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The aim of this study is to identify the dependence of the result of surgical treatment of patients of elderly and senile age with fractures of the proximal femur on the characteristics of the response cytokine-mediated regulatory response to trauma and surgery. Materials and methods: In 74 patients after hip arthroplasty, serum levels of bone metabolism markers were determined using enzyme-linked immunosorbent assay. Patients were divided into 2 groups depending on the results of treatment. Results: It was found that compared with group 2 (treatment outcome is worse) in group 1 (treatment outcome is better) there was a greater number of correlations. In group 1, correlations were found between OPG and RANKL (r = 0.88; p = 0.000), OPG and OPG/RANKL (r = 0.44; p = 0.006), TGF-β1 and OPG/RANKL (r = 0.66; p = 0.000) , IL-6 and OPG (r = 0.67; p = 0.000), IL-6 and RANKL (r = 0.53; p = 0.001), IL-6 and OPG/RANKL (r = 0.39; p = 0.016). In group 2, only between OPG and OPG/RANKL (r = 0.72; p = 0.000), RANKL and OPG/RANKL (r = −0.53; p = 0.0007). In patients of group 2, there was a decrease in the level of OPG relative to the control and a less significant increase in TGF-β1 and IL-6 relative to group 1. Conclusion: The prognosis of the results of treatment of patients with proximal femur fractures is largely determined by the nature of the adaptive response to injury and the implant, the synchronism of the mechanism of stress remodeling of the bone. A less favorable prognosis after arthroplasty is associated with exacerbation of the initial metabolic disorders in the bone tissue due to severe cytokine-mediated dysfunction of the regulatory pathways.

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The aim: The aim of the study was a comparative analysis of indicators characterizing the state of connective tissue in patients with hydronephrosis due to upper urinary tract obstruction, with the presence and absence of recurrence after surgery. Materials and methods: Levels of free and bound hydroxyproline, as well as the key mediator of fibrogenesis transforming growth factor-β1 in serum of patients with congenital and acquired obstructions were determined. Ratio peptide-bound and free hydroxyproline were calculated. Groups were divided according to the presence or absence of recurrence of the stricture for a period of 4.5 years after surgery. Results: Imbalance of the destructive and synthetic processes in extracellular matrix of connective tissue that is characterized by a higher content of fractions of hydroxyproline and transforming growth factor-β1 in the serum were identified. It is shown that the most pronounced changes are observed in patients with relapsing. In patients with a congenital obstruction and a recurrent course of the disease, the highest activation of the collagen metabolism was observed, which was evidenced by the high levels peptide-bound and protein-bound hydroxyproline, relative to these indicators in patients with acquired obstruction (as with the presence and absence of relapses). Conclusions: The increase in the ratio of peptide-bound/free hydroxyproline and the level of transforming growth factor-β1 in the blood of patients with stage II-III hydronephrosis on the 21st day after surgery may be a prognostic marker for the development of disease recurrence.