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У вас в руках свежий номер журнала «Экспериментальная и клиническая гастроэнтерология», посвященный актуальным и нерешенным вопросам в гастроэнтерологии и адресованный широкому кругу врачей разных специальностей. Открывает номер передовая статья в которой описаны оригинальные исследования по проблемам коморбидности у современных пациентов. Так, статья Ткаченко Е. И., Орешко Л. С., Соловьева Е. А., Шабанова А. А., Журавлева М. С. посвящена ассоциации наиболее частых, генетически детерминированных заболеваний: целиакии и дисплазии соединительной ткани В разделе «клиническая гастроэнтерология» представлены: «Роль микробиоты кишечника в развитии ожирения в возрастном аспекте» (авторы М. Ю. Щербакова, А. В. Власова, Т. А. Роживанова), статья продолжает серию публикаций, о роли микробиоты при различных соматических заболеваниях. В актуальном обзоре содержатся сведения о популяционном и видом составе микроорганизмов у пациентов различного возраста, страдающих ожирением, представлен анализ публикаций о механизмах развития метаболического синдрома с учетом вклада кишечника и его значимой составляющей — микробиоты в каскад патологических реакций, приводящих к развитию ожирения. Приводятся данные о результатах комплексного лечения ожирения с включением пробиотиков. Работа Гриценко Т. А., Давыдкина И. Л., Осадчук А. М., Косталановой Ю. В. об особенностях ГЭРБ у пациентов с гемобластозами, получающих полихимиотерапию. Авторы отметили рефрактерность ГЭРБ к терапии ИПП, связанную с нарушениями процессов пролиферации и дифференцировки эпителоцитов на фоне агрессивной полихимиотерапии. Несомненный интерес и клиническую значимость представляет работа Л. П. Розумбаевой, И. В. Козловой, А. П. Быковой о коморбидности патологии печени, билиарного тракта и псориаза. Полученные авторами результаты необходимо учитывать при оценке эффективности и безопасности базисной терапии дерматоза. Ассоциация двух функциональных заболеваний — синдром раздраженного кишечника и функциональная диспепсия с анализом механизмов развития такой коморбидности с позиций нарушений нейрогуморальной регуляции описана в статье М. А. Осадчук, В. О. Бурдиной. Оригинальное исследование А. А. Марковой, Е. И. Кашкиной, Г. Н. Масляковой посвящено иммуногистохимической диагностике нарушений пролиферации кишечного эпителия у пациентов с язвенным колитом в сопоставлении с длительностью заболевания и активностью патологического процесса в кишке. В разделе «Хирургические аспекты гастроэнтерологии» публикуется статья О. И. Кита, Е. М. Франциянц с соавт., посвященная анализу тканевых факторов регуляции неоангиогенеза и фибринолиза при аденокарциноме прямой кишки, имеющих значимую роль в канцерогенезе. В разделе «Экспериментальная гастроэнтерология» — статья Жеребятьева А. С., Камышного А. М. о региональных различиях распределения популяции иммунных клеток в кишечнике, во многом определяющих специфику патологического процесса в эксперименте. В соответствующем разделе номера — две актуальные лекции, посвященные эозинофильному эзофагиту. В последнее десятилетие число публикаций по этой проблеме в зарубежной литературе возросло почти в 200 раз. Объединенными усилиями гастроэнтерологов, аллергологов и патоморфологов созданы международные согласительные и национальные документы, в которых рассмотрены современные клинико-диагностические критерии эозинофильного эзофагита. У российских пациентов разного возраста эозинофильный эзофагит диагностируют редко. Вниманию читателей представлены две взаимно дополняющие лекции «Особенности диагностики эозинофильного эзофагита» (авторы И. С. Садиков, Д. Ш. Мачарадзе, С. Г. Хомерики) и «Эозинофильный эзофагит у взрослых: особенности диетотерапии» (авторы И. В. Козлова, А. Л. Пахомова). Указанные публикации восполняют дефицит сведений по клиническим особенностям, методам диагностики и немедикаментозного лечения этой патологии. Всегда интересна и полезна врачам рубрика журнала «Случаи из практики». В этом номере представлены два клинических наблюдения. Материал Бабаевой А. И. с соавт. посвящен гемангиомам печени у ревматологических пациентов. Обобщая накопленный опыт, авторы трактуют выявленные при УЗИ гемангиомы печени у пациентов