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    1. Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091, Novosibirsk, Russia)

    Keywords: CA-125, heart failure, ascites

    Abstract:Purpose of the study . Assessment of the oncogene CA-125 as a laboratory parameter having non-gynecological genesis on the example of two clinical observations. Materials and methods . A literature review on the clinical signifi cance of the CA-125 oncogene and a description of two clinical observations Results . Oncogene CA-125 is considered as a laboratory indicator of gynecological oncology. The article presents the re- sults of studies of elevated levels of CA-125 in patients wi thout gynecological diseases. The authors give two observations of patients with anasarca and ascites and elevated level of CA-125. Сonclusion . The clinical observations presented by us indicate a vari ety of non-gynecological causes of an increase in the level of the oncoprotein CA-125.

      1. Lee M., Chang M. Y., Yoo H. et al. Clinical Signifi cance of CA125 Level aft er the First Cycle of Chemotherapy on Survival of Patients with Advanced Ovarian Cancer. Yonsei Med J. 2016, vol. 57, no. 3, pp. 580–587.
      2. Mc Lemore M. R., Miaskowski C., Lee K. et al. Diff erences in the Molecular Species of CA125 Across the Phases of the Menstrual Cycle. Biol Res Nurs, 2016, vol. 18, no. 1, pp. 23–30.
      3. Runyon B. A. AASLD Introduction to the revised Amer- ican Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012. Hepatology, 2013, vol. 57, no. 4, pp. 1651–1653.
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      8. Kim E.S., Park K. U., Song J. et al. Th e clinical signifi cance of CA-125 in pulmonary tuberculosis. Tuberculosis (Ed- inb), 2013, vol. 93, no. 2, pp. 222–226.
      9. Basaran A., Zafer T. S. Ascites is the primary cause of cancer antigen-125 (CA-125) elevation in systemic lupus erythematosus (SLE) patients with nephrotic syndrome. Med Hypotheses, 2007, vol. 68, no. 1, pp. 197–201.
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      12. Yilmaz H., Gurel O. M., Celik H. T. et al. CA 125 levels and left ventricular function in patients with end-stage renal disease on maintenance hemodialysis. Ren Fail, 2014, vol. 36, no. 2, pp. 210–216.
      13. Lockhart C.J., Mc Veigh G. E., Harbinson M. T. Elevated CA 125 and ascites: not always malignancy. Ir J Med Sci, 2008, vol. 177, no. 1, pp. 63–66.
      14. Núñez J., Rabinovich G. A., Sandino J. et al. Prognostic value of the interaction between galectin-3 and antigen carbohydrate 125 in acute heart failure. PLoS One, 2015, vol. 10, no. 4, pp. e0122360.
      15. Kaya H., Kurt R., Beton O. et al. Cancer Antigen 125 is As- s o c i ate d w it h L eng t h of St ay i n Pat ient s w it h Ac ute He a r t Failure. Tex Heart Inst J, 2017, vol. 44, no. 1, pp. 22–28.
      16. Becerra-Muñoz V.M., Sobrino-Márquez J.M., Ran- gel-Sousa D. et al. Long-term prognostic role of CA-125 in noncongestive patients undergoing a cardiac trans- plantation. Biomark Med, 2017, vol. 1 no. 3, pp. 239–243.
      17. Kaya H., Zorlu A., Yucel H. et al. Higher cancer antigen 125 level is associated with the presence of permanent atrial fi brillation in systolic heart failure patients. Acta Cardiol, 2016, vol. 71, no. 1, pp. 61–66.
      18. Sekiguchi H., Shimamoto K., Takano M. et al. Cancer antigen-125 plasma level as a biomarker of new-onset atrial fi br i l l at ion i n p o s t menopau s a l women . He a r t , 2 017, vol. 103, no. 17, pp. 1368–1373.

    Full text is published :
    Osipenko M. F., Zhuk E. A., Sokolova T. M., Makarov K. Yu., Drobysheva V. P. Increased level of oncogene CA-125 in the practi ce of a general practitioner. . Experimental and Clinical Gastroenterology Journal. 2018;155(07):09-13
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    1. Irkutsk State Medical University (Irkutsk, Russia)
    2. Kazan State Medical Academy — Branch Campus of the Federal State Budgetary Educational In stitution of Further Professional Education “Russian Medical Academy of Continuing Professional Education» of the Ministry of Healthcare of the Russian Federation (Kazan, Russia)

    Keywords: GERD, young age, night refl ux, obesity, adiponectin

    Abstract:Aims : to investigate the eff ect of acidic night refl ux and seru m adiponectin level on the development of gastroesophageal refl ux disease (GERD) among young patients. Objectives : to compare the clinical manifestatio ns of GERD, the pH-metry data the frequency of pathological nocturnal acid refl ux and serum adiponectin level in young people with normal and overweight. Materials and methods : the study included 62 patients with GERD at the age from 21–44 years. The study group (SG) included 31 patients with a BMI of> 25 kg / m 2 and the group of clinical comparison (CCG) included 31 patients with GERD with a BMI

