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"vestnik vsmu" 2011  vol. 10 №1


Tserkovsky A.L.
Modern views on the problem of stress resistance

Abstract. The aim of this review article is to focus on the problem of stress resistance in the system of higher education by dint of its most urgent aspects consideration.
Sociopsychological and medical significance of stress resistance is determined by its direct connection with the well-being, individual`s mental and physical health, the effectiveness of his or her activity and behaviour.
The article deals with the main aspects of stress tolerance problem: phenomenology, individuality, personality (type A personality; power, inactivity-lability, steadiness of nerve processes; temperament; anxiety; gender; motivation and purposes; self-appraisal) and subjective (personal style and the styles of coping behaviour) determinative factors of stress resistance.
The article also concerns such important aspects as the influence of stress resistance on human health, educational process at the university, as well as the teaching activity.


Smirnov V.Y., Razvodovsky Y.E., Doroshenko E.M., Sheybak V.M.
«Talerin» preparation effect on free amino acids pool in subchronic alcohol intoxication

Abstract. We investigated the effect of intragastric administration of preparation «Talerin» on the pool of free amino acids of the heart of rats in subchronic alcohol intoxication (SChAI). It was found that SChAI decreases the levels of cystathionine and phosphoethanolamine, elevates the levels of alanine, methionine, arginine and tryptophan. The administration of the preparation tested was shown to raise BCAA/AAA ratio, to prevent the increase of the levels of tryptophan, alanine and arginine, and to promote catabolism of sulfurcontaining amino acids in the heart.

Denisenko V.L., Gain Y.M., Shakhray S.V., Veremey E.I., Zhurba V.A., Rukal V.M., Gain M.Y.
Modeling of occlusive large-bowel obstruction in laboratory animals

Abstract. Recently in the world the rise in colorectal cancer incidence has been observed, that causes significant financial losses in the countries with advanced economy. In the USA the cost of complex treatment of patients with this localization of cancer ranks second, making up 6,5 milliards of dollars per year (after breast cancer, for the treatment of which 6,6 milliards of dollars are spent annually). The number of patients being urgently operated on for different complications of large bowel cancer is growing steadily, among these complications occlusive large-bowel obstruction occurring most frequently. To work out effective methods of treatment for complications generally recognized approach is experimental efficacy assessment of these or those therapy techniques on concrete model of pathological condition. In experimental surgery the following methods of occlusive large-bowel obstruction modeling are known: laparotomy and narrowing of large bowel lumen in its distal parts (descending colon or sigmoid colon, rectosigmoid part of large bowel) with the use of special rings, material strips, ligatures. Disadvantages of these methods are execution difficulties; general anesthesia duration; the necessity to perform with the purpose of modeling traumatic operation – laparatomy, significantly worsening the condition of an animal, with further manipulation on large bowel; the impossibility to form an obstruction at the level of rectum (in human beings tumoral obturation of rectum is one of the most probable and frequent causes of low occlusive ileus); the impossibility without relaparotomy and manipulation on large bowel to stop pathological cascade of the disease development. At present there is no method devoid of all specified above shortcomings.


Kulikov V.A.
Reverse transport of cholesterol from macrophages

Abstract. In this literature review modern conception of reverse transport of cholesterol from macrophages is elucidated. The basic phases of this multi-stage process have been described: 1) efflux of cholesterol from macrophages; 2) etherification of cholesterol; 3) transfer of cholesterol and its ethers to the liver; 4) biliary excretion of cholesterol. The basic regulation mechanisms of reverse transport of cholesterol from macrophages are considered. The main routes of medicinal influence on this process have been presented.

Histology, cytology, embryology

Sobolevskaya I.S., Grushin V.N., Myadelets O.D., Kichigina T.N.
Morphology of lipid-containing and lipid-synthesizing structures of the human skin depending on topography

Abstract. The main object of the investigation presented in this article is lipid-containing and lipid-synthesizing structures of the human integumentary system, peculiarities of their allocation and structure depending on topography and functioning.
Lipid layer thickness and the spread of lipid-containing and lipid-synthesizing skin structures depend on the region. Lipid producers of the skin are, firstly, adipocytes of fat tissue; secondly, keratinocytes, which produce fats in terminal differentiation; and thirdly, sebocytes of oil glands, which produce sebum through holocrine secretion.
Lipid-containing structures of the skin are horny layer and interfacial fatty film produced out of oil glands secretion – sebum.


