The aim of the study was to evaluate the hepatotropic and metabolic properties of ursodeoxycholic acid (UDCA) in non-alcoholic fatty liver disease (NAFLD). Materials and methods. UDCA was administered at an average dose of 12.5±1.6 mg/kg/day for 56.7±65.4 weeks (12-240 weeks) to 136 NAFLD patients: 75 men (55.1%) and 61 women (44.9%), with an average age of 49.6±11.2 years, BMI of 31.5±2.7 kg/m², and waist circumference of 104.5±6.3 cm. Liver tests, cytokeratin-18 fragments (FCK-18) were determined (TPS ELISA test system, “Biotech”, Sweden), TNF-a cytokines (Human TNFα Platinum ELISA test system, eBioscience, Austria), IL-6 (Interleukin-6-ELISA-BEST test system, Vector-Best, Novosibirsk), the fatty liver index (FLI) and fibrosis indices (NAFLD FS and FIB-4) were determined. Statistical analysis was performed using StatGraphics Plus software (Statgraphics Technologies, Inc., USA) with the Wilcoxon-Mann-Whitney U test. Results. A reduction in alanine aminotransferase level from 59.4±10.3 to 34.7±6.1 U/l, alkaline phosphatase - from 229.4±23.7 to 173.9±18.6 U/l, gamma-glutamyl transpeptidase- from 69.3±16.8 to 47.3±8.2 U/l, FCK-18 - from 203.5±78.7 to 134.7±61.3 U/l, cholesterol - from 6.1±0, 7 to 5.6±0.5 mmol/l, glycemia - from 6.1±0.7 to 5.6±0.5 mmol/l, HOMA-IR - from 4.6±1.9 to 2.8±0.9, FLI - from 86.2±10.9 to 78.7±12.1, NAFLD FS - from (-1.23±0.5) to (-1.61±0.4), FIB-4 - from 1.49±0.21 to 1.14±0.32 (all p<0.05) have been identified. Conclusions. The use of UDCA in NAFLD had a positive hepatotropic and metabolic effect, manifested in the normalization of liver tests, a reduction in hepatocyte apoptosis, a decrease in steatosis score, liver fibrosis scores, and an improvement in glycemic and lipidemic profile.

According to the generally accepted concept, a persistent diffuse inflammatory process in the lamina propria of the gastric mucosa, occurring within the framework of superficial non-atrophic chronic gastritis, in a number of patients has the potential to transform into chronic atrophic gastritis (CAG), which is the first stage of a multi-stage model of gastric carcinogenesis (Correa cascade). CAH is characterized by thinning of the mucosa, loss of specialized gastric gland cells, and pathological changes in epithelial cells (metaplasia). It is customary to distinguish two main subtypes of CAH: exogenous (EMAG in foreign literature) and autoimmune (AMAG in foreign literature). The etiological basis of exogenous CAH is predominantly H. pylori infection, and autoimmune CAH is based on immune aggression to the parietal cells of the gastric epithelium. Verification of CAH is possible only through pathomorphological examination. Atrophy and intestinal metaplasia can be reversible by eliminating the etiological factor and long-term treatment of the patient, a detailed strategy for which has not yet been developed. However, the use of cyclic or continuous therapy with cytoprotectors seems to be the most promising strategy today.

The aim was to investigate the frequency of mucosal changes associated with colorectal epithelial neoplasms and the expression of potential miRNA and mRNA markers of CRC in the normal mucosa of different parts of the colon. Materials and Methods. In a continuous cross-sectional retrospective study, we examined the results of 3086 colonoscopies from 2019-2020.A prospective study of mucosal samples from 25 patients in 2022-2023 Results. A cohort of 980 patients with neoplasia was identified. A significant increase in the incidence of epithelial neoplasia was found in patients from the fifth decade of life (χ2=38.8, p=0.0000), not differing in subsequent decades of life. Absence of mucosal changes was found in 27.7% of cases. In a prospective study, molecular characteristics of the mucosa of different segments of the colon were analyzed in 169 samples. Nine miRNA markers associated with the development of CRC were studied. Statistically significant differences in expression between different parts of the colon were obtained for miRNA-135b, miRNA-31, and miRNA-20. Among protein-coding genes, significant differences were obtained for MUC2, NOX1, TERT and CDX2 genes. Expression level estimation using the ratio of median values of the studied parameters in different colon sections was 6.5-fold for miRNA-135b, 6.9-fold for miRNA-31, 1.9-fold for MUC2, 1.5-fold for CDX2, and 5.1-fold for the NOX1 gene. Conclusion. Normal/macroscopically unchanged colonic mucosa has significant molecular genetic differences in different sections. Changes in the expression of genes regulating cell proliferation, RNA replication and ensuring the balance of epithelial oxygenation with anaerobicity within the intestine coincide with the distal segments of the colon having the highest frequency of epithelial neoplasia detection.

