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Objective. To study primary resistance of H. pylori to clarithromycin in residents of Gomel region by real-time polymerase chain reaction (PCR RT) using TaqMan® MGB probes.Materials and methods. The study included 184 patients diagnosed with gastritis and duodenitis, K29, median age 48.5 years (25% and 75% were 37 and 61 years old). According to the patients’ questionnaires, no clarithromycin-based eradication therapy was administered. To determine the resistance of H. pylori to clarithromycin, a PCR RV method using TagMan® MGB probes was used.Results. All 184 tested DNA samples were positive for the Rnase P gene (ICS) and were considered in further analysis (Ct, HEX 20.20-34.14). DNA from the cagH gene (Ct, FAM 21.26-33.04), indicating infection with the bacterium, was confirmed in 152 samples (82.6%). DNA from the 23SrRNA gene (point mutations A2142G and A2143G) was detected in 16 of 152 DNA samples 10.5 % (Ct, Hex 20.24-31.17). The positive control samples had characteristic curve growth in the corresponding detection channels; no curve growth was observed in the negative samples.Conclusion. The primary resistance of H. pylori to clarithromycin in the residents of Gomel region was 10.5%, and the use of triple first-line eradication therapy, including PPIs, amoxicillin and clarithromycin, as empirical in this region is consistent with the Maastricht III-VI recommendations and Decree of the Ministry of Health of the Republic of Belarus of 01.06.2017 № 54: clinical protocol “Diagnosis and treatment of patients with digestive diseases.” The use of PCR RT using TaqMan® MGB probes is justified to determine the resistance of H. pylori to clarithromycin, to prescribe individualized treatment and to evaluate the effectiveness of eradication regimens.

The sale, storage and use of vaccines sensitive to high and low temperatures is a problem that can be minimized by enhancing their stability and, as a consequence, improving the effectiveness of the preparation. Live lyophilized vaccines against avian infectious bronchitis are quite sensitive to environmental conditions. The stability of the preparation depends on a number of factors: the stability of the virus strain, the drying media (stabilizer), the mode of lyophilization and storage conditions of vaccines. One of the key components is the drying media, which provides protection during lyophilization, the stability of the preparation throughout the shelf life and its effectiveness during use. The aim of the study was to select the most promising drying media that ensure the stability of vaccines based on strains H-120 and VAR2/V2 during the required shelf life. The results of studies of the effect of different drying media (stabilizers) on the stability of live vaccines against avian infectious bronchitis from strains H-120 and VAR2/V2 at a temperature of 2-8°C and 37 °C. The results show that stabilizers, which include enzymatic peptone and polyvinylpyrrolidone (PVP) ensure the stability of live vaccines against IB from strains H-120 and VAR2/V2 for 18-24 months at a temperature of 2-8°C. The nature of lyophilisate formation, its quality and solubility were studied. The article publishes fragments of research related to the technology of production of live vaccines POLIMUN against avian infectious bronchitis (IB). In order to protect the technology, the authors presented the maximum possible data on the composition of drying media.

Inhibitory coagulopathy in urgent surgery (is it possible to prevent lethality?)

Objective: to carry out the comparative assessment of the intensity and duration of the antibacterial effect of monofilament polypropylene and polyfilament threads made of polyglycolic acid modified with antibiotic-containing coating. Material and methods. The antibacterial activity of thread samples containing an antibacterial preparation from the group of fluoroquinolones against E. coli and P. aeruginosa and its dynamics after soaking the threads in isotonic sodium chloride solution for 18 days with a daily change of the solution were studied.The comparative analysis of other antibacterial threads was carried out. Results. The new biologically active surgical suture material based on polypropylene and polyglycolic acid modified with fluoroquinolone-containing coating has a pronounced and prolonged antibacterial activity against E. coli, P. aeruginosa . Conclusion. The new biologically active surgical suture has proved to be more effective than some known antibacterial threads

