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ANALYSIS OF PHYSICIAN STAFFING WITHIN THE INFECTIOUS DISEASES SERVICE OF THE REPUBLIC OF BELARUS IN 2016-2022 2016-2022年白俄罗斯共和国传染病科医师编制分析
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-490-497
E. N. Krotkova, V. E. Kratenok, T. V. Yasyulya, K. S. Ihumnava, V. M. Khauratovich, V. V. Kulinkina
The article considers the indicators of the staff composition within the infectious diseases service of the Republic of Belarus in different periods from an epidemic point of view. Calculations of infectiologists staffing levels and positions held concurrently as well as the approximate number of specialists involved in providing medical care to patients with a confirmed diagnosis of a new coronavirus infection (COVID-19), were performed, the daily workload per infectious disease doctor was assessed.
文章从流行病的角度考虑了白俄罗斯共和国传染病服务部门不同时期工作人员构成的指标。计算了传染病学家的人员编制水平和同时担任的职位,以及参与为确诊为新型冠状病毒感染(COVID-19)的患者提供医疗服务的专家的大致人数,评估了每位传染病医生的每日工作量。
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引用次数: 0
INTRATHORACIC LYMPH NODES SARCOIDOSIS. A CLINICAL CASE REPORT IN INTERNAL MEDICINE PRACTICE 胸内淋巴结结节病。内科临床一例报告
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-498-503
S. N. Demidik, K. M. Surmach, E. N. Aleksa, N. G. Borisovskaja
Sarcoidosis is a multisystem inflammatory disease of unknown etiology. Thoracic radiography is used to detect pathological changes in the lungs or intrathoracic lymph nodes. The classic image finding of pulmonary sarcoidosis is bilateral, symmetrical hilar and mediastinal lymph nodes enlargement. Lymph nodes are spherical or ovoid shape and homogeneous structure, with smooth clear contours, and without perifocal infiltration and sclerosis. Atypical manifestations of intrathoracic lymphadenopathy in sarcoidosis can be detected rarely. The presented clinical case indicates the importance of high-resolution computed tomography in patients with intrathoracic lymphadenopathy syndrome. It has to be noted that the detection of unilateral or asymmetric enlargement of hilar lymph nodes, the enlargement of mediastinal and pericardial groups of lymph nodes does not exclude sarcoidosis as a possible cause of pathology and requires morphological confirmation of the diagnosis. The case is discussed from the standpoint of personalized medicine and clinical recommendations.
结节病是一种病因不明的多系统炎性疾病。胸部x线摄影用于检测肺或胸内淋巴结的病理变化。肺结节病的典型影像学表现为双侧对称的肺门及纵隔淋巴结肿大。淋巴结呈球形或卵圆形,结构均匀,轮廓光滑清晰,无病灶周围浸润和硬化。结节病胸腔内淋巴结病变的不典型表现是罕见的。本临床病例表明高分辨率计算机断层扫描在胸内淋巴结病综合征患者中的重要性。需要注意的是,发现单侧或不对称的肝门淋巴结肿大、纵隔和心包淋巴结群肿大并不排除结节病可能的病理原因,需要形态学上的诊断证实。从个体化医疗和临床建议的角度讨论了这个案例。
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引用次数: 0
CLINICAL EFFICACY OF THE APPLICATION OF POOLED MESENCHIMAL STEM CELLS OF THE OLFACTORY LINING FOR THE TREATMENT OF PATIENTS WITH SEVERE COMMUNITY-ACQUIRED PNEUMONIA COMPLICATED BY ACUTE RESPIRATORY DISTRESS SYNDROME 应用闻衬间充质干细胞联合治疗重症社区获得性肺炎合并急性呼吸窘迫综合征的临床疗效观察
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-466-476
A. Ye. Hancharou, S. E. Aliakseichyk, A. H. Rynda, N. G. Antonevich, Yu. Yu. Pankratova
Background. The difficulty in diagnosing COVID-19 is associated with the heterogeneity of clinical manifestations, and treatment is difficult because the course of the disease varies from asymptomatic to severe viral pneumonia, with a cytokine storm and development of acute respiratory distress syndrome (ARDS). Certain hopes in the treatment of COVID-19 and ARDS are currently pinned on the use of mesenchymal stem cells (MSCs), due to their ability to influence the immune system and activate the regeneration of damaged tissues. The aim of the study was to improve the clinical efficacy of existing methods of treating patients with severe community-acquired pneumonia complicated by acute respiratory distress syndrome using cell therapy with pooled MSCs. Material and methods. The subjects of the study were patients with COVID-19-associated pneumonia (U07.1 according to ICD-10), severe course, acute respiratory syndrome (U04) (study group (n=14) and comparison group (n=18)). Clinical and laboratory studies were carried out by routine methods using commercial test systems. Results. Good tolerability and safety of the method of treatment of patients with severe COVID-19 complicated by ARDS using pooled MSCs were shown. 