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.

Ключевые слова: хронический калькулезный холецистит, сочетанные заболевания, хирургическая тактика.Comparative analysis of patients with gallstone disease with and without metabolic syndrome has been carried out. In the presence of metabolic syndrome surgery is revealed to be performed under compromised multimorbid conditions that worsen course of comorbidities and quality of life in the postoperative period followed by necessity of optimization of surgical approach and management of patients in the postoperative period.

Материалы и методы. Исследованы 79 больных с вентральными грыжами в возрасте 30-80 лет, соотноше-ние мужчины/женщины 24:88. По классификации Тоскина-Жебровского грыжи малых размеров были у 16 (20,3%) больных, грыжи средних размеров -у 23 (29,1%) больных, грыжи обширных размеров -у 27 (34,2%) больных и ги-гантские у остальных 13 (16,4%) пациентов. По SWR-classification грыжи срединной локализации наблюдались у 59 (74,7%) пациентов, боковой локализации -у 12 (15,2%), сочетанной локализации -у 8 (10,1%) больных. По ширине грыжевых ворот: W1 -у 16 (20,3%) больных, W2 -у 23 (29,1%), W3 -у 27 (34,2%), W4 -у 13 (16,4%) пациентов. Все больные прооперированы. У 57 больных с послеоперационными вентральными грыжами (ПВГ) выполнены открытые операции, включающие в себя симультанные этапы операции. Закрытая герниопластика произведена у 22 больных.Результаты. При открытой герниопластике ранние осложнения наблюдали у 14 (24,5%) больных: у 1 (7,2%) -нагноение раны; у 10 (71,4%) -серомы; у 3 (21,4%) -ранняя послеоперационная кишечная непроходимость. Все больные перенесшие закрытые видеоассистированные операции выздоровели. Выявлено, что при наличии сопут-ствующей патологии оперативное вмешательство осуществляется на отягощенном фоне.Заключение. Представляется крайне важным улучшение непосредственных результатов хирургического лече-ния больных с послеоперационной вентральной грыжей и спаечной болезнью брюшной полости путем оптимиза-ции оперативной тактики и ведения пациентов в послеоперационном периоде.

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