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BackgroundColorectal cancer is among the most common cancers in the world, and splenic flexure colon cancer accounts for about 2-5% of them. There is still no consensus on the surgical treatment of splenic flexure colon cancer (SFCC), and the extent of surgical resection and lymph node dissection for SFCC is still controversial.AimTo compare the postoperative and long-term oncologic outcomes of extended right colectomy (ERC), segmental colectomy (SC) and left colectomy (LC) for SFCC.MethodUp to March 2024, retrospective and prospective studies of ERC, SC, and LC for SFCC were searched through databases. Pooled weighted/standardized mean difference (WMD/SMD), odds ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI) were calculated using a fixed effects model or random effects model, and meta-analysis was performed using Stata.ResultsThis meta-analysis includes 5,918 patients from 13 studies with more lymph node harvest (OR:6.29; 95%Cl: 3.66-8.91; Z=4.69, P=0), more operation time (WMD: 22.53; 95%Cl: 18.75-26.31; Z=11.68, P=0), more blood loss (WMD:58.44; 95%Cl: 20.20-96.68; Z=2.99, P=0.003), longer hospital stay (WMD:1.74; 95%Cl: 0.20-3.29; Z=2.21, P=0.03), longer time to return to regular diet (WMD:3.17; 95%Cl: 2.05-4.30; Z=5.53, P=0), longer first flatus time (WMD:1.66; 95%Cl: 0.96-2.37; Z=4.61, P=0) in ERC versus SC. More lymph node harvest (WMD: 3.52; 95% Cl: 1.59-5.44; Z=3.58, P=0) in ERC versus LC and LC versus SC (WMD: 1.97; 95% CI: 0.53-3.41; Z=2.68, P=0.007), respectively. There is no significant difference between anastomotic leakage, postoperative ileus, total postoperative complication, severe postoperative complication, wound infection, reoperations, R0 resection, postoperative mortality, 5-year overall survival (OS), 5-year disease-free survival (DFS) in three group of patients. In LC versus SC and ERC versus LC, there is no difference between operation time, blood loss, hospital stay, return to regular diet, and first flatus.ConclusionIn the included studies, SC and LC may be more advantageous, with fewer postoperative complications and faster recovery. ERC harvests more lymph nodes, but there is no significant difference in long-term OS and DFS between the three surgical approaches. Given that the included studies were retrospective, more randomized controlled trials are needed to validate this conclusion.

The incidence of gastric cancer associated with esophageal cancer is notably high. In recent years, there has been an increase in patients with gastric conduit cancers due to early detection and radical treatment of esophageal cancer, leading to prolonged survival of the patients. Metachronous gastric cancer following esophagectomy sometimes can pose a clinical challenge for surgeons, while gastric tube reconstruction is a well-established procedure accompanying esophagectomy, treating gastric cancer within the gastric tube can be difficult in contrast. Surgical treatment of gastric tube cancers is often complex and life-threatening. Early detection of gastric tube cancer is crucial for improving prognosis as it allows for less invasive surgical interventions. However, no specific guidelines for detecting gastric tube cancer have been established. In this report, we present a case of gastric tube cancer in a patient that had Ivor-Lewis surgery 20 years ago for preinvasive adenocarcinoma of the thoracic esophagus against the background of Barrett’s esophagus. Recommendations for earlier and more accurate diagnosis and treatment of this pathology are discussed.

The article presents the results of many years work carried out at the Department of Surgery of the I.M. Sechenov First MSMU in one of the priority areas — the study of molecular-genetic markers. The possibilities of use of the molecular-genetic markers in treatment of gastric cancer patients are discussed.

The article deals with the estimation of sensitivity of different diagnostic methods in differential diagnostics of stomach diseases. We found that the performance of the fluorescent diagnostics is very high in the primary diagnosis of gastric cancer and in the differential diagnosis of benign and malignant stomach lesions: sensitivity — 96%, specificity — 78%. The detection rate of gastric cancer with the use of transabdominal ultrasonography reaches 95,6% for the localization of the tumor in antrum or lower third of the stomach body. The diagnostic accuracy is higher in cases of advanced gastric cancer. We also estimate the diagnostic performance of the multidetector computed tomography in the detection and staging of gastric cancer. Multidetector computed tomography with multiplanar reformation and virtual gastroscopy offers new opportunities for imaging of gastric diseases. The detection rate of gastric cancer using this method is 97% regardless of the localization of the tumor. Diagnostic potential of all mentioned methods of visualization of gastric lesions needs to be further explored.