      1. Mitchell DR 1 , Derakhshan MH 1 , Wirz AA 1 , Ballantyne SA 2 , McColl KEL 3 . Abdominal Compression by Waist Belt Aggravates Gastroesophageal Refl ux, Primarily by Impairing Esophageal Clearance. Gastroenterolog, 2017, vol. 152, no8, pp. 1881–1888.
      2. Khan A, et al. Impact of obesity treatment on gastro- esophageal refl ux disease.World J Gastroenterol, 2016, vol. 22, no 4, pp. 1627–1638.
      3. Lee S.W., et al. Impact of Obesity on a Chinese Popula- tion with Erosive Esophagitis and Barrett’s Esophagus. Guta ndLiver, 2016, vol 12 , pp. 167–169.
      4. Zvenigorodskaya L. A., Homeriki S. G., Bondarenko E.YU. GERD in obesity: clinical, functional and morpholog- ical features, approaches to therapy. Vestnik semejnoj mediciny. 2014, no. 3, pp. 15–17.
      5. Bordin D. S., Kolbasnikov S. V., Kononova A. G. GERD: t y pic a l problems of t herapy a nd ways to overcome t hem. Doktor.Ru. Gastroehnterologiya. 2016, no. 1, pp. 14–18.
      6. SubramanianСh.R, Triadafi lopoulosG. Refractory gas- troesophageal refl ux disease. Gastroenterol Rep. 2015, vol.3, no1, pp. 41–53.
      7. JonassonC., WernerssonB., Hoff D. A., Hatlebakk J. G. Validation of the GerdQ questionnaire for the diagnosis of gastroеsophageal refl ux disease. Aliment Pharmacol Th er. 2013, vol. 37, no5, pp. 564–572.
      8. Joseph Mermelstein, Alanna Chait Mermelstein, Maxwell M Chait. Proton pump inhibitor-refractory gastroesoph- ageal refl ux disease: challenges and solutions. Clin Exp Gastroenterol. 2018, no 11, pp. 119–134.
      9. Evsyutina YU.V., Truhmanov A. S. Insuffi cient response to proton pump inhibitor therapy: causes and manage- ment of patients. Tera-pevticheskij arhiv. 2015, vol. 87, no. 2, pp. 85–89.
      10. Halland M, Katzka D. and Iyer P. G. Recent develop- ments in pathogenesis, diagnosis and therapy of Barrett’s esophagus. World J Gastroenterol. 2015, vol. 21, no 21, pp. 6479–6490.
      11. Elias PS 1 , Castell DO 2 . Th e Role of Acid Suppression in Barrett’s Esophagus. Am J Med. 2017, vol. 130, no 5, pp. 525–529.
      12. Ts u k a n o v V. V. Frequency and clinical aspects extrae- sophageal syndromes in patients with gastroesophageal refl ux disease elderly. Ter arhiv. 2016, vol. 88, no. 2, pp. 28–32.
      13. Rydén A. et al. Night-time symptoms and their impact on s le e p i n pat ient s w it h ga s t ro e s oph a ge a l re fl ux disease who have a partial response to proton pump inhibitors: a qualitative patient interview study. Patient. 2013, vol. 6, no 4, pp. 307–314.

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    Kozlova N. M., Kalinovskay I. Yu., Sayfutdinov R. G., Ryzhkova O. V., Fedorova S. O. Role of night refl uxes and serum adipone ctin level in develop- ment of the gastroesophageal refl ux disease in young patients with overweight. Experimental and Clinical Gastroenterology Journal. 2018;155(07):14-19
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    1. Research Institute of Internal and Preventive Medicine — Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Medical Sciences (630089, Novosibirsk, Russia)
    2. Vector-Best (Novosibirsk, Russia)
    3. Federal State Budget Educational Institution of Higher Education «Novosibirsk State Medical University» of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091, Novosibirsk, Russia)

    Keywords: Helicobacter pylori, CagA antigen, population, prevalence.

    Abstract:Aim . To study 20-year trends in the prevalence of antibodies to Helicobacter pylori and CagA antigen in the Novosibirsk population. Methods. Within the framework of population-bas ed studies over 1994–2015 random representative samples of adolescents and adults aged 25–69 years of both sexes in cluding 1,438 citizens (754 adults and 684 schoolchildren) were studied. Results. In adults, the infection rates of Helicobacter pylori did not change signifi cantly. In adolescents, the prevalence slightly decreased, but the dynamics of decline we re much less pronounced than in Eastern and, especially, Western Europe. Cytotoxic strains (CagA) were identifi ed approximately at the same frequency during this time. Conclusion. Interventions are needed to improve the sanitary and hygienic control of the quality of food and water.

      1. Daugule I., Karklina D., Rudzite D. et al. Prevalence of Helicobacter pylori infection among preschool children in Latvia: no signifi cant decrease in prevalence during a ten year period. Scand J Public Health, 2016, vol. 44, no 4, pp. 418–22.
      2. Roberts S.E., Morrison-Rees S., Samuel D. G. et al. Re- view article: the prevalence of Helicobacter pylori and the incidence of gastric cancer across Europe. Aliment Pharmacol Th er , 2016, vol. 43, no 3, pp. 334–345.
      3. Go M. F. Review article: natural history and epidemiol- ogy of Helicobacter pylori infection. Aliment Pharmacol Th er, 2002, vol. 16, suppl. 1, pp. 3–15.
      4. Bui D., Brown H. E., Harris R. B., Oren E. Serologic evi- dence for fecal-oral transmission of Helicobacter pylori . Am J Trop Med Hyg , 2016, vol. 94, no. 1, pp. 82–88.
      5. Tkachenko M.A., Zhannat N. Z., Erman L. V. et al. Dra- matic changes in the prevalence of Helicobacter pylori infection during childhood: a 10-year follow-up study in Russia. J Pediatr Gastroenterol Nutr , 2007, vol. 45, no. 4, pp. 428–432.
      6. Hatakeyama M. Helicobacter pylori and gastric carcino- genesis. J Gastroenterol , 2009, vol. 44, no. 4, pp. 239–248
      7. Tsukanov V.V., Butorin N. N., Maady A. S. et al. Helico- bacter pylori infection, intestinal metaplasia, and gastric cancer risk in Eastern Siberia. Helicobacter , 2011, vol. 16, no 2, pp. 107–112.
      8. Oona M., Utt M., Nilsson I. et al. Helicobacter pylori in- fe c t ion i n c h i ld ren i n E s ton i a : de c re a si ng s eropre v a lenc e during the 11-year period of profound socioeconomic changes. Helicobacter , 2004, vol. 9, no. 3, pp. 233–241.
      9. Bauer S., Krumbiegel P., Richter M. et al. Infl uence of sociodemographic factors on Helicobacter pylori preva- lence variability among schoolchildren in Leipzig, Ger- many. A long-term follow-up study. Cent Eur J Public Health , 2011, vol. 19, no. 1, pp. 42–45.
      10. Reshetnikov O. V., Kurilovich S. A., Krotov S. A., Kroto- va V. A. Helicobacter pylori infection in Siberian pop- ulations. Th e Siberian Scientifi c Medical Journal 2010, vol. 30, Сибирский научный медицинский журнал, 2010, no. 2, pp. 88–93.
      11. Meier H.C., Haan M. N., Mendes de Leon C. F. et al. Early life socioeconomic position and immune response to persistent infections among elderly Latinos. Soc Sci Med , 2016, vol. 166, pp. 77–85.
      12. Porras C., Nodora J., Sexton R. et al. Epidemiology of Helicobacter pylori infection in six Latin American coun- tries (SWOG Trial S0701). Cancer Causes Control , 2013, vol. 24, no. 2, pp. 209–215.
      13. Reshetnikov O. V., Kurilovich S. A., Malyutina S. K. et. al. Prevalence of CagA-producing Helicobacter pylori strains in families. Journal of Microbiology. 2004, no. 6, pp. 97–99.
      14. Schwarz S., Morelli G., Kusecek B. et al. Horizontal ver su s f a m i l i a l t r a n sm i s sion of Helicobacter pylori . PLoS Pathog , 2008, vol. 4, no. 10, e1000180.
      15. Ranjbar R., Khamesipour F., Jonaidi-Jafari N., Rahimi E. Helicobacter pylori in bottled mineral water: geno- typing and antimicrobial resistance properties. BMC Microbiol , 2016, vol. 16, pp. 40.
      16. Saeidi E., Sheikhshahrokh A. vacA genotype status of Helicobacter pylori isolated from foods with animal origin. Biomed Res Int , 2016, 2016, 8701067.
      17. Breckan R.K., Paulssen E. J., Asfeldt A. M. et al. Th e all-age prevalence of Helicobacter pylori infection and potential transmission routes. a population-based study. Helicobacter , 2016, vol. 21, no. 6, pp. 586–595.

