Introduction: The prevalence of chronic pathology of the pharyngeal lymphatic system in preschool children reaches 45% and is mainly manifested by hypertrophy of adenoid vegetations, which in half of cases are combined with chronic inflammation, which, with repeated periods of exacerbation, leads to the development of severe chronic pathology of the upper respiratory tract. The role of microorganisms toleranceto pharmacological agents is widely proven in formation of chronic inflammatory disorders and demand correction of therapeutic schemes. Research tasks: The aim of this research was to study the microbial landscape of oropharynx in children who received surgical for adenoiditis and determine the sensitivity of the identified microorganisms to the pharmacotherapy with antibiotics. Material and Methods: We conducted a study of 1577 children aged from 1 year to 17 years and 11 months who received inpatient treatment at the otorhinolaryngological Department of the OO “Scientific and clinical multidisciplinary center named after Z. I. Kruglaya” in the city of Oryol in the period from 2015 to 2017 for hypertrophy of adenoid vegetations. The patients were divided into three groups based on the years of the study. The study of the oropharyngeal microbial association was performed by preparing a smear followed by Gram staining and bacterioscopy. Determination of the sensitivity of microorganisms to antibacterial drugs was performed by discdiffusion method. Results: We found in patients oropharynx microbial landscape with hypertrophy of chronic vegetation in dynamics over the period from 2015 to 2017, an increase in the number of opportunistic saprophytic flora was detected, which was observed against the background of a clear increase in the number of patients with this pathology an increase in the number of cases associated with saprophytic MRCA flora, represented mainly by Staphylococcus aureus, leads to a decrease in the effectiveness of conservative treatment of chronic adenoiditis, which is expressed in an increase in the number of adenotomies. Conclusion: The study revealed negative consequences of uncontrolled use of antibiotic therapy at the pre-hospital stage and irrational schemes of chemotherapy in hospital units, which is manifested in the growing resistance of microorganisms to both “old” antibacterial drugs and a decrease in sensitivity to pharmacotherapy with the latest generation of antibiotics and requires active revision of the schemes of antibiotic therapy and prevention.

Introduction: Inflammatory mediators play a major role in pathogenesis of acute pancreatitis with TNF (tumor necrosis factor) as the most important one. Development of effective combined therapy could help to decrease tissue damage, improve results and, finally, diminish the mortality rate in this severe pathology. Materials and methods: All the studies were performed on 120 female white Wistar rats, weighing 250±25g. Acute pancreatitis reproduced by an intracanalicular injection of bile salts compound. Results and discussion: The data obtained in the course of the study on the pronounced pancreatoprotective effect of infliximab are explained by its key role in the onset of the systemic inflammatory response, and, therefore, with the blockade of tumor necrosis factor alpha in the early stages, there is no pronounced secondary damage to the pancreas, which is reflected in a significant decrease in edema from 4.87±0.03 in the model up to 2.75±0.04, and as a consequence, an improvement in the blood supply of the acinar tissue from 182.38±15.92 PU up to 287.92±14.64 PU, which is expressed in a decrease in the zones of necrosis and in a decrease in mortality and, finally, efficiency coefficient from 13480.000 to 4283.348. A selective blocker of cysteinyl leukotrienes has a less pronounced protective reaction against damage to pancreatocytes, but to a much greater extent than octreotide. That is expressed by changes in the efficiency coefficient to the level of 8621.18 in montelukast group and 12767.30 in octreotide group, respectively. On the other hand, the effect of the use of infliximab does not surpass that of montelukast, and their combined use has a pronounced additive effect, which is proved by the efficiency coefficient at the level of 2390.33. This reaction is explained by the fact that TNF alpha-mediated pathway of activation of leukotriene biosynthesis is the main, but not the only one. Conclusion: The combined anti-mediator therapy provides a great opportunity to improve the standard therapy of acute pancreatitis.

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Introduction: Mesenteric thrombosis is a severe pathology with necrotization of intestinal tissues and death of the patient. The development of effective pharmacotherapy is an important task facing researchers. Materials and Methods: All studies were performed on 42 female white rats of the Wistar line, weighing 250±25 g. Segmental mesenteric thrombosis was reproduced by ligation of three segmental arteries in the area of the ileum. The volume of necrosis was determined by the triphenyl tetrazolium method. Results and Discussion: We have studied for the first time the effect of the arginase inhibitor L-norvaline on the volume of small intestine necrotized tissues in a model of acute segmental mesenteric thrombosis in rats. The study revealed a decrease in the volume of necrotic tissues from 32.39±0.47% to 23.84±0.39%, and the administration of glibenclamide did not cause complete cancellation of the L-norvaline action and led to a decrease in the volume of necrosis to 29.69±0.42%. Conclusion: Arginase inhibitor L-norvaline has protective effect in intestinal ischemia Graphical Abstract