57% of patients who received pooled MSCs did not need to be transferred to mechanical ventilation in the next 7 days. In the study group, 43% of patients survived (6 out of 14), which was significantly higher than in the control group (5.6%, 1 out of 18) (z=2.07; p=0.038). A correlation was found between lactate dehydrogenase (LDH) levels and the outcome of a severe form of coronavirus infection, and criteria were established for selecting patients for cell therapy based on the level of LDH increase by no more than 1.85 times. Administration of pooled MSCs at LDH level higher than 519.8 U/l was ineffective.
背景。COVID-19的诊断困难与临床表现的异质性有关,治疗困难是因为疾病的病程从无症状到严重的病毒性肺炎不等,并伴有细胞因子风暴和急性呼吸窘迫综合征(ARDS)的发展。由于间充质干细胞(MSCs)能够影响免疫系统并激活受损组织的再生,目前治疗COVID-19和ARDS的某些希望寄托在使用间充质干细胞上。本研究的目的是提高现有方法对重症社区获得性肺炎合并急性呼吸窘迫综合征患者的临床疗效。材料和方法。研究对象为covid -19相关性肺炎(按ICD-10分级为U07.1)、重症病程、急性呼吸综合征(U04)患者(研究组14例)和对照组18例)。临床和实验室研究采用商业测试系统的常规方法进行。结果。合并骨髓间充质干细胞治疗重症COVID-19合并ARDS患者具有良好的耐受性和安全性。57%接受骨髓间充质干细胞合并的患者在接下来的7天内无需转机械通气。研究组患者生存率为43%(6 / 14),显著高于对照组(5.6%,1 / 18)(z=2.07;p = 0.038)。发现乳酸脱氢酶(LDH)水平与严重冠状病毒感染的预后之间存在相关性,并建立了以LDH水平升高不超过1.85倍为基础选择患者进行细胞治疗的标准。LDH水平高于519.8 U/l的合并MSCs给药无效。
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引用次数: 0
MULTIPLE MYELOMA: FEATURES OF THE COURSE AND RESPONSE TO THERAPY IN PATIENTS OF DIFFERENT AGE GROUPS 多发性骨髓瘤:不同年龄组患者病程及治疗反应的特点
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-483-489
Zh. M. Kozich, V. N. Martinkov, J. N. Pugacheva, N. N. Klimkovich
Background: Multiple myeloma (MM) remains an incurable disease with the development of relapses, sometimes with an uncontrolled course leading to death regardless of the age of the patient. The use of new schemes and methods of treatment has not only significantly improved outcomes in younger MM patients but also improved the quality of life and survival in people over 65 years of age. Objective: to determine the clinical features of the course of the disease and response to therapy in patients of different age groups with newly diagnosed multiple myeloma. Material and Methods: An analysis of the data of 139 patients with newly diagnosed MM was carried out. The median follow-up was 25 months, with a maximum of 58 months. Patients were divided into study groups depending on age at the time of diagnosis: the first group - age up to 65 years (n=65); the second group - age from 65 years and older (n=74). The material of the study was clinical and anamnestic data, the results of laboratory blood tests: biochemical analysis and immunochemical analysis. All the patients underwent the whole body CT scan, diffusely weighted whole body MRI and bone marrow aspiration biopsy with immunophenotypic study. As an induction therapy, according to international recommendations, courses of chemotherapy were used using various regimens containing bortezomib, depending on age and comorbidity. Results. The MM variant with IgA secretion occurred 1.76 times more often in the first group (p=0.128). In the first group hypercalcemia was somewhat more common (2.4 times, p=0.099) and an excess of LDH levels (2.9 times, p=0.072). In contrast, the presence of infectious complications (by 1.2 times, p=0.392), excess of the level of β2-microglobulin > 3 mg/l (by 1.6 times, p=0.086) and kidney damage (by 1.45 times, p=0.037) were more common in the second group, and in the latter case the differences were statistically significant. Disease stage (p=0.0001), excess of β2 microglobulin level (p=0.004), excess of LDH level (p=0.03), presence of anemic syndrome (p=0.003), hypercalcemia (p=0.02), presence of infectious complications (p=0.01) at the time of diagnosis were predictors of worse survival in the general group of MM patients. Conclusion. The active use of new therapeutic strategies and regimens improves treatment outcomes not only in patients under 65 years of age, but also in older patients. New studies are needed to identify prognostic factors in individuals of different age groups in order to start personalized therapy and improve treatment outcomes.
