[Improving surgical technique for tracheal resection with anastomosis]. / Usovershenstvovanie khirurgicheskoi tekhniki pri rezektsii lineinoi chasti trakhei s posleduyushchim anastomozom.

OBJECTIVE: To present modern aspects of improving surgical techniques in tracheal resection developed in recent years. MATERIAL AND METHODS: The authors have the most extensive experience in tracheal surgery (>2.000 patients over the past 50 years). Diagnostic capabilities, perioperative management and surgical techniques have changed over such a long period. This concerns the proposed classification of cicatricial tracheal stenosis, features of endoscopic and X-ray diagnostics, indications for various surgeries, choice of surgical approach, technique of tracheal tube mobilization and anastomosis after tracheal excision. Preventive measures for severe postoperative complications are described. CONCLUSION: Such an extensive experience allowed the authors to develop an algorithm for the treatment of patients with tracheal stenosis. This significantly reduced the incidence of postoperative complications and mortality. Replication of such equipment is associated with technical support of hospitals and professional level of specialists consisting of endoscopist, anesthesiologist, intensive care specialist and thoracic surgeon.

[Results of a clinical and experimental study of the safety and efficacy of Cytoflavin in combination with reperfusion therapy for ischemic stroke]. / Rezul'taty kliniko-eksperimental'nogo izucheniya bezopasnosti i effektivnosti primeneniya Tsitoflavina v sochetanii s reperfuzionnoi terapiei ishemicheskogo insul'ta.

OBJECTIVE: To study the efficacy and safety of Cytoflavin in combination with thrombolytic therapy. MATERIAL AND METHODS: At the first preclinical stage, the effect of Cytoflavin, solution for intravenous administration, on the fibrinolytic activity of alteplase (Actilyse) was studied in vitro. At the second, clinical stage, the safety and efficacy of Cytoflavin treatment, initiated within in the first 24 hours from the stroke onset and continued for 10 days, was evaluated in patients with acute stroke who received reperfusion therapy. At the clinical stage of the study, 200 patients were examined: 100 subjects of the main group who received reperfusion therapy in combination with Cytoflavin; 100 control subjects who received reperfusion therapy in combination with other drugs from the neuroprotective group as part of routine clinical practice. RESULTS: The preclinical study has demonstrated that alteplase in the studied concentrations debulks the mass of a thrombus by 2131%. There were no statistically significant differences in the reduction of thrombus weight with addition of Cytoflavin at various concentrations combined with alteplase to the incubation medium. The addition of Cytoflavin to the incubation medium with alteplase had no effect on the concentration of D-dimer in the rat's plasma. In the clinical study, there were no statistically significant differences in the frequencies of intracranial hemorrhages of various types between the study groups. In the multivariable analysis, significant predictors of intracranial hemorrhage were baseline NIHSS score, systolic blood pressure, history of diabetes and anticoagulant use, baseline CT ASPECTS score, but not the treatment group. CONCLUSION: The use of Cytoflavin in combination with thrombolytic therapy is safe. Up-to-date treatment of stroke which includes timely reperfusion and neurometabolic support of recovery leads to the rapid manifest regression of the neurological deficit and to the improvement in functioning and activity of patients with cerebral infarction.

[Efficacy and safety of Cytoflavin in the treatment of diabetic polyneuropathy: results of a multicenter, double-blind, placebo-controlled, randomized CYLINDER study]. / Effektivnost' i bezopasnost' primeneniya Tsitoflavina v terapii diabeticheskoi polineiropatii: rezul'taty mnogotsentrovogo dvoinogo slepogo platsebo-kontroliruemogo randomizirovannogo issledovaniya TsILINDR.

