Multiple myeloma is a malignant tumor of B-lymphocytes with a different clinical picture and course, which is based on cytogenetic and molecular genetic changes. Due to the use of new diagnostic methods FISH (fluorescence in situ hybridization) and NGS (new generation sequencing), it became possible to detect various anomalies associated with the course and prognosis at the initial stage. This makes it possible to stratify patients by risk groups and take these data into account when choosing therapy. High-risk aberrations include deletion 17pt, (4;14), t(14;16), t(14;20), and chromosome 1 abnormalities, as well as mutations in the KRAS and NRAS genes. Patients with these changes are at high risk. They have a lower survival rate and worse prognosis compared to the standard risk group. Therefore, clinicians need to take into account the data of cytogenetics and molecular genetics when making a decision regarding treatment. This will improve the survival and quality of life of this group. The article presents an overview of the most common cytogenetic and molecular genetic rearrangements in multiple myeloma, in confirmation a description of a clinical case is given.

The aim of this literature review is to summarize current data on the morpho-functional characteristics of microglia. The article presents a modern view on the role, function and histological characteristics of microglial cells with an emphasis on the transformation of cells during their activation and dystrophic changes. Several morphotypes of microglial cells are described depending on their functional activity. Variants of dystrophic changes in microglial cells, which are more common in neurodegenerative diseases, are presented.

The risks from military operations significantly exceed the risks inherent in the design decisions of the NPP. It is possible to destroy the protective barriers of nuclear power plants and release into the environment of nuclear fuel, its fission products and activated materials in a gaseous state. The radiation threats to the Republic of Belarus come from the Smolensk and Rivne nuclear power plants. As a result of hostilities at nuclear power plants of neighboring states, it is possible to exceed the response criterion for protective actions aimed at reducing the risk of stochastic effects (50 mSv in 7 days with thyroid irradiation). The use of stable iodine may be recommended in the Belarusian segment of the radioactive trace in the event of hostilities at a nuclear power plant. Other protective measures may be deemed appropriate In the acute phase on the axis of the radioactive trace. In the case of explosions in spent nuclear fuel storage facilities, the main dose-forming radionuclides are 137Cs and 90Sr, which have high migration properties in the food chain. There is a high probability of contamination of agricultural products in excess of the established standards, first of all - 90Sr. As a result of the rise of radionuclides in air during fires and the movement of heavy equipment in the exclusion zone of the Chernobyl NPP, the inhalation intake of radionuclides into the body of residents of Belarus is negligible. It is necessary to support the proposal of the Minister of Energy of Ukraine on the creation of 30-km demilitarized zones around nuclear power facilities.

The aim of the work was to substantiate the maximum concentration limit in the air of the working area (MCLawa) of dust of dry products containing a complex of whey proteins of cow’s milk (WPM), according to the criterion of their leading harmful effect on the body. In experiments with subchronic inhalation intake into the body of white rats, it was found that WPM concentrations at the level of 3,0 and 1,0 mg/m3, which form pronounced dose-dependent allergic, general toxic and immunotoxic effects in the animal body, were active. The concentration at the level of 0,3 mg/m3 was defined as the threshold for the limiting indicator of the allergic effect, which was detected only in 40% of the experimental animals, and the concentration at the level of 0,1 mg/m3 was not effective. According to the criterion of the leading harmful allergic effect of WPM on the body, the value of MCLawa for aerosols of dry products containing whey proteins of cow’s milk, equal to 0,1 mg/m3 for protein marked «allergen», was substantiated.

A comparative analysis of the effective doses of patients in the Gomel region from medical X-ray diagnostics for 2015 and 2020 (the beginning of the coronovirus infection pandemic) was carried out. As a result of the comparative analysis, an increase in the number of chest computed tomography studies in 2020 compared to 2015 by 7,4 times was revealed, while the collective dose increased by 8,2 times. The collective dose of medical exposure to the population of the Gomel region in 2020 is 1,4 times higher than in 2015. Computed tomography made the largest contribution to the collective dose of patients in the Gomel region from X-ray diagnostic studies of the chest cavity in 2020 - 59%, which is 2,8 times higher than in 2015. The widespread introduction of chest X-ray and computed tomography in the diagnosis of COVID-19 has increased patient exposure by 40%.

