Summary. In this review, the role of nitric oxide (NO) in the pathogenesis of the tumor growth and possibilities of its application in the treatment of cancer patients are analyzed. NO is one of the most important mediators of physiological processes being involved in the regulation of practically all body functions in health and disease. The role of NO in the development of many pathological conditions has been extensively studied and debated in recent years. Today it is clear that NO in relation to malignant tumors may exhibit a dual activity — can stimulate tumor growth and cause an opposite antitumor effect. Effects of NO are mostly dependent on its concentration. At low concentrations, NO could inhibit apoptosis and cause mutations that potentially lead to the formation of malignant growth loci. However, a high concentration of NO appears to be detrimental to malignant cells, in particular under conditions of simultaneous exposure to ionizing radiation. In humans, the inducible NO synthase (iNOS, type II) is the most powerful form of NO synthases (NOS) and has the ability to synthesize large amounts of NO for a long time and exert a protective function. iNOS is expressed in macrophages, monocytes, neutrophils, fibroblasts, hepatocytes, and other cell types. In tissue of malignant tumors, the macrophagal iNOS is the main form. Experimental data provide an evidence that activated macrophages and leukocytes, which are the part of peritumorous inflammatory infiltrate, can provide radiosensitization of tumors by direct synthesis of NO and indirectly — through the secretion of cytokines stimulating iNOS activity in cancer cells. Such approach could be useful for the development of new schemes and methods of anticancer therapy based on the activation of endogenous NO biosynthesis pathways.

Hernia of abdominal wall found in 10% of the adult population and take 3-4 place in the structure of surgical diseases. Each year, on the planet performed over 20 million operations of hernia, which is 10-15% of all interventions. For plastic hernias of the abdominal wall during 1 year used 1 million synthetic fishing nets. In Ukraine, about 13 thousand operations performed on strangulated hernias of the abdominal wall when there is inflammatory exudate, infection in the wound. Purpose. In the experiment to prove the applicability of polypropylene mesh for hernioplasty in cases of infection, phlegmon of hernia sac. Materials and methods. The experimental research was conducted on 150 white male rats breed "Wistar" weighing 250-300 g, same age, without disease, detained in accordance with generally accepted standards, at least 10 days before the experiment. In carrying out the experiment followed the major domestic and international standards according to national "general ethical principles of animal experimentation" (Ukraine, 2001). The open question of herniology is possibility of surgical treatment of hernia defect of abdominal wall at the hurt hernia, infecting of wound, phlegmon of hernia. For the study of problem, in an experiment on 150 white rats with the phlegmon of hernia complex research of features of flow of reparative process on an area the allogernioplastic polypropilene net of Linteks esfil is executed. The rats were divided into 3 groups: 1-st group – the plastic arts of hernia by the net of polypropylene of Linteks esfil standard; 2 group – the plastic arts by the net of Linteks esfil easy; 3 group – the plastic arts by the net of Linteks esfil heavy. The opened sore was washed by 0,02% solution of Decasan, Оctenisept farblos (Germany), intramuscular entered 1 ml of Imunophan, Ceftriaxon during a week. A positive dynamics was marked toward diminishing of contamination by microorganisms to 7 days after an operation. There were inflammatory changes in three groups: it was swollen hyperemia of tissues, serous-hemorrhagic excretions from a wound. On the 14th  days reticulated implant was densely fixed to the muscles and was in the thin layer of connecting fabric with more mature granulation fabric. In 21 day reticulated implant surrounded connective capsule which consisted of well-organized collagen fibres with the insignificant external signs of inflammation.  The results of experimental researches confirm possibility of application of reticulated implant for the plastic arts of hernia defect in the phase of inflammation which more frequent meets at the hurt hernia. At presence of festerings excretions in hernia, the use of polypropilene net for the plastic arts must be accompanied careful rehabilitation of wound, abdominal region with adequate antibacterial therapy. Conclusions: The reaction of tissue to implant mesh matches with reaction of tissue bordering to necrotic cells, and the presence of an infected hernia does not worsen the conditions of integration polypropylene implant with tissues. Strengthening mesh in tissues observed at 21 day, and the most pronounced effects of fixation - on 90 days after alloplastic hernioplasty of the hernia defect. The results of experimental researches confirm the possibility of using plastic mesh implants for hernia defect in phase of inflammation that often occurs in strangulated hernia.

An important component of the educational program is to ensure professional erudition, development of clinical thinking (CT), the formation of students' basic practical skills. In the year of the pandemic, it is especially difficult to really promote the development of these components of professional development in students, and modern pedagogical teaching methods, despite their effectiveness in the offline learning process, need development, improvement during distance learning. The need for the formation of CT students was determined by the founders of medicine many centuries ago, important in the creation of professional thinking was the psychological and pedagogical relationship "teacher-student-patient". Unfortunately, today this chain is lost, but the need to form analytical and exploratory thinking in medical students is extremely important, so it is necessary to revise and analyze the pedagogical methodology for modernization and use in distance learning. CT is an element of future professional activity with the help of which an algorithm of actions in specific clinical situations is created, it is the ability to identify and analyze, as well as to search and evaluate relevant information to achieve the appropriate conclusion. This article tries to conduct a conceptual analysis of the pedagogical methodology of CT formation and the possibility of their application in the conditions of distance learning of the discipline "obstetrics and gynecology". New technological programs are necessary for modeling simulation training. The main tasks of higher medical school are to achieve maximum development of intellectual abilities of the student, in the online format this can be achieved through the use of "virtual patients", situational tasks and cases, game techniques and clarity. However, methods of CT assessment and finding a strategy for its development are also important, as it is a key element of doctors' daily practice. In the 21st century, students need to think through their development, be able to work in teams, distinguish between relevant and irrelevant information from the patient, and be multilingual and highly developed so that they can be effective in all disciplines. These are the characteristics that are expected of modern medical students. However, when faced with unspecified emergencies, they are unable to make the right clinical decisions, leading to accidents. The reason for this is the lack of CT skills among young doctors, so the formation begins in school, adapting to the conditions created by the pandemic. Medical schools should teach the principles of scientific methodology and evidence-based medicine, including analytical and critical thinking, throughout the curriculum. It is important to develop a professional algorithm for the development of CT in each teacher, in order to rely on the development stimulus not only on the theoretical basis of students, but also on the ability to analyze clinical situations, and what is important to act properly algorithmically. Attention should be paid to the psychological and pedagogical aspects and approaches to the development of each student in particular. Moreover, there is no consensus on the most effective learning model for teaching CT skills and clinical considerations, and this skill is not effectively tested in medical schools, so the analysis of existing methods and their application in distance learning is extremely important.

