Our objective was to investigate the effect of probiotic therapy on the profile of a psycho-emotional state and nature of neuro-immune-endocrine changes among patients with depressive disorders. Material and methods — The study involved 119 patients, diagnosed with a mild depressive episode (F32.0) or a moderate depressive episode (F32.1). The patients were split among two groups: Main Group, in which subjects were taking a probiotic medicine in addition to the standard therapy (Cipralex + Bac-Set Forte), and Comparison Group in which subjects were taking a placebo pill in addition to the standard therapy (Cipralex). The Control Group consisted of 30 subjects belonging to the health group 1 sensu the Order of the Ministry of Health care of the Russian Federation No. 869an of January 1, 2018. The examination included clinical and psychopathological, psychometric, and laboratory methods. Results — Patients with depressive disorders had dysfunction of cortisol and monoaminergic neurotransmitter systems, along with an increased content of proinflammatory cytokines and nitric oxide in their blood. As a result of the therapy with a probiotic medicine, in combination with an antidepressant, patients with depressive disorders had a statistically significant decrease in the levels of cortisol, dopamine, IL-6, TNF-, and NO, as well as a more pronounced reduction of depression symptoms, in comparison with the indicators of the patients who underwent standard therapy. Conclusion — Use of probiotics resulted in a more pronounced improvement of neuro-immune-endocrine indicators in study subjects, with subsequent improvement of their mental state – particularly, due to less obvious symptoms of depressive disorders.

The relevance of the study is in the fact that disorders of vascular and psychoneuroendocrine genesis often accompany surgical diseases, the issue of ensuring patient safety in the perioperative period remains the basic focus of modern clinical surgery. The purpose of the study is to identify changes in the level of pro-inflammatory cytokines and the functional state of the endothelium, and also to establish whether the transferred simultaneous surgical interventions intensified pro-inflammatory cytokines and changes in the functional state of the endothelium. In this article, changes in the level of proinflammatory cytokines and the functional state of the endothelium are studied, as well as the relationship of these changes with comorbid psychoemotional disorders when performing simultaneous surgical interventions by laparoscopic and open methods in combined diseases of organs of the abdominal and anterior abdominal wall. The authors carried out a prospective, randomized controlled study of 586 patients aged 18 to 72 years who underwent planned simultaneous surgical intervention (SSI) with combined diseases of the abdominal cavity, pelvis and anterior abdominal wall. In the course of the comparative analysis, a general trend was established: the simultaneous surgical interventions caused intensification of proinflammatory cytokines and changes in the functional state of the endothelium.

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Our goal was to study the effectiveness of resveratrol in correcting cognitive impairments and in normalization of neurotrophin levels in patients with type II diabetes mellitus. Material and Methods ― In a randomized placebo-controlled trial, 100 patients with a verified diagnosis of type II diabetes mellitus took part, who were subsequently placed into two groups: the treatment group of 50 patients taking a polyphenol therapeutic drug in addition to standard therapy, and the comparison group of 50 indivuduals taking a placebo medication in addition to standard therapy. The control group consisted of 30 individuals belonging to the health group I sensu RF Ministry of Healthcare. Treatment efficacy was assessed using the Montreal Cognitive Assessment (MoCA) scale. The concentrations of insulin-like growth factor 1 (IFR-1), brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) in blood plasma were analyzed before and after treatment completion (10 weeks later). Results ― Before starting treatment, patients exhibited an increase in the level of IFR-1 and a decrease in the content of neurotrophic factors (BDNF and NGF) in their blood plasma. In patients receiving resveratrol in addition to standard treatment, changes in IFR-1, BDNF and NGF in blood plasma were more noticeable relative to the comparison group and approached the values of the control group. According to the MoCA scale, more pronounced dynamics of cognitive functions was observed in patients of the treatment group. Conclusion ― The high efficiency of the polyphenol therapeutic drug resveratrol in the correction of cognitive impairments in patients with type II diabetes mellitus was established. The use of resveratrol promoted the normalization of the levels of IFR-1 and neurotrophic factors in the blood plasma: in the treatment group, a more pronounced statistically significant decrease in the concentration of IFR-1, along with an increase in BDNF and NGF levels, were observed relative to the control group. The clinically significant effect of resveratrol was in the reduction of cognitive deficit symptoms, which was confirmed by the data of dynamic monitoring on the MoCA scale: in treatment group, there was a statistically significant improvements of optical and spatial functions, attention, abstract thinking, and fulfilling delayed reproduction task; in the comparison group, there was a statistically significant improvement solely of completing delayed reproduction task.

The concept of "Fast Track Surgery" has been of increasing interest, which implies accelerated recovery and a decrease in the frequency of postoperative complications, namely, a decrease in the body's stress response to surgery. The study aimed to assess the effect of Fast Track Surgery on the degree of surgical treatment trauma based on the dynamics of the functional integration of hormonal components of the stress-realizing / stress-limiting systems in the perioperative period. The study was conducted in 3 groups of patients. Groups of patients are comparable in age, sex, diagnosis of an underlying disease, degree of operative-anaesthetic risk ASA, intraoperative parameters, which allowed to carry out an analytical evaluation of the results of the study as objectively and reliably as possible. In the postoperative period, the maximum increase in stress-realizing system parameters in all groups was registered in patients after 1 day after surgery, less significant after LSSI-F: the concentration of daily excretion of dopamine exceeded the preoperative values by 1.2 times, epinephrine 2.0 times, norepinephrine in 1.3 times. Along with the activation of the stress-realizing system, a dynamic increase in the activity of the stress-limiting system was noted: after LSSI-F, the level of GABA increased by 1.3 times, after TSSI, the GABA secretion increased 1.2-fold. Laparoscopic SSI in combination with "Fast Track Surgery" contributed to a decrease in the intensity of the patient's stress response to the operating injury, which, in turn, significantly increased the effectiveness of simultaneous treatment and the quality of life of patients.