Development, production and characterization of SARS-CoV-2 virus-like particles (Coronaviridae: Orthocoronavirinae: Betacoronavirus: Sarbecovirus).

INTRODUCTION: The COVID-19 pandemic caused by SARS-CoV-2 has created serious health problems worldwide. The most effective way to prevent the occurrence of new epidemic outbreaks is vaccination. One of the modern and effective approaches to vaccine development is the use of virus-like particles (VLPs). The aim of the study is to develop a technology for production of VLP based on recombinant SARS-CoV-2 proteins (E, M, N and S) in insect cells. MATERIALS AND METHODS: Synthetic genes encoding coronavirus proteins E, M, N and S were used. VLP with various surface proteins of strains similar to the Wuhan virus, Delta, Alpha and Omicron were developed and cloned into the pFastBac plasmid. The proteins were synthesized in the baculovirus expression system and assembled into VLP in the portable Trichoplusia ni cell. The presence of insertion in the baculovirus genome was determined by PCR. ELISA and immunoblotting were used to study the antigenic activity of VLP. VLP purification was performed by ultracentrifugation using 20% sucrose. Morphology was assessed using electron microscopy and dynamic light scattering. RESULTS: VLPs consisting of recombinant SARS-CoV-2 proteins (S, M, E and N) were obtained and characterized. The specific binding of antigenic determinants in synthesized VLPs with antibodies to SARS-CoV-2 proteins has been demonstrated. The immunogenic properties of VLPs have been studied. CONCLUSION: The production and purification of recombinant VLPs consisting of full-length SARS-CoV-2 proteins with a universal set of surface antigens have been developed and optimized. Self-assembling particles that mimic the coronavirus virion induce a specific immune response against SARS-CoV-2.

[Method of comprehensive physiotherapy of dental patients after COVID-19]. / Metod kompleksnoi fizioterapii u stomatologicheskikh patsientov posle COVID-19.

Functional gastrointestinal disorders, which had an impact on the dentofacial system (pain, loose teeth and falling out of them) in patients who have had COVID-19, drew the close attention of specialists of different profiles. The pathogenesis of worsening post-COVID edentulism is insufficiently studied, as many issues of adequate therapy remain unsolved, in which the role of non-drug technologies in the treatment of dental patients who have suffered from COVID-19 is extremely high. OBJECTIVE: To describe the mechanism of action and clinical effectiveness of the developed combined physiotherapy method, including the induced technique of piracetam iontophoresis on the frontooccipital technic and acupuncture laser therapy in dental patients with complaints of edentulism progression after COVID-19 on the basis of the analysis of single studies on the post-COVID loss of teeth treatment. MATERIAL AND METHODS: A number of patients equal 120 who complained of tooth loss after COVID-19 during the past 6 months were examined. The following initial and end points were considered: dental bleeding and inflammation scores, vascular and endothelial dysfunction markers - levels of intercellular adhesion molecules and their receptors (SlCAM-1, SVCAM-1, VEGF-A, ET-1) before and after treatment. RESULTS: Negative correlation between VEGF-A (pg/ml) concentration in peripheral blood serum and sVCAM-1 (ng/ml) level in the examined patients (r=0.4830, p<0.05) and strong inverse correlation between slCAM-1 (ng/ml) level and sVCAM-1 (r=0.7696, p<0.01) have been established. More significant effects after application of the combined induced method on the head's structures and laser acupuncture have been noted than after acupuncture laser exposure and after inducing technique separately, namely in the form of dental inflammation score correction by 1.76 times (p<0.001), decrease of bleeding score by 2.6 (p<0.05), decrease of concentration of SVCAM-1 by 1.7 times and SlCAM-1 by 2 times (p<0.001), increase of endothelin level by 1.7 times as well as the initial low VEGF-A (pg/ml) by 1.5 times (p<0.01). CONCLUSION: The developed physiotherapeutic complex, which includes laser acupuncture physiotherapy and induced technique of 5% piracetam iontophoresis, can potentially be considered as a physioprophylactic and therapeutic model of post-COVID edentulism.

