In liver diseases, most commonly in the terminal stage of liver failure, a variety of hemostatic defects affecting almost all parts of the blood coagulation system are developing. This leads to diminishing the capabilities of patients with liver diseases to correctly maintain the hemostatic balance.
The severity of hemostatic disorders depends on the nosological form and degree of a liver damage. Depending on the imbalance of the hemostasis system and accumulated clinical/laboratory data, patients with liver diseases can be subdivided into three groups as exhibiting: 1. non-cholestatic liver damage; 2. cholestatic liver damage and 3. liver damage of vascular origin.
The first part of the review discusses multiple alterations in the hemostasis system in patients with noncholestatic liver diseases, which are commonly accompanied by hypocoagulation.

Pain management is a foreground task of physicians specializing in various disciplines. Special attention is paid to the issues of early comprehensive rehabilitation of post-stroke patients and prophylaxis of probable long-term complications related to injuries of different brain structures.
Post-stroke thalamic syndrome is the most frequent multiform complication that requires multidisciplinary efforts. Understanding of the morbid physiology of pain thalamic syndrome is the cornerstone of successful management providing higher quality of patients’ life. Currently, profound changes have taken place in the prophylaxis, diagnosis, and management of post-stroke thalamic syndrome. 
This review highlights the most common types of pain experienced by patients after thalamic stroke, presents morbid physiological mechanisms of pain development depending on the location of ischemic brain injury, and discusses the issues of up-to-date management and rehabilitation of post-stroke thalamic syndrome patients.

Oncological diseases belong to life-threatening pathologies being the second most frequent cause of morbidity and mortality after cardiovascular diseases. Clarification of carcinogenesis mechanisms makes it possible to expand the stock of tools available for prevention of critical illness accompanying this pathological condition.
Nowadays, proteolytic systems of tumor microenvironment (ТМЕ) are regarded as key regulators of a tumor progression including tumor growth, invasion and metastazing. The review discusses ТМЕ structure and role in cancer progression.
Recent data decipher the role of proteolytic systems in the interaction stromal cells with tumor cells in different types of cancer in humans. The most known proteolytic systems contributed to cancer progression are matrix metalloproteinase system (MMP), urokinase-type plasminogen activator system (uPA-system), various cathepsins, granzymes, and elastase. Inhibition of extracellular proteolysis in the course of an oncological process is considered an effective approach to cancer therapy.

Purpose of the study — to evaluate biomechanical regularities of deep deformation of native erythrocytes’ membranes during long-term (up to 32 days) storage of erythrocyte suspension.
Materials and methods. The method for addressing the said problem was atomic-force spectroscopy. The measured value was hHz comprizing the depth to which the probe immersion process was described by interaction with a homogeneous medium. Empirical and theoretical dependence of the interaction force F (nN) on the probe immersion depth h (nm) — F (h) were obtained. Bar charts of relative frequency density of Young’s modulus E were built.
Results. Modulus E changed from 9.3±3.2 kPa — for 3 days of storage, to 22.7±8.7 kPa — for 32 days. Coefficients of skewness were 0.52±0.04 (for day 3) and 0.82±0.09 (for day 32 d), hHz value remaining constant.
Conclusion. Progressively as erythrocyte suspension was stored, erythrocyte membranes to the depth of 700 nm deflected homogeneously in spite of 2.4-fold increase of Young’s modulus.

Purpose of the study: to examine sensibility of baroreceptors and the autonomic nervous in the passive orthostatic test in patients with chronic impairment of consciousness due to severe brain damage and determine their role in the rehabilitation process.
Materials and methods. The study included 30 patients with long-term impairment of consciousness due to severe brain damage (group 1), 10 of them being in the vegetative state (VS) and 20 being in the minimally conscious state (MCS). Craniocerebral trauma was the main cause of severe damage in that group (53% of patients). The comparison group included 24 patients with focal neurological symptoms caused predominantly — 79.2% of cases — by cerebrovascular disorders (group 2). The control group (group 3) consisted of 22 healthy volunteers of a comparable age. All measurements were done with the help of a Task Force Monitor 1030i (CNSystem, Austria) in the course of passive orthostatic test at 0°–30°–60°–0°. Changes in the power of low-frequency (LFS) and highfrequency spectrum (HFS) of heart rate variability and baroreceptors sensibility (BRS) were analyzed. Statistical analysis was carried out using Statistica-10 software. Significance of inter-group differences on unrelated samples was determined by the Mann–Whitney U-test. Differences between groups were considered significant at P 0.05.
Results. Maximal background values of BRS were found in the control group. In group 1 and 2 patients, considerable decrease of that index was noted, which was proportional to the brain damage severity. Similar dynamics was observed for the indices of autonomic nervous system sensibility (LFS and HFS). The main trend of orthostatic changes of BRS, LFS, and HFS was characterized by progressive decrease of the indices with increase of the patients’ angle of tilting and their return to the baseline level after the patients were put back into the horizontal position. 4 patients of group 1 (14%) displayed signs of orthostatic disorders upon tilting to 30°: in 3 cases, orthostatic hypotension was observed, and in one case the postural orthostatic tachycardia syndrome (POTS) was diagnosed. Those patients differed by lower BRS and higher sympathetic system activity (LFS) vs. the same indices of other patients in that group.
Conclusion. Patients with chronic impairment of consciousness during the post-comatose period after a severe brain damage display a significant decrease of baroreceptors sensibility and autonomic nervous system disorders manifesting in significantly lower activity of the sympathetic and parasympathetic systems. The prominence of such disorders is associated with brain damage severity. Their risk of developing orthostatic hypotension during tilting towards a vertical position is higher in patients who have lower baroreceptors sensibility, and this should be taken into account beginning the process of their verticalization.

