Purpose. To study the accumulation of photosensitizer Photoditazine in the bladder mucous in chronic cystitis. Material and methods. 22 patients with chronic cystitis were taken into the study. The time of Photoditazine accumulation in the bladder mucous was determined with a multi-channel optical fiber spectroanalyzer («LESA-01-BIOSPEC»). Photodynamic therapy (PDT) was done with laser «ATKUS-2» having adjustable output power up to 2 W and wavelength 661 ± 0.03 nm. Results. The performed fluorescence spectroscopy has revealed that the maximal accumulation time of Photoditazine in the bladder mucous in chronic cystitis is 120–150 minutes. After laser exposure, by spectroscopy finings, fluorescence intensity decreases by 72.3% which indicates a pronounced photosensitizer excitation and an active photodynamic reaction. Conclusion. The optimal time for laser photodynamic therapy in chronic cystitis is 2–2.5 hours after photosensitizer injection. Spectroscopy findings after laser exposure demonstrate the effectiveness of photodynamic therapy in chronic cystitis.

Objective: to study the effectiveness of photodynamic therapy (PDT) for non-melanoma malignant skin neoplasms with photosensitizer (PS) Photolon in young patients. Material and methods. 59 patients, aged 19–44, with verified diagnosis were treated with PDT technique: basal cell skin cancer (BCSC) – 51 patient; squamous cell skin cancer (SCSC) – 8 patients. Photolon dose was 0.8–1.3 mg/kg. The applied light dose was from 100 to 400 J/cm 2 depending on the clinical and histological form of tumor focus and the contrast index of PS – tumor / healthy skin calculated by findings of fluorescent diagnostics. Results. 6 months after PDT, 84.7% patients with non-melanoma skin cancer cT1-4N0M0 had a complete regression; 11.9% – partial; 3.4% – stabilization. There was a good cosmetic effect as well. It has been revealed that PDT effectiveness in BCSC is higher than that in squamous cell skin cancer; complete regressions was seen in 92.2 and 37.5%, respectively. Relapses during the follow-up period (from 6 months to 10 years) were registered in 8.7% of cases. Conclusion. PDT with Photolon is an effective technique for treating non-melanoma skin cancer with low risk of developing anatomical and functional disorders. It may be a method of choice for treating young people with malignant skin neoplasms.

A clinical case of stenosing cancer in the only lung lobe treated with endoscopic photodynamic therapy (PDT) in combination with argon-plasma coagulation (APC) is presented. Material and methods. A patient with central cancer of the left lung (pT2N0M0, st 1b) had a radical extended pneumonectomy on the left. In 28 months, central metachronous endobronchial cancer of the right main bronchus (cT1N0M0 stIA) developed. Histological examination revealed G2 squamous cell carcinoma. Because of bronchial stenosis in the only lung lobe, the patient was treated with endoscopic PDT followed by APC at the site of the tumor. Lakhta-Milon laser (Russia) with wavelength 662 nm, optical fibers having a microlens and a cylindrical diffuser 1.0 cm long were used for the treatment. Radiation power 500 mW, energy density 70 J/cm². Three hours before PDT, the patient was injected intravenously and dropwise 100 mg of Photoditazine dissolved in 100 ml of physiological solution (ratio 1.2 mg per 1 kg of body weight). Irradiation was made from 3 positions: a flexible light guide with a microlens irradiated the upper lobe spur; then the tumor was irradiated with a light guide having a cylindrical diffuser via residual bronchial lumens. APC of the tumor was performed electrosurgically with device APC ERBE VIO 300D. ForcedCoag mode, power 80 W, argon flow rate 1 liter per minute. Results. One day after the first PDT session, dyspnea became gradually less; on day 6 the patient had the second PDT session by the same technique. After it, his condition improved, vital signs stabilized: shortness of breath and expiratory stridor decreased; respiratory rate – 22 per/min; heart rate – 94 beats/min; sat. O₂ = 86%. Later, despite multiple courses of chemotherapy, the tumor was growing which required regular PDT-APC recanalization at 2–6-week intervals. Such a combined endoscopic treatment maintained a satisfactory quality of life in the patient for 1.5 years. Conclusion. PDT combined with APC can be used as an independent effective technique in antitumor therapy in patients with stenosing lung cancer when other surgical and chemoradial options are ineffective. It also significantly prolongs the life of patients.