背景:多发性骨髓瘤(MM)仍然是一种无法治愈的疾病,随着复发的发展,有时与患者的年龄无关,无法控制的过程导致死亡。新的治疗方案和方法的使用不仅显著改善了年轻MM患者的预后,而且改善了65岁以上患者的生活质量和生存率。目的:了解不同年龄组新发多发性骨髓瘤患者病程及治疗反应的临床特点。材料与方法:对139例新诊断的MM患者资料进行分析。中位随访为25个月,最长为58个月。根据诊断时的年龄将患者分为研究组:第一组-年龄至65岁(n=65);第二组年龄在65岁及以上(n=74)。本研究的材料是临床和记忆资料,实验室血液检查结果:生化分析和免疫化学分析。所有患者均行全身CT扫描、弥漫性加权全身MRI和骨髓穿刺活检并进行免疫表型研究。作为一种诱导疗法,根据国际建议,根据年龄和合并症,使用含有硼替佐米的各种方案进行化疗。结果。伴IgA分泌的MM变异在第一组的发生率是前者的1.76倍(p=0.128)。在第一组中,高钙血症更为常见(2.4倍,p=0.099), LDH水平过高(2.9倍,p=0.072)。相比之下,感染并发症的存在(1.2倍,p=0.392), β2-微球蛋白水平超标;3mg /l组(增加1.6倍,p=0.086)和肾损害(增加1.45倍,p=0.037)在第二组中更为常见,后者差异有统计学意义。疾病分期(p=0.0001)、诊断时β2微球蛋白水平过高(p=0.004)、LDH水平过高(p=0.03)、存在贫血综合征(p=0.003)、高钙血症(p=0.02)、存在感染性并发症(p=0.01)是MM普通组患者生存率较差的预测因素。结论。积极使用新的治疗策略和方案不仅可以改善65岁以下患者的治疗效果,还可以改善老年患者的治疗效果。需要新的研究来确定不同年龄组个体的预后因素,以便开始个性化治疗并改善治疗结果。
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引用次数: 0
THYROID NODULES: MODERN STRATEGY AND CLINICAL EXPERIENCE 甲状腺结节:现代策略与临床经验
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-504-508
O. V. Gulinskaya, N. I. Prokopchik, A. V. Zhigimont, S. I. Zanevsky
There is now a significant increase in the detection of nodular thyroid masses worldwide, leading to fine-needle aspiration biopsies after ultrasound examination. Most cases of differentiated thyroid cancer (follicular and papillary types) present as nodular goiter, and the uncertainty of cytological diagnosis (Bethesda category III and IV) complicates the choice of treatment tactics for patients. Therefore, additional preoperative diagnostic methods are required to understand the nature of the mass, reduce the number of unnecessary operations, and improve the quality of treatment. A multidisciplinary approach to the diagnosis of nodular thyroid masses enables to make timely diagnosis, surgical treatment and a favorable prognosis.