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    Reshetnikov O. V., Krotov S. A., Kurilovich S. A., Denisova D. V., Malyutina S. K. Prevalence of Helicobacter pylori in population-based studies in Novosibirsk (1994–2015) Experimental and Clinical Gastroenterology. 2018;155(07):20-24
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    1. Omsk State Medical University (Omsk, Russia)
    2. Immanuel Kant Baltic Federal University (Kaliningrad, Russia)
    3. Federal state budgetary institution “National Medical and Surgical Center named after N. I. Pirogov” of the Ministry of Healthc are of the Russian Federation (Moscow, Russian Federation)

    Keywords: diet, food behavior, inhibitors of vitamin-K-epoxide reductase, readiness for modifi cation, commitment

    Abstract:The objective of this study was to determine whether feeding behavior and compliance with its modifi cation are diff erent between healthy respondents and those taking or potentially requiring of inhibitors of vitamin-K-epoxide reductase, con- sidering the geographical specifi city of diet. Material and methods . In open multicenter studies 196 respondents’ (88 men, 108 women) food preferences were assessed using questionnaires by NA Nikolaev (2015). Quantitati ve evaluation of compliance with lifestyle modifi cation was studied with questionnaire. Results . There were no signifi cant diff erences in consuming food either increasing (37,0 ± 19,5 points against 37,3 ± 17,98 points; Wald-Wolfowitz (Z), p = 0.16) or decreasing (62,2 ± 26,3 points against 63,4 ± 23,8 points; Wald-Wolfowitz (Z), p = 0.95) the effi ciency of inhibitors of vitamin-K-epoxide reductas e between the studied categories of respondents. The absence of diff erences persisted considering the geographical specifi city of diet (104,9 ± 45,6 points vs. 100,7 ± 43,9 points; Wald-Wolfowitz (Z), p = 0.78). There was no connection betwee n compliance with lifestyle modi fi cation and the actual diet modifi cation in patients taking inhibitors of vitamin-K-epoxide reductase. Conclusions . Doctors’ recommendations of modifying feeding behavior are shown to be ineff ective for patients taking inhibitors of vitamin-K-epoxide reductase. This may be an in dependent risk factor for complications either of proper treatment with these drugs or of underlying disease. Further clinical studies of patients’ compliance with feeding behavior modifi cation are required.

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      3. Huang M., Rigby A. C., Morelli X., et al. 2003. Structural basis of membrane binding by Gla domains of vitamin K-dependent proteins // Nat. Struct. Biol., 9: 751–758.
      4. Mohamed N. Al-Arifi ,Syed Wajid,Nawaf K. Al-Manie,- Faisal M. Al-Saker,Salmeen D. Babelgaith,Yousif A. Asiri, Ibrahim Sales . Evaluation of knowledge of Health care professionals on warfarin interactions with drug and herb medicinal in Central Saudi Arabia. Pak J Med Sci. 2016 Jan-Feb; 32(1): 229–233.
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    Skirdenko Yu.P., Nikolayev N. A., Livzan M. A., Krajcer A. P., Vasil’eva E.O., Zemljanov A. V., Orudzhova L. A. K., Ul’bashev D. S. Compelled feeding behavior: are patients ready to follow our recommendations? Experimental and Clinical Gastroenterology. 2018;155(7): 25–29.
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    1. Federal State Budget Educational Institution of Higher Education «Novosibirsk State Medical University» of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (Novosibirsk, Russia)

    Keywords: cholelithiasis, postcholecystectomy syndrome, gastrointestinal symptoms after surgical treatment of gallstone disease

    Abstract:Study of the conducted studies with the participation of ch ildren and adolescents during the 10-year observation of patients with cholelithiasis (CL). Materials and methods : The work is a fragment of a 10-year follow-up of patients with CL. Two groups were formed: the 1st group (1) (n = 113) patients with cholecystectomy who underwent cholecystectomy (CE) and were prospectively observed for 10 years; 2-nd- (2) (n = 92) — unoperated patients with SCI, a prescription of at least 10 years, the symptoms of which were retrospectively analyzed. Results : Heartburn frequency for the 10-year period increased in the 1st group by 47.8%, in the group (2) by 22.8% (p = 0.005). In the group (1), with the initially symptomatic course, the maximum increased — by 66.3% (p <0.001) and by 45.8% with the initially asymptomatic fl ow (p = 0. 001). In the group (2), in patients with initially asymptomatic course increased by 40% (p = 0.003). The symptom of «bitterness in the mouth» began to be detected more often in the fi rst group by 22.1% (p <0.001), almost independently of the or iginal version of the fl ow. The frequency of the symptom of «fatty food intoler- ance» (NFI) increased in the 2 nd group by 15.2% (p = 0.006), mainly due to the grou p with the initially symptomatic course. The frequency of diarrhea in the 1st group increased by 37.3% (p = 0.046), especially signifi cant in the group with baseline asymptomatic course 33.3% (p = 0.005).The frequency of consti pation increased in the 1st group by 25.6% (p <0.001), pre- dominantly in the symptomatic group with a 27% decrease ( p <0.001).The incidence of bitter mouth symptoms, diarrhea, constipation in group (2) has changed statistically insignifi cantly. Conclusions : During the 10-year follow-up of patients with CL, the frequency of symptoms increased, especially signifi - cantly: heartburn, bitterness in the mouth, diarrhea, constipation in patients after CE. Symptoms of heartburn and constipa- tion began to occur more often in groups with the initially symptomatic course. The symptom of NFI began to be detected more often in the group of unoperated patients with CL.

