus u S. aureus; with complicated - E. coli, S. saprophyticus, S. epidermidis. The abovementioned pathogens showed the low antibiotic resistance (in vitro) to gentamicin and ofloxacin; high antibiotic resistance to cephalosporin (3rd generation) and ciprofloxacin. It is better to prescribe ofloxacin and cefotaxime for patients with complicated UTI; for women with non-complicated UTI - ofloxacin and ceftriaxone. It is necessary to consider nephrotoxicity and low compliance before prescription of gentamicin.