The article  reflects  the  main  statements of the  Maastricht  V/Florence Consensus  Report  (2015), dedicated  to  the  diagnosis and  treatment of Helicobacter pylori infection and associated  with this pathogen  gastroduodenal diseases. The above statements of the  Consensus Report are illustrated as the original, and their own comments.

The physiological role of IgG4 is poorly understood yet. It is known, that they, like other antibodies, are involved in the inactivation and removal of organism agent, which are identified as foreign antigens by immune system. IgG4 also release effector mechanisms: contact  with the specialized immune  cells, which perform  phagocytosis  foreign antigens  or destruction  of the  infected  cells by antibody-dependet cytotoxicity,  after  this interaction. Opinions about the ability to activate complement system are divided. The elevation concentration of that subclass immunoglobulins can be an indicator not only of development of infectious and allergic conditions, but also the presence of the IgG4-related disease in a patient´s organism. IgG4-rd is a recently selected group of pathological conditions and it is becoming relevant to study. It is because they include the conditions, which have been thought  to be separate  nosology previously. In recent years IgG4 –RD has been diagnosed more often, because it has been increasingly being recognized in the medical community. This review includes the latest information from the latest foreign publication.

The aim: to study the impact of Type1 Diabetes mellitus (DM) on systolic function of left ventricle (LV) of young patients  without  cardiovascular disease (CVD) and identify factors associated with dysfunction of global longitudinal systolic deformation. Young patients with Type1 DM (N=71) and without CVD were included in the study. Mean age was 28,7 years, 57% men, glycated hemoglobin 9,9%, body mass index 23,4 kg/m2, and diabetes duration 6,84 [0,5; 24], NT-proBNP 62,62 pg/ml, LV EF 61,7%. Treadmill test was conducted  to all patients  in order to exclude coronary disease. EchoCG examination including analysis of global longitudinal systolic deformation  by two-dimensional  image. Subclinical systolic dysfunction, that is defined as GLS<20%, was observed in 63,3% cases. Left ventricle diastolic dysfunction with slow relaxation (Type1) was observed in 5,6% patients with Type1 DM and GLS<20%. The correlation  was found for GFR and GLS (χ²  12,9, р<0,05,  r=0,62). At the  same time the  relative risk of GLS decreasing with GFR<90ml/min/1,73m2 increased in 2,8 (OR 2,8; 95% CI: 1,4;3,2;p<0,001), with GFR<60ml/min/1,73m2 increased in 3,4 (OR 3,4; 95% CI: 2,3; 4,6; p<0,001). Conclusions: Global longitudinal systolic LV myocardial deformation is a sensitive marker of subclinical myocardial injury of young patients with Type1 DM without CVD.

Aim. Assessing the impact of buspirone hydrochloride on hospitalizations frequency in patients  with chronic heart failure (CHF) and mixed anxietydepressive disorder (MADD).

Materials and methods.  The study involved 49 patients  with heart failure of ischemic etiology and MADD. Patients in Group 1 (n = 25) received buspirone hydrochloride (in the starting dose of 15 mg/day with a gradual (within 2 weeks) increasing to the effective (30 mg/day)) in addition to standard  CHF therapy and coronary heart disease (CHD). Patients in group 2 (n = 24) received standard  therapy of CHF and CHD. After 6 months, we evaluated hospitalizations frequency and duration in patients from both groups.

Results. The risk of hospitalization for heart failure decompensation was significantly lower in patients  from group 1 compared with patients  from group 2 (HR 0.333, 95% CI 1,12-8,05, p = 0.035).

Conclusions. Buspirone hydrochloride admission in addition to standard  therapy  is associated  with reduced risk of hospitalization for decompensation of chronic heart failure in patients with MADD.