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    Full text is published :
    Makarova Y. V., Osipenko M. F., Litvinova N. V., Voloshina N. B. Gastrointestinal symptoms in patients with gilt-patient dise ase in the dynamics of 10-year observation. Experimental and Clinical Gastroenterology. 2018;155(7): 30–36.
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    1. Federal State Budget Educational Institution of Higher Education «Novosibirsk State Medical University» of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091, Novosibirsk, Russia)
    2. The State Budget Health Institution of the Novosibirsk Region “City Clinical Hospital No. 1, Novosibirsk” (Novosibirsk, Russia)
    3. Сytokines laboratory of Vector-Best (Novosibirsk Region, Russia)
    4. Institute of Molecular Biology and Biophysics — subdivision of FRC FTM (IMBB FRC FTM) (Novosibirsk, Russia)

    Keywords: Cytokines of blood serum, excretory profi le of porphyrin metabolism, non-alcoholic fatty liver disease

    Abstract:Purpose of the study . The study of the cytokine spectrum of blood seru m and its relationship with the index of porphyrin metabolism. Materials and methods . 84 patients (22 women and 62 men) aged from 26 to 69 years (mean age 49.6 ± 1.3 years) were examined. The cytokine spectrum of TNF-α, IL-1β, IL-1Ra, IL -6, IL-8, IL-10 and excretory porphyrins: δ-aminolevulinic acid, porphobilinogen, uroporphyrin, and coproporphyrin were determined by special methods. Results . In 59 people (70.2%), elevated concentrations of cyto kines in the serum were recorded. The deviations from the control values for IL-1Ra (39 people, 66.1%) and IL-6 (45 pe rsons, 76.3%) were recorded more often. Violations in the exchange of porphyrins were found in 58 patients (69.0%). On the totality of the disturbances, biochemical syndromes have been identifi ed: an increase in porphyrin precursors, uroporphyrinuria, coproporphyrinuria, urocoppororphyrinuria, combined disorders. A direct correlation was established between IL-6 (r = +0.409), IL-1Ra (r = + 0.478), IL-10 (r = + 0.456) with uroporphyrin fraction, as well as IL-1Ra and δ-pminolevulinic acid (r = + 0.501). The increase in porphyrin precursors and fractions is signifi cantly more often detected with violatio ns of the cytokine spectrum (χ2 = 5.6, at the critical value p = 3.8, p <0.05). Conclusion . Violations of the cytokine spectrum and porphyrin me tabolism are recorded in most patients with NAFLD. The reason for their occurrence at the moment rema ins unclear, which requir es additional research.

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    Krivosheev A. B., Autenshlyus A. I., Boyko K. Yu., Mikhailova E. S., Ryzhikova S. L., Druzhinina Yu.G., Коndratovа M. A. The cytokine and porphy- rine spectrums in patients with non-alcoholic fatty lever disease. Experimental and Clinical Gastroenterology. 2018;155(7): 37– 42.
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    1. Federal State Educational Institution of Higher Education “Omsk State Medical University”, the Ministry of Health of the Russia n Federation (Omsk, Russia)

    Keywords: non-alcoholic fatty liver disease, fi brosis, prognosis

    Abstract:Objective : To increase the eff ectiveness of prediction and diagnosis of fi brosis in patients with non-alcoholic fatty liver disease. Materials and Methods : We conducted an open-type case-control study involving 149 patients with NAFLD and a diff erent stage of fi brosis determined with elastometry and hi stological examination of the liver biopsy specimen (group 1 — without signs of liver fi brosis (n = 40), group 2 — fi brosis 1 (n = 43), group 3–2 (n = 34) and group 4–3 stages (n = 32)). General clinical and laboratory methods of examination were co nducted. In addition, noninvasive markers of fi brosis in the blood serum were studied: the concentration of insulin, leptin, adiponectin, matrix metalloproteinase-9 (MMP-9) and its inhibitors — tissue inhibitor of matrix metalloproteinase-1 and 2 (TIMP-1, TIMP-2). The polymorphism PNPLA3 148M / I (rs738409) was studied by the PCR method as a potential marker of the progression of liver fi brosis in NAFLD. Results : We identifi ed clinical and laboratory signs demonstratin g informativeness in the form ation of progressive stages of fi brosis. It was studied that patients with NAFLD have hy perleptiemia and hyperinsulinemia. Evaluation of various types of leptinresistance allows to diff erentiate patients of high ri sk group for the progression of fi brosis. The nature of fat tiss ue distribution (abdominal obesity) is a highly informative criter ia of high-stage liver fi brosis. Polymorphism of the PNPLA3 gene 148M/I has prognostic signifi cance in the formation and progression of liver fi brosis in patients with NAFLD. The level of leptin, its soluble receptor in the serum, the bioche mical activity of the disease (N ASH), the waist are clinical and laboratory markers for the format ion and progression of liver fi br osis in patients with NAFLD. This markers were included in the mathematical model. Conclusion : Complex quantitative analysis of clinical, instrumental and laboratory indicators allows predicting the forma- tion and progression of liver fi brosis in individuals with non-alcoholic fatty disease.