[Thoracoscopic tracheal resection in a child under extracorporeal membrane oxygenation]. / Torakoskopicheskaya rezektsiya trakhei u rebenka v usloviyakh ekstrakorporal'noi membrannoi oksigenatsii.

Congenital tracheal stenosis in children is a rare, severe and life-threatening respiratory tract malformation characterized by respiratory failure. We have performed 74 surgical interventions in these patients under extracorporeal membrane oxygenation between 2013 and 2022. In this article, we present surgical treatment of a newborn with congenital tracheal stenosis. For the first time in the world, the patient underwent thoracoscopic resection and reconstruction of the trachea under extracorporeal membrane oxygenation.

[Treatment of complications following esophageal electrochemical burns by batteries in children]. / Taktika lecheniya oslozhnenii elektrokhimicheskogo ozhoga pishchevoda batareikoi u detei.

OBJECTIVE: To determine the optimal treatment of patients with complications of esophageal electrochemical burns by batteries. MATERIAL AND METHODS: There were 75 children with esophageal electrochemical burns by batteries between 2010 and 2019. All children underwent X-ray of the cervical spine, chest and abdomen, esophagoscopy with removal of the battery, tracheoscopy. Complications occurred in 39 children: TEF - 21, esophageal stenosis - 19, laryngeal paresis - 14, esophageal perforation - 3. Patients with TEF were divided into 2 groups: clinically stable children without respiratory failure and severe illness with respiratory failure including mechanical ventilation. Group I consisted of 6 children, four of them underwent laparoscopic Nissen fundoplication and gastrostomy. Group II consisted of 15 children. In acute period, 3 children underwent laparoscopic fundoplication and gastrostomy, 8 ones - TEF ligation, 4 patients - tracheal repair with esophageal flap and esophageal extirpation. Patients with esophageal stenosis underwent bougienage. Patients with esophageal perforation required therapy. Tracheostomy was necessary for respiratory failure and bilateral laryngeal paresis. Lateralization procedures were performed in patients with negative course of disease. RESULTS: In the 1st group, spontaneous closure of TEF was found in 3 children after fundoplication and gastrostomy. One child underwent thoracoscopic disconnection of TEF after reduction of fistula. In the 2nd group, fundoplication resulted spontaneous closure of fistula after 2-5 months. In 4 children, recanalization of the fistula or esophageal failure were observed in acute period after TEF ligation. CONCLUSION: Laparoscopic fundoplication and gastrostomy are optimal for TEF and can result complete or partial spontaneous closure of TEF. If radical procedure is necessary in acute period, tracheal repair with esophageal flap and extirpation of the esophagus with subsequent coloesophagoplasty should be considered.

[Laser therapy effect on endothelial dysfunction in patients after the surgery for orthognathic disorders]. / Vliyanie lazernoi terapii na endotelial'nuyu disfunktsiyu u bol'nykh, operirovannykh po povodu ortognaticheskoi patologii.

OBJECTIVE: To optimize postoperative rehabilitation by applying low-intensity laser irradiation (LILI) with different wavelengths in the early postoperative period to prevent inflammatory complications. MATERIAL AND METHODS: After radiological examination and ultrasound diagnostics of the periodontal tissue vessels, surgical methods of orthognathic treatment were performed, after completion of which a course of LILI was carried out. The VEGF its receptors (sVEGF-R1; sVEGF-R2) content was measured by enzyme immunoassay using standard reagent kits. The laser therapy using 635 nm laser light was applied directly to the vestibular and oral surfaces of the gingival tissues and in the operation area, changeable by the scanning method, for 1.5 minutes (5 W power); the pulsed infrared laser therapy (PILT) with the 904 nm wavelength (light pulse duration 100 s, power 15 W, 1500 Hz) applied epicutaneously to the operation projective zones (four control points of the upper and lower jaw) through the skin of the cheek, in stable method (1.5 minutes) with a time range between red and infrared wavelength LILI not exceeding 100 s (1.5 minutes). RESULTS: Vascular and endothelial dysfunction after laser irradiation with different wavelengths is better controlled by increasing the microcapillary blood flow (66.7% gain; p<0.05) in arteriolar and 70.3% in venular sections of capillaries (p<0.01), which is associated by vasodilatation: diameter increased by 26.9% compared to that under the influence of red laser radiation (by 13.0%) and infrared laser radiation (by 7.2%); p<0.01). CONCLUSIONS: Early laser therapy using the low-intensity laser irradiation with different wavelengths improves vasoactive processes of hemoregulation in dental tissues associated with the elimination of vasospasm caused by operative stress, activation of arteriolodilatory effects, contributes to the prevention of development of inflammatory complications.

