During the existence of the department7 doctoraland more than70 master'sdissertations have beenprepared and successfully defended.Earlier doctoral dissertations were defended by G.P.Matveykov (1967) and S.S.Pshonik (1972).More than15 monographsand reference books have beenpublished, hundreds of articles have been written on the most important problems of rheumatology and internal diseases.
Based on the results of studying the metabolic status of individual lymphocytic populations and subpopulations based on the aberrations of isozyme spectra of lactate dehydrogenase in them, a method for determining the state of the B-system of immunity was developed (Inventor's Certificate 1467515).A new method for the diagnosis of autoimmune diseases is the method of studying the structural and dynamic state of lymphocyte membranes using tryptophan phosphorescence (AS 1629787).
Participation of the department inconferences, congresses, seminars
- IX Republican scientific and practical conference with international participation "Actual issues of nephrology and renal replacement therapy"
- "Non-coronary heart disease: mechanisms of development, course options and approaches to therapy"
- Republican scientific and practical conference "Hereditary connective tissue disorders: multidisciplinary pathology"
- Republican scientific-practical conference "Myocardial viability: modern possibilities of diagnosis and treatment"
- Republican scientific and practical conference with international participation "Osteoimmunology: modernity and scientific prospects"
- Conference "Actual Problems of Internal Medicine" dedicated to the 50th anniversary of the 2nd Department of Internal Medicine
- Republican scientific and practical conference "Modern technologies of diagnostics and treatment in cardiology: focus on atrial fibrillation"
- Present and future in the diagnosis and treatment of chronic heart failure
- Republican scientific and practical conference "Cardiomyopathies: modern methods of diagnosis and treatment"
A method has been developed for determining the nature of the course of rheumatoid arthritis by the activity of hyaluronidase in the synovial fluid (Certificate of Authorship 1652916).Much attention has been paid to the study of the mechanisms of blockade of hyperimmune arthritogenesis by methods of targeted modification of metabolism.The ability of exogenous unmodified cAMP, administered in a dose necessary to compensate for its deficiency in the bloodstream, was found to significantly inhibit hyperimmune initiation of arthritogenesis in the experiment.With the clarification of lipid arthritogenic mechanisms (imbalance of the most important fractions and fatty acids, excess tissue lysoforms, arachidonic acid deficiency, etc.), the main directions of effects on lipid metabolism were established in order to suppress the mechanisms of arthritis development.These include the inhibition of specific desaturases, to block the biotransformation of unsaturated fatty acids to arachidonic acid;modulation of the metabolism of arachidonic acid with restriction of anti-inflammatory eicosanoids (the use of competitors of arachidonate in biological membranes and metabolic reactions);inhibition of type A2 phospholipases;modification of lipogenesis;restoration of the structure and properties of the lipid component of cell membranes (N.A. Yusipova, M.A. Savchenko).
The ability of the energy of a low-intensity helium-neon laser to stabilize lysosomal membranes was discovered, which made it possible to successfully use such radiation to block the development of experimental chronic hyperimmune arthritis.As a result, a method was developed for the prevention of rheumatoid arthritis using the radiation of a helium-neon laser in a certain mode (Inventor's Certificate 1737788).The method allows in some cases to stop the development of a hyperimmune articular process in the early stages, to prevent its further progression and chronicity.The application of this method is especially effective in the prenosological stage of the disease.
The presence of biochemical heterogeneity of rheumatoid arthritis was established.The non-specific nature of the reaction of biochemical regulatory mechanisms in response to the rheumatoid process in the body was revealed.
For the first time in systemic connective tissue diseases, a comprehensive integrative study of the neuroendocrine status (pituitary gland, adrenal cortex, gonads, pancreas and thyroid glands) was carried out.This made it possible to establish a number of new pathogenetic patterns in systemic lupus erythematosus and systemic scleroderma.A violation of the glucocorticoid link in the hormonal regulation of immunity was found, which manifests itself in a reduced production of cortisol by the adrenal glands, limited possibilities of its transport by transcortin and resistance of lymphocytes to hormonal effects.A decrease in the activity of progesterone production, a low level of dynamics of insulinemia on load, and an imbalance of sex hormones were also revealed.The effect of long-term intake of glucocorticoids on the hormonal balance of the body was evaluated.New approaches have been proposed to improve the effectiveness of therapy with corticosteroid drugs (Y.M. Dosin, V.G. Apanasovich).Revealed insulin resistance in patients with systemic sclerosis, increasing with the progression of the scleroderma process (V.I. Kurchenkova).
For the first time in the Belarusian population, the staff of the department conducted a study of immunogenetic factors in the occurrence and development of a number of diseases.
