The article presents current experimental and clinical data on the effectiveness and safety of the use of the drug Rebamipide in the therapy of erosive and ulcerative lesions of the gastrointestinal tract (GIT), including those caused by Helicobacter pylori infection, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, endoscopic submucosal dissection for early gastric cancer For a long time, proton pump inhibitors (PPIs) were the only means of drug prevention of these complications. However, PPIs are effective only for the prevention and treatment of pathology of the upper gastrointestinal tract, but not for pathology of the small intestine. With NSAIDs, gastro- and enteropathies, it is advisable to use drugs that can increase the production of prostaglandins and mucus, restore the permeability of the intestinal epithelium, and have anti-inflammatory and antioxidant effects. Today, doctors have a new instrument for protecting the gastrointestinal mucosa - Rebamipide. This drug is a unique cytoprotector that stimulates the production of endogenous prostaglandins and mucus glycoproteins, inhibits reactive oxygen species, the production of inflammatory cytokines and chemokines, and inhibits the activation of neutrophils. In addition, Rebamipide stimulates the synthesis of epidermal growth factor, vascular endothelial growth factor, and nitric oxide. These properties make it possible to use it in various fields of medicine: gastroenterology, ophthalmology, chemotherapy, rheumatology, and endoscopy. Currently, active developments are underway to create new dosage forms of the drug and search for new therapeutic targets. The aim of this study was to analyze the available publications on clinical and experimental studies of the efficacy and safety of using Rebamipide in the treatment of a wide range of pathological conditions.

Currently, diseases of the circulatory system are the leading cause of death. A particular problem of a modern multidisciplinary hospital is the combination of acute coronary syndrome (ACS) with gastrointestinal bleeding (GIB), since it is characterized by a syndrome of mutual burdening and mutually exclusive approaches to treatment. The development of GIB in patients with ACS increases the mortality rate of patients to 50-80%. Despite the practical importance of this problem, today there are no clear recommendations and uniform principles for managing patients with such a unique scenario. The review describes in detail the reasons for the development of GIB in patients with ACS, discusses the mechanisms of action of drugs used in ACS and their importance in the development of GIB. It was found that the incidence of GIB in patients undergoing percutaneous coronary interventions reaches 4%, and the risk of re-bleeding doubles. The options for the treatment of GIB are considered: the role of endoscopic and drug hemostasis, as well as X-ray endovascular embolization of the gastric arteries, is shown as a minimally invasive alternative to traditional surgical intervention. Indications for discotinuation of dual antiplatelet therapy based on an objective assessment of the severity of bleeding have been formulated. Much attention is paid to the issue of prevention of GIB in patients with ACS. Risk factors for hemorrhagic complications were considered, and the risk assessment of possible GIB using the BARC scale was shown.

Objective. To study the parameters of the morpho-functional state of the vascular wall in patients with rheumatoid arthritis (RA) with different levels of total cardiovascular risk (CVR).

Materials and methods. 181 patients with active RA (mean age 40.4 [31.8; 49.6] years) were examined, and 2 groups were formed: 1) patients with the seronegative subtype (n=87); 2) those with the seropositive subtype (n=94). CVR was determined using the modified Systematic COronary Risk Evaluation (SCORE) scale; the intima-media complex thickness (IMCT) and the stiffness index (SI) of common carotid arteries (CCA) were assessed with specific methods.

Results. Low CVR was determined in 86 (48%), moderate risk - in 47%, and high risk - in 5% patients with RA. 176 (97%) patients with RA had signs of subclinical atherosclerosis, with simultaneous IMCT increase above the 75^th percentile and SI increase over 10 m/s in 21% patients. Mean IMCT values and SI in the 2^nd group were higher than in the 1^st group (р=0.018 and р=0.048, respectively). The lower risk was more commonly accompanied by the IMCT increase; as the CVR increased, the proportion of RA patients with SI over 10 m/s increased (р<0.01). A correlation was detected between the age and SI (r=0.58, p=0.035), IMCT parameters (r=0.64, p=0.002). SI correlated with the body mass index (BMI) (r=0.64, p=0.04), and IMTC correlated with the С-reactive protein level (r=0.61, p<0.01). Direct correlation was detected between SI, IMTC, and the Disease Activity Score 28 (DAS28) (r=0.51, p=0.02; r=0.45, p=0.008), RA duration (r=0.42, p=0.04; r=0.58, p=0.04), rheumatoid factor (RF) (r=0.68, p=0.04; r=0.49, р=0.04) and anti-citrullinated peptide antibody (ACPA) levels (r=0.62, p=0.018; r=0.45, р=0.003), respectively.

