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This study aimed to develop a model that fused multiple features (multi-feature fusion model) for predicting metachronous distant metastasis (DM) in breast cancer (BC) based on clinicopathological characteristics and magnetic resonance imaging (MRI). A nomogram based on clinicopathological features (clinicopathological-feature model) and a nomogram based on the multi-feature fusion model were constructed based on BC patients with DM (n=67) and matched patients (n=134) without DM. DM was diagnosed on average (17.31±13.12) months after diagnosis. The clinicopathological-feature model included seven features: reproductive history, lymph node metastasis, estrogen receptor status, progesterone receptor status, CA153, CEA, and endocrine therapy. The multi-feature fusion model included the same features and an additional three MRI features (multiple masses, fat-saturated T2WI signal, and mass size). The multi-feature fusion model was relatively better at predicting DM. The sensitivity, specificity, diagnostic accuracy and AUC of the multi-feature fusion model were 0.746 (95% CI: 0.623-0.841), 0.806 (0.727-0.867), 0.786 (0.723-0.841), and 0.854 (0.798-0.911), respectively. Both internal and external validations suggested good generalizability of the multi-feature fusion model to the clinic. The incorporation of MRI factors significantly improved the specificity and sensitivity of the nomogram. The constructed multi-feature fusion nomogram may guide DM screening and the implementation of prophylactic treatment for BC.

Objective: The aim: The aim of the study is a statistical analysis of the mucosa of the stomach affected by Helicobacter pylori in young people studying at the university., Patients and Methods: Materials and methods: The work contains the results of the study of chronic gastritis of type B in university volunteer students. The study was attended by students of 1-4courses, aged 17 to 25 years, a total of 50 people. Among them were 28 men and 22 women., Results: Results: Various forms of chronic gastritis were found in the mucosa of the topographic-anatomical sections of the stomach, 90% of which were associated with Helicobacterpylori (HP). In all departments there is a different amount of common forms of chronic gastritis. In the pyloric section only atrophic gastritis was detected - 31.0 ± 8.5. Atrophic gastritis was also dominant on the lesser curvature - 32.3 ± 7.8, but its forms were significantly (p <0.5) less pronounced than in the pyloric section. In the area of the body, the above variants of chronic gastritis were found in 34.3 ± 8.7 cases, and the majority were flat erosive gastritis 51.0 ± 9.3. There is a tendency to reduce the degree of bacterial contamination of the gastric mucosa from its pyloric section and the lesser curvature to the walls of the body. With a decrease in the degree of bacterial contamination of the gastric mucosa, the degree of leukocyte infiltration also decreases. Between the degree of contamination of the mucous membrane of Helicobacter pylori and the degree of leukocyte infiltration of the mucous membrane, the Pearson correlation coefficient is rxy - 0,935, the correlation is very strong, the coefficient of determination is D=rxy^2 - 0,874, the statistically significant dependence on the probability is 0.99., Conclusion: Conclusions: Atrophic or hyperplastic gastritis associated with HP is found in the gastric mucosa, respectively, 90% of cases. The degree of bacterial contamination correlates with the degree of leukocyte infiltration of the gastric mucosa. Atrophic or hyperplastic gastritis Helicobacter pylori-associated is a common disease of people in young and working age.

Purpose: The purpose of our work was to study late cardiac complications after treatment for Hodgkin's lymphoma (HL) in children and adolescents. Methods: Sixty-seven patients were examined in the long term (>5 years) after chemoradiotherapy for HL according to two different programs of treatment (groups I and II). Mean total doses of radiotherapy (RT) to the mediastinum were 37.2 and 28.9 Gy, respectively. The status of the heart was assessed at the mean age of 22.7 years with electrocardiography (ECG) and echocardiography (EchoCG). Mean terms of follow-up were 16.4 and 9.5 years for group I and group II, respectively. Results: Incidence of ECG changes was equal between the groups (88% and 90%). The prevalence of signs of valvular calcifications and fibrosis was 70.9% after mediastinal doses ≥30 Gy, and 16.6% after lower doses ( p  = 0.002). Those changes led to considerable valvular dysfunction in four patients. EchoCG signs of pulmonary hypertension were seen in 33.3% patients of group I versus 4.8% in group II ( p  = 0.047). Pericardial effusion was observed in 7.4% and 5.1%, respectively ( p  = 1.0). Left ventricular ejection fraction decreased slightly only in two patients (one in each group). Conclusions: The RT mediastinal dose level is the important risk factor of late heart complications. Nevertheless, the differences in the rate and severity of those complications between the groups should be viewed with caution because of differences in the age at baseline and in follow-up terms. The survivors of HL should undergo life-long regular examinations of the heart status.

