The new annotated checklist of the wild bees of Europe (Hymenoptera: Anthophila)

At a time when nature conservation has become essential to ensure the long-term sustainability of our environment, it is widely acknowledged that conservation actions must be implemented within a solid taxonomic framework. In preparation for the upcoming update of the IUCN Red List, we here update the European checklist of the wild bees (sensu the IUCN geographical framework). The original checklist, published in 2014, was revised for the first time in 2017. In the present revision, we add one genus, four subgenera and 67 species recently described, 40 species newly recorded since the latest revision (including two species that are not native to Europe), 26 species overlooked in the previous European checklists and 63 published synonymies. We provide original records for eight species previously unknown to the continent and, as original taxonomic acts, we provide three new synonyms, we consider two names as nomina nuda, ten names as nomina dubia, three as species inquirenda, synonymize three species and exclude 40 species from the previous checklist. Around a hundred other taxonomic changes and clarifications are also included and discussed. The present work revises the total number of genera for IUCN Europe to 77 and the total number of species to 2,138. In addition to specifying the taxonomic changes necessary to update the forthcoming Red List of European bees, we discuss the sampling and taxonomic biases that characterise research on the European bee fauna and highlight the growing importance of range expansions and species invasions.

Signals of adaptation to agricultural stress in the genomes of two European bumblebees

Human-induced environmental impacts on wildlife are widespread, causing major biodiversity losses. One major threat is agricultural intensification, typically characterised by large areas of monoculture, mechanical tillage, and the use of agrochemicals. Intensification leads to the fragmentation and loss of natural habitats, native vegetation, and nesting and breeding sites. Understanding the adaptability of insects to these changing environmental conditions is critical to predicting their survival. Bumblebees, key pollinators of wild and cultivated plants, are used as model species to assess insect adaptation to anthropogenic stressors. We investigated the effects of agricultural pressures on two common European bumblebees, Bombus pascuorum and B. lapidarius. Restriction-site Associated DNA Sequencing was used to identify loci under selective pressure across agricultural-natural gradients over 97 locations in Europe. 191 unique loci in B. pascuorum and 260 in B. lapidarius were identified as under selective pressure, and associated with agricultural stressors. Further investigation suggested several candidate proteins including several neurodevelopment, muscle, and detoxification proteins, but these have yet to be validated. These results provide insights into agriculture as a stressor for bumblebees, and signal for conservation action in light of ongoing anthropogenic changes.

Revision of the mining bee subgenus Andrena (Longandrena) (Hymenoptera: Apoidea: Andrenidae)

All three hitherto described species of the Palearctic subgenus Andrena (Longandrena Osytshnjuk, 1993), are revised and redescribed. This subgenus is characterized by an unusually long glossa, a rare character among short-tongued bees. A revised diagnosis of this subgenus is given. A key to the species of A. (Longandrena) is provided, and all diagnostic morphological features are illustrated in detail. The Central Asian species Andrena longiceps Morawitz 1895 is recorded for the first time from Iran. The distribution map of the subgenus is also presented.

Redescription of three rare species of Dasypoda bees with first description of D. iberica and D. tibialis females (Hymenoptera, Apoidea, Melittidae)

Dasypoda bees are host-specialized solitary species distributed in the Palaearctic Region. In the framework of a global revision of this genus, comprehensive descriptions of three rare species (D. tibialis Morawitz, D. vulpecula Lebedev and D. iberica Warncke) are presented. The detailed morphology of the D. tibialis male and both sexes of D. vulpecula are given for the first time after a very partial original description. The females of D. tibialis and D. iberica are described for the first time and additional morphological characters of the male of D. iberica are provided. The lectotype of Dasypoda tibialis is designated. Host-plants and new localities are also presented.

