№ 04 (176) 2020
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Уважаемые коллеги, уважаемые читатели!
Похоже, что пандемия COVID-19 доставит еще много хлопот человечеству. Непростая ситуация складывается и в нашей стране, поэтому я особо хочу поблагодарить наших коллег из Военно-медицинской академии им. С.М. Кирова в Санкт-Петербурге, экстренно подготовивших великолепный обзор по поражениям органов пищеварения при этом неизвестно доселе заболевании и представляющих его в нашем журнале в виде передовой статьи. Выражаем надежду, что эта публикация принесет пользу нашим врачам первой линии обороны.
Полагаем, что ознакомление с публикациями Т.В. Ермоловой с соавт., (СПб) и А.И. Долгушиной с соавт., (Челябинск) помогут нашим врачам успешнее бороться с осложненным течением COVID-инфекции в виде гипераммониемии, и самим с помощью L – орнитина L – аспартата (LOLA) полнее восстановиться во время заслуженного, но такого короткого отдыха.
Традиционные «мирного времени» статьи представлены сообщениями А.Ю. Барановского с соавт. из Санкт-Петербурга «Нутриционный статус при болезни Вильсона – Коновалова и его влияние на уровень окислительного стресса», А.П. Пановой с соавт. из двух московских учреждений «Диагностика и клинические особенности течения неалкогольной жировой болезни печени у больных системной красной волчанкой», М.Т. Рустамовой с соавт. из Ташкента «Частота встречаемости, характер и факторы риска поражений эзофагогастродуоденальной зоны у больных бронхиальной астмой» и Немченко У.М. с соавт. из Иркутска «Микробиоценоз толстого кишечника и способность к биопленкообразованию штаммов Klebsiella spp. у детей с функциональными гастроинтестинальными расстройствами».
Иркутяне порадовали еще двумя работами. Это эпидемиологические разработки Н.В. Михайловой и И.Л. Петрунько «Распространённость и структура хронических заболеваний печени различной этиологии на сельском терапевтическом участке Иркутской области» и О.В. Тириковой с соавт. «Частота встречаемости жировой болезни печени в Иркутской области по результатам аутопсий».
Подобного рода сообщения представлены и коллективом авторов из Москвы, Воронежа и Балашихи (Московской обл.) под руководством М.Д. Ардатской «Ретроспективный анализ распространенности, особенностей течения, лечения и исходов дивертикулярной болезни по данным многопрофильного стационара», и также нашими коллегами из Кыргызстана (К.А Ногойбаева с соавт.) «Заболеваемость, смертность и летальность от цирроза печени в возрастном аспекте в Кыргызстане за период 2010-2017 гг.».
Раздел «Хирургическая гастроэнтерология» представлен сообщениями А.М. Першко и соавт., кафедра проф. В.Б. Гуревича (ММА, СПб) «Современные стратегии терапевтического и хирургического лечения болезни Крона», «Особенности экспрессии молекулы сосудистой адгезии при остром панкреатите ΙА фазы» (Ю.С. Винник и соавт. (Красноярск); «Диагностика рака поджелудочной железы методом инфракрасной спектроскопии сыворотки крови (О.В. Красникова и соавт. (Н. Новгород); «Методические и технические аспекты тонкоигольной пункции образований верхних отделов пищеварительного тракта под эндосонографическим контролем» (Э.А. Годжелло и соавт. (Центр хирургии им. Б.В.Петровского, Москва)
Раздел «Экспериментальная гастроэнтерология» открывают две работы весьма актуального направления по протекции повреждения печени нестероидными противовоспалительными препаратами – нимесулидом (Л.В. Лазаренко и П.В. Косарева, Пермь) и парацетамолом (Т.Г. Якупова и соавт., Уфа). Участию печени в модификации пептидергических механизмов регуляции пищеварительных желез посвящено экспериментальное исследование М.А Жураевой с соавт. из Андижана (Узбекистан).
Интересного и полезного чтения, коллеги!
Берегите себя!Вице-президент РНМОТ, Президент НОГР,
Главный редактор ЭиКГ,
Директор Учебного центра при РНМОТ.Лазебник Леонид Борисович -
№4 (176) 2020
LEADING ARTICLE
Features of management of patients with gastroenterological pathology in the conditions of the COVID-19 pandemic
V. B. Grinevich1, Yu. A. Kravchuk1, E.I. Tkachenko 1, A. M. Pershko 1, V.I. Ped1, I.E. Sas1, I.V. Gubonina1, L.B. Lazebnik2, O.V.Stefanyuk2,3
1. Military Medical Academy named after S. M. Kirov, St Petersburg, Russia
2. FSEBI of HE “A.I. Evdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
3. Federal State Budgetary Institution "National Medical Research Centre for Therapy and Preventive Medicine" of the Russian Ministry of Health, Moscow, RussiaVladimir B. Grinevich, Head of 2nd Therapy department of postgraduate education, DSci, professor, Scopus Author ID: 7005167197, ORCID: 0000–0002–1095–8787
Yuri A. Kravchuk, M. D., D.Sc. (Medicine), Prosessor Therapy of Advanced medical Department 2
Evgeniy I. Tkachenko, professor of 2nd Therapy department of postgraduate education, DSci, professor, Scopus Author ID: 7102256824, ORCID: 0000–0002–8858–5642
Vladimir I. Ped, M. D., D.Sc. (Medicine), Prosessor Therapy of Advanced medical Department 2
Anatoly M. Pershko, MD, Professor, assistant of 2 the clinic (therapy of advanced medical)
Irina V. Gubonina, associate professor of 2nd Therapy department of postgraduate education, PhD, associate professor
Leonid B. Lazebnik, professor Department of Outpatient Therapy, Doctor of Medical Sciences
Oksana V. Stefanyuk, researcher of the Department of Biological Markers of Risk of Chronic Non-Communicable DiseasesКравчук Юрий Алексеевич
Yuri A. Kravchuk
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
Frequent damage to the digestive system with a new coronavirus infection, as well as its combination with gastroenterological pathology complicates the whole complex of therapeutic and diagnostic measures for such patients.
Understanding the problem is complicated by a large number of conflicting scientific data of varying degrees of evidence.
