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Abstract. One of the disontogenetic comorbidity factors (DCF) in alcohol addiction formation is presence of scenario sexual incongruence on cultural level in couples, where the woman suffers from alcohol addiction, and at the same time displays the signs of psychosexual ontogenesis disturbance. In order to distinguish DCF of forming combined forms of alcohol addiction in women 46 patients with alcohol addiction and psychosexual development disorder in the form of sexual tactile preferences disturbance (STPD) were examined with the help of clinical psychopathological, clinical sexopathologic and statistic methods of investigation. For the first time, on the basis of comparative study of clinical characteristics of culture-bound sexual scenarios in the investigated women the data about the structure of culture-bound sexual scenarios, predominant scenario type and variants of culture-bound sexual scenarios combinations in couples were received. The obtained findings are important for understanding the process of comorbid alcohol addiction formation in women with psychosexual development disturbances in the form of STPD and for development of differentiated therapeutic programs in this combined pathology.

Abstract. The problems of clinical structure and dynamics of formation of mental deadaptation states in senior officials of the health system are featured. The study involved 200 persons (men and women) aged 31-60 who were investigated using V.V. Boyko's technique and structured narrative interview. The investigation demonstrated mental adaptation disorders in 160 (80%) of patients. Two main states of mental deadaptation, i.e. burn out syndrome and situationally conditioned states of mental deadaptation, were distinguished. The obtained findings should be considered when working out a system of medical psychological management of senior officials of the health system.

Abstract. The purpose of the work was to study the condition of blood-brain barrier by research of specific marker of permeability of blood-brain barrier, albumin in the blood serum and in the cerebrospinal fluid in patients with the different types of multiple sclerosis course, on different stages of activity of pathological process. Investigation blood serum albumin level was conducted using a method of photocalorimetry. Cerebrospinal fluid albumin level was determined by method of immunoenzyme assay. The conclusions about the blood-brain barrier permeability and the degree of inflammatory processes activity were made with the help of calculation of albumin coefficient : Q alb = AlbCSL / of Alb blood (mg/ml). The level of albumin in the serum of blood and CSF depends on the stage of pathological process and type of disease, course i.e. permeability of blood-brain barrier depends on the degree of inflammatory reactions activity, which can serve as an additional parameter in the system of monitoring of patients with multiple sclerosis and estimations of efficiency of therapeutic measures.

Abstract. Severe medical social consequences of acute cerebral blood flow disorders are reflected in the indices of the population disability. Therefore, investigation of the pathophysiology of acute cerebral ischemia and development of effective methods of the revealed disorders correction are important. The number of desquamated endotheliocytes was investigated in the venous blood using immunocytochemistry method and monoclonal antibodies CD34 in the course of examination of the patients in acute period of carotid ischemic stroke and patients with transient ischemic attacks in the carotid basin. Vascular endothelium disorganization manifesting as increase of the number of desquamated endotheliocytes in the peripheral blood flow was revealed, which is a promising direction in the diagnosis of cytochemical disorders in these patients, prerequisite for urgent medical aid and prevention of acute cerebral ischemia.

Abstract. The concept of chronic kidney disease (CKD) does not eliminate the nosological approach to the diagnosis of the disease. CKD suggests the likelihood of adverse outcomes that are measured risks. The main CKD risk is renal process progress with chronic renal failure (CRF) development. It becomes clear that early diagnosis of the causal nosology and the nosological adequate therapeutic management are very important. The aim of the work was to explore the features of the nosological structure of the urinary system in CKD children with the progress towards end-stage of CRF. Clinical data of 222 children aged 7-17 with nondiabetic CKD were studied. The nosological structure analysis of urinary system pathology in CKD patients was carried out. It was established that congenital anomalies of the urinary system prevailed in the nosological structure in CKD children. It was demonstrated that congenital and hereditary nephropathies dominated over acquired nephropathies. It was determined the relative increase of the glomerular diseases proportion in the nosological structure in children with stage III-IV CKD was due to the most unfavorable variants according to the forecast. The necessity of nosological approach to the disease diagnosis in the individual child was proved for determining the effective therapeutic program aimed at prevention of CKD or deceleration of its progress towards end-stage of chronic renal failure.

Abstract. Currently, there is strong clinical evidence about the relationship of high heart rate and cardiovascular morbidity and mortality. Numerous studies emphasize the negative outlook of tachycardia not only in patient with cardiovascular diseases, but also in the general population. Physiological regulation of heart rate is implemented at several levels, i.e. neurogenic, autonomous, metabolic, humoral, and depends on a number of exogenous factors. For a long time the most affordable way to estimate the frequency of the rhythm was to determine the resting heart rate. The modern methods of heart rate analysis include methods of load testing, determination of the heart rate, electrophysiological estimation of the sinus nod function, assessment of heart rate during Holter ECG with the study of heart rate variability. Continuous registration of rhythm with the statistical analysis provides a fundamentally new information on the chronotropic heart function, which may have important clinical and prognostic significance.