[Comparative analysis of the bile duct reconstruction methods in children with choledochal malformation]. / Sravnitel'nyi analiz sposobov rekonstruktsii zhelchnykh khodov pri mal'formatsii obshchego zhelchnogo protoka u detei.

OBJECTIVE: To compare various methods of bile duct reconstruction in children with choledochal malformation (CM). MATERIAL AND METHODS: There were 99 children with CM over 10-year period. Mini-laparotomy (ML), laparoscopy (LS) and laparotomy (LT) were used. We performed radical CM resection and bile duct reconstruction using Roux-en-Y hepaticojejunostomy (RYHJ) and hepaticoduodenostomy (HD). Surgery time, short-term and long-term postoperative outcomes were evaluated. RESULTS: ML was performed in 39 patients, LS - 51 patients, LT - 9 patients. In case of LS, hospital-stay was significantly lower after intracorporeal RYHJ formation compared to extracorporeal technique (p=0.02, Mann-Whitney U-test). Intracorporeal RYHJ requires more time (p=0.0003). Intestinal passage recovered 3 times faster in the ML RYHJ group compared to the LS RYHJ group (p=0.016, Mann-Whitney U-test). ML RYHJ was followed by significantly less duration of postoperative narcotic anesthesia compared to LS HD (3 vs. 4 days, p=0.02, Mann-Whitney U-test). In our study, ML RYHJ has an advantage over LS RYHJ regarding long-term outcomes. HD resulted higher incidence of severe postoperative pancreatitis (p=0.033) that required surgical correction (LT, p=0.043). CONCLUSION: ML RYHJ has some advantages over other methods of bile duct reconstruction. Therefore, we can currently recommend this method as a preferable one.

[Efficiency of minilaparotomy in the treatment of choledochal malformation in children]. / Otsenka effektivnosti mini-laparotomii pri lechenii mal'formatsii obshchego zhelchnogo protoka u detei.

OBJECTIVE: To evaluate an effectiveness of minilaparotomy in the treatment of choledochal malformation (CM) in children. MATERIAL AND METHODS: The study included children with CM who underwent surgery from January 2010 to May 2020. All patients were divided into 3 groups depending on surgical approach: minilaparotomy (ML), laparoscopy (LS) and laparotomy (LT). We analyzed surgery time, early postoperative outcomes and cosmetic results. RESULTS: There were 99 patients with CM for 10 years. ML was performed in 39 patients, LS - in 51 patients, and LT - in 9 patients. Significantly (p-value <0.001, Kruskal-Wallis test with Dunn paired comparison test, p<0.05) less surgery time was observed in ML group. According to Clavien-Dindo classification of surgical complications, we found a significant prevalence of complications in the LS group (p - 0.018, Kruskal-Wallis test). Moreover, LS was characterized by insignificant (p>0.05) predominance of the most severe complications requiring multiple redo surgeries. CONCLUSION: Currently, open surgery is a "gold standard" in the treatment of children with CM. LS is not preferred in children with CM. ML ensures favorable early outcomes in children with CM.

[Physiotherapy complex of the treatment of children with somatoform dysfunction and frequent recurrent diseases]. / Fizioterapevticheskii kompleks lecheniya detei s somatoformnoi disfunktsiei i chastymi rekurrentnymi zabolevaniyami.