The Forest Observation System, building a global reference dataset for remote sensing of forest biomass

Forest biomass is an essential indicator for monitoring the Earth's ecosystems and climate. It is a critical input to greenhouse gas accounting, estimation of carbon losses and forest degradation, assessment of renewable energy potential, and for developing climate change mitigation policies such as REDD+, among others. Wall-to-wall mapping of aboveground biomass (AGB) is now possible with satellite remote sensing (RS). However, RS methods require extant, up-to-date, reliable, representative and comparable in situ data for calibration and validation. Here, we present the Forest Observation System (FOS) initiative, an international cooperation to establish and maintain a global in situ forest biomass database. AGB and canopy height estimates with their associated uncertainties are derived at a 0.25 ha scale from field measurements made in permanent research plots across the world's forests. All plot estimates are geolocated and have a size that allows for direct comparison with many RS measurements. The FOS offers the potential to improve the accuracy of RS-based biomass products while developing new synergies between the RS and ground-based ecosystem research communities.

A new bee species of the genus <i>Dasypoda</i> Latreille (Hymenoptera, Apoidea) from Portugal with comparative remarks on the subgenus <i>Heterodasypoda</i> Michez

A new bee species of the genus Dasypoda Latreille (Hymenoptera, Apoidea, Melittidae), D. michezi Radchenko sp. nov., is described from south-western Portugal. This species belongs to the subgenus Heterodasypoda and appears very similar to D. albimana Pérez 1905, which occurs in the west Mediterranean Basin. A detailed comparative diagnosis of D. michezi with the other 3 species of the subgenus Heterodasypoda, is provided. The new species is most easily distinguishable by the widened protrusion at the apex of the 6th sternum, which is deeply emarginated apically in the form of a wide triangle. In addition, the new species differs from other described species of the subgenus by the structure of the 7th and 8th sterna, male genitalia, and relative dimensions of antennal flagellomeres.

A new widespread European bee species of the genus <i>Dasypoda</i> Latreille (Hymenoptera, Apoidea)

A new bee species of the genus Dasypoda Latreille (Hymenoptera, Apoidea, Melittidae), D. morawitzi Radchenko sp. nov., is described. This species is closely related to, and easily confusable with, D. hirtipes (Fabricius), and its specimens have been previously attributed to the latter species. A comparative morphological analysis of D. morawitzi with other species of the D. hirtipes group is provided. The distribution and trophic links of this new species are discussed.

[Nonalcoholic steatohepatitis and biliary sludge in people with metabolic syndrome]

AIM

To determine the incidence of biliary sludge (BS) and to evaluate the clinical efficacy of Chophytol in patients with nonalcoholic steatohepatitis (NASH) and BS in the presence of metabolic syndrome (MS).

SUBJECTS AND METHODS

Clinical laboratory examination was made in 72 patients with NASH in the presence of MS. BS was identified in 52 (72.2%) examinees who were divided in two (study and control) groups. The efficacy of Chophytol of plant origin, prepared from the purified extract of fresh artichoke (Cynara scolymus) leaf juice, which was used at a dose of 3 tablets thrice daily for a month, was evaluated.

RESULTS

The use of Chophytol was established to promote BS elimination in 87% of the patients. This ceased pain syndrome in 87% and dyspeptic manifestations in 65.2% and normalized the levels of lipids and the biochemical indicators of liver process activity. No adverse drug reactions were seen.

CONCLUSION

Chophytol used in patients with HASH and BS may soon be possible to make general condition better, to alleviate the symptoms of diseases of the liver and biliary system, and to appreciably improve the biochemical indicators of blood and bile.

