Objective. The cytochrome 11B2 aldosterone synthase gene (CYP11B2) that links to aldosterone synthase enzyme synthesis changes and blood pressure regulation is of particular interest among the renin-angiotensin-aldosterone system encoding genes.Methods. One-hundred hypertensive patients with target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were involved in the case-control study. Mean age was 59.87±8.02 years. Diabetes Mellitus type 2 (DM2) was in 28 persons. Chronic kidney disease (CKD) was diagnosed in 29 persons according to the National Kidney Foundation recommendations (2012) after glomerular filtration rate (GFR) decline <60 ml/min/1.73m2 for ≥3 months (measured by CKD-EPI equations). Aldosterone, cystatin-C, and creatinine levels were measured in serum. Control group included 48 practically healthy persons of relevant age. Gene’s nucleotide polymorphism CYP11B2 (-344C/T) was examined by polymerase chain reaction.Results. CKD evolution in hypertensive patients followed by higher systolic and diastolic blood pressure (SBP, DBP) values increased creatinine, cystatin-C, and aldosterone serum concentrations by 28.76%, 28.41% and 29.43% (р<0.05), respectively. Polymorphic site of CYP11B2 (rs1799998) gene is associated with SBP and DBP increase (p<0.05), reduced GFR preferably calculated by CKDEPI-cystatin C (F=10.79–14.45; p<0.001) and elevated aldosterone content (F=55.84; p<0.001), creatinine and cystatin-С as well (F=4.16–5.08; p<0.05) mainly in the ТТ-genotype female carriers (p<0.001). Hypertensive women with DM2 demonstrated stronger relations of CYP11B2 gene polymorphic site with the increased aldosterone content (F=47.52; p<0.001), than women without DM2 (p<0.001) and male patients (p=0.014).Conclusions. Genetic variations involving CYP11B2 might influence the kidney function, hypertension course, and severity via aldosterone secretion upregulation.

The efficacy of intratissue electrophoresis of antibacterial remedies was studied in multimodal treatment of 25 patients with burns of II-III stages with square from 7 % to 12 % of body's surface. It's determined that its using doesn't significantly influence the species composition of the burned wounds microflora but reliably decrease their microbial contamination and increase microorganisms' sensitivity to many antibiotics, improve course of wound healing process, stimulate reparative regeneration. This positively influence terms of burned surface elimination and generally treatment of burned patients.

Abdominal sepsis (AS) is one of the most important problems in modern abdominal surgery. Prediction of AS and complications remains a challenge for modern surgery. The aim of the study is to evaluate the prognostic and diagnostic value of clinical and laboratory parameters in order to substantiate the prognostic complex for patients with AS and to improve existing systems for assessing the severity of patients by modification aimed on adapting to the capabilities of clinics.The proposed modification of the severity scoring scale APACHE II, based on the analysis of clinical and laboratory data obtained in 183 patients with acute peritonitis and abdominal sepsis. The complex of physiological parameters and their prognostic significance in AS was determined by in-depth statistical analysis and determination of predicting values.Most of the analyzed indicators had a likely positive prognostic value in the diagnosis and prognosis of AS. At the same time, the predictive value of the qSOFA scale at low values is negligible. Statistically insufficient prognostic value was obtained for increased temperature above 38,0 °C. The data obtained formed the basis for the development of a digital AS and complications prediction system by modifying the APACHE II scale.The proposed patient' severity scale is accessible and sufficiently informative for use in patients with peritonitis and AS. It is recommended that at least two systems for assessing the severity of a patient's condition be combined. Keywords. Acute peritonitis, abdominal sepsis, physiological parameters, prognosis, diagnosis, risk ratio, modification of APACHE score.

Summary. Inguinal hernioplasty is the most frequently performed surgical operation in the world, but the level of complications still reaches 11 % and of recurrences — 5 %. According to some authors, the reason may be in chronic inflammatory changes of the hernia sac and perihernial tissues. Aim. To study the pathohistological changes of the hernia sac and perihernial tissues of patients with inguinal hernias for development of adequate methods of complications prophylactics. Material and methods. The pathohistological examination of fragments of hernial sac and perihernial tissues of 24 patients with groin hernias was performed. Results and discussion. The investigation detected the signs of chronic inflammation in fragments of tissue of hernial sac in all patients. In 8 (33,3 %) patients the signs of inflammation were found only in fragments of hernial sac, and in 16 (66,7 %) – they were combined with the inflammation of perihernial tissues. Among them, the pronounced signs of chronic inflammation were found in 6 (25,0 %) patients with recurrent groin hernias, they were combined with the pronounced scarring changes of hernial sac and perihernial tissues. Conclusions. 1. Chronic inflammatory changes of the hernia sac and perihernial tissues are among the reasons for the development of postoperative complications and recurrences. 2. An important component of prevention of complications can be use of antibacterial and anti-inflammatory drugs.

Objective: to evaluate the morphological changes in diabetic foot syndrome emphasizing the ultrastructural cellular changes.Material and methods. Biopsies of the chronic lesions in 120 diabetic foot patients following necessary preparatory stages were studied by histological, histochemical and electron microscopy methods.Results. The inflammatory infiltration and destruction and involving all layers of skin and soft tissue, the phenomena of vacuolation, apoptosis or karyolysis; tissue edema, diffuse infiltration by neutrophils, vascular plethora with stasis, thrombosis, and necrosis were observed. Microcirculatory tract thrombosis exacerbated tissue ischemia, contributing to the progression of pathology. The macrophages' cytoplasm characterized by the presence of phagocytosed and digested microorganisms often intact inside them. The changes in the status of nuclear and perinuclear material were accompanied by compression and dehydration of the cell, which ended in its fragmentation and the formation of tightly contacting bodies of various shapesConclusions. Morphological changes in diabetic foot syndrome are diverse and uneven, occurring not only on tissue and cellular level but involves subcellular and molecular structures, encouraging further research in this field. Foci of destruction and lysis of the newly formed epithelium are characteristic for diabetic foot, which is not observed in the normal wound process.