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05) decreased. It is important that the impact of treatment on immune parameters match the clinical effect.The aim of the study was to assess the impact of complex urate-lowering therapy with the addition of a synbiotic on the level of cytokines in the blood and the quality of life of patients with chronic gouty arthritis.; The results of treatment of 68 patients (main group) and 62 patients (comparison group) with chronic gouty arthritis are presented. Patients of the main group took allopurinol at a dose of 300 mg per day with titration of the dose in the direction of increasing it by 100 mg once a month and additionally received a synbiotic 1 capsule three times a day. Patients in the comparison group received only allopurinol treatment. The duration of treatment was 3 months. The control group consisted of 25 practically healthy men of the corresponding age.; An addition of a synbiotic to the treatment regimen demonstrates an increase of urate-lowering effect of allopurinol (a decrease in the level of uricemia by 18.7% versus 13.3%, p less then 0.01), which was combined with a more pronounced anti-inflammatory effect a decrease in the level of CRP by 75% against 26, 3% (p less then 0.01) and IL-1β, IL-6, IL-8, IL-10 and TNFα (all p less then 0.001). According to the questionnaire on the SF-36 scale, in the main group in most subscales there was a statistically significant improvement in the dynamics of the indicators. According to the results of a survey according to the GSRS scale at the visit month 3, in the patients of the main group, the indicators of all subscales statistically significantly changed in the direction of improvement, except for the scale of gastroesophageal reflux syndrome.; The addition of a synbiotic to complex therapy for patients with gout allows morefaster achievement of target levels of uric acid in the blood, contributes to a more rapid normalization of blood CRP and the cytokine profile compared with allopurinol monotherapy. The tendency influence on the clinical manifestations of dysbiotic changes in patients with gout has an additional effect on the quality of life.Aim of study - examine the association between circulating blood adipokine levels (adiponectin, resistin, irisin, nesfatin-1, apelin-12 and obestatin) and hypertension and obesity.; The study included a comprehensive survey of 98 patients, including 52 subjects with hypertension and 46 with hypertension and obesity. The levels of adiponectin, resistin, irisin, nesfatin-1, apelin-12, obestatin has been determined.; On conducting an analysis of the study population, the circulating level of resistin (19.32±0.53 ng/mL vs. 14.90±0.29 ng/mL, p=0.0024) was higher in obese subjects with hypertension than in those without obesity, whereas apelin-12 (1.51±0.09 ng/mL vs. 1.42±0.04 ng/mL, p=0.069) and obestatin (2.97±0.04 ng/mL vs. 3.06±0.04 ng/mL, p=0.073) levels were not different between the two groups. The circulating levels of adiponectin (6.83±0.10 ng/mL vs. 2.54±0.72 ng/mL, p=0.00038), irisin (1.91±0.06 ng/mL vs. 1.19±0.03 ng/mL, p=0.021) and nesfatin-1 (8.07±0.06 ng/mL vs. 6.95±0.04 ng/mL, p=0.0057) were higher role of the studied adipokines in the development of cardiovascular diseases.

The aim of study was to study the changes in the parameters of fibrinolytic and antifibrinolytic systems in patients with alcoholic liver cirrhosis (ALC), depending on the combination with adiposity and decompensation of the disease.; The subject of the study were 104 patients with ALC, 16 women and 88 men aged 34 to 65 years; among them there were 66 patients with ALC associated with adiposity (group I), 38 patients with ALC (group II). Control subjects were 20 practically healthy volunteers (4 women and 16 men). The indicators of circulating blood biomarkers of fibrinolytic and antifibrinolytic systems were measured by the immuno-assay method.; Patients in both groups showed an increase of tissue plasminogen activator (t-PA), type 1 plasminogen activator inhibitor (PAI-1), and plasma-α2-antiplasmin (PAP) complexes, especially in combination with concomitant adiposity. These changes were increasing with worsening of the disease according to Child-Pugh score. The levels of PAI-1A were more pronounced than t then 0.05); Child-Pugh class C - by 35.95% and 24.72% (p less then 0.05). The levels of PAP in patients of groups I and II were higher compared to healthy subjects for Child-Pugh class A by 71.78% and 29.17% (p less then 0.05); class B - by 100.16% and 58.93% (p less then 0.05); class C - by 144.30% and 86.24% (p less then 0.05). It is also evidenced by the increasing D-dimers.; The increase in tPA, PAI-1, D-dimers and decrease in the tPA/PAI-1 index can predict the risk of thrombogenic state in patients with ALC, especially with concomitant adiposity.The goal of research is to optimize the results of surgical treatment of the regional metastases of the maxillofacial area cancer by improving the technique of supragioid and supraomogioid neck dissection with its variants and substantiate the possibility of their application to the patients with malignant tumors of the maxillofacial area. 104 patients aged 7 to 86 years with malignant tumors of the maxillofacial area were examined, including cancer of the lower lip, oral mucosa, and salivary glands. The patients revealed 187 enlarged regional lymph nodes, which were removed in the course of surgery using advanced methods of supragioid and supraomogioid neck dissection. The proposed advanced neck dissection demonstrated high efficiency against regional metastases. In patients who have undergone surgery, the connection of the risk of regional recurrences with the presence of regional metastases has not been established.