Purpose of the study. Analysis of the frequency of occurrence of polymorphisms C786T of the eNOS gene, Lys198Asn of the END1 gene, T1565C (Leu33Pro) of the ITGB3 gene, G1691A of the F5 gene, G20210A of the F2 gene, A8202G of the MMP9 gene, A1298C of the MTHFR gene, C634G of the VEGFA gene in women with diabetes.

Materials and methods. The polymerase chain reaction method was used to study gene polymorphisms in 72 men and 127 women with diabetic feet and 73 men and 125 women with uncomplicated diabetes mellitus. Analysis of the results included Hardy-Weinberg law compliance, Pearson's chi-square, odds ratio, and its confidence interval.

Results: In men with diabetes mellitus and diabetic foot, differences were found between the frequency of occurrence of variants of the A8202G polymorphism of the MMP9 gene. The A/G genotype was found 1.8 times more often in diabetes mellitus. The frequency of the G/G genotype in diabetic foot is 1.6 times higher. With this genotype, the risk of developing a diabetic foot doubles. In women with diabetic feet, the A/A genotype of the A1298C polymorphism of the MTHFR gene was 1.2 times more frequent. The A/C genotype in women with diabetes was found 1.5 times more often. The C/C genotype in diabetic feet was 1.4 times more common.In the presence of the A/C genotype in women, the risk of developing diabetic foot syndrome is reduced by 50%.

Conclusion. The G/G genotype of the A8202G polymorphism of the MMP9 gene in men predisposes to the development of diabetic foot. The C/C genotype of the A1298C polymorphism of the MTHFR gene in women is associated with a protective effect on the development of diabetic foot.

Summary. Rickets is a lesion of various organs and systems. The consequences of rickets can be violations of the functioning of the bone system, an imbalance in the cardiovascular system, the gastrointestinal tract, and the immune system. The aim of the study was to identify clinical features and metabolic changes of the bone tissue in rickets in children.

Materials and methods. Biochemical blood samples of 82 patients with rickets and 26 samples of healthy patients were studied. The age of the examined children is from 3 months to 2 years inclusive.

Results. It was found that children have equally frequent acute (46%) and subacute rickets (54%). Based on the study, it was noted that the pathognomonic for the development of rickets is a decrease in the content of calcitriol and calcitonin in the blood serum, an increase in the level of osteoprotegerin, parathyroid hormone and osteocalcin. Characteristic indicators for the acute course are changes in parathyroid hormone and calcitonin, for the subacute course, changes in osteoprotegerin and osteocalcin are characteristic.

The purpose of the study. The article considers an analytical approach to determining the diagnostic value and diagnostically significant threshold levels of growth factors in severe bronchial asthma in children.

Materials and methods. Concentrations of transforming growth factor B1 and endothelial vascular growth factor were determined in 95 patients with bronchial asthma of varying severity and 24 children of the control group. The diagnostic values of the studied factors were analyzed in the course of the ROC analysis and presented in the form of an ROC-curve.

Results and discussion. The highest concentration of growth factors was recorded in severe bronchial asthma (p). During the ROC analysis, the threshold values for TGFβ1 - 106.2 pg/ml and VEGF-A – 59.2 pg/ml were established, and the information content of each indicator was clarified. The endothelial vascular growth factor has the greatest diagnostic significance.

Conclusion. ROC analysis helps to assess the importance of diagnostic medical technologies, which allows you to improve the algorithm for diagnosing diseases.

The aim of the research is to evaluate the content of antimicrobial peptides (cathelicidin LL-37and a- defensins 1-3), lipopolysaccharidebinding protein (LBP) and free fraction of transforming growth factor beta-1 (Free Active TGF-b1) in mixed saliva in individuals with dental caries associated withdifferent vitamin D status in the body.

Materials and methods. The concentration of antimicrobial peptides-cathelicidin LL-37 and a-defensins 1-3, lipopolysaccharide binding protein in mixed saliva in individuals with different dental caries intensity depending on the active form of vitamin D level in the body is determined using the ELISA method, and the amount of free fraction of transforming growth factor beta-1 is determined using flow cytometry.The content of the vitamin D – 25(OH)D3 metabolite in serum is evaluated by using the chemiluminescent immunoassaymethod (Access 2). Nonparametric methods were used for the statistical processing of the results.

