The problem of treatment for alcohol addiction stays extremely topical due to its prevalence and extent of economic, environmental, demographic and moral losses, which is a serious threat to health, safety, stability and development of the society. This problem is worsened by the fact that despite the variety of approaches and techniques the ultimate effectiveness of the treatment of patients with alcohol dependence (AD), determined by the duration of remission, stays completely inadequate, primarily due to relapse-dangerous clinical situations underlying failures and AD relapse. The literature review deals with pharmacological prevention of AD relapse.

The Republic of Belarus has an effective system of anti-tuberculosis aid, which is proved by the achievements of national phthisiology for the past 6-7 years. The system includes organization of detection, diagnosis and treatment for HIV-associated tuberculosis. The medical aid to this cohort of patients is rendered by phthisiatricians, infectious disease specialists, bacteriologists, psychiatrists, narcologists, whose joint work makes it possible to achieve good treatment results. However the low level of treatment adherence leads to wide-spread dropping out of patients from this process. We analyzed the publications dealing with the organization of medical aid to HIV/TB patients.

At present, Leflunomide is a good alternative to Methotrexate in the treatment for rheumatoid arthritis. It can inhibit two enzymes: dihydroorotate dehydrogenase and tyrosine kinase and lead to the development of antiproliferative, antiinflammatory, immunosuppressive and chondroprotective effects.

The article discusses the problem of choosing a method of constipation treatment from the point of view of evidence-based treatment taking into account individual characteristics of a patient. It presents data on the most effective and safe drugs for the treatment of constipation as well as indications for the application of biological feedback method and surgery.

Purpose. Determine the features of long-term dynamics of invasive and preinvasive cervical cancer (CC) in Gomel region over 1990-2010 and to determine the level of awareness about CC prevention in different population groups. Material and methods. Retrospective epidemiological analysis, method of questioning and statistical information processing were applied. The results. It was found out that there is positive tendency of manifestations of the CC epidemic process in Gomel region in comparison with the national indices whereas the long-term levels of the CC incidence and mortality rates in Gomel region were higher that average ones. The study revealed a low level of knowledge about CC and its prevention among different population groups. Conclusions. It was calculated that the introduction of the diagnosis of human papillomaviruses (HPV) by PCR in Gomel region since 2002 led to twice intense preinvasive CC detection and more frequent diagnosis of invasive CC stage I than in Belarus in general. The study shows the limiting role of the low awareness of CC in the implementation of preventive measures.

Aim of research: systematization and analytical review of scientific publications on the topic, paying attention to practical application of contrast-enhanced ultrasound methods. Material. Publications on contrast-enhanced ultrasound. Results. Possibilities and advantages of present-day contrast-enhanced echography in clinical practice were defined. Conclusion. The application of contrast-enhanced ultrasound methods considerably increases quality of the image, improves diagnostic confidence of clinical specialists, provides wide prospects of diagnostics in various areas of medicine with low general expenses, cheap equipment, availability of studies.

Aim: to study the relation of angiotensin-converting enzyme ACE (I/D) in genetic susceptibility of diabetic nephropathy (DN). Methods. I/D polymorphism of ACE gene was studied in 58 patients with diabetes type 2. Results. There are no reliable differences in detection of DD genotype and D allele in patients with DN and without DN (40,9 and 52,3 %, 19,4 and 41,7 %, respectively) (p = 0,076, LR = 0,313, 95 % DI = 0,084-1,164 for DD and p = 0,266, LR = 0,631, 95 % DI = 0,303-1,312 for D). Conclusion. The comparison of the results of genotyping in patients with and without DN did not reveal any differences in distribution of allele and ACE genotypes.