Studies of the HLA-system of loci A, B, C, DR.A number of antigens, phenotypes and haplotypes characteristic of various clinical variants of the course of rheumatic diseases have been identified.This makes possible to determine the risk of developing the disease, to predict the nature of the course of the pathological process.Thus, the factors predisposing to the onset of rheumatoid arthritis are haplotypes A2 / B27, A2 / B12, DR4 antigen (V.E. Yagur).Quantitative analysis of soluble antigens of the HLA system opens new perspectives in the field of immunogenetic research in rheumatology.A quantitative study of soluble B27 antigens in the blood serum of patients with ankylosing spondylitis revealed a significantly higher level of this antigen in patients in comparison with healthy carriers of B27.This improves the accuracy and reliability of the diagnosis of this disease.This diagnostic method is patented (E.S. Kalia).
In patients with systemic lupus erythematosus, a comprehensive assessment of the functional state of the heart, central and regional hemodynamics of vital organs and systems was carried out using non-invasive research methods.The morphometric, histological and ultrastructural changes in various parts of the heart of patients who died from systemic lupus erythematosus were studied and the predominantly vascular genesis of these disorders was shown.The influence of various schemes of pathogenetic therapy of patients with lupus on cardiac pathology was assessed (M.V. Zyusenkov, N.P. Mitkovskaya).
The state of the functional systems of the pituitary-adrenal gland, thyroid gland, and gonads in patients with primary Sjogren's syndromes was studied.Discoordination in the work of endocrine complexes was revealed, which is manifested by a decrease in the functional activity of the effector glands.Approaches have been developed to improve the effectiveness of treatment of patients with Sjogren's syndrome using glucocorticoids and cytostatics (N.A. Martusevich).
A method of individual immunocorrection in vitro has been developed, when it seems possible to choose the most optimal immunostimulating drug for each patient.Important results have been obtained in the study of the mechanism of action of antirheumatic drugs.It has been proven that D-penicillamine, used in the treatment of patients with rheumatoid arthritis, has a distinct antioxidant effect, which distinguishes it from other basic therapy agents.The mechanism of this effect has been studied.
A method has been developed for the complex treatment of rheumatoid arthritis during the period of remission of the disease, which makes it possible to increase the incidence of complete clinical remission and increase its duration.The prenosological period in thedevelopment of rheumatoid arthritis has beenstudied, its clinical features have been clarified, which makes it possible to reveal the onset of rheumatoid arthritis.A model of mathematical objectification of the activity and severity of the course of rheumatoid arthritis by means of combined laser radiation has been created (A. p. 1142125).A technique has been developed, indications and contraindications for the use of a sauna in the complex therapy of rheumatoid arthritis have been determined (V.V. Marushchak).The clinicuses a new method of treating Sjogren's syndrome with the use of protease inhibitors (Certificate No. 1082434), which significantly improves the functional state of the salivary and lacrimal glands.
Much attention is paid to the development of methods for the individualized treatment of rheumatic diseases.The method of programmed individualized treatment of patients with systemic lupus erythematosus makes it possible to achieve process stabilization in 82% of cases (I.P. Titova).Criteria for choosing the optimal drug for intra-articular administration to patients with rheumatoid arthritis have been determined.The necessity of determining the psychological state of the personality of patients with rheumatic diseases has been substantiated.The existence of various psychological types of attitudes towards the disease in rheumatoid arthritis is shown.Determination of the patient's psychological status helps the doctor in choosing the optimal therapeutic regimen and an individual rehabilitation program.Diagnostics of the types of attitudes towards the disease was the basis for the psychopharmacological and psychotherapeutic correction of inappropriate reactions and forms of behavior of the patient, changes in his reaction to the disease.The specific form of psychocorrectional work was determined by the characteristics of the patient's personality, his age, intellectual level, degree of awareness of the disease, assessment of his condition, attitude to treatment, attitudes towards the future.The assessment of the effectiveness of medical rehabilitation of patients with rheumatoid arthritis during the period of exacerbation of the disease by means of complex exposure to a high-intensity pulsed magnetic field and the use of dosed physical activity (L.A. Malkevich).
A large section of research is devoted to the use of efferent methods for the treatment of rheumatic diseases (N.P. Mitkovskaya,E.S.Belskaya, A.M.Boris, Y.A. Mukharskaya,V.V. Kirkovsky).The mechanism of action, indications and contraindications for use have been studied, new methods of therapeutic plasmapheresis, cryoplasmapheresis, hemocarboperfusion, intravenous laser and ultraviolet blood irradiation, autohemomagnetotherapy, etc. have been developed.