Objective: Introduction: The sharp deterioration in the physical development of the younger generation is worrying. The morbidity of youth has increased by 29.9% compared with the last century. More than 33% of boys and girls, among first-year students with chronic diseases. The aim: Assessing the state of the students' body by examining the results of a survey among the second- and third-year students of the university using a specially designed questionnaire., Patients and Methods: Materials and methods: The material on the assessment of the state of health and the characteristics of the organism has been processed by studying the results of a survey of young men and women aged 20-23, obtained on the basis of using the developed questionnaire., Results: Results: Physical development has been studied in accordance with the state of health of the students, as well as a thorough study of a number of criteria: diseases of the musculoskeletal system were 37.1%, 49.7% and 43.45 among boys aged 20, 22 and 23 and respectively 33.3 %, 38.6% and 47.7% among girls in their 20s, 22s and 23s. The morbidity of eye was 18.0%, 3.8% and 9.9% among boys aged 20, 22 and 23 years and 17.7%, 17.1% and 7.7% among girls aged 20, 22 and 23 years., Conclusion: Conclusions: In the structure of morbidities are diseases of the musculoskeletal system, diseases of the nervous system and the organ of vision. Correlation of the characteristics of the level of students' health and their physical development have indicators on the level of educational adaptation and the number of diseases.

Objective: Introduction: Small intestinal bacterial overgrowth may cause the hyperlipidemia appearance by enterohepatic circulation disturbance which evolves on the background of the early bile acids deconjugation with further endotoxin production and oxidative stress in the liver with hyperproduction of cholesterol and atherogenic lipoproteins. The aim: the determination of prevalence and features of SIBO in a series of patients with hyperlipidemia and in control subjects., Patients and Methods: Materials and methods: Nineteen patients with hyperlipidemia and ten control subjects were studied. Small intestinal bacterial overgrowth was assessed by a lactulose breath test. Such biochemical markers as CRP, ALT, AST, GGTP, apolipoprotein B, bilirubin, cholesterol and lipid profile were determined. Except the routine interpretation of lactulose breath test, which contains the SIBO detection, small intestinal transit time and hydrogen level evaluation with next comparison between groups of patients was realized., Results: Results: Small intestinal bacterial overgrowth was present in 78.9% of patients with hyperlipidemia and 40% in control subjects. The maximal dose of H2 was particularly higher in patients with hyperlipidemia in comparison with control group (94,7±13,69 vs. 36,13±5,4). There was a strong correlation between AST level and SIBO existence in both groups (r=1). Positive connection between LDL, TG, VLDL and the dose of exhaled hydrogen on 120 minute (r=0.6, r= 0.62, r=0.7 respectively) and strong negative correlation between HDL and 120 minute dose (r=-0.74) in main group was marked., Conclusion: Conclusions: Patients with hyperlipidemia have a higher prevalence of small intestinal bacterial overgrowth and there is a relationship between H2 rate and LDL, TG, VLDL.

Objective: Introduction: The most common form of disorder in the victims of extreme events that are difficult to treat and correct and are manifested by psychological, social and somatic changes is post-traumatic stress disorder (PTSD). The aim: To study the experience of rehabilitation of participants based on the municipal institution Poltava Regional Clinical Hospital for War Veterans., Patients and Methods: Materials and methods: We used statistical observation, consolidation and grouping of materials of statistical observation, method of absolute and relative values., Results: Review: In our country, mental disorders in emergency situations began to be studied especially intensively after the Chernobyl disaster. A considerable amount of research is devoted to this issue. Neuropsychiatric and psychoneurological disorders were analyzed carefully and it was established that in those people who were in the enhanced radiation zone, mental maladaptation arose due to psychological traumas, but not because of ionizing radiation., Conclusion: Conclusions: Art therapy turned out to be a popular activity for improving well-being, where the demobilized could do handmade work. Another good way to improve their mood was watching movies with a certain idea, sense. The most influential therapy is relaxation sessions, where the warriors can abstract their mind from everything and enjoy good music or landscapes. Among the group sessions, the "road to peace" theme was the most popular one, where veterans could communicate with a psychologist, express their thoughts and feelings, and, if necessary, consult for the future.