The presented  method  of integrated  assessment of liver fibrosis degree based on the comparison of the data obtained in the study of electric and viscoelastic parameters of erythrocytes by the dielectrophoresis  method  using the electro-optical system  of the detection  cells and method  for indirect elastometry. A high degree of comparability of the results of the above-described  methods  was established  when the degree of fibrosis F 2-4  in the  absence  of marked  cytolysis, cholestasis,  inflammatory  syndrome,  metal  overload. It is shown that  parallel using the methods  of dielectrophoresis and indirect elastography is needed in the presence of a rise of transaminases, gammaglutamyltranspeptidase more than 5 norms, expressed dysproteinemia,  syndromes of iron overload, copper to increase the accuracy in determining the degree of liver fibrosis. The evaluation of dynamics of changes of the degree of fibrosis during antiviral therapy is more accurate by the method  of indirect elastometry, and the method of dielectrophoresis  is preferable in the treatment of nonalcoholic fatty liver disease. In cases of restrictions on the use of the method  for indirect elastography (marked obesity, ascites, cholelithiasis, pregnancy, presence of pacemaker, prosthesis) to determine  the degree of fibrosis the method of dielectrophoresis  of red blood cells can be used. Simultaneous use of both methods  (using the identified discriminatory values) allows to reduce or to neutralize their disadvantages, dependence on associated syndromes, to expand the possibilities of their application, to improve the diagnostic accuracy in determining each of the degrees of liver fibrosis. Integrated application of both methods — indirect elastography and dielectrophoresis of red blood cells — for determining the degree of liver fibrosis allows to achieve high levels of sensitivity (88.9 percent) and specificity (100 percent) compared to the “gold standard” — biopsy of the liver.

Due to  the  high social significance of traumatic  brain injury and its consequences,  dynamics of cognitive functions  at  the  background  of the reduction of reconstructive and plastic surgery is of interest to researchers in the world, but this topic is not sufficiently studied. A large number of patients with bone defects of the skull due to a traumatic  brain injury and skull defects after surgery for tumors, and as a consequence of possible cognitive deficits of these patients  makes it necessary to study and assess the possibility of its compensation  as a result of reconstructive  plastic surgery of the skull. Material and methods. In our study, we examined 54 patients  (12 women and 42 men) in surgical treatment neurotrauma department (reconstructive  surgery) after traumatic  brain injury or skull defect after surgical removal of tumors. The average age of patients  is33,09 years. All patients  were examined by a psychologist before surgery, and on the first, third, and seventh-eighth day after the surgery. MoCA, FAB, Schulte tables, HADS, Spielberger-Hanin anxiety test, a set of stimulus materials for neuropsychological diagnosis, all patients were asked to subjectively evaluate their appearance:  until defect acquisition prior to surgery after treatment (see questionnaire  by Sinbukhova E.[8]), also was used projective drawing method, where patients were asked to perform a series of drawings on the given topics. In our study to reduce the high level of situational and personal anxiety of the patients they had Art-therapy sessions with a psychologist before surgery and from the second day after it. The purpose of research is to study the changes in cognitive function, level of depression, anxiety of patients  with postoperative bone defects of the skull after a reconstructive-plastic surgery. Keywords cognitive function, depression, anxiety, reconstructive  surgery. Results On the 3 days after surgery, a statistically significant increase was observed in the evaluation acording MoCA (preoperative mean value — 22 points, 3 days after the operation  — 24 points, p = 0,0002033). Before сheck out (MoCA) significant improvement  in cognitive function was confirmed. Depression, personal and situational  anxiety was significantly reduced by the time сheck out. By the time of сheck out the emotional  state  of the patients showed significant improvement  of emotional  state  level to the level prior to the defect acquisition. Subjective evaluation of appearance  by the time of сheck out of patients showed a significant recovery of subjective apearance evaluation of the level prior to the defect acquisition. Conclusion. The obtained data revealed a statistically significant increase of early postoperative cognitive function of the background of reconstructive-plastic surgery. Statistically significant results of the reduction  of depression, situational  and personal anxiety, improvement  of the emotional  state  of patients after surgery, at the background of daily Art-therapy (projective drawing) sessions with a psychologis.

