[THE HISTORY OF THE TRANSFORMATION OF THE CONCEPT OF HEALTH].

The article gives an idea of health and diseases in various historical epochs. Depending on the historical period, there is a different amount of information about medicine, including diseases and the concept of «Health¼. This is due to the amount of archaeological and documentary evidence. For a long time, ideas about health have been closely linked with religion. Hippocrates and other scientists of the ancient world at the heart of health determined the state of equilibrium of the four main fluids. With the development of anatomy, physiology and medicine, the development of diseases was considered as damage to anatomical structures and disruption of their functions. In the XIV-XV centuries, a direction appeared that considers the influence of social and social factors on human health. In the XIX century, the ideas of health and disease are further developed based on physiological and anatomical studies. The German Anatomical School compared the concepts of human health and pathology, linked the development of diseases with changes in cells. During the 20th century, on the one hand, medicine became more and more molecular and submicroscopic; on the other hand, global attention to people, both healthy and sick, resumed, which gave rise to synergetic, multifaceted definitions of health. The World Health Organization in 1946 formulated the definition of health as «a state of complete physical, mental and social well-being, and not just the absence of diseases or physical defects.¼ In the future, this concept was repeatedly criticized, as it considered health as an ideal and brought it closer to the concept of happiness. Today it is obvious that the concept of health is a multifactorial concept and, in addition to the medical component, is closely related to other areas of human life: sociology, ecology, cultural studies, economics, etc.

[ORGANIZATION OF MEDICAL REHABILITATION OF PATIENTS WITH COVID-19 IN THE POST-HOSPITAL PERIOD].

The COVID-19 pandemic poses new challenges for the health sector, related to the organization of medical rehabilitation of patients with COVID-19. Special attention is required for patients after artificial ventilation, who have a high risk of developing physical, mental and cognitive disorders. There are acute post-ovoid syndrome lasting more than 3 weeks and chronic-lasting more than 12 weeks after discharge from the hospital. The most common symptoms are: shortness of breath, fatigue, anosmia, ageusia, myalgia, feeling of fever, tightness in the chest, tachycardia, headaches, anxiety, memory loss, sleep disorders, difficulty concentrating. The article presents the stages of rehabilitation of patients with COVID-19. Dynamic monitoring, measures for the prevention of complications, organization and methods of rehabilitation, including physiotherapy procedures and physical therapy, are considered.

[Analysis of the development of acute coronary syndrome during the COVID-19 pandemic].

The study compares two groups of patients with acute coronary syndrome, depending on the presence of COVID-19 in the anamnesis. The comparison groups analyzed the risk factors for cardiovascular diseases, including smoking, heredity, gender differences, age, diabetes, and obesity. The results of biochemical blood tests were analyzed. It was found that patients with acute coronary syndrome who underwent COVID-19 were less likely to have risk factors for cardiovascular diseases. Patients with acute coronary syndrome who underwent COVID-19 were found to have lower blood glucose, cholesterol, very-low-density lipoprotein, and triglycerides. As a result of the study, it was revealed that COVID-19 is an independent risk factor for the development of acute coronary syndrome.

[Clinical portrait of a patient with COVID-19. The experience of a multidisciplinary clinic].

AIM: Evaluation of the clinical characteristics in patients with COVID-19. MATERIALS AND METHODS: The article presents clinical and instrumental data of 1169 patients included in a single-center mixed study. Patients were tested for COVID-19 using polymerase chain reaction, computed tomography (CT), and antibody screening. Clinical history data were collected. RESULTS: In patients with confirmed COVID-19, lung damage and a positive test for antibodies were observed in 75.5 and 45.2% of cases, respectively. The most common symptoms of COVID-19 were: fever (73.2%), weakness, (72.7%) dry cough (62.8%) and shortness of breath (55.4%). Patients with CT-visualized lung lesions were more likely to have clinical symptoms and elevated levels of antibodies. Patients with chronic diseases of the endocrine system, circulatory system, and respiratory system had a more severe course of the disease (CT-14: 91.296.3%) than patients without chronic diseases (CT-14: 85,1%). CONCLUSION: We have compiled a clinical profile of patients with COVID-19 and highlighted the most significant clinical characteristics corresponding to a more severe course of the disease. Our data showed that patients with chronic diseases require a personalized approach and the development of specific criteria for the diagnosis and treatment of COVID-19.

[Vitamin D deficiency study in railway drivers.]

