; ASSOCIATION OF CIRCULATING ADIPONECTIN, RESISTIN, IRISIN, NESFATIN-1, APELIN-12 AND OBESTATIN LEVELS WITH HYPERTENSION AND OBESITY.

Aim of study - examine the association between circulating blood adipokine levels (adiponectin, resistin, irisin, nesfatin-1, apelin-12 and obestatin) and hypertension and obesity.; The study included a comprehensive survey of 98 patients, including 52 subjects with hypertension and 46 with hypertension and obesity. The levels of adiponectin, resistin, irisin, nesfatin-1, apelin-12, obestatin has been determined.; On conducting an analysis of the study population, the circulating level of resistin (19.32±0.53 ng/mL vs. 14.90±0.29 ng/mL, p=0.0024) was higher in obese subjects with hypertension than in those without obesity, whereas apelin-12 (1.51±0.09 ng/mL vs. 1.42±0.04 ng/mL, p=0.069) and obestatin (2.97±0.04 ng/mL vs. 3.06±0.04 ng/mL, p=0.073) levels were not different between the two groups. The circulating levels of adiponectin (6.83±0.10 ng/mL vs. 2.54±0.72 ng/mL, p=0.00038), irisin (1.91±0.06 ng/mL vs. 1.19±0.03 ng/mL, p=0.021) and nesfatin-1 (8.07±0.06 ng/mL vs. 6.95±0.04 ng/mL, p=0.0057) were higher in subjects with hypertension than in those with obesity.; Patients in the highest tertile of resistin were more likely to have obesity and subjects in the highest tertile of adiponectin and nesfatin-1 were more likely to have hypertension. Apelin-12 and obestatin levels in plasma did not differ according to the presence or absence of obesity. The fact that the level of resistin is highest in patients with hypertension and obesity in comparison with patients with hypertension without obesity, and the level of adipokines such as adiponectin, nesfatin-1 and irisin is higher in patients with hypertension without obesity in comparison with patients with hypertension and obesity may indicate a possible different pathogenetic role of the studied adipokines in the development of cardiovascular diseases. Since the cellular and molecular mechanisms of these changes are not definitively established and there are conflicting data in the literature, further research is needed to clarify the mechanisms of the pathogenetic role of the studied adipokines in the development of cardiovascular diseases.

[Technique of invaginative pancreatojejunostomy in pancreatectomy]. / Pogruzhnoi kisetnyi invaginatsionnyi anastomoz pri rezektsionnykh operatsiiakh na podzheludochnoi zheleze.

Pancreatoenterostomy is one of the key moments in pancreatic surgery. It was proposed invaginative pancreatojejunostomy in end-to-side fashion by using of two continuous single-row purse-string sutures. This technique may be used in pancreatoduodenectomy and Beger's procedure. This method will be useful in cases of edematous and erupting pancreatic parenchyma and hard-to-differentiate lumen of pancreatic duct. It is followed by reduced trauma of tissue and bleeding, allows to avoid sutures failure and to achieve sealed anastomosis.

[THE INFLUENCE OF MONO- AND MULTIVASCULAR LESIONS OF CORONARY ARTERIES ON THE COURSE OF CORONARY HEART DISEASE IN PATIENTS WITH DIABETES MELLITUS TYPE 2].

The article assesses the influence of mono- and multivascular lesions of coronary arteries on the course of coronary heart disease at patients with diabetes mellitus type 2. For this purpose, a comprehensive survey of 75 patients with coronary heart disease and diabetes mellitus type 2 was arranged. Depending on the number of vascular lesions of the coronary arteries, according to the data of coronary arteries computer tomography, all patients were divided into two subgroups. The first subgroup included 27 patients with coronary heart disease and diabetes mellitus type 2 with monovascular lesions of coronary arteries. To the second subgroup were included 48 patients with coronary heart disease and diabetes mellitus type 2 with multivascular lesions of coronary arteries. During the analysis of carbohydrate metabolism in cases of coronary heart disease and diabetes mellitus type 2 the HOMA index increase by 25.40% and insulin level increase by 17.05% were revealed at patients with multivascular lesions of coronary arteries in comparison with patients with monovascular lesions of coronary arteries, respectively. The combination of coronary heart disease and diabetes mellitus type 2 with multivascular lesions of coronary arteries was associated with an increase of sortilin level (233,47±47,85 ng/l). A significant increase in triglycerides, lipoprotein cholesterol of very low density influences greatly on the progression of coronary atherosclerosis with lesions of greater number of coronary arteries at patients surveyed. At patients with coronary heart disease and diabetes mellitus type 2 with multivascular lesions of coronary arteries the left ventricle myocardial re-modeling occurred through the increase of left ventricle's size and cavity.

[New markers of progression of chronic heart failure in patients with myocardial infarction, type 2 diabetes and obesity].

