1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)

Keywords: cirrhosis of the liver, spirometry, phospholipids of exhaled air, pulmonary artery pressure, smoking, non-smoking

Abstract:Objective: To study the ventilation function of the lungs and the phospholipids of exhaled air in smoking and non-smoking patients with cirrhosis of the liver (CP) in a comparative aspect. Material and methods: 49 patients with portal hypertension (GHG) and 20 healthy volunteers were examined. Spirography was carried out with the help of the hardware-software complex “VALENTA”. The KVV was collected according to the recommendations of GI Sidorenko. in the morning after rinsing the mouth. The volume of KVB and the concentration of total phospholipids in 1 ml of KVB (OFL, mmol / L) were measured. Phospholipids were extracted by the Blur method. The statistics were implemented using the application software “Statistica for Windows, Release 6.0.” Results of the study and their discussion: In patients with CP, a signifi cant decrease in the ventilation capacity of the lungs was more pronounced in smokers, as well as a decrease in the amount of condensate in the exhaled air (KVV) and phospholipids in KVV. The average pressure in the pulmonary artery with CP was higher than in the healthy. Conclusion: Smokers with pulmonary embolism are more severely aff ected by pulmonary ventilation than non-smokers. There is no signifi cant diff erence in the decrease in the amount of phospholipids in the exhaled air from smokers and non-smoking patients with CP.

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Barlamov P. N., Vorob’eva A.A., Zhelobov V. G., Kravtsova T. Yu. Ventilation function of lungs, content of phospholipids in condensate of outdoor air and pressure in pulmonary artery in smoking and non-smoking patients with liver cirrhosis. Experimental and Clinical Gastroenterology. 2018;156(8): 10–14. DOI: 10.3 1146/1682-8658-ecg-156-8-10-14
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1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)
2. E The Group of Companies “Medsi» (Perm, Russia)

Keywords: Steatohepatitis, alpha-2-macroglobulin, haptoglobin, apolipoprotein A1, elastography

Abstract:The aim of study was to estimate the features structurally functional condition of the liver in non-alcoholic steatohepatitis patients. Methods. This case-control study involved 30 patients with non-alcoholic steatohepatitis and 10 controls aged from 18 up to 60 years. All patients and controls were examined by ultrasound of the liver with defi nition steatosis degree; duplex scanning of abdominal cavity vessels; elastography of the liver with defi nition fi brosis stage on Metavir scale. The levels of the alpha-2-macroglobulin, haptoglobin and apolipoprotein A1 were determined. Results. We revealed S1-steatosis degree at 60%, S2 — at 23% and S3 — at 17% of patients. Fibrosis of the liver was mainly initial degrees: F0 — at 10%, F1 — at 60%, F2 — at 20%, F3 — at 10% of patients. The level of alpha-2-macroglobulin was reliable increase (3,89±0,96 g/l) in the group of patients with non-alcoholic steatohepatitis in comparison with control group — 2,35±1,11 g/l (р=0,001). The obtained data have allowed to create model fi brosis liver predictors in non-alcoholic steatohepatitis patients. Conclusions. Ultrasonic steatosis degree and concentration of alpha-2-macroglobulin in combination with the body weight index and activity of hepatitis can serve the markers of the adverse forecast in non-alcoholic steatohepatitis patients.

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Full text is published :
Trenogina K. V., Obukhova O. V., Mavlitova L. A. Clinical features of a course of the disease and structurally functional condition of the liver in non-alcoholic steatohepatitis patients. Experimental and Clinical Gastroenterology. 2018;156(8): 15–20.
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1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)

Keywords: liver fi brosis, liver cirrhosis, hemostasis

Abstract: The aim was to investigate hemostasis system in patients with liver fi brosis and cirrhosis. Materials and methods. We examined 10 patients with liver fi brosis, 25 patients with liver cirrhosis and 10 healthy people. Primary and secondary hemostasis and Hageman-factor-dependent fi brinolysis were studied. Results. Patients with liver fi brosis had decreased platelets aggregation with inductors, but normal platelet count. Also, they had increased thrombin time (TT) and activated partial thromboplastin time (APTT), but normal prothrombin index (PTI). Patients with liver cirrhosis had thrombocytopenia and decreased platelets aggregation, increased TT and APTT, but decreased PTI. Time of the Hageman-factor-dependent fi brinolysis was increased in patients with liver cirrhosis. Conclusion. Patients with liver fi brosis and cirrhosis have disturbances in primary and secondary hemostasis and patients with liver cirrhosis have decreased activity of Hageman-factor-dependent fi brinolysis. Probably, it could be determined by hepatocytes function failure and/or disseminated intravascular coagulation.