Show the possibility of an alternative use of interventional radiology techniques in complex treatment of patients with inflammatory complications of the diverticular disease of the colon.In 2012-2016, there were 87 patients under our supervision with complicated diverticular disease. In 57 (65.5%) cases were diagnosed infiltrate, in 24 (27.6%) cases - abscess of paracolon area (Ib-II type by Hinchey), in 6 (6.9%) cases (III-IV type according Hinchey) generalized peritonitis have been identified.Emergency laparotomy was performed in 13 patients. Abscesses of paracolon (Ib-II type by Hinchey) area were diagnosed sonographically during the initial examination in 17 patients. 26 percutaneous drainage of diverticulogenous abscesses of different localizations self-locking drainage #8Fr 'pig tail' was carried out under the combined ultrasonic and X-ray control in this group of patients. The technical success of percutaneous drainaging of the abscesses was achieved in all manipulations. 13 patients had a single drainaging, and for diverticular disease - disease-free during the observation period of 1 year to 5 years. Resection of the colon in a planned manner after percutaneous drainage of recurrent abscess of paracolon area was performed in 4 patients. Complications related with the technique of installing drainage were not reported, mortality in the group of drained patients was absent.Ultrasound examination of patients with suspected inflammatory complications of diverticular disease - a necessary and sufficient method for initial diagnosis of the disease. Percutaneous drainage of diverticulogenous abscesses (Hinchey Ib-II) is represented by the pragmatic 'first line' choice in patients with complicated diverticular disease, that allows to treat the pathology steadfastly in most of the cases.Цель - показать возможность альтернативного применения методик интервенционной радиологии в комплексном лечении пациентов с воспалительными осложнениями дивертикулярной болезни ободочной кишки. Материал и методы. В 2012-2016 гг. под нашим наблюдением находились 87 пациентов с осложненным течением дивертикулярной болезни. У 57 (65,5%) больных был диагностирован инфильтрат, у 24 (27,6%) - параколярный абсцесс (Ib-II тип по Hinchey), у 6 (6,9%) - распространенный перитонит (III-IV тип по Hinchey) [5, 9]. Результаты. По экстренным показаниям лапаротомия была выполнена в 13 наблюдениях. У 17 пациентов с параколярными абсцессами (Ib-II тип по Hinchey) диагноз был установлен сонографически при первичном обследовании. В этой группе больных было выполнено 26 перкутанных дренирований дивертикулогенных абсцессов разных локализаций самофиксирующимся дренажем pig tail 8Fr под сочетанным ультразвуковым и рентгенологическим контролем. У 13 пациентов дренирование было однократным, а течение дивертикулярной болезни - безрецидивным за время наблюдения от 1 года до 5 лет. Резекция толстой кишки в плановом порядке после перкутанного дренирования рецидивного параколярного абсцесса была выполнена у 4 пациентов. Осложнений, связанных с техникой установки дренажа отмечено не было, случаев летального исхода после дренирования не было. Технический успех перкутанного дренирования полости дивертикулогенного абсцесса был достигнут во всех манипуляциях. Вывод. Ультразвуковое обследование пациентов с подозрением на воспалительные осложнения дивертикулярной болезни - необходимый и достаточный метод первичной диагностики заболевания. Перкутанное дренирование дивертикулогенных абсцессов (Hinchey Ib-II) представляется прагматичным методом выбора первой линии у пациентов с осложненной дивертикулярной болезнью, позволяющим в большинстве наблюдений стойко купировать осложнение.

Objective: to study acquired and congenital (protein C level) risk factors for development of postoperative venous thrombosis in patients having phlebothrombosis in their past history. Material and methods. The subject of the study was patients (n = 32) with surgical pathology having episodes of pulmonary embolism and/or deep vein thrombosis of the lower limbs in their anamnesis. Congenital and acquired risk factors for venous thrombosis were analyzed in all the patients. We studied the following acquired risk factors: the patients′ age, obesity, varicosity of legs, diabetes mellitus, chronic lung diseases, cancer, smoking, previous trauma and surgery, long-term immobilization and also estro- and gestagenic contraceptives in women. The level of protein C was studied as an inherited factor causing phlebothrombosis. We also included some additional criteria such as early heart failure and stroke (under 45), complications of pregnancy, central vein catheterization, liver diseases, atherosclerosis of cardiac vessels and lower limbs, arterial hypertension into the list of the important risk factors. Results. The most frequent acquired risk factors were arterial hypertension (75 % of the cases), varicose veins (63 %), obesity (56 %), atherosclerosis (44 %), and diabetes mellitus (38 %). Chronic lung and liver diseases, fractures of shin bones, smoking, early infarction and strokes, complications of pregnancy, cancer were detected in the patients less often (6-31 % of the cases). Two thirds of the patients having cases of venous thrombosis revealed the deficient level of natural anticoagulant - protein C: 44 (39; 48) %. Conclusion . The detection of the acquired risk factors and especially the determination of the protein C level in blood serum in patients preparing for surgery is sufficient to be used as screening tests to assess the risk for the development of venous thrombosis.