COPD is characterized by a pathological inflammatory response in the lungs. Inflammation is qualitatively and quantitatively different from that  of smokers and persons without nicotine addiction. There is evidence for the presence of systemic inflammation in COPD, which probably originates in the lungs. Immune system was investigated on the basis of blood cytotoxic lymphocytes such as cytotoxic T — lymphocytes and NK — cells in patients with COPD 2 tbsp. The study included 42 patients with COPD severity according to 2 g (22) GOLD 2014 criteria. 22 patients with COPD 2 tbsp had smoking index of at least 20 pack \ years and 20 patients who had never smoked. In all patients, there were no data on atopy and asthma history. All surveyed patients received inhaled M-holinolitik — tiotropium bromide monohydrate 18 micrograms, and on-demand short-acting bronchodilators for 2 breaths. Age of patients was 1 group (smokers) from 50 to 62 years (mean age 54,1±1,3 years) .2 The second group — 58-75 years (58,21±0,7 years). By indirect immunofluorescence  were determined  relative and absolute  content  in peripheral blood lymphocytes, ekspresiruyuschie antigens CD3, CD4, CD16, CD20, CD23, CD25, CD54, CD71, CD72, HLA-DR, CD95, membrane  immunoglobulin mIgM and mIgG. As a result of the study it was found that  patients  in the early stages of COPD 2 tbsp. there was a significant change in blood levels of cytotoxic lymphocytes,  regardless of the addiction to smoking. But when smoking signs “oxidative stress” are more pronounced,  resulting in a more rapid and possibly further more severe course of the disease. Thus, COPD is characterized by the development  of systemic inflammation, however, the underlying mechanisms, as well as the desirability and feasibility of the suppression of inflammatory processes require further study.

The article describes the case of the primary stomach lymphoma of the stomach in a 29-year-old man. The literature data on the etiology, diagnosis and morphological characteristics of the primary lymphomas of the stomach are presented, the questions of treatment tactics, variants of cytostatic therapy schemes are touched upon.

In the described clinical example, the patient’s medical history is given: from the age of 16 the chronic gastroduodenitis is diagnosed, the patient periodically took omeprazole with a positive effect, there is no evidence of infection with Hp and there is no eradication. In April 2016, he noted the deterioration of health in the form of the appearance of discomfort in the epigastric region. In April 2016, an EHDS was performed at the outpatient stage, where an antral tumor of the stomach was detected, and a biopsy of the formation was taken. Histological examination of atypical cells was not revealed, and in connection with this, in May 2016, he was hospitalized at the A.M. Burnazyan for additional examination.

The article presents  data  of laboratory  and instrumental examination,  the  results  of EGDS, CT of thoracic  and abdominal  cavities, cytological, immunohistochemical,  and cytogenetic studies.

The patient  was given three courses of cytostatic  therapy. The first course of cytostatic  therapy was started  in June 2016, the patient  transferred it satisfactorily, in the post-cytostatic period there was a leukopenia of 2,5 thousand  cells/μl, against which the viral lesion of the tongue mucosa developed, and the therapy with virolex was performed with positive dynamics.

The EGD control showed marked positive dynamics. The second and third courses were conducted in July-August 2016, treatment was satisfactory. In September 2016 he was discharged for dynamic observation by a hematologist.

The article draws the attention of medical practitioners  to the fact that, in the absence of specific clinical manifestations, the basis for the diagnosis of lymphoma in this clinical example is the timely conduct of an endoscopic study with histological, immunohistochemical and cytogenetic  study of the biopsy.

In the process of intensive care in children under exigent infectious states  held a special method  of enteral detoxification salt enteral rastvorom — intestinal lavage. The method  was used in 75 children aged from 1,5 month  to 12 years with a body weight of 3.2 to 44 kg with various infectious pathologies, identifying 8 patients (10,6%) with pneumonia, ask for a ventilator, the translocation of intestinal microorganisms and microbiological confirmation enterohematic connection with the main pathological process is carried out 84 procedures. Positive clinical and laboratory effect was obtained in 70 patients, accounting for 93,31%.