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Gulyaeva I. L., Bulatova I. A., Pestrenin L. D. Characteristics of indicators of the system of hemostasis in patients with fi brosis and cirrhosis of the liver. Experimental and Clinical Gastroenterology. 2018;156(8): 21–24. DOI: 10.31146/1682-8658-ecg-156-8-21-24
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1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)

Keywords: liver fi brosis, chronic hepatitis C, platelets, albumin

Abstract: The aim. The aim was to evaluate the diagnostic capabilities of determining the number of platelets and the concentration of albumin in the blood as an indirect test for assessing the severity of liver fi brosis in chronic hepatitis C (CHC). Materials and methods. There were examined 70 patients with CHC and 30 healthy persons. The number of platelets, the concentration of albumin, the ultrasonic elastography of the liver with the evaluation of the fi brosis stage by METAVIR were determined. Results. The platelet and albumin indices had an inverse strong relationship with the liver density index: r = –0.9 and r = –0.9, respectively. At a platelet level was more than 200×109/l and an albumin concentration was more than 47.3 g/l, fi brosis is excluded. The sensitivity and specifi city of the platelet count were 100% and 77.8%, for albumin levels these values t here were 100% and 73.3%. Moderate and severe fi brosis can be stratifi ed: when a platelet count is less than 200×109/l and an albumin concentration is less than 44.1 g/l it is correspond to fi brosis of stage 3–4. Conclusion. The number of platelets and the concentration of albumin in the blood satisfactorily refl ect the presence and severity of liver fi brosis in patients with CHC. These indicators can be used in wide clinical practice as indirect markers of fi brosis.

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Shchekotova A. P., Bulatova I. A. Number of thrombocytes and concentration of albumin in blood — markers of liver fi brosis in chronic hepatitis C. Experimental and Clinical Gastroenterology. 2018;156(8): 25–28.
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1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)

Keywords: Oddi sphincter insuffi ciency, hepatobiliscintigraphy, duodenal dyskinesia

Abstract: Purpose of research. To evaluate the clinical signifi cance of the loss of the closure function of the Oddi sphincter. Materials and methods: 100 patients after cholelithiasis surgery were divided into two groups: 1 — group (main) — 86 patients after cholecystectomy; 2 — group (comparison) — 14 patients after cholecystectomy with drainage choledoch operations. The dynamics of bile fl ow was assessed by hepatobiliscintigraphy on a gamma camera using the radiopharmaceutical 99Tc-bromide for 90 minutes with choleretic test. Clinical manifestations, results of laboratory, ultrasound, x-ray and endoscopic examinations were analyzed. Results. According to hepatobiliscintigraphy, 20 (23, 2%) patients of group 1 had normal bile fl ow dynamics. 66 (76,8%) patients indicators of hepatobiliscintigraphy consistent with premature and accelerated galeotto, identical fi gures in the 2nd group, where 100% is set, the insuffi ciency of the sphincter of Oddi. Scintigraphic indicators of Oddi sphincter insuffi ciency correlated with signs of functional disorders of the duodenum (r=0.57, p <0.001) and duodenogastric refl ux (r= 0.74, p<0.01), as well as with radiological signs of duodenal dyskinesia (r= 0.73; p<0.01). In 73% of patients of group 1 with Oddi sphincter insuffi ciency and 86% — in the comparison group, diarrhea was observed, against 10% with normal bile passage (p<0.0001). Drug therapy of these disorders was supplemented with prokinetics. Conclusion. Oddi sphincter insuffi ciency after cholecystectomy develops in 77% of cases and acquires the most pronounced clinical signifi cance in patients with duodenal dyskinesia. The relationship of functional disorders of the biliary tract and duodenum should be considered when choosing a therapeutic tactic, supplementing therapy with drugs that regulate intestinal motility.

