Analysis of literature data and the results of our own research on the structure of malignant neoplasms indicate the existence of a certain analogy in the mechanisms of formation and spread of biofilms of microorganisms and malignant tumors. Despite the qualitative difference between cellular abnormalities of both types, they are characterized by horizontal gene transfer, which is a consequence of the formation and accumulation of extracellular DNA of dead tissues and increased permeability of the outer cell membranes. In both cases, this leads to the formation of mutated cells that differ significantly from the original forms. The direct consequence of such mutations is the formation of cells which are low-yielding in this environment and are doomed to death. This ensures both for enrichment of the intercellular component and for the disintegration of cellular aggregates with the formation of "floating islands" of intercellular associations of both types. Such formations are sharply superior to unicellular forms in resistance to adverse environmental factors, which provides the spread of biofilms and metastasis.

Introduction: Ronchopathy is a chronic progressive disease manifested by upper airway obstruction and chronic respiratory failure. The key process of pathological snoring is the obstructive breathing disorders. The obstructive sleep apnea syndrome (OSAS) develops on the basis of snoring. OSAS is accompanied by episodes of hypoxia and reoxygenation, which cause an increase of the level of reactive free radicals whith following development of the oxidative stress. The activation of peroxidative processes of proteins (POP) and lipids (POL) are initiated by free radicals which are noticeable components of endogenous intoxication (EI). The aim of the study was to investigate the intensity of POP and POL processes, the levels of OSAS components, and the indices EI in patients with ronchopathy and OSAS of varying severity in the dynamics of treatment. Materials and methods: 40 patients with ronchopathy and OSAS were examined at the State Institution “Institute of otolaryngology named after prof. O.S. Kolomiychenko of the National Academy of Medical Sciences of Ukraine”. All patients were divided according to the degree of snoring and hypoxia index (HI) into 4 groups of 10 persons each. Control group was formed by 10 healthy donors. The object of biochemical studies was blood serum. The intensity of POP was assessed by reaction with 2,4-dinitrophenyl-hydrazine by the Levin’s method in Reznick’s modification. POL intensity was determined by the interaction with 2-thiobarbituric acid (TBA) by Goncharenko. Catalase activity was determined by the method of Korolyuk and co-authors. The content of free thiol groups was determined by interaction with 5,5'-dithio-bis(2-nitrobenzoic acid). The content of medium weight molecules (MWM) and tyrosine-containing peptides (TCPs) were determined by spectroscopy at 254 and 280 nm, respectively. Statistical processing of the results was performed using the software package for biometric data WinPEPI. Results: Prior to the treatment in patients with ronchopathy and OSAS of varying severity, an increase in the content of MWM and TCPs were noted, that indicates the development of endogenous intoxication. In patients of all groups there was an intensification of POP, which was manifested by a significant increase of aDNFGn, aDNFGo, and kDNFGn levels. The content of TBA-positive products in patients with ronchopathy of both groups was at the level of control and increased significantly at progression of pathological process. In addition, in all groups of patients an increase of catalase activity was detected on the background of TCPs level decrease. It was found the efficacy of the offered treatment of patients with ronchopathy and OSAS of varying severity. The indices of EI, POP, POL, and antioxidant system’s were directed to improvement in contrast to the state before treatment, and some of them were improved almost to the level of control. Conclusions: It is established that the progression of hypoxia is accompanied by autointoxication, which is manifested by an increase in the content of MWM, as well as prove for the activation of catabolic reactions and excessive formation of cells’ breakdown products. It was also revealed by the intensification of POP and POL processes, the activation of which are associated with the development of insufficiency of enzymatic and nonenzymatic components of antioxidant system. The performed treatment can be considered as the effective one since on its completion all the studied indices were restored almost to the level of control.

Relevance. In the modern oncology hypopharynx malignant tumors are one of the urgent and significant problems. Hypopharynx is one of the most frequent localizations in the head and neck. An important factor causing the high occurrence in the population is the asymptomatic course of the disease, resulting in patients presenting for treatment with аn already widespread tumour process. Objective: to summarize and systematize data on the etiology and pathogenesis of hypopharynx cancer. Materials and methods. Analysis of scientific publications in the international electronic scientometric databases Scopus, PubMed by keywords. Search depth – 20 years (2001-2020). Results. In recent years, the view on the mechanisms of the development of carcinogenesis has changed dramatically, the tumour is no longer considered as a mass of malignant cells, but rather as a self-sufficient biological structure with a complex microenvironment in which other subpopulations of cells damaged by cancer are involved. The stromal component of the tumour microenvironment consists of various types of cells such as cancer-associated fibroblasts, neutrophils, macrophages, regulatory T-cells, myeloid suppressor cells, NK-cells etc. These subpopulations of cells interact with each other as well as with cancer cells. In addition to amplification, deletion, loss of heterozygosity, as well as polymorphism of some genes that are directly involved in the cell cycle or act as regulators of posttranscriptional modifiers of their products at the early stages of carcinogenesis may be one of the promising directions in creating a panel of markers for the risk of developing hypopharynx cancer. Conclusions. The microenvironment of the tumor consists of many different cell populations. These parts of the surrounding stroma can function as both positive and negative regulators of all signs of cancer, including evasion of apoptosis, induction of angiogenesis, deregulation of energy metabolism, resistance to detection and destruction by the immune system, and activation of invasion and metastasis. Exploring differences in the composition of the tumour microenvironment and their influence on the development and progression of hypopharynx cancer can help better understand mechanisms underlying different responses to therapy, and help to identify possible targets for clinical intervention.