Abstract. The level of galectin-3 in patients with chronic heart failure and the factors influencing its dynamics in the process of treatment were investigated. All patients were performed complex investigation including standard ECG, 6-minute walking test, EchoCG, Holter's ECG monitoring, galactin-3 determining in the blood serum. A relationship between the dynamics of the level of galectin-3 and clinical course of chronic heart failure was established. The parameter reduced with decrease in the severity of chronic heart failure within 6 months of observation, while elevation of the level of galectin-3 was associated with the progression of heart failure. Galectin-3 level reduction was more clearly observed when target doses of β-blockers (Carvedilol) were administered.

Abstract. The issue of the changes of the levels of pro-inflammatory cytokines in patients with unstable angina and type 2 diabetes mellitus is disputable. This study evaluated the character of changes of pro-inflammatory cytokines by determining tumor necrosis factor-α and interleukin-6 in these patients depending on the functional class of chronic heart failure and analyzed the association of anti-inflammatory cytokines and carbohydrate metabolism parameters. The study involved 104 patients with unstable angina divided into groups depending of the presence of type 2 diabetes mellitus. It was determined that the increase in manifestations of cardiac decompensation in patients with unstable angina and type 2 diabetes mellitus was associated with high activity of pro-inflammatory cytokine level and increase of insulin resistance, which achieved its maximum in patients with accompanying type 2 diabetes mellitus.

Abstract. The purpose of the work was to investigate the influence of progesterone level on the parameters of arterial pressure, ejection fraction, electrocardiographic index of myocardial damage and severity of menopause signs in women in early postmenopause. The investigation was done on 91 patients. Follicle stimulating hormone and inhibin B in the blood serum were determined by immonoenzyme method to diagnose menopause. Severity of menopause signs was assessed using Kupperman H. menopausal index. Myocardium state was assessed with electrocardiographic index of myocardial damage. The study demonstrated that healthy women in the period of early physiological menopause do not demonstrate association between the level of progesterone and electrocardiographic index of myocardium damage as well as ejection fraction of the left ventricle but these parameters depended on high density cholesterol lipoproteins, follicle stimulating hormone, heart rate, apolipoptotein B level and menopause signs.

Abstract. The presence and trends of influence of surgical stress on the changes of the peripheral blood cytokine profile were investigated in patients with complicated sinusitis. The system of intercellular interactions and influence of surgery on it were assessed in patients with complicated sinusitis aged 18-72 by the changes of pro-inflammatory cytokine concentration (interleukin-6, tumor necrosis factor-α (TNF-α) and anti-inflammatory ones (interleukin 1 receptor antagonists (IL-1 RA) , interleukin-4) by method of solid-phase sandwich immunoenzyme assay using diagnostic equipment produced by "Vektor'Best" (Novosibirsk, Russia). Pathogenetic significance of increase of IL-1 RA and TNF-α was identified in sinusitis and its complications on the first day after the surgery. The extent of surgical stress influence depended on the presence and severity of the inflammatory response in complicated sinusitis, which affected the clinical and laboratory parameters in the immediate postoperative period.

Abstract. The technique of planning endoscopic interventions in the nasal cavity and paranasal sinuses using the data of cone-beam tomography with 3D-visualization was used at surgical treatment of the patients aged 16-64. Low radiation load, interaction of the data in the space, and high resolution allowed to the use the technique at the stages of diagnosis, surgery planning, and post-operative control. This technique helps to optimize the choice of surgical approach, sequence of actions, and the necessary instruments.

Abstract. The analysis and review of the author's literature about the risk factors and their role in development and progress of pathological changes in the gastrointestinal mucosa, including esophagus, possibly preceding development of malignancy or immediately accelerating their development in various organs of the gastrointestinal tract, was done. The capabilities of vital (preoperative) examination of the state of the gastrointestinal mucosa, i.e. epithelial dysplasia as one of the risk factors of malignancy, were featured. Due to the increase of the number of early stages of malignant tumors and pre-cancer states, revealed, primarily, due to improvement of the methods of diagnosis, further development of criteria for early diagnosis of malignant tumors and their differentiation is necessary.