Heart rhythm disturbances are significant pathology and one of the reason of sudden cardiac arrest. Locomotive crew drivers are at high risk for cardiovascular diseases, including heart rhythm disturbances. Multiple factors as a professional stress, frequent night shifts, lack of insolation, diet disbalance, low physical activity, exposure to vibration and noise, and an unfavorable industrial climate. In this study it was found that railway-men are predisposed to vitamin D deficiency. This condition reduces resistance to stress and increases risk of unfavorable heart rhythm disturbances.

Efficacy and tolerability of certolizumab pegol in Crohn's disease in clinical practice.

AIM: To assess the efficacy and tolerance of certolizumab pegol (CP) in patients with Crohn's disease (CD) treated in the Department of inflammatory bowel diseases of the A.S. Loginov Moscow Clinical Research Center and to determine the predictors of response to therapy. MATERIALS AND METHODS: All patients with CD who had received the treatment of CP were observed prospectively for at least 6 months or until the date of discontinuation of the drug. The effectiveness of the study was assessed response to therapy by the 6th week, maintaining the clinical response (6th and 26th weeks), the dynamics of endoscopic parameters by the 10th and 54th week of therapy, long-term maintenance of remission, healing fistula. Used univariant and multivariate analyses of predictors of response to treatment. RESULTS: The study included 39 patients: 12 (30.7%) men and 27 (69.3%) female, the average duration of observation was 104 weeks. The interdepartmental range was in the range from 28 to 158 weeks. Clinical improvement occurred in 38 out of 39 (97.4 %) patients with CD. Comparative analysis of response to treatment with CP have bionaive patients previously treated with another inhibitor of TNF-α. In the group of bionaive response to therapy in a month, 6 months and at the end of the observation period occurred at 100.0%, 95.0% and 95.0%, respectively. In the group of patients previously treated with GSI, the response rate was about 94.4 %, 88.9 % and 77.7% week 54 endoscopic response and endoscopic remission was maintained in 46,2% and 30,1% patients, complete healing of the mucosa on the background of maintenance therapy, CP, was preserved in 20.5% of patients with Crohn's disease. In the group of patients with perianal lesions (n=13) complete closure of all fistulas was observed in 5 (38.6 %) patients, partial response was observed in 4 patients (30,7%) patients, in 4 (30.7 %) closure of fistulas occurred. The frequency of adverse events was 0 cases (0.0%). The dose escalation was required in 3 patients (7,7%) patients with CD. Dose escalation in our study required patients with high initial CDAI and previous inefficiencies of the other two inhibitors of TNF-α. Reliable predictors of secondary loss of response and need for dose escalation of the drug has been the continued level of CRP >5 mg/l after 2 weeks initiation of therapy CP and smoking. CONCLUSION: The obtained results demonstrate the efficacy and tolerability profile of CP appropriate for long-term CD therapy in real clinical practice.

[Evaluation of inflammatory and endothelial dysfunction's biomarkers in patients with hypertension at achieving the target blood pressure.]

The target organs damage in hypertension is mainly realized through an endothelial dysfunction. The present study investigated the inflammatory and endothelial dysfunction's biomarkers in patients with hypertension before and after the achieving the target level of blood pressure. We've performed clinical and laboratory study of 44 patients (17 men, 27 women, mean age 58.59 ± 10.57 years) with the hypertension stage II, degrees2-3, high and very high risk of cardiovascular complications, not reaching the target level of blood pressure at the previous therapy. All patients received standardized therapy with a fixed combination of amlodipine / indapamide / perindopril in an individually selected dosage. The duration of the follow-up was 6 months. The levels of pro-inflammatory interleukin-6 (IL-6), anti-inflammatory interleukin-10 (IL-10), vascular cell adhesion molecule-1 (sVCAM-1) and vasculoendothelial growth factor (VEGF) were measured. All patients achieved the target blood pressure level at the end of the study (systolic blood pressure was 125.1 ± 6.9 mm Hg, diastolic - 82.2 ± 5 mm Hg, p < 0.001). After 6 months, there was no significant dynamics of inflammatory biomarkers. The level of sVCAM-1, as an indicator of endothelial dysfunction, decreased (898.67 ± 433.5 ng / ml vs. 1063.5 ± 442.4 ng / ml at the start of treatment, p < 0.001). Thus, it is possible to use vascular cell adhesion molecule-1 as a biomarker of endothelial dysfunction in patients with hypertension. Adequate therapy of hypertension with achievement of target blood pressure levels improves vascular endothelial function, significantly reducing sVCAM-1 expression.

