Цель исследования: оценить уровень кисспептина у девочек с нарушением менструальной функции с учетом массы тела и эффективность аппаратных методов коррекции клинико-гормональных изменений. Дизайн: когортное проспективное исследование. Материалы и методы. Обследованы 70 девочек-подростков 15-17 лет с различными нарушениями менструальной функции. Они были разделены на три группы в зависимости от массы тела: 1-ю группу составили 15 девочек с низкой массой тела в результате нервной анорексии, 2-ю группу-35 девочек с ожирением, 3-ю группу-20 девочек с нормальной или избыточной массой тела, у которых установлен диагноз формирующегося синдрома поликистозных яичников. В группу контроля вошли 20 здоровых девочек того же возраста. Проведена оценка физического развития, возраста менархе, характера менструального цикла. Определены уровни кисспептина, лютеинизирующего (ЛГ), фолликулостимулирующего, тиреотропного, половых гормонов, проведено ультразвуковое исследование органов малого таза. Результаты. У девочек с белково-энергетической недостаточностью чаще всего регистрировалась аменорея, была подавлена кисспептинергическая система, что проявлялось значительным снижением уровней кисспептина, гонадотропных и половых гормонов. У девочек-подростков с ожирением отмечались признаки гиперкортицизма, сниженные концентрации кисспептина, ЛГ, эстрадиола, прогестерона, что сопровождалось различными нарушениями менструалного цикла. У девочек 3-й группы были значительно повышены уровни кисспептина, общего тестостерона, ЛГ, что свидетельствует о заинтересованности центральных механизмов в развитии синдрома поликистозных яичников. Проведение 10-15-дневного курса транскраниальной магнитотерапии в сочетании с транскраниальной электро стимуляцией способствовало нормализации гормонального фона, улучшению клинического статуса и восстановлению менструаль ного цикла у участниц 2-й и 3-й групп. Заключение. Результаты исследования свидетельствуют, что показатели кисспептина зависят от физического развития девочек-подростков. Значительное снижение массы тела, а также ожирение приводят к угнетению кисспептиновых механизмов системы репродукции, что сопровождается различными нарушениями менструальной функции. Высокий уровень кисспептина, по всей вероятности, указывает на его заинтересованность в развитии синдрома поликистозных яичников. Транскраниальная терапия улучшает клинический статус пациенток, способствует восстановлению менструального цикла за счет регулирующего влияния на кисспептинергическую систему. Ключевые слова: коррекция менструального цикла, кисспептин, кисспептинергическая система, транскраниальная магнитотерапия, транскраниальная электростимуляция.

The medical and social significance of diabetes mellitus is determined by a progressive increase in the incidence of the disease, as well as the development of disabling and reducing the quality of life of macro- and microvascular complications in patients of working age, in particular, with the development of diabetic nephropathy (DN), which develops in one third of patients with type 1 and 2 diabetes. DN is the third leading cause of death after diseases of the cardiovascular system and oncological pathologies. In this regard, the identification of DN at the early stages is an important task both from the standpoint of prevention and a more favorable prognosis of the course of diabetes. This review presents data on the possibilities of early diagnosis of DN using blood and urine biomarkers, as well as information on their diagnostic and prognostic value. The analysis of the interpretation of the indicator of microalbuminuria in type 1 and 2 diabetes was carried out. In addition, the literature data of recent years on the informative value of determining markers of podocyte damage, on the role of oxidative stress products, immune-inflammatory factors, and vascular endothelial growth factor in the process of the onset and development of DN are presented. The possibility of their practical use for the diagnosis of DN in clinical practice is discussed. The literature search for this review was carried out using the databases of the RSCI, CyberLeninka, Scopus, Web of Science, MedLine, PubMed for the period from 2011 to 2021. using the following keywords: diabetes mellitus, diabetic nephropathy, markers of diabetic nephropathy; kidney damage, early diagnosis of diabetic nephropathy.