OBJECTIVE: The purpose of the present double-blind, placebo-controlled, randomized clinical trial was to evaluate the efficacy and safety of Cytoflavin in patients with diabetic polyneuropathy (DPN). MATERIAL AND METHODS: Investigational therapy was administered in two steps: intravenous infusions of experimental drug/placebo for 10 days followed by oral administration for 75 days. In 10 clinical centers, 216 patients aged 45-74 years with a diagnosis of type 2 diabetes mellitus, symptomatic distal sensorimotor DPN, confirmed no earlier than 1 year before screening, on stable therapy (no change of drugs and doses) by oral hypoglycemic drugs, intermediate-acting, long-acting or extra-long-acting insulin, and/or GLP-1 receptor agonists. RESULTS: By the end of treatment, the change of the Total Symptom Score (TSS) in the experimental group was -2.65 points, in the placebo group -1.73 points (p<0.001). Improvement of symptoms in the experimental group was achieved regardless of the degree of compensation for type 2 diabetes (both in those with Hb1Ac <8.0% and in those with Hb1Ac ≥8.0%), but demonstrated better results in patients with less severe baseline symptoms (TSS <7.5). Improvement in the components of the TSS scale «paresthesia¼ and «numbness¼ occurred as early as on day 11 of therapy; by the end of treatment, a significant decrease in the «burning¼ component was also demonstrated. The experimental drug had a positive safety profile. CONCLUSION: Cytoflavin, intravenous solution and enteric-coated tablets (SPTF Polysan Ltd.) is indicated for the symptomatic treatment of DPN.

[Study of the effect of Unifuzol on cognitive impairment and damage to the hippocampus and cerebral cortex during course administration to rats with bilateral stenosis of the common carotid arteries, causing chronic circulatory failure]. / Vliyanie preparata Unifuzol na sostoyanie kognitivnykh funktsii v usloviyakh eksperimental'nogo khronicheskogo narusheniya mozgovogo krovoobrashcheniya.

OBJECTIVE: To study the effect of Unifuzol (L-arginine sodium succinate) on cognitive impairment, cerebral blood flow, and damage to the tissues of the hippocampus and cerebral cortex during a 10-day course of administration to rats with chronic cerebral ischemia (CCI) caused by bilateral stenosis of the common carotid arteries (CCA). MATERIAL AND METHODS: The study was conducted on male rats with CCI caused by bilateral stenosis of the CCA by 60%. 40 days after surgery, rats received Unifusol (21, 42 and 84 ml/kg), nicergoline (10 mg/kg), citicoline (500 mg/kg) or placebo (0.9% NaCl) for 10 days. Next, cognitive impairments were assessed in the Morris Water Maze and the New Object Recognition (NOR) test, as well as the level of motor and exploratory activity in the Open Field test. The level of cerebral blood flow was determined immediately after the CCA stenosis and at the end of the experiment. Animals were euthanized in a CO2 incubator, after which the brain was removed and subjected to morphometric analysis. RESULTS: In animals that were modeled with CCA stenosis, pronounced behavioral and cognitive impairments occurred as a result of a decrease in blood flow in the vessels of the brain and subsequent changes in the tissues of the hippocampus and the cerebral cortex. Intravenous course administration of Unifuzol at doses of 42 and 84 ml/kg to animals with CCI was comparable in efficiency to nicergoline and citicoline, which was expressed in greater preservation of the cognitive abilities of animals in the Morris Water Maze and NOR tests. In the Open Field test, animals injected with Unifusol at doses of 42 and 84 ml/kg performed more acts of motor and exploratory activity than animals from the placebo group, and had a higher level of cerebral blood flow (compared to animals that were injected with citicoline). Based on the results of a morphological study, it was found that the most significant neuroprotective effect was provided by nicergoline and Unifuzol (at doses of 42 and 84 ml/kg). CONCLUSION: Unifuzol at a course of administration at doses of 42 and 84 ml/kg, comparable to the reference drugs nicergoline and citicoline, reduces the severity of psychoneurological deficit in animals with CCI, comparable to them improves the microcirculation of brain tissues, preventing damage to brain tissues.

