Objective. To study and identify patterns of development of anemic syndrome in children with juvenile idiopathic arthritis based on clinical manifestations, ferrokinetic parameters, and inflammation markers.

Materials and methods. The study was performed on the basis of the ME «2nd City Children^'s Clinical Hospital» in Minsk. Determination of serum iron, ferritin, transferrin, erythropoietin, latent serum iron-binding capacity (LJCC), concentration of interleukins-6 and -10, tumor necrosis factor-α(TNF-α) in the blood was carried out on the Multiskan enzyme immunoassay analyzer, based From the data obtained, the total serum iron-binding capacity (TIBC) and the percentage of transferrin saturation (TSAT) were calculated.

Results. Disorders in the form of anemia, latent and prelatent iron deficiency were diagnosed in 67,7±5,8 % of children with articular and systemic forms of JIA. At the same time, anemia was detected in 32,3±5,8 % of patients, in other cases there was latent (23,1±9,6 %) and prelatent (12,3±4,1 %) iron deficiency. Among the studied laboratory signs of inflammatory activity, a significant effect on the development of iron metabolism disorders was reflected by such markers as: ESR (H=21,9; p<0,001), CRP (H=8,7; p=0,03), interleukin-6 (H=18,8; p<0,001). Correlation analysis of red blood parameters and iron metabolism with markers of inflammation revealed a number of features depending on the type of iron metabolism disorder. Conclusion. JIA contributes to the development of anemia in every third child, the remaining third of patients have latent and prelatent iron deficiency. More pronounced changes in the values of laboratory signs of iron deficiency and anemia were noted in the systemic form of the disease.

Objective. То substantiate the most promising areas of action to reduce alcohol consumption in the Republic of Belarus.

Materials and methods. Official data of the National Statistical Committee of the Republic of Belarus. Econometric analysis.

Conclusion. To reduce alcohol consumption, the following measures are the most promising: stopping the production of fortified fruit and berry wines, reducing the physical availability of alcohol, promoting a healthy lifestyle. As the main economic measure, it is proposed to increase excise rates on strong alcohol.

Literature review for the period 2017—2023 presents data on the frequency of etiology of chemical burns of the upper gastrointestinal tract in children and the types of damage from aggressive substances. Unintentional ingestion of aggressive substances by children at home occurs everywhere. The proportion of children under 3 years of age is 69—93 % of all age groups of children. Cases of intentional ingestion of aggressive substances by adolescents for the purpose of suicide have been described. The etiology of a chemical burn of the esophagus depends on the geographic region and is associated with the traditional use of acids and alkalis in everyday life and with the industrial production of household chemicals. The most severe damage is caused by sodium hydroxide, called caustic soda. The consequence of a II—III degree esophageal burn is esophageal stricture. For timely assessment of the severity of the burn, it is important to perform esophagogastroscopy within 48 hours. It is necessary to develop a management system to prevent accidental ingestion of aggressive substances by children, as well as the creation of guidelines for the diagnosis and treatment of chemical burns of the upper digestive tract in children.

Objective. То improve the technique of colproctectomy and suturing of the anal stump during the surgical treatment of complicated UC.

Materials and methods. The study group included 10 patients who were operated on for complicated ulcerative colitis at the Minsk Regional Clinical Hospital in the period from 2019 to 2021.

Results. The study group consisted of 5 men and 5 women. The group underwent three proximal and one distal subtotal colectomies, two colectomies and three colproctectomies. One mesorectumectomy with the formation of a pelvic small intestinal J-reservoir was performed after a total colectomy with end ileostomy and the formation of an intra-abdominal rectal stump. When performing subtotal colectomy, total colectomy and colproctectomy, the colon was removed as part of a mesocolonectomy Colproctectomy additionally included mesorectumectomy. In the study group, 3 anal canal stumps were formed with a single-row extramucosal suture using a monofilament thread.

Conclusion. Mesocolonectomy and mesorectumectomy in the surgical treatment of complicated ulcerative colitis can reduce the number of postoperative complications and comply with oncological principles. The use of an extramucosal single-row suture for the formation of an anal stump after colproctectomy is clinically justified.

The content of social medicine as a discipline related to social processes in society, medicine and healthcare is considered. The concepts of individual and public health of the population, features of clinical and social medicine are revealed. The object, subject, subject and methods of social medicine are presented, its purpose and objectives, and connections with other sciences are formulated. The directions of social medicine are described and a brief historical outline is given.

Objective. То investigate tissue reaction in animals after implantation of biological and synthetic vascular grafts.

Materials and methods. The study was carried out on male Wistar laboratory rats (n = 50). The animals were divided into 2 groups: group 1 — with implantation of a fragment of the biological vascular graft (25 animals), group 2 — with implantation of a fragment of a synthetic vascular graft made of Dacron (25 animals). Sampling for morphological examination was performed on the 3rd, 7th, 14th, 21st and 30th days after surgery.

Results. Animals with implanted fragment of a synthetic vascular graft, starting from the 3rd day after surgery, showed signs of fibrinous-purulent inflammation with the formation of purulent exudate on the 7th day, as well as signs of the beginning of the formation of granulation tissue around the graft. In the group of animals with implanted biological vascular graft, signs of maturing granulation tissue around the prosthesis with a large number of vessels and moderate inflammatory infiltration were revealed.

