[EVALUATION OF SYSTEMIC PRO-INFLAMMATORY REACTIONS IN SIMULATING REVERSIBLE OCCLUSION OF ANTERIOR MESENTERIC ARTERY TO JUSTIFY MEDICAL REHABILITATION].

The purpose of the work was to analyze the pro-inflammatory reaction caused by different duration of ischemic-reperfusion of intestinal damage in occlusion of anterior mesenteric artery in the experiment. Ischemic reperfusion damage of the intestinal wall was simulated using reversible occlusion of the anterior mesenteric artery with 30 rats. Two types of operations were carried out: operation 1 - the duration of ischemia 20 minutes, reperfusion - 40 minutes, operation 2 - 30 and 30 minutes, respectively. Four groups were formed by simple sampling: the first - false-operated animals (n=5), the second - model-operation 1 (n=8), the third - model-operation 2 (n=6), the 4th - control group (n=7). Lactate level was determined by BM-Lactat test strips and the number of blood leukocytes was calculated before and after the surgery. During the postoperative period, interleukin-1ß (IL-1ß), tumor necrosis factor α (TNF-α), monocytic chemotoxic factor-1 (MCF-1) in serum were determined. In groups 2 and 3 it was established: a decrease in leukocytes in peripheral blood by 15-20% and an increase in lactate level by 20-120% during the postoperative period with the establishment of direct statistically significant connections between the number of leukocytes in the blood and lactate content (r=+0.83, p=0.01); between the number of leukocytes in the blood and IL-1ß blood level (r=+0.96; p=0,00002); reduction of IL-1ß level in blood with the animals of group 3 as compared with false-operated and MCF-1 level with the animals of group 2 as compared with false-operated, which may be related to the influence of corrective action of anti-inflammatory response. The increase of TNF-a level with the animals of the second group by 1.5-2 times and in the third group by 3 times compared to false-operated animals, which is the most significant manifestation of pro-inflammatory response to ischemia/reperfusion, depends on the degree of the damage due to the duration of ischemic period. The development of systemic pro-inflammatory reactions in the simulation of reversible occlusion of anterior mesenteric artery is the basis for the rehabilitation of patients after various surgical interventions in the intestine in order to prevent abdominal postoperative complications.

[THE RESULTS OF EARLY MEDICAL REHABILITATION OF PATIENTS AFTER HIP PLASTIC WITH A PASSIVE SUSPENSION SYSTEM].

In a prospective randomized controlled longitudinal study, there have been assessed the results of early comprehensive rehabilitation of patients after total hip arthroplasty using "Levitas" passive suspension system. The study involved 85 patients (44 women and 41 men) with primary (77 people; 90,6%) and dysplastic coxarthrosis (8 people; 9,4%). The average age of the patients was 64,3±5,1 years old. Immediate results were evaluated in terms of pain intensity (visual-analogue scale), range of motion (M. D'Aubigne and M. Postel scales), functional activity (Harris scale) and mobility tests ("forward bend", "get up and go"), distant - by posturographic indicators and quality of life of the patients. All the patients were divided into 2 groups by simple randomization. The control group of the patients (42 people) had standard of rehabilitation measures (basic version of standard diet; prevention of early postoperative complications; drug support; alternating magnetic field; magnetic laser therapy; standard complex of physical therapy). The patients of the main group (43 people) additionally had treatment using a passive suspension system "Levitas" (Technomex, Poland). In both groups of patients, after a course of procedures, there has been recorded a significant decrease in pain, an increase in functional activity and an improvement in mobility tests (p <0.05-0.01). At the same time when comparing the final results obtained in the groups, the studied indicators had more significant shifts with the patients who received a complex treatment with additional prescription of "Levitas" sling system (p<0,05). According to the follow-up data, significant differences (p<0,05-0,01) were noted in stabilometric indicators and the quality of life (physical and mental health) which testified in favor of the patients in the main group. The absence of complications, side effects, deterioration in the condition of the patients in both groups indicates the safety of the used early rehabilitation methods. In the main group of the patients who additionally had exercises on the sling system, in comparison with the control group, there has been noted a more complete and high-quality restoration of the functional activity and support ability of the hip joint due to the early relief of pain syndrome, reducing in gait asymmetry, and optimization of the energy efficiency of body balance, which, apparently, is associated with adequate training of neuromuscular apparatus of both operated and contralateral limb, which provides more complete restructuring of the segments of the pelvic girdle.