The purpose of the research was to evaluate markers of intravascular inflammation and proinflammatory and anti-inflammatory cytokines in blood arterial hypertension (AH) patients. It was revealed, that the studied indices in patients with isolated AH I-II were within the values of healthy people. In AH with left ventricular hypertrophy, there was an increase in such markers as von Willebrand factor and soluble P-selectin, tumor necrosis factor α and IL-6, without any essential changes in highly-sensitive СRP and IL-1 levels. The patients had a decreased IL-10 level among anti-inflammatory cytokines. In AH with left ventricular hypertrophy and blood lymphocytosis, there was an increase in the soluble P-selectin level and von Willebrand factor, as well as in highly-sensitive СRP. That was accompanied by increased levels of tumor necrosis factorα, IL-1, IL-6, and IL-10. As for IL-4, no patients with AH revealed essential changes.

Objective: to identify the indices of spectral Doppler intra- and extracranial arteries, as well as the diagnostic value of the indices of internal carotid arteries to assess the cerebral blood flow in an acute severe craniocerebral injury. Material and methods. The state and hemodynamic indices of the internal carotid artery (ICA) were studied in 26 patients with severe craniocerebral injuries. In 23 (88.5 %) cases ultrasonic characteristics were evaluated in the artery cerebri media (MCA). All patients (n = 26) were divided into 2 groups based on the width of the transverse displacement of the medial structures of the brain: the first group (n = 19) had dislocation ≤ 5 mm, the second group (n = 7) - offset > 5 mm. For comparative analysis and identification of correlations between the ICA and MCA hemodynamic indices, patients (n = 23) who had underwent homolateral ultrasound scanning of the arteries were picked out from subgroups 1a (n = 17) and 2a (n = 6). Results. The comparative analysis of the ICA hemodynamic parameters in the groups 1 and 2 revealed an increase in the indices of peripheral resistance in the extracranial cerebral arteries in patients with lateral dislocation more than 5 mm (p < 0.05). The study of the spectral indices of the blood flow in the homolateral arteries in the 1a group showed the presence of a close inverse correlation between the Gosling index in the ICA and Vps in MCA and significant inverse correlation between Ved and TAMX. The patients of the 2a group showed a strong direct correlation between Vps, PI in the ICA and PI in the MCA, as well as RI of both the arteries. Conclusion. The spectral indices of the ICA blood flow (Vps, PI and RI) acquire diagnostic value in the evaluation of cerebral hemodynamics in patients with dislocation of midline structures more than 5 mm.

Acute disturbed cerebral circulation is the second leading cause of death around the world. Carotid stenosis is a cause of acute disturbed cerebral circulation in approximately 25 % of cases. At present, carotid endarterectomy is one of the most frequently performed vascular reconstructions. This is due to the high efficiency of the surgery in the correction of cerebral circulation and prevention of acute disturbances of cerebral circulation. The problem of the further disease progression still remains topical despite the method of intervention and plastic material applied, as restenosis is diagnosed in approximately 10-15 % of the cases. The work studies and analyzes the distant results of various surgical techniques used in carotid reconstructions. It gives a comparative analysis of the plastic materials used in carotid endarterectomy. The analysis of the results showed that there is no optimal technique of surgical correction and plastic material in atherosclerotic lesion of brachiocefal arteries that can help avoid restenosis. This proves a necessity for further investigation and search for a method of surgical correction and alternative tissue for internal carotid reconstruction.

Purpose: to assess effectiveness of fludarabine-containing chemotherapy programs in treatment of oncohematological patients after relapse or in primary chemoresistance. Material and methods. Within 2006-2013, 11 patients with various oncohematologic disorders were treated using fludarabine-containing high-dose chemotherapy programs FLAG or FLAG-Ida at the Republican Research Center for Radiation Medicine and Human Ecology. Results. The best results of this pilot study were obtained in the chemotherapy program FLAG-Ida. Remission was achieved in younger patients, in contrast to the group of elderly patients with no remission. All the patients who achieved remission were female, and among the 7 patients, who did not achieve remission, more than half were men. Conclusion. Thus, on the whole the fludarabine-containing programs of chemotherapy are effective in the treatment for oncohematological pathology, but further research is needed to develop a more differentiated approach to the application of the programs to improve the effectiveness of the therapy of these diseases.