The lecture is devoted to contemporary American phenomenon, who described the American Professor G.L. Fred. The author notes that American doctors are not able to properly inquire, examine the patient and write the history of the disease, focusing mainly on the data of instrumental methods. The author writes that the reason for this is the organization of the American health care, when professors are busy making money, very little attention to the students at the bedside. Currently in the American medical community lost the tradition of Osler, who reformed medicine in favor of a detailed examination of the patient.

The effect of osmolytes (trehalose, sucrose, betaine, D-glucose and hydroxyectoine) on the photoassembly of the functionally active inorganic core of the water-oxidizing complex (Mn4CaO5 cluster) in Mn-depleted PSII preparations (apo-WOC-PSII) was investigated. It was revealed that the efficiency of the photoassembly of the Mn4CaO5 cluster was considerably (three times) increased in the presence of 1 M disaccharides (trehalose or sucrose) in contrast to other osmolytes. It was found that the osmolytes (especially trehalose or sucrose) improved the redox interaction of exogenous Mn2+ with apo-WOC-PSII, enhanced the protective effect of Mn2+ against the photoinhibition of apo-WOC-PSII, protected CaCl2-treated PSII preparations against thermoinactivation, and stabilized the water-oxidizing complex and electron transport from QA to QB in native PSII preparations during heat treatment. It is suggested that the ability of osmolytes to enhance the efficiency of the photoassembly of a Mn4CaO5 cluster depends on their effect on the following key processes: the redox interaction of Mn2+ with apo-WOC-PSII; the stability of apo-WOC-PSII to photoinhibition during the photoactivation procedure; and the stabilization of both the newly assembled functionally active Mn4CaO5 cluster and the electron transfer from QA to QB.

Abstract Background Laparoscopic surgery has justified its efficacy in the treatment of early gastric cancer. There are limited data indicating the eligibility of laparoscopic interventions in locally advanced gastric cancer. Publications describing the safety of laparoscopic techniques in the treatment of local and metastatic gastric cancer complicated by bleeding and stenosis are scarce. Methods The study included patients with histologically confirmed locally advanced and disseminated gastric cancer and complicated with bleeding and/or stenosis who underwent gastrectomy with vital indications between February 2012 and August 2018. Surgical and oncologic outcomes after laparoscopic surgery (laparoscopic surgery) and open surgery (OS) were compared. Results In total, 127 patients (LS, n = 52; OS, n = 75) were analyzed. Baseline characteristics were similar between the groups. Forty-four total gastrectomies with resection of the abdominal part of the esophagus, 63 distal subtotal (43 Billroth-I and 20 Billroth-II), and 19 proximal gastrectomies were performed. The median duration of surgery was significantly longer in the LS group, 253 min (interquartile range [IQR], 200–295) versus 210 min (IQR, 165–220) (p < 0.001), while median intraoperative blood loss in the LS group was significantly less, 180 ml (IQR, 146—214) versus 320 ml (IQR, 290–350), (p < 0.001). Early postoperative complications occurred in 35% in the LS group and in 45 % of patients in the OS group (p = 0.227). There was no difference in postoperative mortality rates between the groups (3 [6 %] versus 5 (7 %), p = 1.00). Median intensive care unit stay and median postoperative hospital stay were significantly shorter after laparoscopy, 2 (IQR, 1–2) versus 4 (IQR, 3–4) days, and 8 (IQR, 7–9) versus 10 (IQR, 8–12) days, both p < 0.001. After laparoscopy, patients started adjuvant chemotherapy significantly earlier than those after open surgery, 20 vs. 28 days (p < 0.001). However, overall survival rates were similar between the group. Three-year overall survival was 24% in the LS group and 27% in the OS groups. Conclusions Despite the technical complexity, in patients with complicated locally advanced and metastatic gastric cancer, laparoscopic gastrectomies were associated with longer operation time, reduced intraoperative blood loss, shorter reconvalescence, and similar morbidity, mortality rates and long-term oncologic outcomes compared to conventional open surgery.