Conclusion. It is feasible to perform an advanced examination for the diagnosis of subclinical atherosclerosis along with the routine evaluation of total CVR using the SCORE scale in patients with active RA.

The aim was to determine the contribution of the rs7674870 single nucleotide polymorphism of the SLC7A11 A>G gene and alcohol abuse to the risk of acute pancreatitis.

Materials and methods. The material for the study was DNA samples obtained from 469 unrelated patients with acute non-biliary pancreatitis and 572 unrelated individuals without gastrointestinal diseases. The average age of the patients was 48.9 ± 13.1, healthy individuals - 47.8 ± 12.1. The diagnosis and severity of ANP were based on clinical symptoms, laboratory and instrumental methods of investigation. The study participants were divided into two groups depending on the amount of alcohol consumed per week: (1) - less than 200 g per week and (2) - more than 200 g per week; according to frequency: (1) - 1 to 2 days a month or less and (2) - 1 or more days a week; and duration: (1) - up to 10 years and (2) - for 10 or more years. Genomic DNA was purified from the thawed blood samples by phenol chloroform extraction method. Genotyping was performed by real-time PCR by discriminating alleles using TaqMan probes on a CFX96 Bio-Rad Laboratories amplifier (USA) using commercial TaqMan SNP Genotyping Assays reagent kits from Applied Biosystems (USA). Associations of alleles and genotypes with a risk of ANP were evaluated by the odds ratio (OR). Statistical analysis was performed with Statistica 10 (StatSoft, USA), SNPstats.

Results. We did not find any association of the rs7674870 single nucleotide polymorphism of the SLC7A11 A/G gene with the risk of ANP. However, the genotype-environment analysis revealed an association between the G/G SLC7A11 A/G rs7674870 genotype with a reduced risk of ANP in the absence of alcohol abuse in terms of frequency (OR=0.54, 95% CI=0.31-0.96, Р=0.02), duration (OR=0.66, 95% CI=0.44-0.99, Р=0.03), and amount of alcohol consumed per week (OR=0.63, 95% CI=0.41-0.97, Р=0.01).

Conclusion. The results obtained may indicate that, in carriers of the G/G SLC7A11 A/G rs7674870 genotype, moderate consumption of alcohol compensates for pathological changes that can lead to the development of ANP.

Objective: experimental study of the influence of neuropeptides on the psychoemotional state of white male rats exposed to “social” stress.

Materials and methods. A study of the psychomodulatory effect of neuropeptides (Semax, Selank, ACTH(6-9)-Pro-Gly-Pro, Pro-Gly-Pro, Pro-Gly-Pro-Leu) under conditions of experimental “social” stress was performed on white non-linear male rats. The studied neuropeptides were synthesized at the Institute of Molecular Genetics of the National Research Center “Kurchatov Institute”. The study of the effect of neuropeptides on the behavior of male white rats was carried out on the model of “social” stress, the methodological reception of which is the constant residence of animals under conditions of sensory contact in order to form aggressive and submissive types of behavior. The effect of neuropeptides on the psychoemotional state of white rats under conditions of “social” stress was assessed on the basis of studying the behavior of animals in the tests “Elevated сruciform maze” and “Porsolt”. The “Elevated cruciform maze” test makes it possible to study the behavior of animals under conditions of variable stress (with a free choice of comfortable conditions) and allows assessing: the level of anxiety of the animal; symptoms of neurological deficiency. The test “Porsolt” provides an assessment of changes in the motor activity of animals and allows you to study the severity of the depressive state.

Results. It was found that the effect of “social” stress on the behavior of male rats contributed to an increase in situational anxiety and the appearance of depressive-like behavioral reactions. It has been proven that the introduction of neuropeptides (Semax, Selank, ACTH(6-9)-Pro-Gly-Pro, Pro-Gly-Pro, Pro-Gly-Pro-Leu) helps to reduce increased anxiety in animals, both with aggressive and submissive types of behavior under conditions of “social” stress thereby providing a psychomodulatory effect.