Introduction: Exposure to high-intensity sounds can cause significant damage to the human auditory system. Joint damage to the auditory system by high-intensity sound and shock waves causes acubarotrauma. Such lesions are systemic in nature, affecting not only the auditory system but also the entire human body. It significantly impairs the quality of life and general condition of the body, causes numerous complications. Therefore, the issues of diagnosis and treatment of hearing impairments caused by acutraumas and acubarotraumas received in combat conditions are highly relevant. Aim: to study the hemostatic indices of patients with combat-caused acoustic trauma and identify the most informative ones. Patients and methods: 22 patients with combat acoustic trauma and 10 healthy volunteers were tested. The object of the study was citrate plasma, which was obtained by standard methods. The content of fibrinogen was determined by thrombin-like enzyme Ancistron-H. Partially activated thromboplastin time and prothrombin time were determined by tests of Siemens, USA. The share of functionally inactive forms of prothrombin was determined by Ecamulin-based diagnostic test. The content of protein C activity was determined by cleavage of synthetic chromogenic substrate (Siemens, USA). The concentrations of soluble fibrin and D-dimer were evaluated by immunodiagnostic test systems "DIA-soluble fibrin" and "DIA-D-dimer" (Diaprof-Med, Ukraine). Statistical processing of the results was performed by WinPEPI package for biometric statistical processing with Student's t-test for evaluation of the difference between patients and the control group. Results and discussion: It was found that fibrinogen’s level in 25% of patients remained at the level of control. In 27% of patients this index decreased on the level of the trend, and in 50% - increased 1.6 times. The elevat ion of fibrinogen’s level proves for a risk of thrombotic complications, since this acute phaseprotein is well-known index of hypercoagulability. Partially activated thromboplastin time index in 14% of the tested group remained at the level of control values. In 14% of patients it was probably 1.4 times shorter, and in 73% of patients it was 1.6 times longer than control. Prolonged partially activated thrombin time may prove for the increased level of circulating coagulation factor VIII. In 82% of patients the index of prothrombin time was probably 2.4 times prolonged, where as in 18% of patients was almost at the level of control. It may prove for an imbalance between the components of blood clotting system. The indices of Ecamulin-based test were multidirectional. In 18% of patients it was on the level of control, in 55% of patients it was slightly shorter, and in 27% of patients - probably elongated 1.4 times. The level functionally inactive forms of prothrombin in 50% of patients didn’t differ of control values, in 23% it was tended to decrease, and in 27% it was 1.6 more. The latter proves for the activation of the blood coagulation system. Protein C is a physiological inhibitor of the blood coagulation system. Its’ level in 50% of patients was reduced by 2.2 times in contrast to control, in 14% it remained on the normal level. As well-known, a decrease in protein C level proves for imbalance between coagulation and anticoagulation in the direction of the first one and is associated with thrombosis. The content of D-dimer in 33% of patients was on the level of control, while the level of soluble fibrin was increased 4 times. In 42% there was a 1.4-fold decrease in D-dimer content at a slight increase of soluble fibrin level. In 25% of patients the indices of D-dimer and soluble fibrin were increased in 4 and 7 times, respectively. Elevated level of soluble fibrin is an early prognostic index of the activation of blood clotting system. Comprehensive determination of the content of soluble fibrin and the level of D-dimer allows to estimate the correlation between the accumulation and destruction of the soluble fibrin. Conclusion: From the above data it follows that the determination of the single index is not enough for adequate assess of the risk of thrombosis and the effectiveness of antithrombotic therapy. On this reason the comprehensive definition of the noted indices should be included into the clinical practice a mandatory algorithm for the diagnosis of prothrombotic conditions in patients with acoustic trauma hearing disturbances.

The common features of the functioning of cellular systems of malignant neoplasms and biofilms are considered. Particular attention is paid to the role of the barrier function of cell membranes. The causes of changes in membrane permeability and their functional consequences are discussed. The position on the increase of cell permeability through membranes as a key condition for the formation and development of both types of cellular anomalies is substantiated.