The analysis and generalization of the results of the works devoted to the study of the reaction to the post-occlusive reactive hyperemia (PORH) test have been carried out with the aim of forming the model of reaction and determining the growth of new scientific directions, not only in diagnostics, but also in therapy. The mechanisms of reaction, protocol, methods of instrumental assessment of the reaction to PORH test, the role of the test in the diagnosis of atherosclerosis, arterial hypertension, and diabetes mellitus are discussed. The reaction to multiple occlusion is analyzed, which is potentially useful as a therapeutic procedure for improving microcirculation. Usefulness is compared between the methods of laser Doppler flowmetry, photoplethysmography, infrared thermography and peripheral arterial tonometry. In the short term, the most intensive development and wide application is predicted for the photoplethysmography.

The possibilities and prospects of optical non-invasive diagnostic technologies for detecting and assessing the severity of microcirculatory and metabolic disorders in rheumatic diseases and diabetes mellitus were assessed. Experimental studies were conducted with the participation of 137 conditionally healthy volunteers and 147 patients with mentioned diseases (77 patients with rheumatic diseases and 70 patients with diabetes). It is shown that the application of laser Doppler flowmetry, fluorescence spectroscopy and diffuse reflectance spectroscopy is of great diagnostic importance for identifying emerging disorders, and these methods can be used as additional diagnostic methods in the arsenal of a practicing physician in the field of rheumatology and endocrinology.

Adaptive wavelet transform techniques for studying of microcirculatory blood flow oscillations are described. It is shown that the suggested methods will be especially claimed in the analysis of low-frequency components of short-lived transient processes under various functional test conditions. In addition, the use of adaptive wavelet transform reduces the essential duration of signal registration, which can be useful in the study of the microhemodynamics in patients with heavy pathologies. Also the method for investigating the phase relationships between microvasculatory oscillations is given which based on estimating the values of wavelet phase coherence function. The proposed method makes it possible to identify frequency intervals with high and low phase correlations of peripheral blood flow oscillations.

The review is devoted to the problems related to changes of the oscillation processes in the skin microvascular bed in human, which result from physiological aging. It is shown that both systemic (arterial hypertension) and local (chronic obstructive pulmonary disease and bronchial asthma) microcirculation disorders are reflected on cutaneous peripheral microhemodynamics. It is demonstrated that these diseases against the background of physiological aging of organism can lead to multidirectional changes of skin microcirculation parameters as compared with healthy subjects. It may be due to both local activation of the compensatory mechanisms with their subsequent influence on the skin microcirculation and adequate drug therapy.

The purpose of this work is to diagnose microcirculatory disorders in the tissues of psoriatic plaques in patients with psoriasis. Material and methods. Using the method of laser Doppler flowmetry (LDF), local hemodynamic parameters were studied in the place of psoriatic lesion of tissue and in uninvolved skin. Results. In the psoriatic plaque, there is an increase in average perfusion, myogenic and cardiac fluctuations, as well as nutritive blood flow as compared to the area of intact skin. Conclusions. The use of spectral analysis of the LDF signal has great potential for assessing the contribution of each link of the microvascular bed in the study the pathogenesis of psoriasis and evaluating the effectiveness of the therapy.

Aim - to assess the state of microcirculation in the skin in patients with pulmonary hypertension due to congenital heart defects (PH-CHD). Material and methods. The study was performed using laser Doppler flowmetry and capillaroscopy in 25 patients with PH-CHD and a control group (n=25). Results. Patients with PH-CHD have a low blood saturation of 90.1 % and 97.2 % (<0.05), a high amplitude of myogenic vasomotions of 0.49 PU and 0.26 PU (<0.05), pulsatile 0.14 PU and 0.11 PU (<0.05) and respiratory associated blood flow fluctuations of 0.24 PU and 0.13 PU (<0.05), respectively. Against this background, there is no evidence of fluid retention in the tissue. Conclusions. Changes in microcirculation are compensatory in the conditions of systemic hypoxia, caused by violations of hemodynamics in the heart and a small circle of blood circulation.