The article describes the mechanisms of gastrointestinal tract (gastrointestinal tract) affection by coronavirus SARS-CoV-2 - induction of inflammation and violation of the permeability of the gastrointestinal mucosa, changes in the composition and function of the intestinal microbiota, impaired intestinal-lung axis interaction. features of the clinical picture affecting the prognosis of the disease, explains the features of the examination, and suggests treatment methods.The article shows the features of the clinical picture that affect the prognosis of the disease, explains the features of the examination, suggests methods of treatment and nutritional support.
Keywords: coronavirus SARS-CoV-2, enterocytes, microbiota, diarrhea, nutritional supportCLINICAL GASTROENTEROLOGY
Ammonia – new therapeutic target for chronic liver diseases
T.V. Ermolova, S.Yu. Ermolov, A.A. Belova
FGBOU “North-Western State Medical University named after I.I. Mechnikov”, St.-Petersburg, RussiaTatiana V. Ermolova, Аss. Professor of Faculty Therapy Department; Scopus Author ID:57199607813, ORCID: 0000-0002-2489-602X
Sergei.Yu. Ermolov, Аss. Professor of Faculty Therapy Department
Anastasiya A. Belova, 6th year studentЕрмолова Татьяна Владиславовна
Tatiana V. Ermolova
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
Fatigue and ammonia levels of capillary blood in medical students
Objective: to study some mechanisms of progression of chronic liver diseases in patients with initial stage of liver fibrosis and the possibility of their correction.
Materials and methods: a total of 69 young patients with chronic liver diseases with initial stage 0-2 fibrosis (26 patients with chronic viral hepatitis C, 43 patients with nonalcoholic steatohepatitis) were examined. Ammonia levels were determined in peripheral blood by the method of single photometry reveals on the analyzer PocketChem BA, ArcRay (Japan), for the integral evaluation of intrahepatic blood flow disorders was used polyhepatography (PHG) is a non – invasive method.The intensity of the activity of the stellate cells of the liver (HSCs) was determined according to the expression of SMA-alpha in a liver biopsy sample. In terms of correction of hyperammoniemia and portohepatic hemodynamics disorders in our study used hepatoprotector with hypoammoniemic effect ornithine (L-ornithine-L-aspartate).
Results: ammonia levels in HCV patients and NASH patients was significantly higher than in the control group, the level of hyperammoniemia prevailed in patients with NASH than HCV patients. Portohepatic hemodynamics disorders were detected in all patients, while the peculiarities of these disorders, depending on the etiology of hepatitis. These hemodynamic disorders were accompanied by signs of activation of HSCs. In the liver tissue we revealed expression of SMA-alpha in HSCs, indicating that the signs of activation of these cells. Efficiencyanalysis of the effectiveness of Ornithine showed a significant reduction of ammonia in the blood and improvement in intrahepatic blood flow in patients with different types of portohepatic hemodynamics disorders on the background of treatment.
Conclusion: in HCV and NASH patients, already at the initial stage sofliver fibrosis, hyperammoniemia was detected (with HCV it was significantly higher), activation of HSCs, which leads to impaired portohepatic hemodynamics in these patients. The use of a hepatoprotector with the hypoammoniemic effect Ornithine leads to a decrease of blood ammonia and an improvement of hepatic microcirculation, which allows expanding the possibilities of the pathogenetic treatment of chronic hepatitis for decrease of fibrogenesis.
Кey words: hyperammoniemia, hepatic stellate cells, intrahepatic microcirculation
A.I. Dolgushina, A.S. Kuznetsova, Yu.V. Kartoshkina, A.A. Selyanina
Chelyabinsk State Medical Academy of Federal Agency of Health Care and Social Development, Chelyabinsk, RussiaAnastasiya I. Dolgushina, ORCID: 0000-0003-2569-1699
Alla S. Kuznetsova, ORCID: 0000-0002-0357-5702
Yuliya V. Kartoshkina, ORCID: 0000-0003-1985-1035
Anna A. Selyanina, ORCID: 0000-0002-3481-8092Кузнецова Алла Сергеевна
Alla S. Kuznetsova
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
Nutritional status at Wilson’s disease and its effect on oxidative stress
Objective. To evaluate the frequency and factors associated with the development of fatigue among students of a medical university.
Materials and methods. Fatigue Assessment Scale (FAS) was used to identify and quantify fatigue. To determine the level of active attention, the electronic number test was used. Assessment of students' physical activity was carried out according to the degree of energy costs. Capillary blood ammonia levels were evaluated using a Pocket Chem BA PA 4140 handheld analyzer.
Results. The median severity of fatigue according to the FAS questionnaire for students of the 5-6 year medical university was 23,0 (21,0-29,0) points. All students were divided into two groups depending on the level of scores on the FAS questionnaire. Pathological fatigue syndrome was identified in 26 (65%) students. In 14 (35%) students, the FAS value was less than 22 points. in men, the level of fatigue corresponded to 21,0 (14,0-29,0) points, in women 23,0 (21,0-29,0) points, without reaching statistical significance (p = 0,321). Among students of the first group (FAS <22 points), the level of physical activity of the middle level was significantly more likely to occur (p = 0,015). In this case, students with low physical activity differed significantly higher values of both physical (14,0 (12,0-18,0)) and mental (11,0 (9,00-14,0)) FAS coefficients (p = 0,001 and p = 0,007). A decrease in BMI of less than 18.8 kg / m2 is associated with an increase in the risk of pathological fatigue among medical students by 0,283 (95% CI 0,087-0,927), and a low level of physical activity by 0,179 (95% CI 0,042-0,753). Additionally, a correlation analysis revealed a negative relationship between the values of the FAS test and the level of the average student achievement score. The median ammonia concentration was 74,0 (66,0-99,0) μmol/L. Among students with capillary blood ammonia levels of more than 100 μmol/L, students with pathological fatigue predominated according to the FAS questionnaire (in 83,3% of cases), and there were no people with average physical activity (p = 0,062).
Conclusions. 1. Students of the 5-6th year of a medical university in 65% of cases have a high level of fatigue, which inversely correlates with academic performance. 2. Factors associated with pathological fatigue in senior medical students are body mass index less than 18,8 kg/m2 (RR 0,283 (95% CI 0,087-0,927)) and low level of physical activity (RR 0,179 (95% CI) 0,042-0,753)). 3. For senior students of a medical university included in the study, the median concentration of ammonia of capillary blood was 74,0 (66,0-99,0) μmol / L; no significant relationship was found between the concentration of ammonia of capillary blood and the level of fatigue.