Objective: to evaluate the sorption potential of various antibiotics on polylactide and polypropylene surgical threads, whose surface is modified by direct radiation grafting of acrylic acid in the presence of N, N- methylene- bis- acrylamide, and antibacterial properties and capillarity of new surgical suture. Material and methods. The surface of the surgical sutures was modified by direct radiation grafting of acrylic acid. The bond strength of different antibacterial preparations was studied with modified threads. The antibacterial activity of the threads with Levofloxacin was studied against St.aureus, E.coli, Ps.aeruginosa . The capillarity of the modified surgical suture was studied. Results. The new surgical suture has a greater affinity to the fluoroquinolone antibiotics, has a pronounced antibacterial activity against E.coli, St.aureus, Ps.aeruginosa . Conclusion. The new surgical suture material can most effectively be used in surgery for prevention of infectious complications in the postoperative period.

Experimental simulation of burn was followed by accumulation of LPO products and suppression of antioxidant enzyme activity in the burn wound. Application of a synthetic analogue of indolicidin led to an increase in MDA and acylhydroperoxide concentrations in the burn wound on experimental day 1. Further application of the peptide in a dose of 100 mg/kg had no significant effect on the studied parameters, while the peptide in a dose of 500 mg/kg was followed by a decrease in the level of LPO products on days 10 and 14. Changes in antioxidant enzyme activities in rats treated with 500 mg/kg indolicidin analogue had a two-phase pattern: an increase on day 4 was followed by a decrease.

Morphological organization of connections of ventro-lateral (nociceptive) and dorso-lateral (analgetic) midbrain central gray (vl SGC and dl SGC), as well as of dorsal raphe nucleus (analgetic zone, Rd), with different limbic structures, responsible for the formation of various emotional states, was studied in 26 cats. The methods of electrical destruction of brain areas were used that were followed by the light and electron microscopic study of degenerating fibers and synapses. Heterogeneity of connections of above mentioned formations with different limbic structures was demonstrated. Connections Rd and dl SGC with upstream limbic structures were found to be very similar in their organization and expression. Connections of vl SGC with the same structures were significantly different. It is suggested that similar (antinociceptive) function of dl SGC and Rd has determined the likeness of their connections. This, in combination with the heterogeneity of SGC in conduction of the pain and analgesia, supports the identification of two brain systems: nociceptive, conducting pain sensitivity, and antinociceptive, inhibiting its conduction. The nociceptive system includes the following structures: vl SGC, posterior and lateral hypothalamic nuclei, preoptic area. In the antinociceptive system two subsystems could be distinguished: midbrain units of these subsystems are localized in different structures (Rd and dl SGC), while the upstream ones are found in the same hypothalamic nuclei--ventromedial, dorsomedial, paraventricular. As far as septum, amigdala, hippocampus and cingular cortex are concerned, it was found impossible to refer them to any of these systems--either nociceptive or antinociceptive--basing solely on the findings of morphological studies because of approximately similar representation of axons of neurons in vl SGC, dl SGC, Rd in these structures.

A study was made of morphofunctional changes in the kidneys depending on duration of ischemia and use of the drug combination proposed by the contributors to the article, for pharmacological protection of the kidney. The examination of intraoperative renal biopsy specimens revealed the hystological structure of the kidney to be more intact, with its functional capacity tending to restore more readily than in control, in those patients in whom pharmacological protection had been embarked on. Constricting the renal artery and carrying on pharmacological protection of kidney we succeeded in effecting a complete elimination of the coral-like calculus fragments in favourable conditions on a "dry" organ, being able to manage with almost non-traumatic nephrotomy associated with minimum loss of blood, which fact resulted in the reduction of the lithogenesis recurrence rate by 17 %.