Effect of Lysine Acridone Acetate on the Level of Apoptosis and Expression of Apoptosis-Associated Proteins during Antioncogenic Therapy in Colorectal Cancer in Mice.

We studied the mechanism of action of cytostatics with the addition of lysine acridone acetate to evaluate the possibility of its use for improving the effectiveness of antioncogenic therapy in colorectal cancer. In Nude mouse model, the level of apoptosis (TUNEL) and expression of proteins CD95, p53, Bcl-2, histone H3, and Ki-67 (immunohistochemistry) were assessed in primary tumor biopsy specimens. It has been shown that cytostatic treatment led to stimulation of p53-mediated apoptosis and suppression of proliferation (Ki-67 expression) of tumor cells, and apoptosis level was increased in groups receiving lysine acridone acetate. H3 expression in the experimental groups was changed.

The rare thoracic complication: perforation of gastric fundus ulcer: a case report.

BACKGROUND: Gastropleural fistula is an exceptionally rare condition, the incidence of which is currently unknown (Kunieda et al. in Intern Med 51(3):331, 2012,  https://doi.org/10.2169/internalmedicine.51.6823 , Iqbal et al. in Cureus 11(2):e4136, 2019, https://doi.org/10.7759/cureus.4136 , Kathayanatt et al. in Lung India 37(2):174-175, 2020, https://doi.org/10.4103/lungindia.lungindia_242_17 ). The etiology varies from traumatic or iatrogenic injury to perforation in a herniated stomach due to ischemia, ulceration, or malignancy. CASE PRESENTATION: A 27-year-old European male presented to our hospital with complaints of general weakness and shortness of breath. The patient had a single episode of hemoptysis before admission. A computed tomography scan demonstrated a left-sided pyopneumothorax, a defect in the left main bronchus, and signs of pneumonia in the lower sections of the right lung. Therefore, a rare complication of perforation of a gastric fundus ulcer with the formation of a subdiaphragmatic abscess, gastropleural fistula, gangrene of the left lung with circular necrosis of the left main bronchus and diastasis of its edges, and pleural empyema on the left is presented in this report. CONCLUSIONS: Although, a radical surgery may be preferable for this suspected malignancy; it should be weighed carefully against the risk of sepsis and the morbidity associated with a prolonged procedure in a sick patient. Damage-control surgery may be a viable option for a very sick patient, with more extensive resection reserved for later, provided the risk of infection and bleeding has been mitigated.

[Development of an algorithm for the appointment of biofeed-back therapy and Cytoflavin for the treatment of osteochondrosis in elderly patients.]

Continuous improvement of protocols for the treatment of various ailments, in particular, osteochondrosis, is one of the important tasks of providing medical care to elderly patients. Supplementation of treatment with Cytoflavin and biofeed-back therapy seems to be a promising solution, however, it is necessary to develop an algorithm to predict it effectiveness in patients taking into account their initial clinical and psychophysiological status. As a result of the treatment, predictors of the effectiveness of the use of Cytoflavin and biofeed-back therapy have been identified and an algorithm for their administration has been developed.

[Biofeed back therapy and Cytoflavin in the system of medical support of the training process of elderly hockey players.]

One of the ways to improve the condition of the elderly body is the method of auto-training with biofeedback, as a means of correcting deviations in the functioning of the regulatory apparatus, as well as improving antioxidant protection and eliminating the effects of oxidative stress using Cytoflavin therapy. These methods seem to be a simple and effective means of correcting negative changes in the FS of elderly hockey players after a training cycle and ensuring the possibility of a more complete recovery of their body. The difference in the points of application made it possible to combine the intake of Cytoflavin and biofeedback training into a single complex correctional and restorative technique. Purpose of the research: to consider the organizational and methodological aspects of introducing a comprehensive methodology for correcting the functional state of elderly hockey players into the system of support of their training process. Based on the results of the study, we have obtained convincing data on the positive effect of the inclusion of Cytoflavin and biofeedback training in the system of medical support for the training process of elderly hockey players. The organizational and methodological aspects of introducing a comprehensive methodology for correcting the functional state of older hockey players into the system of support for their training process considered in this article make it possible to solve a number of problems facing medical workers regarding continuous monitoring of the functional state of older hockey players, proactive diagnosis of their negative deviations, as well as a system of reabilitation.