Introduction. Hernia of the esophageal opening of the diaphragm in 90% of cases is the main cause of the development of reflux esophagitis. The doctrine highlighted a large group of extraesophageal manifestations of reflux esophagitis, including gastrocardiac syndrome.Аim. The purpose of this publication is to evaluate the effectiveness of antireflux surgery in patients with hiatal hernia through the prism of its effectiveness in the dynamics of gastrocardial syndrome regression.Material and мethods. The paper presents the results of diagnostics and surgical treatment of 101 patients with hiatal hernia.Results. According to the data of instrumental research methods, cardiac hernias of the esophageal opening of the diaphragm were detected in 45 (44.5%) patients, cardiofundal in 40 (39.6%), subtotal in 15 (14.8%), total in 1 (0.9%). The main place in the clinical picture of gastrocardial syndrome was occupied by the pain syndrome behind the breastbone (83.1%). Thus, arrhythmias were found in 16 (40.0%) patients with cardiofundal, in 10 (66.6%) subtotal and in 1 (100.0%) total hiatal hernia, and angina pectoris is characteristic of cardiac hernias and was observed in 20 (44.4%) patients. The clinical manifestation of reflex angina pectoris and arrhythmias depended on the degree of shortening of the esophagus. Thus, arrhythmias were more common in patients with cardiofundal (50.0%), subtotal (71.4%), total (100.0%) hiatal hernia with II degree of shortening of the esophagus, and angina pectoris characteristic of cardiac (75.0%) hiatal hernia. with II degree of shortening of the esophagus. Reflex angina is typical for patients of the older age group, and manifestations of arrhythmia are recorded at a younger age. Heart rate variability was considered, according to electrocardiogram and Holter ECG monitoring before and after surgical treatment, where the parameters significantly (p> 0.05) decreased.Conclusions. The phenomena of gastrocardial syndrome regressed after antireflux surgery in 44 (43.5%) patients. Surgical treatment from the endovideosurgical approach did not worsen the results of surgical treatment.

Aim to determine the efficacy of drug aminodihydrophthalazinedione sodium (Galavit) for prevention of progression of the coronavirus infection pulmonary complications: acceleration of regression of pulmonary infiltrates and resolution of COVID-induced pneumonia. 22 patients with medium and severe COVID-induced pneumonia were included in the study. The study included 8 men and 14 women, the average age was 62.17.4 years. Patients with more than one adverse prognostic factor made 82%. Average volume of pulmonary tissue affection (computer tomography CT-2, 2550% of lung volume) was registered in 13 (59.1%) patients, significant volume (CT-3, 5075% of lung volume), in 9 (40.9%) patients. All patients had progressive respiratory failure manifestations due to hypoxemia and related diseases. Aminodihydrophthalazinedione sodium was administered for 714 days from the beginning of disease, at the end of the course of standard complex therapy, in case of preservation of signs of intoxication, negative dynamics according to computer tomography data. Administration of aminodihydrophthalazinedione sodium had a positive effect on the dynamics of clinical scores. The progression of respiratory failure was halted and there was an increase in SpO2 values. According to the control computer tomography data the stabilization of the pulmonary parenchyma affection degree was noted, as well as reduction of the size of the compacted areas in the pulmonary tissue and formation of the picture of organising pneumonia that contributed to reduction of respiratory failure grade. The use of aminodihydrophthalazinedione sodium in complex therapy of COVID-induced pneumonia has a modulating effect on the immune system, prevents the progression of pulmonary tissue affection, promotes regression of infiltration foci, preventing the development of excessive pneumofibrosis and the progression of respiratory failure.

