Acute on chronic liver failure - a new clinical syndrome characterized by acute decompensation in patients with chronic liver disease, leading to the development of multiple organ failure and is characterized by a high mortality rate. From a pathophysiological point of view, based on the development of this syndrome is excessive systemic inflammatory response to the provocation. The extent of the immune response and the severity of organ failure determines the outcome of patients with acute on chronic liver failure. Most often diagnosed in young patients with active alcoholism, reactivation of hepatitis B, severe in patients without decompensated cirrhosis history.

The review deals with new approach in studies of physiological aspects in behavior of specific steroid transport blood proteins, namely, testosterone-binding globulin (TeBG) and cortisol-binding globulin (CBG, transcortin). Authors established experimentally that the dissociation of steroid transport proteins complexes occurs after the target delivery of steroid hormones in venous blood. It accompanied by disappearance of TeBG & CBG cooperative properties and exhibition of all hormone binding sites on these transport proteins. Authors hypothesized that lactate molecules accumulation (e.g. at the shortage of O2 molecules in the bloodstream during physical exercises) can serve as an additional adaptive mechanism to ameliorate providing of working muscles with testosterone by TeBG. According the data obtained the determination of total testosterone concentration in venous blood using RIA kits can is a voluble test for assessment of the physiologically active hormone in the arterial blood (that can be freed by TeBG and taken by target tissues) and mirror the concentration of TeBG molecules in the circulation at puberty.

Leukemic cells accumulate mutations and epigenetic changes in the process of disease development forming heterogeneous cell populations that are subject to selection and may respond differentially to therapy. Chemotherapy in turn damages new DNA generating mutations, and may kill leukemia cells most sensitive to drugs and select drug induced resistant subclones. Therefore, it is necessary to monitor changes in the subclonal composition during disease progression as such increased leukemia cell clonal evolution is the main reason for drug resistance and treatment insufficiency. Targeted treatment may be based on the molecular type of disease and on the tested cellular chemosensitivity of the individual patient at least for remission induction. Cellular drug sensitivity evaluation is not alternative to minimal residual disease estimation and whole exome sequencing. As it is not so easy to inhibit tumor evolution, diagnostics of cells sensitivity in the process of evolution may be of particular interest with remission induction. However, advantages of monitoring procedures sometimes are not so obvious.

The accident at the Chernobyl nuclear power plant was the largest radiation-ecological catastrophe, which was accompanied by a massive release of the radioactive isotope of iodine, which was assimilated by a large part of Belorussian people. The aim of this work was to investigate the incidence of thyroid cancer in Belarus and assess the risk of developing this disease in various groups of affected cohorts. The data from the State Register of persons affected by the Chernobyl accident (from 1987 to 2015) and the data of the Belarusian Cancer Registry (from 1978 to 2015) were used in the study. The analysis was conducted using crude rates (CR), age-specific rates (AsR) and age-standardized rates (ASR) and standardized incidence ratio (SIR). It was shown the intensive increase in the incidence rates of thyroid cancer in the Belorussian population after the Chernobyl accident, which finished after 2001 (CR1986=1,5±0,24, CR2001=10,3±0,63, CR2015=12,5±0,71). Thyroid cancer growth was most significant in most contaminated Gomel, Mogilev and Brest areas. It was shown that the maximum increase in incidence was observed in persons aged 0-4 years at the time of the accident. In the affected population, significantly high risk of thyroid cancer was noted in all groups. The risk was highest in the evacuees in 1995-1999 (SIR=13,0 (9,21-17,70)) and was significantly higher than in the liquidators (SIR=4,4 (3,63-5,25)) and in the cohort of living in contaminated areas (SIR=2,4 (1,88-2,98)). The risk was higher in men than in women, for those who were children at the time of the accident and who were in the most contaminated areas. The dose-response relationship was shown for the evacuees (rS=0,9, p=0,037) and for persons living in contaminated areas (rS=1,0, p<0,001). For the group of liquidators, the dose-effect relationship was not noted (rS=-0,48, p=0,329).