The purpose of the study was to evaluate the clinical significance of CNS biological markers in an ischemic stroke.
Materials and methods. Blood serum biomarkers of CNS were assayed by ELISA in patients suffering from cerebrovascular disorders of ischemic origin. Neuron-specific enolase, brain-derived neutrophic factor (BDNF), glial-derived neutrophic factor (GDNF), protein S-100 total (ɑβ–ββ), sialyl carbohydrate antigen (KL-6), vascular endothelial growth factor, and superoxide dismutase were analyzed. All tests were carried out using automatic microplate immunoassay analyzer Immunomat TM. The study included 43 patients of 50 to 80 years of age, suffering from cerebrovascular disorders; among them there were 24 women and 19 men. Blood serum biomarkers of CNS were assayed within the first 3–6 hours, and on week 2, 3, and 4 from onset of the disease. The control group consisted of 20 volunteers (apparently healthy donors). Statistical analysis was carried out using non-parametrical Mann–Whitney test. Results were considered as significant at P 0.05.
Results. During the pre-necrotic and early necrotic period, higher neuron-specific enolase, protein S-100, superoxide dismutase, and lower brain-derived neutrophic factor and glial-derived neutrophic factor were observed, reflecting structural brain alterations due to disturbed circulation. At later follow-up time-points, BDNF, GDNF, VEGF, and KL-6 increased evidencing activated CNS regeneration processes.
Conclusion. The content of biological markers in blood serum of ischemic stroke patients reflects the disease stages, which helps managing the CNS regeneration processes.

Our aim was to assess the effectivity of continuous flow ventilatory support (CFVS) in those COPD patients undergoing cardiac surgery who developed hypercapnic respiratory failure.
Materials and methods. CFVS was applied in 11 COPD (Stage 2.55±0.52 on average) patients undergoing cardiac surgery, after weaning from «conventional» pressure controlled (PCV) or pressure support ventilation (PSV) mode. All of these patients had hypercapnea with respiratory failure that has been manifested after 15±10 hours after postoperative weaning from ventilator. CFVS was applied using nasotracheal catheter (diameter 5–6 mm) with average inspiratory flow Qin = 26±2,3 l/min while using FiO2 of 0.3–0.35.
Results. Only one out of 11 patients failed to recover from hypercapnic respiratory failure using CFVS and had to be intubated instead. Spontaneous ventilation frequency was gradually decreasing from 24.8±3.6 breaths/min to 16±2 breaths/min after initiation of CFVS (P<0.01). Average value of PaO2 before CFVS was 59±7.5 mmHg and rose to 99.6±4.5 mmHg just before CFVS was terminated (P<0.01). PaCO2 before CFVS was measured to be 73.2±7.5 mmHg and dropped to 45.7±4.3 mmHg (P<0.01). CO2 drop was fast in the first 18 hours from CFVS application. Average time for application of CFVS was 3.09±0.9 day.
Conclusion. CFVS is an effective and minimally invasive mode of ventilation support that can be used in patients suffering from hypercapnic respiratory failure to avoid the need to intubate trachea and connect the patient to conventional ventilator.

Purpose — to assess the efficacy of supplementation therapy for antithrombin deficiency in the combined treatment of sepsis.
Materials and methods. A prospective-retrospective study of the efficacy of supplementation therapy for antithrombin deficiency during sepsis was carried out; 90 patients were examined. The patients were split into two groups whether antithrombin deficiency correction was or was not undertaken. The composite outcome — the incidence of cardiovascular complications as of day 28 from the therapy commencement — was chosen as the primary endpoint of the study. The secondary endpoints of the study were prevalence of adverse events as of day 28 from the therapy commencement and 180-day mortality.
Results. There was no difference between the groups either in respect of 28-day mortality or composite outcome. Analysis of secondary endpoints revealed that in the group of patients who received antithrombin supplementation therapy, the risk of development of an acute renal injury was significantly lower on day 28 and 180 from therapy commencement: OR 3.5 [95% CI 1.05–11.66] at P=0.04 and OR 2.92 [95% CI 1.02–8.31] at P=0.045, respectively.
Conclusion. Correction of antithrombin level to activity level ‘over 61%’ is associated with decreased incidence degree III acute kidney failure (KDIGO).

The paper describes two patients with prolonged disorders of consciousness (PDC) because of non-traumatic brain injury, in whom a clear neurodynamic response to Zolpidem was observed.
In order to illustrate systemic cerebral responses to administration of this drug in LIC patients, an analysis of clinical and electrophysiological changes has been undertaken.
It has been shown that the result of Zolpidem applications in patients with prolonged disorders of consciousness (PDC) should be assessed not only by consciousness dynamics, but with the help of electroencephalogram (EEG) monitoring, too. Distinct response to Zolpidem during different periods of recovery in one patients was found.
Zolpidem can render various effects in patients in vegetative state/with unresponsive wakefulness syndrome (VS/UWS) and in minimally conscious state (MCS). In one patient, sedation with EEG activation was observed, which was a sign of favorable prognosis. The other patient developed more than once local convulsions after Zolpidem administration followed by contact augmentation on the next day.
The mechanism of action, necessary doses of drugs, and markers of forecasting the successful effect of that drug are yet to be further studied.