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    Krolevets T. S., Livzan M. A. Clinical and laboratory markers for predicting liver fi brosis in individuals with non-alcoholic fatty liver disease. Experimental and Clinical Gastroenterology. 2018;155(7): 43–51.
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    1. Federal state budget educational institution of higher education “Chuvash State University n. a. I. N. Ulyanov” (Cheboksary, Russia)
    2. Federal state budget educational institution of higher education “Omsk State Medical University” of the Ministry of Healthcare of the Russia (Omsk, Russia)
    3. Surgut State University (628412, Tyumen region, Surgut, Russia)

    Keywords: Elastometry, shear wave elastography, non-alcoholic fatt y liver disease, alcoholic liver disease, non-invasive diagnostic methods

    Abstract:Diffi culties are known in the process of diff erential diagnosis between non-alcoholic fatty liver disease (NAFLD) and alco- holic liver disease (ALD), since the data of the main objective, laboratory and instrumental methods give similar results, not allowing to reliably speak about the etiology of the process. The most sensitive, specifi c, accurate, minimally invasive and accessible method for diagnosing chronic diff use liver diseases is the combined use of transient elastometry and shear wave elastography. The scientifi c novelty of the proposed work is the applicat ion of combined use of transient elastometry and shear wave elastography as a method of comparative evaluation of ALD (under conditions of abstinence more than 1 month) and NAFLD. The primary importance of abstinence in ALD therapy has been confi rmed. The aim of the study was to make a comparative evaluation of elastometric parameters of liver stiff ness in patients with NAFLD and in ALD under abstinence conditions. Materials and methods . The control group included 30 practically healthy persons with a body mass index (BMI) from 20–30 kg / m2, without pathological changes according to th e general, biochemical blood tests, when evaluating the echostructure of the abdominal cavity according to ultrasound , without any diseases of the liver and other organs in the history, voluntarily agreed to the study (group N). Two equal subgroups of subjects were included in the experimental group: 1. 30 patients with non-alcoholic fatty liver disease (F1), 60% of whom had a BMI> 25 kg / m2 and 40%

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    Diomidova V. N., Tarasova L. V., Trukhan D. I., Tsyganova Yu. V. Comparative evaluation of elastometric indices of liver hard ness in alcoholic and non-alcoholic liver diseases. Experimental and Clinical Gastroenterology. 2018;155(7): 52–56.
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    1. Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091,Novosibirsk, Russia)

    Keywords: E Infl ammatory bowel diseases, steatohepatosis, body mass index, platelets

    Abstract:Purpose . To identify the factors associated with nonalcoholic steatohepatosis/steatohepatitis in patients with ulcerative colitis (UC) and Crohn’s disease (CD). Materials and methods . The study involved 47 patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) aged 24 to 64 years. The diagnosis of steatohepatosis/steatohepatitis was estimated according to the data of ultrasound diagnos- tic of liver. The study did not include alcohol abusers, as well as patients with viral and autoimmune hepatitis.Results . Patients with CD had a reliable association between plat elet count and the presence of nonalcoholic steatohepato- sis/steatohepatitis (median platelet count 287 × 10 9 /L, [192 × 10 9 /L; 420 × 10 9 /L] in patients with nonalcoholic steatohepatosis/ steatohepatitis and 250 × 10 9 /L, [180 × 10 9 /L; 379 × 10 9 /L] in patients without nonalcoholic steatohepatosis/steatohepatitis, p = 0.01). There were no signifi cant diff erences in the body ma ss index (BMI) and age between the groups with nonalcoholic steatohepatosis/steatohepatitis and without nonalcoholic stea tohepatosis/steatohepatitis among the patients with CD. Be- tween patients in the UC group with and without nonalcoholic steatohepatosis/steatohepatitis, signifi cant diff erences were found in the BMI (median BMI 28,7 kg/m 2 [26,2 kg/m2; 32,7 kg/m 2 ] and 20,9 kg/m 2 [18,4 kg/m 2 ; 22,7 kg/m 2 ], respectively, p=0.03), mean hospitalization rates (1,53 hospitalizations/year, [0,1 hospitalizations/year; 2,92 hospitalizations/year] and 0,83 hospitalizations/year, [0,36 hospitalizations/year; 1,46 hospitalizations/year] respecti vely, p=0,025) and age (median age 55,3 years [48 years; 62 years], and 30.4 years, [25 years; 35 years], respectively, р = 0,001). Conclusion . In patients with a CD factor associated with nonalcoholic steatohepatosis/steatohepatitis is the platelet count. In the case of the UC, steatohepatosis is associated with a high rate of hospitalization, BMI, and age.

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    Krasner Ya. A., Osipenko M. F. Factors, associated with nonalcoholic steatohepatosis in patients with infl ammatory bowel dise ases. Experimen- tal and Clinical Gastroenterology. 2018;155(7): 57–61.
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    1. Pavlov First Saint Petersburg State Medical University (St. Petersburg, Russia)
    2. SPb GBUZ City Clinical Hospital No 31 (St. Petersburg, Russia)

    Keywords: ulcerative colitis, treatment algorithm, budesonide-MMX

    Abstract:The article outlines the basic principles of treatment of mi ld-to-moderate ulcerative colitis, according to Russian and international recommendations. Approaches to the treatment of ulcerative coliti s resistant to mesalamine therapy are considered. A review of clinical trials for the evaluation of the eff ectiveness of topical steroids is presented. The algorithm of patient selection for budesonide multimatrix treatment is proposed.

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    Full text is published :
    Shchukina O. B., Kharitonov A. G. Budesonide MMX (cortiment) in treatment algorithm for mild-to-moderate ulcerative colitis. Experimental and Clinical Gastroenterology. 2018;155(7): 62–66. .
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    1. Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091, Novosibirsk, Russia)
    2. Institute of Chemical Biology and Fundamental Medicine of the SB RAS (Novosibirsk, Russia)
    3. City Infectious Clinical Hospital No.1 (Novosibirsk, Russia)
    4. State Research Center of Virology and Biotechnology Vector (Koltsovo, Novosibirsk Oblast, Russia)

    Keywords: acute gastroenteritis, astroviruses, noroviruses, rotaviruses, clinical and epidemiological characteristics, poly- merase chain reaction, genotyping