Survival of bifidobacteria and preservation of their morphological characteristics after 12-month storage of lyophilized cells was studied for the strains of Bifidobacterium bifidum and B. animalis isolated and maintained in the microbial collection of the Department of Microbiology, Moscow State University. A combined approach to pre-lyophilization treatment of microorganisms and subsequent storage was developed in order to improve cell survival. Compared to the standard cryoprotector concentrations, sucrose and glucose (5% and higher) in skim milk, as well as freezing at ‒70°C with subsequent storage at the same temperature resulted in improved survival of bifidobacteria. Under such conditions, the number of viable cells (CFU) after 12 months of storage was two to three orders of magnitude higher than in the case of the standard lyophilization procedure. Investigation of dynamics of resistance of reactivated clones to such gastrointestinal stress factors as gastric juice and bile acids revealed preservation of these properties at all storage modes. However, since the number of surviving cells decreased during storage according to the standard procedure, the number of stress-affected cells was correspondingly lower. Reactivated cultures exhibited high resistance to oxygen, with survival decreasing to 35% of the initial level.

Introduction: The number of obese people in recent decades is increasing significantly. Among the many aspects of obesity in the last decade, the role and importance of changes in the gut microbiota (GM) attracts special attention. The aim of the review was to analyze the results of studies, focused on the role of gut microbiota in the obesity development., Materials and Methods: Screening was conducted on 33 researches, which examined the role of the gut microbiota balance in the development of obesity. Among them, 13 studies were selected for more detailed analysis., Results: Obesity revealed typical changes in GM: an increase in the number of microbes of the genus Firmicutes and a decrease in the number of microbes of the genus Bacteroeidetes, which is particularly vividly demonstrated by studies of rodents. In obese mice, the microfamilies of the genus Firmicutes account for 80% of all GM (in control animals 60%), and the number of microorganisms of the genus Bacteroeidetes decreases by half (from 40 to 20%), compared to mice with normal weight., Conclusion: Despite the complexity of the question of the relationship between GM and obesity, the totality of the data received, especially the results of experimental studies, affirm the thesis that changes in GM may contribute to the development of obesity.

Currently, no molecular biological markers do exist for early diagnosis of breast cancer. One of the possible candidates for the marker of early breast cancer is mammaglobin (MGB1) or SCGB2A2 (secretoglobin, family 2A, member 2), characterized by the maximal expression level in early breast cancer. Using the RT-PCR method MGB1 mRNA expression was examined in 57 tumor tissue samples and 57 samples of morphologically non-malignant tissue (MNT) of breast cancer (BC) patients. Specificity and sensitivity of the MGB1 mRNA assay in peripheral blood of BC patients was evaluated by nested PCR. 169 blood samples (from 95 BC patients, 22 from patients with benign breast tumors, 28 from patients with tumors of other localizations, and 24 samples from healthy donors) have been analyzed. MGB1 expression was significantly higher in BC tissue samples compared to MNT (p=0.0019). The maximal expression level was in the samples T1 (p=0.013), stage I BC (p=0.037), GI (p=0.0019). The MGB1 expression positively correlated with expression of estrogen (p = 0,034) and progesterone (p=0.0004) receptors. Sensitivity and specificity of the MGB1 mRNA assay in peripheral blood were 60.6% and 92.3%, respectively. Expression of MGB1 was higher in BC than MNT and it decreased during BC progression. The sensitivity and specificity of the MGB1 mRNA assay may be used as an additional diagnostic method.