Аlgorithm оf the medical rehabilitation for the pulmonary sarcoidosis patients was designed. It is consist of 6 stages.116 biopsy proved sarcoidosis patients were examined in order to evaluate the efficiency of individualized medical rehabilitation program. It has been proven that pulmonary rehabilitation has positive impact on health status, lung function, physical toleration in 6 min walking test and health-depended quality of life.

The analysis of the dynamics of the ratio of external and internal exposure doses in population, lived in the settlements with different density of soil radioactive contamination, have been conducted. Throughout the whole radioactive contaminated territory the contribution of external radiation decreases with time, and internal is increasing, but the domination of external exposure is noted, and by 2015 the contributions of external and internal radiation are equal. A ranking of the territory in density of soil contamination, values of the dose and the contribution of external and internal components to dose have been conducted. It allowed to select 7 different zones of radioactive contamination. The results of the study will allow to optimize the radiation protection of the residents of the settlements located in the radioactively contaminated areas, and can be used in justifying the principles and criteria for the classification of radioactive contaminated areas to ensure the social protection of citizens. Key words: density of soil contamination, external exposure dose, internal exposure dose, contribution of external and internal components to dose, ranking of the territory

The analysis of the radiation situation in the remote period after the accident due to Chernobyl fallout and radon have been conducted. It was shown that the dose from Chernobyl fallout essentially decreased, and the Chernobyl cesium contaminated area was reduced above two times. Following the latest ICRP recommendations, while was assessing the existing exposure we had taken into account not only the Chernobyl dose, but also natural sources of radiation exposure, such as radon. Based on published material such as the Chernobyl cesium contamination cartograms and volumetric activity of radon in the buildings, as well as the Catalogue of doses - 2015, we have estimated the radiological situation. The considerable irregularity of the radon dose distribution in the territory of Belarus was shown. So the difference in the values of the dose between different regions is several times greater than the dose due the Chernobyl fallout. The conclusion about the need for mandatory accounting of radon in the study of medical and biological effects of radiation from man-made sources.

The peculiarities of dose distribution by sex, age and professional employment of the population are revealed. Based on the identified groups that unite a number of occupations in men and women, reliably differing in the mean value of internal dose, an algorithm for calculating doses has been developed. The basis of the algorithm is the assumption that a group of persons homogeneous in terms of socio-demographic characteristics on the distribution curve of the dose will occupy a definite, time-constant place. As a result of the studies, a methodical approach has been developed that allows to calculate an individual dose to the population living in a radioactively contaminated area.

This review summarizes the current state of one of the most common endocrine diseases - diabetes mellitus. It is noted that the disease is characterized by the presence of a number of complications, resulting in significant financial costs for medical and social care to patients. We consider effective methods of prevention and treatment of diabetes patients. The diet therapy is one of these methods. The need for the establishment of specialized food products with a given chemical composition due to the introduction in their structure of integrated dresser based on mineral and vegetable raw materials describes in the article. Vegetable crops, particularly Jerusalem artichoke, occupy a special place in creating such dresser. The properties of Jerusalem artichoke and its role in the creation of new biologically active additives to food are considered in the article. It is shown that it can be used as part of diet specialty products diabetes.

In the article the features of anthropometric parameters (weight, height, chest circumference) and physical development in individuals of middle age, male article when staying in their recreation areas, persons employed in industry and those who work in the agricultural sector. Statistically lower values of body weight and chest girth, weight and age index and the index of proportionality in persons involved in industrial production, compared to the control group. Persons agricultural sector characterized by a decrease in height, weight and chest girth, and reduced value of the index of proportionality and index Ketle, weight and age of the index that determine physical development. Men living in the recreational area with the same parameters, and some of them and better health indicators, compared to the control group. In studying the characteristics of anthropometric indices and physical development in adulthood men found the negative impact of industry and the agricultural sector on the physical health of men and improvement of physical persons in the recreation area.

