The unique properties and a great therapeutic potential of incretin drugs allowed them to win a firm place in modern algorithms of treatment of type 2 diabetes in an unprecedented short period of time. Due to discovery of the incretin effect and introduction of the incretin mimetics into clinical practice, an interest of the researchers was growing to study the pleiotropic effects of gastrointestinal hormones. In experimental and clinical studies in recent years there has been shown the cytoprotective and cytoproliferative effects of a number of intestinal hormones, namely glucagon-like peptide-1 (GLP-1), ghrelin, and obestatin when administered systemically. This review presents an analysis of the currently available results of fundamental and clinical research on the pleiotropic potential of the gastrointestinal peptides, and also determines the relevance of further research on the metabolic effects of bariatric surgery.

There was held an useful eradication of Helicobacter Pylori in 20 patients with peptic ulcers (Omeprazole, Clarithromycin and Amoxicillin in normal doses). A five - year monitoring period revealed clinical manifestations of relapse in 50% of cases and endoscopic manifestations in 60% of cases (15% - ulcers and 45% - gastral erosions). Relapse of peptic ulcers was accompanied with change of clinical course, it became oligo- or asymptomatic in 83% of patients. Relapse of peptic ulcers was fixed in 45% of patients (15% - in patients with ulcer and 30% - in patients with gastral erosions), at that, erosions were caused by NSAIDs in a half of cases, accompanied with a weak degree of contamination and inflammation of gastral mucosa.

Aim: to determine the condition calcium-regulating system, calcium-phosphate balance in the period of recurrence of peptic ulcer disease and possibility of correction changes in calcium-regulating system (drugs calcitonin, calcium channel-blocking agent, biphosphonate). Materials and methods: 220 patients with peptic ulcer recurrence were examined with examinations of parathyrin, calcitonin, calcium and phosphorus in blood, secretory and motor functions of a stomach. Results: it was established that a recurrence of peptic ulcer disease accompanied by significant increase of parathyrin and calcium in blood, small increase of calcitonin in blood, significant decrease phosphorus in blood. These changes, accompanied by a significant increase of secretory and motor functions of a stomach, reducing production gastromucoproteids. Application in the treatment of peptic ulcer disease calcitrinum, nifedipinum and etidronic acid leads to a significant clinical effect, the normalization of the level of calcium in blood and functions of the stomach. Conclusion: recurrence of peptic ulcer disease has changes in calcium-regulating system. Application in complex treatment of recurrence of peptic hormone C-cells of the thyroid - calcitrinum, calcium channel-blocking agent - nifedipine and biphosphonate - etidronic acid are clinically effective.

The aim of this study was to investigate the clinical characteristics and the nature of the lesions of the upper gastrointestinal tract at 3 and 4 stages chronic kidney disease (CKD). The study included 35 patients with chronic kidney disease who were divided into 2 groups according to the stage of the disease. All patients underwent esophagogastroduodenoscopy. It is established that the progression of CKD increases the risk of upper gastrointestinal lesions, characterized by the presence of erosive and non-erosive lesions. It was revealed that the clinical picture in CKD characterized with decrease of abdominal pain syndrome and frequently dyspeptic syndrome which associated with the pathology of the gastrointestinal tract and as well directly with CKD.

The combination of gastroduodenal pathology of diseases of the joints is a serious problem for modern medicine, due to the high incidence of arthritis in the population, not only the defeat of joints, but also of many other organs and systems. Status of upper gastrointestinal tract and also depends on the used for the treatment of articular syndrome drugs in the first place - non-steroidal anti-inflammatory drugs. In connection with this problem it becomes relevant learning condition of the gastrointestinal tract, in particular the gastroduodenal mucosa.

Purpose. Study the characteristics of proteomic profile of esophageal mucosa in different forms and gradations of gastroesophageal reflux disease (GERD). Materials and methods. The study included 68 patients with verified GERD. Studied the proteomic profile of a gullet a method of tandem time-of-flight MALDI mass spectrometry using bioinformation algorithms. Results. The identified proteins are involved in the regulation of inflammation, apoptosis, adhesion and transport of ions and other important biological processes. The data obtained allow to expand the understanding of the molecular mechanisms of this pathology development. Identified proteins in the esophagus can be used as informative markers of the complicated course of GERD

We explored the psychological and social risk factors for chronic pancreatitis and chronic pancreatitis in combination with metabolic syndrome at the family level, as well as the eating habits of patients. It was found that the highest relative risk have such factors as the existence of conflicts in the family, parents’ lack of love in childhood and excessive strictness of parents. Financial difficulties in the family contribute to the development of chronic diseases and limited treatment options. Eating habits prevailing in the family of patients influence the exacerbation of chronic pancreatitis, even against the background of compliance with dietary recommendations.