Keywords: fatigue, ammonia, hyperammonemia, fatigue rating scale, FAS
A.Yu. Baranovsky1, A.S. Belodedova1, T.F. Fedorova2, E.A. Kondrashina1, L.K. Palgova1, K.L. Raikhelson1, E.Yu. Grigoreva1
1Saint Petersburg University, 199034, Saint Petersburg, 7/9 Universitetskaya Embankment
2Saint Petersburg Clinical Hospital of the Russian Academy of Sciences, 194017, Saint Petersburg, 72 Toreza AvenueAndrey Yu. Baranovsky, Head of the Scientific-Clinical and Educational center of Gastroenterology and Hepatology, Professor, Doctor of Medical Science; ORCID: https://orcid.org/0000-0001-9134-931X
Alexandra S. Belodedova, Scientific-Clinical and Educational center of Gastroenterology and Hepatology, Post-graduate Student; ORCID: https://orcid.org/0000-0003-2807-5269
Tamara F. Fedorova, Head of Therapy and rehabilitation department; Associate Professor, Candidate of Medical Sciences; ORCID: https://orcid.org/0000-0002-9729-2913
Elina A. Kondrashina, Scientific-Clinical and Educational center of Gastroenterology and Hepatology, Associate Professor, Candidate of Medical Sciences; ORCID: https://orcid.org/0000-0002-0142-0264
Ludmila K. Palgova, Scientific-Clinical and Educational center of Gastroenterology and Hepatology, Professor, Doctor of Medical Science; ORCID: https://orcid.org/0000-0003-0973-1312
Karina L. Raikhelson, Scientific-Clinical and Educational center of Gastroenterology and Hepatology, Professor, Doctor of Medical Science; ORCID: https://orcid.org/0000-0002-8821-6142
Elena Yu. Grigoreva, Scientific-Clinical and Educational center of Gastroenterology and Hepatology, assistant; ORCID: https://orcid.org/0000-0002-6159-7539Белодедова Александра Сергеевна
Alexandra S. Belodedova
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
Diagnosis and clinical features of non-alcoholic fatty liver disease in patients with systemic lupus erythematosus
Aim. To study characteristic features of nutritional status of patients with Wilson disease depending on stage of liver damage and determine the impact of malnutrition on oxidative stress level.
Methods.The study included 73 subjects, 33 (15 men and 18 women) had a confirmed diagnosis of Wilson’s disease. All patients with Wilson’s disease (the study group) had liver damage:non-cirrhotic stages - 12 (36.3%), cirrhosis - 21 (63.6%). The control group consisted of 40 healthy subjects (20 men and 20 women) with neither body weight deficiency, nor obesity, nor liver disease. All patients were conducted standard blood tests (clinical and biochemical blood tests), measuring malonodialdehyde (MDA) in blood serum by high-performance liquid chromatography, as well as assessment of height, weight and BMI (Body Mass Index) and analysis the body mass composition with bioelectricalimpedanceanalyzer “Diamant AIST”.
Results. 1. Malnutrition was more common among patients with liver cirrhosis (28.6%) than in patients with non-cirrhotic stages (8.3%).
2. The nutritional status of patients with liver cirrhosis was significantly different from the control group: BMI, total protein and albumin levels, lymphocytes and arm muscular circumference were significantly lower in patients with liver cirrhosis compared to the control group. The decrease in fat and muscular mass was more pronounced among women than men with liver cirrhosis.
3. The group of patients with chronic hepatitis did not significantly statistically differ from the control group in most nutritional status parameters, except for albumin level, which was significantly lower in persons of both sexes withnon-cirrhotic stages; total protein level and body fat percent were significantly higher in men with non-cirrhotic stages than in the control group.
4. The marker of oxidative stress level was significantly higher in patients with liver cirrhosis, and was higher in patients with malnutrition.
Key words: Wilson’s disease; malnutrition; oxidative stress, nutritional status
A.P. Panova1, V.G.Avdeev1, 2, T.N.Krasnova1, 2, O.A.Georginova1, T.P.Rozina1, 2
1 Lomonosov Moscow State University, Moscow, Russia, 119991, Leninskie Gory, 1
2 I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia, 119991, Bolshaya Pirogovskaya st., 2-4, 106Aleksandra P. Panova, postgraduate student, Department of Internal Medicine
Vladimir G. Avdeev, Candidate of Medical Sciences, Associate Professor of the Department of Internal Medicine, Senior Scientist of the Medical Research and Educational Center
Tatiana N. Krasnova, Candidate of Medical Sciences, Associate Professor, acting Head of the Department of Internal Medicine, Associate Professor of the Department of Internal Medicine, Occupational Diseases and Rheumatology
Olga A. Georginova, Candidate of Medical Sciences, Assistant Professor of the Department of Internal Medicine
TeonaP. Rozina, Candidate of Medical Sciences, Associate Professor of the Department of Internal Medicine, Senior Research Scientist, Head of the Department of Gastroenterology of the Medical Research and Educational Center, Associate Professor of the Department of Internal Medicine, Occupational Diseases and RheumatologyПанова Александра Павловна
Aleksandra P. Panova
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
УДК 615.357: 616.248–08
The purpose of the research was to determine the frequency and characterize the course of non-alcoholic fatty liver disease in patients with systemic lupus erythematosus.
Materials and methods. The study included 313 patients with systemic lupus erythematosus, observed in the E.M. Tareev Clinic of Rheumatology, Internal Medicine and Occupational Diseases of I.M. Sechenov First Moscow State Medical University (Sechenov University) in the period from 2001 to 2019. The diagnosis of systemic lupus erythematosus was based on the criteria of the American College of Rheumatology (1997). Examination of all patients included complete blood count, biochemical and immunological blood tests and an abdominal ultrasonography with an assessment of the liver size and the presence of signs of steatosis. In 5 cases a liver biopsy was performed.
Results. In 33 (10,5%) cases a differential diagnosis was made between non-alcoholic fatty liver disease and lupus hepatitis. Non-alcoholic fatty liver disease was the cause of liver damage in 15 (4,8%) patients with ultrasound signs of liver steatosis. Patients with obesity and metabolic syndrome prevailed in this group, and a low immunological activity of lupus was observed. An increase in liver enzymes in patients with liver steatosis was associated with the use of higher minimum doses of prednisolone.
Conclusion. Ultrasound signs of liver steatosis are an important criterion that suggests non-alcoholic fatty liver disease in patients with systemic lupus erythematosus.