Results. In individuals with dental caries, the content of antimicrobial peptides – cathelicidin LL-37 and a- defensins 1-3 in saliva increases against the background of a normal level of 25(OH)D3in the body, and significantly decreaseswith the deficiency of the active form of vitamin D; the amount of LBP increases in case ofdental caries of moderate intensity and normal range of 25(OH)D3, and with a high DMFtindexscorethe concentration of this protein decreases regardless of the level of the active form of vitamin D; the values of TGF - b1 decrease with the increase of the dental caries intensityand the 25(OH)D3deficiency.

Conclusion. In individuals with dental caries (especially, aggravated by 25 (OH) D3 deficiency), significant changes are observed in the content of soluble peptide compounds involved in the processes of protecting the tooth from carious pathogens.

The aim of the research. To study the pathomorphological features of the respiratory system lesions in children with congenital heart defects.

Materials and methods. The study included data from 36 deceased children with diagnosed congenital heart disease at the age from 1 month to 3 years (2.3 ± 4.9 months) with diagnosed congenital heart disease, of which 11 (31%) girls and 25 (69%) boys. Antenatal and postnatal clinical characteristics of the observation group were given on the basis of clinical and anamnestic parameters. Descriptive macroscopic and microscopic characteristics of histological sections of the lung tissue of children with congenital heart defects complicated by heart failure are presented, cytomorphometry of alveolar tissue (length and width of alveoli, thickness of interalveolar spaces) was performed.Statistical data processing was carried out using the Microsoft Excel 2007, Statistica v.10.0 software package.

Results. In the presence of congenital cardiovascular disorders, the development of pulmonary heart diseases was the main cause of death among children. Morphological signs of the presence of congestive heart failure and pulmonary hypertension are intraalveolar and interstitial edema, perivascular fibrosis, peribronchial vessel pericalibration. Signs of remodeling of the wall of the bronchial tree are dystrophic changes in the cells of the mucous membrane, edema of the walls of the bronchi, dilation and plethora of blood vessels, hemorrhages, hypertrophy and hyperplasia of the smooth muscle component. In children with congenital heart defects, the hickness of the interalveolar septa is 2 times greater, the alveoli are reduced in size, their length is 2.6 times and their width is 1.8 times less than in children of the comparison group (p <0.05).

Conclusion. The data obtained indicate the presence of pathomorphological changes in the wall of the bronchi and the architectonics of the alveoli in children with congenital heart disease with hypervolemia of the pulmonary circulation.

The aim of the research is evaluation of multiple organic dysfunction (MOD) prognostic value in outcome of patients with severe acute ischemic stroke (IS).

Materials and methods. 110 patients (49 men, 61 women) with severe acute IS (admission NIHSS ≥14) were included, onset to admission time was before 24 h. We evaluated MOD dynamic features and relation on probable mortality. We used monovariant logistic regression analysis, comparative nonlinear regression analysis for prognostic value evaluation (statistical significance level p <0,05).

Results. With insufficient outcome were associated cardioembolic subtype (p=0,023), lower GCS (p <0,001 on 3rd and 5th days), respiration dysfunction and mechanical ventilation (p<0,001 on 3rd and 5th days), vasopressors support (p=0,007 on 5th day), higher SOFA (p <0,001 on 3rd and 5th days) and SAPS-II (OR 1,15, CI 95% 1,07; 1,24; p<0,001). It revealed, that significantly higher mortality of cardioembolic subtype is seen in 30 – 45 SAPS-II (p<0,05) compare with atherotrombotic subtype.

Conclusion. MOD is one of the most important factors of severe IS outcome prognosis. Therefore, cardioembolic IS associated with worse outcome prognosis compare with atherotrombotic IS.

The aim of the research. To establish the dynamics of the level of antibodies to SARS-CoV-2 after the start of vaccination with the drug "Gam-Covid-Vac".

Materials and methods. 30 medical workers of the hospital (average age 41.8 years), were vaccinated against CAVID-19 with the Gam-Covid-Vac vaccine according to the standard scheme. The beginning of vaccination was 12.10.2020. IgM and IgG titers for SARS-CoV-2 were determined by the ELISA method using the Vector-best test systems (Novosibirsk). The level of antibodies was assessed on the 17th day after the introduction of the first and second components of the vaccine, on the 51st, 81st and 201 days after the start of vaccination. The content of immunoglobulins is presented in BAU/ml. Statistical data processing was carried out using Statistica 10.0.

Results. Our studies show that on the 17th day after vaccination, IgMs to SARS-CoV-2 are detected in all subjects. Their level practically did not change by the 38th day after the start of vaccination. By day 51, there was a decrease in the content of IgM to SARS-CoV-2. The concentration of IgM antibodies to SARSCoV-2 on day 38 depended on their content on day 17 after vaccination (r=0.77), and on day 51 on their content on day 17 (r=0.68), and day 38 (r=0.80).