Background: To analyze the literature data on the features of examination of cardiac patients for the presence of complicated forms of reflux esophagitis, including gastrocardium syndrome. Conclusion: The article considers modern methods of instrumental diagnostics used for the diagnosis of reflux esophagitis complicated by gastrocardium syndrome in a cardiological patient. It is noted that the implementation of a differential approach in the examination of a cardiological patient for the detection of reflux esophagitis complicated by gastrocardial syndrome is possible through the complex simultaneous application of several research methods. The use of a complex combination of instrumental diagnostic methods will contribute to obtaining more meaningful and reliable results aimed at eliminating the likelihood of untimely diagnosis in cardiac patients with reflux esophagitis complicated by gastrocardial syndrome, its manifestations of various nature, on the timeliness of which, in turn, depends on the timely correct diagnosis, as well as the choice of optimal treatment tactics.

We observed resonance effects in the Raman scattering of nanodiamonds with an average size of 2–5 nm excited at a wavelength of 1064 nm (1.16 eV). The resonant Raman spectrum of the 2–5 nm nanodiamonds consists of bands at wavelengths of 1325 and 1600 cm−1, a band at 1100–1250 cm−1, and a plateau in the range from 1420 to 1630 cm−1. When excited away from the resonance (at a wavelength of 405 nm, 3.1 eV), the Raman spectrum consists of only three bands at 1325, 1500, and 1600 cm−1. It is important to note that the additional lines (1500 and 1600 cm−1) belong to the sp3-hybridized carbon bonds. The phonon density of states for the nanodiamonds (~1 nm) was calculated using moment tensor potentials (MTP), a class of machine-learning interatomic potentials. The presence of these modes in agreement with the lattice dynamics indicates the existence of bonds with force constants higher than in single-crystal diamonds. The observed resonant phenomena of the Raman scattering and the increase in the bulk modulus are explained by the presence of Tamm states with an energy of electronic transitions of approximately 1 eV, previously observed on the surface of single-crystal diamonds.

Abstract Viral infections are considered as etiologic factors of subacute thyroiditis. The true incidence of subacute thyroiditis, caused by SARS‐CoV‐2 infection, is probably considerable since it is often masked by more dramatic affection of the respiratory system. This report presents two female patients who developed de Quervain's thyroiditis after COVID‐19 disease.

This manuscript describes the application of a fixed-length ultrasonic spectrometer to determine the kinetics of heat- and photo-induced damage to biological membranes and protein complexes and provides examples of the test measurements. We implemented a measurement scheme using the digital analysis of harmonic signals. To conduct the research, the fixed-length ultrasonic spectrometer was modernized: the speed was increased; lighting was supplied to the sample cells; the possibility of changing the gas atmosphere and mixing the sample was given. Using solutions containing natural concentrations of deuterium oxide, a high sensitivity of the spectrometer was shown. The spectrometer performed well in the measurement of phase state of dimyristoylphosphatidylcholine liposomes, both in the absence and in the presence of additions, which are capable of changing the lipid properties (sodium dodecyl sulfate, palmitic acid, and calcium ions). The heat- and photo-induced changes in the state of photosystem II core complexes were demonstrated using a fixed-length ultrasonic spectrometer. Transitions at 35.5 °C, 43.5 °C, 56.5 °C, and 66.7 °C were revealed. It is proposed that the transitions reflect the disassembly of the complexes and protein denaturation. Thus, the present study demonstrates that a fixed-length ultrasonic spectrometer can be applied to determine the kinetics of heat- and photo-induced damage to biological membranes and protein complexes.

Worldwide the gastric cancer holds fifth place above all oncological diseases and the third among the most common causes of death from cancer, the total number of deaths per year is estimated at 723 000. The vast majority of cases of the gastric cancer are sporadic, but it is known that 1–3% are a manifestation of the hereditary forms and syndromes. This article is dedicated to the new trends and strategies in the management of the risk of the hereditary diffuse gastric cancer. The basics of genetic counseling and current criteria for selecting families are covered, in the aim of analyzing hereditary mutations. The problems of endoscopic screening and dynamic monitoring of the gastric mucosa are discussed. A possible approach of the surgical treatment as preventive gastrectomy is discussed. The features of morphological studies in hereditary diffuse gastric cancer are outlined. The principles of postoperative care are covered. The prospects of medical support for patients with hereditary diffuse stomach cancer are reviewed.

