Hepatorenal syndrome (HRS) is a variant of functional renal failure in acute or chronic liver pathology. Type 1 HRS entails a rapidly progressive decline in kidney function within few days and without liver transplantation, 95,0 % of patients die within the next few weeks. With type 2 HRS, kidney function remains stable or gradually declining over several months. HRS diagnosis is based on the exclusion of other causes of renal failure. Pathophysiological changes in renal failure in the case of HRS are quite complex – they include an increase in the synthesis of vasoactive substances, which lead to a decrease in renal perfusion, a decrease in resistance in peripheral arteriovenous anastomosis, the development of portal hypertension, ascites, a decrease in colloidal osmotic pressure and a consistently increasing delay of sodium and water in the kidneys. HRS therapy is based on acid-base balance and anemia correction, intravenous administration of albumin, paracentesis, the removal of nephrotoxic agents and the renal replacement therapy is only symptomatic.

During “in vivo experiments” there was compared the amplitude and shape of induced contractions mechanograms (MGS) with changes in muscle contractions impedanceograms (IGS). It was made with the help of an atraumatic needle electrode for direct myostimulation and registration of muscle contraction impedance. So the impedance decrease was registered at threshold (local) and maximum IGS. The absolute amplitude values of MGS and IGS were changed proportionally, however, the configuration of the MGS and IGS were different. In a way the action potential and local muscle contraction were preceded the beginning of the "mechanical" response. According to the results of the study, the IGS parameters are proportional to the number of open ion channels Ca2+ and can be used to assess the degree of muscle tissue damage based on changes in the parameters of direct muscle excitability (PMV).

Materials and Methods. There was proposed an original algorithm for a comprehensive assessment of the wound process and methods of using modern wound coatings. It was based on the results of examination and treatment of 102 patients with purulent-necrotic complications of diabetic foot syndrome (DFS), who were treated at the clinic of General surgery of the Military medical Academy from 2015 to 2017.
Results. The data obtained after planimetric, bacteriological and cytological research fully confirm the effectiveness of modern wound coatings.
Conclusion. The suggested algorithm provides an objective assessment of wound process, also demonstrates its dynamics, allows to compare different methods of local treatment, as well as to adjust the treatment regimen of patients with purulent-necrotic complications of DFS.

Fulminant purpura (FP) is an acute rapidly progressing syndrome of disseminated intravascular coagulation, it is accompanied by specific skin manifestations and characterized by extremely high lethality in the absence of adequate timely treatment. This multicomponent disease requires a multidisciplinary approach to its treatment and the phasing of surgical interventions. We have accumulated experience in successful treatment of three patients with fulminant purpura of different etiologies from 2014 to the present time. This article provides an example of the complex treatment of a three-year-old girl with fulminant purpura of both hips that was connected with the deficiency of protein C and the expression after acute respiratory illness.