Objective. To determine the possibilities of improving the effectiveness of etiological diagnosis and treatment of pleural effusions.
Materials and methods. Pleural complications were diagnosed in 470 (20,3 %) of 2420 patients hospitalized in two departments of pulmonary surgery over the past 4 years. Diagnostic puncture of the pleural cavity to detect effusions was necessary in 72 (15,3 %) patients. Clinical and radiological methods of investigation were the main methods for diagnosing pleural effusions and the nature of pathological changes in the lungs. All 470 patients underwent cytological and bacteriological examination of exudate obtained during punctures of the pleural cavity to identify the etiology. Diagnostic bronchoscopy was performed in 296 patients, and videothoracoscopy - in 395 patients.
Results. Clinical and radiological methods of investigation in detecting pleural effusions were  informative in 398 patients out of 470 (84,7 %). Diagnostic puncture of the pleural cavity was necessary to detect effusions in 72 (15,3 %) patients. Clinical and radiological methods in identifying the nature of pathological changes in the lungs and the etiology of pleural effusions were informative in 139 (29,6 %) patients. Cytological and bacteriological examination of the exudate obtained during punctures of the pleural cavity allowed to reveal the etiology additionally only in 61 of 470 patients (13,0 %). The etiological diagnosis was made using the method of the examination of biopsy material obtained during diagnostic bronchoscopy in 46 of 296 patients (15,5 %), during videothoracoscopy - in 205 of 395 (51,9 %). The etiology of pleural effusion and the nature of the disease was established by all research methods in 451 out of 470 patients (96,0 %).
Conclusion. Timely referral of patients with pleural effusions to the departments of pulmonary surgery for diagnostic inverstigations in order to obtain material for bacteriological, cytological and histological examination is necessary to increase the rate of etiology detection to 96 % and achieve a faster and better cure.

Objective. To study the structure of neurogenic urination disorders in patients with spinal cord injuries at various levels.
Materials and methods. 60 patients with spinal cord injuries and neuromuscular bladder dysfunction were examined. The diagnosis was made on the basis of the presented diagnostic algorithm. Urine diversion by patients was carried out in four main ways: 1) uncontrolled urination or assisted emptying of the bladder («tapping», «squeezing») and / or using a urocondom, diaper -- in 20 patients (33,4 %); 2) assisted emptying of the bladder and self-catheterization - in 20 patients (33,4 %); 3) periodic self- catheterization -- in 18 patients (29,9 %); 4) an indwelling urethral catheter/cystostomy was present in 2 (3,3 %) patients.
Results. Thus, an analysis of 60 patients with neuromuscular dysfunction of the bladder after traumatic spinal cord injury showed that it is reasonable to distinguish 2 main types of urination disorders: 1) patients with preserved spontaneous urination, as well as patients with partially preserved independent urination and self-catheterization (1 group,33,3 %). 2) patients who do not have an independent act of urination, urine diversion is carried out only by self-catheterization, a permanent urethral catheter or using a cystostomy (2 group). Patients of the first group are patients with detrusor hyperrefflexia (with a hyperreflex bladder), patients of the second group - with detrusor hyporeflexia (with a hyporeflex bladder).
Conclusion. The proposed division into groups is justified in terms of differences in urinary diversion, as well as existing differences in the causes and levels of spinal cord injury, bladder capacity, and upper urinary tract complications.

Significant increase of the amount of information in the health care system has the potential to lead to an increase in the number of mistakes made by health professionals. According to a number of studies, usage of checklists is one of the ways to reduce risks. Proper development and subsequent implementation of this tool can improve the quality of medical care and lead to a decrease in the number of errors. This article reflects the functions of the checklist and potential points of its application, the features of the structure of this document, and also presents the experience of its application.

About a century and a half has passed since Paul Ehrlich first described mast cells, but even today, in-depth study of the functions of mast cells continues, detailing their participation both in maintaining health and elucidating their role in various pathological conditions. Modern advances in mast cell research have strengthened the understanding that mast cells have unique immune functions, a better understanding of which will have a major impact on human health. There is increasing evidence of their participation in the pathogenesis of not only allergic, but also other diseases, including SARS-CoV-2 infection, psoriasis, myalgic encephalomyelitis, multiple sclerosis, diseases of the digestive system, rheumatoid arthritis, interstitial cystitis, tumor development, cardiovascular vascular diseases and other pathologies associated with chronic inflammation. Modem data on the function of mast cells, their primary and secondary dysfunction, including mast cell activation syndrome, require a new analytical approach - a new worldview. The potential of mast cells and their numerous mediators as therapeutic targets and biomarkers of disease severity and treatment outcome has been actively discussed in the recent literature, which is consistent with the principles of precision medicine.

Subchondral insufficiency fracture of the knee (SIFK) is a new nosologic entity that has replaced the diagnosis of spontaneous osteonecrosis of the knee (SONK). Primary avascular necrosis of the femoral condyles is a differential diagnosis with subchondral fracture of bone insufficiency of the knee joint, which requires a different approach to treatment. This article reviews the principles of diagnosis and results of conservative treatment of subchondral bone insufficiency fracture of the knee (SIFK).