In work was found features amplitude-time characteristics of evoked potentials in sportsmen playing sports and athletes during the concentration. It was found that team sports athletes in experimental situations to respond to a significant stimulus "Where" observed a statistically higher amplitude and statistically lower values of the latent period in the parietal, sagittal frontal, central, parietal areas of the cerebral cortex compared with athletes in the same experimental situations. In situations in response to a significant stimulus "What" athletes were characterized by statistically higher values of amplitude in the anterior, posterior temporal and central regions and statistically lower values of the latent period in the same areas of the brain cortex

This paper describes an comprehensive methodological approach for evaluation of radon danger area and search for critical zones of radon. It presents a complex radon index of territory, which take into account a number of fundamental ecological and geological factors; transition from complex radon index in volume activity of radon; calculation of 99%-th quantile distribution of radon volumetric activity in the locality, it is necessary to determine affiliation of locality to critical zone of radon. It is shown that none of investigated settlements does not apply to critical zone of radon. The data obtained in accordance with the evaluation of radon danger model, fully consistent with experimental measurements.

One of the tasks of the dose monitoring in the remote period of the Chernobyl accident is a correct assessment of the radiation dose of inhabitants of the settlements located in the territory of radioactive contamination. The radiation dose that was formatting in a person is the sum of external and internal exposure. Correct assessment of external exposure dose can be realized through targeted and regular TLD (thermoluminescent dosimetry) measurements of the inhabitants of the most typical settlements in relation to the conditions of external dose formation. This approach allows us to pass away from the widespread dose monitoring to targeted one that would optimize material costs without compromising the quality of doses assessment to residents.

In multicenter study 501 subject (824 eyes), of which there were 362 (72%) female and 139 (28%) male, participated for 39 scientific institutions and medical clinics of four countries (Belarus, Russia, Uzbekistan, Moldova) in 2016. The patients divided into three groups: the initial stage of primary open angle glaucoma, suspected glaucoma, and control. The differences in the structural and functional ophthalmologic parameters studied at the initial stage of glaucoma, suspected glaucoma and the absence of the disease. The authors created the website calculator when completing the questionnaire in which the results of the examination of the patient (age, intraocular pressure, perimetric indices, the ratio of optic cup/disk, the risk factors) is given a probability of the presence of suspected glaucoma or early stage of glaucoma, as well as the absence of disease.

Peripheral retinal degeneration are always the center of attention of ophthalmologists as they are the main reasons for the development of retinal detachment. Currently the most often used division of peripheral degeneration to rhegmatogenous and not rhegmatogenous. The most frequent localization of all types of degeneration were found in upper, upper-outer and lower parts. The retinal breaks are most often localized in the upper outer and lower parts. All vituperations dystrophies of the retina as with gaps and without gaps mainly localized in the extreme periphery. The preferential localization of rhegmatogenous degeneration in the far periphery requires ophthalmologists thorough examination of the ocular fundus with application of three-mirror lens Goldman.

When studying the relationship of polymorphism of genes IL-1 and IL-4 with chronic gastritis and gastric cancer we established the following regional particularities: If the patient has genotype 1/1 IL-1RN the risk of stomach cancer increases 2,2 times (p=0,003, OR=2,21, 95% CI 1,29-3,76); CT genotype IL-4 in C-33T 21 times; The presence of genotype 2/2 IL- 1RN increases the risk of chronic gastritis moderate or high activity of 2,3 times (p=0,021, OR=2,37, 95% CI 1,12 -5,02); If the patient has CT genotype IL-1? C-511T and genotype 2/2 IL-1 RN it increases the risk of infection having oncogenic potential сagA H. pylori strains in 2,2 times (p=0,005, OR=2,21, 95% CI 1,29-3,76) (p=0,034, OR=2,2, 95% CI 1,05-4,62). Data carriers of polymorphic loci for early detection of adverse disease require dispensary observation and inspection mandatory.

The article provides novel information about the concentrations of CYFRA 21-1, TPA, TPS, UBC, NMP-22, BTA and CEA tumor markers in body fluids of stage I-IV bladder cancer patients. The study comprised 945 bladder cancer patients and 120 clinically healthy individuals. Bladder cancer was morphologically verified in all patients. Data were analyzed using nonparametric statistical methods. Выявлены информативные показатели для дооперационной оценки степени инвазии опухоли мочевого пузыря (CYFRA 21-1, UBC, NMP-22, BTA), количества опухолевых очагов (TPA, TPS, UBC), степени злокачественности (NMP-22). Markers with reasonable performance for preoperative assessment of bladder cancer invasion (CYFRA 21-1, UBC, NMP-22, BTA), number of tumor foci (TPA, TPS, UBC) and tumor grade (NMP-22) were identified. Sensitivity and specificity of all markers were defined.