The work is devoted to review the various methods and approaches currently used within the framework of the concept of optical «biopsy» in the study of blood perfusion and metabolism of human organs tissues. The purpose of the review was to study the features and areas of application of these methods and to assess further application possibilities for intraoperative data acquisition in minimally invasive surgery of hepatopancreatoduodenal organs. Preliminary experimental studies were performed with fluorescence spectroscopy method in pathologies of the common bile duct, gallbladder and liver. The data obtained in the work show the prospects for this method application, and serve as the basis for further research in order to obtain additional diagnostic criteria.

The aim of this study was to assess the age-related features of the functioning of the microcirculation system using the LDF method. The estimation of parameters of microcirculation was performed in practically healthy persons of mature age in a one-stage study and in a prospective study in children aged 8 to 11 years. Stable indices of microcirculation were recorded at different stages of adulthood with maximal values in the middle of this age period. In the prospective study, significant changes in the functioning of the microcirculation system in the period from 9 to 10 years, indicating the beginning of the transition to the pubertal period, were noted. The revealed age-specific features of the functioning of the microcirculation system are due to the level of metabolic activity of the body.

The aim of the study was to study a vascular reaction to a test with reactive hyperemia in young women with idiopathic arterial hypotension. 72 women with hypotension (SBP 98 mmHg or less) and 37 women with SBP 120-129 mmHg were examined. A comparative analysis of the response of systemic and peripheral hemodynamics to a test with reactive hyperemia by Celermajer D. In hypotension, occlusion was characterized by an increase in SBP, a change in the diameter and velocity of peripheral arterial and venous blood flow. Thus, the pathological reaction of systemic and peripheral hemodynamics in reactive hyperemia in women with hypotension is a sign of remodeling of the cardiovascular system.

The purpose of the work - to identify patterns of changes in the morphofunctional organization of the vascular bed of the liver at different stages of development of strangulational and obturating acute small bowel obstruction (ASBO). Material and methods. The study was performed on 33 adult mongrel dogs of both sexes weighing 17-20 kg. The morphology of the liver in normal was studied on 2 (two) of those dogs. Twelve animals were simulated with a strangulational ASBO. In 12 animals, a low obturating ASBO was simulated. A morphometric method was used to assess the change in the volume of the vascular bed in terms of the degree of change in the area of the vessels per unit area. Results. In the dynamics of the development of the disease, we revealed patterns of changes in the morphofunctional organization of the vascular bed of the liver. Conclusions. In the process of formation of obturating ASBO, in spite of the absence of clinical manifestations of acute intestinal obstruction, the emergence of a basis for the development of polyorganic insufficiency has already been observed from 2 days.

Introduction. Extremely topical issue of modern medicine is patients’ treatment with critical limb ischemia (CLI). Features Studying of angiogenesis at this category of patients can improve treatment results of the CLI. Aim of research. Concentration change study of hypoxia-induced factor 1α (HIF1α) in patients with CLI before and after revascularization. Materials and methods. Blood was taken from patients with CLI (n=18) with occlusive-stenotic lesions of the popliteal-tibial segment of the arteries of the lower limbs of the three vessels (vein of the foot or lower leg, the femoral artery of the affected limb, cubital vein) to studying of change of concentration HIF1α before and after endovascular revascularization. Also the blood was taken from healthy volunteers (n=10). Results. All patients had resolution of CLI after endovascular revascularization. Indicators of a HIF1α didn’t differ in different vessels of healthy volunteers and patients with CLI before and after endovascular revascularization (р>0.05). Concentration of a HIF1α statistically significantly decreased at patients with a CLI after endovascular revascularization (р<0.0001). Concentration of a HIF1α didn’t differ in patients with a diabetes mellitus type II and without it (р>0.05). Conclusions. It is expedient to release blood sampling for concentration study of a HIF1α from cubital vein or other available vein of the upper limb. Technically successful operation of revascularization with resolution of CLI is characterized by depression of concentration of a HIF1α that can show recovery of limb tissue perfusion. The diabetes mellitus type II doesn’t affect the change of HIF1α concentration in patients with a CLI.