[Study of cytokine profile in men with hypertension.]

Gender differences in the risk factors' influence on the development of cardiovascular diseases determine the study of the pathogenetic causes of these features. Inflammatory is one of the mechanisms for the participation of risk factors in the development of hypertension. The aim of the study was to investigate the relationship between inflammatory biomarkers with hypertension and cardiovascular risk factors in men. The study included 60 men with hypertension who were divided into groups depending on the risk of cardiovascular events: 30 men with low risk and 30 men with high risk. 86 hypertensive patients with risk factors such as obesity, impaired glucose metabolism, impaired lipid metabolism also were examined. Biochemical parameters and a wide range of cytokines: IL-4, IL - 8, IL-10, IL-12, IL-17, IL-18, TGF-ß, TNF-α, IFN-γ were estimated. The obtained results were compared with echocardiographic (EchoCG), ambulatory blood pressure monitoring (ABPM), duplex scanning of the carotid arteries. A direct correlation between the risk factors and target organs' damage - left ventricular hypertrophy, increased intima-media complex thickness, was revealed. The dependence of cytokine profile from risk of cardiovascular events in men was also revealed. We studied the contribution of individual risk factors in men in the development of hypertension and the severity of inflammation. More significant changes in the cytokine profile observed in patients with concomitant hyperglycemia, obesity and dyslipidemia. A correlation between cytokine profile and duration of hypertension also revealed. Correlation analysis revealed the relationship between ABPM parameters and levels of interleukins, HS-CRP, and fibrinogen. Biomarkers of inflammation associated with the severity of visceral obesity, with a BMI. Analysis of results also showed the relationship between hyperinsulinemia or insulin resistance and inflammatory biomarkers. The relationship of inflammation with lipid metabolism in hypertensive men was more significant than with the other studied risk factors.

[Study of heat shock protein gene 70 (HSP70) expression and its polymorphous marker (+ 1267A> G) in women under exposure to a long-term stress.]

There was studied the HSP70 gene and its polymorphic marker + 1267A> G (rs754888705) in the HSP70 gene expression in32 women under long-term stress, which was caused by inpatient treatment of their oncologic child. A control group included 25 women without long-term stress factors. There was studied a correlation between the expression level of the HSP70 gene in women and their high blood pressure (BP) episodes. The average duration of stress in the group of children's mothers was 7.3 (2.5-11.5) months. Anxiety level according to HADS in the main group was significantly increased and amounted to 8.7 (7-10) points, in the control group 5 (2-7) points. Depression level in the main group was significantly higher and amounted to 7.7 (7-9) points, in the control group 3.3 (1-5) points. Comparison of the HSP70 gene expression level in blood of young women of the main study group with expression level of this gene in the control group showed a statistically significant predominance of HSP70 gene expression in the main group. The episodes of high BP in women who were under stress conditions did not influence the expression level of the HSP70 gene. Analysis of the alleles of the polymorphic marker frequency in the gene HSP70-2 1267A> G (rs754888705) in the main and control groups showed a statistically significant predominance of allele A in the group of mothers under stress, and predominance of the allele G in the control group. Comparative analysis of the polymorphic marker genotype frequencies in the gene HSP70-2 1267A> G (rs754888705) showed that the AA genotype is significantly more frequent in mothers with episodes of BP increase compared to women without it. An increased level of the HSP70 gene expression in peripheral blood leukocytes in mothers with a life-threatening disease of their child indicates the damaging effect of long-lasting psychoemotional stress at the cellular level and activation of the protective reaction mediated by HSP70. Studying of the genotype AA characteristics of the polymorphic marker A1267G (rs754888705) of the HSP70-2 gene in women under long-lasting stress will let us evaluate the role of genetic factors in hypertensive reactions development.

Stem Cell Therapy for Perianal Crohn's Disease.

