Aim of the study. To elucidate the association of allelic variants of single nucleotide polymorphism in NRF2 (rs6726395, 177238501A>G) and TLR9 (rs352162, 52218953T>C) genes, each gene separately and in their combination, with peculiarities of the course of critical conditions during lung infection.
Materials and methods. DNA from 86 post#operative patients and oncologic patients was genotyped in an allelespecific fashion using tetra#primer polymerase chain reaction followed by gel electrophoresis analysis of products.
Results. It has been found that septic shock patients with NRF2 177238501A>G GG genotype had increased mortality and higher APACHE II score and developed non#responsive edema more frequently. Patients with NRF2 177238501A>G GG/TLR9 52218953T>C CC genotype combination developed septic shock and nosocomial
pneumonia more rarely.
Conclusion. The homozygous NRF2 177238501A>G (GG) allele combination is unfavorable for the course and outcome of critical conditions only in combination with TLR9 52218953T>C СT or TLR9 52218953T>C TT alleles in septic shock patients. At the same time, the combination of TLR9 52218953T>C СС alleles in the same patients with 'unfavorable' NRF2 177238501A>G GG protects against development of septic shock and nosocomial pneumonia.

Objective: to analyze the human neocortex interneurons (areas 4, 10, 17 and 21 by Brodmann) after cardiac arrest (clinical death).
Materials and methods. The main group included patients (n=7, men) who survived 7—10 days and 70—90 days after cardiac arrest and later died due to heart failure. The control group (n=4, men) included individuals after sudden fatal accidents. The morphometric and histological analysis of 420 neocortical fields (Nissl#staining,
calbindin D28k, neuropeptide Y) was performed using light and confocal microscopy.
Results. We verified all main types of interneurons (Basket, Martinotti, and neurogliaform interneurons) in neocortex based on the morphology of their bodies and dendritic processes in both groups. The number of calbindin- and NPY-positive neurons in the neocortex was similar in the control and in the postoperative period.
However, calbindin- and NPY-immunopositive structure fields including neuronal cell bodies and their dendrites were significantly more represented in neocortex of patients from the main group. Maximum increase in common square in the relative areas of calbindin-immunopositive structures was observed 90 days after ischemia. The squares of NPY#immunopositive fields became larger seven days after resuscitation and remained increased on 90th day post-resuscitation.
Conclusion. Our findings demonstrate an increase of calbindin and NPY expression in human neocortex after clinical death, which can be explained by a compensatory  eaction of undamaged inhibitory cortical interneurons directed to protectbrain from ischemia.

The development of accurate and applicable methods to assess the severity of patient condition is an urgent need in critical care medicine.
The goal of the study was to determine whether the quantitave evaluation of phenylcarboxylic acids (PhCAs) concentrations in blood might be employed to assess the severity of patient condition and treatment efficiency intensive care unit.
Materials and methods. Clinical and laboratory findings in patients (n=58) with acute surgical diseases of abdominal organs were registered on the day of admission to intensive care unit and during follow-up control including lactate level and blood serum PhCA concentrations of phenyllactic (PhLA), p#hydroxyphenyllactic (p-HPhLA) and phydroxyphenylacetic (p#HPhAA) acids. Patients' condition was assessed using APACHE II and SOFA international scales. PhCA concentrations were determined by gas chromatography. The reference group included healthy blood donors (n=25).
Results. PhLA, p-HPhAA, p-HPhLA levels and total concentration of the three PhCAs were shown to be in direct correlation with APACHE II score (rs: 0.624; 0.757; 0.763 and 0.804, respectively; P<0.001). When testing PhCAs as a molecular prognostic criteria, areas under ROC#curves (AUC) were within the range of 0.800—0.900 (P<0.001). Therewith the molecular prognostic criteria were comparable with APACHE II multi#
parameter scale by accuracy: AUCAPACHE II was 0.897 (P<0.001). Lactate level dynamics as a prognostic criterion was inferior in accuracy to the dynamics of PhCA total concentration: AUCС lactate, % 0.667 (P=0.071) vs AUCС 3PhCAs, % 0.862 (P<0.001). In patients with documented bacterial inflammatory complications PhCA level was 2.5 times higher (P<0,001, n=35) and p#HPhLA level was 1.5 times higher than in patients without infectious complications (P=0.048, n=23).
Conclusion. The findings provide evidence for the inclusion of PhCAs (PhLA, p-HPhAA, p-HPhLA, 3PhCAs) in clinical practice as biomarkers of the severity of condition in patients with surgical diseases of abdominal organs. The study showed that change in PhCA serum concentrations reflected the dynamics of patient condition and might be used for objective monitoring of the treatment.