с ревматоидным артритом как системное проявление заболевания, отмечая при этом, что при остеоартрозе гемангиомы печени встречаются достоверно реже. В статье А. Ю. Рябовой с соавт. представлен случай острого холецистита под маской острого инфаркта миокарда. Данное клиническое наблюдение еще раз напоминает практикующим врачам, что холецисто-кардиальный синдром, впервые описанный С. П. Боткиным, часто встречается, но не всегда своевременно распознается у полиморбидных пациентов. В разделе «Материалы конференции» опубликованы материалы выездного пленума НОГР «Болезни органов пищеварения в 21 веке: мультидисциплинарный подход. Гастроэнтерология в возрастном аспекте». Пленум организован совместными усилиями научного общества гастроэнтерологов России и Саратовским государственным медицинским университетом им. В. И. Разумовского МЗ РФ. Саратовский государственный медицинский университет им. В. И. Разумовского — один из старейших медицинских вузов нашей страны. Он был основан более 100 лет назад — в 1909 году. За это время СГМУ преодолел огромный путь от единственного в составе университета факультета до солидного учебного заведения со сложившимися традициями, уникальным медицинским потенциалом и накопленным научным опытом. В университете на протяжении многих лет развивается, обогащаясь новыми идеями и результатами клинических наблюдений, научная гастроэнтерологическая школа, которую основали и продолжают развивать известные хирурги, терапевты, педиатры. В разделе история медицины — яркая и интересная статья об образцовой системе здравоохранения, созданной первым наркомом здравоохранения СССР Николаем Александровичем Семашко. В феврале 2015 года исполняется 80 лет со дня рождения профессора кафедры факультетской терапии Тверской государственной медицинской академии, видного ученого, заслуженного врача России, доктора медицинских наук, профессора Вячеслава Васильевича Чернина. От всего сердца Научное общество гастроэнтерологов России, редакция журнала и коллеги поздравляют Вячеслава Васильевича со славным юбилеем, желают здоровья, радости, интересной и плодотворной работы, творческих побед!
Ответственный за выпуск редактор,
заведующая кафедрой терапии педиатрического и стоматологического факультетов ГБОУ ВПО «Саратовский государственный медицинский университет им. В. И. Разумовского» МЗ РФ доктор медицинских наук, профессор |
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И. В. Козлова | |
Keywords:trophology,microbiota,therapeutic infections,the theory of nutrition
Abstract:This paper presents an analytical review of A. Ugolev’s scientific heritage (the theory of adequate nutrition, all-purpose functional blocks, the unity of natural and artificial technologies, the discovery of membrane digestion, new doctrine - trophology) to explain trophological aspects of noospherogenesis. The authors have presented their specific views for the development of these ideas; the theory of therapeutic infections, the holistic theory of nutrition, the endoecological deficiency syndrome, the activation of all-purpose functional blocks, evasion receptors, new principles of treatment with the effects on microbiota, combining the essence of the diseases and their treatment.
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Tkachenko E.T., Sitkin S.I., Oreshko L.S., Medvedeva O.I. TROPHOLOGY ASPECTS OF NOOCPHEROGENESIS. ON THE 90TH ANNIVERSARY OF AM UGOLEV. Experimental and Clinical Gastroenterology Journal. 2016;126(02):04-13
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Keywords:Ugolev AM,membrane digestion,enteral nutrition,parenteral nutrition
Abstract:In the article is considered theoretical and practical significances of discovery of Russian academician A. M. Ugolev in 1959 of intestinal membrane digestion. After this discovery the idea of “digestive-transport conveyor” in the small intestine was formulated. Consequence of this the development and introduction in the clinical practice of enteral nutrition method had become. Today in hospitals are used more 300 different enteral nutrition formulas. Now enteral nutrition are prescribed in different clinical conditions. Parenteral nutrition is used only when the performing of enteral feeding is impossible.