OBJECTIVE: Assessment of index parameters of vegetative status, vegetative tonus, vegetative reactivity in children with somatoform dysfunction syndrome of the autonomic nervous system (SDSANS), who often suffer from recurrent respiratory viral diseases, in the dynamics of the use of a physiotherapeutic complex, including BioAcoustic methods of treatment of biofeedback, overvenous laser exposure and impact to projection zones of the thymus. MATERIAL AND METHODS: 111 children 7-12 years old (mean age 10.8±0.9 years) with a verified diagnosis of SDSANS were examined. The observation period was 3-4 years. As an initial- and endpoints the cardiovascular, autonomic, immune and clinical and instrumental criteria of recurrent viral infection were taken. Physiotherapeutic treatment in the form of the developed complex was carried out in the main group (laser therapy + biofeedback) and two comparison groups (group 1 - laser therapy, group 2 - biofeedback), in the control group, patients received drug therapy without physical factors. RESULTS: After the applying of complex therapy, a more significant positive dynamics was established both on the part of ECG parameters (normalization of the T wave, QRS and PQ complex) and on the part of vegetative parameters, which indicates a high cardiotrophic support of the developed complex, which helps to reduce the level of cardiovascular complaints of 75.2±5.2%. CONCLUSIONS: The developed physiotherapeutic complex, including overvenous laser exposure, laser impact to the projection zones of the thymus and BioAcoustic treatment complex of biofeddback, can be considered as a physioprophylactic and therapeutic model of recurrent respiratory viral pathology in children with SDSANS.

[Prion diseases and the biosecurity problems.]

The review presents the current state of the problem of prions and prion diseases with an emphasis on theepidemiological and epizootological risks of pathogens that cause fatal neurodegenerative diseases in humans and animals. The results of molecular genetic studies of the conversion of normal PrPc prion protein molecules to infectious forms of PrPd, resistance to physical disinfection methods, in particular exceptional thermal stability, and their ability to overcome interspecific barriers, while increasing virulence, are described. The possibility of infection not only by nutrition, when eating even heat-treated meat of sick animals, but also due to surgical interventions, especially neurosurgical and ophthalmic, as well as the use of immunobiological preparations, are emphasized. Since there are currently no means for the effective treatment of prion diseases in the world, attention is drawn to the high degree of relevance for the biosafety of the country to develop domestic highly sensitive test systems that can effectively detect prion infectious protein in vivo at the preclinical stage of the disease. The latest methods of automatic protein amplification and identification of prion proteins are briefly described as the most promising areas of research in the field of diagnosis of prion diseases.

Genetic diversity of group A rotaviruses in Moscow in 2018-2019.

Here, we present the results of a study in which 639 samples obtained between October 2018 and April 2019 from patients with symptoms of acute gastroenteritis were tested for the presence of a rotavirus infection. The antigen of group A rotavirus was detected in 160 samples (25% of those tested). To study the genetic diversity of group A rotavirus, RNA was isolated from the samples, and polymerase chain reaction combined with reverse transcription (RT-PCR) with primers specific for the VP4, VP6, and VP7 genes of group A rotaviruses was performed. At least one fragment of the group A rotavirus genome was found in 101 samples (15.8%). These fragments were sequenced, and their G and P genotypes-as well as their combinations-were determined. The predominant G genotypes were G9 (35.8% of all genotyped samples) and G4 (28.4%), but the rare G12 genotype was also found (3.0%). The dominant P genotype was P[8]. The spectrum of certain G/P combinations of genotypes included seven variants. The most common variants were G9P[8] (37.2%) and G4P[8] (30.2%).

[Advantages of Kasai procedure through minimally invasive approach in children with biliary atresia (in Russian only)]. / Preimushchestva mini-dostupa pri vypolnenii operatsii Kasai u detei s biliarnoi atreziei.