Crohn's disease and ulcerative colitis are chronic inflammatory bowel diseases characterized by progressive course. For the past 20 years the prevalence of this pathology has increased in children, mostly among urban population of industrialized countries. Chronic inflammatory bowel diseases in children and adolescents have their peculiar features, change the quality of life, causing a number of psychological and social problems.

The article analyzes the causes of fatal outcomes and structure of postoperative complications in patients who died of acute destructive pancreatitis. The analysis of morphological changes of internal organs has shown that the cause of early fatal outcomes is massive enzymatic noncorrected intoxication, and late lethal outcomes are caused by the intoxication associated with resorbtion of toxic substances from necrotically changed parapancreatic cellular tissue. The special attention is given to the features of anatomic interrelation of the destructively changed pancreas and the affected parapancreatic cellular tissue. An obligate lesion of the parapancreatic cellular tissue was found in the necrosis centres in the pancreas parenchyma. The article studies morphological changes in the wall of the small intestine that cause enteral insufficiency in acute destructive pancreatitis. It was shown that according to the autopsy data, the real number of observations of total pancreatonecrosis was not adequate if to compare with that that was supposed according to the data of clinical and intraoperative inspections. The analysis of operative interventions showed that purulent-necrotizing parapancreatitis is an object of surgical intervention.

Purpose. The comparison of time needed for development of peripheral blockade of the sciatic nerve, made with 1 % lidocaine and adrenaline (1:200 000) under ultrasound guidance of the subgluteal and popliteal access. Material and methods. Patients were divided into two groups. In group A (20 patients), the blockade of the sciatic nerve was performed by the subgluteal access, in group B (20 patients) - by popliteal access. All the blockades of the sciatic nerve were performed with 30 ml of 1 % lidocaine with adrenaline (1:200 000) with the use of electrical stimulation of the peripheral nerves under control ultrasonic imaging. Results. In group A, the sciatic nerve sensory block developed in 15 (14, 16) minutes, the complete motor block developed in 15.5 (15, 17). In group B, the sensor block developed in 40 (38.5, 42.5) minutes, the complete motor block did not develop in any patients. Conclusion. The blockade of the sciatic nerve blockade with 1% lidocaine with adrenaline (1:200 000) under ultrasound guidance leads to faster development of thr subgluteal access sensor block than in its blockade of the popliteal access (15 (14, 16 ) vs. 40 minutes (38, 5 , 42.5 ) minutes, respectively.

Objective: to study individual variability of the cystic artery and cystic duct. Material and methods. To achieve the goal of the research, 95 human organic complexes from the Grodno Regional Autopsy Bureau were dissected in accordance with Mortuary and Funeral Business Act of the Republic of Belarus No. 55-3 of 12.11.2001. While examining the complexes, the source of the cystic artery origins, their number and sources of additional arteries to the gall bladder were studied. We also examined the area of the cystic duct confluence, its diameter, length and type of structure. Results. The study revealed considerable variability of the morphometric parameters of the cystic artery and cystic duct. Conclusion. The variability of the morphometric parameters of the cystic artery and cystic duct is a basis to develop special approaches to clipping and their crossing during laparoscopic cholecystectomy.

This article assesses the dynamics of cardiointervalography indices in non-linear rats before and after a daily 12-day swimming test «until refusal». The model of physical stress in the swimming test led to a shift in the cardiointervalography indices to the prevalence of the parasympathetic nervous system function in experimental animals, which may be indicative of high functionality of a biological organism in response to regular exercise. After 12 days of physical exercise «until refusal» the electrocardiogram of rats revealed cardiac arrhythmias in the form of ectopic activity.

The article presents the data on the sex and age dynamics of the cardiovascular parameters in 1693 boys and 1757 girls of Gomel aged 7-17, examined within 2010-2012. Based on the data, centile tables were made up to assess the levels of systolic and diastolic pressure and heart rate. It was found out, that the periods of the maximum increase of the systolic pressure level in boys was recorded at the end of puberty, and in girls - before its beginning. The level of diastolic pressure considerably increased in the city schoolchildren of the both sexes at the end of the puberty period. The decrease of the heart rate was most considerably observed in boys aged 12-13, and in girls aged 9-10. The parameters of systolic pressure correlated more with the anthropometric features of body than the parameters of diastolic pressure and the heart rate.