AIM: To compare the effectiveness of the effect of combination therapy (local and systemic administration) with bone marrow mesenchymal stromal cells (MSC), anticlitokine therapy with infliximab (IFX), and antibiotic (AB)/immunosuppressive (IS) therapy on the frequency of healing of simple perianal fistulas in Crohn's disease. MATERIALS AND METHODS: In our study, the 1-st group of patients aged 19 to 58 years (Me-29) (n = 12) received MSCs culture systemically according to the scheme and locally. The 2-nd group of patients with CD (n = 10) from 20 to 68 years old (Me-36) received anticytokine therapy with infliximab (IFX) according to the scheme. The 3-d group of patients with CD (n=14) from 20 to 62 years old (Me-28) received antibiotics (AB) and immunosuppressors (IS). Efficacy was assessed by the index of perianal activity of Crohn's disease (PCDAI) and the frequency of relapses. RESULTS: After 12 weeks among patients of the 1-st group, healing of simple fistulas was noted in 8/12 patients (66.6%), in the 2-nd group in 6/10 (60.0%) In the 3-d group, in 1/14 patients (7.14%). After 6 months in the 1-st group of patients, healing of simple fistulas was preserved in 8/12 (66.6%), in the 2-nd group - in 6/10 (60.0%). In the 3-d group - in 1/14 patients (7.14%). After 12 months in the 1-st group, healing of simple fistulas was preserved in 7/12 (58.3%), in the second group - in 6/10 (60.0%). In the 3-d group - in 2/14 patients (14.3%). After 24 months, among the patients of the 1-st group, fistula closure was maintained in 5/12 patients (41.6%), in the 2-nd group - in 4/10 (40.0%). In the 3-d group - in 0/14 patients (0.0%). CONCLUSION: Combined cellular and anticytokine therapy of CD with perianal lesions significantly contributes to the more frequent and prolonged closure of simple fistulas, as compared to antibiotics/immunosuppressors, and to a decrease in the frequency of recurrence of the disease.

[The detection of cortisol level in blood plasma of patients with arterial hypertension at resistance to stress impacts of various degree.]

The analysis was applied to the results of detection of level of cortisol in pre-operational period before planned arthroscopy in 63 patients (aged from 45 to 50 years) with hypertension disease stage I and II with different stress resistance. The stress resistance was detected using such tests as Perceived Stress Scale (PSS) and the Depression, Anxiety and Stress Scale (DASS). In most of patients, the analysis of results of testing demonstrated an average level of stress and and average anxiety before the operation. 20 stress resistant patients and 43 stress non-resistant patients were picked out. The level of cortisol in pre-operational period turned out reliably higher in patients with low stress resistance. The data analysis according results of day monitoring of blood pressure prior to implementation of arthroscopy established that in stress non-resistant patients a more expressed increasing of velocity of morning rising of systolic and diastolic blood pressure as compared to stress resistant patients. After surgical intervention, velocities of morning rising of systolic and diastolic blood pressure also were higher in stress non-resistant patients. They also had lower values of day index of systolic blood pressure (non-dipper). In stress resistant patients, day index of systolic blood pressure before and after was within the limits of standard values. The average values of systolic and diastolic blood pressure registered within limits of on standard values. However, they were higher in pre- and post-operational periods among patients with low stress resistance. The received results reflect alteration of function of cardio-vascular system in response to psychological stress that is more expressed in patients with low stress resistance.

[The genetic aspects of occupational hearing impairment]. / Geneticheskie aspekty professional'noi neirosensornoi tugoukhosti.

This article was designed to be the overview of the current literature publications concerning the identification of the genetic markers of susceptibility to the noise-induced loss of hearing. The analysis of these data has demonstrated that the major gene polymorphisms associated with the development of this pathological condition are localized in the genes encoding for the antioxidant systems, potassium homeostasis, and adhesion molecules as well as in the genes involved in intercellular coupling, the mechanisms underlying the cellular response to stress, activation and regulation of heat shock proteins, and signaling function of the immune system. It is concluded that the further investigations into the genetic aspects of the full-genome sequencing techniques and the search for genomic associations could greatly contribute to the development of personalized medicine and the reduction of risks of occupational noise-induced sensorineural impairment of hearing.

[Efficacy of adalimumab for Crohn's disease in real clinical practice]. / Effektivnost' adalimumaba pri bolezni Krona v real'noi klinicheskoi praktike.