The issues of formation of secondary osteoporosis in patients with chronic pancreatitis (CP) were discussed in this paper. It was shown that the chronic relapsing nature of the disease process in the pancreas leads to hypokalemia due to malabsorption of calcium and vitamin D as the result of maldigestion. As well as the redistribution of ionized and total calcium blood between the body fluids, which can be a consequence of long-term nature of pain. At the same time, the study of the content of enzymes bone found their decline to a greater extent characteristic index tartrate resistant acid fosfatazy- marker of bone resorption. Changes in bone metabolism were confirmed by ultrasound bone (densitometry) at which proved the development of osteoporosis in 47,7% of cases, and osteopenia in 35,7% of patients. The conclusions about the need for pre-clinical diagnosis of osteoporotic states in patients with CP, correction of diet and administration of appropriate therapy were made.

Research objective - to conduct electrophysiological analysis for experimental ulceration stages in rats studying changes in the electrical activity (EA) frequency characteristics (FCH) (frequency response) of the stomach and duodenum. Materials and methods: The study was conducted in 5 experimental groups of outbred albino rats weighing 250-300 g with acetate stomach ulcerative injury (SUI). Using the method of direct multi-channel electrocardiography, we recorded the EA of gastric corpus (SB), its pyloric (PO) and the entry part of duodenum. We analyzed the frequency response of EA smooth muscles of stomach and duodenum during the period of seven days after the simulation SUI. The obtained by Shapiro-Wilk test data was distributed in accordance with statistically significant differences between samples - using the Student’s t test. Correlation analysis was performed basing on the calculation of Pearson correlation coefficient. Results: The average value of the frequency EA and TJ PO increased on the second day of the experiment 55.7% (p <0.01) and 53.0% (p <0.01), respectively, were down on the fourth day and then increased from 5 to 7 day of the experiment by 87.6% (p <0.01) in TJ and 89.8% (p <0.01) in the PO. The frequency EA LDK increased on the seventh day of the experiment 32,4% (p <0.05). The frequency EA LDK increased on the seventh day of the experiment 32.4% (p <0.05). Frequency EA inter-correlation among all the components of the gastroduodenal complex (GC) were the closest on the fourth day after inflicting the stomach ulcerative injury. Conclusion: Frequency EA changes in correlation of components GC can serve as functional markers its integral condition in the process of experimental ulceration.

The goal: to investigate a preventive activity for novel medication magnesium 2-aminoethansulfonate in experimental hepatitis in pregnant rats. Material and Methods. The study has been conducted in firs week pregnant rats with paracetamol and ethanol-induced liver injury. Results. There has been found out that new domestic compound magnesium 2-aminoethansulfonate (laboratory name LBK-527) introduced daily at a dose of 28 mg/kg per os during 6 days, limits cytolysis and cholestasis caused by either paracetamol or ethanol intake in experiments in pregnant rats. Study shows that liver of the animals, that have been given LBK-527 simultaneously with either 500 mg/kg paracetamol or 10 ml/kg 40% ethanol, remains being structurally close to normal. The substance prevents acute toxic liver dystrophy and the organ’s structure disintegration made by mentioned toxic agents. Having administered at a therapeutic dose LBK-527 isn’t associated with faetotoxicity and embriototoxity in experiments in rats.