In animals with synthetic vascular graft, 3 weeks after surgery, classical macrophage giant cell granulomas surrounded by layers of collagen fibers were present in all the studied samples. Proliferating fibroblasts were found along the periphery of the inflammatory infiltrate in a group of animals with a biological vascular graft made of bovine xenopericardium.

On the 30th day, a fibrous capsule was formed in all animals with a fragment of a synthetic graft, and fibroblasts, connective tissue fibers and blood vessels were found in animals with implanted biograft.

Conclusion. There were no statistically significant morphological differences in the response of the rat organism to implantation of a biological vascular graft made of bovine xenopericardium compared with synthetic vascular graft made of Dacron coated with modified gelatin.

The aim of our study is to optimize calculations related to the evaluation of radiation doses when the radiation treatment schedule changes, by simulating such changes in the Web-application «Linear-quadratic model for medical physicists and radiation oncologists», developed on the basis of the theory of linear-quadratic model. As a model study material, we considered the case of changing the radiation treatment regimen in the mode of dose per fraction 2,66Gy to 42,56 Gy, α/β 3 Gy with an interruption that increases the number of days of treatment from 22 to З1. The evaluation was made of the decrease in the effectiveness of the delivered radiation doses when a break occurs in radiation treatment, if the missed fractions are transferred to the end of the RT course without adjusting the dose per fraction; the possibility of compensating for the loss in the effectiveness of the supplied radiation doses was determined by transferring the missed days to Saturday and carrying out fractions twice a day on some days of treatment, as well as taking into account proliferation; It is considered how much the dose needs to be changed per fraction to achieve the effect planned at the start of treatment.

Objective. То study the effectiveness criteria and the need to convert patients from the test stage of sacral neuromodulation (SNM) to permanent sacral neuromodulation.

Materials and methods. 60 patients with spinal cord injury and the presence of neuromuscular bladder dysfunction were studied. Of these patients, after a joint consultation of a neurologist, urologist and neurosurgeon, 30 patients were selected to perform test sacral neuromodulation: 15 women and 15 men, the average age of the patients was 42,2±13,2 years. Patients in the acute period after injury were excluded from the study. The average time since injury was 11,0±9,6 years.

Results. Patients in group A with a hyperreflexive bladder showed more pronounced positive changes in the main indicators taken as criteria for the effectiveness of the test phase of SNM. One patient from group В did not improve in any of the parameters; therefore, the installed electrode was removed from him and he was excluded from the study. Thus, 29 out of 30 patients (96,6 %) received a permanent sacral neuromodulator after evaluation of the test phase.

Conclusion. A decrease in the number of daily micturitions and self-catheterizations, a decrease in the volume of residual urine and an improvement in the quality of life by 50 % or more from the initial data are not only positive effects of the test phase of sacral neuromodulation, but also predictors of the success of permanent sacral neuromodulation.

Objective. To evaluate the role of EC in the diagnosis of pancreatic fibrosis in CP.

Materials and methods. In Vitebsk Regional Clinical Hospital from 2019 to 2021. in 18 patients with various forms and complications of chronic pancreatitis, a complex correlational diagnosis of pancreatic fibrosis was performed using UE, CT and morphological examination of intraoperative biopsy specimens.

UE the study was performed with an ultrasound transducer with a frequency of 3,5—7,0 MHz in the В-mode using the transabdominal shear wave method in the Shear Wave Elastography (SWE) mode on the GE HEALTHCARE apparatus. The tissue stiffness was assessed on the basis of Young’s modulus of elasticity in the SWE mode according to the nature of the distribution of color mapping in the blue-cyan-yellow-red scale.

Histological examination of intraoperative biopsy specimens is carried out as follows: аfter fixation in 10% neutral formalin solution and standard histological wiring, serial sections were stained with hematoxylin and eosin. After automated staining, the preparations were washed under running water, dehydrated in alcohol, and cleared in carbol-xylene and xylene. The sections were then embedded in Biomount medium and covered with a coverslip. Using light microscopy at x100, x200, x400 magnification, changes in the pancreatic tissue were assessed. Histopreparations were photographed using a computer image analysis system (a Leica DM 2000 microscope with a digital camera and the Leica Aplication Suite, Version 3.6.0 licensed program).

The criteria for assessing the fibrous transformation of the pancreatic parenchyma at CT were: the density of the pancreatic tissue according to Housefield.

Computer morphometry was performed using ImageJ I.52p image processing software.

Results. During a morphological study of biopsy specimens, fibrous changes in the pancreas were identified in 18 cases.

The data obtained after performing the UE correlated with the data of the morphological examination of biopsy specimens. In a comparative assessment of qualitative indicators of the degree of fibrous transformation of the pancreatic parenchyma based on the results of ultrasound, CT and morphology, the sensitivity was 86 %, the specificity was 88 %, and the probability of a correct diagnosis was 81%

Based on the results obtained, we have developed a classification of the degree of density (fibrosis) of pancreatic tissue:

Blue and light blue colors — 0—6,2 kPa — fabric of normal density;

Yellow color— TP—10,9 kPa— medium density fabric;

Red color— 10,9 kPa or more — dense fabric.

Conclusions. Thus, in a comparative assessment of fibrotic changes in the pancreatic parenchyma in CP, according to the results of ultrasound, CT and morphological studies, a high diagnostic efficiency of UE was established and can be used as a non-invasive method for assessing fibrotic changes in the pancreatic tiss

ue.