Objective: to develop protective properties of the amino acid-microelement composition «Tritarg» in experimental lead intoxication. Material and Methods. The experiments were conducted on white female rats. Free amino acids were tested by the reversed-phase HPLC. Results. Lead intoxication leads to a significant increase of total free amino acids and their nitrogen-containing metabolites in rats` blood plasma. The concentration of glutamate and proline, as well as the relative amount of aromatic amino acids increase in the spleen. The introgastric administration of «Tritarg» into rats treated with lead acetate, increased the level of hyperaminoacidemia and also stimulated the release of amino acids into cells and, probably, their metabolism in the spleen. Conclusion. The ten-day introgastric administration of «Tritarg» into the rats treated with lead acetate increases mobilization of free amino acids, as well as methionine, cystathionine, taurine in the blood plasma and spleen.

The basis of the methodological approach to the assessment of individualized external radiation dose in people affected after the Chernobyl accident is the ascertained gender and age peculiarities in formation of an individual external dose. Seven age-gender groups that differ significantly as per their average value of external radiation dose have been singled out. A relation was found between the average external dose of the age-gender groups and that of a settlement, expressed in «coefficient of individualization», whose values are determined for each age-gender group. The methodological approach of the assessment of individual external doses was tested. The difference between the calculated and instrumentally measured external radiation doses was at an average 21 %.

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.

Objective: to compare the state of vegetative regulatory systems of sportsmen going in for swimming and gymnastics. Material and methods . The indicators of vegetative regulation of sportsmen were studied using statistical, temporal and spectral analysis of heart rhythms with hardware-software complex «Omega S». Results. The comparison of the peculiar features of vegetative regulation of heart rate revealed that a kind of sport activity has significant influence on the vegetative tonus of sportsmen. Conclusion. The autonomic regulation of the heart rhythm is predominant in swimmers, but gymnasts are characterized by the predominant central regulation with more evident humoral-metabolic effect.

Objective: to study bactericidal properties of metal cations against Staphylococcus aureus and Pseudomonas aeruginosa . Material and methods. Minimum inhibitory and minimum bactericidal concentrations of metal salts were determined by the method of broth dilution. The kinetics of growth and dying of S.aureus and P.aeruginosa was studied in broth culture medium in the presence of metal cations in concentrations four times exceeding the minimum bactericidal concentrations. Results. The cations of silver and copper proved to possess a marked bactericidal effect. It was showed that an increase of oxidation-reduction potential leads to an increase of the antibacterial efficiency of the metal cations. Conclusion. A relation of the oxidizing activity of the metal cations and their bactericidal action was revealed.

The aim of the work was to study the effect of new polyamide-based antibacterial surgical sutural material modified with silver nano-particles and obtained by the method of metal and vapour synthesis on the course of inflammatory wound process in vivo. Material and methods. Polyamide threads produced by «Volot» (Russia), Specification 9432-001-24648800-95 and their analogs modified with silver nano-particles were used in the work. Sutural material was implanted into the back muscles of outbred female albino rats. Local inflammatory and tissue reaction was assessed in compliance with State Standard Specification P ISO 10993 «Medical Products. The assessment of the biological effect of medical products». Results. The research revealed earlier occurrence of the proliferative stage of inflammation when using a modified thread and formation of a well blood-supplied thin connective tissue capsule, which makes it possible to consider this as a precondition for wound healing by primary intention. Conclusion. The thread modified with silver nano-particles is more bioinert and causes less evident inflammatory response of the tissues to implantation.

