Introduction. The incidence of respiratory system involvement in patients with rheumatoid arthritis (RA) has currently increased; thereby new diagnostic methods have been developed actively. Meanwhile role of vascular disorders in pathogenesis of lung injury is almost unknown and single-photon emission computed tomography (SPECT) isn't used as method of lung assessment in RA. The detector of endothelial glycocalyx damage syndecan-1 is little known but potentially perspective serum marker of lung injury in RA. Objective. The purpose of the study was to investigate the role of vascular disorders in lung injury in patients with RA. Materials and methods. 61 patients with RA without comorbid lung diseases were enrolled in the study. Control group consisted of 26 healthy persons. Patients underwent survey and physical examination, high-resolution computed tomography (HRCT) and SPECT of the lungs and pulmonary function tests (PFTs). Also serum levels of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (ACCP) and syndecan-1 were measured. Results. All patients developed microcirculation impairment on SPECT. Vascular disorders were according to changes of lung structure detected by HRCT (r = 0.434; p = 0.044). Areas of hypoperfusion matched with ground glass opacities, lung fibrosis, branching linear structures and airway obstruction on HRCT-SPECT fusion scans. Syndecan-1 level was higher in patients with RA compared with healthy controls (р = 0.019). Conclusion. Vascular disorders are important in pathogenesis of lung injury in RA, and SPECT has high sensitivity in lung assessment. Perfusion impairment in lungs correlates with syndecan-1 level, thus syndecan-1 could be used as marker of lung injury in RA thereafter.

The aim of the study - to investigate the dynamics of the temperature of fingers and palms in response to short-term ischemia. Materials and methods. The temperature dynamics of fingers and palms was studied with infrared thermal images before, during and after 2 minutes of provocable ischemia in the right hand in 14 healthy volunteers; in 5 blood donors after 400 ml of blood loss; and in 35 patients diagnosed with traumatic hemorrhagic shock. Infrared monitoring of hands temperature was performed by using ThermoTracer TH9100XX (NEC, USA) thermal imager. Ambient temperature of the examination room was 24-25°C, the temperature window of the thermal camera was set to the range of 25 to 36°C. Quantitative data are presented as mean ± standard deviation. Results. During the cuff occlusion test the fingers temperature of the healthy volunteer and blood donors after 60 minutes from collection 400 ml of blood was reduced by more than 0,1°C. After the cuff occlusion test in the pads of the fingers developed local hyperthermia, after 60-90 seconds of their temperature rises above baseline on 0.5-1.5°C, and then restored to the original level values for 3-5 minutes. Patients with hemorrhage by ATLS classification of more than 35% after the termination of cuff occlusion test hyperthermia in the fingertips are not developed, and they remained below baseline over 3-5 minutes the temperature. Conclusions. Changes in local temperature of human fingers after using cuff occlusion test can serve as a criterion for the adaptation of the regional blood flow to the blood loss.

Introduction and purpose. Disturbances of pulmonary microcirculation in patients with pulmonary Langerhans' cell histiocytosis and various types of respiratory failure are characterized by different scintigraphic patterns. Aim: to identify features of the circulatory disturbances in the lungs of patients with histiocytosis X, and various forms of bronchial conductivity changes. Material and methods: analysis of changes of microcirculation in the lungs in 54 patients with histiocytosis X, with different types of respiratory insufficiency, assessed by means of single photon emission computed tomography, perfusion scintigraphy and multislice computed tomography. Results and conclusions: in patients with histiocytosis x with obstructive type of respiratory failure, microcirculatory changes were detected at a very early stage of development of the disease. In the terminal stage of the disease, a typical scintigraphic pattern «candle flame» was observed. In patients with combined restrictive and obstructive changes (mixed type), no differences from changes of blood flow in obstructive variant were observed. In the restrictive type of respiratory failure, disorders of microcirculation do not have any typical scintigraphic pattern. The presence of characteristic nodular lesions and increasing fibrotic changes of all structural units were observed in the parenchyma of the lung.

The aim of the study. Estimate microcirculatory parameters of myogenic range in postmenopausal women with normoglycemia, prediabetes and diabetes mellitus type 2. Material and methods. Among the surveyed 94 women (58.0 (53.0; 63.0) years old), in the natural menopause (duration 7.0 (2.0; 13.0) years), depending on the status of carbohydrate metabolism (WHO, 2011) by measuring the levels of glycated hemoglobin, we identified three groups: group 1 (n = 52) - with diabetes mellitus 2 type, 2 (n = 16) - with prediabetes, 3 (n = 26) - with normoglycaemia. We evaluated anthropometric and biochemical parameters; microcirculation was assessed by laser Doppler flowmetry. Statistical analysis was performed using the SPSS software (version 17.0). The level of statistical significance of differences was at p ≤ 0.05. Results. Women with impaired glucose metabolism (group 1 and 2) with increased abdominal fat deposition have the elevated basal vasospasm and impaired microvascular reactivity due to increased myogenic tone. We found that group 1 has negative association of LDF parameters of myogenic range with blood pressure and duration of hypertension. We identified that increasing concentrations of atherogenic lipids contribute to basal and postocclusive vasodilation independently of the state of glucose metabolism. Conclusion. Identified associations and differences in the LDF parameters of myogenic range at the basal and reperfusion microcirculation reflect the increase of vasospasm and microcirculatory disturbances during progression of carbohydrate metabolism disorders in postmenopausal women.