AIM: To compare early and long-term results of different surgical interventions in children with biliary atresia. MATERIAL AND METHODS: Retrospective analysis included medical records of children with biliary atresia who were treated at the Filatov Munitsipal Children's Hospital and National Medical Research Center for Obstetrics, Gynecology and Perinatology from 2000 to 2018. There were 91 patients. All patients were divided into three groups. Group 1 - conventional Kasai procedure (n=24), group 2 - laparoscopic Kasai surgery (n=45), group 3 - Kasai procedure through minimally invasive approach (n=22). Groups were comparable. RESULTS: Duration of Kasai procedure through minimally invasive approach was 69±12,97 min that was significantly less than in groups 1 and 2 (p1,3=0,006085; p2,3=0,000024). ICU-stay was minimal in group 3 (1.27±0.55 days, p1,3<0,05; p2,3<0,05). Abdominal drainage time was maximal in group 2 (11.28±6.37 days) and minimal in group 3 (5.86±2.39 days, p2,3=0.0002). Early and 2-year postoperative surgical efficiency was similar in all groups. There were no surgical complications in group 3. In group 2 one child had gastrointestinal bleeding followed by successful medication. There were 3 surgical complications in group 3: adhesive intestinal obstruction, small and large intestine perforation and 2 cases of gastrointestinal bleeding. There was one lethal outcome in the first group. Overall annual survival in children with native liver was 81.8%, 2-year - 51.7%. CONCLUSION: Kasai procedure through minimally invasive approach is justified and rational method with certain benefits of open and laparoscopic interventions and can be considered as a method of choice in treatment of children with biliary atresia.

The Structural Arrangement and Relative Abundance of Aliphatic Units May Effect Long-Wave Absorbance of Natural Organic Matter as Revealed by 1H NMR Spectroscopy.

The objective of this study was to shed light on structural features which underlay intensity of long wave absorbance of natural organic matter (NOM) using 1H NMR spectroscopy. For this purpose, a set of the NOM samples was assembled from arctic and nonarctic sampling sites (the Kolyma river basin and Moscow region, respectively). It was to ensure a substantial difference in the humification degree of the isolated organic matter-the biogeochemical proxy of the long-wave absorbance of NOM. The assembled NOM set was analyzed using solution-state 1H NMR spectroscopy. The distribution of both backbone and exchangeable protons was determined using acquisition of spectra in three different solvents. The substantially higher contribution of nonfunctionalized aliphatic moieties CHn (e.g., materials derived from linear terpenoids, MDLT) in the arctic NOM samples was revealed as compared to the nonarctic ones. The latter were characterized with the higher content of CHα protons adjacent to electron-withdrawing groups which belong to carboxyl rich alicyclic moieties (CRAMs) or to aromatic constituents of NOM. We have calculated a ratio of CHn to CHα protons as a structural descriptor which showed significant inverse correlation to intensity of long wave absorbance assessed with a use of E4/ E6 ratio and the slope of absorption spectrum. The steric hindrance of aromatic chromophoric groups of the NOM ensemble by bulky nonfunctionalized aliphatic moieties (e.g., MDLT) was set as a hypothesis for explanation of this phenomenon. The bulky aliphatics might increase a distance between the interacting groups resulting in inhibition of electronic (e.g., charge-transfer) interactions in the NOM ensemble. The obtained relationships were further explored using Fourier transform mass spectrometry as complementary technique to 1H NMR spectroscopy. The data obtained on correlation of molecular composition of NOM with 1H NMR data and optical properties were very supportive of our hypothesis that capabilities of NOM ensemble of charge transfer interactions can be dependent on structural arrangement and relative abundance of nonabsorbing aliphatic moieties.

The DNA of Bacteria of the World Ocean and the Earth in Cosmic Dust at the International Space Station.

Cosmic dust samples from the surface of the illuminator of the International Space Station (ISS) were collected by a crew member during his spacewalk. The sampler with tampon in a vacuum container was delivered to the Earth. Washouts from the tampon's material and the tampon itself were analyzed for the presence of bacterial DNA by the method of nested PCR with primers specific to DNA of the genus Mycobacteria, DNA of the strains of capsular bacteria Bacillus, and DNA encoding 16S ribosomal RNA. The results of amplification followed by sequencing and phylogenetic analysis indicated the presence of the bacteria of the genus Mycobacteria and the extreme bacterium of the genus Delftia in the samples of cosmic dust. It was shown that the DNA sequence of one of the bacteria of the genus Mycobacteria was genetically similar to that previously observed in superficial micro layer at the Barents and Kara seas' coastal zones. The presence of the wild land and marine bacteria DNA on the ISS suggests their possible transfer from the stratosphere into the ionosphere with the ascending branch of the global electric circuit. Alternatively, the wild land and marine bacteria as well as the ISS bacteria may all have an ultimate space origin.