The ferrokinetic indices of blood serum of rats with acetaminophen-induced hepatitis under the conditions of alimentary deprivation of protein were assessed in the work. Research was conducted on 4 groups of animals: 1 - control; 2 - rats maintained on low-protein diet; 3 - rats with acute acetaminophen-induced hepatitis, maintained on full-value ration, 4 - rats with acute acetaminophen-induced hepatitis, maintained under the conditions of alimentary deprivation of protein. The serum iron content of and serum iron binding capacity were determined colorimetrically,% of the transferrin iron saturation - as a ratio of serum iron concentration to maximal iron binding capacity of serum transferrin. The presence of hemosiderin inclusions and the character of hemosiderosis were determined in the liver sections, stained by Perls method. Qualitative determination of C-reactive protein in blood serum was carried out by immunoenzymatic method. It is shown, that in protein-deficiency rats any significant changes of iron metabolism indices and hemosiderin accumulation weren’t observed. At the same time in rats with acetaminophen-induced hepatitis the 5-fold increase of the serum iron content against the background non-significant increase of serum iron binding capacity and the 2-fold increase of the transferrin iron saturation is established. Simultaneously in the hepatocytes and reticuloendothelial system cells the accumulation of hemosiderin in the low dispersion form is observed, equating the second degree of hemosiderosis on the background emerging of C-reactive protein in serum. In protein-deficiency rats with toxic liver injury an abrupt increase of serum iron against the background reduction of the total serum iron binding capacity and maximal saturation of transferrin by iron ions is observed. It is established, that for animals from current group the third degree of mixed type hemosiderosis and the intensification of the inflammatory reaction in liver is characterstic. Conclusion was made, that alimentary deprivation of protein under the conditions of toxic liver injury is the critical factor for structural-functional state of liver, being accompanied by the iron metabolism disturbances, development of hemosiderosis and intensification of the inflammatory reaction in liver. Research results may be used for the biochemical rationale of the therapeutic approaches for the elimination and correction of the toxic liver injury consequences.

Aim: to detect the bacteriocin genes of probiotic strains Lactobacillus acidophilus D-75 and Lactobacillus acidophilus D-76 (components of Vitaflor dietary supplement). Materials and Methods: The antagonistic activity of L. acidophilus D-75 and L. acidophilus D-76 strains was estimated by the deferred antagonism method. The identification of bacteriocin genes was performed by PCR using helveticin J gene primers. Amplified fragments were sequenced using ABI PRISM® 310 Genetic Analyzer and were analyzed using NCBI/BLASTX. Results: The test bacteria exhibit pronounced antagonistic activity (AA) against Escherichia coli O75 and Salmonella Enteritidis 209. In the presence of Actoflor-S (metabiotic dietary supplement) the antagonistic activity of tested probiotic strains was 2-2.5-fold increased indicating its inducible nature. The identical sequences of 537 bp homologous to gene fragment of helveticin of L. helveticus DPC4571 (lhv_1632 gene) were detected in DNA of both strains. Sequencing of these fragments showed difference in three nucleotides compared to the reference DNA of DPC4571 strain (A instead of G at position 46, C instead of T at position 249 and A instead of T at position 537), but all these replacements do not lead to changes in the amino acid sequence of a bacteriocin. For L. acidophilus D-76 another bacteriocin gene fragment of 283 bp was identified (in addition to 537 bp fragment). The latter had 95% homology with the helveticin J gene of L. helveticus R0052 (R0052_09025 gene). In NCBI/BLASTX database the sequences homologous to the helveticin gene of L. helveticus DPC4571 were found in 11 microorganisms related to L. acidophilus, L. amylovorus, L. crispatus, L. gallinarum, L. helveticus and L. kitasatonis. Conclusion: Thus, our study shows that there are at least two bacteriocins in L. acidophilus D-76 and one bacteriocin in L. acidophilus D-75. However, the true potential of these probiotic bacteriocins for human health has yet to be realized.

Aim of study was determination of effectiveness of endoscopic delation and oxide of nitrogen in the treatment of benign esophageal strictures. Materials and Methods: Results of using delation and oxide of nitrogen in the treatment of 112 patients with benign esophageal strictures. Results: It was shown that oxide of nitrogen in the speed up process of epythelisation.

The introduction of a screening diagnosis of precancerous lesions of gastric mucosa and elaboration of new methods of radical treatment is an important aspect of gastric cancer prevention. Digestive endoscopy with subsequent morphological study allows with high probability to correctly assess the structure of the lesion and to identify changes that have prognostic value. Gastric adenoma is the obligate precancerous lesion because the presence of intraepithelial neoplasia. Aim - retrospective review the clinical-morphologic characteristics and frequency of gastric adenoma in a large series of endoscopies from patients with gastric polyps. Methods - 163 gastric adenomas were diagnosed by histological examination in a series of 990 patients who had upper digestive endoscopies done. The patients were analyzed as the age, sex, and the adenomas as the histological and Yamada classification, as well as their location, size, histopathological findings studied. Results - gastric adenomas were diagnosed in 16,5% in a series of patients with gasric polyps, more frequently in the women. Gastric adenomas were primarily single and developed in the antrum of stomach. High grade dysplastic foci were found in 0,6% adenomas, which size was lesser than 2 cm. Intestinal metaplasia with high grade prognostic value was found in 18,4% cases. A carcinoma was not detected.

