1 РНПЦ трансплантации органов и тканей УЗ «9-я городская клиническая больница», 2 УЗ «Минский городской диагностический центр», г. Минск, Республика Беларусь Центральный понтинный миелинолиз (ЦПМ)редкое, но крайне тяжелое осложнение после ортотопической трансплантации печени. Причина ЦПМ до настоящего времени точно не определена. Тем не менее быстрая коррекция гипонатриемии рассматривается как основной этиологический фактор. В настоящей статье нами представлены два клинических случая ЦПМ у пациентов, подвергшихся ортотопической трансплантации печени. Мы также обсуждаем патофизиологию, эпидемиологию, клиническую картину, способы лечения и меры профилактики ЦПМ. Ключевые слова: гипонатриемия, центральный понтинный миелинолиз, трансплантация печени.Central pontine myelinolysis (CPM) is the rare, but extremely severe complication after orthotopic liver transplantation. The reason for CPM is currently not precisely defi ned. However, the rapid correction of hyponatremia is considered as the main etiological factor. In this paper we present two clinical cases of CPM in patients underwent orthotopic liver transplantation. We also discuss the pathophysiology, epidemiology, clinical presentation, treatment options and preventive measures of CPM.

Despite the fact that the key role of the liver in the formation of the immune response to injury is not in doubt, the mechanisms of weakening the immune response to infectious and noninfectious lesions in patients with hepatic failure remain unclear. We propose an original hypothesis of forming the ways to limit the amplitude of the systemic inflammatory response in patients with the end-stage liver disease. The basis of the hypothesis is the idea that as a result of reducing the intensity of the natural stimulation of membrane mCD14 receptors by the ligands of infectious nature, the basic mechanism of the systemic immune response induction by liver macrophages (

The highest intensity of decomposition of plant residues under spring barley crops was in the crop rotation with sideral steam of 88%, which was higher by 2.3% compared to pure, and for tillage by 88.3%. Soil enrichment with the enzyme urease on the Zvyagintsev scale is considered average and sufficient for the conversion of ammonium nitrogen in nitrogen exchange. High intensity of decomposition of plant residues, sufficient activity of soil urease are the indicators that characterize high soil fertility, were insufficient to obtain high yields of barley. The productivity of spring barley of the Povolzhsky 65 variety in some years reached 3.2 t / ha when tillage on a fertilized background in crop rotations with pure and sideral steam. Averaged four-year results on the yield of barley showed the highest results on tillage on a fertilized background and revealed the advantage of sideral steam. The correlation coefficients of decomposition of plant residues of soil and urease activity, as well as the yield of spring barley, showed a positive correlation for all variants of the experiment, in which an increase in one indicator is associated with an increase in the other.

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The researches are targeted at the efficiency increase of summer barley by application of various ways of soil main processing, in the conditions of insufficient moistening of Central Volga area. Researches were conducted in two the five-field crop rotations on pilot fields of «Agriculture, Soil Science, Agro Chemistry and Land Registry» depart-ment of the Samara GSHA in 2005-2008. The following options of soil main processing were studied: plowing on depth of 20-22 cm; loosening on 10-12 cm; zero processing. Average samples during three stages were investigated from the pilot field of all options of soil processing in triple frequency: in a phase of shoots, heading and after harvesting. Samples taken from various depths: 0-5, 5-10, 10-20 and 20-30 cm, were crushed and sifted. Assessment of total number and ratio of main groups of microorganisms in the soil were carried out by method of microbiological seed-ing of soil mixture on solid nutrient mediums. Content seeding was sterilized in the autoclave. Bacterial inoculation was made on the meat-peptonny agar (MPA), actinomycetes – on the starch-and ammonia agar (SAA), micromy-cetes – on Czapek's. The productivity of summer barley was determined by the mechanized method with regard to area. Soil microbiocenosis change under the influence of various ways of processing was considered. As a result of the conducted researches influence of the fallow tillage on productivity of barley is noted. Barley used with green manured fallow for seeding increases its productivity by 5.5%. Its influence on the general biogennost of the soil is noted. The traditional processing of the soil had no significant effect on productivity of the studied culture.