AIM: To evaluate the efficacy and safety of adalimumab (ADA) in patients with Crohn's disease (CD) treated at the Department of Inflammatory Bowel Diseases, Moscow Clinical Research and Practical Center, and to determine the predictors of a therapy response. SUBJECTS AND METHODS: All the patients with CD treated with ADA were followed up for at least 6 months or until the drug was discontinued. Therapeutic effectiveness was evaluated at 4 weeks and 6 months after the initiation of treatment and at the end of a follow-up. Complete intestinal mucosal healing was assessed at 3 and 12 months following treatment initiation. Univariate and multivariate analyses were used to determine the predictors of treatment response. RESULTS: A clinical analysis covered 70 patients (57.1% male); the follow-up period averaged 112 weeks. Perianal fistulas were at baseline established in 22 (31.4%) patients with CD. 12 (17.4%) patients had been previously treated with infliximab (INF), 7 of them discontinued the drug for secondary loss of response and 5 for adverse reactions. 68 (97.1%) patients responded to an induction course of ADA. At 4 weeks, 6 months, and at the end of the follow-up, clinical remission occurred in 66.7, 80.4 and 67.4 % of patients with luminal CD and in 45.4, 36.5, and 36.4% of those with perianal CD, respectively. At 3 and 12 months and at the end of the follow-up, there was complete healing of the intestinal mucosa in 23.5, and 41.2 and 29.5% of cases, respectively. Six (8.8%) patients responding to the induction course needed to be optimized with ADA to 40 mg weekly. The time interval between treatment initiation and dose optimization averaged 30 weeks (range 12-120 months). There were 15 (21,4%) adverse events that were responsible for ADA discontinuation in 3 (4,2%) patients. CONCLUSION: The findings demonstrate the efficacy and safety of ADA used in clinical practice.

[Frequency of Lymphocytes with Mutations at the Locus of T-Cell Receptor in Residents of Radiation Polluted Bryansk Region 28 Years after the Chernobyl Nuclear Power Plant Accident].

The aim of this study is to assess the level of somatic mutagenesis according to the frequency of lymphocytes bearing mutations at the locus of T-cell receptor (TCR) in the residents of the Bryansk region contaminated with radionuclides as a result of the Chernobyl accident. The study was :conducted in 2014 in two regional centers - Klintsy and Novozybkov (average¹³7Cs pollution density of 322 and 708 kBq/m²,.respectively). The average frequency of the TCR-mutant cells in the total group of examined residents of the Bryansk region (n = 237) was not significantly different from that in the group of agematched control persons living in un- contaminated areas (n = 146): 3.8 x 10⁻4 vs 3.5 x 10⁻4, respectively (p = 0.84). However, after separation of examinees into 3 groups depending on age at the start of irradiation (at.the moment of the Chernobyl acci- dent) it was found that the average frequency of the TCR-mutant cells in the persons exposed in utero was 1.6 higher than that in the control group (p = 0.04). Proportion of persons with an increased frequency of the mutant cells (more than the age norm of this indicator) among prenatally exposed population reached 23.8%; which was about.4 times higher than in the control group (p = 0.04). Proportion of persons with an increased frequency of the TCR-mutant cells in group "0-17 years at the start of irradiation", was about 2 times higher than in controls, but this difference was not statistically significant (8.0% vs 4.3%, respectively, p = 0.33). In the third group "18 or more years old at the start of irradiation" we could not register the difference in the average frequency of theTCR mutant cells or the proportion of persons with an increased frequency of these cells in comparison with the age-matched control group. In general, comparison with earlier data shows that age-related regularities of somatic mutagenesis established 15-18 years after the Chernobyl accident persist at a later date (after 28 years in this study).

[Accumulation of doxorubicin conjugates with dendritic polymer and vector protein in normal and tumor cells in vitro].

Accumulation of doxorubicin (Dox), its conjugates with the second generation dendritic polymer (G2-Dox) and vector pro- tein (recombinant third domain of alpha-fetoprotein - 3D-G2- Dox) in normal and tumor cells was studied in vitro within the framework of the development of selective transport system of anticancer drugs to the target cells. The objects of the study were cells of peripheral blood mononuclear fraction of healthy donors and cells of breast adenocarcinoma lines MCF-7 and MCF-7/MDR1, differing in chemosensitivity. G2-Dox and 3D-G2-Dox accumulated in tumor cells of the both lines better than free Dox (p<0,05). However removal of these drugs out of cells MCF-7 and MCF-7/MDR1 was significantly different: in the latter case all free Dox was excluded from the cells for 24 hours while Dox, accumulated in composition with dendrimers, still remained in the cells. It was important that 3D-G2-Dox (unlike the G2-Dox) accumulated in normal cells worse than free Dox (p<0.01). Thus, the results indicate that the use of 3D-G2-Dox is the most promising because it accumulates in tumor cells better and in normal cells worse than free Dox. Furthermore it can be assumed that the use of 3D-G2-Dox would be especially useful in cases of multi-drug resistance associated with the high expression of P-glycoprotein.