Sivakov V.P.
Cardiac rhythm variability - the periods of forming conceptions about modulation of heart rate and promising directions of further investigations

Abstract. In this article questions concerning the formation of conceptions about heart rate variability are considered. Historical data on pulse diagnosis as a starting point in the formation of views about the considered problem are presented.
The period of the first references to the phenomenon of heart rate variability (XVIII century) has been distinguished, beginning from the discovery of the fact of «respiratory arrhythmia» to the revealing of «Traube-Hering waves» and «Mayer’s waves».
In the chronological order the stages of studying wave structure fluctuations of blood pressure and heart rate have been analyzed. Four basic historical periods in the studying of heart rate variability have been distinguished. Promising directions in the study of cardiac rhythm variability have also been shown.

Internal medicine

Kozlovsky V.I., Dubas I.O.
Aggregation of the suspension of leukocytes and platelets and erythrocyte deformability in patients with arterial hypertension after survived community-acquired pneumonia

Abstract. This article is devoted to an urgent problem of microcirculatory disorders (MD) in patients with arterial hypertension (AH) in case of the development of community-acquired pneumonia (CAP) and evaluation of association of the studied microcirculatory indices with peculiarities of AH course, complications, lethal outcomes of cardiovascular diseases. Considerable MD are known to be noticed in patients with AH, which can essentially be aggravated in case of CAP occurrence and promote the development of unfavourable cardiovascular events (CVE). It has been established that CAP occurrence was accompanied by significant increase in aggregation of the suspension of leukocytes and platelets (SLP) and decrease in erythrocyte deformability (ED) which remained during hospital treatment also in the postpneumonic period in patients with the 2nd degree of AH. The total number of unfavourable CVE within 1 year after CAP reliably correlated with ED, aggregation of the SLP and was reliably larger than that in patients with the 2nd degree of AH without CAP. It is rational to administer medicines reducing aggregation of the SLP and improving ED in patients with the 2nd degree of AH in the postpneumonic period.

Lagutchev V.V.
The prognosis of cardiovascular complications development in patients with obliterating atherosclerosis of the lower limbs arteries

Abstract. With the purpose of prognosing individual risk of cardiovascular events development in patients with obliterating atherosclerosis of the lower limbs arteries (ОАLL) five-year dynamic observation of 48 patients (all males) at the age of 53,11±5,47 years, suffering from ОАLL and 20 practically healthy men (mean age 47,70±7,33 years) was made.
In patients with ОАLL in 50% of cases during five years’ period clinical manifestations of atherosclerosis of other localizations develop. To prognose the probability of vascular accident development in patients with ОАLL, the level of HDL-C,VLDL-C, C-rp and the presence of Chlamydophilia pneumoniae and Virus herpes simplex II are of the greatest value.

Shchupakova A.N., Lagutchev V.V.
The assessment of interrelation between immune status and cholesterol profile in patients with obliterating atherosclerosis of the lower limbs arteries

Abstract. With the purpose of establishing interrelation of functioning of immune status and cholesterol profile in patients with obliterating atherosclerosis of the lower limbs arteries (OALL) 56 patients (all males) at the age of 51,2±5,64 years, suffering from ОАLL and 20 practically healthy men (mean age 49,4±6,8 years) were examined.
It has been determined, that in 93% of patients with ОАLL hyperbetacholesterinemia prevails as well as versatile changes of immune system indices in the form of increasing quantity of general T-lymphocytes in blood – in 44% of persons, active T-lymphocytes – in 35%, T-supressors / cytotoxic – in 39%, B-lymphocytes (СD20) – in 67%, circulating immune complexes – in 91% in combination with rising absorption activity of neutrophils and lysis intensity of the absorbed cells, phagocytic index being invariable. The interrelation between changes of immune system and activity of direct cholesterol transport in patients with ОАLL has been established.


Strupovets I.N.
Minimum CNS damages in the early neonatal period and their role in the development of infantile cerebral paralysis in premature babies

Abstract. The purpose of this study was to investigate minimum damages of the central nervous system in preterm infants in the neonatal period from the position of catamnesis.
Structural changes in the brain, such as intraventricular hemorrhage and periventricular first degree infiltration in preterm infants have been shown to constitute danger not only in the acute period, but in the remote period as well. The findings of our study indicate the possibility of neurological sequelae associated with minimal damage to the central nervous system in preterm infants.

Semyonova O.V.
Biliary tract pathology risk group of children

Abstract. Multifactor biliary tract pathology hampers the revealing of children risk group for carrying out the preventive programs. The purpose of this investigation was the formation of biliary tract pathology risk group of children on systematization of anamnesis peculiarities in sick children, as risk markers, for the organization of well-timed rehabilitation. 300 children at the age of 5-14 years, 103 boys, 197 girls, were examined; 95 children were with dysfunction of biliary tract, 115 suffered from cholecystitis, 34 were ill with acute cholecystitis, 20 children had cholelithiasis. The control group consisted of 36 children, in whom in the presence of clinical symptoms of functional dyspepsia and biliary pain no pathology was revealed. The examination was carried out according to generally accepted branch standards under the conditions of gastroenterological department, the results were processed by means of STATISTICA program. On the basis of the results of the study anamnesis peculiarities scale was created for children with biliary tract pathology (the markers of children risk group), in which the peculiarities are ranged on 10-score scale, in accordance with the frequency of their revealing as distinct from the control group and the indication of the most typical pathology of the biliary tract. The designed scale allows to plan the individual preventive programs in accordance with the revealed anamnesis peculiarities and expected biliary tract pathology.