Purpose: to study the effect of low-level laser therapy (LLLT) and preparation Cholisal at the microflora of oral mucous in prosthetic stomatitis (PS). Material and methods. Patients were divided into the following groups: Group 1 – control, without PS signs; Group 2 with PS had conventional treatment (sanitation of the oral cavity, removal of supra- and subgingival dental deposits, elimination of traumatic occlusion nodes, curettage of pathological pockets); Group 3 with PS had conventional treatment plus LLLT; Group 4 with PS had conventional treatment plus Cholisal; Group 5 with PS had conventional treatment plus LILI and Cholisal. The oral mucosa of patients with PS was irradiated externally every day for 7 days during 3 min. Matrix-VLOK laser with KL–VLOK head, wavelength of 0.63 mkm – an analog of helium-neon laser (red light) -, output power 2 mW was used. The irradiation dosage was calculated by the equation: D = (P/S) × t, where D is radiation dose, P (W) is radiation power on the wound surface, S (cm²) is area of wound radiation, t (s) is exposure time. Thus, if the erosion surface area is 1–2 cm², the irradiation dose has to be 3–6 J. Cholisal was applied topically before night sleep without subsequent LLLT. In the combined application of LLLT and Cholisal, irradiation was done in the morning. Results. It has been found out that LLLT reduces inflammatory processes and the level of microbial contamination in the oral mucous. Cholisal also reduces microbial contamination. The most effective technique for treating the oral mucous is a combined application of LLLT and Cholisal. Conclusion. The presented studies demonstrate effective outcomes in combined application of LLLT and Cholisal for reducing inflammatory processes and microbial contamination of the oral mucous in prosthetic stomatitis.

Purpose. To study the effectiveness of low-level laser therapy (LLLT) for the correction of homeostatic disorders in severe mechanical jaundice of non-tumor origin at the early postoperative period. Material and methods. The authors present their results of treating 45 patients with mechanical jaundice (MJ) of non-neoplastic genesis and of various severity. Patients were randomized into three groups: Group 1 (n = 15) – patients with mild MJ who were prescribed standard treatment at the postoperative period; Group 2 (n = 15) – patients with severe MJ who were also prescribed standard treatment; Group 3 (n = 15) – patients' state similar to that of Group 2 but who were added laser therapy sessions to their standard treatment. Laser «Matrix» was used for this. The intensity of lipoperoxidation processes, phospholipase activity, microcirculation, hemostasis and liver functional state were assessed. Results. It was found that at the early postoperative period (up to day 8), patients with mechanical jaundice of non-tumor genesis have marked deviations in homeostasis, like oxidative stress, activation of phospholipase system, microcirculatory disorders, hepatic dysfunction and hemostatic disorders, the severity of which is associated with the severity of pathology. The therapeutic effectiveness of basic treatment at early stages in patients with mild MJ was enough, while in patients with severe MJ not always. Conclusion. Supravascular quantum irradiation added to standard therapy in patients with severe mechanical jaundice promotes more rapid restoration of hepatic dysfunction and more effective correction of the homeostatic system.