The article discusses the life quality of patients with gastroesogeal reflux disease (GERD), occurring against the background of metabolic syndrome (MS). Fifty patients were screened for the presence of GERD using the GERD questionnaire. Patients were divided into 3 groups: patients with all components of MS (8 people), patients who did not have one of the components of MS (22 people) and patients without MS (30 people). Quality of life was assessed using the SF-36 questionnaire. The results have revealed that in the group of patients with complete MS, the physical component of life quality was statistically significantly lower than in patients without MS. The decrease was due to the scales of physical functioning and pain intensity. The presence of MS is an independent factor that worsens the course of GERD.

Introduction: Duodenal ulcer is the most common disease of the gastrointestinal tract with a prevalence of 4-15%, occurs 4 times more often in prevalence with peptic ulcer and occurs more often from 30 to 55 years. The contribution of hereditary factors to the etiopathogenesis of diseases is 5.5-50%. Objective: to evaluate the role of SNP×SNP interactions of polymorphic loci of candidate genes (rs2294008, rs505922, rs6136, rs8176720, rs2519093, rs507666, rs651007, rs579459, rs649129) in the development of duodenal ulcer (DU). Materials and methods: The sample consisted of 217 patients with DU and 347 individuals of the control group, the regulatory potential of polymorphic loci was evaluated using the online databases, genotyping was performed by PCR. The study of SNP×SNP interactions of polymorphic variants of candidate genes associated with the development of GU was carried out using a modification of the MDR (Multifactor Dimensionality Reduction) - Model-Based-MDR (MB-MDR) method, data visualization was carried out in the form of a dendrogram and graph using MDR software (v. 3.0.2). Results: Six out of 9 studied SNPs as part of 5 significant models of interlocus interactions are involved in the formation of duodenal ulcer. The largest number of models includes rs2294008 of the PSCA gene, rs8176720 and rs579459 of the ABO gene. These polymorphic variants have a pronounced regulatory potential in many organs (tissues), incl. in the organs of the digestive system.

Purpose of the study. Assessment of the immune status in patients with chronic colostasis and methods for its correction. Material and methods. An assessment of the severity of disorders in the immune system was carried out with a comparative study of indicators of both cellular and humoral immunity in the blood serum in 92 patients with various stages of chronic colostasis. The patients were divided by disease stage: 31 (33.7%) - in the compensation stage, 33 (35.9%) - in the subcompensation stage, and 28 (30.4%) - with decompensated chronic colonic stasis. Results. The results of a study of immunological parameters in patients with chronic colostasis indicate the presence of changes in the immune status. In patients with sub- and decompensated stages of colostasis, the most pronounced decrease in T-lymphocytes (CD3+) (from 0.89±0.18x109/l to 0.67±0.22x109/l), T-helper cells (CD4+) (from 0.53±0.7x109/l to 0.38±0.6x109/l), as well as (CD8+) (from 0.57±0.4x109/l to 0.45±0.5x109/l). These changes indicate the functional failure of cells of the immune system. There is also a change in the humoral immunity, expressed by increased functional activity of B-lymphocytes, which is manifested in an increase in the level of Ig A (from 5.71 ± 2.4 g/l to 6.42 ± 2.9 g/l) and Ig M (from 5.73±2.1 g/l to 6.36±2.7 g/l) at sub- and decompensated stages of chronic colostasis. An increase in CEC concentration was also noted (from 84.6±11.4% to 90.7±9.4%). In order to improve the immune status of 32 patients with chronic colostasis, the immunomodulator Timocin was included in the complex treatment regimen, which was used intramuscularly at a dose of 1.0 ml every day for 7-10 days. Against the background of immunocorrection, these patients showed normalization of all studied parameters, in contrast to patients who did not receive immunocorrective therapy. Conclusion. Thus, with chronic colostasis, a secondary deficiency of the immune system is observed, the severity of which depends on the duration and stage of colostasis. This deficiency is manifested by a violation of both cellular and humoral immunity, requiring the pathogenetic inclusion of immunocorrective therapy in the complex of rehabilitation measures, especially in the early postoperative period.