Mycobacterial variability was studied in active tuberculosis patients from radioactive contamination area subject to close radiation control. For such areas it was noted that the patients discharge altered coccoid mycobacteria stained with routine luminescent dyes. Biological investigations of freshly isolated strains revealed potentiation of M. tuberculosis virulence in patients with respiratory tuberculosis. A large number of patients from the contaminated areas against control demonstrated primary resistance to rifampicin and isoniazid.

21 surgically removed gastric carcinomas of different histologic structure and stage of development were studied ultrastructurally. A variety of morphological manifestations of local immune reactions and nonspecific antitumour resistance were observed. These manifestations were characterized by the contacts of lymphocytes, macrophages, polymorphonuclear leukocytes, plasma cells with each other and with tumour cells and by the presence of variable changes in tumour cells. The causes of such a variety are discussed and they may be due to different types of cytotoxicity, stage of the interaction between the effector and the target and so on.

Vascular bed of the infiltrating mammary gland carcinomas characterized by the incomplete maturity, atypia and polymorphism is studied electron microscopically. Two groups of vascular structures were investigated: avascular part represented by pseudovessels and vascular part with protocapillaries, capillaries, sinusoids and venulae that are distinguished by their morphofunctional properties and the degree of maturity. The vascular bed is characterized by a structural and functional heterogeneity. Ultrastructural properties characterizing the stages of the vascular bed morphogenesis are presented: angiogenesis activation, relative vascular differentiation and regression of some parts which occur asynchronically and are due to the properties of the stromal parenchymal relations in different microareas, and to the heterogeneity of the tumour on the whole.

1. To determine the impermeability of unsaturated soils to water in hydrotechnical construction, calculation methods based on consideration of the number and size of water-conducting channels with consideration of the regularities established theoretically and experimentally can be used in preliminary stages. 2. It is advisable to use field methods for a more reliable evaluation of the water permeability of unsaturated soils. 3. Along with hydraulic testing, methods of air testing wells and pits should be used widely. The reliability of the results of air testing has been established theoretically and experimentally. 4. The experience of surveys for hydrotechnical construction in the USSR showed the effectiveness of the given methods of determining the water permeability of unsaturated soils.

Interneuronal connections of area 7 of the cat parietal cortex with projection areas of the visual, auditory, and somatosensory cortex were analyzed by orthograde degeneration and retrograde transport of horseradish peroxidase methods. By combined investigation the cortico-cortical sources of afferentation of parietal area 7 could be precisely identified and concentration sites of neurons sending their axons into this area identified, and the morphological characteristics of these neurons could also be determined.

The electron-microscopic study of skin cylindroma indicates that these tumors derive from the sweat glands, apparently the apocrine glands, and cells of the tumor and fibroblasts of the stroma take part in the formation of hyaline substance.

The stroma of the papillary and follicular thyroid carcinoma was studied histochemically, morphometrically and electron microscopically. The functionally active vascular bed was found to have a greater length in the papillary carcinoma as compared to the follicular one. Likewise the cell infiltration and the number of fibroblasts with a high dehydrogenase activity were more pronounced in the papillary carcinoma. It is believed that these properties of the stroma are connected with the function of parenchymatous carcinoma cells.

Immunocompetent cells were studied in the stroma and epithelium of 34 cases of mammary gland dysplasia. The following stainings were used for light microscopy: hematoxylin and eosin, methods of Brachet, van Gieson, Romanovsky-Giemsa, hallocyanine alums, Gomori, PAS-reaction as well as the determination of acid and alkaline phosphatases, glucose-6-phosphate and succinate dehydrogenase were used. 14 cases were studied ultrastructurally. Two types of small B lymphocytes and one type of large lymphocytes, stromal macrophages are described. Their morphofunctional characteristics is given and their properties in proliferating and non-proliferating fibroadenomatosis are shown. Interaction of intraepithelial large granular lymphocytes (normal killers) with immature epithelial cells resulting in the death of these epitheliocytes is described. The results obtained are regarded as a morphological manifestation of the immune surveillance.