    Abstract:Objectives of the study : determination of clinical and epidemiological featur es of astrovirus infection in adult residents of Novosibirsk hospitalized with acute gastroenteritis (AGE), and genetic characteristics of the identifi ed isolates of astrovirus . Materials and methods : 1469 patients aged 15 to 91 years, hospitalized with a diagnosis of AGE in the period from January 2016 to February 2018 were examined. Along with the genera lly accepted methods of diagnosis, feces were examined by PCR for the presence of astroviruses, rotaviru ses o and noroviruses of the second genogroup. Results : Viral etiology of AGE was established in 311(21.2%) people. Astrovirus infection was diagnosed in 27 (1.8%), inferior in frequency to noroviruses (13.5%) and rotaviruses (5.7%). Astroviruses were detected throughout the year, mostly in patients under the age of 30 (88.9%). Half of the cases of astrovirus AGE (48.1%) showed consumption of seafood on the eve disease. Astrovirus AGE proceeded in a moderate form, characterized by fever from the fi rst day of the disease, in most patients with subfebrile (92.6%). In 81.4% of patients, watery diarrhea was observed, in the remaining 18.6% of patients the disease proceeded in the form of acute gastritis. Signifi cant diff erences of clinical sympto ms, indicators of a haemogram and coprogram in patients with astroviruses AGE from other vi ral OGE are not installed. Astroviruses of three genotypes, HAstV-4 (48%), HAstV-1 (44.5%) and HAstV-8 (7.5%) were circ ulating during the observation period. In 2016, HAstV-4 was dominant, and then HAstV-1 became dominant by the end of 2017. In two patients for the fi rst time in Novosibirsk, HAstV-8 was determined. Conclusion : The absence of specifi c manifestations of viral AGE of various etiologies, including astrovirus AGE, determines the need to introduce into clinical practice test systems for the verifi cation viral pathogens into clinical practice. The stud y of the genetic diversity of astroviruses reveals the change of the dominant geno type and is important for understanding the patterns of astrovirus circulation both in th e Novosibirsk region and in Russia as a whole.

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    Kapustin D. V., Krasnova E. I., Zhirakovskaia E. V., Khokhlova N. I. et al. Clinico-epidemiological characteristic of astrovirus infection in hospitalized adults in Novos ibirsk. Experimental and Clinical Gastroenterology. 2018;155(7): 67–72.
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    1. A. I. Evdokimov Moscow State University of Medicine and Dentistry (Moscow, Russia)

    Keywords: Herbal Medicine. Hepatobiliary pathology. Standardized silymarin. Legalon

    Abstract:Standardized original silymarin has a number of therapeutic eff ects: membrane stabilizing; antioxidant; metabolic; antiinfl am- matory; detoxifi cation; regenerative; antifi brotic; cytoprotective; reducing the severity of fatty liver disease; reduction of neutral fat in the liver; antiviral; immunomodulating; an tifi brotic; antiproliferative; normalizing the level of cholesterol in the blo od; antidepressant; diaphoretic; diuretic. The review pro vides data on clinical observations that testify to the effi cacy and safety of standardized silymarin in order to recommend its use for the prevention and treatment of a number of diseases of the hepa- tobiliary system. The hepatoprotector Legalon (MEDA, Germany) has a high degree of purifi cation according to Rottapharm | Madaus and meets the European standard for the content of silymarin in the preparation and is produced in accordance with GMP criteria. “Legalon” is a preparation, the quantitative det ermination of silymarin in which is carried out by a modern metho d of high-performance liquid chromatography. These factors allow us to treat Legalon as a “reference” preparation of silymarin.

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    Kazyulin A. N., Shestakov V. A., Goncharenko A. Ju., Pavleeva E. E., Lubeznova I. Ju. Preparations of standardized silymarin. Mechanisms of action and prospects for clinical application. Experimental and Clinical Gastroenterology. 2018;155(7): 73–85.
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    1. Novosibirsk Research State University (Novosibirsk, Russia)
    2. Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091, Novosibirsk, Russia)
    3. Institute of Internal and Preventive Medicine — Branch of FIC “Institute of Cytology and Genetics of SB RAS” (Novosibirsk, Russia)

    Keywords: stomach, morphology, hemoblastoses, cytostat ic therapy, clinical-hematological remission

    Abstract:Purpose of the study . To study the morphofunctional state of the stomach in patients with hemoblastosis in the period of clinical-hematologic remission (GSR). Materials and methods . 164 patients with lymphomas were examined. The average number of courses of polychemo- therapy (PCT) is 9.4 + 0.9, the average duration of remission is 66.47 + 9.26 months. Comparison group — 72 patients with chronic HP-associated gastritis without hematologic disease. Results . During the period of GSR, the frequency of symptoms of gastric dyspepsia increased, with the pain syndrome being negligible, the frequency of pyloric Helicobacter (HP) de tection decreased signifi cantly . The relationship of HP and dysplasia of the epithelium of the gastric mucosa was noted, which was detected much more often than in patients with chronic HP-associated gastritis without hematological pathol ogy (OR = 319, (95% CI- (20.06–5073.5, p <0.0001), which suggests more a high risk of developing gastric cancer in patients with hemoblastosis in the GSR period. Сonclusion . Morphological changes in the stomach, including ulce rogenic and procancerogenic (erosion, atrophy, dyspla- sia) in patients with hematological diseases in the period of clinical and hematological remission are more frequent and expressed more than before treatment.

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    Soldatova G. S., Ageeva T. A., Pospelova T. I., Kurilovich S. A., Kovynev I. B. Morphofunctional state of stomach in patients with haematological malignancies in the period of clinical and haematological remission. Experimental and Clinical Gastroenterology. 2018;155(7): 86–90.
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    1. Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091, Novosibirsk, Russia)

    Keywords: chronic diff usion diseases of a liver, skin itch, mycoses, seborrhea, xerodermiya, teleangiektaziya, Campbell de Morgan’s spots

    Abstract:The purpose of the work was to study the characteristics of clinic of dermatoses and registration frequency of “extrahe- patic signs”, accompanying diseases of liver and biliary tract, a diagnosis which has already been verifi ed before resorting to Dermatologists. Materials and methods : the work is based on the aggreg ated results of clinical, laborato ry and instrumental examinations conducted during the 10 years of 368 patients with diseases of the liver and biliary tract. Results : in structure of nosological forms of dermatoses at 368 pa tients with various forms of the chronic diff use diseases of a liver (CDDL) most often were registered: an itch of a skin — 86,4%, mycoses of feet — 77,1%, a seborrhea — 60,9%, a superfi cial candidiasis of a skin and mucous — 50,8%, a chromophytosis — 41,0%, a human papillomavirus infection — 40,8%, a xerodermia — 31,5%. The prevalence and intensity of clinical implications of dermatologic symptoms depend on the nature of pathological process in a li ver and testify to its gravity and activity. Conclusion : considering the high frequency of registration at CDDL of onikhopatiya, teleangiectasias, trichopathies, Camp- bell de Morgan’s spots and high informat ional content of a symptom of “the become empty veins”, extension of the register of extrahepatic “signs”, and change of this term on more denotated — dermatologic symptoms of a dermal syndrome of CDDL is represented expedient. The submitted data can be used both by gastroenterologists, and dermatologists.