Changes in the Relative Number of SP Cells of Melanoma Line B16 after Radiation Exposure in vivo.

The quantitative regularities of changes of cancer stem cell (CSC) population were explored after local γ-irradiation of experimental tumors (murine melanoma line B16). CSCs were detected by the ability of these cells to exclude Hoechst 33342 fluorescent dye and to form a so-called side population (SP) under flow cytometry study. In the control group of unexposed mice a positive correlation was found between the proportion of CSCs (SP) and tumorweight at the initial stage of growth (R = 0.77, p = 0.009). In the advanced stages of tumor growth similar relationship was not revealed. Statistically significant increase in the proportion of CSCs (SP) occurred 2-5 days after exposure of tumor to a dose of 10 Gy as compared to control; this index returned to the control level 8 days after irradiation. On the second day after exposure to radiation a linear correlation between the percentage of CSCs and a radiation dose in the range of 2-10 Gy was established (R = 0.98, p = 0.003), confirming a higher radioresistance of this population as compared to other cells not only in vitro (as it was previously shown by us and other authors), but also in vivo. These results suggest the possibility of application of this model system to assess the CSC sensitivity to various antitumor agents in vivo, including preclinical trials, and clarify the details of the practical application of this method.

[COMPARATIVE STUDY OF MECHANICAL STRESS EFFECT ON HUMAN AND ANIMAL ERYTHROCYTES].

Sensitivity of human and animal (bovine, rat, rabbit, equine) erythrocytes to the effect of mechanical stress has been studied. Mechanical stress effect was demonstrated to result in a time-dependent (5-60 min) release of potassium cations out of mammalian erythrocytes and a partial hemolytic cell damage. Herewith the release levels of potassium ions and hemolysis did not coincide for erythrocytes of all the mammals except rabbit ones. The most sensitive to mechanical stress (60 min) by the parameters of hemolytic damage and potassium ion release were rat (32%) and bovine (66%) erythrocytes respectively, the lowest sensitive by both parameters were rabbit ones (about 20%). Implemented correlation analysis has demonstrated a statistically significant negative relation between the values of mechanical hemolysis of mammalian erythrocytes and surface-volumetric ratio of cells (rs = -0.900, P = 0.037). A feasible relationship between the content of phosphatidylethanolamine in mammalian erythrocyte membranes and the level of potassium cation loss under mechanical stress effect is under discussion.

[Dyssynergic defecation is one of the causes of chronic constipation].

AIM: To define the rate and type distribution of dyssynergic defecation (DD) in patients with primary chronic constipation (CC) and to evaluate the efficiency of biofeedback (BFB) therapy. SUBJECTS AND METHODS: One hundred and thirty-two 18-to-89-year-old patients treated in the Moscow Clinical Research and Practical Center for primary CC were examined using proctological examination, colonofibroscopy, anorectal manometry (ARM), and the balloon expulsion test. RESULTS: Different types of DD were identified in 44.69% of the patients. Defecation disorder type 1 was prevalent (in 64.4% of the patients with DD). The positive result of BFB therapy was noted in the patients with DD and fecal incontinence. CONCLUSION: The timely detection of functional defecation disorders can recover the lost function of pelvic floor muscles by BFB therapy and exclude the uncontrolled patient use of laxatives.

[Common variable hypogammaglobulinemia: the author's observation].

The paper gives a case history of a patient with common variable hypogammaglobulinemia (CVHGG). Its clinical picture was characterized by frequent inflammatory airway diseases, pansinusitis, and periodic rises in temperature up to febrile ones. The diagnosis was established on the basis of the decreased serum concentrations of immunoglobulins (IG) A, M, and G, the unusual small intestinal (SI) wall relief created by large lymphoid follicles, as well as the characteristic sign of CVHGG, namely, the lack of plasma cells in the lamina propria of the SI mucosa. Antibacterial therapy was noted to have a good effect that confirmed the leading role of excessive bacterial growth in the pathogenesis of chronic diarrhea and fever, which are the major clinical manifestations of CVHGG in this patient.

[Tissue engineering in urology, new approaches for urinary bladder reconstruction].

Tissue engineering as applied to urologic pathology is covered extremely poor in the literature despite recently gaining popularity of regenerative medicine. The review reflects the current problems associated with reconstructive surgery of the urinary bladder, experience of the researchers from the United States in implementing cellular technologies for bladder replacement, the problems and prospects of this direction in case of such a severe pathology, as fibrous transformated bladder.