The article presents the results of a clinical observation assessing the role of adipocytokines in patients with psoriatic arthritis (PsA) combined with non-alcoholic fatty liver disease. 50 patients with PsA and 70 patients with PsA and NAFLD were comprehensively examined. When psoriatic arthritis was combined with non-alcoholic fatty liver disease, pronounced skin-articular syndrome, high activity, progression of radiological changes and low effectiveness of standard treatment were observed. In patients with psoriatic arthritis with non-alcoholic fatty liver disease, adiponectin levels were found to decrease by 1.6 times and leptin concentrations to increase by 1.4 times compared to control values. The identified changes in the level of adipocytokines may have contributed to the progression of the disease and functional joint failure.

Non-alcoholic steatohepatitis (NASH) is the leading cause of chronic liver disease in the modern world. Besides metabolic and cardiovascular comorbidities, NASH is associated with increased prevalence of neurocognitive and psychiatric disorders. Sage-leaved rock-rose Cistus salviifolius L. (CS) is a plant with a wide spectrum of biological activities including possible psychotropic and procognitive effects. In view of the above, the present study was aimed at exploring the potential therapeutic effects of a CS aqueous extract in behavioural and memory dysfunction associated with experimental murine alimentary/toxic NASH. 90 male C57Bl/6 mice were randomized into the following groups: (1) Control: NASH + no treatment; (2) CS253: NASH + 253 mg·kg-1 b. w. CS ex-tract; (3) CS506: NASH + 506 mg·kg-1 b. w. CS extract. NASH was induced over 3 months, and the drugs were administered orally q. d. during the experimental period. As assessed by the Open field, Elevated plus maze, and Light/dark box test, both doses of the CS extract induced sedation with possible anxiogenic effect in mice. In addition, the CS extract alleviated spatial memory dysfunction but had no effect on object recognition memory. Possible mechanisms behind the extract’s effects include the potentiation of calcium-dependent neuronal signaling as well as the modulation of central γ-aminobutyric acid, acetylcholine, or monoamine neurotransmission, which requires further elucidation.

Wilson disease (WD) is a rare autosomal recessive disease in which copper accumulates in liver cells (hepatocytes) and other organs. The development of the disease is associated with mutations in the ATP7B gene, which is located on chromosome13q14. The product of this gene is a multifunctional intracellular P1-type ATPase enzyme that accelerates copper excretion through the bile duct when intracellular copper levels are high. It also metabolizes copper in other ways, preventing it from accumulating in hepatocytes. The main ways to combat Wilson’s disease are to reduce copper intake and stimulate its excretion from the body. The advent of oral chelators has revolutionized the treatment of BV, but they, as well as low-copper diets, cannot fully solve many of the problems. For example, current conventional therapies are unable to correct copper metabolism and are unable to cross the blood-brain barrier. In addition, many patients with BV face serious side effects, and the need to take medication at least twice a day for the rest of their lives creates a problem of adherence to treatment. All of this indicates that traditional therapeutic strategies have been practically exhausted and that innovative approaches to disease treatment based on the elimination of the cause of the disease are required. This review considers both current conventional therapies and potentially new therapies, including gene therapy and gene repair, which offer the hope that a complete cure of Wilson’s disease is possible. In addition, a team approach to the management of Wilson’s disease is discussed, as well as factors that contribute to achieving good patient adherence to treatment.

This review is dedicated to the ectopic bitter and sweet taste receptors in respiratory system and to their role in pathogenesis of respiratory obstructive diseases. It has been experimentally shown that these receptors, in addition to taste perception, are involved in a number of other physiological and pathological processes (for example, in the immune response, bronchodilation). The possible advantages of bitter taste receptor ligands as a new class of bronchodilator drugs and the interaction of bitter and sweet taste receptors are considered.