The study showed the results of univariate and multivariate analyses of treatment of patients with low-grade brain supra- tentorial infiltrative gliomas. It was reaffirmed the importance of the most significance of such adverse prognostic factors as histology, tumor size, displacement of midline structures of the brain, age and neurological deficit. When assessing the prognostic significance of severity of the debut of clinical symptoms in this category of neuro-oncological patients as well as radical surgical treatment of the primary tumor there were obtained data confirming the absence of their independent prognostic significance.

Six stably growing strains of bifidobacteria possessing probiotic properties were isolated from the feces of newborn children and animals. According to the results of molecular analysis, one strain was classified as Bifidobacterium bifidum, while five belonged to Bifidobacterium animalis. Initial identification of the strains was carried out using the primer pairs for the 16S rRNA gene (g-Bifid-F/R, Bif164/662) and for the xfp gene specific for bifidobacteria. Subsequent sequencing of complete genes encoding 16S rRNA synthesis in the isolates confirmed their species affiliation. The cultures exhibited high resistance to gastroenterological stress (5 ≤ RD ≤ 10) and may be therefore recommended as:potential probiotics.

The biological effect of the extracellular peptide reactivating factor (RF) from Luteococcus casei on cells of probiotic cultures was studied. The RF showed the protective and reactivating effects on the Bifidobacterium bifidum cells under the action of bile salts and an acidic stress. Also, it acted as a cryoprotector during lyophilisation and long-term culture storage. The RF and the L. casei culture liquid (CL) were shown to have bifidogenic properties. The degree of protection and reactivation of lactic-acid bacteria under the action of bile salts depended on the particular strain properties. The maximum degree of protection (more than thirteen-fold) and reactivation (close to three-fold) was found in Lactobacillus casei, while the minimum values were characteristic of Lactobacillus reuterii. The resistance of lactobacilli to bile was increased in the row of L. acidophilus, L. casei, L. plantarum, L. rhamnosus, and L. reuterii correlating with the RF protection degree.

The results of complex neurological and neuropsychological study with evaluation of anxiety levels in young and middle-age patients with chronic hepatitis and liver cirrhosis are presented in the article. Raised anxiety levels with statistically significant difference to control group patients were found. By turn, anxiety levels in patients with chronic hepatitis were lower than in patients with liver cirrhosis. The most of examined patients had middle (with tendency to low level as well as with tendency to high level) and high level of anxiety.

We used combinations of taxan-based neoadjuvant and adjuvant full-dose chemotherapy and aggressive combined radiotherapy including clinical target volume extension, increased total dosage, hyperthermia, cryo- and local chemotherapy as radiosensitizers, for treatment of invasive and locally-advanced breast cancer or endometrial carcinoma with poor prognosis. 3D-ultrasound/CT/MRI--based designing of radiotherapy and monitoring of dynamic definition of target volume and "high risk volume" in organs at risk in cases of tumor progression was an indispensable measure. As a result, no local recurrence was reported in 73% for 36 months.

The chief factors of aggression are discussed together with mechanisms of protection of gastric and duodenal mucosa. Results of treatment of 30 patients with gastritis (Helicobacter pylori negative) with a cytoprotective drug smecta are presented.

Modern definition, classifications, diagnosis and treatment of irritable bowel syndrome (IBS) are presented together with results of treatment of 30 patients with irritable bowel syndrome with the new selective calcium-channel blocker dicetel.

Non-steroid antiinflammatory drug (NSAID)-related gastropathy is regarded as the most important NSAID-induced complication. The above term is used to signify erosive and ulcerous injuries to the stomach and duodenum, having a characteristic clinical picture.

The nosologic and etiopathogenetic structure of the cholestatic syndrome encountered both in surgical and therapeutical practice is described.

Results are submitted of bacteriological investigations in those persons with duodenal peptic ulcer who had been called up. The presence of regional strains of H. pylori is ascertained together with their sensitivity to certain antibacterial drug preparations. A rational antihelocobactertherapy schedule is proposed.

A classification is submitted of cholelithiasis, taking account of stages of the illness, its main clinical forms and complications, with the diagnostic criteria and policy of treating it being pointed out. The use of the above classification ensures succession of surgeons' and therapists' work in questions of diagnosis, prophylaxis, and treatment of patients with cholelithiasis.