[NONALCOHOLIC FATTY LIVER DISEASE: DIAGNOSTIC, SYMPTOMS, TREATMENT. GUIDELINES WERE APPROVED BY THE XV GASTROENTEROLOGICAL SCIENTIFIC SOCIETY OF RUSSIA IN 2015]

According to the World Health Organization, it is recorded steady growth of the number of chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD), in recent years. As an independent nosological entity, NAFLD is one of the risk factors for cardiovascular diseases, associated with abdominal-visceral obesity, peripheral insulin resistance (IR), and is regarded as the hepatic component of Metabolic syndrome (MS). Nowadays there are no generally accepted national standards for diagnosis and treatment of NAFLD for physicians, gen- eral practitioners, gastroenterologists in Russia. This was the essential reason in their development. The main reason of The guidelines development is the absence of generally accepted national standards for diagnosis and treatment of NAFLD for physicians, general practitioners, gastroenterologists in Russia. These guidelines are based on the global and local data of treatment experience of NAFLD, recently published in reviews, analytical studies in the literature. Guidelines are intended for physicians, general practitioners, gastroenterologists and contain the description of the preferred approaches to the provision of diagnostic, curative and preventive care of patients NAFLD. The quality of recommendations was grading according to the GRADE approach.

[AUTOIMMUNE LIVER DISEASES: CLINICAL FEATURES, DIAGNOSIS, TREATMENT. GUIDELINES WERE APPROVED BY THE XV GASTROENTEROLOGICAL SCIENTIFIC SOCIETY OF RUSSIA IN 2015]

The group of liver autoimmune diseases (LAD) includes autoimmune hepatitis (AIH), Primary biliary cirrhosis (PBC) and Primary sclerosing cholangitis (PSC) The guidelines on clinical diagnosis and management of patients based on a review and analysis of recent publications on this topic in the global and domestic literature and on the authors'experience in treating patients with autoimmune liver disease.

[CHANGES IN MICROBIOCENOSIS OF THE COLON IN PATIENTS WITH CHRONIC LIVER DISEASE AND LATENT HEPATIC ENCEPHALOPATHY]

Interest in the study of complications of liver disease, in particular latent hepatic encephalopathy, due to its wide distribution, difficulty in diagnosis, the lack of differentiated treatment approaches. The correlation dependence of the influence degree of dysbiosis in the development of latent hepatic encephalopathy contributes to the formation of multiple organ pathology, including associated with the violation of the intestinal microbiota in chronic liver disease, is a separate link in the pathogenesis of hepatic encephalopathy. Dysbiosis of the colon in patients with chronic dislivoniami the liver is the triggering factor in the development of latent hepatic encephalopathy, and its level directly correlated with the execution time of the tests of numbers and lines, the manifestation of asthenovegetative syndrome, intestinal dyspepsia, cytolysis, cholestasis, hepatocellular nedostatusnosti.

[COURSE OF BILIARY SLUDGE ON THE BACKGROUND NON-ALCOHOLIC FATTY LIVER DISEASE]

To date, the factors significantly reduces the tolerance of the liver against the development of NAFLD and GSD. At the stage of biliary sludge cholelithiasis is found in more than half of the patients suffering from NAFLD. BS violates jelchnokamennouu and releaxation activity of hepatocytes, thereby slowing the passage of bile through the intrahepatic and extrahepatic bile ducts that aggravate the course of NAFLD. The reasons for the formation of sludge is not completely understood. To date there are no accepted tactics of conducting and treatment of patients with HB in the background of NAFLD. In our work we demonstrate one possible way to tackle this important problem.

[Tactics for the correction of intestinal microbiocenotic disorders in the combination therapy of patients with chronic liver diseases]

AIM

To evaluate the efficacy of the symbiotic Linex used in the combination therapy of liver cirrhosis (LC).

SUBJECTS AND METHODS

Seventy-four patients with LC, including 44 who received additionally the symbiotic Linex and 30 who had conventional therapy, were examined. All the patients underwent clinical and biochemical blood tests, abdominal ultrasonography, fecal test for bacteria, gas chromatography-mass spectrometry of the blood composition of microbial markers, number connecting test, and quality-of-life assessment (SF-36).

