EXPERIMENTAL GESTATIONAL DIABETES DISRUPTS THE FORMATION OF IMMUNE TOLERANCE IN OFFSPRING.

OBJECTIVE: The aim: To analyze the mRNA gene expression level of Aire, Deaf1, Foxp3, Ctla4, Il10, Nlrp3 and distribution of NLRP3+-cells in mesenteric lymph nodes (MLNs) of the offspring of rats with GD, both untreated and treated with glibenclamide and in conditions of insulin oral tolerance formation. PATIENTS AND METHODS: Materials and methods: The study involves 160 male rats, one- or six-month-old. The mRNA genes expression was studied by real time quantitative poly¬merase chain reaction. Structure of Nlrp3+ -cells population was studied by histological sections of MLNs. RESULTS: Results: We observed AIRE gene repression, reduced mRNA levels of Deaf1 and the transcription factor Foxp3 in offspring of rats with GD. This was accompanied by inhibition of IL-10 gene expression and negative costimulatory molecules Ctla4. The development of the experimental GD was accompanied by transcrip¬tional induction of the Nlrp3 gene in MLNs of descendants. The administration of glibenclamide to pregnant female rats with GD inhibited the transcription of the Nlrp3 gene only in one-month-old offspring (5.3-fold) and did not change it in six-month-old animals. In offspring of rats with GD, the density of the NLRP3+-lymphocyte population in the MLNs increased, more pronounced in one-month-old animals. The administration of glibenclamide to pregnant rats with GD reduced the number of NLRP3+ -lymphocytes only in one-month-old offspring (by 33.0 %), whereas this index in six month-old offspring even increased. CONCLUSION: Conclusions: Experimental prenatal hyperglycemia leads to increased proinflammatory signaling and violation of peripheral immunological tolerance formation more pronounced at one month of life.

HOLISTIC APPROACH IN COMMUNICATION SKILLS TEACHING OF MEDICAL STUDENTS.

OBJECTIVE: The aim: To analyze the relevance of communicative competence in medical practice and to choose the best pedagogical methods by improve communication skills in future doctors through the use of a holistic approach in teaching. PATIENTS AND METHODS: Materials and methods: Sociological, informational and analytical research methods were used in the research. CONCLUSION: Conclusions: The holistic direction in education promotes partnership between a student and a teacher, the achievement of mutual understanding and trust, better commitment and motivation to learn. The use of feedback forms helps to recognize and understand the needs and feelings of each student, work effectively with diversity, motivates the teacher to continuous self-development and self-improvement. Modern teaching methods such as working in small groups, Storytellling and role-play according to students are more valid in mastering the communicative competence of the future doctor.

METABOLIC THERAPY IN THE COMPLEX TREATMENT OF CHRONIC PANCREATITIS WITH STABLE CORONARY ARTERY DISEASE.

OBJECTIVE: The aim: To study the effectiveness of using medicine meldonium in standard therapy to the correction of prooxidant-antioxidant and kallikrein-kinin disorders in patients with chronic pancreatitis andstable coronary artery disease. PATIENTS AND METHODS: Materials and methods: The study included 90 patients with chronic pancreatitis andstable coronary artery disease.They were divided into two groups: I group (45 patients) received standard treatment; II group (45 patients) along with basic therapy received medication meldonium (Vazonat) for 2 capsules (500 mg) once daily for two months. Indicators prooxidant-antioxidant system in blood plasma was determined by biochemical method, indicators of kallikrein-kinin system- by chromatographic method. RESULTS: Results: The better status of the prooxidant-antioxidant system and kallikrein-kinin system was observed in patients who received in addition to standard protocol treatment with meldonium. CONCLUSION: Conclusions: Adding to the complex therapy of patients with chronic pancreatitis and stable coronary artery disease of the medicine meldonium helps to improve the prooxidation-antioxidant status and disorders in the kallikrein-kinin system more significantly compared with standard basic therapy.

combination effect of hypertonic disease with chronic pancreatitis on the processes maintain homeostasis.

OBJECTIVE: Introduction: Abnormalities comorbidity - a frequent phenomenon in medical practice. This determines the relevance of research processes maintaining homeostasis with a combination of various diseases. The aim of this study was to examine and compare the character of vegetative, antioxidant, kallikrein-kinin system and parameters of endogenous intoxication disorders in the patients with isolated essential hypertension and with combination of hypertonic disease and chronic pancreatitis. PATIENTS AND METHODS: Materials and Methods: Cardiointervalography was used in the research with definition of standard statistical and spectral heart rate variability. Determination of superoxide dismutase, glutathione, catalase, middle molecular peptides, total proteolytic activity of plasma by the hydrolysis of protamine sulfate, prekallikrein, kallikrein, α1 -proteinase inhibitor, α2 -macroglobulin and kininase II was conducted by laboratory methods. RESULTS: Results: Sympathicotonia with the moderate tension of adaptation processes, violation of antioxidant protection, kallikrein-kinin system and displays of endogenous intoxication were found in the patients with isolated hypertension. Reduction of sympathicotonia, reducing total power spectrum, increasing the share of humoral-metabolic effects on heart rate, tendency to asympathicotonia autonomic reactivity, lower levels of superoxide dismutase, glutathione, prekallikrein, α2 -macroglobulin, kininase II, higher levels of catalase, middle molecular peptides, total proteolytic activity of plasma kallikrein were observed upon accession the concomitant chronic pancreatitis. CONCLUSION: Conclusions: The signs of compensatory mechanisms disruption and increased autonomic nervous system imbalance with a decrease in ductility autonomous processes in the load were determined upon accession the concomitant chronic pancreatitis. The combination of pathologies also accompanied by more severe manifestations of endogenous intoxication, significant violations of antioxidant and kallikrein-kinin systems.