现在在世界范围内,甲状腺结节性肿块的检测显著增加,导致超声检查后进行细针穿刺活检。大多数分化型甲状腺癌(滤泡型和乳头状型)表现为结节性甲状腺肿,细胞学诊断的不确定性(Bethesda分类III和IV)使患者治疗策略的选择复杂化。因此,术前需要额外的诊断方法来了解肿块的性质,减少不必要的手术次数,提高治疗质量。多学科方法诊断结节性甲状腺肿块,使及时诊断,手术治疗和良好的预后。
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引用次数: 0
FEATURES OF CLINICAL AND LABORATORY PARAMETERS IN PATIENTS WITH SARS-COV-2 INFECTION DEPENDING ON THE RESULTS OF SEROLOGICAL DIAGNOSIS sars-cov-2感染患者血清学诊断结果的临床和实验室参数特征
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-460-465
S. A. Lialikau, S. B. Volf, I. A. Kurstak, S. N. Demidik, O. N. Mahiliavets, E. V. Kotova, N. E. Markevich
To date, over 270 million people have been ill with COVID-19 and more than 2 million have died. Tens of thousands of new cases of the disease are still registered in the world every day, so the assessment of the methods for diagnosing SARS-CoV-2 associated pathology remains highly relevant. The aim of the study was to evaluate the variability of clinical and laboratory parameters in patients with SARS-CoV-2 infection depending on the results of serological diagnostics. Material and methods. 170 patients (88 women, 82 men aged 23 to 90 years) diagnosed with community-acquired interstitial pneumonia following SARS-CoV-2 infection were examined in accordance with the clinical protocol, in 80 of them the blood levels of IL-1β, IL-6, IL-18, CXCL8, and interferon-α were determined. Results. It was found that only in 34.09% of cases a negative PCR result for the presence of the genetic material of SARS-CoV-2 viruses in patients diagnosed with interstitial pneumonia coincided with a negative result of testing for IgG and/or IgM to the viral antigen. A positive PCR result was confirmed by the presence of elevated levels of antibodies in 64.29% of cases. In PCR-positive patients, stage II III respiratory failure was determined significantly more often than in PCR-negative ones (in 40.28% and 16.32% of cases, respectively, p<0.01), and their condition was more often regarded as severe and extremely severe (in 31.94% and 10.0% of cases, respectively, p<0.05). The level of antibodies was associated with the severity of the immune response to a viral infection: the volume of lung damage, the blood level of the pro-inflammatory cytokine IL-18, acute phase inflammation proteins, and the activity of intracellular enzymes were significantly higher in patients with elevated levels of IgG and/or IgM than in patients with negative results of these tests. Conclusions. The determining of IgM and IgG specific to the Spike antigen of the SARS-CoV-2 virus does not duplicate, but complements the molecular genetic study. PCR helps to detect the presence of the genetic material of the virus. Detection of the level of antibodies can be used to make a conclusion about the intensity and stage of the immune response to a viral infection.
迄今为止,已有2.7亿多人感染COVID-19, 200多万人死亡。世界上每天仍有数以万计的新病例登记,因此评估诊断SARS-CoV-2相关病理的方法仍然具有高度相关性。该研究的目的是根据血清学诊断结果评估SARS-CoV-2感染患者临床和实验室参数的变异性。材料和方法。按照临床方案对170例确诊为SARS-CoV-2感染后社区获得性间质性肺炎患者(88例女性,82例男性,年龄23 ~ 90岁)进行检查,检测80例患者血液中IL-1β、IL-6、IL-18、CXCL8和干扰素-α水平。结果。结果发现,在诊断为间质性肺炎的患者中,SARS-CoV-2病毒遗传物质PCR阴性结果与病毒抗原IgG和/或IgM检测阴性结果相吻合的病例仅占34.09%。64.29%的病例抗体水平升高,证实PCR阳性。pcr阳性患者II - III期呼吸衰竭确诊率明显高于pcr阴性患者(分别为40.28%和16.32%,p < 0.01),重症和极重症患者较多(分别为31.94%和10.0%,p < 0.01)。抗体水平与病毒感染免疫反应的严重程度相关:IgG和/或IgM水平升高的患者肺损伤的体积、促炎细胞因子IL-18的血液水平、急性期炎症蛋白和细胞内酶的活性明显高于这些测试结果为阴性的患者。结论。SARS-CoV-2病毒刺突抗原特异性IgM和IgG的测定不重复,而是对分子遗传学研究的补充。聚合酶链反应有助于检测病毒遗传物质的存在。抗体水平的检测可用于对病毒感染的免疫反应的强度和阶段作出结论。
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引用次数: 0
EFFECT OF OREGONIN ON THE MICROBIOME AND FORMATION OF THE AMINO ACID FUND OF THE INTESTINE, LIVER AND PLASMA 俄勒冈素对肠道、肝脏和血浆微生物群及氨基酸基形成的影响
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-477-482
I. V. Nikalayeva, V. M. Sheibak, O. B. Astrouskaya, E. M. Doroshenko, V. Yu. Smirnov