An analysis of the birth rate in the context of the urban and rural population of the Gomel region in dynamics for 2009-2019 was carried out. The sources of information are the official data of the National Statistical Committee of the Republic of Belarus on the number of live births and birth rates of the urban and rural population of the Gomel region. In 2019, compared to 2009, a statistically significant decrease in the birth rate of the population of the Gomel region was established due to a statistically significant decrease in the birth rate of the urban population and the rural population. Among the urban population, a statistically significant decrease in the birth rate in 2019 compared to 2009 was found in the city of Gomel, and the Dobrush, Yelsk, Zhlobin, Kalinkovichi, Lelchitsy, Loev, Mozyr, Rechitsa, Rogachev, Svetlogorsk districts, among the rural population - only in the Gomel district. The number of children ever born in the region decreased by 20,0% in 2019 compared to 2009. The minimum values of the birth rate of the urban and rural population of the Gomel region were registered in 2019, the maximum value of the birth rate of the urban population of the Gomel region was registered in 2015, rural - in 2016. The range of values for the birth rate of the rural population is 1,2 times greater than the range of values for the birth rate of the urban population. A statistically significant decrease in the birth rate of the population of the Gomel region in 2019 compared to 2018 is due to a statistically significant decrease in the birth rate among the rural population. Among the urban population, a statistically significant decrease in the birth rate in 2019 compared to 2018 was found only in the city of Gomel and in the Kalinkovichi district. Among the rural population, a statistically significant decrease in the birth rate in 2019 compared to 2018 was found only in the Buda-Koshelevo and Rogachev districts of the Gomel region. Measures aimed at increasing the birth rate in the region have been developed.

We have carried out an analysis of perception of social and environmental factors, motivational and psychological characteristics in 114 adults divided into vaccinated and unvaccinated (antivaxxers) against coronavirus infection (COVID-19) according to the author’s method. The surveyed are represented by 4 groups. The obtained data made it possible to determine the difference between antivaxxers in terms of the studied characteristics and to give recommendations for optimizing the vaccination company.

The article presents a comparative analysis of laboratory criteria for patients with adrenal incidentalomas. Based on the data of statistical analysis, additional criteria were identified, the presence of which indicates the degree of risk of developing subclinical Cushing’s syndrome within 3-5 years. The use of additional diagnostic criteria made it possible to assess the progression of target organ damage in patients in whom the hormonal activity of a benign adrenal neoplasm was not confirmed during the initial examination. To systematize and rationalize the examination of patients with adrenal incidentaloma, a diagnostic algorithm has been developed. The autonomous hypersecretion of cortisol by the formation of the adrenal gland is determined. After additional examination, patients are distributed to one of the following groups: 1) hormonally inactive adrenal formation/group of low risk of SCS development; 2) patients with SCS/high risk of developing SCS. Treatment tactics are formed individually depending on the age and severity of the comorbidity.

The analysis of ultrastructural changes in stapes (pedicles and head) of 18 patients with otosclerosis was carried out. The material for the study was taken during the surgical treatment of the disease (stapedoplasty). The structural changes in stapes were found: focal changes in the bone tissue were characteristic of the active process of resorption and lysis with osteocytes activation, as well as manifestations of active mineralization of bone, the absence of its restructuring into the classic lamellar bone, and foci of abnormal osteogenesis. This study showed ultrastructural changes in stapes in patients with otosclerosis.

The article reviews the features of the perception of the problem of smoking by the population on the example of studying the attitude of various categories of the population to the problem of smoking.The survey results of the population on the issues of smoking are presented, an assessment of the main factors that can contribute to the formation of public opinion on the spread of tobacco smoking. It will also let identifying factors for the introduction of new mechanisms that contribute to smoking cessation.

We have determined the risk of developing renal alograft dysfunction in patients with chronic kidney disease at organ transplantation based on an assessment of the total plasma antioxidant capacity. The pro/antioxidant balance of the blood plasma of recipients was studied before surgery and 24 hours after by the method of luminol-dependent chemiluminescence (LDCL) on a fluoriometer/spectrophotometer. We evaluated the main indicator of LDCL luminescence intensity (Imax). According to the study results, Imax before surgery in patients with RAD did not differ from recipients with NGF. As early as 24 hours after kidney transplantation, there was a significant decrease in the level of pro/antioxidant balance in blood plasma in both groups of patients. On the seventh day, it was revealed that 17 patients had allograft dysfunction, and 30 had normal function. At the same time, after 24 hours the Imax level was higher in the group of patients with NGF than in the RAD group. Thus, assessment of the total antioxidant capacity of the plasma in patients in the early post-transplant period makes it possible to determine the probability of developing renal allograft dysfunction.

The ultrasonic characteristics of the parathyroid glands were studied in 478 patients with CKD and 60 individuals in the comparison group. It has been established that the PTH 65 pg/ml corresponds to a PTG volume of 0,20 cm3; at PTH 185 pg/ml, the volume of the largest PTG is 0,31 cm3, the total volume is 0,33 cm3; for 500 pg/ml - 0,53 and 0,71 cm3, respectively; 1000 pg/ml - 0,88 and 1,31 cm3; 1500 pg / ml - 1,23 and 1,91 cm3. Insignificant differences in the size of the largest PTG and of the total PTG volume indicate that in SHPT there is a dominant PTG, the volume of which should be taken into account when making a clinical decision. The typical ultrasonic characteristics of hyperplastic PTG in SHPT were determined, in case of detection of which and the correspondence of the serum concentration of PTH to the volume of the visualized parathyroid tissue, further studies on imaging of the PTG are inappropriate. The limitations of the method are the presence of concomitant thyroid pathology, cases of PTG ectopia in areas inaccessible to ultrasound, as well as visualization of signs of hyperplastic parathyroid glands in 29,6% of cases in the absence of secondary hyperparathyroidism.