[Simultaneous surgery for concomitant lung cancer and diffuse coronary atherosclerosis]. / Simul'tannye operatsii pri rake legkogo i diffuznom koronarnom ateroskleroze.

OBJECTIVE: To evaluate the early outcomes of simultaneous surgeries in patients with concomitant lung cancer and coronary artery disease. MATERIAL AND METHODS: We retrospectively reviewed 37 consecutive patients who underwent CABG with adjunct endarterectomy (n=21) or long segmental coronary artery reconstruction (n=25) and lung resection between 2003 and 2019. Mean age was 61.4±6.7 (range 58-71) years. Males prevailed (n=32, 86.4%). Median sternotomy was used in all patients. Myocardial revascularization was followed by on-pump lung resection. The most common procedure was lobectomy (94.6%) of the right upper lobe (83.7%). Lymph node dissection was performed in all patients. RESULTS: CPB time was 162±19.3 min, aortic cross-clamping time 71±14.2 min. There was no in-hospital mortality. Incidence of perioperative myocardial infarction was 5.4%. Postoperative complications were atrial fibrillation (n=6, 16.6%), re-exploration for bleeding (n=1, 2.7%), pneumonia (n=2, 5.4%). Mean hospital-stay was 14.4 days (range 11-21). CONCLUSION: Simultaneous lung resections and coronary artery reconstruction is a safe and reliable surgical method in patients with diffuse coronary atherosclerosis and lung cancer. The developed system of choice, evaluation and surgical treatment of patients with concomitant cardiopulmonary pathology is fundamental for successful treatment of these difficult patients. We need larger randomized studies for certainty.

[The results of phase III multicenter open randomized controlled study REM-Chol-III-16 in patients with intrahepatic cholestasis syndrome caused by chronic diffuse liver diseases].

AIM: To assess the safety and efficacy of Remaxol, solution for infusion, compared with parenteral form of S-adenosyl-L-methionine, in the treatment of patients with intrahepatic cholestasis syndrome accompanying chronic diffuse liver diseases of various etiology. MATERIALS AND METHODS: In a multicenter open-label comparative study of the safety and efficacy of Remaxol (inosine + meglumine + methionine + nicotinamide + succinic acid) 317 patients aged 18 to 65 years were randomized into 2 groups: patients of the experimental group (n=168) received intravenous Remaxol, solution for infusion, 400 ml, and patients of the control group (n=149) Heptral (S-adenosyl-L-methionine) 800 mg. The duration of treatment was 10 days. The primary efficacy endpoint was the proportion of patients who responded to therapy, as demonstrated by dynamics of laboratory parameters of liver functional status: decrease in gamma glutamyl transpeptidase level by 40%, and/or alkaline phosphatase level by 30%, and/or decrease total bilirubin level by 30% from baseline by the end of the treatment course. RESULTS: The proportion of responders was 51% in the Remaxol group vs. 44.9% in the Heptral group (p=0.303); the lower limit of the one-sided 95% confidence interval for the difference in the proportions of responders was -4.01%, which exceeds the non-inferiority margin pre-defined by the study protocol, thus, the non-inferiority hypothesis was proven, i.e. Remaxol at a dose of 400 ml/day demonstrates similar efficacy to Heptral at a dose of 800 mg/day in patients with intrahepatic cholestasis syndrome associated with chronic diffuse liver diseases. Similar positive trends in the levels of transaminases, total bilirubin and the severity of pruritus were revealed in both treatment groups. We did not reveal statistically significant between-group differences in the frequency of adverse events definitely related to the study treatment. CONCLUSION: Administration of Remaxol as a part of the pathogenetic therapy of patients with intrahepatic cholestasis syndrome who need hepatoprotection is justified.