Conclusion. This study expands the understanding of the regulatory role of neuropeptides in the body, demonstrating the possibility of their influence on the psychoemotional state.

The aim of the study is to determine the size and to identify the features of histoarchitectonics of the uterine tube ampulla of an old-aged female.

Materials and methods. The ampulla of both uterine tubes was examined in 26 nulliparous and 78 giving birth elderly women using morphometric, histological, immunohistochemical, and micrometric research methods.

Results. The length and outer diameter of uterine tubes at the points of transition of isthmus into the ampulla and ampulla into the infundibulum as well as in the central part of ampulla are characterized by the absence of a statistically significant difference in parameters in nulliparous and giving birth women. The histoarchitectonic features of the ampullae of the uterine tubes in nulliparous and giving birth women in old age consist in the flattening of the epithelium of the mucous membrane, which forms many closely spaced thickened folds that create an uneven narrowing of the ampulla lumen, and the proliferation of connective tissue between the bundles of muscle fibers of the muscular membrane. The presence of Ki-67 expression in single cells of less than 1%, as well as a thin layer of epithelial membrane antigen in the epithelium of the ampulla along with the complete absence of its expression in the stroma reflect normal tissue regeneration and act as an equivalent to the anatomical norm in elderly females. When comparing lumen areas of ampulla and its wall at mid-section as well as the circumference of epithelial lining, a predominance of parameters in the right uterine tube was revealed (p<0.01).

Conclusion. The study showed the similar qualitative and quantitative morphological characteristics of the uterine tube ampullae both in nulliparous and giving birth females in old age.

According to WHO data, nowadays at least 2.2 billion people worldwide currently have visual impairment or blindness, of which more than 11.9 million people worldwide have moderate to severe irreversible visual impairment that could be prevented.

Objective: to assess the clinical course of a standard infected corneal burn during treatment using combined ophthalmic medicinal films levofloxacin + dexpanthenol and dexamethasone + dexpanthenol from a comparative perspective.

Materials and methods. The article investigates the pharmacological activity of five different drug regimens for the treatment of an infected corneal burn in rabbits. Treatment of the first wave began 1 hour after the formation of a standard infected corneal burn. Treatment of the second wave began after the absence of signs of an inflammatory reaction was detected. The clinical course of the standard infected corneal burn was assessed immediately after the formation of the burn and the infection, 1 hour, 2, 3, 5 and 14 days after the experiment started.

Results. Clinical recovery began on the 3rd day in experimental group 2 treated with combined ophthalmic medicinal films of levofloxacin 1.5 mg + dexpanthenol 1 p/day. On the 5th day of the experiment, recovery was recorded in the experimental group 1 treated with 1.5 mg levofloxacin-based eye films once a day, as well as in comparison group 2 treated with 0.5% levofloxacin 4 times a day and 5% dexpanthenol 6 times a day. On the 7th day after the formation of a standard infected corneal burn, clinical recovery was recorded in comparison group 1 treated with instillations of levofloxacin 0.5% 4 times a day. In the control group with placebo treatment no conjunctiva inflammatory reaction was recorded on the 14th day of the experiment, however, there was persistent corneal opacity in the form of a spot at the burn site.

Conclusions. While treating a standard infected corneal burn, the use of combined ophthalmic medicinal films can shorten the clinical recovery period to 3 days, in comparison with treatment with instillations, where recovery occurred on the 5th day of the experiment.

Objective. To determine the variability of morphometric parameters of ethmoid bone structures in childhood and to identify the most significant of them to optimize surgical interventions.

Materials and methods. Craniometry of 87 native samples of children's skulls aged 1-21 years without gender identity, and 85 computer tomograms (CT) scans of children of the same age were carried out. Measurements on skulls were made with caliper gage, metal ruler. The CT scan was performed on «Toshiba» 4-slice computer scanner «Asteion-S4» with a 0.5-1.0 mm increment. To assess the validity of the differences between the rows, the t-criterion was used for independent samples.