Purpose. To study potentials for correcting hemostasis and hemorheology with intravenous laser blood irradiation (ILBI) and cytokine therapy (CT) in indirect revascularization at the perioperative period in patients with critical ischemia of lower extremities. Material and methods. A prospective controlled clinical trial included 162 patients with critical lower limb ischemia (CLLI) having distal arterial steno-occlusion who had indirect revascularization surgery. CLLI etiological factors were: obliterating atherosclerosis in 108 (66.7%) patients and obliterating thromboangiitis in 54 (33.3%) patients. 56 patients had chronic ischemia of degree III; 106 patients – chronic ischemia of degree IV. All patients were divided into 5 groups who had various curative modalities at their perioperative period: Group I (n = 34) –standard treatment; Group II (n = 32) – standard treatment + ILBI; Group III (n = 32) – standard treatment + CT with Roncoleukin; Group IV (n = 33) – standard treatment + ILBI + CT; patients from Group V (n = 31) in revascularizing osteotrepanation had intraosseous marrow laser irradiation (IOLI) – standard treatment + ILBI + CT. The researchers also studied dynamics of hemostatic parameters (fibrinogen – F, fibrinolytic activity – FA, fibrin degradation products – PDF, activity of antithrombin-III, plasminogen – P) and hemorheology (erythrocyte deformability – DE, von Willebrand factor – WF, ADP induced platelet aggregation). The obtained hemostasis and hemorheology findings were compared with identical parameters of 48 practically healthy subjects («reference group»). Results. On admission, patients with CLLI in distal steno-occlusion had a sharp change in their hemostasis formula shifting towards hypercoagulation and deterioration of hemorheology. ILBI and CT techniques applied either separately or in combination with other therapeutic measures in the perioperative period of indirect revascularization normalized parameters of blood coagulation system (for all parameters – p < 0.05; r = 0.4) and of hemorheology (for DE – p < 0.05; r = 0.4; for WF and ADP-induced platelet aggregation – p < 0.05; r = 0.3). The best results were obtained under the combination of ILBI and CT at the perioperative period of indirect revascularization, especially in revascularizing osteotrepanation with IOLI. Conclusion. ILBI and CT applied in combination with standard treatment at the perioperative period in indirect revascularization reliably correct hemostasis and hemorheology in patients with CLLI and distal arterial steno-occlusion.

Purpose. To study the effectiveness of laser therapy in patients with cardiovascular diseases using a diagnostic hardware-software complex. Material and methods. 120 patients with cardiovascular diseases (arterial hypertension – AH and ischemic heart disease – IHD) were taken into the study. Patients were divided into three groups depending on the rehabilitation program and prescribed basic medicamentous therapy: Group I – reflexotherapy (RT); Group II – RT and laser therapy (RT + LT); Group III (controls) – basic medicamentous treatment. At reflexotherapy sessions, biologically active points were electrostimulated with pointed pulses from «Lasper» device (Japan) having amplitude 0.8–2.5 V, pulse duration 1.5 ms, frequency 10 Hz and exposure 20 minutes. Infrared «Mlada» apparatus, generating in continuous mode with wavelength 0.85 μm, output power of two emitters 30 mW was used for laser therapy sessions. The effectiveness of treatment was assessed with diagnostic hardware and software complex (APK) «Physiocontrol-R» (Russia) which includes: analyzer of heart rate variability by cardiointervalogram, hemodynamic analyzer, psychological testing program (Spielberger, Beck, SAN test). The renin-angiotensin-aldosterone system (RAAS) and sympatho-adrenal system (SAS) were assessed with biochemical analyzer «Chemetrics' (USA). The developed calculation algorithms were used for assessing organism's functional reserves and risks of developing common diseases. Discriminant equations derived by us were used to assess the effectiveness of rehabilitation measures and to define groups of patients with varying level of effectiveness. Results. General mechanisms of RT and LT therapeutic effects in patients with cardiovascular diseases have been found out: correction of SAS and RAAS activity, limitation of excessive sympathetic impacts at heart and restoration of autonomic regulation function of the cardiovascular system, as a whole, which has been confirmed by the dynamics of biochemical parameters and SAS and RAAC decrease. Application of RT + LT complex for the rehabilitation of patients with hypertension and ischemic heart disease is more effective compared to RT monotherapy, which is confirmed by the largest increase in loading threshold (by 49.4%) when analyzing findings of the exercise test. Conclusion. 1. RT + LT complex applied in patients with cardiovascular diseases for rehabilitation is more effective modality in comparison with RT monotherapy. 2. The hardware-software complex «Physiocontrol-R» has been found to be a possible tool for evaluating the effectiveness of non-medicamentous therapy. 3. The developed diagnostic modality: algorithms for calculating a quantitative assessment of body's functional reserves and defining risks of common diseases as well as the discriminant equations for determining the level of effectiveness in different groups of patients – can be widely used for assessing the effectiveness of treatment.