Currently identified a large number of biomarkers that are closely linked with the development of chronic heart failure, some of which are clusterin and fractalkine. Accordingly, the purpose of our study was - to evaluate the role of clusterin and fractalkine in progression of chronic heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. We investigated 71 patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. All patients with postinfarction cardiosclerosis, diabetes and obesity were divided into groups according to the functional class of chronic heart failure (CHF). It was found that an increase the level of fractalkine and reduced clusterin leads due to the development of systolic dysfunction and heart failure progression in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. Fractalkine and clusterin play an important role in progression of the heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity, and this gives them the right to be considered indicators of the severity of CHF.

[GENE POLYMORPHISM Gln27Glu ß2-ADRENERGIC RECEPTORS IN PATIENTS WITH ISCHEMIC HEART DISEASE AS A FACTOR OF DEVELOPMENT AND PROGRESSION OF OBESITY].

Currently large numbers of genetic markers that are closely linked to the development of cardiovascular diseases and obesity are identified. The aim of our study was the study of polymorphism Gln27Glu ß2-adrenergic receptor gene as a possible factor in the pathogenesis of obesity in patients with coronary heart disease. We conducted a comprehensive survey of 337 patients with coronary heart disease. All patients were divided into two groups according to the presence of obesity: the first group - patients with coronary artery disease with normal body weight (n=115), the second group - patients with coronary heart disease and obesity (n=222). The control group consisted of 35 healthy people. It was established that the presence of the G allele and genotype G/G Gln27Glu ß2-adrenergic receptor gene are at risk of development and progression of obesity in patients with coronary heart disease.

[The role of adipokines in formation of lipid and carbohydrate metabolic disorders in patients with cardiovascular disease].

Cardio-vascular disease is an important public health problem in all developed countries.The challenge isto learn thepathogenic mechanisms of this disease.Attention of scientists of the world are drown to the role of hormones in the development of adipose tissue metabolic disorders. Adipose tissue is composed of adipocytes embedded in a loose connective tissue meshwork containing adipocyte precursors, fibroblasts, immune cells, and various other cell types. Adipose tissue was traditionally considered an energy storage depot with few interesting attributes. Due to the dramatic rise in obesity and its metabolic sequelae during the past decades, adipose tissue gained tremendous scientific interest. It is now regarded as an active endocrine organ that, in addition to regulating fat mass and nutrient homeostasis, releases a large number of bioactive mediators (adipokines) modulating hemostasis, blood pressure, lipid and glucose metabolism, inflammation, and atherosclerosis. The aim of our study was to examine the metabolic disorders in patients with cardiovascular disease. Based on identifying the nature of changes of insulin antagonists and of insulin sensitizers. We were investigated 68 patients with hypertension, which included 35 women and 33 men.Estimated distance of carbohydrate and lipid metabolism and adipose tissue hormone imbalance. Our results suggest that the mechanisms underlying the progression of diabetes and obesity in patients with hypertension against metabolic disorders that manifest dysfunction of carbohydrate and lipid metabolism are associated with insulinorezistense and hypervisfatinemia and hyperrezistinemia against hypoadiponektinemia occur in hypertensive patients by having diabetes mellitus type 2.

[Production of 70 kDa recombinant human heat shock protein in baculovirus expression system and assessment of its antiviral activity].

AIM: To obtain human recombinant 70 kDa heat shock protein (Hsp70) in baculovirus expression system and to study its antiviral activity. MATERIALS AND METHODS: Baculovirus expression system was used to obtain recombinant HSP70. Plasmid pFastBacHTb-Hsp70 containing sequence coding HSP70 gene with insertion of 6 histidine residues in protein reading frame was constructed. Competent cells MAX Efficiency DH 10 Bac were transfected with pFastBacHTb-Hsp70 plasmid with following extraction of recombinant bacmid Bac-Hsp70. In order to obtain baculovirus expressing HSP70, Sf-9 cells were transfected with Bac-Hsp70 bacmid. Hsp70 extraction and purification was performed with column metal-chelating affinity chromatography using Ni2+ ions. Protective efficacy of recombinant human HSP70 was estimated using model of Venezuelan equine encephalitis (VEE) in mice. RESULTS: Recombinant bacmid Bac-Hsp70 was constructed based on Bac-to-Bac expression system. Baculovirus expressing human HSP70 have been produced after transfection of Sf-9 cells with Bac-Hsp70 bacmid. Cultivation of recombinant baculovirus in Sf-9 cells and application of metal-chelating affinity chromatography allowed to extract purified fraction of HSP70. Experiments on mice infected with VEE virus demonstrated significant protection from death after administration of HSP70 in dose 15 mcg/mice. CONCLUSION: Application of baculovirus expression system and insect cell line for accumulation of recombinant baculoviruses in combination with Ni(2+)-mediated metal-chelating affinity chromatography allowed to obtain highly purified human recombinant HSP70 with marked antiviral activity.