Сhronic endometritis is a medical and social problem that leads to impaired reproductive health of women. Even after elimination of the causative agent of inflammation detect changes in the endometrium by determining immunohistochemical markers (СD 138). The purpose of this study is to analyze the incidence of chronic endometritis in women of reproductive age with reproductive health disorders.; We performed hysteroscopy and determination СD 138 30 patients with recurrent pregnancy loss, 47 women with primary infertility and 36 women who applied for a pregnancy planning examination and endometrial polyps detected during routine ultrasound. In patients with habitual miscarriage, primary infertility, and women in the planning of pregnancy and endometrial polyps, a high frequency of bacterial vaginosis and recurrent inflammatory diseases of the lower parts of the reproductive system was noted (p>0.01). In the study of infectious agents of the lower parts of the reproductive system of patients of all groups found in the pathological growth of ureoplasmic infection and a group of non-specific infections (Enterococcus faecalis, Esherichia coli, Proteus sp, Klebsiella sp, S. aureus, agactactia) (p>0.05). Hysteroscopic changes in endometrial pathology were present in 57% of women with habitual miscarriage and primary infertility (p>0.05). In immunohistochemical examination of the endometrium, chronic endometritis was diagnosed in 80% of patients with habitual miscarriage, in 55% of women with primary infertility and in 61% of women when planning pregnancy and polyps of the endometrium (p>0.01).Morbidity of USD is constantly rising in Armenia as well as in the world and this tendency is rising on its own. The prevalence for 100,000 of population has grown from 252,1 in 1990 to 519.6 in 2014. If in 1990 the incidence of USD was 52.6 new cases per 100,000 of population, in 2014 the incidence grew to 196.2 new cases. SN 52 price We have analyzed data of 793 patients, who were examined and treated at "Izmirlyan" Medical Center from 2006 to 2013 with the diagnosis of USD. The stones were removed by a medical expulsion technique as well as surgically by ESWL, URS, PNL, laparoscopy or open surgery. Chemical analysis of stone shows that 49,56% patients had calcium oxalate stones, 7,19% - uric acid stones, 0,76% - carbonate stones, 0,38% - phosphate stones, 0,26% - cystine stone and 41,6% - Mixed stones. The stone distribution by chemical composition in patients from Yerevan is the following 52,3% - calcium oxalate stones, 5,9% - uric acid stones, 1,05% - carbonate stones, 0,42% - phosphate stones, 40,33% - mixed stones. The stone type largest percentage by regions of Armenia oxalate stones in Armavir region of Armenia - 58,4%; uric acid stones in Tavush and Sunik regions - 25% and 17,6%; mixed stones in Lori and Vayots-Dzor regions. In conclusion we can say that in a small country like Armenia USD is one of the most widespread diseases with different stone composition, depending on the region, as far as the landscape of the country varies from 380 to 4100 m above sea level and climate ranges from hot subtropical to cold high-land. CaOx stones are seen most frequently throughout Armenia, the percentage of these stone ranged from 31,25% to 58,4%, with a medium value of 49,56%. Next largest group is represented by mixed stones, which mostly consist of CaOx again and uric acid stones, which, of interest, constitutes more stone burden in absolute figures compared to pure uric acid stones.Objective - to present the rationale for the choice of surgical tactics for patients with acute pancreatitis by using the levels of transforming growth factor ß1 (TGF-ß1) in the diagnosis of severity and differential diagnosis of sterile and infected forms of pancreatic necrosis.; The data on the study of a comprehensive clinical and instrumental examination of 94 patients with acute pancreatitis of varying severity were analyzed mild - 20; average - 12; severe - 62 (34 with the infected and 28 with the sterile form of pancreatic necrosis), some features of the content of TGF-ß1 in the blood serum depending on the severity of acute pancreatitis and the form of pancreatic necrosis. Morphological studies of the pancreas (45 cases) in those operated on with severe acute pancreatitis were carried out by immunohistochemistry. The algorithm for early differential diagnosis of sterile and infected forms of pancreatic necrosis was improved based on the use of the diagnostic coefficient (DK) and the informative (I) significance of indicators TGF-β1, ARACNE II, CT-index Balthazar, which made it possible to optimize approaches to the choice of surgical intervention. An immunohistochemical method in the autopsy material of the pancreas revealed an increase in the expression of TGF-β1 in the tissue as the severity of destructive pancreatitis progresses from sterile to infected forms.; Taking into account the levels of TGF-ß1 in the diagnosis of the severity of acute pancreatitis, differential diagnosis of sterile and infected forms of pancreatic necrosis allows differentiated and timely changes in the strategy of surgical intervention - the choice between "closed", "half-open" and "open" types of surgical operations, reduce the number of repeated interventions and reduce postoperative mortality.We studied the immediate and long-term results of various methods of gastric resection in 35 patients operated at the S.S. Yudin State Medical Center in Moscow from 2000 to 2019. 20 (57.1%) patients were operated on for perforation, and 15 (42.6%) patients underwent surgery for ulcerative bleeding. There were 27 (77.2%) males and 8 (22.8%) females. The average age of patients was 48.3±2.3 years. The diagnosis of peptic ulcer disease was previously made in 24 (68.6%) patients, the duration of the disease was 7.7±2.7 years. Of the 35 patients, 29 (82.8%) underwent standard gastric resection without vagotomy with Billroth-II anastomosis in various modifications and 6 (17.2%) underwent pylorobulbar resection with Billroth-I anastomosis with bilateral stem vagotomy. According to the analysis of the results of surgical interventions, gastric resection was accompanied by a significant number of early postoperative complications observed in 18 (51.4% of patients) associated with the nature of the operation, 10 and 5 patients had complications from the cardiovascular and respiratory systems.