RESULTS

The symbiotic-treated patients showed a significant improvement in biochemical parameters (decreases in transaminase activities, bilirubin levels, hepatic protein-synthetic function--there were elevations in the concentrations of total protein from 74.0 +/- 0.50 to 78.1 +/- 0.80 g/l (p < 0.05) and albumin from 30.6 +/- 1.7 to 35.5 +/- 1.6 g/l (p < 0.05). There were also increases in the count of bifidobacteria from 8.7 +/- 0.1 to 9.1 +/- 0.1 Ig CFU/g (p < 0.05), lactobacilli from 5.0 +/- 0.2 to 5.2 +/- 0.2 Ig CFU/g (p < 0.05) and in the total count of Escherichia coli from 7.6 +/- 0.3 to 7.9 +/- 0.3 Ig CFU/g (p < 0.05); a tendency for normalization of microbial markers was revealed by mass spectrometry; the manifestations of hepatic encephalopathy were alleviated (the number connecting test showed a reduction from 51.0 +/- 3.58 to 29.7 +/- 4.10 sec (p < 0.05)), and the quality of life improved.

CONCLUSION

By normalizing enteric microbiocenosis, the symbiotic Linex positively affects the course and prognosis of LC and it is both a symptomatic and pathogenetic agent for the treatment of patients.

[Approaches to the treatment of patients with climacteric disorders complicated with menopausal metabolic syndrome with cholestasis]

RESEARCH OBJECTIVE

Development of the individual comprehensive program of follow treatment of patients with climacteric disorders complicated MMS (menopausal metabolic syndrome) with cholestasis; on the basis of application of low-dose hormone replacement therapy in combination with ursodeoxycholic acid, to improve the quality of life.

MATERIALS AND METHODS

We observed 101 woman with climacteric syndrome, obesity and cholestasis; conducted a comprehensive clinical and laboratory examination, ultrasound of the hepatobiliary system, measurement modified menopausal index (MMI), the measurement of the quality of life on questionnaire SF-36 before treatment and after 6 and 12 months.

THE RESULTS

Positive and statistically significant changes in lipid spectrum, the activity of transaminases, bilirubin and its fractions, improvement of MMI and quality of life, the indices of coagulation remained virtually unchanged.

CONCLUSION

Low-dose hormone replacement therapies in combination with ursodeoxycholic acid are highly effective drugs for the treatment of menopausal syndrome, which normalize lipid profile of patients and the performance of the hepatobiliary system.

[New aspects of pharmacological effects of ursodeoxycholic acid]

The paper reviews the use of hepatoprotective agents in chronic liver diseases (CLD) and biliary disorders. A variety of clinical studies have shown the beneficial effect of ursodeoxycholic acid (UDCA) in liver disease worldwide. Besides the well-known mechanisms of action of UDCA we could show its prebiotic effect. Several studies have demonstrated that UDCA serves as a potential therapeutic agent for a number non-hepatobiliary disorders including cardiovascular disease, immune disorders, organ transplantation and other.

[Fatty liver in elderly patients with atherosclerotic coronary artery disease (according to autopsy data)]

In article it is a question of morphological research of fragments of tissue of a liver at 143 elderly and old patients with atherosclerosis of the coronary arteries which have died on offices of the S-Petersburg hospital for veterans of wars in 2006-2010. Average age of the died patients was defined in the range from 61 till 98 years and made 82.3 ± 1.3 years. It is established that at geriatric patients with atherosclerotic defeat of coronary arteries fatty regeneration of a liver was observed in 25.9 ± 7.3%; more than at 2\3 geriatric patients with atherosclerosis of coronary arteries it was noted cteatogpatit with the minimum degree of the activity, thus specified degree of activity came to light at the surveyed patients with fatty regeneration of a liver (77.8 ± 8.0% against 60.7 ± 6.1% in group without fatty regeneration of a liver) more often. Cardiovascular diseases caused death of patients with atherosclerosis of coronary arteries and fatty regeneration of a liver, than in group of patients without a fatty degeneration of a liver (91.7 ± 4.8% of cases and 73.8 ± 4.9% of cases respectively) more often. Patients of senile age with atherosclerosis of coronary arteries and fatty regeneration of a liver died because of cardiovascular diseases, than their contemporaries in group without fatty regeneration of a liver (89.7 ± 6.1% and 71.3 ± 5.7% respectively) more often.