The article suggests integrated (joint) assessment, monitoring and analysis of the quality and degree of environmental sustainability of the Republic of Belarus, taking into account the principles of the «green» economy. The subject of the study is the influence of the environmental factor on the social and economic development of the Republic of Belarus. The aim of the study is to develop and approbate a methodology for an integrated assessment of the level of the ecological state and its impact on the socio-economic development of the republic. Methods of research - economic and statistical, analysis, synthesis, inductive, deductive, comparison, system, expert assessments, etc. A number of factors substantiating the development of a methodology for determining priorities and directions for the formation of environmental policy balanced on social and economic criteria, based on a comprehensive assessment indicators reflecting the level of the environmental situation in the Republic of Belarus, the implementation of which will promote economic growth and reduce social tensions while improving the quality of the environment. The results of the mathematical calculations are given, the relative values of the indicators are converted into the final rating estimates by years, and the rating of the republic is formed relative to each year under review. The basic principles in the field of environmental protection are formulated to ensure environmentally friendly conditions for society and citizens. Priority directions of ensuring environmental sustainability of the Republic of Belarus are determined.

The prognosis of advanced lung adenocarcinoma (LUAD) remains unfavorable, with chemotherapy constituting a primary treatment modality. Discerning the efficacy of chemotherapy for advanced LUAD is imperative. Prior investigations have demonstrated the prognostic value of albumin and D-dimer individually for malignancies; however, the predictive capacity of albumin-to-D-dimer ratios (ADR) for advanced LUAD subjected to first-line platinum-based chemotherapy remains unexplored. A cohort of 313 patients with advanced LUAD was retrospectively examined in this study, spanning from January 2017 to January 2021. ADR threshold values were ascertained via receiver operating characteristic analysis, followed by the evaluation of the association between pretreatment ADR and clinicopathological characteristics, disease control rate (DCR), and overall response rate (ORR) pertinent to first-line chemotherapy. Prognostic factors for progression-free survival (PFS) were determined employing Cox univariate and multivariate analyses. Subsequently, survival data were illustrated utilizing the Kaplan-Meier method and scrutinized through the log-rank test across the entire and subgroup populations. ADR demonstrated a superior area under the curve (AUC) value relative to albumin and D-dimer individually and exhibited enhanced prognostic predictive capability compared to albumin-to-fibrinogen ratios (AFR) for advanced LUAD (AUC: 0.805 vs. 0.640, DeLong test: p<0.001). ADR yielded a cut-off value of 16.608. A greater proportion of non-smokers was observed within the high-ADR group (ADR>16.608) compared to the low-ADR group (ADR≤16.608). Patients in the high-ADR group displayed elevated BMI and Na+ levels and reduced neutrophil count, monocyte count, globulin, and alkaline phosphatase (all p<0.05). Notably, the high-ADR group exhibited heightened DCR (96.7% vs. 89.2%, p=0.008) and ORR rates (70.1% vs. 51.0%, p=0.001) relative to the low-ADR group. Multivariate analysis outcomes indicated that high ADR constituted an independent risk factor for PFS (hazard ratio: 0.24, p<0.001). Furthermore, patients in the high-ADR cohort displayed a significantly prolonged median PFS (254 vs. 142 days, p<0.0001) compared to their low-ADR counterparts. In subpopulations exhibiting favorable implications for PFS, as determined by multivariate analysis, high-ADR patients consistently demonstrated extended PFS durations relative to the low-ADR group (all p<0.0001). Collectively, our findings suggest that ADR constitutes a novel and promising prognostic indicator for advanced LUAD patients, surpassing the accuracy of albumin and D-dimer individually and AFR. ADR thus serves as a potent instrument for assessing treatment effects and PFS in advanced LUAD patients undergoing first-line chemotherapy. [ABSTRACT FROM AUTHOR]