Kidney biopsies from 18 patients with primary gout were studied. Glomerular changes were found in all cases along with alterations in tubuli and vessels and stromal sclerosis. They were characterized by local thickening of basal membranes of capillaries, increase in the mesangial matrix, focal or diffuse proliferation of mesangial and endothelial cells of various degree of severity. Proliferation and activation of endothelial cells, mesangiocytes, podocytes, signs of podocyte damage, were found electron-microscopically. Subendothelial lucid zones were observed in the basal membrane, possibly at the site of uric acid deposits. The above described alterations resemble those in focal mesangio-capillary or mesangial proliferative glomerulonephritis.

Upon the analysis of 50 cases of cancer of the stomach, the authors compared the size and composition of stromal cellular infiltrate, the size of active vascular bed in the tumor, mitotic activity of the tumor cells, the severity of regression in adenocarcinomas and signet ring cell polymorphocellular carcinoma of the stomach. The authors established the necessity of a comprehensive investigation of the tumor parenchyma and specificities of parenchymal blood supply for determination of local immune response in the tumor in relation to its efficiency.

The intensity of differentiation of adenocarcinoma and non-differentiated cancer cells was studied histochemically and electron microscopically. A higher ratio of nucleus volume to cytoplasm volume and nucleus nuclei acids to cytoplasm RNA, low secretory activity in adenocarcinoma cells as compared to nondifferentiated cancers were found. Adenocarcinomas were shown to have a higher activity of NADP-dependent dehydrogenases, more numerous free ribosomes as compared to nondifferentiated carcinoma. This suggests a lower degree of cell differentiation and high proliferative activity in adenocarcinomas than in nondifferentiated carcinoma. Differences in the intensity of cell and tissue differentiation in adenocarcinomas and nondifferentiated carcinoma and due to differences in their histogenesis and must be taken into account in evaluations of the prognosis.

The ultrastructural study of the renal carcinoma revealed some differences in the fine structure of the two main cell types: clear and dark cells. The cytoplasm of clear cells is rich in fat and glycogen. Fat is found in lipid vacuoles and glycogen in diffuse granularity in the cell cytoplasm. Dark cells contain small amounts of fat and glycogen but have well developed mitochondria and other organelles. Comparison of these cell types shows some features of their similarity such as microvilli on the cell surface, desmosomes and interdigitations in the region of cell contacts and channels between tumour cells. These features suggest that clear and dark cells have a common origin from the epithelium of the proximal tubules.

All the 6 animals with the model of acute destructive pancreatitis died at day 2-3 from progressive pancreonecrosis, endogenous intoxication and dystrophic changes in the parenchymatous organs. After occlusion of the pancreatic ducts, acinous tissue atrophy began from the end of the second week, total atrophy occurred after 3 mos. Diabetes mellitus didn't develop for 2 years. Treatment of acute destructive pancreatitis by means of a full-value occlusion of the pancreatic ducts lead to recovery of the animals, and is perspective for the use in clinics.

Cortico-cortical connections of sensory (visual, auditory and somatosensory) areas of cortex with parietal associative cortex were investigated in cat by means of retrograde axonal transport of horse-radish peroxidase and Fink-Haimer technique. The shape, size and localization of cells which make monosynaptic connections between the primary sensory areas and parietal cortex and the distribution of fiber terminals of such cells in the associative parietal cortex were determined. Maximum number of cells connected with field 7 of the parietal associative cortex was found in field V1 of the visual cortex, and with field 5 in field S1 of the somatosensory cortex. Besides HRP-positive pyramidal neurons, mainly localized in layers II-IV, labelled stellate and spindle-shaped cells were found in a small amount. The connections of parietal associative cortex are discussed on the basis of the data obtained.

The interneuronal connections of the parietal associative cortex were studied in cat using the methods of retrograde axonal transport of horseradish peroxidase (HRP) and terminal degeneration (Fink-Heimer). Data on laminar topography of the afferents within area 7, and the nature of axonal terminals from visual, auditory and somatic sensory fields of cortex were obtained. The places of concentration of associative neurons and their morphological characteristic are described.