[Alcoholic hepatitis]

The aim of the study was to evaluate Kholit efficiency in complex treatment of alcoholic hepatitis. 72 patients with proved chronic alcoholic hepatitis were examined. 37 of them underwent complex treatment including Kholit. Kholit in complex treatment of patients with chronic alcoholic hepatitis was shown to promote improvement of the general patient's state, disappearance of objective signs of the disease, normalization of laboratory and instrumental data.

[Pathogenetic therapy of metabolic syndrome at the stage of visceral lesions]

Insulin resistance and oxidative stress play an important role in the pathogenetic mechanism of non-alcoholic fatty liver disease. Hepatoprotective therapy that blocks the second phase of pathogenesis (oxidative stress) is a promising modality for the treatment of non-alcoholic steatohepatitis (NACH). An alternative approach is the use of medicines recovering the mitochondrial membrane, lipid bi-layer of the plasma membrane, oxidative phosphorilation, and cellular metabolism. In this context, succinic acid-based remaxol showing antioxidative, antihypoxic and cytoprotective activities can be regarded as a promising metabolic hepatoprotector for the treatment of non-alcoholic fatty liver disease. The present original study demonstrated the clinical efficacy of remaxol in pathogenetic therapy of NACH in patients with metabolic syndrome. Its introduction in the combined treatment of NACH increased functional capacity of the liver by decreasing the severity of cytolysis, cholestasis, hepatomegalia, and steatosis (ultrasonic study), improved lipid metabolism, reduced cholesterol level, triglyceridemia, and atherogenic index. Remaxol exerted nephroprotective action in patients with diabetic nephropathy at stage 1 of chronic renal insufficiency (increased glomerular filtration rate and decreased blood creatinine level). The study demonstrated the advantage of medications with antihypoxic properties over traditional therapy of NACH.

[Metabolic correctors based on succinic acid as pathogenic therapy in chronic virus hepatitis]

Chronic viral hepatitides (CVH) run with long-term activation of the system of mononuclear phagocytes associated with hyperproduction of active oxygen forms. This can be considered as risk factors of antioxidant insufficiency which determines the course of the disease. Now, antioxidant, cytoprotective medicines are more and more actively used in hepatology. The results are reviewed of many Russian clinical trials of efficacy of metabolic correctors based on siccine acid (reamberin, remaxol) as pathogenetic treatment in CVH. Metabolic correctors in combined treatment of CVH improve basic clinico-laboratory indices, raise efficacy of basic therapy, correct insufficiency of antioxidant defense. The results of the studies confirm advantage of antihypoxic medication over standard infusion therapy for treatment of CVH patients.

[Efficiency of using cycloferon as part of combined therapy for chronic hepatitis C (a review of multicenter clinical trials)]

The results of a study of the efficiency of treatment in patients with chronic hepatitis C conducted in a complex of multicenter clinical trials of the impact of various antiviral therapy regimens including the interferon genesis inductor cycloferon are reviewed. Four hundred and seventy-eight patients with hepatitis C virus infection were followed up. The study has demonstrated that the incorporation of cycloferon into the standard treatment regimen, which is manifested by the effect of drug synergism, by producing antiviral, immunomodulating, and antifibrotic effects, is a promising pharmacotherapy for chronic hepatitis C. This treatment is economically sound, reduces the incidence and degree of adverse reactions and increases the quality of life in the patients.

[Reamberin for pathogenetic therapy of acute and chronic viral diseases of the liver]

The study including 427 patients with acute and chronic viral hepatitis was designed to assess results of clinical and laboratory diagnostics of hepatic problems and the state of thiosulfide antioxidative system. It was shown that infusion of succinate-containing preparation reamberin (400 ml/day for 10 days) took less time to eliminate clinical manifestation of the disease (dispeptic and asthenovegetative syndromes) than conventional therapy. Simultaneously the levels of biochemical markers of hepatic cytolysis and cholestasis significantly decreased while serum antioxidative potential recovered. The normal size of the liver was achieved 3.4 times more frequently than in control. No side effects or adverse reactions other than listed in the instruction for use of reamberin occurred. The preparation had to be withdrawn only in one patient.