Purpose. To develop a technique for potentiating the low-opioid multimodal anesthesia with LED radiation in the red range of the spectrum at 650 ± 20 nm using autonomous optoelectronic devices. Material and methods. Portable semiconductor LED devices AFC 660 k-630/670 emitting in the red range with wavelength 650 ± 20 nm were used for contact LED exposure. 78 abdominal patients (59 women and 19 men), aged 65–87, with concomitant diseases had the multimodal anesthesia. Patients' weight ranged from 68 to 127 kg. All patients had the 3rd degree of anesthetic risk by MNOAR classification. Patients were divided into two groups: studied and control. In the studied group (n = 52), 35 patients had planned laparoscopic cholecystectomy; 17 patients had laparoscopic hernia repair. In the control group (n = 26), 19 patients had laparoscopic cholecystectomy, and 7 patients had laparoscopic hernia repair with alloplasty. A comparative study of two protective techniques against surgical aggression was made: studied group – multimodal anesthesia potentiated by contact LED exposure at the projection of large vessels with AFC bracelet (physiotherapeutic LED apparatus); control group (n = 26) – multimodal anesthesia not potentiated with contact LED exposure. Results. It has been found out that the potentiated multimodal anesthesia with portable semiconductor LED device AFC 660 k-630/670 in the red range with wavelength of 650 ± 20 nm reduced fentanyl consumption in the studied group by 3 times (in the control group fentanyl consumption was 4.76 ± 0, 39 μg/kg/h; in the studied group – 1.53 ± 0.15 μg/kg/h). Peripheral hemodynamic parameters at all stages of surgical intervention practically did not show any significant changes from the initial values. The index of central hemodynamics CI in the studied group increased at the end of the surgery from 2.53 ± 0.36 l/min m² to 3.61 ± 0.46 l/min m². The total peripheral vascular resistance in the studied group decreased compared to the initial values from 1654.2 ± 345.1 din.c.cm^–5 to 1136.7 ± 485.1 din·c·cm^–5. In the control group, CI increased comparing to the initial values from 2.79 ± 0.36 l/min m² to 3.14 ± 0.37 l/min m². Total peripheric vascular resistance in the control group decreased from 1448.5 ± 344.5 din·c·cm^–5 to 1223.9 ± 437.1 din·c·cm^–5 in comparison with the initial values. Conclusion. Potentiation of multimodal anesthesia by contact LED exposure during abdominal surgery in patients of the studied group stabilized hemodynamics, increased the cardiac index and decreased total peripheral vascular resistance better than in the control group during anesthesiologic support.

Purpose. To study effects of intravenous laser blood irradiation (ILBI) with laser debridement of wounds and abdominal cavity, which are added to the standard laparoscopic and surgical treatment of perforated gastroduodenal ulcers. Material and methods. 31 patient with perforated gastroduodenal ulcers and symptoms of peritonitis were treated in the hospital. They were divided into two groups. In the control group (n = 19), after preoperative preparation patients were operated laparoscopically with suturing a perforated ulcer, sanitation and drainage of the abdominal cavity. In the main group (n = 12), after preoperative preparation, laparoscopic suturing of a perforated gastroduodenal ulcer in combination with ILBI, laser debridement of the wound and abdominal cavity were made. On admission, all patients were examined by the standard scheme: clinical examination, instrumental examinations (R-scan of chest, ultrasound examination of abdominal organs, electrocardiography, external respiration). To solve the task, the generally accepted clinical examination steps were added with biochemical testings (dynamics of changes in free radical lipid oxidation processes and in antioxidant blood protection parameters). Results. When treating patients with perforated gastroduodenal ulcers laparoscopically in combination with ILBI and laser debridement of wounds and the abdominal cavity, the researchers noted the following in the main group: better indices of average mass molecules (MSM), less blood intoxication, immunity increase – what, in its turn, leads to the increase in lipid peroxidation and antioxidant protection at the final stage of treatment. Such positive effects have decreased the number of postoperative complications as well as the average duration of treatment, if to compare with traditional care, thus ultimately, leading to less financial costs. Conclusion. The laparoscopic technique in combination with ILBI and laser wound and abdominal sanitation in patients with perforated gastroduodenal ulcers is a promising modality which has a high medical and social importance.