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Khoroshilov I.E. IMPORTANCE OF A. M. UGOLEV’S DISCOVERIES FOR THE ENTERAL AND PARENTERAL NUTRITION DEVELOPMENT. Experimental and Clinical Gastroenterology Journal. 2016;126(02):14-17
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Keywords:Nf-kB,peptic ulcer disease ,disbacteriosis ,transendoskopic treatment ,gastroduodenal zone
Abstract:The purpose of the study. To determine the prognostic significance of the expression of molecules of PCNA, Bcl-2, NF-Kb and tachykinins (substance P, neurokinin A) in patients with gastric ulcer (GU) receiving cytotoxic therapy. Materials and methods. Total surveyed 90 patients divided into 3 equal groups. The first comparison group consisted of patients with chronic atrophic H. pylori-associated gastritis (CAG) (30 pers.). A second control group consisted of patients with gastric ulcer (30 pers.). Third, the study group consisted of 30 people. with GU suffering from hematological malignancies, in a period of complete clinical remission of the disease and receiving supportive polychemotherapy (PCT). Patients underwent endoscopy, morphological and immunohistochemical study of the mucous membrane of the antrum and body of the stomach to detect the expression of molecules of PCNA, Bcl-2, neurokinin A, substance P and factor Nf-Kb. Results. The total level of dyspeptic syndrome on visual scale analogue in patients receiving chemotherapy and GU (GUpct) was significantly higher (p<0.05) compared with patients with GU. It should be noted that patients with GUpct reducing clinical symptoms is much slower (p<0.05). At the same time in 13 (43.3%) patients with GUpct determines the duration of ulcer healing, whereas in patients with GU in only 4 (13.3%) patients. Patients with GUpct more frequently (p <0.05) were verified II and stage III chronic gastritis (CG), while Stage I - less (p <0.05). Patients with GUpct significantly more often (p<0.05) was determined by the II degree of CG and significantly less (p<0,05) - IV degree. Patients with GUpct determined significantly lower (p <0.05), the expression performance PCNA, substance P and neurokinin A and higher (p<0,05) - Bcl-2 and factor Nf-kB. Conclusion. GU in patients receiving chemotherapy, dyspeptic syndrome is characterized by severe, advanced stage of CG on the background of relatively low severity of CG in accordance with the classification of OLGA (2008). Patients with GUpht have a significant level of violation of regeneration changes how is this atrophy, intestinal metaplasia, dysplasia of gastric mucosa association with gross violations of the processes of epithelial cell homeostasis of epithelial cells regulation after molecules PCNA, Bcl-2, NF-kB and tachykinins (substation P, neurokinin A).
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Sazonova O.V., Davydkin I.L., Osadchuk A.M., Gritsenko T.A. CLINICAL AND ENDOSCOPIC, MORPHOLOGIC AND IMMUNOHISTOCHEMICAL FEATURES OF GASTRIC ULCER IN H. PYLORI-INFECTED INDIVIDUALS RECEIVING CYTOTOXIC THERAPY. Experimental and Clinical Gastroenterology Journal. 2016;126(02):18-24
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Keywords:Helicobacter pylori,microbiota,gastritis,peptic ulcer disease,polyposis,gastric cancer
Abstract:The aim of the study was to examine changes in the microbiota gastric an diseases gastroduodenal zone to highlight gender features. We examined patients at esophagogastroduodenoscopy performed biopsies mucous membrane fence with the wall mucus, followed by microscopic, microbiological, histological examination. When polyposis and gastric cancer incidence in women H. pylori was less than that of men. In diseases of the gastroduodenal zone level changes gastric microbiota reflects the morphological condition of the mucous membrane, the gender differences in most cases are not detected. The highest frequency of inoculation and the amount typical for Streptococcus, Staphylococcus epidermidis, H. pylori, Candida spp., Escherichia coli, Lactobacilli. Status microbiota gastroduodenal zone in patients with consider when correcting their treatment.
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Kurusin V.M., Matveeva L.V. GENDER FEATURES CHANGES OF MICROBIOTA GASTRIC AT DISEASES GASTRODUODENAL ZONE. Experimental and Clinical Gastroenterology Journal. 2016;126(02):25-29
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Keywords:Helicobacter pylori,periodontal pocket,Imudon,polymerase chain reaction
Abstract:Introduction. Helicobacter pylori infection is due to the high prevalence in population attracts the clinical interest of researchers in the whole World. It is well known that this microorganism not only resides in the mucosa of the gastrointestinal tract, but is also defined in the periodontal pocket of the oral cavity. The aim of investigation - to evaluate Helicobacter pylori diagnostics in the mouth and prove a method of relief of the inflammatory process by applying immunomodulator Imudon. Results. On the basis of obtained results it was found that the inclusion of topical immunomodulator Imudon in the complex therapy of Helicobacter pylori-associated diseases leads to reduction of inflammatory potential through the decrease of the TNFα, IL-6 activity in saliva and to increase the protective properties of saliva as a result of increased levels of mucin, significantly reduces the frequency of relapses in the one year after therapy. Conclusion. It is practically important to determine the effectiveness of eradication therapy by the study of the contents of the tooth-gingival pocket for the detection of genetic material of Helicobacter pylori, as well as to include in the complex therapy of Helicobacter pylori-associated diseases of the immune modulator Imudon.