[Cytoflavin as a modulator of rehabilitation treatment of patients with ischemic stroke complicated by post-intensive care syndrome]. / Tsitoflavin kak komponent reabilitatsionnogo lecheniya patsientov s ishemicheskim insul'tom, oslozhnennym PIT-sindromom.

OBJECTIVE: To assess an effect of cytoflavin on the results of rehabilitation treatment and the increase in exercise tolerance in patients with stroke complicated by post-intensive care syndrome (PICS). MATERIAL AND METHODS: The data of 53 patients who underwent neurorehabilitation in the ICU after ischemic stroke were analyzed. Depending on the treatment regimen, the patients were divided into two groups. Group 1 (main, n=36) received cytoflavin (iv drip in a volume of 10 ml of a solution for injections per 200 ml of a 0.9% solution of sodium chloride) for 10 days in addition to the complex of neurorehabilitation measures. Group 2 (control, n=17) included patients, who had only a standard set of neurorehabilitation measures for 10 days. The efficacy of the therapy was evaluated using indirect calorimetry, and the oxygen and energy load price index was calculated. To assess the tolerability of rehabilitation methods, a verticalization test was used. Treatment tolerance was assessed by the incidence of adverse reactions in each group. RESULTS AND CONCLUSION: The components of the energytropic effect of cytoflavin can have a positive modulating effect, increasing the tolerance of rehabilitation measures for the treatment of PICS in patients with ischemic stroke. Further research is required.

[Transsternal occlusion of main bronchi fistulae after pneumonectomy]. / Transsternal'naya okklyuziya svishcha glavnogo bronkha posle pnevmonektomii.

OBJECTIVE: To summarize our experience in transsternal occlusion of main bronchus fistula. MATERIAL AND METHODS: We have performed 146 transsternal occlusions of the main bronchi for the period from 1979 to 2018. There were 123 (84.2%) men and 23 (15.7%) women. Mean age of patients was 63 years. Lung tuberculosis was diagnosed in 36 (24.7%) patients, lung cancer - 91 (62.3%) patients, non-specific suppurative lung diseases - 14 (9.6%) patients, trauma - 5 (3.4%) patients. All patients underwent transsternal occlusion of the main bronchi fistulae with or without pericardial cavity dissection. Wedge-shaped bronchial resection or tracheal bifurcation resection were carried out for a short stump fistula. RESULTS: Perioperative complications occurred in 28 (19.2%) out of 146 patients. Intraoperative complications developed in 4 (2.6%) patients. Postoperative complications were observed in 25 (17.1%) patients. Intraoperative mortality rate was 1.4% (n=2), postoperative mortality - 6.2% (n=9). Thus, overall mortality rate was 7.6% (n=11 It should be noted that intraoperative complications were absent if dissection of the pericardium and pulmonary artery stump ligation were not performed. CONCLUSION: Transsternal occlusion of the main bronchi fistulae was successful in 80.8% of patients. In these cases, healing of fistulae was not associated with any complications. Thus, we believe that transsternal occlusion of the main bronchial stump fistula should be considered as preferable surgical strategy.

[Cytophlavin inclusion in complex treatment of diabetic foot syndrome with signs of lower limb blood vessels medicalcinosis]. / Vkliuchenie Tsitoflavina v komleksnom lechenii sindroma diabeticheskoi stopy s priznakami mediakal'tsinoza sosudov nizhnikh konechnostei.