Actuality. Surgical interventions in case of spleen injury are aimed to achieve a reliable hemostasis, but due to the morphological structure of the spleen suturing does not lead to this goal; therefore, in most cases, surgeries end with splenectomy. However, removal of the spleen causes postplenectomic hyposplenism, and it urges to search for other modalities alternative to splenectomy. Purpose. To assess the effectiveness of interventions with minimal access in the left hypochondrium for organ-sparing surgery (OSS) on the spleen with laser light application. Material and methods. Outcomes of surgical treatment in 126 patients with closed spleen injury were analyzed. Of the total number of patients, organ-preserving surgeries with laser light were performed in 59 (46.8%) cases; among them 36 (28.6%) patients were operated on with minimal access surgery, and in case of upper midline laparotomy – in 23 (18.2%) cases. Medilas fibertom 5100 laser device (DORNIER Ltd) with wavelength 1064 nm was used for the discussed organ-sparing surgeries. In all cases, surgeries were ended with drainage of the abdominal cavity. Results. As it has been found out, the most optimal technique for OSS in spleen injury is laparoscopy which allows not only to evaluate the volume of intra-abdominal blood loss, but also to define the nature of spleen injury and presence or absence of damage to other abdominal organs. The minimal approach for closed spleen injury has both advantages and disadvantages. The advantages are technical convenience in performing surgery on the spleen and possibility to apply laser technology for OSS. However, OSS with laser light on the spleen with closed injury is recommended if patient’s hemodynamics is stable, organ injury is isolated, OSS is technically possible and there is no any damage to vessels of the spleen hilus. A significant disadvantage of minimal access surgeries is inability to perform a thorough revision of abdominal organs what is compulsory in urgent cases. Conclusion. Minimal access surgery with high-level laser energy in closed spleen injury is possible only if spleen injury is isolated.

The primary treatment of tophaceous gout is to control the disease by pharmacological therapy. Additional surgical intervention is used to correct cosmetic deformation in joints or disabling functional disorder; however, one of its reported complications is hyperuricemia and recurrent attacks of pain. Objectives: to access the effectiveness of Low Intensity Laser therapy as addition to urate lowering treatment in patients with tophaceous gout, who underwent joints surgery in the Chengdu Rheumatism Hospital, in comparison to those patients who received only nonsurgical treatment. Subjects and methods. The effectiveness of Low Intensity Laser therapy (LILT) and urate lowering treatment in patients with tophaceous gout was investigated in 63 male patients of Chengdu Rheumatism hospital with tophaceous gout who underwent joints surgery. Control group was formed of 63 gout patients comparable in age and pre-treatment uric acid, who received non-surgical treatment.
Results. Patients underwent surgery in one or two sessions, the most common lesion site being foot joints: toes (49.41%), ankle (39.68%) and knee (34.92%), with restricted mobility in the mentioned joints. Levels of CRP before the treatment were elevated in almost all patients (median 3.74 (0.2, 48.75) mg/L), regardless of the other comorbidities. Urate lowering therapy notably reduced the levels of CRP to 2.44 (0, 33.27) mg/L in study group and to 1.3 (0.13, 31.72) mg/L in controls. After surgery and following urate lowering therapy all patients noted functional improvement and reduction of pain. Decrease in serum urate levels were reported in 96.83% of patients in study group and in 93.65% of controls. There was no significant difference in serum UA between patients who underwent joint surgery and who didn’t. Patients, who in addition to surgery received Low-Level Laser Therapy therapy, had a lowest mean serum UA after treatment (280.93 ± 97.05 μmol/L), but due to wide range of variation, difference to other groups wasn’t statistically significant. Addition of laser therapy also helped to reduce the pain almost twice (0.56±0.56 compared to 1.04 ± 0.91). However, we haven’t registered notable anti-inflammatory influence of LILT. There was a weak direct link established between levels of serum UA and CRP after treatment, but in patients receiving laser therapy, CRP was elevated more often, compared to those who weren’t prescribed with LILT or controls. Conclusion. Arthroscopic shaving and other surgical approaches focused on joints often doesn’t affect system hyperuricemia in any way and can’t be viewed as a substitute to urate lowering therapy. However, our experience confirms that timely performed surgery contribute to functional improvement and reduction of pain in gout patients. Low Intensity Laser therapy doesn’t affect hyperuricemia or guarantee long-term systemic anti-inflammatory effect, but help to additionally relieve pain in joints and thus enhance treatment effect and quality of patients’ life.