Khryshchanovich V.Y., Tretyak S.I.
The problems of replacement therapy in postsurgical hypothyroidism

Abstract. Hypothyroidism development, as well as the majority of other chronic diseases, is accompanied by decrease in life quality of the patients. Despite adequate replacement therapy, a number of life quality parameters in patients with hypothyroidism remain unsatisfactory. The influence of chronic thyroid insufficiency and concomitant gastrointestinal disturbances on life quality of the patients has not been studied yet.
The investigation carried out deals with this problem. Cross–sectional study of 95 patients with postsurgical hypothyroidism (the postoperative follow-up lasted for 38 months) was conducted. In 26 patients hypothyroidism was isolated (the first subgroup), in 69 patients in the postoperative period hypoparathyroidism was revealed (the second subgroup). The patients constantly took levothyroxin and, if indicated, calcium and vitamin D (or its analogs). Both subgroups of patients matched in sex, age and duration of postoperative period. The assessment of life quality, symptoms of hypothyroidism and thyroid homeostasis was made by means of valid questionnaire GSRS, questionnaire TSQ, TSH serum indices.
In all patients with postoperative hypothyroidism the increase of GSRS score covering all parameters was noted (P>0,05), the highest decrease in life quality being observed on constipation and dyspeptic syndromes scales. The signs of gastrointestinal disturbances were marked to a greater extent in patients with hypothyroidism and permanent hypoparathyroidism. In both subgroups of patients the following symptoms prevailed: constant drowsiness (63%), anxiety (74%), cramps (62%), dryness of the skin (57%), palpitation and heart pains (83%), excessive sweating (73%), feeling of heat (58%).
Standard treatment given nowadays for hypothyroidism fails to fully restore patients` life quality. Further studies are necessary to investigate the influence of more physiological treatment options including transplantations on the life quality of these patients and their moods.

Okulich V.K., Fedyanin S.D., Plotnikov F.V., Bulavkin V.P., Kovalenko A.A., Zubareva I.V., Matskevich E.L.
Rational use of antibiotics in the treatment of pyonecrotic forms of diabetic foot

Abstract. We examined 425 patients with pyonecrotic forms of diabetic foot in the bacteriological laboratory. Microorganisms strains were identified with the help of commercial biochemical test-systems ATB Expression. Sensitivity of microorganisms to antibiotics was studied with the help of ATB Expression biochemical analyzer, with standard disks method, serial dilution method and by means of original test-systems «AB-STAPH», «AB-PSEU», «AB-GRAM(-)» and «AB-ENTER». The leading role of staphylococci, Enterobacteriaceae, Pseudomonadaceae in the ethiology structure of pyonecrotic forms of diabetic foot was proved. We developed the empiric antibiotic therapy scheme of the studied disease, based on ethiology structure data, dynamics of microflora and strains sensitivity to antibiotics.


Krylov A.Y.
Immunohistochemical analysis of synchronous multifocal carcinoma of the stomach

Abstract. Comparative immunohistochemical analysis of the expression of markers of apoptosis and proliferation (p53, Bcl 2 and Ki67) in the cells of synchronous mulifocal stomach carcinomas (n=21) associated with colon cancer was made. As the control group 21 observations of stomach carcinoma with five-year survival rate, without backsets and multiplicity after stomach resection were used. It was determined that the value of proliferation index Ki67 and apoptosis Bcl 2 in the investigated group was higher than that in the control one.
At clinicomorphological analysis of the expression of epidermal growth factor receptors (HER2/ neu) in the cells of resected stomach carcinomas (n=52) hyperexpression of this marker was revealed immunohistochemically in 23% of cases. These cases were represented by the tumours with histological pattern of adenocarcinoma (intestinal type). In the tumours of diffuse type HER2/ neu hyperexpression was not revealed. The obtained results testify to the economic feasibility of carrying out high-priced HER2/neu hyperexpression screening to make a decision about the target therapy with gerceptin first of all in the tumours with histological pattern of adenocarcinoma.