The aim of this study was to evaluate the effect of cytoflavin inclusion in therapy regimens of patients with diabetic foot syndrome and medicalcinosis on the microcirculation of the lower limb blood vessels. For this purpose, 64 patients with type II diabetes mellitus (subcompensated form), diabetic foot syndrome and signs of medicalcinosis foot blood vessels of various severity were examined. All patients were divided into 2 groups depending on the therapy scheme: patients of group I (33 people) received insulin, antibiotics, disaggregants, statins, anti-inflammatory drugs, painkillers, detoxification therapy. Patients of group II (31 patients) in addition to the main therapy received cytoflavin according to the scheme: 10 ml per 0.9 ml NaCl 200 ml intravenously, drip at a rate of 60 cap/min, 10 days course, then 2 tablets 2 times a day for 1 month. The severity of the microangiopathy of the lower extremities was assessed considering transcutaneous oximetry data in dynamics (before treatment, on the 10th and 40th day of therapy) gained using TCM-2 device (RADIOMETER, Denmark) with has heating oxygen electrode type Clarc. Before the treatment subcompensated level of metabolic disorders corresponding to the II degree of microcirculatory disorders was registered in all patients. Against the backdrop of cytoflavin inclusion in the complex therapy, there was an improvement in the metabolic rate (up to compensated) with a decrease in the degree of microcirculation disorders up to I degree. Positive dynamics of metabolic disorders significantly reduced frequency and extent of surgical interventions. The results obtained suggest that cytoflavin should be included in the treatment regimens of patients with this pathology.

[Peculiarities of barbituric acid derivatives acute poisoning clinical picture in patients of elderly and senile age and their therapy.]

In this article materials obtained during treatment of 61 patients with acute poisoning with phenobarbital, which is part of Corvalol and Valocordin, are presented. It has already been established that phenobarbital acute poisoning in elderly and senile patients is accompanied by more frequent development of central nervous system, respiratory system (pneumonia) and cardiovascular system complications, which cause more severe clinical course and risk of an adverse outcome of acute poisoning. This research has shown that for hypoxia correction during phenobarbital acute poisoning in elderly and senile patients it is advisable to include Reamberin in the treatment regimen, which has no adverse effects on central haemodynamic parameters and effectively reduces severity of metabolic disorders.

[Clinical efficacy of the immunomodulatory agent cycloferon (tablets) in viral respiratory infections: Results of a systematic review and meta-analysis]. / Klinicheskaia éffektivnost' immunomoduliatora tsikloferona (tabletki) pri virusnykh infektsiiakh organov dykhaniia: rezul'taty sistematicheskogo obzora i metaanaliza.

The authors carried out a systematic review and subsequent meta-analysis of randomized clinical trials evaluating the efficacy of the immunomodulator agent cycloferon as tablets in adults and children with viral respiratory diseases. A total estimate of its clinical efficacy was obtained in terms of compared heterogeneous groups and response variables. The data published in 16 articles were used to calculate the formal parameters of the clinical efficacy of cycloferon (increased absolute and relative benefits, odds ratio (OR); the number of patients needed to be additionally treated with cycloferon to achieve a favorable outcome or to prevent a poor outcome in one patient, etc.). High heterogeneity hampered the unequivocal interpretation of results; however, combining the compared homogeneous groups in the meta-analysis (with adjustments for fixed and random effects) increased the statistical power of the investigation. In children aged 6 to 18 years, the OR for the positive effect of the drug (no new cases after its preventive administration) was 5.3 (95% confidence interval (CI), 4.8-5.9), heterogeneity test, χ2 = 249.5; p=0.000...; I2 = 94.8% (95% CI, 92.7-96.3%). This suggested the heterogeneity of clinical trial data and extrapolated this estimate to medical practice. The use of cycloferon in adults to treat acute respiratory viral infection enhanced their chances of enduring the disease in a mild form and avoiding serious complications: the OR for positive outcomes was 9.7 (95% CI, 7.0-13.0), while the effect was more homogeneous than in children (heterogeneity test, χ2 = 7.4; p=0.061...; I2 = 59.4% (95% CI, 0-86.5). Thus, the use of cycloferon to treat and prevent acute viral respiratory infections showed a more than 5-fold increase in the probability of avoiding the disease or enduring the latter in a mild form.

[Evaluation of bio-inverse communication and Cytoflavin effects on the dynamics of the clinical and psychophysiological condition of elderly patients with osteochondrosis].