Background. This article analyzes the effect of a course intragastric administration of oregonin on the microbiocenosis of parietal mucin, the morphological structure of the intestinal mucosa, as well as the formation of the amino acid fund of the microbial-tissue complex of the small intestine, liver and plasma. Objective. The aim of the study was to identify the mechanisms of the biological activity of oregonin when administered to normal animals. Material and methods. The experiments were performed on white female rats weighing 180-240 g. The animals were enterally administered with 0.005% aqueous solution of oregonin at a dose of 5 mg/kg of body weight for 10 days daily. The control group received equivalent volumes of saline. In samples of the microbial-tissue complex of the small intestine, liver and plasma, the concentrations of free amino acids and their nitrogen-containing metabolites were determined by HPLC. Morphological and microbiological studies were carried out according to standard methods. Results. In animals treated with oregonin, there were no negative changes in the structure of the jejunal wall. In the microbiome of the parietal mucin, an increase in the population of anaerobes was observed, due to the growth of bifidobacteria and lactobacilli. At the same time, a bacteriostatic effect was recorded against lactose-negative and gas -forming microflora. In the microbial-tissue complex of the small intestine, after the enteral administration of oregonin, the total levels of amino acids and nitrogen-containing derivatives, which are produced mainly by facultative anaerobic microflora, decreased. In the liver, the intake of oregonin led to an increase in the total amount of amino acids and their derivatives. The total content of proteinogenic amino acids and their nitrogen-containing derivatives also decreased in the blood plasma. Conclusion. Oregonin demonstrates a high biological activity when administered enterally to animals. Positive changes in the intestinal microbiome and increased production of mucin, on the one hand, probably inhibit the production of nitrogen-containing products by facultative anaerobes, and on the other hand, initiate the use of free amino acids for biosynthetic purposes in tissues, while preventing their catabolism.
背景。本文分析了一个过程灌胃俄勒冈蛋白对肠壁粘蛋白微生物病、肠黏膜形态结构以及小肠、肝脏和血浆微生物组织复合物氨基酸基形成的影响。目标。该研究的目的是确定俄勒冈蛋白在正常动物体内的生物活性机制。材料和方法。实验对象为体重180 ~ 240 g的雌性白鼠。用0.005%的俄勒冈素水溶液,以5 mg/kg体重的剂量肠内给药,连续10天。对照组给予等量生理盐水。在小肠、肝脏和血浆的微生物组织复合物样品中,用高效液相色谱法测定游离氨基酸及其含氮代谢物的浓度。形态学和微生物学研究按标准方法进行。结果。在用俄勒冈素治疗的动物中,空肠壁的结构没有负面变化。在壁粘蛋白的微生物组中,由于双歧杆菌和乳酸菌的生长,观察到厌氧菌的数量增加。同时,还记录了对乳糖阴性菌群和产气菌群的抑菌作用。在小肠微生物组织复合体中,经肠内给药俄勒冈蛋白后,主要由兼性厌氧菌群产生的氨基酸和含氮衍生物的总水平降低。在肝脏中,摄入俄勒冈蛋白导致氨基酸及其衍生物的总量增加。血浆中蛋白质氨基酸及其含氮衍生物的总含量也有所下降。结论。俄勒冈素在动物肠内注射时显示出很高的生物活性。肠道菌群的积极变化和粘蛋白的增加,一方面可能抑制兼性厌氧菌产生含氮产物,另一方面,启动游离氨基酸在组织中用于生物合成目的,同时阻止其分解代谢。
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引用次数: 0
GENERAL PRINCIPLES OF BACTERIAL COMMUNICATION 细菌交流的一般原理
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-453-459
T. V. Artsiukh, E. A. Sidorovich, D. V. Tapalskiy
This article presents up-to-date information on the phenomenon of intercellular communication in bacteria, its role in the expression of virulence genes and, in particular, in the spread of antibiotic resistance. The basic principles of quorum functioning inherent in all currently known bacterial communication systems are highlighted. The main signaling molecules (autoinducers) of intraspecies, interspecies, epinephrine and peptide communication have been analyzed. The role of blocking information communication (signaling molecules) between bacteria as an alternative to the discovery of new antibiotics against bacteria with extreme and complete antibiotic resistance have been evaluated. Key words: quorum sensing, signaling molecules, receptors, gene expression, quorum suppression.