Purpose of research: to study morphologic and functional changes in the application of various patch tissues in the inclusion into the arterial flow. Material and methods. Various patch tissues were studied in experiments: polytetrafluoroethylene prosthesis was used as an artificial tissue, a major saphenous vein was used as a superficial autologous vein, superficial femoral vein was used as a deep vein. Results and discussion. Data about wall thickness, area of endothelial nuclei and vascularization of various plastic materials in arterial flow were obtained. Conclusion. The femoral vein possesses more stable morphological and functional properties in comparison with the major safenous vein and is less prone to develop fibrosis then vascular prosthesis. It makes the femoral vein a plastic material with good prospects for brachiocephalic reconstructive surgery.

An exponential model of the long-term dynamics of¹³⁷Cs accumulation by fruit bodies of Boletus edulis has been developed. The interrelation of the radionuclide intake by forest food products with meteorological factors was established (it was inversely proportional between precipitation and¹³⁷Cs accumulation and directly proportional between temperature and¹³⁷Cs accumulation by mushrooms). A method of bioindication for the prognostic assessment of¹³⁷Cs accumulation by blueberries was proposed on the basis of the data on contamination of blueberry vegetative mass within a month before the fruiting. On the basis of the average indices of¹³⁷Cs accumulation by mushrooms for various forestries of Gomel region, we made the prognostic assessment of the internal dose of the population due to the consumption of forest food products.

Immobilization stress has physical and psycho-emotional effect on animals. Numerous authors noted the negative impact of this type of stress on the state of the male reproductive system. The present work shows the negative impact of short-term immobilization (3 hours) on the state of the sperm antioxidant status and the morphology of rats testis. The study was conducted on 24 sexually mature male outbred albino rats. The rats of the experimental group (n = 11) showed a reduction in the antioxidant status of the sperm. The animals exposed to immobilization stress observed morphological changes in the testis: reduced diameter of seminiferous tubules and thickness of the germinal layer, as well as violation of meiotic division in developing germ cells.

Objective: set the particular structure and morphometric parameters of medulla oblongata and spinal cord in Siamese twins with 18-week gestation of the intrauterine development. Material and methods . The morphological study was conducted on oblongata and spinal cord of female conjoined twins (thoraco-omfalopag) with the gestational age of 18 weeks. The measurement of the parietal-coccygeal length of the longitudinal and transverse dimensions of the medulla oblongata and the spinal cord was performed by conventional methods. The material for the study was obtained as a result of abortion for medical reasons. From the material paraffin blocks were made for performing serial sections of the spinal cord and medulla. The slides were stained with hematoxylin-eosin, toluidine blue, Van-Gieson, and silver impregnation by Bilshovski. The resultant preparations were visually evaluated under the microscope Micromed XS 5520, video capture camera performed ScienceLab DCM 520. Statistical processing of digital data using a standard software package «Statistica 8.0» by Statsoft company. Results. The work presents the results of anatomical and histological examination of the medulla oblongata and spinal cord of the thoraco-omfalopaga human fetus of 18 weeks of fetal development. Conclusion. We found out the peculiarities of architectonic structures and morphometric parameters of the medulla oblongata and spinal cord, as well as the topography and size of the nuclei, the degree of differentiation of their constituent neurons.

Algorithm of hygiene audit the execution of health hygiene programmer formation at schoolchildren installation on a culture of health the substantiated in the article. Describes the types and forms of audit.

The article deals with the problem of identifying the border-lines among such notions as «endowment», «talent» and «genius». On the basis of the works of philosophers, psychologists and psychiatrists and also articles from foreign and Russian encyclopedic dictionaries, the author identifies the main characteristics of genius, distinguishing it from talent. This article presents the role of biological and social and psychological aspects in the emergence of a potential genius or extraordinary talent.

The prevalence of cystic fibrosis in people in Kirov region has been studied taking into account the regional clinical and genetic features of the disease. The most common mutation of cystic fibrosis is F508del. The predominant clinical form of cystic fibrosis is a mixed form of the severe course of the disease. Cystic fibrosis with F508del mutation is accompanied by a slowly progressive chronic bronchopulmonary process and marked by pancreatic insufficiency.