We conducted a study of 150 patients on the basis of polyclinic № 91 in St. Petersburg. The effect of Cytoflavin and bio-inverse communication therapy on the dynamics of the condition of elderly patients with osteochondrosis was evaluated. A number of positive effects from such an addition to existing therapy, potentiating the nominal effect, were revealed.

[Effect of the Cytoflavin on the distal polyneuropathy severity in patients with diabetic foot syndrome with arteries mediacalcinosis]. / Vliianie tsitoflavina na vyrazhennost' distal'noi polineiropatii u bol'nykh sindromom diabeticheskoi stopy s mediakal'tsinozom arterii.

The aim of the study was to evaluate the effectiveness of cytoflavin in the complex treatment of patients with diabetic foot syndrome. MATERIAL AND METHODS: The research is based on the results of a comprehensive survey of 140 people with diabetic foot syndrome. Depending on the treatment, all patients were divided into 2 groups. The first group (n=35) received basic therapy. The second group (n=35) in addition to basic therapy received cytoflavin 10 ml (+200 ml 0.9% NaCl) for 10 days, followed by switching to the tablet form of the drug 2 tablets twice a day for 1 month. RESULTS: Analyzing the severity of polyneuropathy after treatment, we noted a more positive dynamic in patients who in addition to standard therapy received cytoflavin.

[Microelemental homeostasis correction of and oxidative stress in patients with acute intestinal obstruction]. / Korrektsiia narushenii mikroélementnogo gomeostaza i okislitel'nogo stressa u patsientov s ostroi tonkokishechnoi neprokhodimost'iu.

AIM: To improve the results of treatment of patients with acute small bowel obstruction. MATERIAL AND METHODS: The research is based on the results of a comprehensive survey 202 people with acute small bowel obstruction. Reamberin was used in 102 patients treatment. RESULTS: It was established that metalloenzymes take an active part in the formation of endotoxemia in people with acute small bowel obstruction. Also, in patients as a result of an imbalance between oxidant and antioxidant systems, accumulated a significant amount of lipid peroxidation products, along with it a decrease activity of enzymes of antioxidant system. reamberin application in complex treatment of acute small bowel obstruction provided the reduction in the time correction of oxidative stress by preventing the growth and activity of lipid peroxidation products with simultaneous stimulation of the antioxidant system and contributed to the normalization of microelement homeostasis.

[Optimization of tissue reparation at treatment by Remaxol]. / Optimizatsiia protsessa reparatsii tkanei pri ispol'zovanii Remaksola.

AIM: Studying influence of remaxol on reparative process of tissue reparation in a laparotomy wound. MATERIAL AND METHODS: 90 patients with the acute appendicitis complicated by local peritonitis in the early postoperative period are examined. 50 patients received traditional therapy. Therapy of other 40 patients included Remaxol (intravenous introduction, daily within 5 days, of 400 ml). RESULTS AND CONCLUSION: It is established that Remaxol optimizes the course of reparative process in laparotomy wound that was confirmed with data of tenziomety and wound exudate cytological research. Efficiency of a Remaxol is based on its capability to improve microcirculation, antiedematous action and its capability to reduce excessive intensity peroxide oxidation of membrane lipids, phospholipase activity and the phenomena of a hypoxia.

[Peculiarities of clinical and psychophysiological status of elderly patients with osteochondrosis.]

We conducted a study of 220 patients in polyclinic № 91 in St. Petersburg. It was revealed that elderly patients with osteochondrosis are characterized by a high prevalence and severity of osteochondrosis against the background of metabolic disorders in the structures of the spine. At the same time, the actual condition of the spine does not always determine the severity of the pain syndrome. The effect of osteochondrosis on the development of comorbid pathology has been clarified. The ways of correction of the clinical and psychophysiological status of elderly patients with osteochondrosis such as appointment of Cytoflavin, behavioral therapy and biofeed back therapy are suggested.