Key words: non-alcoholic fatty liver disease, systemic lupus erythematosus, lupus hepatitis, glucocorticosteroids
Frequency, nature and risk factors of lesions of the esophagogastroduodenal zone in patients with bronchial asthma
M.T. Rustamova, I.V. Liverko, S.S. Khayrullaeva, B. Sаhova
Tashkent medical academy, Tashkent, UzbekistanРустамова Мамлакат Тулабоевна
Mamlakat T. Rustamova
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
The questionnaire screening of patients with bronchial asthma showed that the majority of patients do not focus on existing complaints from the digestive organs and refer them to manifestations of their underlying disease. Esophagogastroduodenalfibroscopic examination of patients with asthma for the first time reflected the presence of Esophagogastroduodenal zone (EGDZ) pathology in 67.3% of patients, of which erosive-ulcerative lesions were detected in 21.3% of cases and catarrhal lesions - in 46% of cases. It is necessary to pay attention to the fact that the resolving factors for the development of the pathology of the Esophagogastroduodenal zone in patients with bronchial asthma are behavioral factors - smoking, drinking alcohol, strongly cooled drinks and violation of the safe use of the inhaler, creating serious prerequisites for the development of this pathology. The high frequency of EGDZ lesions in patients with bronchial asthma correlates with the duration of administration and doses of glucocorticosteroid therapy, which emphasizes its role as a trigger for the development of the pathology of the Esophagogastroduodenal zone.
Keywords: bronchial asthma, glucocorticosteroid therapy, Esophagogastroduodenal zone
Microbiocenosis of colon and ability to biofilm formation of strains Klebsiella spp. in children with functional gastrointestinal disorders
U.M. Nemchenko, E.A. Kungurtsevа, M.V. Savelkaeva, E.V. Grigorova, E.I. Ivanova, T.V. Tunik, L.V. Rychkova
Scientific Сentre for Family Health and Human Reproduction Problems, Irkutsk, RussiaUlyana M. Nemchenko, PhD of biological Sciences, researcher of the laboratory of the microbiome and microecology; ORCID: 0000-0002-7656-342
Ekaterina A. Kungurtseva, Junior researcher of the laboratory of the microbiome and microecology; ORCID: 0000-0002-4535-9397
Marina V. Savelkaeva, gastroenterologist, pediatrician highest category; ORCID: 0000-0001-6793-6493
Ekaterina V. Grigorova, PhD of biological Sciences, researcher of the laboratory of the microbiome and microecology; ORCID: 0000-0001-6588-2591
Elena I. Ivanova, PhD of biological Sciences, researcher of the microbiome and microecology; ORCID: 0000-0003-4216-8859
Tatiyana V.Tunik, Junior researcher of the laboratory of the microbiome and microecology; ORCID: 0000-0002-2355-0289
Lubov V. Rychkova, doctor of Medical Sciences, Professor RAN, director of the research center; ORCID: 0000-0003-2910-0737Немченко Ульяна Михайловна
Ulyana M. Nemchenko
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
Objective of the study: to establish the features of large intestine microbiocenosis in children with functional gastrointestinal disorders (FGIDs) and to analyze the biofilm ability of Klebsiella spp. strains isolated in the study.
Materials and methods: the coprological tests from 83 children, divided into two groups: The first group (n=34) is children under one year, the second group (n=49) is children over one year. The ability of biofilm formation has been studied in 53 strains of Klebsiella spp. identified in this study.
Results: It has been identified that significant factors in pathogenesis of FGIR in children are deficiency indices of bifidobacterial content, appearance of modified Escherichia coli strains and increase of microbial density of dominant species of opportunistic bacteria - Klebsiella spp. and Staphylococcus aureus. Klebsiella was shown to have the ability to form biofilm communities (48.1% in children under one year old and 50.0% in children over one year old). It is revealed that the presence of Klebsiella in the intestine is a significant risk factor for the development of dysbiosis 2-3 degrees, and in the absence of Klebsiella spp. as part of the intestinal microbiocenosis in children, regardless of age, dysbiotic disorders of 1 degree (p<0,05) were recorded.
Conclusion: Persistence Klebsiella spp. with biofilm formation ability has implications for the conservation and continued existence of associative pathological microbiocenosis that exacerbate bowel dysfunction.Key words: intestinal dysbiosis, bacterial biofilms, degree of biofilm formation, opportunistic Enterobacteriaceae, children
УДК 616.36-003.826-036.22(1-22)Prevalence and structure of fatty liver disease of varying etiology at the rural therapeutic stretch
N.V. Mikhailova1, I.L. Petrunko2
1Usolsk City Hospital, 665459, Usolye-Sibirskoye, Kuibysheva str., 4
2Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional EducationNatalya V. Mikhailova, physician district
Irina L. Petrunko, Head of the Department of medical examination, Professor, MD; ORCID: http://orcid.org/0000-0001-6239-4859Петрунько Ирина Леонидовна
Irina L. Petrunko
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
УДК 616.36-003.826-036.22(571.53)
The aim of the research: Examination of the prevalence, bending, age and sex structure of fatty liver lesions (FL) of different etiology in rural therapeutic area.
Materials and methods: 1152 person (73.5%) from 1568 the population of the rural therapeutic area, came to the examination.
Results: Free fatty liver disease (NAFLD) was revealed at 21.4%, alcoholic liver disease (ALD)-24.0% of the rural population (p>0.05).FL associated with viral hepatitis B and/or C, detected at 1.7%; toxic hepatitis -1 man - 0,09% among the surveyed.Prevalence of NAFLD was 220.1; FLD - 246.0; FL associated with viral hepatitis B and/or C -17.4;FL amid toxic hepatitis - 0.9 on 1000 population rural therapeutic plot.In NAFLD, the ratio between men and women was 1: 4.3 (p <0.001). Liver steatosis significantly prevailed in the nosological structure of NAFLD (p <0.001), it was in 225 (91.1%), steatohepatitis in 20 (8.1%), cirrhosis in 2 (0.8%) people, no gender differences were revealed (p>0.05). Almost half the patients accounted for working age (48.2%): men - 51.1%, women - 47.5%; differences are not significant (p> 0.05). In ALD the ratio between men and women was 1:1.4 (p>0.05). The nosological structure of ALD: liver steatosis in 167 (60.5%), steatohepatitis in 62 (22.5%), cirrhosis in 47 (17.0%) people. Most patients with ALD, both men (73.0%) and women (75.2%), were of working age (p <0.001).FL among persons with positive markers of viral hepatitis B and/or C 20 have been identified (1.7% of the total number surveyed) people: men - 9 (45.0%), female - 11 (55.0%) (p>0.05). Nosological structure of FL: liver steatosis - 10 (50.0%), steatohepatitis - 2 (10.0%), liver cirrhosis -7 (35.0%), liver cancer - 1 (5.0%).