[Complications and long-term results of delayed esophagoezophagostomy for esophageal atresia]. / Oslozhneniia i otdalennye rezul'taty otsrochennogo ézofago-ézofagoanastomoza pri atrezii pishchevoda u detei.

AIM: To evaluate complications and long-term results of delayed esophagoesophagostomy in children with esophageal atresia (EA). MATERIAL AND METHODS: 165 EA children were operated at the Filatov Municipal Children's Hospital #13 for the period 2006-2016. Primary esophageal anastomosis was performed in 136 (82.4%) children with tracheoesophageal fistula. In 5 (3%) neonates with non-fistulous EA esophago- and gastrostomy were made for further coloesophagoplasty. Other 24 (14.5%) children underwent gastrostomy for delayed esophagoesophagostomy. 6 (25%) of them died within 12 days after admission. 18 survivors with gastrostomy subsequently underwent delayed esophagoesophagostomy. RESULTS: Postoperative complications occurred in 16 (88.9%) children. Esophageal anastomosis failure occurred in 4 (22.2%) patients, stenosis of anastomosis in 11 (61.1%) children, gastroesophageal reflux in 14 (77.8%) children. Early postoperative mortality was 16.7% (3 children). In remote period 92.3% of children were not adapted to normal diet and only in 7.7% of patients eating behavior corresponds to the age. 11 children underwent prolonged esophageal bougienage. 9 children underwent re-operation after delayed anastomosis. Esophageal extirpation was made in 4 children. CONCLUSION: Esophago- and gastrostomy provides 100% survival if primary esophageal anastomosis is impossible. Herewith, in children without esophagostomy mortality rate was 25%. We still can not confirm that delayed esophageal anastomosis is a good alternative for children with esophageal atresia. In view of our results the number of candidates for delayed esophageal anastomosis should be reduced.

[THE SPECIFITY OF MOTOR SYSTEMS ORGANISATION AND IT''S INFLUENCES ON RESULTNESS OF ACTIVITY IN HEALTHY PEOPLE AND PATIENTS WITH EPILEPSY].

The specificity of motor systems and its influences on effectiveness of modeling purposeful activity in 46 healthy people and 110 patients with epilepsy was studied. Using cluster analysis the patients with epilepsy were divided in 2 groups: high- and low efficient. The differences of physiological parameters, which characterize the activity of central level of motor systems and visual-motor reaction, were determined. The high level of activation of cortical mechanisms of decision-making and preparedness to motor reaction in the group of healthy people and low effectiveness associated with insufficient activation of these mechanisms in the group of patients with epilepsy was described.

[Oil degradation by basidiomycetes in soil and peat at low temperatures].

A total of 17 basidiomycete strains causing white rot and growing on oil-contaminated substrates have been screened. Three strains with high (Steccherinum murashkinskyi), average (Trametes maxima), and low (Pleurotus ostreatus) capacities for the colonization of oil-contaminated substrates have been selected. The potential for degrading crude oil hydrocarbons has been assessed with the use of fungi grown on nonsterile soil and peat at low temperatures. Candida sp. and Rhodococcus sp. commercial strains have been used as reference organisms with oil-degrading ability. All microorganisms introduced in oil-contaminated soil have proved to be ineffective, whereas the inoculation of peat with basidiomycetes and oil-degrading microorganisms accelerated the destruction of oil hydrocarbons. The greatest degradation potential of oil-aliphatic hydrocarbons has been found in S. murashlinskyi. T. maxima turned out to be the most successful in degrading aromatic hydrocarbons. It has been suggested that aboriginal microflora contributes importantly to the effectiveness of oil-destructing microorganisms. T. maxima and S. murashkinskyi strains are promising for further study as oil-oxidizing agents during bioremediation of oil-contaminated peat soil under conditions of low temperatures.

[Sliding traсheal plasty in children under extracorporeal membrane oxygenation (first experience in Russia)].