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Sarsenbaeva A.S., Smolyagina A.V., Akhmedov V.A. THE CORRECTION OF THE LOCAL IMMUNE RESPONSE AT THE PATIENTS WITH HELICOBACTER PYLORI INFECTION. Experimental and Clinical Gastroenterology Journal. 2016;126(02):30-34
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Keywords:fatty liver disease,postoperative hypothyroidism,steatosis ,protein degeneration ,fibrosis
Abstract:The aim was to investigate the morphological features of the liver in animals at different periods of post-operative hypothyroidism to reproduce the experimental fatty liver disease. Materials and methods: thyroidectomy was performed 20 laboratory rats, females breed nonlinear, thyroid was mobilized without thyroid thyroidectomy to 10 individuals. The morphological pattern of the rat’s liver was studied in terms of 4 and 8 weeks after surgery at the light optical level. Results. 4 weeks after thyroidectomy was found in rat liver protein and fatty degeneration with focal of inflammatory infiltration, against the backdrop of a serous edema. On the 8th week of the experiment observed the progression of degenerative, necroinflammatory processes expressed hydropic dystrophy, atomizing steatosis and the appearance of periportal fibrosis.
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Dzhulay G.S., Shchelochenkov S.V., Petrova M.B., Bibikova A.A. EXPERIMENTAL POSTTERIOIDEKTOMIC FATTY LIVER DISEASE IN RATS. Experimental and Clinical Gastroenterology Journal. 2016;126(02):35-39
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Keywords:psychogenic stress,dysmotility of the gastroduodenal zone,duodenogastric reflux
Abstract:Psychogenic stress in rabbits caused dysmotility of the gastroduodenal zone: inhibition of contractile activity (CA) in antral and pyloric parts of the stomach simultaneously with the increase of CA in proximal and distal parts of duodenum. Stress induced inhibition of the gastric contractile activity is substantially “non-adrenergic non-cholinergic” and only in the initial phase of the reaction it appears to be «α-adrenergic”. The strengthening of CA in the proximal duodenum resulted from the direct exciting action of endocrine stress factor on the smooth muscle of the gut. The strengthening of the CA in the distal duodenum is a result of the endocrine action of catecholamines on stimulating β-adrenergic receptors of enteric cholinergic neurons. Stress induced dyscoordination of the gastroduodenal motility can cause duodenogastric reflux and as a consequence, erosive damage of the gastric mucosa.
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Ovsiannikov V.I., Berezina T.P., Shemerovskii K.A. EMECHANISMS OF GASTRODUODENAL DYSMOTILITY UNDER STRESS. Experimental and Clinical Gastroenterology Journal. 2016;126(02):40-44
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Keywords:activity karbohidrat,ischemia of the small intestine,mo-vidual experiments
Abstract:The purpose of the study. To study the activity of carbohydrase in model ex-perimented on dogs. Material and methods. The research was carried out on 20 adult mongrel dogs of both sexes weighing from 12 before 22 kg and consisted of two series of experiments. The first one was 12 animals with 50% wrap-retirement stenosis of the celiac trunk. In the second series of experiments consisted of 8 animals with 50% compression stenosis of the cranial brizee Noi artery. The activity of amidalas and sucrase were determined to wrap-retirement narrowing of the arteries and through 114-173 after stenosis. Results. In conditions of chronic ischemia of the small intestine revealed as an increase in the activity of one, and unchanged levels of other Carbo-hydras: in biopsies of the mucosa of the proximal small intestine experienced dogs activity of pancreatic alpha-amylase stress-Valas is on average 13 times the original values, the activity of one membrane enzymes - gamma-amylase was increased by 4 times, the activity of another membrane enzyme sucrase remained without changes.
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Khoroshinina L.P. ACTIVITY ACTUAL INTESTINAL ENZYMES OF PANCREATIC ENZYMES AND ISCHEMIA OF THE SMALL INTESTINE (EXPERIMENTAL STUDY). Experimental and Clinical Gastroenterology Journal. 2016;126(02):45-47
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Keywords:The pancreas,secretion,adaptation,enzymes,secreted-transported modules
Abstract:Aim of review. Statement of modern traditional and original view on essence and mechanisms of postprandial adaptation of pancreatic enzymes secretion is presented. Main points. The exosecretion of synthesized de novo and recreted pancreatic enzymes is adapted to nutrient content of the meal by means of duodenal-pancreatic stimulated and inhibition peptidergic mechanisms, generalized and selected-induced enzyme-substrate complexes of duodenal chyme. The managed module secreted-transported pancreatic system is important as a normal criterion in urgent adaptation.