[Hepatoprotective activity of remaxol in patients with chronic hepatic disorders]

This milticentre randomized clinical study of the efficiency of remaxol infusion solution (hepatoprotective medicine for chronic liver dysfunction) included 494 patients with chronic hepatitis B and C. 294 of them staying in 7 clinics were given remaxol and 200 ones received placebo. Randomization was achieved by the envelope method. A detailed description of clinical and laboratory characteristics of the diseases is presented. Effects of remaxol vs placebo on the functional activity of affected liver are discussed. Results of laboratory and clinical analysis indicate that mechanism of remaxol action is based on hepatoprotective, antioxidative, and anticholestatic activities of the drug.

[The effectiveness of antibiotics in typical and atypical pneumonias depending on combination with glucocorticosteroids]

Sixty-seven cases of prolonged pneumonia were analyzed. The study found that in cases with a typical onset the efficacy of antibiotics with predominantly bactericidal activity was much higher when they were administered in combination with glucocorticosteroids (GCS); bacteriostatic preparations were not used in such cases. In prolonged pneumonia with an atypical onset the efficacy of mainly bacteriostatic antibiotics was significantly higher than that of bactericidal ones, but the efficacy of both did not increase when they were combined with GCS. The use of GCS in addition to antibiotics shortens the time to pneumonia resolution in cases with both typical and atypical onset, regardless the character of antibacterial therapy.

[Psychosomatic aspects of therapy in patients with ischemic heart disease of behavioral type A]

Forty-five patients aged 34 to 67 years who had coronary heart disease (CHD) were examined. Anaprilin was given in a dose of up to 120 mg daily. Concurrently with positive changes in the anginal syndrome there were improved sleep, decreases in hot temper, irritability, anxiety, phobic manifestations, hypochondrical trends, and neurotic asthenization, increased working and social orientation. During anaprilin therapy, cardialgias reduced or disappeared, the incidence of arrhythmia decreased. There was a reduction in the personality profile in the scales "neurotic triad" and "psychoasthenia", significantly diminished reactive anxiety, and a decrease in the blood levels of aldosterone, cortisol, triiodothyronine, and thyroxine. Thus, supplementation of anapriline to the combined therapy for patients with CHD of behavioral type A (BTA) positive affected the clinical course of the disease. Hormonal disorders in BTA CHA may be eliminated by anaprilin. Configuration of the personality profile was leveled in patients with CHA of "coronary" type.

[Liver pathology in patients with primary hemochromatosis--homozygous carriers of C282Y mutation ]

Liver pathology was studied in 3 patients with primary chemochromatosis. In two cases so-called iron free foci with signs of hepatocytes with feature of dysplasia were found. Many siderosomes were found ultrastructurally in the cytoplasma of hepatocytes. Histological markers of virus infection were absent in a patient with positive serum HbsAg and HCV-Ab. Alcohol did not produce typical histological changes. In this case grave liver reticuloendothelial hemosiderosis typical for secondary hemochromatosis and overloading with iron of spleen pulp according to MR imaging were observed.

[Liver hemosiderosis in chronic hepatitis]

Liver hemosiderosis (LH) was studied in chronic hepatitis (CH) B and C and CH of other and alcoholic (AL) etiology. LH was present in 122 patients (a study group) and was absent in 188 patients (a comparison group). LH is considered to be a marker of organ iron overload. The total incidence of LH was 39.4 +/- 2.7%, including 33.3 +/- 5.6% in LH-B, 49.3 +/- 5.8% in LH-C, and 48.7 +/- 8.0% in AL. The association with LH was characterized by a longer duration of the disease, by a higher activity and degree of hepatic cirrhosis. The efficiency of reaferon therapy was lower in hepatitis B and C in the presence of LH. These forms of the disease are considered to be secondary hemosiderosis.