Our objective in this study was investigation into the effectiveness of the enzymic preparation Kirshner Pancreal in 27 patients with chronic pancreatitis. It is shown that against the background of treatment with the above drug patients dispelled the pain syndrome and manifestations of the maldigestion syndrome. The described drug made for normalization of the blood serum content of beta-lipoproteins. The drug is well-tolerated by patients, no adverse effects were noted.

Peptic ulcer (PU) is one of the most prevalent medical problems. It is essential for PU patients to undergo gastrofibroscopy, pH-metry, and examination for Helicobacter pylori during the phase of exacerbation. Results of a comprehensive evaluation of patients will, we believe, help in ensuring the chosen treatment schedule compliance for each particular patient. Use of amoxycillin, metronidazole, and bismuth combined with raniberl in treatment of the above category of patients appeared to be an effective therapeutic alternative designed to eradicate Helicobacter pylori.

The study was concerned with radiotherapy planning using individual data on tissue volume to be treated. The investigation used criteria based on correlations of TDF, actual volume identified by ultrasound, computed and magnetic resonance tomography and dose fractionation regime. As a result, grave complication rates dropped 3 times including cases of locally advanced tumors, non-traditional dose fractionation and advanced regimens of polychemotherapy.

Findings on sonography diagnostic potential to be used in screening for endometrial carcinoma suggested an ultrasound examination of 235 postmenopausal patients who had had no relevant complaints. As a result, criteria of ultrasound screening for endometrial tumors in postmenopausal patients were worked out. Later, sonography was carried out in 596 endometrial carcinoma patients with a view to verify the diagnosis. It pointed to inadequate identification of microinvasive carcinoma (up to 5 mm) by transabdominal and transvaginal scanning. Sonography, however, efficiently diagnosed marked infiltration (9.4%), organ involvement (88.4%) and metastatic lesions in the ovaries.

Osteodensity was compared in 582 postmenopausal patients with such pathologies as urogenital atrophy, osteoporosis, vulvar craurosis, breast carcinoma, hyperplasia and endometrial carcinoma. A double-photon Z-ray densitometer with a computer program designed for postmenopausal women examination was employed. It was shown that osteodensity measurements can distinguish two opposite patterns of homeostasis in postmenopause: involute-atrophic vs. hyperplastic processes in target tissues characterized by high oncological susceptibility. However, if strict and clear distinctions are applied, many patterns of pathology combination so typical of postmenopause will stay outside the classification. Much in further studies of the problem will depend on progress made in investigation of estrogen receptors in target tissues.

The article addresses the issue of comparative efficacy of those drug preparations having hepatoprotective action (hepatofalk, ursofalk, lipin, lavalon) by parameters characterizing lipid peroxidation (LPO). The above drug preparations enhance resistance of brush membranes, lower LPO processes. It was hepatofalk and lipin that had the most pronounced positive effect on LPO processes in patients with chronic toxic and postviral hepatitis.

Investigations designed to study gastric mucosa (GM) in patients with chronic primary gastroduodenitis with the aid of electron microscopy showed the abnormal changes in the cellular, subcellular membranes and capillaries to be of the same type as they are in peptic ulcer (PU) though poorly manifest. Changes in GM under chronic atrophic gastroduodenitis (ChGD) suggested involutive changes while in chronic secondary gastroduodenitis (ChSGD) it was generally not different from the mucosa ultrastructure in healthy subjects except for changes in surface epithelium. Based on the histoenzymologic studies it has been ascertained that in ChPGD there occurs a rise in lysosomal enzymes similar to that encountered in PU, reflecting the intensity of catabolic processes, decrease in the activity of enzymes of the capillary wall and mitochondria respiratory chain against the background of compensatory enhancement of the activity of the glycolytic enzyme lactate dehydrogenase. In ChAGD the activity of all the enzymes was low, while in ChSGD it did not differ significantly from that in healthy subjects.

283 cases of bronchiolo-alveolar lung carcinoma (BALC) are studied and clinico-roentgenologic forms are compared with morphological variants. Structural features of BALC with and without mucus production as well as those of the undifferentiated variants are described.