本文介绍了细菌细胞间通讯现象的最新信息,其在毒力基因表达中的作用,特别是在抗生素耐药性传播中的作用。所有目前已知的细菌通讯系统中固有的群体功能的基本原则被强调。分析了种内、种间、肾上腺素和肽通讯的主要信号分子(自诱导剂)。阻断细菌之间的信息交流(信号分子)作为发现新抗生素的替代方案,对极端和完全抗生素耐药的细菌的作用已经进行了评估。关键词:群体感应,信号分子,受体,基因表达,群体抑制。
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引用次数: 0
GENERALIZED ANXIETY DISORDER, ITS IMPACT ON THE CARDIOVASCULAR SYSTEM AND MODERN APPROACHES TO THERAPY 广泛性焦虑障碍,其对心血管系统的影响和现代治疗方法
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-509-514
Е. G. Koroleva, E. A. Klimovich, М. P. Mazalkova
The aim of the article is to analyze the most modern and effective approach to the treatment of generalized anxiety disorder (GAD). This disorder occurs quite often - up to 6.6% among other neuroses. To prescribe the right therapy, first of all, it is necessary to accurately diagnose it. Since GAD has a rather high comorbidity (combination with other neurotic disorders), diagnosis is often difficult, as a result of which the selection of therapy may be inaccurate. In addition, a number of factors play a role in the etiology of GAD - genetic, social (various stressful moments), as well as somatic predisposition. To date, no preference has been given in its etiology to any specific factor. They may vary from patient to patient. In this connection, in the diagnosis of GAD, a strict individual approach is important in the selection of therapy.
本文的目的是分析最现代和最有效的方法来治疗广泛性焦虑障碍(GAD)。这种疾病经常发生——在其他神经症中高达6.6%。要开出正确的治疗方案,首先要对其进行准确诊断。由于广泛性焦虑症有相当高的合并症(与其他神经性疾病合并),诊断通常很困难,因此治疗的选择可能是不准确的。此外,许多因素在广泛性焦虑症的病因学中起作用-遗传,社会(各种压力时刻),以及躯体易感性。迄今为止,在其病因学上没有任何特定因素的偏好。他们可能因病人而异。在这方面,在广泛性焦虑症的诊断中,在选择治疗方法时,严格的个体方法是重要的。
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引用次数: 0
GRODNO STATE MEDICAL UNIVERSITY – 65 YEARS! THE FACULTY OF MENTAL HEALTH MEDICINE – 30 YEARS! OUR HISTORY AND OUR GRADUATES – OUR PRIDE AND CONFIDENCE IN THE FUTURE 格罗德诺州立医科大学- 65年!精神健康医学系——30年!我们的历史,我们的毕业生,我们对未来的骄傲和信心
Pub Date : 2023-11-08 DOI: 10.25298/2221-8785-2023-21-5-429-433
S. L. Boyko, V. I. Voronets, A. Yu. Pavlyukovets
The article provides an outline of the history of the Faculty of Mental Health Medicine from the decision to create a new direction in medical education to the present 30th anniversary. The main stages in the formation of the faculty as well as brief biographies of the deans of the faculty are covered; the graduates who the university and the country are proud of are also mentioned.
本文概述了心理健康医学院从决定开创医学教育新方向到现在30周年的历史。该课程涵盖了学院形成的主要阶段,以及学院院长的简介;他们还提到了学校和国家引以为傲的毕业生。
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引用次数: 0
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Zurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta
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