Keywords: free fatty liver disease, alcoholic liver disease, the prevalence of, rural population
Autopsy incidence rate of fatty liver disease in the Irkutsk region
O.V. Tirikova 1, N. M. Kozlova 1, A.U. Tarasov 1, S.M. Eliseev 1, S.V. Lunenok2
1 Irkutsk State Medical University, 664003, Irkutsk, street Krasnogo Vosstaniya, 1
2 Irkutsk Regional Bureau of Forensic Medical Examination, 664022, Irkutsk, street Gagarina, 4Olesya V. Tirikova, MD, assistant lecturer of the Department of Faculty Therapy
NataliyaM. Kozlova, MD, PhD, head of the Department of Faculty Therapy
Sergey M. Eliseev, MD, deputy chief doctor
AleksanderU. Tarasov, MD, associate Professor
Svetlana V. Lunenok, MD, head of forensic histology departmentТирикова Олеся Владимировна
Olesya V. Tirikova
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
The aim. To study the epidemiology of fatty liver disease among the population of the Irkutsk region.
Materials and methods. The study was conducted on the basis of "Irkutsk Regional Bureau of Forensic Medical Examination». The object of the study was medical documentation – “The act of autopsy”.
Results. The analysis of the results of 7809 autopsies performed in 2012. A total of 7246 acts of autopsy were examined. Morphological signs of fatty liver disease were detected in 1602 (22.1%) cases.
Conclusion. 1. Fatty liver disease among residents of the Irkutsk region is 22.1%, and does not depend on gender: for women, 21.8% and for men, 22.3%; 2. Fatty liver disease is significantly more common in women in the age group from 25 to 59 years, in other age groups there is no difference between men and women. People of young, old age and long-livers are least susceptible to fatty liver disease; 3. The median life expectancy of those who died of cardiovascular diseases with steatohepatitis is 2.5 years less than with steatosis, while the DALY index with steatosis is 13.6 years, and with steatohepatitis is 13.5 years, which has no significant difference.
Key words: fatty liver disease, steatohepatitis, steatosis
Retrospective analysis of the prevalence, characteristics, therapy and outcomes of diverticular disease according to the data of a multidisciplinary hospital
M.D. Ardatskaya1, I.S. Podstavkina2, V.I. Mordasova2, N.N. Korotkikh2, G.V.Garushyan3
1 Central State Medical Academy of the Administrative Department of the President of Russia, Moscow, Russia
2 Budgetary institution of health care “Voronezh regional clinical hospital №1”, Voronezh, ussia
3 Central Military Clinical Hospital of National Guard, Moscow region, Balashikha, RussiaMaria D. Ardatskaya, Doctor of Medical Science, professor, professor of gastroenterology department; Scopus Author ID: 8713439300
Irina S. Podstavkina, head of the gastroenterology department
Valentina I. Mordasova, chief freelance gastroenterologist of the Voronezh region
Nikolay N. Korotkikh, deputy head physician for surgery
Grigoriy V. Garushyan, senior physician-gastroenterologist in the gastroenterology departmentАрдатская Мария Дмитриевна
Maria D. Ardatskaya
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Morbidity, mortality and case fatality rate from liver cirrhosis in the age aspect in Kyrgyzstan for the period 2010-2017
Aim of investigation: to study the prevalence, characteristics, therapy and outcomes of diverticular disease (DD) according to the data of a multidisciplinary hospital.
Material and methods: the retrospective survey included 50 patients treated in the Voronezh Region Clinical Hospital №1 in the period from 2016 to 2018 according to the following characteristics: age and gender, number of previous hospitalizations associated with DD and complications of diverticulosis, the results of clinical diagnostic and instrumental examination data, conservative treatment and surgical interventions.
Results: Within the discovered data there were 38 (79.1%) emergency and 12 (20.9%) planned admissions. Gender differences were established with the predominance of female patients: 28 women (56%) and 22 men (44%) respectively. According to age differences 4 patients were under 30 years (8 %), 7 — from 31 to 40 years (14 %), 13 – from 41 to 50 years (26 %), 17 – from 51 to 60 years (34 %), 9 people were older than 61 years (18 %). The average age was 39.2 ± 2.1 years. The majority of patients were of working age.
Acute diverticulitis was the predominant form of DB – 28 (56 %) cases. Bleeding was detected in 2 (4 %) cases, peridiverticular infiltrate — in 4 (8 %) cases, peridiverticular abscess — in 3 (6 %) cases, and recurrent chronic diverticulitis — in 13 (26 %) cases.
Repeated development of DD complications over a three-year follow - up period was found in 40 (80%) patients. Of the 28 (56%) patients with acute diverticulitis who did not receive anti-relapse treatment, 21 (42%) were subsequently operated on for DD complications.
Conclusion:
1. The results of the performed analysis showed that every second patient with DD was of working age (up to 68 years). In the period from 2016 to 2018, there was a tendency of increase in the incidence of DD in patients of all age groups.
2. Acute diverticulitis was the predominant form of DB (56%). Peridiverticular infiltrate and peridiverticular abscess were detected in 8% and 6% of cases respectively.
3. Within three years, repeated development of DD complications was observed in 40 (80%) patients of the studied sample. Of the 28 patients (56%) with acute diverticulitis treated conservatively and not receiving anti-relapse therapy, 21 people (42%) were subsequently operated on for complications of DD.