Criteria for the diagnosis and differential diagnosis of autoimmune diseases have been developed with the study of the spectrum of autoantibodies (ANA, dsDNA,ssDNA, histones, U1RNP, Sm, SS-A / Ro, SS-B / La, centromeres, nucleoli, Scl 70, ANCA, etc.).Determination of antibodies by indirect immunofluorescence is a more sensitive diagnostic method than the tests used in everyday practice to detect antibodies to DNA and lupus cells (S.A. Duben).
An important section of the department's work is the study of the role of infectious factors in the occurrence and development of rheumatic diseases.
Work is carried out to assess the role of the hepatitis C virus in systemic connective tissue diseases.For this purpose, liver biopsy has been introduced into clinical practice (S.V. Gubkin).Methods of diagnosis and ways of optimizing the treatment of chronic chlamydial infection have been studied (I.A.Varonko).
To create an electronic archive of the rheumatological department and improve the system for assessing the severity and predicting the course of systemic diseases of the connective tissue, an automated case history of a rheumatological profile has been developed (V.E. Yagur, D.P. Moiseenko).
The efforts of the department staff are aimed at the development and implementation of new methods of treatment and prevention of joint diseases and systemic connective tissue diseases (I.P. Titova, V.G. Apanasovich, I.P. Grigorchuk).The efficacy of complementary therapy for patients with rheumatoid arthritis with the inclusion of a number of homeopathic medicines (N.Y. Dostanko), the effectiveness and safety of new drugs used for the treatment of joint diseases (V.M. Sidenko) were studied.
Research continues (K.A. Chizh, A.K. Tushina) on the development and implementation of methods for predicting and choosing treatment tactics for nephritis in patients with systemic lupus erythematosus.Differentiated laboratory and morphological diagnostics will help to identify predictors of early exacerbation and remission of lupus nephritis, assess the effectiveness of drug therapy.
The topic Formation and clinical characteristics of a group of patients with rheumatoid arthritis, the formation and socio-demographic characteristics of a group of conventionally healthy individuals, selection of peripheral blood samples for genotyping by allelic variants of genes responsible for the immune response in order to conduct DNA diagnostics of the risk of developing rheumatoid arthritis in the adult population within the framework of activity 6.4."Molecular genetic risk assessment of autoimmune diseases" of the scientific and technical program of the Union State "Development of innovative genogeographic and genomic technologies for identification of personality and individual characteristics of a person based on the study of gene pools of regions of the Union State (DNA identification)" was financed from the budget of the Union State (Yagur V.E., Dostanko N.Y).
Professor Soroka N.F.and associate professor Chizh K.A.continue to carry out scientific work within the framework of the theme of the State Scientific and Technical Program "New methods of providing medical care", subprogram "Internal diseases" 2016-2020."To develop and implement a method for predicting the exacerbation and onset of remission of nephritis in systemic lupus erythematosus."Methods are being developed for laboratory and morphological diagnostics of kidney damage in systemic lupus erythematosus to identify predictors of early exacerbation and the onset of remission of lupus nephritis.The results of the work will be formalized in the form of a doctoral dissertation.
According to subprogram 1 "Innovative biotechnologies - 2020" of the State program "Science-intensive technologies and equipment" for 2016 - 2020 under the leadership of Associate Professor Chizh K.A.scientific work continues on the topic "To develop a biomedical cell product based on pooled cultures of mesenchymal stem cells for the treatment of patients with systemic lupus erythematosus."The end result of the research project will be the development of a biomedical cell product based on pooled cultures of mesenchymal stem cells for the treatment of patients with systemic lupus erythematosus.
The study of the role of Chlamydophila pneumonia in diseases of the joints and spine is continued by S.V. Sharuba, the study of the functional state of the respiratory system in rheumatoid arthritis and spondyloarthritis is the topic of S.V. Fedorovich's scientific work.
The study of hereditary disorders of connective tissue, a significant medical and social problem, continues in young people.Introduced into clinical practice (E.L. Trisvetova, O.A. Patorskaya, A.V. Polyanskaya) methods of assessing external signs of dysembryogenesis, complex instrumental diagnostics of minor heart anomalies, revealed the features of arrhythmic syndrome and associated diseases.
In addition to the problems of rheumatology, the staff of the department is developing other topical issues of internal diseases.In the field of cardiology, an interesting study was carried out to assess the role of soluble tumor necrosis factor-alpha receptors in patients with chronic heart failure (T.S. Zybalova).In the field of pulmonology, the effect of plasmapheresis on the effectiveness of treatment of patients with severe bronchial asthma has been studied (O.G. Chekryzhova).In the field of gastroenterology, the possibilities of using daily intragastric pH-metry to increase theefficiency of treatment of acid-dependent diseases of the gastrointestinal tract werestudied(N.V. Kapralov, I.A. Sholomitskaya).The department is a training center in the republic for the introduction of the method of daily intragastric and intraesophageal pH monitoring into clinical practice.