The effect of osmolytes (trehalose, sucrose, betaine, D-glucose and hydroxyectoine) on the photoassembly of the functionally active inorganic core of the water-oxidizing complex (Mn4CaO5 cluster) in Mn-depleted PSII preparations (apo-WOC-PSII) was investigated. It was revealed that the efficiency of the photoassembly of the Mn4CaO5 cluster was considerably (three times) increased in the presence of 1 M disaccharides (trehalose or sucrose) in contrast to other osmolytes. It was found that the osmolytes (especially trehalose or sucrose) improved the redox interaction of exogenous Mn2+ with apo-WOC-PSII, enhanced the protective effect of Mn2+ against the photoinhibition of apo-WOC-PSII, protected CaCl2-treated PSII preparations against thermoinactivation, and stabilized the water-oxidizing complex and electron transport from QA to QB in native PSII preparations during heat treatment. It is suggested that the ability of osmolytes to enhance the efficiency of the photoassembly of a Mn4CaO5 cluster depends on their effect on the following key processes: the redox interaction of Mn2+ with apo-WOC-PSII; the stability of apo-WOC-PSII to photoinhibition during the photoactivation procedure; and the stabilization of both the newly assembled functionally active Mn4CaO5 cluster and the electron transfer from QA to QB. [ABSTRACT FROM AUTHOR]

The article considers methodological approaches to the analysis and assessment of country risk taking into account foreign experience. The subject of the study is country risk. The purpose of the study is to substantiate a methodical approach to the analysis and assessment of country risk for its application in the Republic of Belarus, taking into account its specificity. Research methods – dialectical approach, systemic and method of comparative analysis. The essence of the concept of «country risk», influencing factors is defined. The analysis of the experience of the country risk assessment by various foreign agencies is presented; classification of the applied methodological approaches to the construction of a rating assessment using quantitative analysis, qualitative and combined, taking into account the study of their weak and strong points. The most significant indicators for assessing the possible country risk for their application in the conditions of the Republic of Belarus are substantiated, taking into account the specifics of the country, assessing opportunities and constraints in the preparation and implementation of an effective policy for attracting external financing to meet its domestic needs when the government develops a plan for socio-economic development of the republic long-term perspective.

A related Holstein breed has recently been used to improve domestic dairy cattle and create highly productive herds by purchasing semen from breeding bulls, as well as a large number of heifers and calves of foreign breeding. The purpose of the work is a comparative assessment of the productive qualities of Black Pied and Holstein cows of foreign breeding. Purebred Holstein cows differ from animals of Black Pied breed in milk yield per lactation. Cows of both breeds have fairly high suitability for machine milking. The priority remains with the animals of the Holstein breed of foreign selection. In terms of milking intensity and udder volume, they reliably surpass Black Pied cows at P≤0.05 - P≤0.01, respectively, in terms of indicators. Holstein cows were also the best in the udder index. Correlation coefficients between the productive qualities, as well as between the quantitative indicator of productivity and the qualitative indicators of the suitability of cows for machine milking, were the same or did not differ significantly. A positive correlation was established between milk yield and the duration of the service period from 0.1 to 0.05, depending on the breed.

In the original article, there was a mistake in the legend for ** Figure 5 ** [...]

Photosynthesis occurring in chlorenchymal tissues of lignified branches of perennial plants (cortical photosynthesis) has a significant impact on their productivity and resistance to adverse environmental conditions, such as water deficiency and low temperatures. Cortical photosynthesis occurring under the outer bark of a lignified grape vine can become a convenient marker for breeding freeze-tolerant varieties. The following approaches can be undertaken to assess the functional state of the cortical photosynthetic apparatus: (1) analysis of the variable chlorophyll fluorescence parameters and (2) biochemical analysis of photosynthetic membrane preparations. To evaluate these approaches, in this work we have carried out the comparative analysis of characteristics of the cortical photosynthetic apparatus in grape varieties differing in freeze tolerance. This work was supported by grant №18-04-00079 from the Russian Foundation for Basic Research.

Oxygen is a natural acceptor of electrons in the respiratory pathway of aerobic organisms and in many other biochemical reactions. Aerobic metabolism is always associated with the formation of reactive oxygen species (ROS). ROS may damage biomolecules but are also involved in regulatory functions of photosynthetic organisms. This review presents the main properties of ROS, the formation of ROS in the photosynthetic electron transport chain and in the stroma of chloroplasts, and ROS scavenging systems of thylakoid membrane and stroma. Effects of ROS on the photosynthetic apparatus and their roles in redox signaling are discussed.