Purpose of the work: Study of the nature of structural changes and features of early dynamic inflammatory processes in kidney tissues under conditions of acute pyelonephritis in diabetes mellitus. The study analyzed the results of an experiment conducted on sixty-two 8-9-month-old "pure" line rats, weighing 300-400 grams, by reproducing hyperglycemia against the background of which acute pyelonephritis was simulated by enteral infection with an E. Coli isolate of 107 colonies of forming units with subsequent cold stress. Animals were withdrawn from the experiment on days 3, 7, and 14, and kidney tissues were examined by electron microscopy. The results showed that on day 3 after pyelonephritis modeling, no significant ultrastructural changes were detected in the cortical layer of nephrons, only signs of metabolic activity were observed in individual cells. In the renal medulla, the structure of the proximal and distal tubules is more preserved than in the cortex. Structural changes were consistent with the stage of serous inflammation. With further observation on the 7th and 14th day of the course of complicated pyelonephritis, pronounced morphological changes occur: the endothelial cells of the glomerular capillaries, proximal and distal tubules are destructively changed with signs of deep destruction of their structures. Changes in the glomeruli and tubules of the cortical substance prevail, which is a predictor of the course of the inflammatory process to the stage of acute purulent pyelonephritis. Analysis of the obtained electron microscopic data on the dynamics of ultrastructural changes in kidney tissue during the simulation of acute pyelonephritis on the background of diabetes mellitus justifies the need for further development of new approaches to complex treatment. Conclusions: 1. Formation of a morphological matrix for the course of acute pyelonephritis in diabetes mellitus, which is characterized by ultrastructural changes in nephrons and renal tissue, which initially develops in the kidneys due to microvascular collapse, tissue hypoxia, critical energy-consuming disorders of its resynthesis, which are associated with diabetic nephropathy and pose a risk for a complicated course of the infectious-inflammatory process. 2. Experimentally established ultrastructural changes in the kidneys demonstrate the need for further development and implementation of comprehensive approaches to treatment tactics.

Cognitive Behavioral Therapy, Hematologic Neoplasms, Child, Mental Health, Randomized Controlled Trial