Introduction and aim - to determine the relationship of dyslipidemia and endothelial shear rate in the unpaired visceral arteries in patients with atherosclerosis in the abdominal aorta pool. Mathereals and methods. The study included 50 people. All patients were examined by a single protocol. Conduct a full clinical-laboratory and instrumental examination, supplemented by the following laboratory parameters: total cholesterol (TC), triglycerides, HDL, LDL, apolipoprotein A1, apolipoprotein B, Remnant cholesterol calculated using the formula: total cholesterol - (HDL+LDL). All patients underwent Doppler ultrasound unpaired branches of the abdominal aorta ultrasound scanner Voluson E6 (General Electric) was performed, Toshiba Aplio 500. Measurement of the shear rate (shear rate) is determined by the formula: SR=4xVpeak/Vd, Vpeak - peak flow rate visceral branches of the abdominal aorta, Vd - end-diastolic diameter of the visceral branches of the abdominal aorta. Results and discussion. The analysis of the various characteristics of the regional blood flow showed lower values of shear rate in the celiac trunk in patients with atherosclerosis of the visceral branches of the aorta. In the group of patients with abdominal aortic atherosclerosis pool demonstrated significantly lower levels of HDL, higher levels of VLDL, atherogenic factor, apolipoprotein B, triglycerides and Remnant cholesterol. Correlation analysis revealed an inverse association between the level of Remnant cholesterol and shear rate in the celiac trunk (r = -0.284, p = 0.04). Conclusions. The development of atherosclerosis in the celiac trunk and/or the superior mesenteric artery is associated with higher triglycerides, VLDL, Remnant cholesterol, apoliporoteinom B. In patients with atherosclerosis of visceral arteries decrease in endothelial shear rate in the celiac trunk was correlated with increased levels of Remnant cholesterol.

Introduction and purpose. Endothelial cells are subjected to biomechanical stress produced by the bloodstream and tunica media of the vessel. Vascular stiffness and endothelial shear stress have cooperative effects on the endothelial structure and function. However, the relationship of shear stress and arterial stiffness is still poorly understood. The purpose of the study was to assess the relationship of endothelial shear rate and both local and regional vascular stiffness in patients at different stages of the development of atherosclerosis. Methods. The study included 60 patients, 33 men and 27 women. The average age of patients was 54.8±11.7 years. Regional arterial stiffness was assessed by measurement of the pulse wave velocity in the arteries of elastic and muscular types. Local stiffness of the carotid arteries was characterized by Peterson elastic modulus, Young's modulus, stiffness index β, the deformation of the common carotid artery. Endothelial shear rate was measured at the site of the common carotid artery. Results. Average values of carotid endothelial shear rate were equal to 433±127 s-1. Reduced endothelial shear rate in the carotid arteries was associated with an increased Peterson modulus (r = -0.289; p = 0.025) and the stiffness index β (r = -0.280; p = 0.037), and moreover - with decreasing vascular distensibility (r = 0.288; p = 0.026) and deformation (r = 0.296; p = 0.024). Assessment of the relationship between endothelial shear rate and regional vascular stiffness showed weak statistically significant negative correlation of shear rate and PWVcf (r = -0.367; p = 0.014). Conclusion. In study subjects endothelial shear rate reduction in the area of the common carotid artery was associated with an increased Peterson modulus, stiffness index β, decreasing deformation of carotid arteries and increase in aortic stiffness.

Purpose. To evaluate the role of changes in coronary blood flow in ischemic heart disease clinic reopening after PCI. Materials and methods. The study included 90 patients with coronary heart disease by 40 to 75 years, who underwent emergency PCI (15 patients) and planned (75 patients) procedure. The risk of complications is calculated on a scale Syntax Score. We investigated the venous blood obtained before and after 6 and 12 months following PCI. In the same period, performed stress echocardiography. In case of resumption of CAD patients clinic conducted stress echocardiography and repeated PCI. The intensity of thrombin formation was assessed using a thrombin generation test (TGT) in platelet-poor plasma and the modified reaction mixture by adding human recombinant thrombomodulin (rh-TM) to assess the degree of activation of the protein C system. Results. A total of 4 years of observation, a total of 30 cases of coronary heart disease is ascertained clinic renewal. Despite the different risk of complications on a scale Syntax Score, the incidence of complications between the groups did not differ. Among the factors that determine the risk of complications during the first year of observation, the most important is the degree of stenosis of the left circumflex artery and a violation of regional contractility in the basin of the artery. In the development of complications of the next 3 years of follow up indicators of stress echocardiography, the intensity of the formation of thrombin and lack of exercise. Conclusions. It was found that CAD clinics renewal is not only a violation of the coronary blood flow. CAD risk clinical relapse rate also depends on the formation of thrombin and protein C system activity.