Резюме. У статті розглядається дуже важливе питання інтеграції онлайн-навчання у вищих навчальних закладах. У зв’язку із розвитком пандемії задля забезпечення карантинного режиму усі навчальні заклади було переведено в режим онлайн-навчання з використанням онлайн-платформ, таких як ZOOM, Microsoft TEAMS, Google Classroom та інші. Проаналізувавши світовий досвід навчання у різних університетах, зокрема і в медичному університеті, ми побачили, що у Європі наші колеги-викладачі давно практикують змішаний тип навчання. А саме: частина лекцій та семінарських занять, усі домашні завдання, атласи, книги, відеоматеріали та відеолекції студент отримує у своєму особистому кабінеті або класі (який знаходиться на серверах університету). Викладачі мають доступ до цих особистих кабінетів та можуть відстежувати прогрес студентів, а саме: кількість опрацьованого матеріалу, чи переглянуті відео повністю, чи здані домашні завдання, чи вирішені тести. Практична частина, а саме відпрацювання певних навиків, які є необхідними кожному студенту-медику у своїй майбутній медичній практиці, відбувається циклом у різних відділеннях та лікарнях. Така схема змішаного навчання дозволяє студентові опрацьовувати теоретичний матеріал у зручний для нього час. Українські університети до періоду пандемії були виключно на офлайн формі навчання. І, на жаль, в умовах жорсткого карантину, реалізувати змішану форму навчання вкрай важко, зважаючи на певні загальнодержавні обмеження. Існувала така ймовірність, що студенти-медики продовжать навчання онлайн з осіннього семестру. Було б доцільно з боку керівництва першочергово провести детальний та ретельний інструктаж щодо освоєння онлайн-платформ для якісного проведення пар, лекцій чи семінарських занять.

Corona virus infection currently remains a key question giving new and new strains. The disease itself has a multisymptomatic course, in which various organs and systems are affected. The oral cavity is no exception. For dentists, it becomes an important task to detect lesions of the oral cavity at various stages of the disease development and during the so-called recovery period, to increase the effectiveness of treatment and, if necessary, to refer the patient to narrow specialists: a neuropathologist, psychologist or other doctor in order to develop rehabilitation measures. The aim is to study the manifestations of post-covid syndrome in the oral cavity. Materials and methods. On the basis of the Department of Dentistry of the National Institute of Scientific Research of the IFNMU, as part of the advisory assistance for diseases of the oral cavity, in the period from 2021 to 2022, an examination of 33 patients who suffered from a coronavirus disease of varying degrees of severity was carried out. These patients were referred for consultation from private dental institutions, dental polyclinics in the city of Ivano-Frankivsk and the region. A significant part of patients sought help online. Clinical research methods included collection of complaints, anamnesis of the disease, analysis of extracts of medical histories from medical institutions. The dental examination was carried out according to the generally accepted scheme: examination of the oral cavity, in particular, the condition of the mucous membrane (color, moisture, presence of pathological formations), the condition of the periodontal tissues, oral hygiene, hard tissues of the teeth, orthopedic structures, traumatic factors, bad habits were evaluated. Research results. Results of the study Based on the results of the examination of the patients, we diagnosed a number of pathological conditions of the oral cavity, which included candidal stomatitis (glossitis) and they accounted for 30% of the examined, lichen planus - 30% of cases. These are the persons who were hospitalized for a covid disease. In the rest of the patients who suffered from the disease in a mild form, periodontal tissue damage was noted in 25%, the presence of aphthous rashes in 15% of cases. From the number of people examined, we observed combined pathologies in 5 people: candidiasis, ChPL and glossitis or gingivitis (periodontitis) and aphthae. Microscopic examination of smears from the oral cavity indicates a significant number of fungi of the genus Candida, provided that there is no bacterial flora, that is, dysbacteriosis was observed. Having analyzed the prevalence of pathological conditions of the oral cavity in the examined patients, the tendency of the formation of candidal stomatitis in patients on the background of antibiotic therapy of pneumonia is followed. The development of lichen planus, which the patients had not observed before, is a consequence of stress and shock during the illness. Conclusions. The obtained results of the examination justify the need to carry out a dental examination of persons suspected of being infected with coronavirus -19 even after clinical recovery. The task of the dentist is to timely diagnose lesions of the oral cavity, to choose the most adapted treatment algorithm for the identified pathology in order to prevent complicated progression.