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      8. Kurbacheva O. M., Pavlova K. S. Principy diagnostiki i lecheniya bol’nyh s kozhnymi problemami, soprovozh- dayushchimisya zudom [Principles of diagnosis and treat- ment of patients with pruritus skin problems]. Russian Medical Journal. 2011, no.11, pp.682–687.

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    Pozdnyakova O. N., Nemchaninova O. B., Spitsyna A. V., Lykova S. G., Reshetnikova T. B., Evstropov A. N. Nosologic structure and features of dermatoses in patients with diseases of the liver and biliary tract. Experimental and Clinical Gastroenterology. 2018;155(7): 91–96.
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    1. State Budgetary Institution of Higher Professional Education “Voronezh State Medical University named after N. N. Burdenko” of the Ministry of Public Health of the Russian Federation (Voronezh, Russia)
    2. State Institution of Healthcare of the Voronezh Area “Voronezh Area Clinical Antitubercular Dispensant named after N. S. Pophvi snevy” (Voronezh, Russia)

    Keywords: tuberculosis, viral hepatitis C, pathogenetic therapy, “Remaxol”, hepatotropic eff ect

    Abstract:Purpose of the study . The study of the eff ectiveness of the domestic hepatoprotector “Remaxol” in the complex treatment of patients with pulmonary tuberculosis in combination with CHC on the background of drug and alcoholic liver damage. Materials and methods . 108 patient histories with diagnosis of pulmonary tuberculosis were analyzed, in which chronic hepatitis C (CHC) was defi ned as a concomitant pathology. The average age of the patients was 36.4 ± 10.5 years. Patients of the fi rst group (n = 37) with a diagnosis of pulmonary tuberculosis in combination with CHC on the background of chronic alcohol intoxication received complex chemotherapy for tuberculosis, and as a pa thogenetic therapy, Remaxol was intravenously dripped 400 ml once a day for 12 days. The comparison group (n = 23) with the same diagnosis were on complex antituberculous chemotherapy in combination with pa thogenetic and symptomatic th erapy. Patients of the sec- ond group (n = 25) with a diagnosis of pulmonary tuberculosis against the background of CHC in combination with drug damage to the liver received a complex ch emotherapy for tuberculosis, as well as a Remaxol intravenous drip 400 ml once a day for 12 days in quality of pathogenet ic therapy. Patients of the control group (n = 23) with the same diagnosis were on complex antituberculous chemotherapy in combinat ion with pathogenetic and symptomatic therapy. Results . Infusion therapy with the drug “Remaxol” led to the rapid disappearance of dyspeptic disorders and pain syn- drome, a signifi cant decrease in cytolysis. The pronounced hepatotropic eff ect of the drug “Remaxol” was confi rmed by the rates of decrease in the average indices of ALT and total bilirubin. The conclusion . The use of hepatoprotector “Remaxol” in the complex treatment of patients with pulmonary tuberculosis with concomitant pathology of HCV on the background of al cohol and drug damage contributes to the improvement of the functional state of the liver.

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      3. Asratjan A. A. Clinical and epidemiological features of hepatitis B and C in patients with pulmonary tubercu- losis Jepidemiologija i vakcinoprofi laktika 2013; 6:20–27.
      4. Mordyk A. V., Bereznikov A. V., Konev V. P. Drug dam- age to the liver with a persistent course and insuffi cient response to therapy: the results of departmental exper- tise and clinical observations Problemy tuberkuleza i boleznej legkih 2010; 4: 43–47.
      5. Pritulina Yu.G., Salomakhin G. G., Fil G. V. Eff ective- ness of use of remaxol hematophylene protector in complex therapy of chronic hepatitis C. Eksperimen- tal’naya i Klinicheskaya Gastroenterologiya. 2017; 148 (12): 41– 4 6 .
      6. Kravchenko A. V., Zimina V. N. Antiretroviral Th erapy in Patients with HIV Infection and Tuberculosis In- fekcionnye bolezni: novosti, mnenija, obuchenie 2012; 1: 15–22.
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      9. Zaplutanov V. A., Romancov M. G., Suhanov D. S. Remaxol: abstract collection of experimental and clinical research papers cited in PubMed SPb, 2012. 178 p.
      10. Volchegorskij I. A., Novoselov P. N., Ushkareva Je. V. Eff ect of Remaxol on the effi ciency of standard treatment for infi l- trative pulmonary tuberculosis Ter Arkh. 2016;88(3):73– 78. doi: 10.17116/terarkh201688373–78.
      11. Shurygin A. A., Alekseeva Ju. A. Th e eff ectiveness of the use of remaxol in the treatment of liver damage caused by taking anti-tuberculosis drugs Ftiziatrija i pul’monologija 2016; 1: 51–53.
      12. Shikalova I. A., Shilov V. V., Batocyrenov B. V., Vasil’ev S.A., Loladze A. G. Features of pharmacological correction of acute toxic hepatopathy in patients with severe forms of acute alcohol poisoning. Klinicheskaja medicina 2012; 1: 60–64. PMID: 22567943
      13. Vinnikova MA, Utkin SI, Nenasteva AY, Zakharov MV Th e effi cacy of remaxol addition in the treatment of alcohol withdrawal syndrome Zh Nevrol Psikhiatr Im S S Korsakova. 2016;116(1):40–46. doi: 10.17116/jnevro20161161140–46