Abstract. Earlier studies performed by the authors have demonstrated multidirectional effects of the components of second-line quadritherapy on the state of aggressive-protective factors in the gastroduodenal mucosa. The purpose of this work was to investigate two standard schemes of second-line quadritherapy in patients with duodenal ulcer. It was determined that schemes with Omeprazole, De-Nol, amoxicillin, tetracycline and Omeprazole, De-Nol, tetracycline, metronidazole influence equally the dynamics of clinical symptoms and frequency of H. pylori eradication. However, the first scheme more effectively influenced the disorders in the mechanism of synthesis of protective mucus barrier and regeneration processes, which contributed to the high frequency of ulcer cicatrisation.

Abstract. Blood serum lipid profile was investigated in 131 women with adenomatous and glandular endometrial hyperplasia with obesity and normal body mass. It was revealed that the majority of patients with adenomatous and glandular endometrial hyperplasia demonstrated disorders of lipid blood profile characterized by dyslipoproteinemia predominantly type IIa and IIb. Dyslipoproteinemia development occurred due to increase of atherogenic classes of lipoproteids and reduction of antiatherogenic high density lipoproteids. Lipid blood spectrum in patients with endometrium hyperplasia was accompanied by disorders in lipid transport system, characteristic both for obesity and negative influence of hyperinsulinemia and ovarian hyperandrogeny. The presence or absence of metabolic syndrome based on insulin resistance manifesting by hyperinsulinemia, dyslipoporteidemia, ovarian hyperandrogeny significantly influences development of endometrial hyperplasia.

Abstract. Poor ovarian response syndrome (PORS) is characterized by controlled ovarian stimulation not exceeding 3-5 preovulatory follicles by the end of the protocol. In our study we compared patients with normal response to stimulation and patients with PORS. Diagnostic value of two techniques, Doppler ultrasound of ovarian blood flow and determining blood anti-Muller hormone, was compared. Such Doppler ultrasonography parameters as resistance index and pulse index were used for quantitative interpretation of spectrum curves of blood flow velocity. Anti-Muller hormone in the blood was determined using immunoenzyme assay based on the principles of enzyme enhanced two-stage sandwich control. It was established that Doppler ultrasound parameters of ovarian blood flow were prognostically more valuable and accurate in determining PORS vs. determining blood anti-Muller hormone, yielding false-positive results in a number of cases.

Abstract. Using the literature data the authors discuss an urgent issue of present-day orthopedics, i.e. the use of biochemical markers in the diagnosis of osteoarthritis for assessment of the degree of inflammatory destructive changes in the joints. Social significance and practical importance of investigation of metabolic disorders in the organism of the patients with osteoarthrosis are emphasized. The leading role of the components of extracellular matrix (proteoglycanes, glycosaminoglycans, collagen proteins as well as cytokines, C-reactive protein, resistin, eicosanoids) in development of the pathological processes is stressed. It was determined that biochemical markers are important diagnostic tests at assessment of the inflammatory process activity as well as destructive changes in the joints at osteoarthrosis. This allows to apply the biochemical parameters to laboratory diagnosis and assessment of therapy efficacy in orthopedics and traumatology..

Abstract. Modern ideas of Ukrainian and foreign scientists on the mechanisms of immunological and biochemical disorders in patients with osteoarthritis in combination with hypertension and obesity are discussed. The leading role in the pathogenesis of osteoarthrosis is played by disorders of synthesis of inflammatory and pre-inflammatory cytokines, proteins of acute phase of inflammation and lipid peroxidation system. The ability of pre-inflammatory cytokines to change the function of the endothelium, modulate the level of neuromediators production and stimulate sympathoadrenal system partially determines development of arterial hypertension at osteoarthrosis. Participation of obesity in the pathogenesis of osteoarthrosis can be explained by leptin hyperproduction and its influence on the immune system. The reported literature data prove the presence of pathophysiological interaction between obesity, arterial hypertension, and osteoarthrosis.

Abstract. The purpose of the work was to improve the results of treatment of patients with unresectable metastatic gastric cancer by development and application of methods of regional endarterial and endolymphatic chemotherapy. The results of treatment of 125 patients with the unresectable metastatic gastric cancer aged 32-80 who were treated at DRAC from 2000 to 2009 and received endarterial, intravenous and endolymphatic chemotherapy, were analyzed. Endarterial and endolymphatic chemotherapy were shown to have a few amount of toxic complications. It was proven that endolymphatic chemotherapy was more effective at the mainly metastatic involvement of parietal peritoneum and extraperitoneal lymphatic nodes, while endarterial chemotherapy renders more pronounced effect at presence of metastasis to the liver and pancreas.