Objective: to identify the effectiveness of the drug Reamberin in complex intensive threatment of patients with cardiac surgery in heart fibrillation and remodeling of prosthetic heart valves and plastic defects of atrial and ventricular septa.
 Reamberin according the following protocol: 400 ml in the first 6 hours of the postoperative period as an intravenous drip at a rate of 60—90 drops/min. In group 2 (control group), 26 patients received standard intensive care medication. In addition to standard clinical and laboratory tests during the study following components were quantitavile determined in blood: troponin I, lactate dehydrogenase, creatine kinase, isofractions of creatine kinase
MB, transaminases (alanine aminotransferase and aspartate aminotransferase).
Results. Treatment of patients from the main group revealed the recovery of functional parametersof the myocardium, improved dynamics of cardiac enzymes and normalization of blood acid-base status.

Conclusion. Inclusion in the complex intensive therapy of post#cardiac surgery of the Reamberin in patients experiencing heart fibrillation after the cardiopulmonary bypass followed by electrical defibrillation improved the clinical course of the early postoperative period and reduced the risk of complications and early mortality.

Goal of research: to evaluate efficiency of videothoracoscopy in diagnosis and treatment of patients with injuries and emergency diseases ща chest organs.
Material and methods: Study wasbased on treatment results analysis of 2111 patients with injuries and chest organs emergency diseases, who were treated at Republican Research Centre of Emergency Medicine in 2001-2014. Chest trauma made up 1396 (66,1%) victims. There were 477 (22,6%) patients with spontaneous pneumothorax. At the stages of initial diagnosis, the radiologic evaluations, CT investigations and videothoracoscopies were performed. In chest trauma patients the videothoracoscopy underwent in 844 cases, in spontaneous pneu#
mothorax this method was employed in 290 patients. Complicated forms of lung echinococcosis were observed in 238 (11,3%) patients and complicated forms of lung echinococcosis were evident in 72 patients.

Results. Videothoracoscopy and video-assisted interventions allowed to eliminate lungs and pleura pathology in 1206 (57,1%) patients, whereas the traditional methods were effective only in 905 cases (42,9%).
Conclusions. Investigation methods such as multiplanar radioscopy, radiography, chest CT and videothora-coscopy must be included into algorithm of diagnosis and surgical treatment of chest injuries and emergency diseases of chest organs. At chest trauma the videothoracoscopy allows to avoid broad thoracotomy from 9,4% to 4,7% of cases, to reduce the frequency of repeated interventions from 17,4% to 0,5% and diminish a number of early postsurgery complications from 25,4% to 10,9%. Videothoracoscopy of chest traumas allows to reduce frequency of repeated interventions from 19,8 to 1,7%.

Study objective: to improve treatment results of patients with AP complicated by DT by early concomitant use of artificial lung ventilation (ALV) and detoxification by plasmapheresis.
Methods of study and treatment. 146 patients with chronic alcoholic intoxication (CAI) and AP development complicated by DT were enrolled to the study. Patients of Group I (reference group, n=45) received «standard» therapy. Group II included patients who received extracorporeal detoxification by plasmapheresis in addition to «standard» therapy (n=51). Group III included patients who underwent oxygenation correction by ALV in addition to «standard» therapy and extracorporeal detoxification by plasmapheresis (n=50).
Results. During the evaluation of plasmapheresis efficacy, more rapid normalization of blood biochemistry in patients from Group II was noticed. The following parameters were decreased: blood α#amylase by 73.2%, bilirubin level by 33.3%, AST by 34.1%, ALT by 17.7%; arterial blood lactate level was normalized by 47.6% on Day 3 vs. Group I (p<0.05). 17.7% patients (n=8) in Group I and 17.6% patients (n=9) in Group II received respiratory support by ALV at different time points due to severe hypoxia. Concomitant use of exogenous detoxification by plasmapheresis and early ALV in patients with AP complicated by DT decreased delirium duration from 5.4±0.2
days (Group I) and 4.1±0.2 days (Group II) to 1.1±0.1 days in Group III patients. In patients of the Group III no cases of self-aggression were reported. No significant differences were observed between Group I and Group II.
Conclusion. Concomitant use of exogenous detoxification by plasmapheresis and early extended ALV during complex therapy of patients with AP complicated by DT improves blood biochemical parameters and decreases delirium duration and in-patient duration of treatment. Medication sedative therapy with extended ALV levels abrogates the development of a self-aggression.

This article focuses on specialized scientific Practicum organized on April 14s 2016 by the Laboratory of biophysics of cells membranes in critical illness of V. A. Negovsky Research Institute of General Reanimatology for students enrolled in the specialty «Medical Biophysics» at the I. M. Sechenov First Moscow State Medical University. During the study students had mastered a number of techniques: atomic force microscopy, calibrated electroporation, spectrophotometry. Students familiarized with the methodology of scientific experiment and mathematical treatment of the results.