Key words: diverticular disease, diverticulitis, complications of diverticular disease, colon
K.A. Nogoibaeva.1,2, S.T. Tobokalova.1, S.I. Umarova. 3
1Kyrgyz State Medical Institute of Retraining and Advanced Training named after S. B. Daniyarova, Bishkek, Bokonbaeva 144a, 720040, Kyrgyzstan
2Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek, Akhunbaeva 92, 700020, Kyrgyzstan
3 Kyrgyz Russian Slavic University named after B.N. Yeltsin, Bishkek, Kiev 44, 720000, KyrgyzstanKalys A Nogoibaeva, Department of Infectious Diseases, HIV / AIDS and dermatovenerology; Associate Professor; Department of General and Clinical Epidemiology, Associate Professor, PhD; Scopus ID:26640604900, ORCID: https://orcid.org/0000-0003-0673-872X
Saparbu T. Tobokalova, Department of Infectious Diseases, HIV / AIDS and dermatovenerology, Head of the Department of Infectious Diseases, HIV / AIDS and Dermatovenereology, MD, Professor
Svetlana I. Umarova, Department of Therapy No. 1, Faculty of Medicine, PhD, Associate ProfessorНогойбаева Калыс Асанбековна
Kalys A Nogoibaeva
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
The purpose is to study the dynamics of morbidity, mortality and case fatality ratefrom liver cirrhosis in the age aspect from 2010-2017 in Kyrgyzstan.
Materials and methods: Analyzed state reporting forms No. 12 “Report on morbidity and preventive work (family medicine center, dispensary)” and “C 51 - Distribution of deaths by sex, age groups and causes of death” from 2010-2017.Data processed by Microsoft Office Excel.
Results: The average cumulative prevalence of liver cirrhosis (K 74) in persons older than 15 years for the period 2010-2017 was 50.9 0/0000, the average incidence is 12.3 0/0000, the mortality is 45.2 0/0000. Persons over 75 years old had the highest mortality rate –160, 7 0/0000, the age group “45-59 years old” occupied the third position (92.8 0/0000) after the persons «60-74 years old» (140.9 0/0000). It is necessary to emphasize the presence of mortality among children and individuals 15–24 years old, although the incidence rates (0.20/0000and 2.50/0000, respectively) and the proportion (0.2% and 1.6%, respectively) were low.In the period 2015-2017 were registered 47 children with “K 74”, of which 15 were first identified, and for 2011–2017yy. 32 children with a fatal outcome. Over the past 3 years there has been a tendency for the growth of all three indicators in children. For 2010-2017yy. the average cumulative case fatality ratein persons over 15 years of age prevailed over children in 2,069.9 cases per 10,000 patients (8878.4 0/000and 6808.5 0/000, respectively). The case fatality rateamong adults decreased 1.6 times (11176.8 0/000and 6815.2 0/000, 2010 and 2017, respectively), and among children 1.5 times (4285.7 0/000and 2857.1 0/000, 2015 and 2017, respectively).
Conclusion: On the basis of the obtained data, in order to improve the K 74 accounting system, an emergency notification (Form No. 58u) was introduced in the country for newly detected and lethal cases of cirrhosis and liver cancer in the outcome of hepatitis B and C. To develop specific prevention measures and control strategies in general, the country needs a register of patients with cirrhosis and liver cancer with etiological interpretation.
Key words: liver cirrhosis, incidence, morbidity, mortality, case fatality rate, ≥ 15 years, ≤ 14 yearsSURGICAL GASTROENTEROLOGY
Modern strategies of therapeutic and surgical treatment of Crohn's disease
A.M. Pershko, V.B. Grinevich, I.A. Solovyov, D.P. Kurilo
Military medical a cademy named after S.M. Kirov, 194044, St Petersburg, RussiaAnatoly M. Pershko, professor of 2 the clinic (therapy of advanced medical), MD, Professor
Vladimir B. Grinevich, honored doctor of the Russian Federation, head of the 2 clinic (therapy improvement of doctors), MD, Professor
Ivan A. Solovyov, head of the Department of naval surgery, MD, Professor
Denis P. Kurilo, adjunct of the Department of naval surgeryКурило Денис Петрович
Denis P. Kurilo
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
УДК 616.37-002-074:612.13
Purpose of the study. Analysis of the results of recent studies of BC with the aim of understanding the possibility of changing or modifying the natural course of BC with therapeutic or surgical methods, the possibility of a complete cure of BC with therapeutic methods.
Materials and methods. This review examines the results of recent studies aimed at studying the effect of modern therapeutic methods for treating CD for the course of this disease and the possibility of reducing the number of surgical interventions.
Results. The concept of competent therapeutic treatment of BC in the long term (more than 7 years) has not been confirmed. The accumulating experience of repeated bowel resections in patients with CD, suggests that the phenotype of the disease in the re-operated patients with CD remains the same, regardless of the nature of the treatment. However, the risk of surgical interventions in patients with CD in recent years has decreased.
Conclusion Early diagnosis (CT, MRI) and the earlier treatment of complications instead of prescribing therapeutic treatment, effective prevention of relapses with modern drugs in the postoperative period leads to the fact that recently there has been a decrease in the risk of surgical interventions in patients with CD. Surgical strategy is aimed at the use of “economical” resections with the formation of the primary small-intestinal or small-colonic anastomosis in an open way.
Keywords: Crohn's disease, complications of CD, CD phenotype, biological preparations, anti-TNF therapy, 5-ASA, pentas, fistula, strictures, open treatment, laparascopic treatment
Peculiarities of the expression of the vascular adhesion molecule in acute IA phase pancreatitis
Yu.S. Vinnik, S.S. Dunaevskaya, V.V. Deulina
Krasnoyarsk State Medical University named after prof. V.F. Voyno- Jaseneckiy Ministry of Health RF, 660077, Russia, г. Krasnoyarsk, street. Partizana Zsheleznyazka, 1Yurii S. Vinnik, Doctor of Medicine, professor, the head of the department of the general of surgery of the prof. M.I. Gulman; ORCID: http://orcid.org/0000-0002-8995-2862
Svetlana S. Dunaevskaya, Doctor of Medicine., professor, professor of general surgery’s department named after prof. M.I. Gulman; ORCID: http://orcid.org/0000-0003-2820-4737
Vera V. Deulina, the graduate student of general surgery’s department named after prof. M.I. Gulman; ORCID: http://orcid.org/0000-0002-7515-0500Дунаевская Светлана Сергеевна
Svetlana S. Dunaevskaya
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УДК 616-073 584
Purpose: to estimate the expression of a molecule of vascular adhesion of PECAM-1 (CD 31) at patients with acute pancreatitis of varying severity in ΙА phase diseasedevelopment.
Materials and methods. Work has clinical character and is based on the prospective analysis of observation and treatment of 135 patients with acute pancreatitis of various degrees of severity. Patients were divided into three groups, depending on severity of a disease: 1 group – 45 patients with slight acute pancreatitis, the 2nd group – 45 patients with medium-weight acute pancreatitis, the 3rd group – 45 patients with heavy acute pancreatitis. Blood sampling for a research was carried out at receipt prior to therapy. Phenotyping of lymphocytes was carried out by method of an indirect immunofluorescence by means of mouse monoclonal antibodies to the molecules CD31 receptors of lymphocytes.