The article presents information on the incidence of cervical cancer in the Gomel region for the period from 2012 to 2019. In the structure of the incidence of women in the Gomel region, malignant tumors of the cervix in 2019 occupied the 10th ranking place and amounted to 2,65%. An increase in the incidence of cervical cancer among rural women from 14,520/0000 in 2014 was revealed to 33,530/0000 in 2019. When studying the age-specific incidence rates of cervical cancer, it was found that the maximum incidence rates were observed in the group of 35-39 years old - 30,42±3,30/0000. As a result of cytological studies using the liquid cytology method, it was found that in 95,9% of cases, pathological changes in the cervix were not detected. Cervical intraepithelial neoplasias of varying degrees (ASC-US, LSIL, HSIL) were found in 459 women, which accounted for 4,1%. The share of HSIL (44,5%) was detected in the age group of 25-39 years, which indicates a high incidence of precancerous diseases of the cervix in young women.

To establish the stages of diagnosis of immune mechanism disorders in preterm infants, a comprehensive clinical and laboratory examination of 120 infants born at Me=33,5 (29,5-35,0) weeks of gestation was performed, determining markers of T- and B-cell neogenesis (TREC/KREC) and subpopulations of T- and B-lymphocytes.The impaired immune mechanism in preterm infants was evidenced by a persistent decrease in peripheral blood lymphocytes ≤1.0×109/l after 4 days of life; reduced or undetectable levels of T- and B-cell neogenesis markers by 37 weeks postconceptional age; and reduced lymphocyte subpopulation scores.

The article presents the results of an experimental study of the IL-6 interaction with the synthetic peptide Ser-Phe-Tyr-Arg, which is a structural analogue of the soluble IL-6 receptor (gp80). The interaction of the peptide with the cytokine was been evaluated by the change in the concentration of IL-6, which was assessed by enzyme immunoassay. The binding efficiency was been calculated based on a statistical analysis of the dependence of the concentration of the complex IL-6 with the peptide on the initial concentration of the cytokine. Studies have shown that Ser-Phe-Tyr-Arg, both in free and immobilized form, has the ability to bind IL-6. The results obtained are the basis for the development of medical products for hemosorption in order to extract IL-6 from human blood plasma.

As a result of the study, the most significant differences in the frequency of occurrence between the group of patients with DM1 and the comparison group were identified for the alleles DRB1*03, DRB1*04, DQA1*0301, DQB1*0302, which gives reason to consider their carriage as a risk factor for the development of DM1. Moreover, we have identified DRB1*07, DRB1*13, DRB1*15, DQA1*0102, DQA1*0201, DQB1*0602-8 alleles which were significantly more common in the comparison group. It may indicate their «protective» nature. In our study the most specific for DM1 patients were the following genotypes: DRB1*03/*04, DRB1*04/*04, DQA1*0301/*0301, DQA1*0301/*0501, DQB1*02/*0302. The frequencies of genotypes with the participation of «protective» alleles turned out to be less specific for the comparison group than the individual frequencies of these alleles.In the group of patients with DM1, the DRB1*03 allele was found only in the DRB1*03-DQA1*0501-DQB1*02 haplotype. The DRB1*04 allele in most cases of DM1 was found in the DRB1*04-DQA1*0301-DQB1*0302 haplotype. The DRB1*04-DQA1*0301-DQB1*0304 haplotype was detected less frequently. Haplotypes prevailing in DM patients in the comparison group were characterized by low frequency.

The formation, preservation and strengthening of children’s health is a priority in modern society, since children will determine its social and economic development in the future. Currently, the weak development of the musculoskeletal system of children is of particular concern. Flexible bones can easily bend with incorrect poses and uneven loads. The slight extensibility of the musculoskeletal system provides children with well-expressed flexibility, but can’t create a strong muscular corset to preserve the normal location of bones, which leads to violations of musculoskeletal relationship of spinal column.The article presents changes in the strength endurance of the trunk muscles of children after the implementation of an improved program aimed at correcting violations of the musculoskeletal relationship of the vertebral column.

The review covers the methods of estimation of doses in organs and tissues and effective radiation dose to patients during diagnostic X-ray radiography. This estimation can be reliably made based on conversion coefficients, which were calculated using Monte-Carlo method in advance. One needs to specify the radiation yield or dose-area product, which were measured from the particular X-ray machine. Conversion coefficients are calculated for anthropomorphic phantoms. The calculation requires detailed description of the anatomy. The calculation can be performed on the doctor’s computer for specific exposure conditions if there is an opportunity. Computer programs for estimation of radiation dose to patients during X-ray radiography are reviewed.