Purpose of the study. To determine the association of individual biomolecular markers of oncogenesis MMP‑2, MMP‑9 and the inhibitor of metalloproteinases TIMP‑1 with the risk of tumor invasion and metastasis in the early and late postoperative period in various types of surgical treatment of RCC.Materials and methods. The study prospectively included medical data of 60 patients with kidney cancer with T1-3N0 M0 who received surgical treatment at the Urology Clinic of the S.R.Mirotvortsev Design Bureau of the SSMU from 2016 to 2019. The patients were divided into 3 groups: 1st group included 20 patients who underwent kidney resection for elective indications, with tumors of the renal parenchyma; 2nd group – 20 patients who underwent radical nephrectomy by laparoscopic approach; Group 3-20 patients who underwent radical nephrectomy with lumbotomy access. All patients being in the early (7-10th day) and long-term postoperative period (after 1 and 2 years) by solid-phase ELISA, on a StatFax 4200 analyzer using eBiosence and Cloud-Clone Corp reagent kits, a study was made on the basis of the concentration in the blood serum of markers of oncogenesis MMP‑2, MMP‑9 and TIMP‑1 metalloproteinase inhibitor.Results. In all groups of patients with RCC, an initial increase in the concentration of MMP‑9 was revealed compared to the control (p≤0.05). According to the results of the ROC analysis, this indicator has a high specificity and sensitivity in terms of predicting RCC at the preoperative stage. The highest sensitivity and specificity for detecting tumor progression was demonstrated by matrix metalloproteinases: MMP‑2 – sensitivity 96 %, specificity 67 % (cut-off point 357.5 pg/ml) and MMP‑9 – sensitivity 87.5 % and specificity 62 % (cut-off point 958 ng/ml). At the same time, TIMP‑1 showed less significant indicators – sensitivity and specificity (74 % and 60 %, respectively) with a cut-off point of 0.49 ng/ml.Conclusion. Serum MMP‑2 and MMP‑9 are a marker of a poor prognosis for the progression of RCC. Elevated levels of MMP‑9 in the blood serum of RCC patients before and after various types of surgical treatment reflect the individual characteristics of the patient’s body and the tumor process. Dynamic monitoring of the level of markers of oncogenesis in patients with RCC allows a personalized approach to the choice of the scope and method of surgical treatment of RCC.

Introduction. Micro- and macroangiopathies significantly reduce the duration and quality of life for diabetes mellitus (DM) patients, which determines the relevance of developing new ways to treat them, including non-drug ones. One of such methods is the autotransplantation of full-thickness skin flap providing a distant stimulating effect on microcirculation.The aim of the study was to investigate the influence of skin flap autotransplantation on microcirculation at alloxan insulin deficiency in white rats.Material and methods. The studies were carried out on 60 male scrub rats divided into the following groups: the control group, the comparison group (alloxan diabetes rats), the experimental group consisting of alloxan diabetes animals which had skin flap autotransplantations performed on them. Skin microcirculation (MC) of the dorsum of the feet was studied by laser Doppler flowmetry.Results. Alloxan insulin deficiency caused a violation of the MC in rats which manifested by a decrease in perfusion of the skin of the dorsum of the foot in association with a decrease in the amplitudes of endothelial and neurogenic oscillations. On the 42nd day of the experiment in alloxan diabetes animals which had skin flap autotransplantations performed on them the statistically significant increase (p=0.000001) in the perfusion index by 43 % was observed attesting to microcirculation improvment. This was accompanied by an increase in the normalized amplitudes value of endothelial (by 44 %, р=0.000047) and neurogenic (by 20 %, р=0.019515) perfusion fluctuations relative to rats of the comparison group.Conclusions. It can be concluded that skin flap autotransplantation has a positive effect on the state of MC in the feet in experimental diabetes rats due to the improvement of tissue perfusion and modulation of its activity.