Results. The obtained data demonstrate that the percent of CD31-expressing of lymphocytes depends on weight of acute pancreatitis. At initially severe form of a disease, there was strengthening of process of transendothelial migration of lymphocytes in the center of forming of a necrosis in pancreas tissue. In our research significantly (p <0.001, p1 <0.001, p2 <0.001) the percent of the CD31-expressing lymphocytes to 13.21 increased [12.50; 5.76].
Conclusion. The obtained data demonstrate that there is an interrelation between PECAM1 expression as a marker of intercellular interactions and severity of acute pancreatitis.
Keywords: sharp pancreatitis, heavy sharp pancreatitis, molecule of vascular adhesion
Pancreatic cancer diagnosis by infrared serum spectroscopy
O.V. Krasnikova1, A.S. Gordetsov1, A.A. Puzankov2 1
Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation, 603005, Nizhny Novgorod, Minin and Pozharsky Square, 10/1
2Privolzhsky district medical center Federal Medical and Biological Agency of Russia, 603005, Nizhny Novgorod, Nizhnevolzhskaya emb., 2Olga V. Krasnikova, Department of General Chemistry, Associate Professor
Alexander S. Gordetsov, Department of General Chemistry, Professor
Alexey A. Puzankov, endoscopist, surgeonКрасникова Ольга Владимировна
Summary Purpose of the study. To develop a method for early diagnosis of pancreatic cancer using infrared spectroscopy of blood serum.
Olga V. Krasnikova
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Materials and Methods: 30 patients with pancreatic disease were examined by IR spectroscopy of blood serum.
Results. Changes in the content of metabolites in the blood when a disease of the pancreas causes changes in spectroscopic characteristics. These changes in the IR spectra of the blood make it possible to form differential diagnostic images of pancreatic cancer and acute pancreatitis.
Key words: IR spectroscopy, diagnosis, pancreatic cancer, acute pancreatitis
УДК 616-072.1-006-216.1-089.82-079.4
Methodological and Technical Aspects of EUS-Guided Fine Needle Aspiration of the Upper Digestive Tract Lesions
E.A. Godzhello, N.A. Bulganina, M.V. Khrustaleva
Petrovsky National Research Centre of Surgery, 119991, Moscow, Abrikosovsky per., b. 2, RussiaElina A. Godzhello, MD, PhD, Chief Scientific Employee of the Endoscopic Department
Natalia A. Bulganina, PhD, Scientific Employee of the Endoscopic Department
Marina V. Khrustaleva, MD, PhD, Head of the Endoscopic DepartmentБулганина Наталья Анатольевна
Natalia A. Bulganina
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
Aim. Analysis of the results of our own experience of EUS-guided fine-needle aspiration (EUS-FNA) of digestive tract lesions, depending on the technical and methodological aspects.
Materials and methods. From 2007 to July 2019, the EUS-FNA was performed in 86 patients. Aspirating and ProCore needles of various calibers were used. Punctures were performed once (54), two- (20), three- (8) and four times (4) both with and without aspiration.
Results and discussion. Material suitable for histological examination was obtained in 86% of patients: with a single puncture - in 83.3% of cases, double - in 91.3%, triple - in 100%, four times - not obtained. Using 19G needles, the material was obtained in 80.5%, 22G in 93%, 25G in 100% of cases. Punctures were successful in 90.5% of patients with pancreatic lesions, in 75% of patients with subepithelial lesions, in 80% of cases with abdominal and retroperitoneal lesions, in all patients with lymphadenopathy, mediastinal and liver lesions. With aspiration, punctures were successful in 85.5% of cases, without aspiration in 100% (3/3). With the combined method (with and without aspiration), the material obtained in different modes in 11 patients was equally sufficient for histological examination. It was also noted that one of the Fujifilm echoendoscopes used for performing the EUS-FNA has an inconvenient design of the biopsy channel distal part. A surgery was performed on 50 out of 86 patients; in 42 (84%) of them, the EUS-FNA material was suitable for performing a morphological examination. The histological examination results conformity of the material obtained by fine-needle aspiration and surgical material was 88.1% (37/42).
Conclusion. It is necessary to consider many factors to obtain the most effective results in the EUS-FNA, since none of them is prevailing.
Keywords: EUS-FNA, endosonography, fine-needle aspiration, aspiration, ProCore, histological examination, lesions of upper digestive tract organsEXPERIMENTAL GASTROENTEROLOGY
УДК 619 : 616.36 : 615.322 + 615.244
Comparative evaluation of the application of hepatoprotector LIV-52 and prebiotic Rekicen-RD in preventive correction of experimental NSAID-hepatopathywith Nimesulide
L.V. Lazarenko 1, P.V. Kosareva 2
1 Perm Institute of the Federal Penal Service, 125, Karpinski str., Perm, Russia, 614012
2 Perm State National Research University, 15, Bukireva str., Perm, Russia, 614990Ludmila V. Lazarenko, Associate Professor of the Department of Zootechnics, Candidate of Veterinary Sciences; ORCID: 0000-0003-1250-2676
Polina V. Kosareva, Professor of the Department of Inorganic Chemistry, Chemical Technology and Technosphere Safety, Doctor of Medical Sciences; ORCID: 0000-0002-0853-925XЛазаренко Людмила Викторовна
Ludmila V. Lazarenko
This email address is being protected from spambots. You need JavaScript enabled to view it.Summary
Transcriptional activity of glutathione system genes in toxic hepatitis caused by paracetamol
Objective: to conduct a comparative assessment of the use of the hepatoprotector and the prebiotic in NSAIDs-hepatopathy, induced by prolonged use of nimesulide using histological and immunohistochemical methods.
Materials and methods: The experiment was conducted on laboratory animals (rats), which were used to model NSAID-hepatopathy by administering nimesulide by the oral route for 21 days. Animals from the two experimental groups received a hepatoprotector and a prebiotic (simultaneously with nimesulide). The effect of the drugs was assessed by the results of histological examination of the liver tissue and the manifestation of the immunohistochemical expression of receptors of tumor necrosis factor α (TNFαR1) on hepatocytes. To detect receptor expression, labeled TNFR1 (polyclone) antibodies, species-specific to rat tissue antigens, were used.