Laser light can stimulate cell proliferation and restoration of various tissues after injury. The age aspect of laser irradiation effects at muscle regeneration, in particular the response of myosatellitocytes and myocytes, remains unexplored. The purpose of the research was to study the effect of laser light at the area of nuclei and the number of myosatellitocytes, as well as the area of myocyte nuclei in a model of posttraumatic regeneration of skeletal muscle in animals of different age groups. Material and methods. 32 laboratory mongrel rats, divided into 2 groups – young (3 months) and old (30 months) – were taken into the experiment. The formed surgical injuries at the caviar muscle on the left limb were experimental; they were irradiated with laser light (1060 nm, power 2.0 W, continuous mode, exposure 60 s, one time); injuries on the right limb were dynamic control. The animals were removed from the experiment on days 7 and 14. Tissue samples were fixed in formalin, histological sections were prepared, hematoxylin-eosin and Van Gizon picrofuxin were stained, and a digital image of objects was morphometrically analyzed. Results. It was found that after laser irradiation of the muscle, the area of nuclei and the number of myosatellites increase significantly compared to the control group, regardless of animal’s age. The response to myocyte nuclei to laser light was seen in both age groups, but it was significantly higher in younger animals. The obtained results demonstrate that laser radiation has the potential to activate muscle regeneration regardless of animal’s age.

Currently, medical specialists still face problems while treating pathological subepithelial capillary structures, in particular, capillary angiodysplasias of the skin. One of the promising techniques for their removal is photothermolysis by laser light of yellow-green spectral range which is selectively absorbed by pigments, hemoglobin, blood in the vessels with further vessel hardening and regression. Purpose. To make a comparative trial in vitro at experimental models so as to confirm the effect of selectivity of «green» laser light at hemoglobin-containing tissues, in particular, at subepithelial vascular structures. Material and methods: An experimental solid-state semiconductor laser, generating green light with wavelength 525 nm which is near the absorption peak of hemoglobin and oxyhemoglobin, was used. Experimental models were cooled samples of the liver, skin and a preparation combined of them as well as laboratory minipigs of Svetlogorsk population. In the trial, the researchers compared changes developed after the irradiation of abovementioned objects with «green» laser light. To make comparison, morphological, macroscopic and histological findings from irradiated zones were analyzed. Results. Specific differences in the damaged zones of experimental models as well as in the liver and skin were found. While examining the liver, one can see locally more pronounced changes and a minus destruction looking like a narrow sphenoid-shaped crater with relatively narrow zones of compact and cellular necrosis, clear boundaries between them as well as unchanged adjacent tissues. On the skin, one can see a minus destruction of much smaller size with zone of peripheral coagulation 3–5 times wider and without compact and cellular layers; there are also no clear boundaries with unchanged tissues. In the combined sample, green laser light – which is less absorbed by the skin- penetrates through it, thus affecting the underlying liver where one can see more pronounced thermal changes, if to compare with the skin. Conclusion. The selectivity effect of «green» laser light with wavelength 525 nm at hemoglobin-containing tissues has been confirmed. This conclusion is a promising finding for applying the selective photothermolysis in pathological subepithelial capillary structures which will ensure precise treatment with minimal damage to skin tissues.