The level of IgG class antibodies to SARS-CoV-2 increased significantly after immunization with the 2nd component and changed from 51 days from the start of vaccination to 81 days after vaccination, the IgG titer to SARS-CoV-2 fell sharply (by 5.6 times). Moreover, in 8 (27%) people, the antibody titer was not determined by the test system used. By 201 days after vaccination, the IgG titer to SARS-CoV-2 in 9 (31%) of the examined patients increased sharply, and in 50% of the examined subjects, antibodies were detected again. The overall increase in the IgG titer to SARS-CoV-2 was from 81 to 201 days by 3.2 times.

The content of IgG to SARS-CoV-2 on days 17, 38 and 51 correlated with the concentration of IgM, as well as with IgG at an earlier time. At the same time, the content of IgG to SARS-CoV-2 on 81 days after vaccination was less dependent on the concentration of IgM, and there was a strong correlation with IgG on 51 days (r=0.82). On day 201, a direct positive correlation of IgG to SARS-CoV-2 was observed with the age of the people participating in the study (r=0.44).

In the pathogenesis of the unfavorable course of the new coronavirus infection COVID-19, deviations in the state of blood flow are of significant importance.

Objective: to compare early changes in the state of blood flow in COVID-19 with the outcome of the disease.

Materials and research methods. In 55 patients with severe COVID-19 in the early respiratory phase, a simultaneous study of the state of macrohemodynamics was carried out using a non-invasive method of volumetric compression oscillometry and microcirculation using an mDLS sensor (Dynamic Light Scattering, Rehovot, Israel). Subsequently, a group of patients (36 people), who were discharged from the hospital in connection with recovery, and a group of patients (19 people), whose disease ended in death, were identified.

Results. In the COVID-19 group with a favorable outcome, the mean blood pressure, pulse blood pressure velocity, heart rate and pulse wave velocity were higher. At the same time, in deceased patients, the hemodynamic index of the axial high-frequency flow of the microcirculation system sharply decreased. The revealed deviations in the parameters of hemodynamics and microcirculation indicate changes in the state of blood circulation in vessels of different diameters, which is an essential link in the pathogenesis of the severe course of COVID-19. With the progression of circulatory failure, organ dysfunction and multiple organ failure are induced.

Conclusion. The unfavorable course of COVID-19 is accompanied by numerous failures of the mechanisms of conjugation of cardiac output and the state of hemodynamics in vessels of different caliber and capacity.

The purpose of the article is to generalize modern ideas about the role of the main collagenforming macro-and microelements, their mutual influence on the process of collagen formation in undifferentiated connective tissue dysplasia in children. Many studies have proven the fundamental role of calcium (Ca) and magnesium (Mg) in the formation of collagen. Calcium is the main structural component of the inorganic substance of the collagen matrix and affects the constancy of other elements such as magnesium, zinc, and copper. The deficiency of the essential elements of collagen formation - zinc and copper - leads to a violation of the formation of structural elements of connective tissue, the formation of congenital malformations and changes in the process of osteogenesis. The article presents the negative impact of iodine and selenium deficiency on the formation of connective tissue dysplasia. The authors note that at this time the problem of disadvantage important collagen-forming elements in undifferentiated connective tissue dysplasia in children.

The review summarizes literature data on endothelial dysfunction in hypothyroidism. There are presented materials on action of nitric oxide on vascular endothelium and on methods for determination of endothelial dysfunction by invasive and non-invasive methods. Data on the effect of thyroid function on the endothelium are summarized, in particular, issues of endothelium-dependent vasodilation in subclinical hypothyroidism are considered.

The review summarizes literature data on rare forms of gastritis and gastopathies. The described gastritis include: lymphocytic, plasmacytic, eosinophilic, granulomatous; a separate group includes gastritis that develop under the influence of external factors: drug-induced, NSAID-induced and post-radiation gastritis. As part of the question of gastropathies, we paid attention to the description of Menetrie's disease, portal hypertensive gastropathy, and GAVE syndrome. We presented materials on the frequency of occurrence of each pathology, etiology, clinical manifestations, morphological and endoscopic diagnostic criteria and consideredthe issues of differential diagnosis and treatment tactics for these diseases.

This review contains information about the structure and principles of functioning of ATP-sensitive potassium channels. The article presents information about the physiological role of the Kir6.2 subunit of ATP-sensitive K + channels in various tissues, and the pathology associated with mutations in the KCNJ11 gene, which regulates the work of Kir6.2.