Results: histological examination of animals from experimental groups revealed the preservation of liver tissue, which was manifested by a decrease in pathological disorders. The study of immune responses in the pathogenesis of NSAIDs-hepatopathy demonstrated that the simultaneous use of both hepatoprotector and prebiotic significantly reduced the effect of tumor necrosis factor α on liver tissue, which was confirmed by a low level of TNFαR1 expression in animals of experimental groups compared to manifestations of TNFαR1 expression in animals with NSAID-hepatopathy. Hepatoprotector had a more pronounced protective effect compared to the prebiotic.
Conclusion: studies have shown that the simultaneous use of both hepatoprotector and prebiotic with nimesulide reduces histomorphological and immune disorders in the liver tissue. Drugs can be recommended for the correction of pathological disorders of the liver tissue with prolonged use of NSAIDs.
Key words: NSAID-hepatopathy, hepatoprotector, prebiotic, tumor necrosis factor
Т.G. Yаkupova1, G.F. Mukhammadiyeva1, D.O. Karimov1, E.G. Kutlina2, A.B. Bakirov1, Ya.V. Valova1, S.S.Bajgil'din1, M.M. Ziatdinova1
1 Ufa Research Institute of Occupational Health and Human Ecology, Ufa, Russia
2 Ufa Medical College, Ufa, RussiaTat'yana G. Yаkupova, Junior Researcher of the Department of Toxicology and Genetics with an experimental laboratory of laboratory animals, Post-graduate; ORCID: https://orcid.org/0000-0002-1236-8246
Guzel' F. Mukhammadiyeva, Senior Researcher of the Department of Toxicology and Genetics with the Experimental Clinic of Laboratory Animals, candidate of biological sciences; ORCID: http://orcid.org/0000-0002-7456-4787
Denis O. Karimov, head of the department of toxicology and genetics with the experimental clinic of laboratory animals, candidate of medical sciences; ORCID: http://orcid.org/0000-0003-0039-6757
Elena G. Kutlina, 1st year student of the faculty of nursing
Ahat B. Bakirov, director, Professor, doctor of medical sciences; ORCID: http://orcid.org/0000-0003-3510-2595
Yana V. Valova, Junior Researcher of the Department of Toxicology and Genetics with an experimental laboratory of laboratory animals, Post-graduate; ORCID: http://orcid.org/0000-0001-6605-9994
Samat S. Bajgil'din, Junior Researcher of the Department of Toxicology and Genetics with an experimental laboratory of laboratory animals, Post-graduate; ORCID: https://orcid.org/0000-0002-1856-3173
Munira M. Ziatdinova, Junior Researcher of the Department of Toxicology and Genetics with an experimental laboratory of laboratory animals; ORCID: https://orcid.org/0000-0002-1848-7959Якупова Татьяна Георгиевна
Tat'yana G. Yаkupova
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УДК 612.35:612.343:615.35
The aim of the study was to study the changes in the transcriptional activity of the GSTM, GSTP and GSTT genes in acute toxic hepatitis caused by paracetamol and against the background of preliminary administration of drugs (heptor, mexidol, oxymethyluracil).
Material and methods: Toxic hepatitis was modulated in male albino mongrel rats assigned to five groups (control group, primed with paracetamol without subsequent administration of the drug, with the administration of heptor, mexidol and oxymethyluracil). After 24 and 72 hours of paracetamol administration, the rats were anesthetized and the mRNA levels of the GSTM, GSTP and GSTT genes in the liver homogenate were examined. Drugs were administered one hour before paracetamol administration.
Results: It has been shown that with 24-hour exposure to paracetamol, the expression ratio of the GSTM gene increased from -0.37 in the control group to 1.03 in the untreated group. After 72 hours of exposure to the toxicant, it was elevated compared with the control group in all groups (paracetamol without treatment — 0.77; heptor — 1.74; mexidol — 1.51; OMU — 1.62). An analysis of the representation of GSTT gene transcripts after 72 hours of exposure showed a stepwise increase and decrease in the expression level in the groups studied. The expression of the GSTP gene with the 24-hour experiment was reduced and ranged from -0.3 to -1.51. (F = 2.916; p = 0.038), and with 72 hours of exposure to paracetamol, the results were opposite. Statistically significant values (p = 0.032) were obtained by comparing the group with paracetamol without treatment and when used as the OMU drug.
Conclusion: the results obtained may indicate the involvement of the given genes in paracetamol metabolism in liver cells. It was found that OMU is a hepatoprotector responsible for restoring the antioxidant defense system.
Key words: toxic hepatitis; paracetamol; heptor; mexidol; oxymethyluracil; expression
The role of liver in modification of peptidergic mechanisms of regulation of digestive glands
M.A. Zhuraeva, V.A. Aleinik, S.M. Babich, M.K. Yakubbekova, N.A. Yusupova
Andijan State Medical Institute, Republic of Uzbekistan, Andizhan, 170127, Atabekova St., 1,Mohigul A. Zhuraeva, Candidate of Medical Sciences, Associate Professor of the Department of General Practitioners 1, , Faculty of Medicine, applicant
Vladimir A. Aleinik, Doctor of Medical Sciences, Professor, professor, professor of the Department of Normal Physiology
Svetlana M. Babich, Candidate of Medical Sciences, Associate Professor, Head of the Department of Social Hygiene and Health Management
Mavluda K. Yakubbekova, Assistant of the Department of Faculty Therapy, Faculty of Medicine
Nodira A. Yusupova, Applicant, Assistant of the Department of Faculty TherapyЖураева Мохигуль Азимовна
Summary
Mohigul A. Zhuraeva
This email address is being protected from spambots. You need JavaScript enabled to view it.Studies were performed on 84 rats in 12 series, 7 acute experiments in each series. Studied the change in gastric and pancreatic secretion with the introduction of the short-chain peptide CCK-8 and pentagastrin in the presence of trypsin and contrуcal. It was concluded that the short-chain peptide CCK-8 and pentagastrin are utilized by the liver to a large extent. Trypsin, when passing through the liver, reduces the ability of the liver to utilize CCK-8 and pentagastrin. The protease inhibitor contrуkal® when passing through the liver increases the ability of the liver to utilize these peptides. It is concluded that the liver is involved in the modification of peptidergic mechanisms of regulation of the digestive glands.
Key words: liver, utilization, CCK-8, pentagastrin, trypsin, contrycal®, rats, gastric secretion, pancreas secretion