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    Pritulina Yu.G., Fil G. V., Kornienko S. V., Plohotnyuk N. V. New approaches to pathogenetic therapy of patients suff ering wi th tuberculosis and viral hepatitis C. Experimental and Clinical Gastroenterology. 2018;155(7): 97–101.
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    1. Research Institute of Internal and Preventive Medicine — Branch of the Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences (Novosibirsk, 630089, Russia)
    2. Federal State Budget Educational Institution of Higher Education «Novosibirsk State Medical University» of the Ministry of Heal th of Russia (FSBEI HE NSMU MOH Russia) (630091, Novosibirsk, Russia)
    3. Rzhanov Institute of Semiconductor Physics Siberian Branch of Russian Academy of Sciences (Novosibirsk, 630090, Russia)
    4. Boreskov Institute of Catalysis SB RAS (Novosibirsk, 630090, Russia)
    5. Vorozhtsov Institute of Organic Chemistry Siberian Branch of Russian Academy of Sciences (Novosibirsk, 630090, Russia)

    Keywords: erythrocyte membranes, fatty acids, colorectal cancer, chromatography-mass spectrometry

    Abstract:With the aim of highly sensitive chromatography- mass spectrom etry (Agilent 7000B, USA) with triple quadrupole analyzer and electron ionization source). Followed by statistical proc essing of measurement results the fatty acid composition of erythrocyte membranes in patients with colorectal cancer (6 3,2+9,4 years; 57 men, 43 women) of diff erent stages and localizations and persons of comparison group (61,7+7,5 years; 14 men, 10 women) was studied. The study revealed signifi cant diff erences in fatty acid (FA) levels in erythrocyte membrane phospholipids in patients with colorectal cancer associated with the stage of disease and in control group. Patients with colorectal cancer (CRC) com- pared to the control group was set to increase level of polyunsaturated fatty acids, mainly due to the omega-3 (including docosapentaenoic, docosahexaenoic), since the early stages of CRC (p<0.001–0.05) and a decrease in the level of saturated C14:0, C15:0, C17:0 (p

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    Full text is published :
    Kruchinina M. V., Osipenko M. F., Kruchinin V. N., Prudnikova Ya.I., Gromov A. A., Shashkov M. V., Sokolova A. S. Feature of composition of fatty acids of erythrocyte membranes in patients with colorectal cancer of diff erent stages. Experimental and Clinical Gastroenterolo gy. 2018;155(7): 102–111.
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    1. Saratov State Medical University n. a. V. I. Razumovsky (Saratov, Russia)
    2. Orthopedics and Neurosurgery of Saratov State Medical University n. a. V. I. Razumovsky (Saratov, Russia)

    Keywords: chronic pancreatitis, osteopenia, cytokines, dysbiosis

    Abstract:Purpose of the study . To investigate the frequency and some mechan isms of osteopenia in chronic pancreatitis. Materials and methods . In a study of 161 patients with chronic pancreatitis included. Bone-turnover markers was mea- sured: osteocalcin, β-CrossLaps, dual-energy X-ray absorptiom etry was performed. The analysis of the content cytokines IL-2, IL-6, IL-8 in colonic biopsies, composition of the gut microbiota. Results . Bone disorders is associated with an increase in cytoki nes in colon biopsy and the altered intestinal microbiota.

      1. Ivashkin V. T., Maev I. V., Okhlobystin A. V. et. al. Guide- lines of the Russian gastroenterological association on diagnostics and treatment of a chronic pancreatitis. RJGHC. 2014. Vol.24. no.4. pp.70–97.
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      5. Bykova A. P., Kozlova I. V. Mechanisms of development and characteristics the pathology of the gastrointestinal tract in chronic pancreatitis. 2016;11(135):69–75.
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      11. Ivashkin V. T., Maev I. V., Okhlobystin A. V. et. al. Diag- nostics and treatment of exocrine pancreatic insuffi cien- cy: clinical guidelines of the Russian gastroenterological Association. Ross z gastroenterol gepatol koloproktol 2017;27(2):54–80
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      13. Ghassem-Zadeh S, Gaida MM, Szanyi S et al. Distinct patho- physiological cytokine profi les for discrimination between autoimmune pancreatitis, chronic pancreatitis, and pancre- atic ductal adenocarcinoma. J Transl Med 2017;15(1):126.
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    Bykova A. P., Kozlova I. V., Tsareva E. E. Some mechanisms of osteopenia in chronic pancreatitis. Experimental and Clinical G astroenterology. 2018 ;155 ( 7 ) : 112 –117.
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    1. IC RAS, FSRC “Crystallography and Photonics” (Moscow, Russia)
    2. City clinical hospital No 1 named after N. I. Pirogov (Moscow, Russia)
    3. KSMA — Branch Campus of the FSBEI FPE RMACPE MOH (Kazan, Russia)

    Keywords: gallbladder diseases, cholelithiasis, gallbladder stones , X-ray microtomography, powder diff raction, electron microscopy, elemental analysis

    Abstract:The aim . The study of morphology and composition of gallbladder st ones in the search for the po ssibility of diff erentiation of cholesterol type stones by X-ray tomography technique. Materials and methods . In-vitro investigation of gallstones were performed by the X-ray microtomography, X-ray phase analysis and electron microscopy methods. Results . The phase and element composition of gallstones were determined in our experiments. Cholesterol monohy- drate, cholesterol anhydrous and calcium carbonate were discov ered in the gallstones composition. 3D-distributions of linear attenuation coeffi cients of gallstones were obtained from X-ray microtomography measurements. The agreement of experimentally measured linear attenuation coeffi cients with the calculation based on tabular data for pure cholesterol is demonstrated. The cavities of diff erent morphological stru cture formed in the process of growth were found in the gallstones. On the basis of X-ray, electron microscopic and opti cal measurements the possibility of formation of thin layers of bilirubin on the surface of cholesterol stones is demonstrated.

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    Asadchikov V. E., Buzmakov A. V., Voloshin A. E., Dyachkova I. G. et al. Studies of the morphology, phase and elemental composition of gall stones by instrumental methods. Experimental and Clinical Gastroenterology. 2018;155(7): 118–123.
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