Aim. Current clinical recommendations accentuate current methods for the diagnosis and treatment of irritable bowel syndrome (IBS).Key points. IBS is a functional bowel disorder manifested with recurrent, at least weekly, abdominal pain with the following attributes (any two leastwise): link to defecation, its frequency or stool shape. The symptoms are expected to persist for at minimum three months in a total six-month follow-up. Similar to other functional gastrointestinal (GI) disorders, IBS can be diagnosed basing on the patient symptoms compliance with Rome IV criteria, provided the absence of potentially symptom-causative organic GI diseases. Due to challenging differential diagnosis, IBS can be appropriately established per exclusionem, with pre-examination as follows: general and biochemical blood tests; tissue transglutaminase IgA/IgG antibody tests; thyroid hormones test; faecal occult blood test; hydrogen glucose/ lactulose breath test for bacterial overgrowth; stool test for enteric bacterial pathogens and Clostridium difficile A/B toxins; stool calprotectin test; abdominal ultrasound; OGDS, with biopsy as appropriate; colonoscopy with biopsy. The IBS sequence is typically wavelike, with alternating remissions and exacerbations often triggered by psychoemotional stress. Treatment of IBS patients includes dietary and lifestyle adjustments, various-class drug agents prescription and psychotherapeutic measures.Conclusion. Adherence to clinical recommendations can facilitate timely diagnosis and improve medical aid quality in patients with different clinical IBS variants.

Introduction: Valproic acid (VA) is carboxylic acid with a branched chain, which is used as an antiepileptic drug. Valproic acid influence on cells in vivo: VA, which is an antiepileptic drug, is also a teratogen, which causes defects of a neural tube and an axial skeleton, although the mechanisms are not yet fully clear. Valproic acid influence on mesenchymal stem cells (MSC) in vitro: It is shown that valproic acid reduces the intracellular level of oxygen active forms. Valproic acid effect on tumor cells: VA inhibits tumor growth through several mechanisms, including the cell cycle stop, differentiation induction and inhibition of growth of tumor vessels. Valproic acid influence on enzymes: It affects mainly GSK-3. Valproic acid influence on animals’ cells: It is shown that VA can significantly improve an ability to develop in vitro and improve nuclear reprogramming of embryos. Erythropoietin (EPO): Is an hypoxia-induced hormone and a cytokine, which is necessary for normal erythropoiesis. EPO is widely used in in vitro experiments. Conclusion: Thus, the influence of VA and EPO on cells can be used in cell technologies.

Ключевые слова: грыжа, эндопротез, алмазоподобное углеродное покрытие.It is presented the results of implantation of meshendoprostheses with and without carbon coating for surgical treatment of abdominal hernias in experiment and clinical practice. It was shown that diamond-like carbon coating minimizes primary tissue reaction against foreign material and provides complete implant's biological integration into subcutaneous connective tissue as areactive encapsulation with connective tissue. Suggested meshendoprostheses withdiamond-like carbon coating decrease local inflammatory reaction in operated area and thereby reduce number of exudative complications in early postoperative period.

Today, considerable progress in the renal cell carcinoma (RCC) treatment has been made due to development of targeted and immunotherapeutic approaches to the RCC treatment, especially in metastasising carcinoma. In the early stages of RCC, it is possible to use partial or total surgical nephrectomy, but in metastases development, the range of efficient treatment methods is dramatically limited. Appearance of targeted drugs like PD-1 and CTLA-4 receptors and their ligands' inhibitors in clinical practice has significantly increased the total survival rate of patients with renal cell carcinoma. Emergence of adoptive cell therapy has opened new possibilities and prospects in RCC treatment. Previously activated in vitro cells are used there, which provides antineoplastic activity. For example, it could be antigen-specific cytotoxic T-lymphocytes (CTL), lymphokine-activated natural killers (LAK-NK-cells) and tumour-infiltrating lymphocytes (TILs). In this review, the authors specified the main molecular markers, associated with RCC; and signalling pathways (VEGFR-and EGFR-signalling pathway), which directly take part in carcinogenesis. The paper also looks at clinically applicable targeted immune drugs and the principle of their effect on tumorous cells. Besides, modern clinical studies of cell drugs have been considered. At the moment, there are a number of variants of targeted and immune drugs for the metastatic RCC treatment. Patients have no opportunity to use all the available agents because of their cost and toxicity level. For the most efficient treatment of patients with diagnosed metastatic RCC, it is necessarily to carry out risk stratification and prognostic factors for the response to treatment.

Introduction: Choledocholithiasis is still an actual problem of treatment of complicated forms of cholelithiasis. The difficulties in treatment of this pathology are caused by the predominance of elderly and senile aged patients whom biliary stenting in most cases can be used as the only method of treatment. The purpose of the study is to justify the usage of endobiliary prostheses with antiseptic coating in the treatment of patients with choledocholithiasis. Material and methods: We analyzed the results of 95 patients’ treatment with “difficult” choledocholithiasis and in these casesbiliary endoprostheses were used at the first stage of curing. In 56 cases (group 1–58.4%), stenting was performed with “traditional” plastic prostheses without special coating, 39 stentings (group 2–41.6%) were performed with plastic stents, the surfaces of which were modified with 10% betadin solution. Results: The frequency of patient’s postoperative complications of the 1st group was 19.64% and 7.69% in the 2nd group. The decrease of specific complications such as early stent obturation and the development of purulent cholangitis was identified. The rate of complications in cases of endobiliary uncoated stenting using was 7.14% and 5.36% and these complications occurred in 2.56% and 2.56% in the group where Betadine coating was used. The term of serving of the biliary stents in the 2nd group (182.3±37.1 days) was significantly higher than the term of the uncoated stents (125.8±33.9 days). Conclusion: The usage of the antiseptic coating reduces the risk of developing of purulent-septic complications and increases the duration of functioning of biliary stents in patients with “difficult” choledocholithiasis.