The aim of this study was to study meaning of bile ducts angulation in postcholecystectomical syndrome developing. Materials and methods. There were 27 patients to be followed-up, 15 of them were performed long-term multi-stent placement in order to pursue bile ducts angulation to be liquidate and angles. After that control estimation was having versus 12 patients of control group. Results. Author have seen diminish average amount of angles, their increased and accelerate of evacuation contrast speed into duodenum. That all have correlate with severe of postcholecystectomical syndrome and positive dynamic. Conclusion. The bile ducts angulation have meaning in postcholecystectomical syndrome developing and long-term multi-stent placement is effective way of its treatment.

Objective: the aim of study was testing and introduction in clinical practice combination of EUS with sonoelastography, fine-needle biopsy and needle-based confocal laser endomicroscopy in advanced diagnostic of pancreatic disease. Materials and methods: in the period from February 2014 to December 2015, we accumulated experience of EUS-FNA in 72 patients mostly with tumor pathology of the pancreas. In 16 cases we used 19G, in 49-22G, and in 7 patients - 25G needles. In 5 patients we used COOK Echotip Procore needle. In 8 cases we performed confocal laser endomicroscopy through the 19G needle (nCLE) in 3 patients with cystic and in 5 - with solid tumors. In 20 patients, there we used HITACHI-PENTAX sonoelastography was performed. Results: There were no complications in EUS-FNA. In all cases we received pathology verification of disease. nCLE results always confirmed by morphological examination of material. In elastography examination normal pancreatic tissue had a equable green-yellow color, in chronic pancreatitis on the same background there were areas of blue seal parenchyma, in the cases pancreatic adenocarcinoma it was marked predominance of blue color scale, in neuroendocrine tumors - diffuse distribution of green and blue areas. Using nCLE in patients with adenocarcinoma revealed the destruction of certain glands, polymorphic nuclei of epithelial cells, with their enlargement, deformation, loss of polarity. Appliance of Procore needle has its technical features, but allowed us to obtain more material with less bloody - due to fewer number of passes. Conclusion: Thus, our study confirms the effectiveness of EUS-FNA with sonoelastography and nCLE. It defines objectives for improvement and expansion of the range for their clinical use.

Research aim is estimation of dependence between integral hematological indexes and chemiluminescence of neutrophils at severe acute pancreatitis. Materials and methods: The 70 patients with acute pancreatitis were examined, severity of disease were reviled based on integral score Ranson, results of clinical and laboratories examinations, diagnosis was confirmed by instrumentals methods of diagnostics. Patients were divided into two clinical groups: 35 patients with no severe acute pancreatitis and 35 patients with severe acute pancreatitis. Integral hematological indexes were calculated based on results of clinical blood test. Functional activity of neutrophils were estimated by chemiluminescence analysis, activator of reaction was luminal. Results: Severe acute pancreatitis was characterized by lowering of intensity chemiluminescence with prevalence hypoxic type of active oxygen’s generation 94,28% patients. High negative correlations between integral indexes of inflammatory reaction and degree of endotoxicosis (Kalf - Kalif’s leukocytal index of intoxication, index of correlation between neutrophils and lymphocytes, G. D. Dashnayahtsa nuclear index and reactive response of neutrophils) and indexes of chemiluminescence reaction, which show type of active oxygen’s generation (intensity of reaction and peak reaction time) were revealed. It allowed talking about high degree of oxidative stress at expressed inflammatory and necrotic process in pancreatic tissue. Decrease of antioxidant resources against a background expressed pathologic process at severe acute pancreatitis was confirmed by High negative correlations between и index of correlation between neutrophils and square under curve of chemiluminescence reaction (-0,62, p=0,001 at spontaneous reaction and -0,72, p=0,001 activated).