The article presents the results of the introduction of a new method of medical care for patients with acute stroke on the basis of innovative medical and organizational technologies, which led to an increase in patients' adherence to treatment and improving the expected results of treatment efficacy.

The article is devoted to the study of the clinical efficacy of the use of highly selective β- adrenoreceptor blocking agent of bisoprolol and β- adrenoreceptor blocking agent, which possesses additional vasodilating properties of carvedilol in the treatment of stable stenocardia within the patients with diabetes mellitus type 2. A comparative analysis of the effect of the studied medicines on the dynamics of heart strokes and the life quality of patients in the treatment process was carried out. It has been determined that bisoprolol and carvedilol have a comparable distinct antianginal effect, but carvedilol increases the physical component of life quality of the patients statistically more significant.

Human papilloma virus (HPV) infection is known to be important etiologic factor for the development of cervical hyperproliferative diseases, including malignant tumors. It can be assumed that course of HPV infection is able to change under conditions of chronic low-level radiation exposure, which leads to various disorders of the immune system. Since the data on this issue are very limited, the aim of the work is to evaluate the prevalence and the structural features of high carcinogenic risk (HCR) HPV in residents of areas contaminated with radionuclides as a result of the Chernobyl accident. The cervical scrapes from 491 women were tested for the presence / absence of HPV DNA of 14 HCR genotypes. In case of positive screen test the HPV genotype, quantitative load and physical status of HPV DNA (episomal, integrated form) were determined. The distribution patterns of genotypes and quantitative load of HCR HPV were elucidated, as well as the physical status of HPV types 16 and 18 in different age group of women infected. A rather high level of HCR HPV infection was revealed in women of reproductive age living in radiation contaminated areas. The findings indicate the necessity for continuous monitoring with the use of screening programs, including HPV testing, to identify a group of high carcinogenic risk.

There were analyzed the outcomes of adenomyosis, complicated menorrhagia and pain syndrome and its combination with hysteromyoma and endometrial hyperplasia with the usage of levonorgestrel-releasing system and endometrial ablation. It was detected that treatment efficiency in the elimination of uterine bleeding and pain syndrome by the method of LNG-IUS installation is comparable to hysteroresectoscopic endometrial ablation of endometrium. However, when the volume of uterus is more than 15000 mm3, the multimodal approach is more preferable, while hysteroresectoscopic endometrial ablation is conducted simoultaneously with the following installation of LNG-IUS, in comparison with monotreatment.

The present data showed that the Belarusian model of iodine deficiency elimination based on mandatory use of iodized salt in industrial food processing is also effective in the risk groups of children and pregnant women residing in rural areas.

An article contains the main results of the activities carried out by Federal Scientific Organization «Saint-Petersburg Research Institute of Radiation Hygiene after professor P.V. Ramzaev» of Federal Service for Surveillance of Consumers Rights Protection and Human Well-being (FSO RIRH after P.V. Ramzaev) under governmental contracts signed for the realization of the actions of the «Cooperated Activity Program for the Overcoming Consequences of the Chernobyl Disaster by the Union State During the Time Period up to 2016». The data of radiation monitoring carried out in 65 referent settlements of Bryansk region bordered with Belarus is obtained and generalized during 2012-2016. Comprehensive radiation hygienic survey of the Bryansk region 65 referent settlements was carried out; unified methodological support for population dose estimation was developed; the suggestions were developed for the limitation of the external and internal exposure doses for the population living in radioactive contaminated territories of Russia and Belarus considering international approaches; the catalogue (information sourcebook) is created of the average annual exposure doses of population and it’s critical (the mostly exposured) groups for 65 referent settlements of Bryansk region, surveyed in 2014-2016; the data is prepared for the unified reference book of the contamination of the foodstuffs produced in the radioactive contaminated territories of Russia bordered with Belarus (regarding Russian produce from Bryansk region).