Results. The ethmoidal labyrinth at the age of 1-1.5 and 2-3 years has the smallest size: length - 26.9-28.7 mm, width - 7.1-7.7 mm, height - 14.1-15.9 mm. However, the cribriform plate reaches in infancy almost the same size as an adult (length 21.7 mm, width 10.4 mm at the front and 11.2 mm at the back) and is rectangular or oval in shape. By adolescence, its shape changes to trapezoidal or triangular. Frequency of pneumatization of crista galli (8.3-82.4%) increases in children's age groups similar to that of sinuses. Trans-ethmoid access to the base of the skull during endonasal operations is significantly difficult in children under 4 years old. Transcribriform access to the anterior cranial fossa and crista galli can be used from infancy.

Conclusion. The ethmoid bone is mostly formed by the time of birth. The increase is observed by the age of 2 years, and then in 13-16 years, in 17-21 years the growth of the ethmoid bone stabilizes.

The improvement of drug therapy for a number of neuropsychiatric diseases requires the search for new directions of action in comparison with those currently used. Most of the drugs used affect molecular targets that modulate interstructural (interneuronal) interactions. Influencing the deeper processes of synaptic and neuronal homeostasis may be a new direction in the treatment of these diseases. This review examines the mechanisms of homeostatic plasticity of synaptic transmission and electrical excitability of neurons, which balance each other and stabilize the functioning of neurons and neural networks. The first type of homeostatic plasticity is regulated by the intracellular Ca²⁺ concentration and the activity of protein kinases, and the second one - by membrane density of voltage-dependent ionic channels. Analysis of literature data shows that alterations in some neuro-psychiatric diseases reveal disorders of homeostatic plasticity more often in terms of monodirectional alterations of synaptic impacts and neuronal electrical excitability. Thus, mainly in preclinical studies, it was revealed that stress-induced depressive disorders of behavior are accompanied by a unidirectional increase in pyramidal neurons of 2/3 layers of the prefrontal cortex of rodents, or a weakening in neurons of the 5^th layer of synaptic drive and electrical excitability. Similar disorders of homeostatic plasticity were observed by other authors in pyramidal neurons of the dorsolateral prefrontal cortex in schizophrenia, depending on the prevalence of positive or negative symptoms. In chronic neuropathic pain, an increase in the excitability of peripheral neurons of the spinal / trigeminal ganglia, neurons of the dorsal horns, and cortical neurons and an increase in incoming synaptic influences were revealed. The observed disturbances were accompanied by changes in the density of ion channels in neuronal membranes. The peculiarities of the distribution and biophysical properties of voltage-dependent potassium channels allow us to consider them as a probable molecular target for the correction of disorders of homeostatic plasticity.

Objective: To evaluate the efficacy of the selank regulatory peptide against cognitive-affective disorders in patients with atopic dermatitis (AD).

Material and methods. The analysis of cognitive-affective disorders of 65 patients with atopic dermatitis (AD), randomized into 2 statistically comparable groups, was carried out. Patients of the first group received basic drug therapy (BT) for AD, the second group - a combination of selank and BT (S + BT) intranasally, 2 drops in each nasal passage, 3 times a day, for 14 days. The control group consisted of 30 healthy individuals. The levels of personal (LT) and reactive (RT) anxiety, alexithymia, the level of β-endorphin in the blood, and the quality of life (QOL) before treatment and after 30 days from its start were assessed.

Results. In patients with AD, the level of RT was 4.2 times higher than in the control group, RT - 3.2 times, alexithymia - 18 times. In the BT group, 30 days after the start of treatment, RT decreased 1.4 times and RT - 1.3 times. In the C+BT group, the decrease in LT and RT was equally significant - by 2.4 times. The levels of alexithymia and blood β-endorphin in the BT group did not change significantly. In the S+BT group, alexithymicity of patients decreased by 1.2 times, and the level of β-endorphin in the blood increased by 1.9 times. The quality of life index in the BT group decreased 1.2 times after 30 days from the start of therapy, and 1.7 times in the S + BT group.

Conclusion. Patients with AD are characterized by the increased levels of personal and reactive anxiety and alexithymia, which reduce their quality of life. The use of the selank regulatory peptide in the complex treatment of patients with AD has a corrective effect on affective-cognitive impairment, contributing to a decrease in the levels of personal and reactive anxiety, alexithymia, increases the level of β-endorphin in the blood and improves the quality of life of patients.