The differences in the type and tension of the general unspecific adaptational reactions in cancer patients with varying prevalence of the process in biliopancreaticoduodenal zone and volume of surgical intervention were revealed. It was shown prognostic significance of the numerical score of the type and tension of the adaptational reaction a day after pancreatoduodenal resection for the development of postoperative complications.

Aim of research: Evaluate clinical advantages of combined therapy using Ursodeoxycholic acid (UDCA) with spasmolytic of patients with second stage biliary sludge (BS) - in a form of echo-heterogeneous bile containing clots. Materials and methods: 42 patients with 2nd stage BS were examined. 1st group (21 patients) was treated by UDCA monotherapy, 2nd group (21 patients) received combined therapy: UDCA with Hymecromone for 4 weeks. 4 week later, clinical and echographical assessment of the therapy provided was conducted. Results: patients who received the combined therapy had more expressed decrease of pain syndrome in the right hypochondrium than those who received the monotherapy. During the study of gallbladder contraction function (GCF) any reliable evidence of its change wasn’t found in both groups, thus the combined therapy (UDCA + Hymecromone) does not increase GCF. According to ultrasonography, an improvement of gallbladder content (transition from the 2nd stage BS to the 1st and reduction of an amount and size of clots and suspension) was observed in 81% patients from the 1st group (UDCA), and in 95% patients from the 2nd group (UDCA + Hymecromone). Conclusion: research data show increased effectiveness of treatment of patients with 2nd stage BS while using the combination of UDCA and Hymecromone.

Pain in chronic pancreatitis is one of the most mysterious and complex problems of modern gastroenterology. In a review article presents current information about intrapancreatic and central mechanisms of formation of pain in patients with chronic pancreatitis. Based on the pathogenetic mechanisms outlined prospects for the treatment of patients with chronic pancreatitis with pain syndrome.

The publication is based on a retrospective analysis of 344 radiological studies of the upper digestive tract and analysis of the literature. We propose the hypothesis of the gastric motility, based on the following points: 1) The gastric cardia is the intra-abdominal portion of the lower esophageal sphincter (LES). Its tone increases in response to the increasing pressure in the stomach. 2) In gastroesophageal reflux disease (GERD), the cardia cannot withstand the pressure and subsequently opens. Depending on the degree of insufficiency of the LES and the force applied during provocative test, angular deformity of the stomach appears, due to the shortening of LES as well as a downsizing of the gas bubble in the stomach; 3) Pyloric sphincter (PS) is a true sphincter. Evacuation from the stomach is the result of the opening of the PS due to increase of antral pressure above the "threshold" level; 4) The evacuation starts in the upright position, when the liquid chyme above PS creates hydrostatic pressure above the threshold; 5) When hydrostatic pressure is reduced below the threshold level or in the recumbent position the antral pressure is created by the clamping of deep peristaltic wave and formation of the closed antral cavity; 6) The portioned evacuation is provided in two ways; а) the volume of antral cavity corresponds to the volume of duodenal bulb; b) in upright position after filling of the duodenal bulb the postbulbar sphincter is closed, whereby the pressure in the bulb rises, which leads to a reflex contraction of the PS and cessation of the e stomach emptying.

The aim: to present some information about the rare primary hypertrophy of the pylorus in adults and a clinical case of a patient with this disease. Materials and methods: the patient A., 52 years of age, after which clinical-instrumental and laboratory research was diagnosed with infiltrative form of cancer of the pylorus with decompensated stenosis. The used: videothoracoscopy, fluoroscopy, peripheral computer electrogastrogram, local fluorescence spectroscopy. The General blood and urine tests, biochemical blood tests, PCR for the determination of tumor markers. Results. The resection of 2/3 of the stomach Billroth I. histological examination of the pylorus diagnosed with hypertrophy of circular muscle fibers, to a lesser extent, hypertrophy of the longitudinal fibers with inflammatory changes. Conclusion: in cases of suspected infiltrative form of cancer of the pylorus in adults differential diagnosis it is advisable to include the primary hypertrophy of his.

In the article we present clinical case of rare tumors of the pancreas - solid-pseudopapillary tumor. The stages of diagnostics and clinical-instrumental and morphological features. We performed spleen preserving distal pancreatectomy as a definitive treatment. The article provides a review of literature on this issue as well.