Histamine intolerance is one of the most common adverse reactions to food. Histaminosis was detected in 1-3% of the population [3]. The etiology of this condition is diverse: drugs that affect the activity of enzymes involved in histamine degradation, concomitant diseases, as well as foods that contain a lot of histamine, or are histaminoliberators. In this article, we will talk about biogenic amines in food, as well as about permitted foods on a low-histamine diet.

Currently, there is a tendency in the healthcare system of the Russian Federation to acquire obesity of II and III degrees. The existing excess body weight in patients with cholelithiasis is an aggravating factor that contributes to the occurrence of complications in the process of providing highly qualified medical care. For this reason, the research work is aimed at determining postoperative complications that may occur after laparoscopic cholecystectomies in overweight patients. The set of research material was based on data from the surgical department taken in the period from 2022 to 2023. In the course of the study, gender dependence was established before the onset and manifestation of signs of obesity of II and III degrees after surgery. The materials obtained in the course of the study allowed us to identify 4 age groups, namely: 50-55, 56-60, 61-65 and 66-70 years old. The analysis of patients in the second age group showed the largest number of comorbid pathologies in comparison with the other groups. The most common combined diseases were hypertension, coronary heart disease and type 2 diabetes mellitus. Among the most common complications that patients with a diagnosis of gallstone disease could face were: pain syndrome and lack of stool, and less common complications were: peritonitis, iatrogenic choledochal injury and postcholecystectomy syndrome. The result of the study was the presented material, which allows us to characterize the possible type of postoperative complication depending on the degree of obesity of the patient.

Purpose of the study: to study the clinical and endoscopic features of gastroduodenal involvement in patients with end-stage chronic kidney disease (CKD C5D) receiving replacement therapy with program hemodialysis. Materials and methods: in the process of clinical study on the basis of the dialysis department of the Kirov Regional Clinical Hospital, three groups of patients with chronic kidney disease receiving renal replacement therapy (RRT) with program hemodialysis (KBPS5D) with different lengths of dialysis therapy were sequentially formed. Based on the patients’ complaints from the gastrointestinal tract, the presence of symptoms of gastric dyspepsia was determined. H. Pylori was also determined and esophagogastroduodenoscopy was performed. Results: depending on the duration of RRT with program hemodialysis, features of the pathology of the upper gastrointestinal tract were identified. When assessing the symptoms of gastric dyspepsia, the most common complaints were: nausea, belching, and a feeling of early satiety. In patients of group I the severity and frequency of dyspeptic symptoms were maximum. In patients of group II, the frequency and severity of dyspeptic syndrome is significantly lower than in group I. But with increasing duration of treatment with program hemodialysis, the frequency of dyspepsia symptoms increased again. Esophagogastroduodenoscopy data showed a high prevalence of chronic gastritis and chronic duodenitis in patients with CKD in all groups. Conclusion: patients with CKD S5 during the introduction into program hemodialysis (during the first month of RRT) have a high frequency and clinically pronounced course of concomitant diseases of the upper gastrointestinal tract that reduce quality of life. The duration of RTA with hemodialysis from 1 to 12 months is associated with a moderate frequency of gastroduodenal lesions. With an increase in the duration of RTA for more than a year, the frequency of gastropathies, including erosive ones, increases again. The data obtained indicate the need to study the effect of gastroduodenal lesions on the quality of life, the prognosis of dialysis patients and the creation of recommendations for the prevention, diagnosis and treatment of diseases of the upper gastrointestinal tract accompanying terminal renal failure.

The article describes the clinical observation of liver damage in untimely diagnosed hyperthyroidism. A diagnostic search was conducted to clarify the cause of hepatitis, during which thyroid pathology was revealed.

The article presents a clinical case of a 17-year-old boy with diagnosed abdominal aortic trunk compression syndrome (Dunbar syndrome), clinically manifested by complaints of prolonged pain in the epigastrium and suprapubic region, periodic dilution of stool, frequent urge to defecate. Ultrasound of mesenteric vessels and CT of abdominal organs with double contrast allowed to establish pathological changes, which revealed echoscopic signs of stenosis of the proximal segment of the abdominal artery, stenosis of the ventral trunk mouth up to 60-70% thickened right leg of the diaphragm. The complexity of this clinical case lies in the fact that this pathology is a rare diagnosis of exclusion, the formulation of which required a wide range of differential diagnosis.