Hygiene and ecology

Krylov A.Y., Malashenko S.V., Davydov V.N.
Monitoring of 137Cs content in the liver of the deceased residents of Vitebsk and Gomel regions of the Republic of Belarus

Abstract. The content of 137Cs in the liver of the deceased from Vitebsk and Gomel regions of the Republic of Belarus was studied by gamma-ray spectrometry method. The analysis of the previous researches data was carried out. The content of 137Cs in the samples of liver tissue of the deceased residents of Gomel and Gomel region still remains much higher than in those of the deceased from Vitebsk and Vitebsk region. In the deceased residents of Gomel the content of 137Cs in the samples of liver tissue is significantly lower, than in those of the deceased residents from the regions served by Mozyr inter-district pathoanatomical department which includes also the areas of «tight control». The content of 137Cs in the samples of liver tissue of the deceased both with hepatic cirrhosis and without it does not differ substantially.

Cherkasova O.A., Ivanov V.S.
Industrial enterprises of the town of Vitebsk as a source of soil pollution with heavy metals

Abstract. This article is based on actual data obtained while conducting research work on determination of the degree of soil pollution in the town of Vitebsk in the vicinity of industrial metal-working enterprises in 2009. In the soil samples taken the content of heavy metals (Cd, Co, Cu, Zn, Pb, Mn) was determined. It is these heavy metals that chiefly pollute urban surroundings.
The basic sources of city soils pollution - the metal-working enterprises: «Metal construction works», «Steel», «Mechanical plant», «Plant of tractor spare parts», «Works of sanitary-technical intermediates», «Instrument-making works», «Motor repair works», «Machine-tool plant» were analyzed in this article. The obtained data enabled us to estimate the level and danger of the urbanized industrial sector, to reveal spatial heterogeneity and dynamics of pollution, to determine the most unfavourable territories for population residing.

Forensic medicine

Denisenko A.G.
The determination of B-lymphocytes by the method of rosetting with anti-CD22 diagnosticum at different intervals after death

Abstract. To determine the remoteness of death the amount of B-lymphocytes was analyzed in dynamics by the method of rosetting with erythrocytic anti-CD22 diagnosticum. The quantity of CD22 expressing B-lymphocytes was determined in blood of 10 deceased who died of mechanical traumas and asphyxia. Our research revealed statistically significant changes in В-cellular component of immune system with the decrease of B-lymphocytes levels over up to three days period.
Median decrease for receptors, expressing CD22 on B-lymphocytes made up 10% [25th and 75th percentiles = 8, 12] at the interval of 27-36 hours after death; 4,5% [4, 5] 51-64 hours after death; 2,5% [2, 3] 65-78 hours after death (р<0.001); 12% [10, 14] 17-26 hours after death and 8% [6, 9] (р<0.01) 37-50 hours after death.
The advantage of using erythrocytic diagnosticum with monoclonal antibodies for the determination of the remoteness of death consists in the simplicity of this method and the possibility to perform the reaction under standard conditions.


Butvilovsky A.V., Barkovsky E.V., Karmalkova I.S.
Chemical foundations of teeth enamel demineralization and remineralization

Abstract. In this article modern conceptions of chemical composition of teeth enamel, its properties and mechanisms of mineralization are surveyed. Great attention is given to isomorphous and isoionic substitutions in the structure of apatites, the stages of substances penetration into them, chemical foundations of tooth hard tissues demineralization and conditions of their mineral composition restoration under the influence of oral fluid and remineralizing solutions.

Chernyavsky Y.P., Kavetsky V.P.
Modern approaches to correction of minor dentition defects

Abstract. The article deals with modern approaches to correction of minor dentition defects. The priority of using the conventional and alternative replacement techniques that are most widely spread in the Republic of Belarus has been assessed. The peculiarities of choosing the constructions proposed by the dentists depending on their experience and place of work have been studied. Recommendations for correction of minor dentition defects given by the dentists of different specialization have been compared. The choice of restorative constructions made by dentists in various clinical situations has been grounded. Practical recommendations have also been given.

Kabanova A.A., Okulich V.K., Bogdan N.Y.
Myeloperoxidase of the oral fluid in patients with odontogenic phlegmons

Abstract. The aim of this research is to study the content of myeloperoxidase (МPО) in the oral liquid in patients with odontogenic phlegmons and to determine its diagnostic value. 214 samples of the oral liquid received from 64 patients with acute odontogenic osteomyelitis of the lower jaw complicated by phlegmon of one of the cellular spaces (38 patients) and phlegmon of two or more cellular spaces (26 patients) have been studied. МPО was determined by means of the modified Schindler’s technique. As a result it has been established, that MPO level of the oral liquid in patients with odontogenic phlegmons is above its level in healthy people, MPO level in patients with the widespread phlegmons being higher than that in patients with the limited phlegmons. The formula to determine the prevalence of pyo-inflammatory process according to МPО content in the oral liquid has been proposed.

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