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: Repin M. V., Mikryukov V. Yu. The clinical signifi cance of sphincter Oddi`s insuffi ciency after cholecystectomy. Experimental and Clinical Gastroenterology. 2018;156(8): 29–34.
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1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)
2. Regional Children’s Clinical Hospital (Perm, Russia)

Keywords: non-alcoholic fatty liver disease, obesity, diabetes, children, adolescents

Abstract: Currently, non-alcoholic fatty disease is one of the frequent liver diseases not only in adults, but also in adolescents and even children. The growth of this pathology is associated with an increase in the number of patients suff ering from obesity, diabetes, insulin resistance. Studies on fatty liver degeneration with insulin-dependent diabetes mellitus (type 1) are not enough. The aim of the study was to evaluate and compare laboratory and instrumental data in children with non-alcoholic fatty liver disease in endocrinological pathology.The article presents the results of a survey of 67 children and adolescents with fatty hepatosis (41 children with type 1 diabetes and 27 with obesity). It was shown that in children with obesity, an increase in alanine transaminase was signifi cantly more frequent in comparison with the group of children with diabetes (p=0,047). There was a trend towards a more frequent increase in triglycerides, cholesterol and low-density lipoproteins and children with diabetes, but no signifi cant diff erences were found in the groups. According to the results of ultrasound examination of the abdominal cavity organs, all patients showed signs characteristic of fatty hepatosis, without signifi cant diff erences in groups.

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Full text is published :
Furman E. G., Koryukina I. P., Zarnitsyna N. Yu., Ponomareva M. S., Chistousova G. V., Akhmedov R. M. Non-alcoholic fatty liver disease with endocrine diseases in children and adolescents. Experimental and Clinical Gastroenterology. 2018;156(8): 35–40. DOI: 10.31146/1682-8658-ecg-156-8-35-40
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1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)

Keywords: child nutrition, macro- and micronutrients, correction of nutrition

Abstract: The assessment of early infant nutrition and its infl uence on the anthropometric indicators (mass, body height) and the development of nutritional-related diseases in catamnesis was performed. Alimentary diaries of 61 children (from 6 to 36 months) were analyzed. Children by age were divided into three groups. Low energy value of the diet was determined in the three groups (1138,3±249,6 kcal) and a violation of the ratio of macro- and micronutrients was found. Prior to the correction of nutrition, 77,8% of the children had a number of background nutrition-related diseases. Nutrition correction was conducted in macro-and micronutrient. After diet correction in 11.2% of children was observed negative dynamics in the anthropometric parameters, anthropometric indices of 44.4% of children were normalized. After correction of the nutrition the number of children with alimentary-dependent diseases decreased (from 77,8% to 27,8%). It was determined that children of early age had insuffi cient basic macro- and micronurtients in the diet. After the correction of day nutrition 44.4% of the children had investigated positive dynamics of anthropometric indices and reduction of nutrition-related diseases.

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Full text is published :
Lundina G. V., Repetskaya M. N., Toropova E. A., Golovina V. V. Modern aspects of early infant nutrition. Experimental and Clinical Gastroenterology. 2018;156(8): 41–44.
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1. E. A. Vagner Perm State Medical University (614990, Perm, Russia)

Keywords: peptic duodenal ulcer, arterial hypertension, hemostasis

Abstract: The aim of the work is to study the indicators of coagulation and anticoagulant hemostasis, as well as fi brinolysis in patients with duodenal ulcer (DU) and arterial hypertension (AH) in order to predict and prevent possible complications. Materials and methods. The main group consisted of 18 patients with DU and AH 1–2 degree, stage II, high (3) group of cardiovascular risk (mean age 47.36±5.41 years). Comparison groups consisted of 22 patients with DU (mean age 40.53±4.28 years), 20 patients with AH (mean age 48.72±6.32 years) and 10 healthy people. Coagulation, anticoagulation and fi brinolytic components of hemostasis system were evaluated. Results. The hemostasis system in patients with UD and AH is characterized, it´s manifested by hypercoagulation, paracoagulation and a defi ciency of fi brinolysis, which may be due to metabolic liver dysfunction

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Full text is published :
Zarivchatsky M. F., Kravtsova T. Yu. Plasma factors of hemostasis in the peptic ulcer disease associated with arterial hypertension. Experimental and Clinical Gastroenterology. 2018;156(8): 45–49. DOI: 10.31146/1682-8658-ecg-156-8-45-49
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