Tardipherone is capable of maximum absorption in the initial portion of small intestine, iron being in its retarding form, which fact ensures a prolonged action of the drug, mucoprotease being a part of tardipherone composition acting to guard gastric and duodenal mucosae against irritating effect of iron. Tardipherone was found to be efficacious in treating patients with ulcer disease complicated by bleeding. Under its effect the hemogram indices get normalized as does the ratio of aggressive to protective factors of gastric juice, which factors play a major part in the emergent relapse of the illness. The use of tardipherone was found to be justified in the treatment of patients with chronic atrophic gastritis, being associated with gratifying shifts in the clinical picture of the condition and improvement in the hemogram characteristics.

Based on the studies made in 84 patients with calculous cholecystitis and 12 patients with calcifying pancreatitis, an efficiency was shown of infusional administration of pyrencepine or ranitidine to prevent stress postoperative erosive-and-ulcerous lesions of gastroduodenal zone. Gastrocepine is shown to be superior to ranitidine and can be withdrawn without a maintenance dose, as well as becouse its cytoprotective effects with respect of the gastric and duodenal mucosa.

A study made in 72 patients showed a positive influence in ulcer disease of gastrocepine and H2-blockers of receptors to histamine on histoenzymological and ultrastructural changes in the mucous membrane of the stomach and duodenum. Gastrocepine was found to be superior to H2-blockers of receptors to histamine due to its apparent cytoprotective effect and ability to improve microcirculation.

The indices for the gastric contents aggression and protection ratio returned to normal in patients with peptic ulcer and preulcerous condition during the treatment with smekta due to a decrease in proteolytic activity and increase in the synthesis of the mucus protective proteins. Monitoring of intragastric pH in the body of the stomach throughout 24 hours in patients with peptic ulcer of duodenal location revealed significant acid-neutralizing effect of smekta. Patients with nonspecific ulcerous colitis enjoyed freedom of side effects as a result of the use of salofalk and derived full therapeutic benefit from this treatment. Under the effect of smekta there occurred suppression of the growth of pathogenic proteolytic flora, improvement of qualitative properties of coli flora and growth of sugar-lytic flora in patients with intestinal dysbiosis. According to the data available, smekta strengthens the mucous barrier by improving the conformation of the mucus structural elements.

In the present investigation on the treatment of patients with nonulcerous dyspepsia and peptic ulcer, hiatus hernia complicated with reflux esophagitis, a mechanism has been studied of the action of topalkan, a 3rd generation aluminium-magnesium antacid, that involves not only its antacid properties but in an even greater degree the availability of alginic acid in its formula which has antipeptic and protective effect with respect of the mucous membrane of the stomach and esophagus, and provides, together with the magnesium salts, a floating layer of the preparation in the stomach. In grave course of nonulcerous dyspepsia (preulcerous condition) and peptic ulcer complicated by reflux disease of the esophagus topalkan was used in combination with present-day antisecretory preparations pyrenzepine or H2-blockaders of histamine receptors capable of enhancing the antisecretory effect of topalkan as well as endowed with cytoprotective properties with respect of the mucous membrane of the stomach and duodenum promoting healing of erosions and healing and scarring of ulcerous defects.

Use of treatment complexes including non-drug methods (auricular acupuncture, pathogenetic dietotherapy, ILBR) or reduced doses of modern pharmacopreparations allowed to achieve rapid clinical and endoscopic remission in patients with ulcer disease. Simultaneously occurs normalization of the aggressive and defensive properties of the gastric juice, immunological, microcirculatory changes in the body and gastroduodenal mucosa. The vascular laser blood radiation reduced antacid dose and pathogenetic dietotherapy.

Intravascular laser radiation of the blood was employed in 68 patients with ulcer disease in the complex treatment with antacid; cholinolytic, antioxidant agents. The employment of helium-neon laser as an immunomodulator resulted in an improvement of indices of cellular and humoral immunity, normalization of lipid peroxidation, increased resistance of the gastric and duodenal mucosa, reduction of the time of scarring of the ulcer defect against the background of rapid clinical remission, increase of the interrecurrence period.