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Korot’ko G.F. POSTPRANDIAL ADAPTATION OF PANCREATIC SECRETION. Experimental and Clinical Gastroenterology Journal. 2016;126(02):48-55
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Keywords:dyspepsia,discomfort,tone,stress,mechanoreceptors,prokinetic,antidepressants
Abstract:This review elucidates the data on etiology and pathogenesis of functional (unulcerous) dyspepsia, clinical features, diagnostic, therapeutic and prophylactic approaches to this pathology.
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Skvortsov V.V., Potapova M.V., Skvortsov K.Yu., Fedorova O.F. MODERN PROBLEMS OF DIAGNOSTICS AND TREATMENT OF FUNCTIONAL (UNULCEROUS) DYSPEPSIA. Experimental and Clinical Gastroenterology Journal. 2016;126(02):56-63
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Abstract:The review examined modern condition of development directions physiology of digestion, like structure and function of the intestinal barrier, the microbiota of the digestive tract in its relations with the microorganism.
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Mar’yanovich A.T. THE INTESTINAL BARRIER, THE MICROBIOTA, MICROBIOME. Experimental and Clinical Gastroenterology Journal. 2016;126(02):64-69
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Abstract:Article (literature review) is devoted to the actual problem of osteopenia and osteoporosis in children with Crohn’s disease and ulcerative colitis
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Gabrusskaya T.V. THE DEFEAT OF BONE TISSUE IN CHILDREN WITH INFLAMMATORY BOWEL DISEASES. Experimental and Clinical Gastroenterology Journal. 2016;126(02):70-78
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Keywords:Helicobacter pylori,mucosal microflora,normomicrobiocenosis,oesophagogastroduodenal zone,peptic ulcer,chronic gastritis,oesophagitis,disbacteriosis
Abstract:Aim. Determine the qualitative and quantitative composition of the mucosal microflora of oesophagogastroduodenal zone to determine the location of Helicobacter pylori and its place in normomicrobiocenosis and dysbacteriosis in cases of peptic ulcer, chronic gastritis and oesophagitis. Materials and methods. Clinical and microbiological studies were conducted in 50 healthy individuals-volunteers, 130 patients with peptic ulcer, 36 - chronic gastritis and 24 - chronic esophagitis. Results of the study. Helicobacter pylori in 33% of cases included in normomicrobiocenosis of mucosal microflora oesophagogastroduodenal zone, which consists of 12 genera of microorganisms and carries out all protection functions. The recurrence of peptic ulcer disease, exacerbation of chronic active gastritis and oesophagitis are accompanied by a dysbacteriosis of mucosal microflora with overgrowth of typical and atypical microorganisms for normal biotope with reduced occurrence of Helicobacter pylori. Conclusion. Helicobacter pylori in the biocenosis of mucosal microflora of oesophagogastroduodenal zone is not an infection, has no independent significance in the development of peptic ulcer, chronic gastritis and esophagitis, does not require eradication.
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Chernin V.V., Chervinets V.M., Bazlov S.N. THE ROLE OF HELICOBACTER PYLORI IN NORMOMICROBIOCENOSIS AND DYSBACTERIOSIS OF MUCOSAL MICROFLORA OF OESOPHAGOGASTRODUODENAL ZONE IN THE CASES OF PEPTIC ULCER, CHRONIC GASTRITIS AND OESOPHAGITIS. Experimental and Clinical Gastroenterology Journal. 2016;126(02):79-86
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Abstract:Aim. Find out the condition of mucosal microflora in gastroduodenal ulcer patients in different phases of its recurrence, to determine changes in the value of dysbiotic changes in ulcerogenesis, develop and confirm new transendoscopic treatment of gastroduodenal ulcers. Materials and methods. The study included 134 patients and 10 healthy volunteers Results At relapse of peptic ulcer and distant from the ulcer areas of the mucosa were allocated to 28 genera and species of microorganisms with a wide range of enzymatic activity and cytotoxicity, that corresponds to the 2-3 degree dysbacteriosis and shows microbiological parameters infected wound which required sanation. Conclusion. Application for transendoscopic sanation of gastroduodenal ulcers of new compounds iodine-lysozyme, dimexide-iodine-lysozyme and chitosan with bactericidal and sorption effects, can significantly reduce the time of ulcer healing and restore normobiocenosis of mucosal microflora of the gastroduodenal zone.
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Bazlov S.N., Chernin V.V. NEW ASPECTS OF TRANSENDOSCOPIC TREATMENT OF PEPTIC ULCER ASSOCIATED WITH DYSBACTERIOSIS OF GASTRODUODENAL ZONE. Experimental and Clinical Gastroenterology Journal. 2016;126(02):87-91
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