Objective. To study the effect of tacrolimus on some cellular parameters of the immune system in patients 1, 3 and 5 years after kidney transplantation.
Materials and methods. The method of flow cytometry examined 63 people of the second period of adulthood with a transplanted kidney with terms after surgery of more than 1 year, more than 3 years and more than 5 years. The control group consisted of 15 men and 15 women of the same age. Statistical data analysis was performed using the R version 4.0.5 application package (2021-03-31).
Results. The study revealed a decrease in the number of DC2 1 year after surgery in men, both in comparison with women of the same group and in comparison with the control group, while at a later date, gender differences are leveled, and the number of DC2 remains reduced in comparison with control group. Analysis of the DC2/DC1 ratio revealed its decrease in comparison with healthy people in all periods of the study. At the same time, 5 years after the operation, a lower DC2/DC1 ratio was found in men compared to women in the same group. Also at all times after kidney transplantation, there is a statistically significant increase in the percentage of total T-lymphocytes and a decrease in NK cells and pre-B and B-lymphocytes.
Conclusions. The found gender differences in the content of dendritic cells and their ratio may indicate the possibility of an increased intensity of antigen presentation in men compared to women. The revealed increase in the content of T-lymphocytes may be a compensatory response to a decrease in NK cells and pre-B and B-lymphocytes, or an insufficient dosage of tacrolimus.

Objective. To study the effect of COVID-19 pandemic on the results of surgical treatment of patients with malignant lung tumors.
Materials and methods. The material for the study included observations of 1187 patients with malignant lung tumors who underwent radical surgical treatment in the volume of anatomic lung resection (lobectomy, bilobectomy, pneumonectomy, including video-assisted and combined ones) at the oncologic thoracic department of the Alexandrov Russian Research Center for Oncology and Medical Radiology. The patients were divided into 2 groups: those operated on in 2018 -2019 before pandemic onset and in 2020-2021, i.e. in the pandemic period. The 30- and 90-day mortality rates and 1-year overall survival were chosen as the main outcome measures.
Results. The 30- and 90-day mortality rates for 2018 -2019 and 2020-2021 were 2,8 % and 3,8 % (p=0,3061) and 4,4 % and 6,4 % (p=0,1197), respectively. There were no significant intergroup differences in overall survival rates (p=0,3725).
Conclusions. The COVID-19 pandemic did not result in a statistically significant worsening of surgical outcomes in patients with malignant lung tumors compared with the pre-pandemic period.

This article reviews the case of a 16-year-old adolescent patient with tuberculous meningitis (TM), who was admitted to the Republican Scientific and Practical Center for Pulmonology and Tuberculosis (RSPCPT) for 425 days. Thearticle aims to discuss the degree of likelihood and severity of NV in the same patient using diagnostic scales (Thwaites diagnostic index, 2002, Lancet Consensus System, 2010). The result on using of the diagnostic indexes shows high likelihood of TM in the patient. Clinical data also suggests the high severity of TM. The study highlights the need for use and development of more modern diagnostic methods and scales for the patients with suspected TM.

The article summarizes information about an outstanding statesman and politician, chairman of the Mogilev and Gomel provincial executive committees, an employee of the state security bodies of the RSFSR and the USSR (CHEKA, GPU and OGPU), organizer of health and science in the BSSR, Ivan Zakharovich Surta. The main data from his short biography (44 years), professional activity are given.

The life and professional path of the famous pediatric surgeon V. D. Lapitsky, one of the founders of the pediatric surgery service in Belarus, is briefly described.

Objective. To study morphological changes in the distal segment of the sciatic nerve upon modulation of cannabinoid CB₂-receptors of mesenchymal stem cells in peripheral neuropathy model.
Materials and methods. Peripheral neuropathy was modeled by excision of a section of the sciatic nerve in Wistar rats. On the 7th day of the experiment, mesenchymal stem cells derived from the rat's adipose tissue were injected into the site of nerve injury at a dose of 110⁶ cells/kg with no additional impacts, with preliminary incubation with the CB₂-receptors agonist AM1241 or the selective antagonist AM630. On the 21st and 90th days of the experiment, a histological assessment of the distal segment of the sciatic nerve was performed.
Results. It was found that activation of CB₂-receptors by the selective agonist AM1241 in the soft tissues of the area of sciatic nerve injury, as well as on mesenchymal stem cell's membranes, was accompanied by a decrease in the number of damaged nerve fibers and proliferation of Schwann cells in the distal segment of sciatic nerve by the 90th day of the experiment. Inhibition of CB₂-receptors by a selective AM630 antagonist was characterized by suppression of the reparative effect of mesenchymal stem cells.
Conclusion. The data obtained indicate the role of cannabinoid CB₂-receptors in the implementation of the regenerative effects of mesenchymal stem cells.