The aim - to assess the state of peripheral perfusion in patients with critical lower limb ischemia (CLLI) before and during the longterm period after spinal cord stimulation (SCS). Material and methods. Microcirculatory blood flow (MBF) of the lower limbs (LL) was studied in 42 patients with CLLI by transcutaneous oximetry (ТсрО₂, mmHg) and laser doppler flowmehy (Perfusion Units (PU)). Results. Prior to SCS we observed a reduction in peripheral perfusion and a disturbance the function of MBF in the form of a paradoxical reaction of blood flow during the orthostatic test (OT). After SCS, we observed an increase in tissue metabolism and MBF from 10.5 (6.4-16.0) mmHg and 1.0 (0.5-1.9) PU to 39.5 (15.0-57.0) mmHg and 5.7 (2.3-9.6) PU respectively, with an improvement in MBF function as an adequate response in OT. Conclusions. With CLLI, we detected a decrease in peripheral perfusion and breaking mechanisms of adaptation of MBF during OT. After SCS there is an increase the level of peripheral perfusion and improvement in the function of MBF.

Cerebral hemodynamics and peripheral microcirculation was studied in 44 men during a passive postural orthostatic test. 7 people had poor orthostatic stability (OS). The study of cerebral hemodynamics (REG) showed that in individuals with good OS during the test, the blood filling of the brain is reliably increased (p<0.05), in a group with poor OS it practically does not change. The background dates of cerebral blood flow in the group with poor stability are significantly lower (p<0.001) relative to the parameters of the group with good tolerance of the test. In a group with good OS were stable blood flow in the microvasculature during the test. In a group with poor OS , vascular responses were expressed. The arterio-venular blood flow increases, the intensity of capillary blood flow is reduced. Blood flow indices are decrease - PI 2.7 times, RI 1.9 times, this is the dilution of microcirculation vessels.

Objective - to identify the most accurate way of drugs endothelial protective properties evaluation. Material and methods. Blood endothelin-1 (E) and acetylcholine-induced endothelial dependent vasodilation (EDV) were measured for 9 months in type 2 diabetic patients receiving either metformin (MET) (group 1) or MET and liraglutide (LIR) (group 2). Results. E was normal in group 1 at baseline and decreased only with glycaemia decline, in group 2 it was primarily increased and declined independently on glycaemia dynamics. In both groups E normalized in 6 months. EDV was impaired primarily in groups 1 and 2 and normalized only in group 2 in 9 months. Conclusions. LIR improves endothelial function, independently on glycaemia. Dopplerography in more accurate in drugs endothelial protective effects evaluation than circulating markers.

The aim of the study was to assess the degree of reversibility of microcirculatory disorders in the modeling of LL desynchronosis depending on the duration of exposure to continuous illumination. Material and methods. Microcirculation was studied by laser Doppler flowmetry. Male rats were subjected to continuous light stimulation for 10 (group 1) and 21 (group 2) days, and then kept under natural light for 21 days. Results. Continuous lighting caused a disturbance of microhemodynamics which tended to recover after normalization of the light regime in the rats of group 1. In the animals of group 2, circulation in microvessels was not restored. Conclusions. Reversibility of the changes can serve as a criterion for distinguishing the adaptive response to inadequate photoperiod and LL-desynchronosis.

Experimental thrombosis of mesenteric vessels was caused by the upper mesenteric artery compression by 30 minutes at different levels in 7 rabbits. With the help of microcirculation prarameters registered by the device «Minimax-Doppler-K» and ad oculus evaluation the zones of intestinal wall ischemia caused by thrombosis were determined. It is revealed that the ad oculus ischemia zones are significantly less common in area than the ischemia zones registered with the help of the device. Subsequent studies can reduce the % of insolvency of the seams after operations.