Thanks to the approaches of precision medicine, great strides have been made in the diagnosis and treatment of diabetes mellitus, taking into account the individual characteristics of each patient or subgroups for monogenic subtypes of diabetes and newborn diabetes. For monogenic diabetes, molecular genetics can identify discrete etiological subtypes, the manifestation of which has profound implications for treatment, and predict the further development of concomitant clinical signs that allow early prophylaxis or supportive therapy. In contrast, second-type diabetes mellitus has a polygenic nature, which makes it difficult to define discrete clinical subtypes. The implementation of the approaches of precision medicine in the diagnosis and treatment of diabetes mellitus will allow a targeted selection of drug therapy. This review shows the successful use of precision medicine in monogenic diabetes and the possibilities of this approach to solving problems in diabetes of the second type.

Apoptosis, along with proliferation, is a form of lymphocyte response to activating stimuli. In the early stages of cell differentiation, the apoptotic response prevails and it results to the formation of tolerance to inductor antigen. Mature lymphocytes proliferate in response to stimulation and it means the initial stage in the development of the immune response. Since in this case apoptosis and proliferation acts as alternative processes, their ratio can serve as a measure of the effectiveness of the cellular response to activating signals. The resistance of autoreactive T-cells to apoptosis is the main key point in the development of type 1 diabetes mellitus (T1DM). Autoreactive T-cells migrates from the bloodstream to the islet tissue of the pancreas and take an active part in b cells destruction. The resistance of autoreactive effector T-cells to apoptosis may suggest their high proliferative potential. Therefore, the comparative evaluation of apoptosis and proliferation of peripheral blood lymphocytes can give a more complete picture of their functional state and thus will help to reveal the causes of ineffective peripheral blood T-ceiis apoptosis in patients with T1DM and will help to understand more deeply the pathogenesis of the disease. in this article, the features of proliferative response of peripheral blood T-cells in patients with T1DM and in individuals with high risk of developing T1DM have been studied. Apoptosis of T-cell subpopulations has been investigated. The correlation between the apoptotic markers and the intensity of spontaneous and activation- induced in vitro T-cells proliferation of was revealed. it was determined, that autoreactive peripheral blood T-cells were resistant to apoptosis and demonstrated the increased proliferative potential in patients with T1DM and in individuals with high risk of developing T1DM.

The objective of the study is to show significance of desynchronosis laboratory markers in risk assessment of metabolic syndrome (MS) development. Materials and Methods. There were examined 98 men, aged 43-88, diagnosed with dyscirculatory encephalopathy showing one and more risk factors for development of cardiovascular diseases. They were divided into 2 groups according to the international guidelines of 2009: with MS (n = 61) and without MS (n = 37). Parameters of fats, glucose metabolism, inflammatory mediators, fat tissue metabolism markers, melatonin metabolite excretion (6-sulfatoxymelatonin) were defined in blood serum and urine. Results. The article presents data on changes in leptin, adiponectin, PAI-1, testosterone production and 6-sulfatoxymela-tonin excretion in patients with MS. There are calculated threshold values of these markers definitely increasing MS risk and logistic regression equation which allows assessing MS risk for an individual patient. Conclusion. Detected disorders of melatonin synthesis diurnal dynamics in patients with MS and interconnection between melatonin production and adiponectin, leptin, PAI-1, testosterone synthesis allow considering these parameters as desynchronosis markers significant for MS development.

The brief review, dedicated to Septic Acute Injury (S-AKI) - the syndrome simultaneously corresponding to criteria of sepsis and acute kidney Injury. Sepsis or AKI are diagnosed 30-50 % of critical patients. Sepsis is promoting the developing of AKI and AKI is promoting the development of sepsis. Morbidity and lethality in S-AKI is higher than that is sepsis and in AKI separately. The main mechanisms of the development of: a) AKI in sepsis - the toxic septic blood containing huge amounts of proinflammatory factors damage the renal tubules resulting tubular disfunction; b) sepsis in AKI - uremia is damaging distal organs and functions of immune systems which provoke sepsis development. For early diagnostics of S-AKI in patients admitting in critical care units the simultaneous measurements and monitoring of sepsis and kidney biomarkers are to be made. The problems of such measurements is that AKI decreases the clearance of septic markers and their levels are increasing in noninfectious conditions. From the other hand in septic conditions inflammation can increase the levels of renal markers independently of renal pathologies. In general in sepsis, AKI and in S-AKI the increased levels of sepsis markers reflect simultaneously severity of infectious inflammation and of renal disfunction, and kidney markers reflect simultaneously severity of renal disfunction and of infectious inflammation. The correction of cut-off values of septic markers used for S-AKI diagnostics must be based on the degree of severity of renal disfunction in critical patients.

This review presents the basic information on the generally pathophysiology of multiple organ dysfunction syndrome and especially the development of target-organ dysfunction. The modern biomarkers that can diagnose organ dysfunction in the early stages of their development.

There is an ongoing debate about what the laboratory should do with hemolyzed samples. Several strategies are proposed for managing the results obtained in such samples. The safest option from the analytical and clinical points of view is to perform a study of a new sample without hemolysis. Another approach is to carry out a test irregardless, but at the same time indicate a limit on the clinical interpretation of the result, by making a comment on possible hemoglobin interference. The choice of strategy should be based on a comparison of the risk of negative consequences in the absence of a test result and the likelihood of harm due to the transfer of the result with high uncertainty to the clinician.

The aim of the study was to Substantiate the format of tests for laboratory diagnosis of ToRCH-infections, to identify the causes of insufficient sensitivity and specificity of the ELISA tests on the example of determination of immunoglobulin M against cytomegalovirus, and to offer the solutions. Conclusions. The method of mucapture solves the problem of specificity, and the variant of sequential incubation with conjugates - the first incubation with Biotin, the second with streptavidin - enhances the signal by increasing the number of covalent bonds, which increases the sensitivity of the test.

Modern therapeutic approaches can significantly correct iron-deficient co and normalize iron metabolism in women during gestation, but for this, the practitioner must make the right decision to conduct both screening studies in this group of patients and to choose the optimal personalized laboratory diagnosis in pregnant women with clinically expressed pathological changes.

Introduction. The problem of irregularities in the fibrinolysis system during extracorporeal circulation is investigated closely and does not lose its relevance. The aim of research. To research and identify fibrinolysis system violations performed in cardiac surgical patients undergoing cardiopulmonary bypass surgery with minimized extracorporeal circuit (MiECC). Materials and methods. 50 patients were examined with coronary artery bypass grafting: 15 ones operated with MiECC (main group); 35 ones operated with heparin-coated extracorporeal bypass circuits (control group). Performance evaluation of fibrinolytic system was carried out prior to surgery, after protamine, 12 hours after operation, 7 days later, on discharge and one month after surgery. Results. Balance of fibrinolytic system after the operation shifts to the side of the oppression. Structural parameters of a fibrin clot (size CS and D density) according to thrombodynamics test correlate well with Xll-dependent fibrinolysis. Patients after surgery with MiECC in comparison with the conventional circuit have lower thrombinemia, minimal number of activated platelets, faster recovery of plasma fibrinolytic capacity, and accordingly lower risks of thrombotic complications. Conclusion. Fibrinolysis system indicators show the advantage of usage at aorto-coronary bypass with minimized heparin-coated extracorporeal bypass circuits.