[Possibilities of complex etiological diagnosis of chronic viral hepatitides B and C]

Etiological markers for HBV and HBC were studied in 26 cases of chronic hepatitis. In 21 cases coincidence of serological and immunohistochemical results was found, in 9 cases markers of other viruses were registered. Immunohistochemical markers were identified in 3 of 5 liver biopsies in patients with negative serological tests. Histological signs of HBV and HBC corresponded to those of serological and immunohistochemical ones in 17 cases.

[Metabolic heterogeneity of glycogen in hepatocytes of patients with liver cirrhosis]

Concentrations of the total glycogen (TG) and of its labile and stable fractions (LF and SF, respectively) were determined in hepatocytes of portal and central zones of the normal human liver and in the liver of patients with cirrhosis of viral and alcohol etiology. Using the PAS reaction, TG and its LF and SF were revealed in histological sections of the material obtained by liver punction biopsies. Concentrations of TG and its fractions were measured by television cytophotometry. In liver cirrhosis, concentrations of TG, LF, and SF in both zones of the hepatic lobule were much higher than in the normal liver. The ratio between hepatocyte TG concentration in the portal zone and that in the central zone (P/C ratio), both in norm and in viral cirrhosis, exceeds 1.0 to reach, respectively, 1.26 +/- 0.02 and 1.03 +/- 0.01. The glycogen fraction composition in cells of both liver lobule zones in viral cirrhosis does not significantly differ from that in norm. On the contrary, in the liver of patients with alcoholic cirrhosis, the P/C ratio falls to 0.82 +/- 0.02 to be accompanied by qualitative changes in glycogen composition.

[Clinico-morphologic characteristics of primary hemochromatosis]

12 autopsy cases of primary hemochromatosis were studied: 11 males (aged between 29 and 69 years, mean age 51 years) and 1 57-year-old female. Clinical course in 6 patients ran with predominant liver damage to the small nodule or was of biliary cirrhosis type, in 3 cases main manifestation was diabetes mellitus and in 3 cases cardiomyopathy. Generalized pattern of hemosiderine deposits with involvement of the liver, pancreas, heart, adrenals, pituitary, epiphysis, thyroid and other organs was established by the Pearl's test. Apart from pigment degeneration, atrophy and fibrosis, compensatory and regenerative changes were found. These changes should be taken into account when the disease is analyzed clinically and morphologically.

[Plasmapheresis efficacy in the treatment of patients with chronic cholestatic hepatitis and primary biliary liver cirrhosis]

Effectiveness of plasmapheresis in a combined treatment of 46 patients with chronic cholestatic hepatitis and 30 with primary biliary cirrhosis of the liver was studied. Gratifying therapeutic results from plasmapheresis were achieved in 62 patients (81.5%). Time-related clinical manifestations of the illness, biochemical and immunological indices in the early post-plasmapheresis period were different in the groups studied. The mechanisms of therapeutic effect of plasmapheresis in patients with chronic cholestatic diseases of the liver were found to be chiefly due to its immunocorrective action, elimination of toxic products, returning to normal of rheological parameters of blood.

[The efficacy of immunomodulating preparations in treating patients with chronic cholestatic liver diseases]

A study of 102 patients with chronic cholestatic liver diseases revealed that levamisole, T + activin and thymalin possess an immunostimulating effect increasing the level of lymphocytes, T-lymphocytes, activate the functional activity of lymphocytes in patients with chronic cholestatic hepatitis and primary biliary cirrhosis. T = activin, thymalin produce a more pronounced normalization of the immune response by increasing the contents of T-lymphocytes and their subpopulations, elevating the functional activity of mononuclears, reducing the concentration of immunoglobulins, cyclic immune complexes. These changes favour controlling the immuno-inflammatory process in the liver, normalization of clinical manifestation of the disease.