Abstract. The results of chemoradiation treatment with the use cisplatin and 5-fluoruracil (5-FU) in patients with locally-advanced cancer of the stomach depending on microsatellite instability (MSI) of loci of BAT-25 and BAT-26 responsible for genes of postreplicative reparation of MSH2, MLH1 are presented. It is shown that 50% of patients with locally advanced cancer of the stomach have mutation phenotype with MSI on BAT-25; BAT-26 loci. Maximum therapeutic effect of x-ray therapy with modification with cisplatin was achieved in patients without MSI; and modification with 5-FU at MSI on BAT-25; BAT-26 loci. Toxic effects of chemoradiation therapy are not connected with genetic features of the tumor and are the result of action of cisplatin and 5-FU on the organs and systems of the organism of the tumor-carrier.

Abstract. To evaluate the significance of laboratory indices for determining the malignancy grade, updated laboratory techniques (immunoenzyme, immunoturbidity method, spectrofluorometry, electron paramagnetic resonance spectrometry) were used to study tumor markers, growth factors, angiogenesis, intercellular adhesion, and endothelial damage, products of inflammation and oxidative modification of proteins and lipids in body fluids of 552 patients with nonmusculo-invasive urinary bladder cancer. Statistical analysis of the obtained findings allowed to distinguish of investigating 27 parameters of 8 indices of maximal correlation with the tumor grade. An algorithm for laboratory examination of urinary bladder cancer patients, which makes it possible to predict the tumor grade as early as in the preoperative period, is proposed. This enables the clinicians to assess adequately the risk of disease recurrence or progression and to use a differentiated treatment approach.

Abstract. The achievements of neurobiology and immunology have facilitated in establishing anatomical and functional associations between the nervous and immune system. The findings of the recent research suggest that similarly to the other systems of the human body, the immune system is controlled by nerve reflexes regulated by the central nervous system. The inborn immune response is inhibited by inflammatory reflex including afferent axis, receiving the signals of danger and efferent axis, cholinergic anti-inflammatory pathway. This pathway plays an important role in the control of pro-inflammatory cytokine production by monocytes and macrophages. Besides inflammatory reflex, other nervous links involved in the regulation of inborn and adapted immune responses were identified. This review features the role of nervous responses in immune homeostasis maintenance.

Abstract. Urgency of investigation of chronic glomerulonephritis is connected with the fact that the course of this disease is characterized by stable progress, the process gradually results in renal tissue sclerosis and loss of its function. Clinical laboratory methods were used to investigate the character and role of immunological features of lipid metabolism disorders in the pathogenesis of nephrotic syndrome in patients with chronic glomerulonephritis. The results of the study of lipoprotein-containing immune complexes in patients with chronic glomerulonephritis with nephrotic syndrome without it are reported. The study demonstrated improvement in LDLP-IgA and reduction in LDL?P-IgG in all patients, most pronounced in those with nephrotic syndrome, which also had elevated levels of LDLP-IgM. The possible mechanisms of influence of lipoprotein-containing immune complexes on glomerular changes in chronic glomerulonephritis were described. The association between the level of LDLP and proteinuria development, and the changes in glomerular filtration rate is shown.

Abstract. The state of active artificial antitoxic antidiphtheria immunity was investigated in children aged 1-14 with the history of viral hepatitis A during 6 months of convalescence. The level of titers of specific antibodies to diphtheria in the peripheral blood was determined. The investigation of the level of active artificial antitoxic immunity to diphtheria was done using passive hemagglutination reaction. The influence of viral hepatitis A in the period of convalescence on the state of active artificial antitoxic immunity to diphtheria was investigated in previously vaccinated children. Significant reduction of antibody titers to diphtheria agent in the period of convalescence in children with the history of viral hepatitis A compared with clinically healthy children of all ages was revealed. It was found out that the level of active artificial antidiphtheria immunity in the period of hepatitis A convalescence was characterized by dynamic changes depending on the age of the children and initial state of their immunity. In particular, it was proven that the presence of non-protective antibody titers in children aged 7-14 years with hepatitis A was observed 6 months after the discharge from the hospital; the proportion of patients with non-protective antibody titers was 52.0%. Recovery of antibody levels occurred only 6 months after the onset of the disease, but before that time it did not reach the initial level.

Abstract. At present detergents are main component of domestic chemicals, therefore their invasion to the environment has acquired a global character. The purpose of this work was to make medical biological assessment of metabolism, toxicodynamics and toxicokinetics of detergents as well as to investigate the mechanisms of biological effect of nonionogenic, cation active, and anion active surface active agents (SAA) on the organism of experimental; animals. Twenty-five samples of SAA with given technical characteristics were chosen, the necessity of the choice was conditioned by a great volume of their production and extensive use in various areas of economy. It was established that the molecular mechanism of SAA biological effect consisted in primary disorder of structural organization of biological membranes of all inner organs, including genetic apparatus, followed by the changes in its function. Practical recommendations of prevention of the damaging effect of SAA were formulated.