AIM: To improve the results of surgical treatment of children with extended tracheal stenosis. MATERIAL AND METHODS: Since 2013 slidingtraсheal plasty under extracorporeal membrane oxygenation was performed in 4 children aged 1 year 2 months - 4.5 years with extended tracheal stenosis in Children's City Clinical Hospital №13. Patients' weight was from 10,5 to 16 kg. Extended tracheal stenosis and complete cartilag inousrings were confirmed in all patients after peoperative survey. Indications for surgery were based on medical history data, the severity of respiratory failure and survey data. Sliding traсheal plasty by different approach esunder extracorporeal membrane oxygenation was applied in all patients. RESULTS: There were no intraoperative complications. In the study group 1 patient died in remote postoperative period after discharge due to deterioration of his condition caused by upper respiratory tract infection and acute respiratory failure. In immediate postoperative period 1 patient had pronounced growth of granulation tissue in the area of anastomosis followed laser photocoagulation and prolonged intubation. The average ICU-stay was 24 days, the duration of mechanical ventilation - 11 days. Follow-up carefor patients was conducted on terms of 4-6 and 12 months after surgery. In 2 patients moderate complaints of recurrent bronchitis without signs of respiratory insufficiency during 6-8 months postoperatively were observed. In one child complaints were completely absent.

[Thoracoscopic lung resection in children].

The spectrum of pulmonary surgical pathology in newborns and infants is mainly presented by congenital diseases. Surgery is the main radical method of treatment of children with congenital lung diseases. By this time in the N.F.Filatov City Children's Hospital No13 it is performed more than 1000 endoscopic operations on the thoracic cavity including more than 300 lung resections. More than 190 cases were caused by congenital lung disease. The results of treatment of 194 infants with congenital lung disease for the period 2005-2014 are analyzed in this article. 14 (22%) patients were operated urgently. 8 patients (12%) with compensated respiratory failure underwent surgery at the age of 8 to 46 days. Children with absence of clinical manifestations underwent thoracoscopic lung resection at the age of 3 to 8 months. Thoracoscopic lobectomy was performed in the 40 cases (62%). There were no intraoperative complications. Thoracoscopic lung resection for malformations in newborns and infants is currently the method of choice. It allows to visualize pathological focus intraoperatively and to perform precise dissection of pulmonary root structures using modern equipment. Thus, it improves course of postoperative period and reduces duration of hospital-stay. Repeated lung resection in patients with recurrent tuberculosis of operated lung (literature review and own data).

[Endosurgical treatment of the bile duct lesions in children].

UNLABELLED: Question of feasibility of laparoscopic Kasai procedure and laparoscopic hepaticojejunostomy for biliary atresia (the BA) and choledochal cysts (the CC) in children has been a subject of discussion for a long time and still remains unsolved. AIM: To improve the results of surgery for biliary tract malformations (the BTM) in children using laparoscopic technique. MATERIALS AND METHODS: The are 55 patients with BA and CC, who were performed endosurgical operations, and 37 patients, who were performed traditional open surgical procedures. During this study we worked out and put into laparoscopic practice some new methods. We've made an analysis of technical features of liver transplantation after laparoscopic and traditional Kasai's operation in BA. RESULTS: The duration of laparoscopic Kasai procedure was significantly longer than open surgery (p < 0.05). In CC the duration was the similar (p > 0.05). There was no any urgent surgical complication after laparoscopic Kasai procedure in contrast to open surgery. We observed significantly fewer complications (40%) after laparoscopic hepaticojejunostomy than after traditional hepaticojejunoduodenostomy (84.6%, p < 0.05). The average length of stay in ICU and duration of analgesia after laparoscopy was significantly lower than after open surgery (p < 0.05). Comparing the efficiency of endosurgery and traditional operations using coloration of stool, decreasing of bilirubin level and the presence of indications to liver transplantation criteria we didn't find any significant difference (p > 0.05). CONCLUSION: At the same efficiency of laparoscopic and open reconstructive surgery for BA and CC the first has a number of incontrovertible advantages. Our experience allows us to recommend laparoscopic procedures to perform for the correction of BTM in children.

[The organization of medical stomatological care of women in post-natal period].

The article presents the following new data. The medical social aspects of women with stomatological pathology during post-natal period are characterized by age gender, professional, educational and organizational aspects. The issues of impact of characteristics of medical stomatological care of women in post-natal period are considered. The results of survey of women in post-natal period using questionnaire targeted to detection of stomatological diseases are presented.