Introduction and purpose. Chronic cerebrovascular insufficiency - an actual problem of modern medicine. The key pathogenetic link of this group of diseases is a long-term violation of perfusion in the microvasculature. Currently, it is shown that low-intensity electromagnetic radiation at frequencies of millimeter and submillimeter ranges had an influence on processes in the microcirculation. The aim of this study was to examine the impact on perfusion indices in the vessels of the brain microcirculation in conditions of chronic ischemia. Materials and methods. Experiments were conducted on 52 male rats, which were divided into 3 groups. The first group consisted of 27 rats, which model of chronic cerebral hypoperfusion were reproduced. The second group consisted of 15 rats with chronic cerebral hypoperfusion and daily 30-minute exposure to low-intensity electromagnetic radiation at frequencies 150.176...150.664 GHz. 10 sham-operated rats for the analysis microcirculation mechanisms used the method of laser Doppler flowmetry were included in the third (control) group. The average perfusion, as well as active and passive mechanisms flow modulation were investigated. The main results and discussion. It was found that low-intensity electromagnetic radiation at frequencies 150.176...150.664 GHz contributes to the normalization of perfusion parameters in conditions of prolonged ischemia due to stimulation of active and passive flow modulation mechanisms. This effect is probably related to the prevention of endothelial dysfunction, as well as the influence of electromagnetic radiation on the functional activity of platelets and blood rheology. Conclusion. Thus, the results of the study suggest that low-intensity electromagnetic radiation at frequencies 150.176...150.664 GHz, is a promising method for non-drug correction of perfusion disturbances at long cerebrovascular insufficiency.

Introduction and purpose. A number of landmark trials have demonstrated clear benefits of metformin therapy in the prevention of macrovascular outcomes. Nevertheless, there is a lack of robust evidence to suggest whether metformin therapy will have similar beneficial outcomes in one of the most serious type 2 diabetes-related renal microvascular complications known as diabetic nephropathy. The study aimed to evaluate the effects of ten-week metformin treatment on renal morphofunctional changes in rats with non-genetic type 2 diabetic nephropathy. Materials and methods. Starting at 3 weeks after unilateral nephrectomy, adult male Wistar rats were fed the high-fat diet for 5 weeks, and then successively received nicotinamide (230 mg/kg) and streptozotocin (65 mg/kg) intraperitoneally in 15-min interval. Results. Starting at 11 weeks after confirmation of diabetes, metformin treatment did not attenuate routine renal dysfunction markers such as creatinine, creatinine clearance and albuminuria compared to placebo-treated diabetic group, and glomerulosclerosis index and glomerular expression of type IV collagen didn't significantly change either. Nevertheless, level of urinary kidney injury molecule-1, considered to be the marker of tubular damage in diabetes, was significantly lower in metformin-treated animals. Moreover, reduction of tubulointerstitial lesion tended to be significant. Conclusions. Under conditions of diabetic nephropathy modeling, metformin has shown direct protective effects against diabetic tubular disturbance. To assess long-term renal outcomes of these findings, more pre-clinical studies and clinical trials are required.

Minimization of irreversible myocardial damage after ischemia-reperfusion episode remains valid and unsolved problem. Among of many pharmacological agents have been effective in experimental studies, only a few of them are evidence of its efficacy in clinical trials. This is largely explained by the mechanism of action of these compounds, aimed primarily at preventing reperfusion injury, and do not affect myocardial cells subjected to prolonged ischemia without reperfusion. In recent years, the interest of researchers confined to the mechanisms of programmed necrosis or necroptosis, which morphologically has no different to necrosis, but has molecular targets for suppression. In this paper, on the model of global ischemia-reperfusion in rats we have studied cardioprotective effects of high-activity and low-toxicity necroptosis inhibitors - necrosulfonamide and necrostatin-1s. We demonstrated the infarct-limiting effect of these compounds, as well as the best parameters of intracardiac hemodynamics after an episode of global ischemia-reperfusion. We believe these compounds are interesting for further preclinical studies.

This review is devoted to a discussion of the dual role of connexin intercellular structures and gap junction (GJ) in normal and cerebral ischemia. The review describes the structure and form of connexin structures such as gap junctions and hemichannels. It is shown that the properties of connexin structures depend on the connexins. We describe a substance that can be transported through connexin structure. The data on the possible increase in the number of GJ after ischemia/cerebral hypoxia. A hypothesis about the development of post-ischemic neuronal syncytium formation by GJ. We discuss ways of blocking of GJ to reduce post-ischemic brain damage.